Changes in alcohol consumption according to the duration of unemployment: prospective findings from the French CONSTANCES cohort

Objectives

To prospectively examine the association between the duration of unemployment among job seekers and changes in alcohol use in a year.

Design

A prospective study.

Setting

French population-based CONSTANCES cohort.

Participants

We selected 84 943 participants from the CONSTANCES cohort included between 2012 and 2019 who, at baseline and 1-year follow-up, were either employed or job-seeking.

Outcome measures

Multinomial logistic regression models computed the odds of reporting continuous no alcohol use, at-risk alcohol use, increased or decreased alcohol use compared with being continuously at low risk and according to employment status. The duration of unemployment was self-reported at baseline; thus, the employment status at 1-year follow-up was categorised as follows: (1) employed, (2) return to employment since less than a year, (3) unemployed for less than 1 year, (4) unemployed for 1 to 3 years and (5) unemployed for 3 years or more. Analyses were adjusted for age, gender, education, household monthly income, marital status, self-rated health, smoking status and depressive state.

Results

Compared with being continuously at low risk (ie, ≤10 drinks per week), the unemployment categories were associated in a dose-dependent manner with an increased likelihood of reporting continuous no alcohol use (OR: 1.74–2.50), being continuously at-risk (OR: 1.21–1.83), experiencing an increase in alcohol use (OR: 1.21–1.51) and a decrease in alcohol use (OR: 1.17–1.84).

Conclusion

Although our results suggested an association between the duration of unemployment and a decrease in alcohol use, they also revealed associations between at-risk and increased alcohol use. Thus, screening for alcohol use among unemployed job seekers must be reinforced, especially among those with long-term unemployment.

Access to therapy for child sexual abuse survivors: Preliminary dialogue of barriers and facilitators between caregivers

by Jonathan Jin, Huda Al-Shamali, Lorraine Smith-MacDonald, Matthew Reeson, Wanda Polzin, Yifeng Wei, Hannah Pazderka, Peter H. Silverstone, Andrew J. Greenshaw

Background

Difficulties in access to therapy were highlighted by COVID-19 measures restricting in-person gatherings. Additional challenges arise when focusing on caregivers of child sexual abuse (CSA) survivors in particular, which are a population that has been historically difficult to engage with due to issues of stigma and confidentiality.

Objectives

To present preliminary qualitative results from caregivers of CSA survivors.

Methods

This study was conducted with caregivers of CSA survivors. Two hybrid webinar/focus groups were conducted using a video conferencing platform in fall of 2021 with two groups of stakeholders (11 caregivers and 5 moderators/clinical staff at Little Warriors, an intensive episodic treatment facility). Sessions were recorded, transcribed, and thematically-analyzed using standard qualitative methodology.

Results

A total of 11 caregivers contributed to the data. Themes include: (1) Challenges of starting and maintaining treatment (i.e., emotional impact of intake day, challenges of enrolling), (2) Therapeutic benefits of specialized treatment (i.e., feeling safe and supported and the importance of trauma-informed care), and (3) Barriers and facilitators of treatment (i.e., avenues to scale-up and self-care).

Conclusion

The importance of a strong therapeutic alliance was highlighted by both caregivers/clinical staff and further support is needed for families post-treatment. The present hybrid webinar/focus group also achieved engagement goals in a population that is typically difficult to reach. Overall, the response rate (12%) was equivalent to reported registrant attendance rates for general business to consumer webinars and the recommended focus group size. This preliminary approach warrants replication in other populations outside our clinical context.

Prevalence and determinants of high-risk human papilloma virus among men who have sex with men in Benin: a cross-sectional study embedded in a demonstration project on pre-exposure prophylaxis against HIV

Objectives

This study aims to assess the prevalence and factors associated with anal high-risk human papilloma virus (HR-HPV).

Design

A cross-sectional study conducted from 24 August 2020 to 24 November 2020.

Setting

Primary care, Cotonou, Benin.

Participants

204 HIV-negative men who have sex with men initiating oral pre-exposure prophylaxis.

Primary outcome measure

Anal HR-HPV genotypes using GeneXpert HPV assay. Fourteen HR-HPV were evaluated: HPV-16 and HPV-18/45 in 2 distinct channels and the 11 other genotypes as a pooled result (31, 33, 35, 39, 51, 52, 56, 58, 59, 66 and 68). The potential independent variables analysed included anal gonorrhoea and chlamydia infections, and sociodemographic and sexual behaviour factors. To assess the determinants of HR-HPV, univariate and multivariate Poisson regression models were performed by using SAS V.9.4.

Results

Mean age±SD was 25.9±4.8 years. 131/204 men claimed insertive sex procured more pleasure. Thirty-two participants, accounting for 15.7% of the study sample, had gonorrhoea and/or chlamydia. The prevalence of any HR-HPV genotype was 36.3% (95% CI 30.0% to 43.0%). In total, 7.8% of men had HPV-16 and 7.4% had HPV-18/45. The prevalence for the pooled genotypes (31, 33, 35, 39, 51, 52, 56, 58, 59, 66 and 68) was 29.9%. Receptive anal sex during the last 6 months was strongly associated with prevalent HR-HPV infections. The adjusted proportion ratio (aPR) was 1.93 (95% CI 1.31 to 2.83). Gonorrhoea and chlamydia were also associated with the outcome of interest; p value for both infections was

Conclusions

In Benin, anal HR-HPV was common among HIV-negative men who have sex with men. Among this highly vulnerable population, there is a need for integrated preventive and management strategies targeting HPV and other sexually transmitted infections.

Papel del equipo de enfermería durante la atención al paciente con sospecha de Infarto Agudo de miocardio

Objetivos: Describir el papel del equipo de enfermería en el cuidado de pacientes con sospecha de infarto agudo del miocardio. Metodo-logía: revisión integradora de la literatura, utilizando las bases de datos MEDLINE, PUBMED, LILACS, CUIDEN, CINAHL, y las Prácticas Recomendadas de la Sociedad Brasileña de Cardiología. Se incluyeron publicaciones de 2010 a 2021, que estuvieran en portugués y de acceso gratuito. Resultados: se obtuvo una muestra final de 26 artículos, siendo seleccionados y agrupados en tres categorías temáti-cas: A) Conocimiento del equipo de enfermeria sobre los protocolos para el atendimiento a los pacientes con sospecha de Infarto agudo de miocardio B) la Sistematización de la asistencia de enfermeria durante el atendimiento inicial; C) Papel del equipo de enfermeria. Conclusiones: el equipo de enfermeria es visto como parte fundamental en las unidades de atención, por lo tanto, es necesario actualizar a estos profesionales para un mejor soporte técnico y científico, basado en la evidencia.

Abordaje del dolor en pacientes con insuficiencia cardíaca

Objetivo: Describir el abordaje del dolor en pacientes con insuficiencia cardíaca, según lo encontrado en la literatura. Metodología: se realizó una investigación bibliográfica con búsqueda en las bases de datos MEDLINE, PUBMED, LILACS, CUIDEN, CINAHL, utilizando los descriptores Manejo del dolor, insuficiencia cardíaca y Automedicación, junto con el operador booleano AND. Se seleccionaron artículos en portugués, publicados entre 2010 y 2020, que respondieron al objetivo de la investigación. Las publicaciones duplicadas fueron ex-cluidas al final de las búsquedas en cada base de datos, obteniendo una muestra final de 31 artículos. Resultados: se encontró que el dolor se puede clasificar: 1) Según su naturaleza en nociceptivo (que puede ser somático y visceral), neuropático y mixto) y 2) Según su intensidad: en agudo, crónico o recurrente. Por lo tanto, el abordaje del dolor dependerá de su origen y de la necesidad del individuo.

Cuidados de enfermería en el pre y postoperatorio de cirugía cardíaca

Objetivo: identificar la producción científica que trate sobre cuidados de enfermería durante el período pre y postoperatorio de pacientes sometidos a cirugía cardíaca. Metodología: Revisión integradora de la literatura con enfoque cualitativo, realizada en las bases de datos CUIDEN, CINAHL, LILACS, LATINDEX, SciELO (Scientific Electronic Library Online) y BDENF (Base de datos bibliográfica especializada en el área de enfermería de Brasil) con un período de tiempo de 2007 a 2020. Resultados: Los principales diagnósticos de enfermería encontrados para el preoperatorio fueron: ansiedad y riesgo de infección, aspiración e integridad de la piel. Los diagnósticos para el postoperatorio fueron: dolor agudo, disminución del gasto cardíaco, alteración del intercambio de gases, riesgo de desequilibrio en el volumen de líquidos y electrolitos, alteraciones en la percepción sensorial, perfusión ineficaz del tejido renal, termorregulación ineficaz y escaso conocimiento sobre las actividades de autocuidados. Conclusión: La sistematización de la atención de enfermería se considera fundamental, para garantizar una atención segura y de calidad a los pacientes sometidos a procedimientos quirúrgicos.

Changing behaviour in pregnant women: a scoping review

Improving health and wellbeing is a major goal in healthcare all over the world (WHO, 2015). Midwives and other healthcare professionals play a key role in educating women about healthy pregnancies (WHO, 2013a). During the course of pregnancy, women may experience a variety of psychological changes, including developing the motivation to change their lifestyle habits (Lindqvist et al., 2017). To support “behaviour change through a life-course approach” and to implement the WHO strategy for strengthening nursing and midwifery towards the achievement of the “Health 2020” goals (WHO, 2015, p.4), it is important for healthcare professionals to increase their knowledge of behaviour change programmes (BCPs) during pregnancy.

Eficacia del tratamiento para las personas agitadas en situaciones de emergencia en comparación con los servicios comunitarios: revisión sistemática

Objetivo: Conocer la eficacia del tratamiento de personas con conducta hetero agresiva en los servicios de urgencias en comparación con los servicios de salud comunitarios. Método: Revisión sistemática de estudios en bases de datos: LILACS, Psychinfo, Scopus, Web de Ciencia, PUBMED y literatura gris en Google Scholar y en la lista de referencias. La búsqueda se realizó en junio de 2016. Dos mil ciento sesenta estudios fueron encontrados y seis de estos estudios fueron seleccionados para su análisis después de la aplicación de los criterios de exclusión. Resultados: El acercamiento a individuos con comportamiento agitado, agresivo o violento ocurre con mayor frecuencia en servicios de emergencia general y psiquiátrica con intervención médica. Los medicamentos utilizados para controlar la agitación y la sedación fueron benzodiazepina (midazolam, lorazepam), antihistamínico (prometazina), antipsicóticos típicos (haloperidol y droperidol) y antipsicóticos atípicos (olanzapina, ziprasidona, risperidona y quetiapina). Conclusión: Todos los fármacos evaluados promueven la sedación, pero esta revisión muestra ventajas en el uso de la combinación de haloperidol más prometazina.