Conectar
by Laura Maniscalco, Marco Enea, Peter de Winter, Neeltje de Vries, Anke Boone, Olivia Lavreysen, Kamil Baranski, Walter Mazzucco, Adriano Filadelfio Cracò, Malgorzata Kowalska, Szymon Szemik, Lode Godderis, Domenica Matranga
According to the World Health Organization (WHO), in 2022 there was a shortfall of approximately 1.2 million doctors, impacting healthcare system and patient care. Understanding turnover intentions is crucial for managing the healthcare workforce and ensuring continuous, and high-quality patient care. This study investigates the prevalence of physicians planning to leave their hospital or the profession, and risk factors such as job demand, resources, satisfaction, and burnout across four European countries. A cross-sectional multicenter study was conducted in eight hospitals across Belgium, the Netherlands, Poland and Italy, including both academic and non-academic institutions. Data from Poland were excluded due to a low response rate, to preserve respondent anonymity. Multivariable logistic regression analyses were performed, adjusted for country, demographics, and work context, using significant variables from the univariable analysis. The overall intention to leave the hospital was 16.5%, with the highest rates in Belgium (19.6%) and Italy (19%), and the lowest in the Netherlands (9.8%). The intention to leave the profession was 9.1%, with the highest rate in the Netherlands (16.1%), followed by Belgium (6.3%) and Italy (5.7%). Physicians at higher risk of leaving the hospital were younger (adjOR = 0.90, 95%CI = 0.86–0.93), lacked colleague support (adjOR = 3.18, 95%CI = 1.06–9.36), and were dissatisfied with job prospects (adjOR = 2.38, 95%CI = 1.02–5.54) and overall work (adjOR = 2.71, 95%CI = 1.09–6.69). Those more likely to leave the profession were from the Netherlands (adjOR = 4.14, 95%CI = 1.62–11.4), surgeons (adjOR = 2.90, 95%CI = 1.22–6.78), working in non-academic hospitals (adjOR = 2.43, 95%CI = 1.01–5.97), lacked development opportunities (adjOR = 5.97, 95%CI = 1.01–36.2), or were dissatisfied with career prospects (adjOR = 2.77, 95%CI = 1.04–7.27). Health system managers and relevant stakeholders involved in the planning, implementation, or evaluation of health policies and reforms aimed at improving healthcare job retention should take into account the key determinants of the intention to leave identified in this study.Traditional peoples and communities (TPCs), such as indigenous peoples and quilombolas (communities descended from escaped African slaves), face challenges related to food security and the impact of the food environment on their health. Changes in food systems, urbanisation and loss of territorial rights have contributed to less healthy eating patterns, with increased consumption of ultra-processed foods and a higher prevalence of chronic non-communicable diseases. Despite this, there are gaps in knowledge about how the food environments of these communities are investigated, especially in relation to the physical, economic, political and sociocultural dimensions.
This scoping review will be conducted following the methodological framework developed by the Joanna Briggs Institute for scoping reviews, and its reporting will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Extension for Scoping Reviews checklist. A systematic search will be carried out in the following databases: PubMed, SciELO, Web of Science, Embase and EBSCO, using terms related to traditional populations and food environments. The studies to be included will be selected according to the inclusion and exclusion criteria defined based on the population, concept and context technique. The study population will include TPCs, such as indigenous peoples and quilombolas; the concept will address the food environment in its physical, economic, political and sociocultural dimensions; and the context will encompass studies conducted at a global level, without any restrictions on geographic location. The study type will include original articles and grey literature. The screening of studies will involve independent reviewers and predefined inclusion and exclusion criteria. Data synthesis will be presented in tables, including information on focus, geographic scope and methodology of the selected studies. The risk of bias will be assessed using the Risk of Bias in Non-randomised Studies of Exposure tool.
As the study does not involve the collection of primary data or human participants, it does not require ethical approval. The results will be submitted to peer-reviewed journals and presented at public health and nutrition conferences, contributing to the advancement of knowledge on food environments of TPCs.
Resumen:
Introducción. El uso en pediatría de adhesivos tisulares como el cianocrilato para el cierre de heridas ofrece ventajas significativas. Es un procedimiento sencillo rápido e indoloro, conformándose como una alternativa en la población pediátrica debido a las características específicas de estos pacientes. Objetivo. Evaluar la efectividad del adhesivo tisular con cianocrilato en el cierre de heridas en zonas pilosas y mentón. Metodología. Se diseñó un estudio observacional prospectivo conformado por pacientes pediátricos que acudieron a urgencias con heridas que requerían sutura en zona mentoniana, ceja y cuero cabelludo. Se valoraron variables demográficas y clínicas, así como la colaboración del menor y grado de satisfacción de padres y profesionales tras la aplicación de cianocrilato. A los 3 meses se valoró la cicatrización. Los datos se analizaron mediante el programa estadístico SSPS. Resultados. Las heridas en zonas pilosas presentaron una correcta epitelización con un índice ≤ 2 según escala de Vancouver. Se establecieron diferencias estadísticamente significativas entre la localización de la herida y su cicatrización (p<0.05). Se objetivó un grado de concordancia moderado entre la satisfacción de los padres y los profesionales con un p-valor < 0.001. Discusión. Los adhesivos tisulares con base de cianocrilato parecen una alternativa válida y segura para la reparación de heridas en zonas con folículo piloso. Cuenta con la aprobación de pacientes, familiares y profesionales que realizaron el procedimiento. Los resultados respecto a la cicatrización evaluados a los 3 meses son más satisfactorios en áreas pilosas.
ABSTRACT
Introduction. The use of tissue adhesives like cyanoacrylate for wound closure in pediatrics offers significant advantages. It is a simple, fast, and painless procedure, making it an alternative in the pediatric population due to the specific characteristics of these patients. Objective. To evaluate the effectiveness of tissue adhesive with cyanoacrylate in closing wounds on the scalp or hairy areas and the chin region. Methodology. A prospective observational study was designed, consisting of pediatric patients who presented to the emergency department with wounds requiring sutures in the chin, eyebrow, and scalp areas. Demographic and clinical variables were assessed, as well as the cooperation of the child and the satisfaction level of parents and healthcare professionals after the application of cyanoacrylate. Scar healing was assessed at 3 months. Data were analyzed using the statistical software SPSS. Results. Wounds in hairy areas showed proper epithelialization with an index ≤2 according to the Vancouver scale. Statistically significant differences were found in the relationship between wound location and its healing (p<0.05). Additionally, a moderate level of agreement was observed between parent and professional satisfaction, with a p-value <0.001. Discusión. Cyanoacrylate-based tissue adhesives appear to be a valid and safe alternative for wound repair in areas with hair follicles. They are well-received by patients, their families, and the professionals who performed the procedure. The results regarding scar healing evaluated at 3 months are more satisfactory on the scalp and eyebrow compared to the chin region.
Introducción. La pandemia del SARS-CoV-2 ha supuesto un fuerte impacto en la población, incluida la pediátrica, a pesar de que esta se ve menos afectada por la COVID-19. Para poder cubrir el aumento de la demanda sanitaria, fue necesaria la reorganización de todo el sistema sanitario, especialmente en los servicios de críticos y urgencias. Material y métodos. Estudio observacional descriptivo longitudinal trata de evaluar el impacto de la pandemia en el servicio de urgencias pediátricas de un hospital público de tercer nivel de Castilla y León, analizando las características de los pacientes menores de 14 años que fueron atendidos entre el 2019 y 2020 en dicho servicio. Se registraron datos demográficos y asistenciales de cada una de esas visitas en una base de datos. Resultados.
Los datos mostraron un fuerte descenso en el número de atenciones a pesar de lo cual se produjo un aumento en la proporción de ingresos. La afluencia según los diferentes motivos de consulta, niveles de triaje y grupos de edad mostró una tendencia similar entre los dos años, a pesar de la disminución en números absolutos. Se observó un repunte en la proporción de atenciones clasificadas con niveles de gravedad más urgente. Discusión. La bibliografía consultada constata la disminución en el número de urgencias y el aumento de gravedad de los niveles de triaje, que se refleja en un aumento del porcentaje de ingresos. Parece evidenciarse una disminución de las enfermedades infecciosas y traumatológicas y un repunte de problemas de salud mental y convulsiones.
ABSTRACT
Introduction. The SARS-CoV-2 pandemic has had a strong impact on the population, including the pediatric population, despite the fact that it is less affected by COVID-19. In order to cover the increase in health demand, it was necessary to reorganize the entire health system, especially in critical and emergency services. Material and methods. This longitudinal descriptive observational study tries to evaluate the impact of the pandemic on the pediatric emergency service of the HCUV by analyzing the characteristics of patients under 14 years of age who were treated between 2019 and 2020 in said service. Demographic and care data from each of these visits were recorded in a database. Results.
The data show a strong decrease in the number of visits, despite which there was an increase in the proportion of income. The influx according to the different reasons for consultation, triage levels and age groups shows a similar trend between the two years, despite the decrease in absolute numbers. A rebound is observed in the proportion of care classified as more urgent levels of severity. Discussion. The bibliography consulted confirms the decrease in the number of emergencies and the increase in severity of triage levels, which is reflected in an increase in the percentage of admissions. There seems to be a decrease in infectious and traumatic diseases and a rebound in mental health problems and seizures.
FreshRSS 