Conectar
We designed the Optimising Care in Critically Ill at the UCHealth by Liberalising the Target O2 in Mechanically ventilated intensive care unit (ICU) Patients to determine the effectiveness of a multimodal educational and electronic health record order panel intervention in limiting occult hypoxaemia and hyperoxaemia in patients receiving invasive mechanical ventilation by targeting a prespecified oxygen saturation (SpO2 90%–96%) range.
This trial is a pragmatic electronic health record-embedded, multisite, cluster-randomised, stepped-wedge implementation of a multimodal educational and electronic health record order panel intervention aimed at achieving a standardised intermediate target range of SpO2 (90%–96%) or partial pressure of oxygen (PaO2 60–100 mm Hg) in mechanically ventilated adult patients admitted to the ICU across a 10 hospital health system that includes a large academic centre and smaller community hospitals.
The primary endpoint is ventilator-free days to day 30, defined as the number of days alive and not receiving support through invasive mechanical ventilation following the first initiation of invasive mechanical ventilation in a participating ICU during the hospitalisation. Secondary outcomes include a variety of clinical endpoints: hospital-free days to day 30, all-cause mortality to day 90, need for supplemental oxygen at discharge and incidence of occult hypoxaemia and hypoxaemia. We will analyse primary and secondary endpoints using a mixed effects modelling framework, with specific distributions chosen depending on the type of outcome (eg, binary, count, ordinal, time-to-event).
Research is performed under a waiver of informed consent for minimal-risk research, as approved by Colorado Multiple Institutional Review Board (24-0065). Results will be disseminated in peer-reviewed publications and at national and international conferences.
Interprofessional education (IPE) is a key factor, preparing students for collaboration to improve quality in healthcare. Current literature implies that IPE research needs to be relevant for students, teachers and stakeholders ensuring that research answers the most important research issues. Therefore, the objective of this study was to establish outcomes of a partnership between students, teachers and clinicians to rank the top 10 research priorities for IPE.
James Lind Alliance Priority Setting Partnership (JLA).
Higher health education in Sweden.
Students, teachers and healthcare professionals (clinicians).
According to the JLA process, a steering committee was established. A pilot survey to gather research uncertainties highly relevant for participants was performed and tested by the content validity index. The pilot survey was followed by a main survey with 53 participants and a final workshop to determine the top 10 research priorities.
The content validity index was satisfactory for 23 out of 27 research uncertainties, followed by minor changes and removal of three uncertainties. After processing the 24 uncertainties from the main survey, 21 remained in the workshop. The final top 10 research priorities included measurements to evaluate IPE, promoting and hindering factors for IPE, educational models for IPE, longitudinal studies on effects from IPE and implementation of IPE.
The priorities represent consensus areas from students, teachers and clinicians to guide future research and justify and inform strategic allocation of research funding.
Respiratory syncytial virus (RSV) is a significant cause of respiratory infections in young children. Since 2021, RSV has been a notifiable disease in Australia. However, current surveillance systems focus on hospitalised RSV, with limited surveillance at a community level through primary care clinics. This approach only captures RSV requiring hospitalisation. Less severe illnesses, while not captured, may have significant social and economic impacts including the associated cost of care and absenteeism. The aim of this study is to establish an understanding of the broader burden of RSV in young children in a community setting.
The PATROL (Parents Actively Tracking RSV in Little Ones) project is a prospective longitudinal observational study of RSV and other respiratory viruses in children
Incidence rates of RSV illness and asymptomatic carriage will be calculated and compared with the incidence rate ratios of other respiratory viruses.
The Government of Western Australia Child and Adolescent Health Service Human Research Ethics Committee approved all study materials. Results and findings will be disseminated through manuscripts, conference abstracts and presentations, participant newsletters and appropriate general news media items.
To describe the variation in nurse educators' conceptions of how they facilitate critical thinking in bachelor nursing students.
Qualitative study with a phenomenographic approach.
Data was collected through twenty-six semi-structured interviews with nurse educators conducted in Sweden between March and June 2024.
The result of this study can be understood as five descriptive categories: Creating a safe and trustful relationship with the students, Encouraging a dialogue with the students, Using space as a tool, Using artefacts as a tool, and Using oneself as a tool.
The conclusion is that the facilitation of critical thinking needs to be based on a safe and trustful relationship between educators and students. Without this relationship, it is not possible to establish the central dialogue, where the educator can facilitate critical thinking through asking counterquestions and provoking the students.
To become critical thinkers, the students need to put their knowledge and assumptions in a new light and question them. Here, the educator has a vital role in being the guide and facilitator.
The result indicated that it is vital for the educators to build a safe relationship with the students. The relationship is a precondition for the facilitative dialogue where the educators can ask reflective and provoking questions to stimulate critical thinking. Future nurses need to be prepared with critical thinking to enable evidence-based clinical decisions both during clinical practice as well as when being registered nurses.
SRQR guidelines.
This study did not include patient or public involvement in its design, conduct, or reporting.
Background
In the United States, Black adults have the highest prevalence of obesity and hypertension, increasing their risk of morbidity and mortality. Caregivers of persons with dementia are also at increased risk of morbidity and mortality due to the demands of providing care. Thus, Black caregivers—who are the second largest group of caregivers of persons with dementia in the United States—have the highest risks for poor health outcomes among all caregivers. However, the physiological changes associated with multiple chronic conditions in Black caregivers are poorly understood.
Objectives
In this study, metabolomics were compared to the metabolic profiles of Black caregivers with obesity, with or without hypertension. Our goal was to identify metabolites and metabolic pathways that could be targeted to reduce obesity and hypertension rates in this group.
Methods
High-resolution, untargeted metabolomic assays were performed on plasma samples from 26 self-identified Black caregivers with obesity, 18 of whom had hypertension. Logistic regression and pathway analyses were employed to identify metabolites and metabolic pathways differentiating caregivers with obesity only and caregivers with both obesity and hypertension.
Results
Key metabolic pathways discriminating caregivers with obesity only and caregivers with obesity and hypertension were butanoate and glutamate metabolism, fatty acid activation/biosynthesis, and the carnitine shuttle pathway. Metabolites related to glutamate metabolism in the butanoate metabolism pathway were more abundant in caregivers with hypertension, while metabolites identified as butyric acid/butanoate and R-(3)-hydroxybutanoate were less abundant. Caregivers with hypertension also had lower levels of several unsaturated fatty acids.
Discussion
In Black caregivers with obesity, multiple metabolic features and pathways differentiated among caregivers with and without hypertension. If confirmed in future studies, these findings would support ongoing clinical monitoring and culturally tailored interventions focused on nutrition (particularly polyunsaturated fats and animal protein), exercise, and stress management to reduce the risk of hypertension in Black caregivers with obesity. 
FreshRSS 