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To understand the factors that contribute to the risk of suicide among lesbian, gay, bisexual, transgender, queer, intersex and asexual (sexual minorities) youth.
The increase in the likelihood of suicide has made it an urgent issue in public health, particularly among young people, where it now ranks as the fourth leading cause of death. This issue becomes even more significant when focusing on sexual minorities.
A cross-sectional study was performed in targeted young individuals (15–29 years). Several variables were assessed, including suicide risk, self-esteem, presence and severity of depressive symptoms, perceived social support and self-reported levels of anxiety and depression.
Statistically significant disparities were observed in suicide risk, presence of depressive symptoms and self-reported levels of anxiety and depression, all of which were more pronounced in sexual minority youth compared to heterosexual cisgender individuals. Likewise, statistically significant differences were noted concerning self-esteem and family support, both of which were lower in sexual minority youth.
This study has identified risk factors, such as anxiety, depression and limited social support, as well as protective factors, like higher self-esteem and self-concept. Understanding and addressing all these factors are essential in reducing the elevated rates of suicide among sexual minority youth. Consequently, evidence-based interventions such as Gender and Sexuality Alliances, which empower and create safe spaces for sexual minority youth, possess substantial potential for effectively addressing this issue.
Given sexual minorities vulnerability, healthcare pros, especially nurses, must grasp suicide risk factors. They can help by educating, offering care, assessing risk and fighting stigma. This guarantees safety and access to mental health services for at-risk individuals from sexual minorities.
The reporting follows the STROBE checklist.
People who were invited to participate voluntarily completed a range of questionnaires.
Nutrition during the complementary feeding period (6–23 months) is critical to ensure optimal growth and reduce the risk of diet-related disease across the life course. Strategies to reduce multiple forms of malnutrition (stunting, overweight/obesity and anaemia) in infants and young children (IYC) are a key priority in low-income and middle-income countries, including Peru. This study aims to co-design and develop prototypes for interventions to address the multiple forms of malnutrition in IYC in urban Peru, using a participatory design approach.
The study will be based within peri-urban communities in two areas of Peru (Lima and Huánuco city). Following the identification of key nutritional challenges for IYC aged 6–23 months through formative research (phase I), we will conduct a series of workshops bringing together healthcare professionals from government health centres and caregivers of IYC aged 6–23 months. Workshops (on idea generation; creating future scenarios; storyboarding and early implementation and feedback) will take place in parallel in the two study areas. Through these workshops, we will engage with community participants to explore, experiment, co-design and iteratively validate new design ideas to address the challenges around IYC complementary feeding from phase I. Workshop outputs and transcripts will be analysed qualitatively using affinity diagramming and thematic analyses. The intervention prototypes will be evaluated qualitatively and piloted with the participating communities.
Ethical approval for this study was obtained from the Ethical Review Committee of the Instituto de Investigación Nutricional (IIN) Peru (388-2019/CIEI-IIN), Loughborough University (C19-87) and confirmed by Cardiff University. Findings of the participatory design process will be disseminated through a deliberative workshop in Lima, Peru with national and regional government stakeholders, as well as participants and researchers involved in the design process. Further dissemination will take place through policy briefs, conferences and academic publications.
To gain staff feedback on the implementation and impact of a novel ambulatory monitoring system to support coronavirus patient management on an isolation ward.
Qualitative service evaluation.
Semi-structured interviews were conducted with 15 multidisciplinary isolation ward staff in the United Kingdom between July 2020 and May 2021. Interviews were audio-recorded, transcribed and analysed using thematic analysis.
Adopting Innovation to Assist Patient Safety was identified as the overriding theme. Three interlinked sub-themes represent facets of how the system supported patient safety. Patient Selection was developed throughout the pandemic, as clinical staff became more confident in choosing which patients would benefit most. Trust In the System described how nurses coped with discrepancies between the ambulatory system and ward observation machines. Finally, Resource Management examined how, once trust was built, staff perceived the ambulatory system assisted with caseload management. This supported efficient personal protective equipment resource use by reducing the number of isolation room entries. Despite these reported benefits, face-to-face contact was still highly valued, despite the risk of coronavirus exposure.
Hospital wards should consider using ambulatory monitoring systems to support caseload management and patient safety. Patients in isolation rooms or at high risk of deterioration may particularly benefit from this additional monitoring. However, these systems should be seen as an adjunct to nursing care, not a replacement.
Nurses valued ambulatory monitoring as a means of ensuring the safety of patients at risk of deterioration and prioritizing their workload.
The findings of this research will be useful to all those developing or considering implementation of ambulatory monitoring systems in hospital wards.
This manuscript follows the Consolidated criteria for Reporting Qualitative Research (COREQ) guidelines with inclusion of relevant SQUIRE guidelines for reporting quality improvement.
No Patient or Public Contribution.
by Carlos Ignacio Reyes-Farias, Marcelo Reategui-Diaz, Franco Romani-Romani, Larry Prokop
BackgroundSodium-glucose cotransporter 2 (SGLT-2) inhibitors have shown a favorable effect on cardiovascular and renal outcomes in patients with type 2 diabetes mellitus (T2DM). However, their efficacy in patients with chronic kidney disease (CKD) with or without T2DM has not yet been analyzed.
ObjectiveTo assess the cardiovascular and renal effects of SGLT-2 inhibitors in patients with CKD with and without T2DM, including all CKD patients in the current literature.
MethodsWe searched MEDLINE, EMBASE, CENTRAL and Scopus for randomized controlled trials of SGLT-2 inhibitors that evaluated cardiovascular and kidney outcomes in patients with CKD, or trials in which these patients were a subgroup. We defined 2 primary outcomes: a composite of cardiovascular death or hospitalization for heart failure, and a composite renal outcome. For each outcome, we obtained overall hazard ratios with 95% confidence intervals by using a random effects model.
ResultsWe included 14 randomized controlled trials. SGLT-2 inhibitors decreased the hazard for the primary cardiovascular outcome (HR 0.76; [95% CI 0.72–0.79]) and the primary renal outcome (HR 0.69; [95% CI 0.61–0.79]) in patients with CKD with or without T2DM. We did not find significant differences in the subgroup analyses according to diabetes status, baseline eGFR values or the type of SGLT-2 inhibitor used.
ConclusionIn patients with CKD, treatment with SGLT-2 inhibitors in addition to standard therapy conferred protection against cardiovascular and renal outcomes. Further research on patients with non-diabetic CKD should be done to confirm the utility of these medications in this population. (PROSPERO ID: CRD42021275012).
The United Kingdom Childhood Cancer Study’s (UKCCS’s) matched cohort was established to examine the longer term morbidity and mortality of individuals previously diagnosed with cancer before 15 years of age, comparing future healthcare patterns in 5-year cancer survivors to baseline activity seen in age- and sex-matched individuals from the general population.
Predicated on a national childhood cancer case-control study conducted in the early 1990s (4430 cases, 9753 controls) in England, Scotland and Wales, the case population comprises 3125 cancer survivors (>5 years), and the control population 7156 age- and sex-matched individuals from the general population who did not have cancer as a child. Participants are now being followed up via linkage to national administrative healthcare databases (deaths, cancers and secondary care hospital activity).
Enabling the creation of cohorts with minimal selection bias and loss to follow-up, the original case-control study registered all newly diagnosed cases of childhood cancer and their corresponding controls, regardless of their family’s participation. Early findings based on the registered case population found marked survival variations with age and sex across subtypes and differences with deprivation among acute lymphoblastic leukaemia (ALL) survivors. More recently, comparing the health-activity patterns of the case and control populations revealed that survivors of childhood ALL experienced excess outpatient and inpatient activity across their teenage/young adult years. Adding to increased risks of cancer and death and involving most clinical specialties, excesses were not related to routine follow-up monitoring and showed no signs of diminishing over time.
With annual linkage updates, the UKCCS’s maturing population-based matched cohorts provide the foundation for tracking the health of individuals through their lifetime. Comparing the experience of childhood cancer survivors to that of unaffected general-population counterparts, this will include examining subsequent morbidity and mortality, secondary care hospital activity and the impact of deprivation on longer term outcomes.
Objetivo principal: comparar los dispositivos supraglóticos frente a los dispositivos infraglóticos no quirúrgicos en el manejo de la vía aérea, para determinar cuál de ellos reúne las mejores condiciones para un uso eficiente en la atención en urgencias y emergencias. Metodología: la búsqueda fue realizada en las bases de datos de Pubmed, Cinahl y Scopus, incluyendo todos aquellos ensayos clínicos aleatorizados cuya antigüedad no sobrepasase los 10 años, redactados tanto en inglés como en español en población pediátrica o adulta. Se excluyeron ensayos realizados en cadáveres o maniquíes. Para evaluar su calidad metodológica hemos utilizado la escala PEDro. Resultados principales: encontramos un total de 8 ensayos clínicos que cumplieron con los criterios de inclusión. Conclusión principal: sería conveniente, pero no necesario, utilizar dispositivos supraglóticos en situaciones de emergencia.
FreshRSS 