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Microbial interactions among Gardnerella, Prevotella and Fannyhessea prior to incident bacterial vaginosis: protocol for a prospective, observational study

Por: Muzny · C. A. · Elnaggar · J. H. · Sousa · L. G. V. · Lima · A. · Aaron · K. J. · Eastlund · I. C. · Graves · K. J. · Dong · C. · Van Gerwen · O. T. · Luo · M. · Tamhane · A. · Long · D. · Cerca · N. · Taylor · C. M.
Introduction

The aetiology of bacterial vaginosis (BV), a biofilm-associated vaginal infection, remains unknown. Epidemiologic data suggest that it is sexually transmitted. BV is characterised by loss of lactic acid-producing lactobacilli and an increase in facultative and strict anaerobic bacteria. Gardnerella spp are present in 95%–100% of cases; Gardnerella vaginalis has been found to be more virulent than other BV-associated bacteria (BVAB) in vitro. However, G. vaginalis is found in women with normal vaginal microbiota and colonisation is not sufficient for BV development. We hypothesise that Gardnerella spp initiate BV biofilm formation, but incident BV (iBV) requires incorporation of other key BVAB (ie, Prevotella bivia, Fannyhessea vaginae) into the biofilm that alter the transcriptome of the polymicrobial consortium. This study will investigate the sequence of microbiologic events preceding iBV.

Methods and analysis

This study will enrol 150 women aged 18–45 years with normal vaginal microbiota and no sexually transmitted infections at a sexual health research clinic in Birmingham, Alabama. Women will self-collect twice daily vaginal specimens up to 60 days. A combination of 16S rRNA gene sequencing, qPCR for Gardnerella spp, P. bivia and F. vaginae, and broad range 16S rRNA gene qPCR will be performed on twice daily vaginal specimens from women with iBV (Nugent score 7–10 on at least 2 consecutive days) and controls (with comparable age, race, contraceptive method and menstrual cycle days) maintaining normal vaginal microbiota to investigate changes in the vaginal microbiota over time for women with iBV. Participants will complete daily diaries on multiple factors including sexual activity.

Ethics and dissemination

This protocol is approved by the University of Alabama at Birmingham Institutional Review Board (IRB-300004547) and written informed consent will be obtained from all participants. Findings will be presented at scientific conferences and published in peer-reviewed journals as well as disseminated to providers and patients in communities of interest.

Career development of doctorally prepared nurses

Abstract

Aim

To integrate research literature regarding careers, career development and factors influencing the career development of doctorally prepared nurses.

Design

An integrative review.

Data Sources

Medline, CINAHL and Embase were searched in June 2022 without time restrictions.

Methods

Peer-reviewed empirical publications written in English with different types of study designs were included. Two researchers independently applied eligibility criteria, selected studies and conducted quality appraisals using Joanna Briggs checklists. Data were extracted and analysed using a convergent integrated approach with thematic analysis. Themes were established within three categories based on the research questions: career, career development and factors influencing career development.

Results

Twenty-two studies were included. Nine themes were identified. One theme regarding careers describes that doctorally prepared nurses need to prioritize work within different positions. The two themes focusing on career development described the need to determine career goals after the doctorate and further develop competencies. Six themes described factors influencing career development: ‘Intrinsic motivation to improve health care and nursing education’, ‘Available support sources’, ‘Professional development programmes’, ‘Work–life balance’, ‘Organizational infrastructures for career advancement’ and ‘Competition and hostile treatment among colleagues’.

Conclusion

Limited knowledge of the careers and career development of doctorally prepared nurses was found. Doctorally prepared nurses need to balance work with various part-time positions. Careers and career development could be supported by the development of structures for career advancement as well as supportive working environments.

Impact

Doctorally prepared nurses with strong careers are important to health care and nursing as they generate and implement new knowledge into clinical practice and thereby support the improvement of (nursing) care and patient outcomes. This study provides considerations towards strengthening the careers of doctorally prepared nurses.

Reporting Method

PRISMA.

Patient or Public Contribution

No Patient or Public Contribution.

Effect of transconjunctival sutureless vitrectomy versus 20‐G vitrectomy on surgical wound closure in patients: A meta‐analysis

Abstract

A meta-analysis was conducted to evaluate the impact of transconjunctival sutureless vitrectomy (TSV) over 20 G vitrectomy on wound healing, as well as the requirements for closing the wound in order to treat vitreoretinal diseases. Among the 500 cases who had been treated with vitrectomy to September 2023, 250 were treated by transconjunctiva without vitrectomy and 250 were treated with 20 G vitrectomy. The odds ratio (OR) and mean difference (MD) of 95% confidence interval (CI) were computed to evaluate the influence of wound opening and closing on vitrectomy diseases. The evaluation of vitreoretinal diseases was performed with either a random-or fixed-effect model, which involved TSV compared to 20 G vitrectomy. Compared to 20 G vitrectomy, the opening time of the wound in TSV was less (MD, −2.03; 95% CI, −2.87, −1.19; p < 0.0001); Compared to 20 G vitrectomy, the closing time of the wound was less (MD, −4.84; 95% CI, −6.38, −3.03; p < 0.0001); Nevertheless, there were no statistically significant differences in the incidence of vitreous haemorrhage after TSV surgery compared with 20 G vitrectomy (OR, 0.74; 95% CI, 0.25, 2.18; p = 0.59). TSV vitrectomy can shorten the duration of the operation and speed up the healing of the wound. It is suggested that additional studies be carried out with a larger sample size in order to verify this conclusion.

Effects of rapid rehabilitation nursing on surgical‐site wound infection and postoperative complications of patients undergoing thoracoscopic lung cancer surgery: A meta‐analysis

Abstract

This meta-analysis systematically evaluates the impact of rapid rehabilitation nursing interventions on wound infections and postoperative complications in patients undergoing thoracoscopic lung cancer surgery. A comprehensive literature search was conducted, from database inception to November 2023, using databases including PubMed, Embase, Google Scholar, Cochrane Library, China National Knowledge Infrastructure, and Wanfang databases to identify randomized controlled trials (RCTs) that focused on the application of rapid rehabilitation nursing in the perioperative period of thoracoscopic lung cancer surgery. Two researchers independently screened the literature, extracted data, and assessed the quality based on inclusion and exclusion criteria. Data analysis was performed using Stata 17.0 software. A total of 22 RCTs involving 2319 patients were included in the analysis. The results indicated that the application of rapid rehabilitation nursing in thoracoscopic lung cancer surgery significantly reduced the incidence of wound infections (OR = 0.32, 95% CI: 0.20–0.54, p < 0.001) and postoperative complications (OR = 0.24, 95% CI: 0.18–0.31, p < 0.001). This study demonstrates that implementing rapid rehabilitation nursing interventions during the perioperative period for patients undergoing thoracoscopic lung cancer surgery can significantly decrease the occurrence of wound infections and complications, thereby facilitating rapid patient recovery.

Understanding the impact of chronic diseases on COVID‐19 vaccine hesitancy using propensity score matching: Internet‐based cross‐sectional study

Abstract

Aims and Objectives

To investigate whether chronic diseases are associated with higher COVID-19 vaccine hesitancy and explore factors that influence COVID-19 vaccine hesitancy in patients with chronic diseases.

Background

Vaccine hesitancy has been acknowledged as one of the greatest hazards to public health. However, little information is available about COVID-19 vaccine hesitancy among patients with chronic diseases who may be more susceptible to COVID-19 infection, severe disease or death.

Methods

From 6 to 9 August 2021, we performed an internet-based cross-sectional survey with 22,954 participants (14.78% participants with chronic diseases). Propensity score matching with 1:1 nearest neighbourhood was used to reduce confounding factors between patients with chronic diseases and the general population. Using a multivariable logistic regression model, the factors impacting COVID-19 vaccine hesitancy were identified among patients with chronic diseases.

Results

Both before and after propensity score matching, patients with chronic diseases had higher COVID-19 vaccine hesitancy than the general population. In addition, self-reported poor health, multiple chronic diseases, lower sociodemographic backgrounds and lower trust in nurses and doctors were associated with COVID-19 vaccine hesitancy among patients with chronic diseases.

Conclusions

Patients with chronic diseases were more hesitant about the COVID-19 vaccine. Nurses should focus on patients with chronic diseases with poor health conditions, low socioeconomic backgrounds and low trust in the healthcare system.

Relevance to Clinical Practice

Clinical nurses are recommended to not only pay more attention to the health status and sociodemographic characteristics of patients with chronic diseases but also build trust between nurses and patients by improving service levels and professional capabilities in clinical practice.

Patient or Public Contribution

Patients or the public were not involved in setting the research question, the outcome measures, or the design or implementation of the study. However, all participants were invited to complete the digital informed consent and questionnaires.

Correlates of death anxiety for patients with cancer: A systematic review and meta‐analysis

Abstract

Objective

A systematic review and meta-analysis was performed to identify the factors related to cancer death anxiety based on available evidence.

Design

This systematic review and meta-analysis followed the PRISMA 2020 guidelines.

Methods

Seven databases were searched to identify studies on the relationships of cancer death anxiety with demographic characteristics, disease factors and psychosocial factors from inception to May 2023. The Agency for Medical Research and Quality (AHRQ) scale was used to evaluate the quality of the included studies. After two researchers independently completed the literature search, data extraction and quality evaluation, meta-analysis was conducted by using RevMan5.3 and Stata 17.0 software.

Results

In total, 52 studies were included in this review. The results revealed that there were positive correlations of death anxiety with female sex, the symptom burden, anxiety levels, depression levels, fear of recurrence, attachment avoidance, psychological distress, resignation and confrontation coping. Death anxiety was negatively correlated with age, education level, ability to perform daily activities, self-esteem, spiritual well-being, sense of meaning in life, resilience, quality of life, social support and religious beliefs.

Conclusions

Our results can inform the design of interventions to address death anxiety and improve the overall quality of life of cancer patients. Healthcare professionals should promptly identify and focus on death anxiety in high-risk populations of cancer patients.

Relevance to Clinical Practice

Cancer patients commonly experience death anxiety, and this anxiety has a nonnegligible impact on patients' mental health and overall quality of life. This study can inform the development of interventions by clinical healthcare professionals.

No Patient or Public Contribution

This was a meta-analysis based on data from previous studies.

Application of maple leaf‐shaped flap combined with negative pressure wound therapy in the perianal circular skin defect reconstruction

Abstract

We aimed to explore the efficacy of maple leaf-shaped flap in the repair of perianal circular skin defect. This study is a retrospective review of patients with perianal circular skin defect after skin tumour resection and repaired with maple leaf-shaped flap. Patients included in this study were admitted in our department between January 2010 and January 2023. A standardized data collection template was used to collect related variables. The design and surgical procedures of maple leaf-shaped flap are carefully described in this study. Negative pressure wound therapy (NPWT) was applied to assist wound healing postoperatively. Twenty-seven patients were included in this study. The average wound size after tumour resection measured 4 × 5 cm2–10 × 10 cm2. The circular skin defect was repaired by maple leaf-shaped flap, and NPWT was used after surgery. Twenty-five patients achieved primary wound healing and flaps were well-survived. Slight infection occurred in two patients, and both were cured after dressing change. During the follow-up period of 6–24 months, no tumour recurrence occurred. The perianal morphology can be well-restored by maple leaf-shaped flap, and the defecation control function of anus was not impaired. The application of maple leaf-shaped flap and NPWT is a promising way in the repair of perianal circular skin defect with little complication and satisfying outcomes.

A comprehensive study on the risk factors and pathogen analysis of postoperative wound infections following caesarean section procedures

Abstract

Postoperative wound infections (PWIs), a subtype of surgical site infections, are a significant concern for patients undergoing caesarean sections (C-sections). Understanding risk factors and pathogen profiles can greatly assist in early diagnosis and effective treatment. This study aimed to identify risk factors and analyse the pathogenic landscape contributing to PWIs in C-sections. A nested case-control study was carried out, utilising stringent criteria for case selection and control matching. Diagnostic criteria for surgical site infections included both clinical and microbiological parameters. Risk variables examined included patient age, Body Mass Index, duration of surgery and several other clinical indicators. Microbiological analysis was performed using the BD Phoenix-100 Automated Bacterial Identification System. Statistical analyses were conducted using SPSS version 26.0, and risk factors were evaluated through both univariate and multivariate analyses. A total of 50 patients, aged between 20 and 45 years (mean age 26.3 ± 5.6), developed PWIs following C-sections. The study revealed a temporal distribution and various clinical indicators of PWIs, including elevated white blood cell count and C-reactive protein levels. Gram-negative bacteria were found to be more prevalent at 57.4%. Notable pathogens included Pseudomonas aeruginosa and Acinetobacter baumannii. Antimicrobial resistance patterns were also identified, highlighting the need for a targeted antibiotic approach. Increased infection risks were linked to lack of prophylactic antibiotics, absence of preoperative povidone-iodine antisepsis, operations over an hour, anaemia, amniotic fluid contamination, diabetes, GTI, premature rupture of membranes and white blood cells counts above 10 × 109/L. The study provides critical insights into the risk factors and microbial agents contributing to PWIs following C-sections. Our findings emphasise the importance of early diagnosis through clinical and laboratory parameters, as well as the need for constant surveillance and reassessment of antibiotic stewardship programs.

Incidence, pathogens and antimicrobial resistance of blood and cerebrospinal fluid isolates from a tertiary neonatal unit in South Africa: A 10 year retrospective review

by Reenu Thomas, Claude Ondongo-Ezhet, Nini Motsoaledi, Mike Sharland, Michelle Clements, Sithembiso Velaphi

Objective

To determine trends in incidence, etiology and antimicrobial susceptibility of blood and cerebrospinal fluid (CSF) culture confirmed infections in hospitalized infants in a large tertiary neonatal unit in South Africa.

Methods

Single-center, retrospective review of laboratory records of bacteria and fungi, and their susceptibility profiles, isolated from blood and CSF of infants hospitalized in the neonatal unit at Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa, from 1st January 2010 to 31st December 2019. Laboratory data on isolates and their antimicrobial susceptibilities were collected. Coagulase-negative Staphylococcus, Corynebacteria and Bacillus spp. were excluded. Patient-level clinical and laboratory data were not available.

Results

There were 8,319 significant isolates, giving an infection rate of 14.3/1000 patient-days. Infection rates increased from 12.0 to 15.7/1000 patient-days (estimated average yearly change 0.6[95%CI, 0.5–0.7];p = Acinetobacter baumannii (44%) and Klebsiella pneumoniae (39%). Carbapenem resistance was seen in 31% of all Gram-negatives and increased over time (estimated average yearly change 4.8%[95%CI,4.2%-5.3%];pStaphylococcus aureus was the most common Gram-positive isolated. Rates of methicillin-resistant Staphylococcus aureus decreased from 91% to 55%(estimated average yearly change -2.8%[95%CI,-3.5%–2%],pCandida parapsilosis (52%) and Candida albicans (35%) were the most common fungi isolated.

Conclusions

There has been a marked overall increase in rates of blood and/or CSF infections, with an absolute increase in Gram-negative infections observed, replacing Gram-positive and fungal pathogens. Extended spectrum beta-lactamase Gram-negative isolates are being replaced by carbapenem resistance, with around one third of all significant Gram-negative isolates now carbapenem resistant. Research into hospital based novel treatment and prevention interventions for neonatal sepsis should be urgently prioritized.

HP promotes neutrophil inflammatory activation by regulating PFKFB2 in the glycolytic metabolism of sepsis

by Song Chen, Qian Zhang, Liyan Sun, Wei Song, Tao Zhang, Weidong Song, Jian Wan

Background

Sepsis, described as an inflammatory reaction to an infection, is a very social health problem with high mortality. This study aims to explore the new mechanism in the progression of sepsis.

Methods

We downloaded the GSE69528 dataset to screen differentially expressed genes (DEGs) for WGCNA, in which the key module was identified and analyzed by DMNC algorithm, expression verification and ROC curve analysis to identify the hub gene. Furthermore, the hub gene was analyzed by immunoassay, and the potential mechanism of hub gene in neutrophils was investigated by in vitro experiments.

Results

The turquoise module was the key module for sepsis in WGCNA on 94 DEGs. The top 20 genes of DMNC network were verified in GSE69528 and GSE9960, and 10 significant genes were obtained for ROC analysis. Based on the ROC curves, HP was considered the hub gene in sepsis, and its expression difference in sepsis and control groups was substantially significant. Further, it was demonstrated the knockdown of HP and PFKFB3 could suppress glycolysis and inflammatory cytokine levels in dHL-60 cell treated with LPS.

Conclusion

In conclusion, HP is identified as a potential diagnostic indicator for sepsis patients, and HP promotes neutrophil inflammatory activation by regulating PFKFB2 in the glycolytic metabolism of sepsis confirmed by in vitro experiments. These will help us deepen the molecular mechanism of sepsis.

Developing an early warning system for detecting sepsis in patients with trauma

Abstract

The purpose of this study was to analyse the risk factors for sepsis in patients with trauma and develop a new scoring system for predicting sepsis in patients with trauma based on these risk factors. This will provide a simple and effective early warning method for the rapid and accurate detection and evaluation of the probability of sepsis in patients with trauma to assist in planning timely clinical interventions. We undertook a retrospective analysis of the clinical data of 216 patients with trauma who were admitted to the emergency intensive care unit of the emergency medicine department of the Hebei Medical University Third Hospital, China, between November 2017 and October 2022. We conducted a preliminary screening of the relevant factors using univariate logistic regression analysis and included those factors with a p value of <0.075 in the multivariate logistic regression analysis, from which the risk factors were screened and assigned, and obtained a total score, which was the sepsis early warning score. The incidence of sepsis in patients in the intensive care unit with trauma was 36.9%, and the mortality rate due to sepsis was 19.4%. We found statistically significant differences in several factors for patients with sepsis. The risk factors for sepsis in patients with trauma were the activated partial thromboplastin time, the New Injury Severity Score, growth differentiation factor-15 levels, shock, mechanical ventilation and the Acute Physiology and Chronic Health Evaluation II score. The area under the receiver operating characteristic curve of the sepsis early warning score for predicting sepsis in patients with trauma was 0.725. When the cutoff value of the early warning score was set at 5.0 points, the sensitivity was 69.9% and the specificity was 60.3%. The incidence of sepsis in patients with trauma can be reduced by closely monitoring patients' hemodynamics, implementing adequate fluid resuscitation promptly and by early removal of the catheter to minimize the duration of unnecessary invasive mechanical ventilation. In this study, we found that the use of the sepsis early warning score helped in a more accurate and effective evaluation of the prognosis of patients with trauma.

The influence of minimally invasive esophagectomy on wound infection in patients undergoing esophageal cancer surgery: A meta‐analysis

Abstract

The impacts of minimally invasive esophagectomy (MIE) in comparison with open esophagectomy (OE) on postoperative complications, wound infections and hospital length of stay in patients with esophageal carcinoma (ESCA) using meta-analysis to provide reliable evidence for clinical practice. A search strategy was developed and computer searches were performed on Embase, Web of Science, PubMed, Cochrane Library, Wanfang, China Biomedical Literature Database and China National Knowledge Infrastructure databases for clinical studies that reported the effects of MIE in comparison with OE in patients with ESCA. The retrieval time was from their inception to October 2023. Two authors independently performed literature screening, and data extraction and literature quality evaluation were performed separately for the included studies. Meta-analysis was performed using Stata 17.0 software. Overall, 26 studies with 2427 ESCA patients were included in this study, of which 1203 were in the MIE group and 1224 were in the OE group. The results showed that, compared with OE, ESCA patients who underwent MIE were less likely to develop postoperative wound infections (odds ratio [OR] = 0.31, 95% confidence intervals [CIs]: 0.20–0.49, p < 0.001) and complications (OR = 0.23, 95% CI: 0.18–0.30, p < 0.001) and have a shorter hospital stay (standardized mean difference = −1.93, 95% CI: −2.38 to −1.48, p < 0.001). MIE has advantages over OE in terms of shorter hospital stay and reduced incidence of postoperative wound infections and complications.

Simplified dressing change after surgery for high anal fistula: A prospective, single centre randomized controlled study on loose combined cutting seton (LCCS) technique

Abstract

Background

Dressing change is the most important part of postoperative wound care. The aim of this study was to evaluate whether a more effective, simple and less painful method of dressing change for anal fistulas could be found without the need for debridement and packing. Data related to postoperative recovery were recorded at postoperative days 3, 7, 14, 21 and 180.

Methods

In this experiment, 76 subjects diagnosed with high anal fistula were randomly divided into a simplified dressing change (SDC) group and a traditional debridement dressing change(TDDC) group according to a ratio of 1:1.

Results

The SDC group had significantly fewer pain scores, bleeding rates, dressing change times, inpatient days and lower average inpatient costs than the TDDC group. There were no significant differences in wound healing time, area and depth and Wexner score between the two groups.

Conclusions

Studies have shown that the use of simplified dressing changes does not affect cure or recurrence rates, but significantly reduces dressing change times and pain during changes, reducing patient inpatient length of stay and costs.

Assessing the impact of digital transformation on capital market information efficiency under environmental uncertainty: Evidence from China

by Tao Feng, Xiaohuan Dong, Yueyun Wang

Digital transformation is an emerging development opportunity for enterprises in the digital economy and comprehensively reflects the application of digital technology to production, operation, and management strategies. This study used data on A-share listed enterprises in Shanghai and Shenzhen from 2007 to 2022 to examine the relationship between the digital transformation of enterprises and information efficiency of the capital market. Findings revealed that digital transformation can improve the information efficiency of the capital market and that environmental uncertainty plays a more significant regulatory role. The greater the environmental uncertainty, the more enterprises with a high degree of digital transformation can promote the information efficiency of the capital market. Additional analysis showed that the promotional effect of digital transformation on the information efficiency of the capital market is better for non-state-owned enterprises and small and medium-sized enterprises. This study provides detailed insights into digital transformation and capital market information efficiency, which enriches the research related to the economic consequences of digital transformation and demonstrates the theoretical and practical value of corporate digital transformation.

Validity and reliability of the Waterlow scale for assessing pressure injury risk in critical adult patients: A multi‐centre cohort study

Abstract

Aim

To evaluate the predictive validity and reliability of the Waterlow scale in critically adult hospitalised patients.

Design

A multi-centre cohort study.

Methods

This study was conducted in 72 intensive care units (ICUs) in 38 tertiary hospitals in Gansu Province, China. All adults admitted to the ICU for greater than or equal to 24 h without pressure injury (PI) on admission were screened by the Waterlow scale on admission, during ICU stay and ICU discharge from April 2021 to February 2023. Receiver operating characteristic (ROC) curves were used to determine a potential cut-off value for critical adult hospitalised patients. Cut-off values were then determined using Youden's index, and sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated based on these cut-off values. Test–retest reliability was used to evaluate inter-rater reliability.

Results

A total of 5874 critical patients on admission were included, and 5125 of them were assessed regularly. The area under curve (AUC) was 0.623 (95% CI, 0.574–0.690), with a cut-off score of 19 showing the best balance among sensitivity of 62.7%, specificity of 57.4%, positive predictive value of 2.07% and negative predictive value of 99.08%. The test–retest reliability between the first assessment and the regular assessment was 0.447.

Conclusions

The Waterlow scale shows insufficient predictive validity and reliability in discriminating critical adults at risk of PI development. To further modify the items of the Waterlow scale, exploring specific risk factors for PI in the ICU and clarifying their impact degree was necessary. Risk predictive models or better tools are inevitable in the future.

Patient or Public Contribution

Patients or family members supported nurses with PI risk assessment, skin examination and other activities during the inquiry.

Risk factors of foot ulcers in patients with end‐stage renal disease on dialysis: A meta‐analysis

Abstract

The present study aims to assess the risk factors for foot ulcers in patients undergoing dialysis for end-stage renal disease (ESRD) and to provide evidence-based guidance for prevention and treatment. A systematic search was conducted on PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, Chinese Biomedical Literature Database and Wanfang Data from the database inception until May 2023 to identify relevant studies investigating the risk factors for foot ulcers in dialysis patients with ESRD. Two independent researchers conducted the literature screening and data extraction. The meta-analysis was performed using STATA 17.0 software. Ultimately, six articles comprising 1620 patients were included for analysis. The meta-analysis revealed that male (OR, 1.464; 95% CI: 1.082–1.980, p = 0.013), hypertension (OR, 1.781; 95% CI: 1.293–2.4550, p < 0.001), peripheral artery disease (PAD) (OR, 5.014; 95% CI: 2.514–9.998, p < 0.001), type 1 diabetes mellitus (T1DM) (OR, 2.993; 95% CI: 1.477–6.065, p = 0.002) and type 2 diabetes mellitus (T2DM) (OR, 2.498; 95% CI:1.466–4.256, p = 0.001) were risk factors for foot ulcers in dialysis patients with ESRD. Conversely, the female sex (OR, 0.683; 95% CI: 0.505–0.924, p = 0.013) was a protective factor against foot ulcers. Our analysis revealed that male sex, hypertension, PAD, T1DM and T2DM were risk factors for foot ulcers in patients undergoing dialysis for ESRD. Conversely, the female sex was a protective factor against foot ulcers. Therefore, it is crucial to strengthen health education that targets patients with these risk factors and regularly screen high-risk individuals. Early detection and treatment can help delay disease progression.

Factors influencing nurses' intent to provide care involved in coronavirus disease 2019: Theory of planned behaviour perspectives

Abstract

Aims and objectives

To identify the factors influencing the intent to provide care among nurses involved in coronavirus disease 2019 (COVID-19) care.

Background

COVID-19 was first reported in Wuhan, China, in 2019. In 2020, the World Health Organisation declared it a pandemic, leading to 5,827,104 deaths and 421,203,495 confirmed cases as of 19 February 2022. The high transmissibility of COVID-19 has prolonged the pandemic for over 2 years, resulting in deleterious effects on nurses' physical and mental health. The fear of infection and isolation may lead to negative experiences and perceptions among COVID-19 frontline nurses, which may ultimately degrade the quality of patient care. Thus, it is essential to identify factors influencing of nurses' intent to provide care.

Design

Cross-sectional study.

Methods

Data were collected from 169 nurses involved in direct COVID-19 care at a hospital designated for infectious disease care in Korea from August to September 2021 using an online questionnaire. STROBE checklist was followed.

Results

Nurses' intent to provide care significantly differed based on whether they lived with parents and had adequate availability of personal protection equipment. The correlation analysis indicated that the intent to provide care was significantly positively correlated with normative beliefs, control beliefs, attitude towards the behaviour, subjective norms and perceived behavioural control. Perceived behavioural control, control beliefs and attitude towards the behaviour were significant factors influencing nurses' intent to provide COVID-19 care.

Conclusion

This study showed that nurses perceived behavioural control and positive behaviour towards providing COVID-19 care fundamentally influenced their intent to provide care.

Relevance to clinical practice

In clinical practice, the safety and rights of individual nurses who participated in COVID-19-related patient care are promoted, and ultimately, the quality of patient care is improved. Furthermore, active support at the organisation and government level is needed to strengthen the capabilities necessary for nursing patients with infectious diseases.

Professional quality of life and fear of COVID‐19 among Spanish nurses: A longitudinal repeated cross‐sectional study

Abstract

Aim and Objectives

To evaluate changes in compassion fatigue (CF), burnout (BO), compassion satisfaction (CS) and fear of COVID-19 among Spanish nurses by comparing two assessment points: before and after the COVID-19 vaccination campaign.

Background

The COVID-19 pandemic has produced a great impact in healthcare worker's professional quality of life, especially among nurses. CF, BO and fear of COVID-19 decisively affect the care provided by nurses and put them at risk for mental health problems, so longitudinal studies are essential.

Design

A repeated cross-sectional design was carried out with a time-lapse of 12 months.

Methods

A total of 439 registered nurses in December 2020 and 410 in December 2021 participated in this study through an online survey. Data were collected using the Professional Quality of Life Questionnaire and the Fear of COVID-19 Scale. Occupational and sociodemographic variables were also analysed. This article adheres to the STROBE guidelines for the reporting of observational studies.

Results

The fear of COVID-19 has not been reduced among nurses. The levels of BO remain stable and continue to be high in half of the professionals. CF has been reduced with a small effect size (d = 0.30), while CS has also decreased (d = 0.30). Positive correlations were found in both assessment points between fear of COVID-19 and BO (r = .44, p ≤ .001; r = .41, p ≤ .001) and also between fear of COVID and CF (r = .57, p ≤ .001; r = .50, p ≤ .001). Negative correlations between fear and CS were also found (r = − .16, p = .001; r = − .22, p ≤ .001).

Relevance to Clinical Practice

Programmes to reduce fear of COVID-19, BO and CF are needed to improve mental health and to prevent psychological distress among nurses, as well as to increase CS and preserve the productivity and quality of nursing care.

Patient or Public Contribution

The nurses collaborated by participating in the present study anonymously and disinterestedly.

Barriers to uptake of cataract surgery among elderly patients in rural China: a cross-sectional study

Por: Ma · X. · Hao · J. · Jan · C. · Wan · Y. · Xie · Y. · Liu · C. · Shi · Y. · Hu · A. · Cao · K. · Congdon · N. · Rozelle · S. · Dong · Z. · Wang · N.
Objective

To investigate factors that differentiate elderly adults in rural China who accept free vision screening and cataract surgery from those who could benefit from vision care but refuse it when offered.

Design

We conducted a population-based, cross-sectional study between October and December 2016. Logistic regression models were used to examine the predictors of accepting free vision screening and cataract surgery.

Setting

Rural communities in Handan, China.

Participants

Adults aged 50 years or older, with presenting visual acuity ≤6/18 in the better seeing eye, suspected by examining ophthalmologist to be due to cataract.

Results

Among 613 persons with cataract identified on a population basis, 596 (97.2%) completed the household survey (mean (SD) age, 71.5 (10.0) years; 79.8% female). A total of 214 persons (35.9%) refused participation, while 382 (64.1%) took part in the vision screening. A total of 193 (50.5%) participants were found eligible for surgery, while 189 (49.5%) were not. Among 99 randomly selected participants who were offered immediate free surgery, surgery was accepted by 77 participants (77.8%) and refused by 22 (22.2%). In the multivariate model, being engaged in income-generating activities (p

Conclusion

Our results suggest that refusal of basic eye examinations may be at least as important a determinant of low surgical rates in rural China as lack of acceptance of surgery itself.

Wound healing and postoperative management in paediatric patients following 27‐Gauge Transconjunctival Sutureless Vitrectomy for vitreoretinal conditions

Abstract

The utilization of 27-G TSV, or 27-Gauge Transconjunctival Sutureless Vitrectomy, poses distinct difficulties in the context of paediatric patients, particularly those younger than 14 years old, on account of the dearth of exhaustive documentation concerning the efficacy and results of these operations. Therefore, this retrospective study was to evaluate the safety and efficacy of 27-G TSV in paediatric patients, with emphasis on management of intraoperative and postoperative complications and postoperative wound healing. A total of 54 eyes of 52 paediatric patients who underwent 27-G TSV at Sichuan Provincial People's Hospital were included in the study. The average duration of follow-up was 9.32 ± 3.35 months. The complication with the highest incidence rate was Rhegmatogenous Retinal Detachment (RRD), which was detected in 27.8% cases. Familial Exudative Vitreoretinopathy (FEVR) and Persistent Fetal Vasculature (PFV) each accounted for 16.7% of the cases. Retinopathy of Prematurity (ROP) and Vitreous Haemorrhage (VH) constituted 11.1% and 14.8%, respectively, of the reported cases. Lens injury (1.9%), cannula slippage (7.4%) and wound leakage (5.6%) were intraoperative complications. Iatrogenic retinal detachment occurred at 3.7%. Hypotony (10.8% of patients), vitreous haemorrhage (9.3%), cataract formation (9.3%), ocular hypertension (8.1%) and retinal detachment (5.6%) were postoperative complications. Effective management strategies were executed, such as performing in situ trocar puncture to address cannula slippage and promptly suturing to address wound leakage. 27-G TSV exhibited promise as the therapeutic alternative for range of vitreoretinal disorders in paediatric patients, accompanied by complications that were controllable during and after the procedure. Strict preoperative planning and precise surgical technique are indispensable in order to maximize patient outcomes and guarantee effective wound healing and recovery within this particular demographic.

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