Conectar
by Naoya Nakagawa, Ami Igarashi, Hideaki Yokogawa, Akira Kobayashi, Tomomi Higashide, Satoru Yamagami, Takahiko Hayashi
The aim of this study was to identify the clinical factors associated with postoperative visual acuity following Descemet’s membrane endothelial keratoplasty (DMEK), with emphasis on the impact of macular diseases. This retrospective multicenter study included consecutive eyes that underwent DMEK between March 1, 2011, and June 30, 2022, and had available optical coherence tomography findings. Eyes with other ocular diseases causing visual loss were excluded. Overall, 77 eyes of 66 patients were included in the study. Univariable and multivariable regression analyses were performed to identify the predictors of best-corrected visual acuity (BCVA) at the final follow-up. Worse preoperative visual acuity and macular comorbidity were identified as independent predictors of poorer postoperative BCVA. Among macular pathologies, cystoid macular edema was most strongly correlated with reduced vision in the univariable analysis (β = 0.195; p = 0.016). In the subgroup analysis, worse preoperative visual acuity and macular comorbidity remained significant predictors (pTo evaluate emergency patient care from a chronophysiological perspective, examining circadian variations in symptom presentations and physiological parameters.
Single-centre retrospective analysis.
Department of Emergency Medicine, Clinical Centre, University of Pécs, Hungary (August 2022 to August 2023).
Patient data including symptom categories, time of presentation (divided into eight 3-hour intervals), sex and age were collected. A total of 32 977 patient records were analysed. Symptoms were classified using the International Classification of Diseases, 10th Revision. For hypertension, random proportionally stratified sampling was performed (n=120).
Primary outcomes were the circadian distribution of emergency presentations across 14 symptom categories and their variation by time of day, age and sex. Secondary outcomes included diurnal variation in hypertension-related cases, examining blood pressure, pulse rate, triage time and medication use.
Cardiovascular cases peaked between 09:00 and 12:00 (p
Symptom presentations in emergency care follow distinct circadian patterns, highlighting the influence of biological rhythms on clinical demand. Recognition of these temporal trends may support more effective ED scheduling and resource allocation.
To assess the comparative effectiveness of educational interventions in neurological disease for healthcare workers and students.
Systematic review.
Medline, Embase and Cochrane through to 1 June 2025.
Studies evaluating neurological disease educational interventions with a comparator group (observational cohort/randomised controlled trial (RCT)) were included.
A Preferred Reporting Items for Systematic Reviews and Meta-Analyses-compliant systematic review was conducted (PROSPERO: CRD42023461838). Knowledge acquisition and educational methodologies were collected from each study. Study outcomes were classified using the Kirkpatrick and Kirkpatrick four-level model (learner reaction, knowledge acquisition, behavioural change, clinical outcome).1 Risk of bias was assessed using the Newcastle-Ottawa scale for non-randomised studies and the Cochrane Risk of Bias tool for RCTs.2 3
A total of 67 studies involving 4728 participants were included. Of these, 36 were RCTs, and 31 were observational studies. Virtual interventions were the most common (67.2%, n=45 studies), primarily targeting either medical students (46.3%, n=31 studies) or specialists (40.3%, n=27 studies). Overall, 70.1% (n=47) of studies demonstrated outcomes in favour of the intervention. However, few studies used K&K level 3/4 outcomes, with two studies evaluating behaviour change (level 3) and three assessing clinical outcomes (level 4 combined with other levels). No study exclusively assessed level 4 outcomes. Meta-analysis of 22 RCTs with calculable standardised mean differences (SMDs) (n=1748) showed a significant benefit of interventions (SMD 0.75, 95% CI 0.22 to 1.27, p=0.0056).
This review highlights a growing body of research particularly focusing on virtual techniques, specialist audiences and treatment-oriented content. Few studies assessed changes in practice or patient care. Non-specialists remain underrepresented. Future studies should prioritise assessing the clinical impact of educational interventions within non-specialist audiences.
Predicting medical/surgical nurses' delivery of patient pressure injury prevention education within 24 h of hospitalisation.
A cross-sectional sub-study drawn from a larger multisite randomised controlled trial.
A consecutive sub-sample of 300 randomly assigned control group participants was recruited from 20 medical and surgical wards at two major hospitals (July 2020 to August 2023) in Queensland, Australia. Semi-structured observations and chart audit data were collected, including patient education, demographic and clinical data. Binary logistic regression identified hospital site, clinical and patient predictors contributing to pressure injury prevention education delivery by nurses.
Seventeen (5.7%) participants received pressure injury prevention education within the first 24 h of admission. Body mass index was an independent predictor, increasing the odds of nurses delivering patient education.
Few episodes of pressure injury prevention education were observed in this study. As a patient's body mass index rises, they are more likely to receive preventative education from nurses soon after admission.
Our findings underscore the need for standardised inclusive protocols and ongoing nurse training to assess and address education needs beyond single risk factors like body mass index. Further research should explore other factors influencing patient education delivery in hospitals.
This study adhered to STROBE guidelines. Dr. Brett Dyer, statistician, is part of the author team.
No patient or public contribution.
A comprehensive understanding of the impact of environmental noise on patient outcomes is crucial for nurses who play key roles in sound environment adjustments. However, no review has comprehensively explored these effects in hospitalized patients.
To synthesize evidence on the impact of noise on inpatient outcomes, providing a comprehensive view.
This scoping review was conducted in accordance with the Joanna Brigs Institute methodology for scoping reviews and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines. We searched PubMed, CINAHL Plus, and the Cochrane Library for articles published in January 2024.
We identified 28 eligible articles. In the 28 articles, the most common patient outcome was sleep, followed by psychological state, physiological state, satisfaction and well-being, delirium, pain, and unplanned readmission. Further, 21 (75.0%) articles included only patients in intensive care units (ICUs), 25 (89.3%) used cross-sectional analysis, and only 13 (46.4%) performed multivariable analysis adjusted for confounding factors. In the 13 articles that used multivariable analysis, noise was associated with decreased sleep quantity and quality in both ICU and ward patients, increased delirium risk in ICU patients, increased risk of readmission within 30 and 90 days after hospital discharge, increased heart and respiratory rates in ICU patients, and increased anxiety in ICU patients.
Nurses need to pay more attention to the negative impact of noise on inpatient outcomes. The findings of this study would promote the comprehensive understanding of nurses on noise impact on inpatient outcomes and their commitment to noise reduction in hospital environments.
FreshRSS 