FreshRSS

🔒
❌ Acerca de FreshRSS
Hay nuevos artículos disponibles. Pincha para refrescar la página.
AnteayerTus fuentes RSS

Real-world data evaluating Guys rapid diagnostic clinic as an alternate pathway for patients with FIT levels below 10

Por: Monroy-Iglesias · M. J. · Martin · S. · Cargaleiro · C. · Jones · G. · Steward · L. · Murtagh · C. · Bruno · F. · Millwaters · J. · Schizas · A. · Watson · H. · Haire · A. · Haire · K. · Moss · C. L. · Russell · B. · Srirajaskanthan · R. · Van Hemelrijck · M. · Dolly · S.
Objective

To analyse the effectiveness of rapid diagnostic clinics (RDCs) as an alternative pathway for patients with concerning symptoms and a faecal immunochemical test (FIT) result

Design

A retrospective and prospective cohort study.

Setting

GSTT RDC, one of England’s largest single-centre RDCs. Sociodemographic and clinical characteristics of FIT

Participants

Patients with an FIT result

Results

A total of 1299 patients with an FIT

Conclusion

This study demonstrates the effectiveness of RDCs as an alternate pathway for FIT

Using interoperable nursing care data to improve outcomes for multiple traumas patients with Impaired Physical Mobility

Abstract

Aim(s)

To demonstrate how interoperable nursing care data can be used by nurses to create a more holistic understanding of the healthcare needs of multiple traumas patients with Impaired Physical Mobility. By proposing and validating linkages for the nursing diagnosis of Impaired Physical Mobility in multiple trauma patients by mapping to the Nursing Outcomes Classification (NOC) and Nursing Interventions Classification (NIC) equivalent terms using free-text nursing documentation.

Design

A descriptive cross-sectional design, combining quantitative analysis of interoperable data sets and the Kappa's coefficient score with qualitative insights from cross-mapping methodology and nursing professionals' consensus.

Methods

Cross-mapping methodology was conducted in a Brazilian Level 1 Trauma Center using de-identified records of adult patients with a confirmed medical diagnosis of multiple traumas and Impaired Physical Mobility (a nursing diagnosis). The hospital nursing free-text records were mapped to NANDA-I, NIC, NOC and NNN linkages were identified. The data records were retrieved for admissions from September to October 2020 and involved medical and nursing records. Three expert nurses evaluated the cross-mapping and linkage results using a 4-point Likert-type scale and Kappa's coefficient.

Results

The de-identified records of 44 patients were evaluated and then were mapped to three NOCs related to nurses care planning: (0001) Endurance; (0204) Immobility Consequences: Physiological, and (0208) Mobility and 13 interventions and 32 interrelated activities: (6486) Environmental Management: Safety; (0840) Positioning; (3200) Aspiration Precautions; (1400) Pain Management; (0940) Traction/Immobilization Care; (3540) Pressure Ulcer Prevention; (3584) Skincare: Topical Treatment; (1100) Nutrition Management; (3660) Wound Care; (1804) Self-Care Assistance: Toileting; (1801) Self-Care Assistance: Bathing/Hygiene; (4130) Fluid Monitoring; and (4200) Intravenous Therapy. The final version of the constructed NNN Linkages identified 37 NOCs and 41 NICs.

Conclusion

These valid NNN linkages for patients with multiple traumas can serve as a valuable resource that enables nurses, who face multiple time constraints, to make informed decisions efficiently. This approach of using evidence-based linkages like the one developed in this research holds high potential for improving patient's safety and outcomes.

No Patient or Public Contribution

In this study, there was no direct involvement of patients, service users, caregivers or public members in the design, conduct, analysis and interpretation of data or preparation of the manuscript. The study focused solely on analysing existing de-identified medical and nursing records to propose and validate linkages for nursing diagnoses.

Portuguese observational cross-sectional clinical imaging study protocol to investigate central dopaminergic mechanisms of successful weight loss through bariatric surgery

Por: Pais · M. L. · Crisostomo · J. · Abrunhosa · A. · Castelo-Branco · M.
Introduction

Bariatric surgery (BS) is the treatment of choice for refractory obesity. Although weight loss (WL) reduces the prevalence of obesity-related comorbidities, not all patients maintain it. It has been suggested that central mechanisms involving dopamine receptors may play a role in successful WL. This protocol describes an observational cross-sectional study to test if the binding of central dopamine receptors is similar in individuals who responded successfully to BS and age- and gender-matched normal-weight healthy individuals (controls). As secondary goals, the protocol will investigate if this binding correlates with key parameters such as age, hormonal status, anthropometric metrics and neurobehavioural scores. Finally, as exploratory goals, we will include a cohort of individuals with obesity before and after BS to explore whether obesity and type of BS (sleeve gastrectomy and Roux-en-Y gastric bypass) yield distinct binding values and track central dopaminergic changes resulting from BS.

Methods and analysis

To address the major research question of this observational study, positron emission tomography (PET) with [11C]raclopride will be used to map brain dopamine type 2 and 3 receptors (D2/3R) non-displaceable binding potential (BPND) of individuals who have successfully responded to BS. Mean regional D2/3R BPND values will be compared with control individuals by two one-sided test approaches. The sample size (23 per group) was estimated to demonstrate the equivalence between two independent group means. In addition, these binding values will be correlated with key parameters to address secondary goals. Finally, for exploratory analysis, these values will be compared within the same individuals (before and after BS) and between individuals with obesity and controls and types of BS.

Ethics and dissemination

The project and informed consent received ethical approval from the Faculty of Medicine and the Coimbra University Hospital ethics committees. Results will be disseminated in international peer-reviewed journals and conferences.

Electrophysiological correlates of symbolic numerical order processing

by Clemens Brunner, Philip Schadenbauer, Nele Schröder, Roland H. Grabner, Stephan E. Vogel

Determining if a sequence of numbers is ordered or not is one of the fundamental aspects of numerical processing linked to concurrent and future arithmetic skills. While some studies have explored the neural underpinnings of order processing using functional magnetic resonance imaging, our understanding of electrophysiological correlates is comparatively limited. To address this gap, we used a three-item symbolic numerical order verification task (with Arabic numerals from 1 to 9) to study event-related potentials (ERPs) in 73 adult participants in an exploratory approach. We presented three-item sequences and manipulated their order (ordered vs. unordered) as well as their inter-item numerical distance (one vs. two). Participants had to determine if a presented sequence was ordered or not. They also completed a speeded arithmetic fluency test, which measured their arithmetic skills. Our results revealed a significant mean amplitude difference in the grand average ERP waveform between ordered and unordered sequences in a time window of 500–750 ms at left anterior-frontal, left parietal, and central electrodes. We also identified distance-related amplitude differences for both ordered and unordered sequences. While unordered sequences showed an effect in the time window of 500–750 ms at electrode clusters around anterior-frontal and right-frontal regions, ordered sequences differed in an earlier time window (190–275 ms) in frontal and right parieto-occipital regions. Only the mean amplitude difference between ordered and unordered sequences showed an association with arithmetic fluency at the left anterior-frontal electrode. While the earlier time window for ordered sequences is consistent with a more automated and efficient processing of ordered sequential items, distance-related differences in unordered sequences occur later in time.

Educational technologies for teaching hand hygiene: Systematic review

by Daiane Rubinato Fernandes, Bruna Nogueira dos Santos, Carolina Scoqui Guimarães, Elaine Barros Ferreira, Amanda Salles Margatho, Paula Elaine Diniz dos Reis, Didier Pittet, Renata Cristina de Campos Pereira Silveira

Aim

To gather available scientific evidence on technologies used to teach hand hygiene to professional populations and lays involved in health care in the hospital setting. This systematic review was designed as proposed by Preferred Reporting Items for Systematic Reviews and Meta-Analysis, included studies reporting primary, original, quantitative research findings with no date limit and written in English, Spanish or Portuguese. The search was performed in the following electronic databases: Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Excerpta Medica dataBASE, Literatura Latino-Americana e do Caribe em Ciências da Saúde, US National Library of Medicine, Scopus, Web of Science, Google Scholar and ProQuest. The eligibility criteria were applied independently by two reviewers to select the studies, first by reading the titles and abstracts on the Rayyan platform and then by full text reading of the eligible studies. After a descriptive analysis, the studies were subjected to critical evaluation of their methodological quality using JBI tools.

Results

Seven studies were included, addressing various methods for teaching hand hygiene using different technological resources, such as audiovisual electronic devices, videos, virtual reality, and gamification using tablets and smartphones, in different populations.

Conclusion

Using technologies to teach hand hygiene considerably helps patients, visitors, and relatives in learning the procedures and efficiently improves hand hygiene compliance rates among healthcare professionals, creating evidence-based repetitive learning opportunities for patients and caregivers.

Serotype 3 Experimental Human Pneumococcal Challenge (EHPC) study protocol: dose ranging and reproducibility in a healthy volunteer population (challenge 3)

Por: Hazenberg · P. · Robinson · R. E. · Farrar · M. · Solorzano · C. · Hyder-Wright · A. · Liatsikos · K. · Brunning · J. · Fleet · H. · Bettam · A. · Howard · A. · Kenny-Nyazika · T. · Urban · B. · Mitsi · E. · El Safadi · D. · Davies · K. · Lesosky · M. · Gordon · S. B. · Ferreira · D. M.
Introduction

Since the introduction of pneumococcal conjugate vaccines, pneumococcal disease rates have declined for many vaccine-type serotypes. However, serotype 3 (SPN3) continues to cause significant disease and is identified in colonisation epidemiological studies as one of the top circulating serotypes in adults in the UK. Consequently, new vaccines that provide greater protection against SPN3 colonisation/carriage are urgently needed. The Experimental Human Pneumococcal Challenge (EHPC) model is a unique method of determining pneumococcal colonisation rates, understanding acquired immunity, and testing vaccines in a cost-effective manner. To enhance the development of effective pneumococcal vaccines against SPN3, we aim to develop a new relevant and safe SPN3 EHPC model with high attack rates which could be used to test vaccines using small sample size.

Methods and analysis

This is a human challenge study to establish a new SPN3 EHPC model, consisting of two parts. In the dose-ranging/safety study, cohorts of 10 healthy participants will be challenged with escalating doses of SPN3. If first challenge does not lead into colonisation, participants will receive a second challenge 2 weeks after. Experimental nasopharyngeal (NP) colonisation will be determined using nasal wash sampling. Using the dose that results in ≥50% of participants being colonised, with a high safety profile, we will complete the cohort with another 33 participants to check for reproducibility of the colonisation rate. The primary outcome of this study is to determine the optimal SPN3 dose and inoculation regime to establish the highest rates of NP colonisation in healthy adults. Secondary outcomes include determining density and duration of experimental SPN3 NP colonisation and characterising mucosal and systemic immune responses to SPN3 challenge.

Ethics and dissemination

This study is approved by the NHS Research and Ethics Committee (reference 22/NW/0051). Findings will be published in peer-reviewed journals and reports will be made available to participants.

Efficacy of early cardiac rehabilitation after acute myocardial infarction: Randomized clinical trial protocol

by Caroline Schon, Amanda Felismino, Joceline de Sá, Renata Corte, Tatiana Ribeiro, Selma Bruno

The acute myocardial infarction (AMI) present high mortality rate that may be reduced with cardiac rehabilitation. Despite its good establishment in outpatient care, few studies analyzed cardiac rehabilitation during hospitalization. Thus, this study aims to clarify the safety and efficacy of early cardiac rehabilitation after AMI. This will be a clinical, controlled, randomized trial with blind outcome evaluation and a superiority hypothesis. Twenty-four patients with AMI will be divided into two groups (1:1 allocation ratio). The intervention group will receive an individualized exercise-based cardiac rehabilitation protocol during hospitalization and a semi-supervised protocol after hospital discharge; the control group will receive conventional care. The primary outcomes will be the cardiac remodeling assessed by cardiac magnetic resonance imaging, functional capacity assessed by maximal oxygen consumption, and cardiac autonomic balance examined via heart rate variability. Secondary outcomes will include safety and the total exercise dose provided during the protocol. Statistical analysis will consider the intent-to-treat analysis. Trial registration. Trial registration number: Brazilian Registry of Clinical Trials (ReBEC) (RBR- 9nyx8hb).

Prevalence of adverse events in pronated intubated adult COVID‐19 patients: A systematic review with meta‐analysis

Abstract

Aim

To present the pooled estimated prevalence of adverse events in pronated intubated adult COVID-19 patients.

Design

A systematic review and meta-analysis.

Data sources

This study used the Cochrane Library, CINAHL, Embase, LILACS, Livivo, PubMed, Scopus, and Web of Science databases as data sources.

Methods

The studies were meta-analysed using JAMOVI 1.6.15 software. A random-effects model was used to identify the global prevalence of adverse events, confidence intervals and the heterogeneity data. Risk of bias was assessed using the Joanna Briggs Institute tool, and the certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach.

Results

Of the 7904 studies identified, 169 were included for full reading, and 10 were included in the review. The most prevalent adverse events were pressure injuries (59%), haemodynamic instability (23%), death (17%) and device loss or traction (9%).

Conclusion

The most prevalent adverse events in mechanically ventilated pronated patients with COVID-19 are pressure injuries, presence of haemodynamic instability, death and device loss or traction.

Implications for the patient care

The evidence identified in this review can help improve the quality and safety of patient care by helping to design care protocols to avoid the development of adverse events that can cause permanent sequelae in these patients.

Impact

This systematic review addressed the adverse events related to prone position in intubated adult COVID-19 patients. We identified that the most prevalent adverse events in these patients were pressure injuries, haemodynamic instability, device loss or traction and death. The results of this review may influence the clinical practice of nurses who work in intensive care units and, consequently, the nursing care provided not only to COVID-19 patients but for all intubated patients due to other reasons in intensive care units.

Reporting method

This systematic review adhered to the PRISMA reporting guideline.

Patient or public contribution

As this is a systematic review, we analysed data from primary studies conducted by many researchers. Thus, there was no patient or public contribution in this review.

Predictors of professional burnout and fulfilment in a longitudinal analysis on nurses and healthcare workers in the COVID‐19 pandemic

Abstract

Aims and objectives

(1) To investigate the vulnerability of nurses to experiencing professional burnout and low fulfilment across 5 months of the COVID-19 pandemic. (2) To identify modifiable variables in hospital leadership and individual vulnerabilities that may mitigate these effects.

Background

Nurses were at increased risk for burnout and low fulfilment prior to the COVID-19 pandemic. Hospital leadership factors such as organisational structure and open communication and consideration of employee opinions are known to have positive impacts on work attitudes. Personal risk factors for burnout include symptoms of depression and anxiety.

Methods

Healthcare workers (n = 406 at baseline, n = 234 longitudinal), including doctors (n = 102), nurses (n = 94), technicians (n = 90) and non-clinical administrative staff (n = 120), completed 5 online questionnaires, once per month, for 5 months. Participants completed self-report questionnaires on professional fulfilment and burnout, perceptions of healthcare leadership, and symptoms of anxiety and depression. Participants were recruited from various healthcare settings in the southeastern United States. The STROBE checklist was used to report the present study.

Results

Both at baseline and across the 5 months, nurses working during the COVID-19 pandemic reported increased burnout and decreased fulfilment relative to doctors. For all participants, burnout remained largely steady and fulfilment decreased slightly. The strongest predictors of both burnout and fulfilment were organisational structure and depressive symptoms. Leadership consideration and anxiety symptoms had smaller, yet significant, relationships to burnout and fulfilment in longitudinal analyses.

Conclusions

Burnout and reduced fulfilment remain a problem for healthcare workers, especially nurses. Leadership styles and employee symptoms of depression and anxiety are appropriate targets for intervention.

Relevance to clinical practice

Leadership wishing to reduce burnout and increase fulfilment among employees should increase levels of organisational support and consideration and expand supports to employees seeking treatment for depression and anxiety.

Public controversy and citizens’ attitude formation about animal research: A case for scholarship and recommendations on conflicts at the science-society interface

by Elena Link, Katharina Emde-Lachmund, Sophie Bruns, Anja Dittrich, Meike Stiesch, Axel Haverich, Stefan Treue, Christoph Klimmt

Activist groups attack animal research and put scientists and their institutions under pressure, whereas scientists often remain silent. We report an interdisciplinary research project driven by a communication science perspective on how citizens respond to news reports about animal research (3 experiments, overall N = 765) and a German science-initiated information platform (“Tierversuche verstehen”; controlled user study, N = 100). Findings demonstrate that a critical journalist perspective within neutral, two-sided news reports (e.g., skeptical expert statements or images of suffering animals) does not affect citizen opinion strongly. Information media provided by scientific institutions seem to be welcomed even by citizens who hold critical prior attitudes. From these results, we develop a set of recommendations for future public communication of animal research that builds on best practices in organizational and crisis communication. These suggestions are intended to empower animal researchers to actively participate in public debate to support citizens’ informed attitude formation.

Physical activity among older adults with multimorbidity: Evidence from a population-based health survey

by Bruno Holanda Ferreira, Ricardo Goes de Aguiar, Edige Felipe de Sousa Santos, Chester Luiz Galvão Cesar, Moisés Goldbaum, Camila Nascimento Monteiro

Introduction

The promotion of physical activity has been recognized as an important component in the management and prevention of multimorbidity, a condition that is increasing prevalent worldwide, including in Brazil. However, there is a scarcity of studies exploring the disparity in physical activity levels between individuals with and without multimorbidity. Therefore, the study aimed to estimate the prevalence of multimorbidity and physical activity among older adults, as well as analyze the relationship of a sufficient level of physical activity and multimorbidity, while considering sociodemographic characteristics of residents in São Paulo, Brazil.

Materials and methods

Data from 1.019 participants aged 60 years or older (59.7% female; mean age 69.7±7.7) were collected from the Health Survey (ISA-Capital, 2015) conducted in the city of São Paulo, Brazil. We defined multimorbidity as the presence of two or more chronic conditions, and for physical activity, classified a sufficient level (≥150 min/week). Prevalence Ratios (PR) with 95% Confidence Intervals (95%CI) were estimated using univariate and multivariate Poisson regression to examine the relationship between multimorbidity and sufficient level of physical activity.

Results

67.7% of the participants lived with multimorbidity, while 30.1% had achieved a sufficient level of physical activity. There was a higher prevalence of sufficient level of physical activity among older adults with two (PR = 1.38; 95%CI 1.02–1.88) and four (PR = 1.37; 95%CI 1.00–1.87) chronic conditions. Older adults with multimorbidity who were 70 years or older (PR = 1.77; 95%IC 1.13–2.77), female (PR = 1.65; 95%CI 1.16–2.36), without a partner (PR = 1.43; 95%IC 1.03–1.99), and had a per capita income of 1 to 2.5 (PR = 1.83; 95%IC 1.00–3.33) were more likely to achieve a sufficient level of physical activity compared to their peers without multimorbidity.

Conclusions

The study highlights sociodemographic disparities in the sufficient level of physical activity among multimorbidity, suggesting the importance of considering these factors when planning public policies aimed at promoting physical activity.

Lambs supplemented with Amazonian oilseed co-products: Meat quality and fatty acid profile

by Vinícius Costa Gomes de Castro, Juliana Cristina de Castro Budel, Thomaz Cyro Guimarães de Carvalho Rodrigues, Bruna Almeida Silva, Waléria Cristina Lopes Joset, Alyne Cristina Sodré de Lima, Shirley Motta Souza, Rui José Branquinho Bessa, Suzana Paula Almeida Alves, Jamile Andrea Rodrigues da Silva, Maria Regina Sarkis Peixoto Joele, André Guimarães Maciel e Silva, José de Brito Lourenço-Júnior

The Amazon has a wide variety of oilseeds that generate a huge amount of co-products with potential for use in animal nutrition. The objective was to use alternative resources (oilseed cakes) in the feeding of lambs to assign a sustainable destination to this biomass, and evaluate its influence on the quality and fatty acid (FA) profile of the meat. Twenty-four lambs, male, castrated, crossbred Dorper × Santa Inês, weighing 30 ± 1.3 kg of initial body weight, were distributed in a completely randomized design in 4 treatments (diets) with six replications (animals). The control diet (Control) contained corn and soybean meal as main ingredients, which were partially replaced in the other diets by cupuassu cake diet (Cup), palm kernel cake diet (Palm) and tucuma cake diet (Tuc). The inclusion of Amazon cakes influences the lipid (P = 0.02) and protein (P longissimus lumborum); reduces cooking losses (P 0.05). The inclusion of oilseed cakes influences the chemical composition, physical parameters, composition and fatty acid profile of the meat, but does not influence the indicators of atherogenicity, thrombogenicity and cholesterolemia.

Análisis de la teoría de la diversidad y universalidad del cuidado cul-tural de Madeleine Leininger

Este estudio tuvo como objetivo analizar la Teoría de la Diversidad y Universalidad del Cuidado Cultural de Madeleine Leininger. Se trata de un estudio
de análisis interpretativo basado en el modelo de evaluación de la teoría propuesto por Johnson, realizado en enero y febrero de 2022. Se constató que la teoría de Leininger tiene consistencia teórica y capacidad de contribuir a la práctica, la ciencia y la profesión de enfermería. La teoría es de fácil comprensión, con un lenguaje accesible y claro, y presenta conceptos bien definidos que estimulan la formulación de proposiciones. También presenta variables y supuestos que contribuyen a la interpretación y comprensión de proposiciones, así como conocimientos teóricos que ayudan a explicar y hacer predicciones sobre los fenómenos de interés para la enfermería. El análisis permitió evidenciar en la teoría de Leininger la consistencia teórica y la capacidad de contribuir a la práctica de enfermería.
Se destaca la relevancia de la aplicación de los enfermeros en diferentes contextos de trabajo para lograr un cuidado guiado cultural y congruentemente
con el contexto y las necesidades de los individuos.

Latin American Cerebral Palsy Register (LATAM-CPR): study protocol to develop a collaborative register with surveillance of children with cerebral palsy in Latin American countries

Por: Ruiz Brunner · M. d. l. M. · Jahan · I. · Cuestas · E. · Cieri · M. E. · Escobar Zuluaga · J. · Condinanzi · A. L. · Sanchez · F. · McIntyre · S. · Smithers-Sheedy · H. · Muhit · M. · Badawi · N. · Diaz · R. · Diaz · A. · Carranza · J. · Duran · C. · Quintero Valencia · C. A. · Melarag
Introduction

Cerebral palsy (CP) is one of the leading causes of childhood disability globally with a high burden in low-income and middle-income countries (LMICs). Preliminary findings from the global LMIC CP Register (GLM CPR) suggest that the majority of CP in LMICs are due to potentially preventable causes. Such data are lacking in the Latin American region. Generating comparable epidemiological data on CP from this region could enable translational research and services towards early diagnosis and early intervention. We aim to establish a Latin American multicountry network and online data repository of CP called Latin American Cerebral Palsy Register (LATAM-CPR).

Methods and analysis

The LATAM-CPR will be modelled after the GLM CPR and will support new and emerging Latin American CP registers following a harmonised protocol adapted from the GLM CPR and piloted in Argentina (ie, Argentine Register of Cerebral Palsy). Both population-based and institution-based surveillance mechanisms will be adopted for registration of children with CP aged less than 18 years to the participating CP registers. The data collection form of the LATAM-CPR will include risk factors, clinical profile, rehabilitation, socioeconomical status of children with CP. Descriptive data on the epidemiology of CP from each participating country will be reported, country-specific and regional data will be compared.

Ethics and dissemination

Individual CP registers have applied ethics approval from respective national human research ethics committees (HREC) and/or institutional review boards prior to the establishment and inclusion into the LATAM-CPR. Ethical approval for LATAM-CPR has already been obtained from the HREC in the two countries that started (Argentina and Mexico). Findings will be disseminated and will be made publicly available through peer-reviewed publications, conference presentations and social media communications.

Socio-demographic profile of medical students in Aotearoa, New Zealand (2016-2020): a nationwide cross-sectional study

Por: Bagg · W. · Curtis · E. · Eggleton · K. S. · Nixon · G. · Bristowe · Z. · Brunton · P. · Hendry · C. · Kool · B. · Scarf · D. · Shaw · S. · Tukuitonga · C. · Williman · J. · Wilson · D. · Crampton · P.
Objective

To determine the socio-demographic profile of all students enrolled to study medicine in Aotearoa New Zealand (NZ).

Design and setting

Observational, cross-sectional study. Data were sought from the Universities of Auckland and Otago, the two NZ tertiary education institutions providing medical education, for the period 2016–2020 inclusive. These data are a subset of the larger project ‘Mirror on Society’ examining all regulated health professional enrolled students in NZ. Variables of interest: gender, citizenship, ethnicity, rural classification, socioeconomic deprivation, school type and school socioeconomic scores. NZ denominator population data (18–29 years) were sourced from the 2018 census.

Participants

2858 students were enrolled to study medicine between 2016 and 2020 inclusive.

Results

There were more women (59.1%) enrolled to study medicine than men (40.9%) and the majority (96.5%) were in the 18–29 years age range. Māori students (rate ratio 0.92; 95% CI 0.84 to 1.0) and Pacific students (rate ratio 0.85; 95% CI 0.73 to 0.98) had lower overall rates of enrolment. For all ethnic groups, irrespective of rural or urban origin, enrolment rates had a nearly log-linear negative relationship with increasing socioeconomic deprivation. Enrolments were lower for students from rural areas compared with those from urban areas (rate ratio 0.53; 95% CI 0.46–0.61). Overall NZ’s medical students do not reflect the diverse communities they will serve, with under-representation of Māori and Pacific students and students who come from low socioeconomic and rural backgrounds.

Conclusions

To meaningfully address these issues, we suggest the following policy changes: universities commit and act to Indigenise institutional ways of knowing and being; selection policies are reviewed to ensure that communities in greatest need of doctors are prioritised for enrolment into medicine (specifically, the impact of low socioeconomic status should be factored into selection decisions); and the government fund more New Zealanders to study medicine.

Tiempo de respuesta al timbre; una oportunidad para mejorar el flujo de trabajo

Introducción. Actualmente el timbre conecta a los pacientes con la expectativa de una asistencia inmediata cuando perciben una necesidad, ya sea para asistencia de rutina o tengan un cambio agudo en su condición. El tiempo de atención al timbre impacta en la calidad de atención, satisfacción del paciente, y el flujo de trabajo. El objetivo fue describir el tiempo promedio de la respuesta al timbre en la Unidad Coronaria. Metodología. Estudio transversal del tiempo de respuesta al timbre estratificado por turno. Se recogieron datos sociodemográficos de los pacientes, los motivos de la llamada al timbre, y la satisfacción de los pacientes de forma anónima y digital. Resultados. Se analizaron 200 timbres, con un tiempo promedio de 5’42”. El promedio de edad de los pacientes que accionaron el timbre fue de 56 años, de los cuales 51% eran mujeres. Los principales motivos de llamada fueron la movilización (24.9%) e higiene/eliminación (19.2%), y los pacientes se mostraron satisfechos siempre o casi siempre (81%) con el tiempo de atención al timbre. No se halló una asociación entre los días de internación y la cantidad de llamadas al timbre. Discusión. A pesar de que el tiempo es superior a los “minutos dorados”, los pacientes presentan un elevado grado de satisfacción. La variabilidad de los tiempos en los distintos turnos y los principales motivos de llamada por turno muestran un enorme desafío en la gestión de enfermería para anticipar y priorizar las necesidades que el paciente transmite a través del timbre.

Abstract

Introduction. Currently, the call light connects patients with the expectation of immediate assistance when they perceive a need, whether it is for routine assistance or a sudden change in their condition. The response time to the call bell impacts the quality of care, patient satisfaction, and workflow. The objective of this study was to describe the average response time to the call bell in the Coronary Unit. Methodology. A cross-sectional study of response time to the call bell stratified by shift, over 3 days, with a minimum of 7 days between each day. Sociodemographic data of patients, reasons for the call bell, and patient satisfaction were collected anonymously and digitally. Results. 200 call bells were analyzed, with an average response time of 5'42". The average age was 56 years, with 51% being female. The main reasons for calling were mobilization (24.9%) and hygiene/elimination (19.2%). Most patients were satisfied with the response time to the call bell (81% always or almost always). There was no association found between length of stay and the number of call bells. Discussion. Despite the response time being longer than the "golden minutes," patients show a high degree of satisfaction. The variability of response times in different shifts and the main reasons for calling by shift show a huge challenge in nursing management to anticipate and prioritize the needs that the patient expresses through the call bell.

Caídas: adherencia a las medidas de prevención en un hospital de alta complejidad

Objetivo. Determinar la adherencia a las medidas de prevención de caídas en pacientes adultos internados en un hospital de alta complejidad desde el año 2019 al 2021. Metodología. Estudio cuantitativo, observacional, descriptivo y transversal. La población de estudio fueron las auditorías de prevención de riesgo de caídas en adultos en un hospital de alta complejidad de Buenos Aires, Argentina. La selección de la muestra fue de tipo probabilístico aleatorio, estratificado según el año de recolección del dato (2019-2021). Se tomó una muestra de 246 reportes. Resultados. El porcentaje de adherencia a las medidas de prevención de caídas son: 82% del 2019, 100% del 2020; y en el 2021 del 86%. Dentro del conjunto de medidas, las que presentaron mayor adherencia a lo largo de los últimos 3 años fueron: punto azul en puerta y timbre, arrojando entre un 99-100% de adherencia. Mientras que las medidas relacionadas a la educación y el material educativo presentaron un descenso en el 2021, pasando del 100% de adherencia en el 2020, a 90% y 82% respectivamente. Discusión. Se observó que, a lo largo de los últimos 3 años, la adherencia a las medidas de prevención fue alto, arrojando un 89% de adherencia. En un análisis posterior, observamos que las medidas punto azul pulsera, punto azul puerta, frenos, altura, barandas, educación, timbre y teléfono; fue en aumento. Mientras que, la medida de prevención en relación al material educativo brindado al paciente presentó una disminución en su nivel de adherencia.

 

ABSTRACT

Objective. To measure adherence to prevention measures in adult patients admitted to a highly complex hospital from 2019 to 2021. Methodology. Quantitative, observational, descriptive and cross-sectional study. The population observed was based on audit about the prevention risk of falls in adults hospitalized in a high complexity hospital from Buenos Aires, Argentina. The selection of the sample was of random probabilistic type, stratified according to the year of data collection (2019-2021). A sample of 246 audits was taken. Results. The percentage of adherence to fall prevention measures are: 82% in 2019, 100% in 2020; and in 2021 86%. Within the set of measures, those that presented greater adhesion over the last 3 years were: blue dot on the door and bell, yielding between 99-100% adherence. While the measure related to education and educational material presented a decrease in 2021, going from 100% adherence in 2020, to 90% and 82% respectively. Discussion. It was observed that, over the last 3 years, adherence to prevention measures was high, showing 89% adherence. During a later analysis, we observed that the measurements blue dot bracelet, blue dot door, brakes, height, railings, education, doorbell and telephone; increased. Meanwhile, the prevention measure in relation to the educational material provided to the patient, decrease in its level of adherence. 

 

 

Calidad de vida de madres cuidadoras de niños con necesidades especiales de salud

Objetivo: evaluar la calidad de vida de los cuidadores de niños con necesidades especiales de salud. Método: estudio cuantitativo, en una Unidad de Pediatría, con 16 madres de niños con necesidades especiales de salud. La recolección de datos se produjo mediante la aplicación del instrumento WHOQOL-bref. Para el análisis de los datos se utilizó la estadística descriptiva e inferencial. Resultados: la calidad de vida de los familiares cuidadores es influenciada por los aspectos físicos; psicológica; del medio ambiente y de las relaciones sociales. Conclusiones: la percepción general de la calidad de vida de estos cuidadores no puede considerarse satisfactoria, ya que los valores asociados a todos los ámbitos son relativamente bajos.

Lesiones cutáneas en pacientes con enfermedades potencialmente mortales: cuidados en el entorno hospitalario

Objetivo principal: Conocer la percepción de los profesionales de enfermería sobre la prevención y tratamiento de lesiones en pacientes hospitalizados con enfermedades potencialmente mortales. Metodología: Estudio con enfoque cualitativo y cuantitativo, descriptivo y exploratorio, realizado en unidades clínicas, quirúrgicas, unidad de cuidados intensivos y unidad de urgencias de un hospital del sur de Brasil. Datos recogidos en 2014 mediante entrevistas semiestructuradas con 118 profesionales de enfermería. Resultados principales: Se identificaron tres categorías temáticas: La percepción de la atención; Prevención y tratamiento de lesiones; y Dificultades y estrategias para implementar la atención. Conclusión principal: El escenario de investigación no cuenta con unidad de cuidados paliativos. Realidad de la mayoría de los servicios, aumentando la posibilidad de desconocimiento del tema. Sin embargo, se cree que los resultados de este estudio pueden contribuir a reforzar la necesidad de esta línea de atención.

❌