Conectar
by Kenneth S. Noguchi, Kevin Moncion, Elise Wiley, Ashley Morgan, Eric Huynh, Marla K. Beauchamp, Stuart M. Phillips, Lehana Thabane, Ada Tang
BackgroundStroke impacts nearly 14 million people annually. Muscle strength and physical function are often affected by stroke and important determinants of stroke recovery. Resistance exercise training (RT) has been shown to improve muscle strength, but RT prescriptions may be suboptimal for other aspects of stroke recovery. Parameters such as frequency, intensity, type, and duration may influence the effectiveness of RT interventions but have not been systematically evaluated.
Objectives1) To determine the effects of RT on stroke recovery, and 2) to examine the influence of RT parameters on intervention effects.
Eligibility criteriaRandomized controlled trials examining the effects of RT will be eligible for this systematic review if they: 1) included only adults with stroke or transient ischemic attack, 2) compared RT to no exercise or usual care, and 3) did not apply a co-intervention.
Study selectionEight databases (MEDLINE, EMBASE, EMCARE, AMED, PsychINFO, CINAHL, SPORTDiscus, and Web of Science) and 2 clinical trials registries (ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform) will be searched from inception. Two independent pairs of authors will compare titles, abstracts, and full-text reports against the eligibility criteria. Conflicts will be resolved by consensus or third author.
Main outcome measuresThe construct of interest is stroke recovery. An advisory group of clinicians, researchers, and partners with lived experience of stroke will be consulted to determine specific outcome measures of interest, and to rank their relative importance. We expect to include measures of physical function, strength, cognition, and quality of life. Random-effects meta-analyses will be used to pool results for each outcome across studies, and RT parameters (frequency, intensity, type, and duration) will be used as covariates in meta-regression analyses.
ConclusionThe results of this review will inform the optimal RT prescription parameters for promoting stroke recovery.
by Wim Van Neer, Mircea Udrescu, Joris Peters, Bea De Cupere, Stéphane Pasquali, Stéphanie Porcier
Since predynastic times, baboons (Papio hamadryas and Papio anubis) were important in ancient Egypt for ritual and religious purposes. These species did not occur naturally in Egypt and therefore had to be imported, but little is known about their exact provenance and the conditions in which they were kept through time. Here, we analyse the skeletal remains of a collection of baboon mummies coming from Thebes (Egypt), representing a minimum of 36 individuals, from a palaeopathological and demographic point of view. The pathological cases are described, figured where relevant, and the discussion attempts to understand their aetiology. The prevalence of the different types of deformations and pathologies is compared with that of other captive baboon populations from more or less contemporary (Tuna el-Gebel and Saqqara) or older (predynastic Hierakonpolis) sites. This is combined with observations on the age and sex distribution and the proportion of hamadryas and anubis baboons to draw conclusions about the conditions of keeping, possible breeding on-site, provenance of the animals and the trade routes used for import. As in Tuna el-Gebel and Saqqara, the baboons from Gabbanat el-Qurud suffered from numerous metabolic diseases due to chronic lack of sunlight and an unbalanced diet. This and the demographic data suggest that there was a local breeding population derived from animals captured downstream from the Sudanese Nile Valley (for anubis) and from the Horn of Africa or the southern part of the Arabian Peninsula (for hamadryas). A new series of radiocarbon dates is provided, placing the baboons from Gabbanat el-Qurud between the end of the Third Intermediate Period and the beginning of the Late Period.There is an urgent need to support primary care organisations in implementing safe and high-quality virtual consultations. We have previously performed qualitative research to capture the views of 1600 primary care physicians across 20 countries on the main benefits and challenges of using virtual consultations. Subsequently, a prototype of a framework to guide the implementation of high-quality virtual primary care was developed.
To explore general practitioners’ perspectives on the appropriateness and relevance of each component of the framework’s prototype, to further refine it and optimise its practical use in primary care facilities.
Participants will be primary care physicians with active experience providing virtual care, recruited through convenience and snowball sampling. This study will use a systematic and iterative online Delphi research approach (eDelphi), with a minimum of three rounds. A pre-round will be used to circulate items for initial feedback and adjustment. In subsequent rounds, participants will be asked to rate the relevance of the framework’s components. Consensus will be defined as >70% of participants agreeing/strongly agreeing or disagreeing/strongly disagreeing with a component. Data will be collected using structured online questionnaires. The primary outcome of the study will be a list of the essential components to be incorporated in the final version of the framework.
The study has received ethical approval conceded by the Imperial College London Science, Engineering and Technology Research Ethics Committee (SETREC) (reference no .6559176/2023). Anonymous results will be made available to the public, academic organisations and policymakers.
by Nora Tabea Sibert, Tobias Kurth, Clara Breidenbach, Simone Wesselmann, Günther Feick, Ernst-Günter Carl, Sebastian Dieng, Mohamad Hatem Albarghouth, Atiqullah Aziz, Stefan Baltes, Elisabeth Bartolf, Jens Bedke, Andreas Blana, Marko Brock, Stefan Conrad, Christopher Darr, Florian Distler, Konstantinos Drosos, Gregor Duwe, Amr Gaber, Markus Giessing, Nina Natascha Harke, Axel Heidenreich, Sameh Hijazi, Andreas Hinkel, Björn Theodor Kaftan, Shatlyk Kheiderov, Thomas Knoll, Gerd Lümmen, Inga Peters, Bülent Polat, Valentin Schrodi, Jens-Uwe Stolzenburg, Zoltan Varga, Julius von Süßkind-Schwendi, Vahudin Zugor, Christoph Kowalski
BackgroundIncontinence and sexual dysfunction are long-lasting side effects after surgical treatment (radical prostatectomy, RP) of prostate cancer (PC). For an informed treatment decision, physicians and patients should discuss expected impairments. Therefore, this paper firstly aims to develop and validate prognostic models that predict incontinence and sexual function of PC patients one year after RP and secondly to provide an online decision making tool.
MethodsObservational cohorts of PC patients treated between July 2016 and March 2021 in Germany were used. Models to predict functional outcomes one year after RP measured by the EPIC-26 questionnaire were developed using lasso regression, 80–20 splitting of the data set and 10-fold cross validation. To assess performance, R2, RMSE, analysis of residuals and calibration-in-the-large were applied. Final models were externally temporally validated. Additionally, percentages of functional impairment (pad use for incontinence and firmness of erection for sexual score) per score decile were calculated to be used together with the prediction models.
ResultsFor model development and internal as well as external validation, samples of 11 355 and 8 809 patients were analysed. Results from the internal validation (incontinence: R2 = 0.12, RMSE = 25.40, sexual function: R2 = 0.23, RMSE = 21.44) were comparable with those of the external validation. Residual analysis and calibration-in-the-large showed good results. The prediction tool is freely accessible: https://nora-tabea.shinyapps.io/EPIC-26-Prediction/.
ConclusionThe final models showed appropriate predictive properties and can be used together with the calculated risks for specific functional impairments. Main strengths are the large study sample (> 20 000) and the inclusion of an external validation. The models incorporate meaningful and clinically available predictors ensuring an easy implementation. All predictions are displayed together with risks of frequent impairments such as pad use or erectile dysfunction such that the developed online tool provides a detailed and informative overview for clinicians as well as patients.
To identify the available evidence regarding nursing roles in skin cancer screening and early detection and the reported education and training undertaken to do so.
Scoping review, reported in accordance with PRISMA-ScR.
A database search of Medline, CINAHL, Scopus, Embase, Emcare and JBI was conducted in November 2021. A grey literature search was conducted in February 2022. Searches were updated in August 2023.
The data were extracted and synthesized into themes related to nursing roles and education.
Of the 2285 identified studies, 54 were included in the review. Nursing roles included screening and early detection, prevention and patient education or counselling. Except for specialized nurse practitioners, nurses working in primary clinical care mostly engage in skin cancer supportive/administrative roles rather than leading collaborators in screening and early detection. The education and training for nurses were identified around themes of didactic education, clinical experience, training in dermoscopy, performance and knowledge assessment and self-efficacy.
The roles and responsibilities of nurses working in skin cancer screening and early detection are highly variable, as are the reported training and education programmes. Little research has been conducted to explore this nursing role or the educational requirements needed for proficiency. With appropriate best practice education, it is within most primary care nurses’ scope of practice to obtain competence in delivering opportunistic skin cancer screening.
While most nurse specialists in dermatology will be proficient in dermoscopy and skin cancer screening, nurses who work in general practice are often underutilized due to a lack of opportunity and a clear pathway to becoming proficient in dermoscopic skin cancer screening. Most nurses involved in skin cancer screening are employed in advanced roles, and only a few studies investigating educational interventions utilized dermoscopy among advanced nurses. With specific training, nurses can work within their full scope of practice and increase access to skin cancer screening and early detection.
Adhered to JBI Guidance for Conducting Systematic Scoping Reviews.
Open Science Framework, https://doi.org/10.17605/OSF.IO/XUNE6
N/A; a literature review.
Randomised controlled trials (RCTs) with a placebo comparator are considered the gold standard study design when evaluating healthcare interventions. These are challenging to design and deliver in surgery. Guidance recommends pilot and feasibility work to optimise main trial design and conduct; however, the extent to which this occurs in surgery is unknown.
A systematic review identified randomised placebo-controlled surgical trials. Articles published from database inception to 31 December 2020 were retrieved from Ovid-MEDLINE, Ovid-EMBASE and CENTRAL electronic databases, hand-searching and expert knowledge. Pilot/feasibility work conducted prior to the RCTs was then identified from examining citations and reference lists. Where studies explicitly stated their intent to inform the design and/or conduct of the future main placebo-controlled surgical trial, they were included. Publication type, clinical area, treatment intervention, number of centres, sample size, comparators, aims and text about the invasive placebo intervention were extracted.
From 131 placebo surgical RCTs included in the systematic review, 47 potentially eligible pilot/feasibility studies were identified. Of these, four were included as true pilot/feasibility work. Three were original articles, one a conference abstract; three were conducted in orthopaedic surgery and one in oral and maxillofacial surgery. All four included pilot RCTs, with an invasive surgical placebo intervention, randomising 9–49 participants in 1 or 2 centres. They explored the acceptability of recruitment and the invasive placebo intervention to patients and trial personnel, and whether blinding was possible. One study examined the characteristics of the proposed invasive placebo intervention using in-depth interviews.
Published studies reporting feasibility/pilot work undertaken to inform main placebo surgical trials are scarce. In view of the difficulties of undertaking placebo surgical trials, it is recommended that pilot/feasibility studies are conducted, and more are reported to share key findings and optimise the design of main RCTs.
CRD42021287371.
To explore family caregivers' experiences of contributing to self-care of patients with chronic obstructive pulmonary disease (COPD).
A qualitative description study.
Individual semi-structured interviews were conducted face-to face, by telephone or video calls in a purposive sample of 17 family caregivers of patients with COPD recruited in Italy, and analysed through content analysis. The consolidated criteria for reporting qualitative studies (COREQ) checklist was used for study reporting.
Ten subcategories were derived from 106 codes grouped into three main categories: family caregiver contributions to maintaining disease stable and ensuring a normal life for patients; family caregiver contributions to disease monitoring; and family caregiver contributions to coping with disease exacerbations. Family caregivers provided practical and emotional support, and their contribution was essential to improve treatment adherence, to enable the patient to continue living a normal life, and to have access to the healthcare services. Family caregivers were constantly vigilant and monitored patients daily to detect worsening conditions, and they managed exacerbations especially when patients were unable to do it due to their critical conditions.
This study broadens knowledge of family caregivers' contributions to patients' self-care in COPD, describing the different ways family members provide daily care to patients and the many responsibilities they take on.
Family caregivers perform a variety of behaviours when supporting patients with COPD in self-care, especially when patients are more dependent and the disease more severe. Nurses should acknowledge the various contributions provided by family caregivers and develop educational interventions aiming to support them in patient care and improve patient outcomes.
Researchers shared the draft study report with participants for validation and feedback. This helped to strengthen the study design and results.
Objetivo: Generar una teoría de situación específica para explicar el control de miedo, ansiedad y estrés postraumático en personal de enfermería que atendió a pacientes Covid. Desarrollo: La teoría de las transiciones, fue base para la teoría de situación específica con los cuatro pasos de Dulock y Holzemer: (1) identificar y aislar principales conceptos, (2) especificar relaciones entre conceptos, (3) ordenar jerárquicamente los conceptos según nivel de abstracción, y (4) ilustrar relaciones actuales entre variables. Conclusión principal: La teoría de situación específica para explicar el control de miedo, ansiedad y estrés postraumático basada en la Teoría de las Transiciones es útil para explicar las condiciones de transición personales que facilitan e inhiben el paso hacia un nuevo rol de cuidado y explicar indicadores que intervienen en el proceso y resultado en el personal de enfermería.
Las TICs permiten que el estudiante acceda al material de estudio y, a su vez, interactúe con el profesor y con otros estudiantes. La pandemia COVID-19 ha obligado a docentes a impartir clases virtuales de urgencia para cumplir con las actividades académicas programadas.
El objetivo es analizar el nivel de satisfacción de docentes en el desarrollo de las clases virtual en tiempos de pandemia. El diseño fue observacional, descriptiva, de corte transversal, enfoque cuantitativo, el universo estuvo compuesto por docentes de la FENOB-UNA Casa Central y Filiales, con una muestra de 114 docentes, la selección se realizó a través de un muestreo no probabilístico de casos consecutivos, la recolección de datos se hizo a través de una encuesta en línea con un cuestionario elaborado por las investigadoras, validada por expertos. Los hallazgos más relevantes fueron: mayoritariamente de sexo femenino, del grupo etario de 36 a 55 años, de estado civil casado, procedentes del departamento Central, son docente catedráticos y ejercen su labor solamente en la FENOB-UNA, cuenta con conexión a internet, utiliza computadora portátil y destina 2 horas para las clases. El análisis entre las características sociodemográficas y el nivel de satisfacción con el desarrollo de las clases virtuales es estadísticamente significativo con la variable edad. Se concluye que el nivel de satisfacción de docentes en el desarrollo de las clases virtuales en tiempos de pandemia fue medianamente satisfecho.
ABSTRACT
ICTs allow the student to access the study material and, in turn, interact with the teacher and other students. The COVID-19 Pandemic has forced teachers to teach emergency virtual classes to comply with scheduled academic activities. The objective is to analyze the level of satisfaction of teachers in the development of virtual classes in times of pandemic. The design was observational, descriptive, cross-sectional, quantitative approach, the universe was made up of teachers from the FENOB- UNA Central House and Subsidiaries, with a sample of 114 teachers, the selection was made through a non-probabilistic sampling of cases. consecutive, data collection was done through an online survey with a questionnaire prepared by the researchers, validated by experts. The most relevant findings were: mostly female, in the age group of 36 to 55 years, with married marital status, from the Central Department, are professors and work only at FENOB-UNA, have an internet connection, He uses a laptop and allocates 2 hours for classes. The analysis between the sociodemographic characteristics and the level of satisfaction with the development of virtual classes is statistically significant with the age variable. It is concluded that the level of satisfaction of teachers in the development of virtual classes in times of pandemic was moderately satisfied.
Objetivo principal: Describir las experiencias de las madres que vivieron accidentes domésticos que involucraron a sus hijos, a la luz del Modelo de Adaptación de Roy. Método: Estudio cualitativo. Los datos fueron recolectados a través de entrevistas y sometidos a la técnica de análisis de contenido. Se utilizó como marco teórico el Modelo de Adaptación de Roy. Resultados principales: Participaron 17 madres, cuyos discursos fueron agrupados en tres categorías: enfrentar el desafío de salvar la vida de su hijo; reconocer el momento de (falta de) cuidado de su hijo; y aprender de sus errores. Conclusión principal: Se identificaron madres con dificultades para reconocer sus errores y posibles negligencias, que les atribuyeron la responsabilidad del accidente al hijo. Los enfermeros, cuando basan su práctica clínica en el Modelo de Adaptación de Roy, deben prestarles atención a las necesidades emocionales de los sistemas adaptativos de los involucrados.
Objetivo: comprender el significado del no abandono en el adulto mayor de la comunidad. Metodología: estudio cualitativo descriptivo realizado en un municipio de Guanajuato, México de febrero-diciembre 2022. Se eligieron personas mayores de 60 años sin distinción de género; tipo de muestreo por conveniencia con saturación de información con 8 participantes; los datos fueron recolectados mediante entrevistas presenciales semi-estructuradas que fueron audio grabadas. Todos los participantes firmaron un consentimiento informado. Resultados: emergieron cuatro temas: 1. Necesidad de apoyo familiar, 2. Necesidad de sentirse integrado, 3. Necesidad de sentirse funcional y activo y 4. El abandono es soledad. Conclusión: el no abandono está construido a partir de la dinámica familiar y la funcionalidad, cada persona mayor le otorga un significado basado en la comunicación con sus familias, incluso a distancia, siendo reconfortante. Algunos viven solos y eso representa un espacio de satisfacción personal. La integración familiar es imperante, así mismo el mantenerse activos.
Objetivo principal: Determinar la efectividad de la hipotermia terapéutica (HT) como medida de neuroprotección y de reducción de la mortalidad en recién nacidos con encefalopatía hipóxico-isquémica (EHI). Metodología: Enfermería Basada en Evidencia. Bases de datos consultadas: Cinahl, Cuiden, Epistemonikos, Lilacs, PubMed, Scopus, Scient Direct, Scielo, Librería Cochrane y Google Académico, traducción documental a través del DeCS, lectura crítica realizada mediante FLC 3.0 y síntesis de la evidencia de acuerdo con la escala Oxford. Resultados principales: 18 estudios comparados, encontrándose un 83% de efectividad neuroprotectora de la HT, evidenciando la importancia de su aplicación en tiempos <6 y 6-12 horas. Conclusiones principales: La HT tiene un impacto positivo en el tratamiento de la EHI de moderada a grave, mejora la neuroprotección, aumenta la función neurológica y el pronóstico del sistema nervioso, disminuye la discapacidad grave y la tasa de morbimortalidad neonatal.
Objetivo principal: Elaboración y validación de un cuestionario sobre detección precoz de lesiones oculares en el paciente crítico pediátrico. Metodología: Estudio descriptivo de validación de contenido de un cuestionario. Se seleccionó bibliografía científica, se redactaron los ítems y se validó el contenido mediante un panel de 8 expertos con experiencia en unidades de cuidados intensivos pediátricos. Resultados principales: 53 artículos relacionados con la aparición de daño ocular en unidades de cuidados intensivos fueron seleccionados. Se agruparon los factores de riesgo y se incluyeron aquellos que superaron la valoración de un panel de expertos. Conclusión principal: el contenido de este cuestionario para detectar lesiones oculares en unidades de cuidados intensivos pediátricos es un instrumento repre-sentativo, por lo que puede usarse en estudios posteriores para establecer su fiabilidad, validez, viabilidad y sensibilidad al cambio.
Objetivo principal: determinar si se puede establecer la lactancia materna en mujeres que se hayan realizado cirugía de aumento o reducción mamaria. Metodología: se realizó una revisión bibliográfica y se propusieron como criterios de inclusión que los documentos utilizados estuviesen publicados en español, inglés o portugués y en los últimos 10 años. El criterio de exclusión era descartar estudios realizados en animales. Resultados: se obtuvieron 8 artículos para revisar: 3 eran estudios observacionales y 5 revisiones bibliográficas. En 7 de los 8 artículos se concluyó que establecer la lactancia materna es posible tras una mamoplastia. Conclusión principal: es posible establecer la lactancia materna tras una cirugía de reducción o aumento mamario, aunque puede existir mayor dificultad que en la población general. Por ello, es necesario que los profesionales sanitarios acompañen y ayuden a la mujer durante la lactancia materna.
Objetivo: Describir los factores relacionados entre la adherencia terapéutica y el tratamiento farmacológico antihipertensivo. Material y métodos: Estudio observacional de prevalencia sobre una muestra de 100 pacientes hipertensos a tratamiento que acudieron a la Unidad de Hipertensión Arterial del Complejo Hospitalario Universitario de Ferrol. Resultados: La media de edad es de 59,71±13.97 años. El 84% son conocedores de su enfermedad. El 86% de los pacientes son cumplidores, test morinsky-Green. El 36% de los pacientes están confusos con el actual cambio a prescripción electrónica de medicamentos genéricos. La no adherencia se asocia con una mala percepción de los genéricos (p=0,027; OR=0,98) y con vivir en zonas rurales (p=0,028; OR: 2,13). Conclusión: La percepción de la prescripción de genéricos por el usuario es mala aunque la adherencia al tratamiento es buena (86%). La no adherencia fue mayor en las zonas rurales y los pacientes con una mala percepción de la e-receta y medicamentos genéricos.
El tratamiento de pacientes pediátricos con cáncer es un proceso estresante que cursa con periodos de ansiedad. Para el pre y postratamiento, la musicoterapia tiene efectos significativos al reducir la ansiedad, mejorar el estado de ánimo y la calidad de vida, y aliviar moderadamente el dolor [fragmento de texto].
FreshRSS 