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Surgical versus non-surgical management of orbital fractures: study protocol for evidence generation of a prospective multicentre observational cohort registry

Introduction

There remains little consensus or guidelines for the clinical management of traumatic orbital fractures (OFx). The OFx Registry aims to increase real-world clinical evidence for the treatment of OFx via prospective, multicentre, international data collection. The primary objectives of this observational cohort study are (1) to document current treatment practices for and (2) to assess the outcomes of surgical and non-surgical treatment of orbital floor and/or medial wall fractures.

Methods and analysis

Approximately 300 adult patients presenting with a displaced OFx in the orbital floor and/or medial wall will be enrolled prospectively over a recruitment period of ~36 months. All eligible patients treated either surgically or non-surgically as per routine standard of care will have follow-up assessments at 6 weeks, 3 months and 6 months post-treatment. Demographic data, injury details, treatment details and outcome measures will be documented in a cloud-based database. Outcome measures include clinical outcomes (eg, diplopia, extraocular motility, and condition of the eyelid, globe and soft tissues), radiological outcomes from collected images, patient-reported outcomes (eg, Diplopia Questionnaire and the newly developed AO Craniomaxillofacial (CMF) Injury Symptom Battery) and complications. A statistical analysis plan will be prepared before final analysis summarising the descriptive statistics to be used for data assessment. Appropriate research questions and statistical tests may be applied additionally, depending on the availability and quality of data collected.

Ethics and dissemination

Ethics approval was obtained before patients were enrolled at each participating site. Patient enrolment followed an informed consent process approved by the responsible ethics committee. Peer-reviewed publications are planned to disseminate the study results.

Trial registration number

NCT03887988.

Armonizando el cuidado: efectos de la música en directo en el bienestar de los pacientes oncológicos e intérpretes en el ámbito hospitalario

Introducción. Las intervenciones de música en directo pueden ayudar a mejorar el bienestar tanto psicológico como físico, emocional y espiritual. El presente proyecto nace de un trabajo colaborativo e interdisciplinar entre dos titulaciones de grado: Enfermería e Interpretación Musical. Objetivos. Analizar la efectividad de una intervención musical en directo en el bienestar de pacientes oncológicos. Metodología. Se plantea un estudio de diseño mixto. Un estudio cuasiexperimental sin aleatorización para evaluar el efecto de la intervención con grupo un control (N=33) y experimental (N=33) durante la administración del tratamiento en un hospital de día oncológico. Se recogerán variables sociodemográficas y clínicas (nivel de ansiedad, afectividad y signos vitales). También se analizarán los niveles de ansiedad y variación en los signos vitales en los intérpretes (estudiantes de música) antes y después de los ensayos y de la intervención. Se diseña un estudio cualitativo fenomenológico-hermenéutico para conocer las experiencias de los pacientes y los intérpretes tras la intervención musical. Aplicabilidad práctica. En este proyecto se destaca la importancia de la colaboración entre estudiantes de dos disciplinas complementarias en contextos sanitarios reales.

ABSTRACT

Introduction. Live music interventions can help enhance psychological, physical, emotional, and spiritual well-being. This research project stems from a collaborative and interdisciplinary effort between two undergraduate programs: Nursing and Musical Performance. Objectives. To analyze the effectiveness of a live music intervention on the well-being of oncology patients. Methodology. A mixed-methods study design is proposed. A quasi-experimental study without randomization will evaluate the effect of the intervention with a control group (N=33) and an experimental group (N=33) during chemotherapy treatment administration in a day hospital. Sociodemographic and clinical variables (anxiety levels, affectivity, and vital signs) will be collected. The levels of anxiety and changes in vital signs in the performers (music students) will be analyzed before and after rehearsals and the intervention. A phenomenological-hermeneutic qualitative study is designed to understand the experiences of the patients and performers after the musical intervention. Practical Applicability. This project emphasizes the importance of collaboration between students from two complementary disciplines in real healthcare settings, starting from their formative stages.

Exploring the Role and Skill Requirements of Registered Nurses Working in Rural and Remote Areas. A Scoping Review

ABSTRACT

Introduction

Registered nurses (RN)s account for the majority of the rural and remote health workforce and require different skills, knowledge and working practices compared to their metropolitan counterparts. Given the complexity and diversity of the rural and remote work environment, it is important to investigate the contemporary literature on the role and skill requirements of the RNs in these locations.

Methods

A scoping review was undertaken in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews. With the permission of the authors, this scoping review extends the work by Muirhead and Birks (2020) who explored the RN role in these locations in 2017. Database searches were conducted in the Cumulative Index for Allied Health and Nursing Literature (CINAHL), Cochrane, JBI, OVID (Emcare), Proquest, PubMed, Scopus and Rural and Remote Health Database. Studies published from November 2017 to June 2024 were included to reflect the current international roles of rural and remote RNs.

Results

A total of 74 articles were included in the study. The overarching categories identified were clinical roles and non-clinical roles. Ongoing analysis established the subcategories of fundamental/foundational, specialist, management roles, support roles and ancillary roles. Four tensions within the rural and remote context were also identified; Generalist and specialist role; Poorly prepared or unprepared; Extended scope of practice; and Role uncertainty.

Discussion

Registered Nurses in rural and remote locations conduct a wide variety of skills and tasks. Their role is expansive, context-dependant, and dynamic. Analysis of the literature found that globally, similarities exist for the role, including comparable challenges, barriers and opportunities Resource availability in a country impacts RN preparation, emphasising the need for systemic improvements to ensure equitable outcomes, especially in rural and remote areas.

Conclusion

The role of the rural and remote RN is broad and unique and requires different breadth and depth of skills and knowledge. The rural and remote RN role includes all levels of care for all patients across the lifespan, with varying resource and support levels. This scoping review provides valuable insight into the skills required to care for diverse communities. Understanding these requirements is essential, as it can inform the future focus on rural and remote nurse education and training and its subsequent impact on the quality of care for people living in rural and remote communities.

Systematic review of healthcare interventions for reducing gender‐based violence impact on the mental health of women with disabilities

Abstract

Purpose

Women with disabilities are more exposed to violence. The health sector has a key role in all three levels of prevention of violence against women. The objective of this paper was to review the interventions for preventing gender-based violence and reducing its impact on the mental health of women with any form of disability.

Method

Relevant studies were identified through conducting searches in PubMed, Scopus, CINAHL, PsyInfo, Social Services Abstracts, and PILOTS. Two reviewers analyzed and selected studies. A qualitative synthesis was made.

Results

3149 references were obtained, among which eight articles describing nine interventions from the USA and the UK. Most were intended for women with mental/intellectual disability and assessed intimate partner or sexual violence. Only one study showed high methodological quality. They were found to be particularly effective as regards improvement of the skills acquired by participants, but the results as regards improved mental health are not consistent.

Conclusion

Our review shows very little evidence of effective interventions. Further studies are required with higher internal validity and female sample groups with diverse disabilities.

Clinical Relevance

Gender-based violence is a highly prevalent problem for women with disabilities, and in addition to being a public health challenge is a violation of human rights. Health care systems and policymakers should take a key role in all three levels of prevention of violence against women with disabilities. Interventions with longer follow-up times are required. It is also important for interventions to be designed in consultation with people with disabilities.

Intervenciones enfocadas a la prevención de la formación de una hernia paraestomal en personas con ostomías de eliminación

Hombre de mediana edad, con vida sedentaria, al que se le practica un estoma de eliminación temporal. Objetivo: Identificar intervenciones consensuadas de autocuidado del paciente, basadas en la evidencia, con criterios de implementación y evaluación, destinadas a la prevención de hernias paraestomales. Metodología: Búsqueda bibliográfica de evidencia científica: Formulación de preguntas clínicas, localización de información, contextualización, (lectura crítica y síntesis de evidencias), implementación y evaluación (modelo PRAXIS: Interconexión de evidencia científica con conocimiento tácito de enfermera clínica, educando en prevención e involucrando al paciente a través de investigación-acción- participativa: Compartencia); Entrevista-recogida de datos de grupo focal para determinar recomendaciones de autocuidado. Resultados principales: 5 RBP y 17 prácticas de autocuidado. Conclusiones: RBP identificadas ampliamente reforzadas con prácticas de autocuidado aportadas por expertas del grupo focal. Problema principal: Adherencia al tratamiento. Se determinaron prácticas sencillas resolutivas. Carencia principal: Necesidad de mayor y mejor soporte psicológico, sexual, fisioterápico y nutricional.

Perinatal contraceptive counselling: Effectiveness of a reinforcement intervention on top of standard clinical practice

To assess the effectiveness of supplemental perinatal contraceptive counselling in addition to standard Spanish postpartum contraceptive counselling with regard to contraceptive use and use of effective contraception up to 1 year postpartum. Women's satisfaction with counselling and the method chosen was also assessed.
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