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Mapping behavioural interventions to reduce sugar-sweetened beverage (SSB) consumption among US adults: a scoping review protocol

Por: Cruz · J. · Palma · H. · Marshall · C. D. · Castellon-Lopez · Y. · Datta · G. D. · Torres · V.
Introduction

Sugar-sweetened beverages (SSBs) are sugary drinks such as sodas, fruit drinks and sweetened teas and are the leading source of added sugars in the American diet. SSBs are also linked to chronic diseases like type 2 diabetes, cardiovascular disease and certain cancers. Despite their well-known health risks, SSB consumption remains high in the United States of America (USA), with 63% of adults consuming them daily, often exceeding the recommended limit of 50 g of added sugar per day. Though efforts to reduce SSB intake through educational programmes, policy initiatives and taxes exist, further research is needed to assess the effectiveness of interventions to reduce SSB consumption in the USA. Understanding the role of behavioural interventions in lowering SSB consumption among adults is critical to address public health strategies.

Methods and analysis

The proposed scoping review will be conducted in accordance with the Joanna Briggs Institute methodological framework for scoping reviews. An advanced search will be conducted in three electronic databases: PubMed, PsycINFO and Scopus. The reference lists of included studies will also be reviewed to identify additional relevant literature. All identified citations will be compiled in EndNote, and duplicate citations will be eliminated. Identification of studies will occur through the three-step search process: (1) initial screening of studies according to inclusion criteria, (2) eligibility determined through full-text assessment and (3) inclusion of qualified studies meeting the criteria. To be included, studies must report on an existing behavioural intervention to reduce SSB consumption. All studies will undergo screening by two independent reviewers. Any disagreements that arise will be resolved through discussion or with an additional reviewer. A data extraction tool has been developed to extract relevant data from all eligible studies. The extracted data will be presented in a diagrammatic form, alongside a narrative summary, in line with Preferred Reporting Items for Systematic Reviews and Meta-Analysis: extension for Scoping Reviews reporting guidelines.

Ethics and dissemination

Ethics approval was not sought as all data will be collected from published literature. We will present our findings at relevant conferences and submit manuscripts for publication in peer-reviewed journals.

How Often Are Hospitalised Children Physically Restrained During Painful and Stressful Procedures?

ABSTRACT

Aim

To analyse the incidence of physical restraint use during painful and stressful procedures in hospitalised children, as well as the factors associated with its use.

Design

Observational, longitudinal and prospective study.

Methods

Children aged between 28 days and 10 years in a public hospital in Brazil were each observed undergoing clinical procedures over a 6-h period. Data were collected on demographics, observed pain using validated measures, stress behaviours, and the use of physical restraint. Descriptive and inferential analyses were performed. National ethical guidelines were strictly followed.

Results

1210 procedures were observed on 75 children, including 351 painful and 859 stressful procedures. Physical restraint was used in 270 (22.3%) procedures; of these, 131 (48.5%) were painful procedures and 139 (51.5%) were stressful procedures. In stressful procedures, at least one stress-related behaviour was observed before the initiation of physical restraint. Factors associated with increased use of physical restraint during painful procedures were younger children, with higher levels of care dependency, higher pain scores during procedures, and those who underwent intravenous medication administration, airway suctioning, tube insertion, and fixation changes. In stressful procedures, the factors associated with higher use of physical restraint were younger children, hospitalisation due to respiratory conditions, those who underwent physical examinations, inhaled medication, and nasal lavage; and the child's expression of stress behaviour before the procedure starts. Predictors of physical restraint included morning period, younger age group, male or female sex, and transfer from the Intensive Care Unit.

Conclusion

A high incidence of physical restraints was observed across multiple painful and stressful procedures performed within a 6-h period, associated with variables related to both the child's characteristics and the procedures.

Implications for the Profession and/or Patient Care

This study aims to encourage reconsideration of the frequent use of physical restraint in paediatric procedures, calling for a reframing of its application as an unquestioned practice toward an approach that prioritises protecting and respecting a child as a subject with needs, rights, and desires.

Reporting Method

Strengthening the Reporting of Observational studies in Epidemiology (STROBE).

Prenatal detection of congenital heart defects using the deep learning-based image and video analysis: protocol for Clinical Artificial Intelligence in Fetal Echocardiography (CAIFE), an international multicentre multidisciplinary study

Por: Patey · O. · Hernandez-Cruz · N. · DAlberti · E. · Salovic · B. · Noble · J. A. · Papageorghiou · A. T. · CAIFE Research Group · Adu-Bredu · Ahuja · Aye · Black · Bo · Brent · Carvalho · Craik · Cavallaro · SivaCosta · DAlberti · Eccleston · Everingham · FreitasPaganoti · Farmer
Introduction

Congenital heart defect (CHD) is a significant, rapidly emerging global problem in child health and a leading cause of neonatal and childhood death. Prenatal detection of CHDs with the help of ultrasound allows better perinatal management of such pregnancies, leading to reduced neonatal mortality, morbidity and developmental complications. However, there is a wide variation in reported fetal heart problem detection rates from 34% to 85%, with some low- and middle-income countries detecting as low as 9.3% of cases before birth. Research has shown that deep learning-based or more general artificial intelligence (AI) models can support the detection of fetal CHDs more rapidly than humans performing ultrasound scan. Progress in this AI-based research depends on the availability of large, well-curated and diverse data of ultrasound images and videos of normal and abnormal fetal hearts. Currently, CHD detection based on AI models is not accurate enough for practical clinical use, in part due to the lack of ultrasound data available for machine learning as CHDs are rare and heterogeneous, the retrospective nature of published studies, the lack of multicentre and multidisciplinary collaboration, and utilisation of mostly standard planes still images of the fetal heart for AI models. Our aim is to develop AI models that could support clinicians in detecting fetal CHDs in real time, particularly in nonspecialist or low-resource settings where fetal echocardiography expertise is not readily available.

Methods and analysis

We have designed the Clinical Artificial Intelligence Fetal Echocardiography (CAIFE) study as an international multicentre multidisciplinary collaboration led by a clinical and an engineering team at the University of Oxford. This study involves five multicountry hospital sites for data collection (Oxford, UK (n=1), London, UK (n=3) and Southport, Australia (n=1)). We plan to curate 14 000 retrospective ultrasound scans of fetuses with normal hearts (n=13 000) and fetuses with CHDs (n=1000), as well as 2400 prospective ultrasound cardiac scans, including the proposed research-specific CAIFE 10 s video sweeps, from fetuses with normal hearts (n=2000) and fetuses diagnosed with major CHDs (n=400). This gives a total of 16 400 retrospective and prospective ultrasound scans from the participating hospital sites. We will build, train and validate computational models capable of differentiating between normal fetal hearts and those diagnosed with CHDs and recognise specific types of CHDs. Data will be analysed using statistical metrics, namely, sensitivity, specificity and accuracy, which include calculating positive and negative predictive values for each outcome, compared with manual assessment.

Ethics and dissemination

We will disseminate the findings through regional, national and international conferences and through peer-reviewed journals. The study was approved by the Health Research Authority, Care Research Wales and the Research Ethics Committee (Ref: 23/EM/0023; IRAS Project ID: 317510) on 8 March 2023. All collaborating hospitals have obtained the local trust research and development approvals.

Prospective study of continuous rhythm monitoring in patients with early post-infarction systolic dysfunction: clinical impact of arrhythmias detected by an implantable cardiac monitoring device with real-time transmission--the TeVeO study protocol

Introduction

Updated primary prevention strategies are needed for post-infarction sudden cardiac death (SCD) based on implantable cardioverter-defibrillator (ICD). Current recommendations, based on left ventricular systolic function and functional class, may be obsolete because they are derived from ancient studies that do not incorporate the potential benefit of either current comprehensive treatment of ischaemic heart disease or modern device programming. Among patients with post-infarction left ventricular dysfunction, modern implantable cardiac monitoring devices (ICM) allow a unique opportunity to determine in real-time the burden of non-sustained ventricular tachycardias and their relationship to the subsequent occurrence of sustained or symptomatic events.

Methods and analysis

Approximately 200 patients with left ventricular ejection fraction (LVEF) equal to or less than 40% after acute myocardial infarction will be included in the study. They will be implanted with a Confirm RX, an ICM with real-time remote connection via a smartphone. At 6 months, LVEF and functional status will be re-evaluated and cardiac morpho-functional characterisation will be performed by MRI. At this time, and following current European guidelines, patients with an indication will receive an ICD; the others will continue to be monitored using an ICM for a minimum of 2 years. Patients are expected to be followed up for 4 years after the index event. More than 20 000 remote transmissions are expected to be analysed. The study will focus on the relationship between the detection of non-sustained ventricular tachycardias by ICMs (defined as at least 8 R-R intervals at 160 beats per minute) and the subsequent occurrence of symptomatic arrhythmic events. An advanced statistical analysis will be performed using machine and deep learning techniques to determine the clinical variables, those that are derived from monitoring and imaging tests and related to mid-term prognosis.

Ethics and dissemination

The study was approved by the Ethical Committee of the University Hospital of Salamanca (protocol number PI 2019 03 246) on 30 April 2020. Each patient will be informed about the study in both oral and written form by a physician and will be included in the study after written consent is obtained.

For the first time, a study will provide real-time information on the arrhythmic burden of patients with post-infarction ventricular dysfunction and its prognostic implications in the medium term. Several publications in scientific journals are planned.

Trial registration number

NCT04765943.

Protein hydrolysates from fish wastes: nutritional characteristics and its inclusion in diets for <i>Octopus maya</i>

by Honorio Cruz-López, Cristina Pascual, Magalli Sanchez, Pedro Domingues, Carlos Rosas, Pedro Gallardo

The utilization of fish waste protein as an alternative to crab and squid protein presents an important alternative for octopus fattening. During this study, nutritional characteristics of fish protein hydrolysate (FPH) and its inclusion in prepared diets were evaluated on growth performance and enzyme activity of digestive gland of O. maya juveniles. FPH were prepared using fish waste and their nutritional properties were evaluated. Four diets with different levels of FPH (0%, 10%, 15%, and 20%) in substitution for crab meals were fed to octopuses (mean body weight 100 mg) individually distributed for 70 days. Regarding yield, at the end of the hydrolysis period (day 15) the FPH fraction constitutes 67% of the total silage (dried powder). Small peptides were recorded in FPH (-1) and eight non-essential amino acids (NEAAs; 427 mg g-1). Also, the free amino acids (FAAs) content was 8.3% of the total amino acids content with the predominance of taurine. Octopuses fed with FPH15 had the highest weight gain (3.06 g), SGR (4.76% day-1), and survival (90%) compared to FPH0. Total alkaline protease activity of octopuses digestive gland was lower in FPH20 (3550 U mg of protein−1) than in the control (5277 U mg of protein−1). Incorporating protein hydrolysate derived from fish waste into prepared diet may offer unique advantages in promoting optimal growth and general physiological well-being for O. maya.

Exploring the acceptability, appropriateness, feasibility and satisfaction of an implementation strategy for out-of-HOspital administration of the Long-Acting combination of cabotegravir and rilpivirine as an optional therapy for HIV in Spain (the HOLA st

Por: Negredo · E. · Hernandez-Sanchez · D. · Alvarez-Lopez · P. · Falco · V. · Rivero · A. · Jusmet · J. · Cuerda Palomo · M. A. · Flores de la Cruz · A. B. · Pavon · J. M. · Llavero · N. · Campany · D. · Faus · V. · Broto-Cortes · C. · Bailon · L. · Aguilar · D. · Ruiz · F. · Miranda · C.
Introduction

The HOLA study is a 12-month randomised, hybrid implementation-effectiveness, phase IV, double-arm, open-label, multicentric study including virologically suppressed people living with HIV (PWH). HOLA, which started in September 2023, evaluates acceptability, appropriateness, feasibility and satisfaction of out-of-hospital administration of cabotegravir and rilpivirine long-acting (CAB+RPV LA).

Methods

A total of 110 PWH who are already under treatment with CAB+RPV LA or switch their antiretroviral therapy to CAB+RPV LA will be recruited from two main hospitals in Barcelona (Germans Trias I Pujol and Vall d’Hebrón) and Costa del Sol Hospital, in Marbella. The patients will be randomised 1:1 into a hospital group (administration of CAB+RPV LA in the hospital) and the outpatient group (out-of-hospital administration), including community or primary care centres. The main objectives of the study are to compare the acceptability at month 12 of the administration of CAB+RPV LA in and out-of-hospital centres from the perspective of patients, and assess and compare the safety and tolerability of CAB+RPV LA. The study takes place at nine clinical units in Catalonia and Andalusia (three tertiary hospitals (recruiting centres), one community centre, one sexually transmitted infection clinic and four primary care centres).

Ethics and dissemination

The current publication refers to V.3.0 of the protocol, with issue date 14 April 2024, as approved by the Comité de Ética de la Investigación con medicamentos del Hospital Universitari Germans Trias i Pujol (approval number AC-23-042-HGT-CEIM). The clinical trial will be conducted according to the principles of the Declaration of Helsinki, Fortaleza, Brazil, October 2013. This study will be conducted according to Spanish regulations regarding clinical trials (Royal Decree 1090/2015) and biomedical investigations (Organic Law 14/2007 of biomedical investigation and the Royal Decree 1716/2011), and the Clinical Trial Regulation (Regulation EU No 536/2014). Confidentiality requirements will follow the required Data Protection legislation. Enrolment completion in the study is expected by the end of May 2024, with an end of study expected in May 2025. Results emerging from this study will be reported in HIV national and international meetings as well as published in international journals with a high impact factor. If the outcome is deemed positive, we will also develop and propose policy guidelines for the integration of the administration of CAB+RPV LA in alternative outpatient facilities into the standard of care in the HIV care pathway.

Trial registration number

NCT06185452/EUCT number: 2023-503963-41-00.

A práxis da enfermagem à luz do modelo de sistemas de cuidados na Covid-19 longa em países lusófonos

O presente ensaio propõe uma reflexão sobre a práxis de enfermagem sob o modelo dos sistemas de cuidado tendo em vista a síndrome da Covid-19 longa em países lusófonos. Deste modo, buscou-se problematizar ações ligadas ao cuidado e as diferentes facetas da assistência por meio dos pressupostos teóricos do modelo de sistemas. A partir desta faceta entende-se que os pontos ligados à prática do enfermeiro envolvem questões éticas, científicas e políticas acerca do trabalho de enfermagem em períodos de crise sanitária, especialmente, na Covid-19 longa. Se faz primordial, portanto, investir em ações programáticas de formação seja com a educação em saúde, formação profissional ou investimento sanitário visando o equilíbrio de um sistema holístico em saúde.

Competências profissionais do enfermeiro: Revisão Integrativa de literatura

Objetivo: identificar, nas produções científicas, os fatores relacionados à construção da identidade
profissional do enfermeiro. Métodos: Trata-se de revisão integrativa realizada nas bases de dados
SCIELO, BDENF e LILACS disponíveis na Biblioteca virtual em saúde no intervalo temporal de
2015 a 2019 a partir dos descritores “Papel do profissional de enfermagem” AND “Cuidados de
enfermagem” OR “Competência profissional”. Resultados: A identificação profissional do
enfermeiro está relacionada à sua atuação no serviço de saúde com estratégias de atendimento
domiciliar, empreendedorismo, gerenciamento do cuidado e da equipe, educação em saúde,
consultas de enfermagem, procedimentos técnicos, articulação da rede de atenção, organização do
serviço e qualificação da equipe mas que sofrem algumas limitações individuais, organizacionais,
institucionais e sociais. Conclusão: A identificação dos fatores que caracterizam o enfermeiro e
fomentam sua identidade profissional exerce grande influência no empoderamento da categoria e
melhor autonomia nos diversos campos de atuação.
Descritores: Papel do profissional de enfermagem; Cuidados de enfermagem; Competência
profissional.

Perspectives of Patients Regarding Artificial Intelligence and Its Application in Healthcare: A Qualitative Study

ABSTRACT

Background

Artificial intelligence integration into healthcare has gained significant attention in recent years, with its use ranging from disease diagnosis to surgical assistance. While artificial intelligence's potential to improve patient outcomes and optimise patient care is undeniable, concerns regarding privacy, transparency, and the potential for medical errors persist. To take full advantage of artificial intelligence's transformative abilities, understanding patient perceptions and attitudes towards its integration into medicine is crucial for ethical considerations and health outcomes.

Purpose

This study aimed to describe patients' perceptions of medical artificial intelligence and its integration into the healthcare system, drawing attention to a crucial yet understudied aspect of artificial intelligence adoption in Kazakhstan.

Design

Descriptive qualitative design.

Method

From February to March 2024, the researchers conducted semi-structured interviews amongst 13 patients. The interviews were audio-recorded, transcribed, translated, and then analysed using a thematic analysis approach. The study adhered to the COREQ guidelines.

Result

Five themes emerged from 13 interviews: the benefits of artificial intelligence on patient care, the importance of human factors on patient care over artificial intelligence, revolutionising patient care delivery through artificial intelligence, patient education and artificial intelligence, and balancing technology and human interaction in artificial intelligence-driven intervention.

Conclusion

Patient perceptions of artificial intelligence integration into healthcare were primarily positive. Nevertheless, patients prefer artificial intelligence as a supplementary tool under human supervision due to risks such as possible medical errors and violations of patient privacy.

Patient or Public Contribution

Patients provided the data for this study. The researchers interviewed them about their perceptions of medical artificial intelligence and its integration into the healthcare system. The patients or the public contributed nothing to the other aspects of the study.

Análisis temático sobre el uso de equipos de protección individual en Covid-19

Objetivo describir el acceso y el uso de los equipos de protección individual por parte de los profesionales sanitarios en el contexto de la pandemia de Covid-19. Estudio cualitativo descriptivo, realizado con profesionales de la salud en período de julio a agosto de 2020 a través de un formulario vía Google Forms. El análisis se realizó con el software Interface de R para el Análisis Multidimensional de Textos y Cuestionarios, mediante la Clasificación Jerárquica Descendente y análisis de similitud, aprobado por el dictamen 4.120.399. 42 profesionales de la salud participación del estudio. Se identificaron cuatro clases. En la clase 1, los profesionales informaron de la mala calidad de los equipos recibidos para la protección; en la clase 2, destacaron la compra de equipos de protección; en la clase 3, señalaron cómo la sustitución de los equipos pasa por la gestión y en la clase 4, informaron de la reutilización de estos insumos. Así, los profesionales denotan dificultades relacionadas con el acceso y uso de los equipos de protección individual, lo que merece una mayor atención por parte de los servicios, con el objetivo de mejorar la calidad de la protección de estos profesionales y garantizar la seguridad en el trabajo.

¿Unidades de cuidado o unidades de vigilancia intensiva?

Introducción: La denominación de las unidades de cuidado intensivo (UCI) ha variado a lo largo del tiempo. Desde unidades de vigilancia intensiva, unidades de terapia intensiva, unidades de medicina intensiva hasta unidades de cuidados críticos. En la practica estas denominaciones parecen superponerse a tal punto que parece prevalecer la vigilancia sobre el cuidado.

Metodología: artículo reflexivo con enfoque fenomenológico hermenéutico que aborda el fenómeno de la vida cotidiana en la UCI en relación al diseño espacial, las relaciones de poder y el tiempo vivido para problematizar la denominación Unidad de Cuidados Intensivos en contraposición de Unidad de Vigilancia Intensiva.

Resultados: la vida cotidiana de la UCI, es un espacio reglado y altamente controlado, en el que a través de diversos mecanismos se conduce la vida de los profesionales y pacientes a tal punto de tener características de lo que autores como Goffman consideran instituciones totales. En las cuales, a través de mecanismos de despersonalización se homogeniza la heterogeneidad característica de lo humano

Conclusión:  Cuidar implica vigilar, estar atento, estar de guardia y controlar en algunos casos. Sin embargo, no se reduce a ello, el cuidado implica también reconocerse como ser finito y vulnerable, es decir como ser eminentemente compasivo. Cuidar como acto instintivo y reflexivo a la vez, supone una doble naturaleza entre pathos y logos, esta misma naturaleza no puede desdibujarse al interior de las UCI

Derivación teórica del proceso de afrontamiento y adaptación del adulto mayor al proceso de institucionalización

Introducción: En el adulto mayor la necesidad de los servicios de salud tendrá un incremento debido a que el proceso de envejecimiento poblacional está acelerado y se intensifica cada vez más, aunado a esto, por las desigualdades sociales, económicas y de comorbilidades que presenta este grupo poblacional, la demanda de espacios en instituciones de adultos mayores se verá incrementada. Objetivo: Desarrollar una derivación teórica a partir de la teoría de rango medio del proceso de afrontamiento y adaptación de Roy, para abordar el fenómeno de afrontamiento y adaptación del adulto mayor al proceso de institucionalización. Metodología: Para realizar este proceso se abordó la metodología propuesta por Jacqueline Fawcett, esta consta de cinco pasos: 1. Identificación de conceptos. 2. Clasificación de los conceptos de la teoría de rango medio. 3. Identificación y clasificación de proposiciones. 4. Jerarquización de las proposiciones. 5. Construcción de diagramas. Resultados. Con la metodología utilizada se propone un diagrama de derivación Conceptual-teórico-empírico con diagrama de proposiciones. Conclusión: Se elaboró una propuesta teórica que busca enriquecer las intervenciones de cuidado de enfermería, por lo tanto, se exhorta a que se tenga en cuenta para realizar futuras investigaciones que puedan probar los supuestos en diversos niveles de abstracción.

Prácticas culturales para prevenir la COVID-19 en una comunidad indígena

Introducción: La pandemia por la COVID-19 sigue azotando al mundo, pero existen comunidades indígenas que han adoptado diversas medidas de protección en sus hogares y comunidad. Objetivo: Describir las prácticas culturales para prevenir la COVID-19 en una comunidad indígena del Perú, 2021. Método: Investigación cualitativa descriptiva. El muestreo fue no probabilístico por conveniencia, participaron del estudio 08 madres y 02 padres de familia de la comunidad nativa Supayacu. Para la recolección de datos se aplicó cuatro entrevistas vía Zoom y seis de manera presencial previo consentimiento informado. Se analizaron los datos mediante el análisis de contenido temático. Resultados: Emergieron cuatro categorías: a) Organización comunal: Cierre de fronteras, proceso de adquisición y desinfección de víveres, b) Cuidados culturales en la alimentación y uso de medicina tradicional, c) Adopción de las medidas preventivas: Lavado de manos, uso de mascarillas, alcohol, higiene del hogar, d) Creencias y rituales religiosos: castigo divino, ayuno y oración. Conclusiones: Esta comunidad indígena utilizó sus saberes y prácticas culturales ancestrales para protegerse de la COVID-19, esto basado en su organización, el cierre de fronteras, el uso de plantas medicinales y sus creencias religiosas. Además, cumplieron con las medidas preventivas como el lavado de manos, uso de mascarillas, alcohol, y el distanciamiento social.

Clima organizacional en una institución educativa de enfermería de nivel pregrado

Introducción. El clima organizacional es el conjunto de percepciones que los individuos y los grupos que trabajan en una organización tienen de su lugar de trabajo; se hace referencia general a que se trata de una característica colectiva, formada por las interacciones entre los trabajadores; fenómeno que se relaciona con la satisfacción y productividad en las organizaciones y de allí el interés por su estudio. Objetivo. Identificar el tipo de clima organizacional en una institución educativa de enfermería durante el periodo de marzo a abril de 2022, con la finalidad de elaborar propuestas de intervención. Metodología. El presente estudio es de tipo transversal, descriptivo de corte cuantitativo, que se llevará a cabo en una institución educativa en San Luis Potosí, en el periodo de abril a mayo de 2023. Se utilizarán dos instrumentos para la recolección de datos: una cédula de datos sociodemográficos y el instrumento para caracterizar el clima organizacional en profesores de centros escolares de educación superior. Se utilizará el programa SPSS versión 21.0 para él análisis y procesamiento de los datos. Relevancia. Se espera que el presente trabajo aporte los suficientes insumos para el diseño de intervenciones centradas en mejorar o potenciar el clima organizacional de la institución educativa.

ABSTRACT

Introduction. The organizational climate is the set of perceptions that individuals and groups working in an organization have of their workplace; general reference is made to the fact that it is a collective characteristic, formed by interactions between workers; phenomenon that is related to satisfaction and productivity in organizations and hence the interest in its study. Objective. To identify the type of organizational climate in an educational institution of nursing during the period from March to April 2022, in order to develop intervention proposals. Methodology. The present study is a cross-sectional, descriptive, and quantitative study, which will be carried out in an educational institution in San Luis Potosi, during the period from April to May 2023. Two instruments will be used for data collection: a sociodemographic data form and an instrument to characterize the organizational climate in teachers at higher education schools. The SPSS version 21.0 program will be used for data analysis and processing. Relevance. It is expected that the present work will provide sufficient inputs for the design of interventions focused on improving or enhancing the organizational climate of the educational institution.

The role of orthobiologics in chronic wound healing

Abstract

Chronic wounds, characterized by prolonged healing processes, pose a significant medical challenge with multifaceted aetiologies, including local and systemic factors. Here, it explores the complex pathogenesis of chronic wounds, emphasizing the disruption in the normal phases of wound healing, particularly the inflammatory phase, leading to an imbalance in extracellular matrix (ECM) dynamics and persistent inflammation. Senescent cell populations further contribute to impaired wound healing in chronic lesions. Traditional medical management focuses on addressing underlying causes, but many chronic wounds resist to conventional treatments, necessitating innovative approaches. Recent attention has turned to autologous orthobiologics, such as platelet-rich plasma (PRP), platelet-rich fibrin (PRF) and mesenchymal stem cells (MSCs), as potential regenerative interventions. These biologically derived materials, including bone marrow aspirate/concentrate (BMA/BMAC) and adipose tissue-derived stem cells (ADSCs), exhibit promising cytokine content and regenerative potential. MSCs, in particular, have emerged as key players in wound healing, influencing inflammation and promoting tissue regeneration. This paper reviews relevant scientific literature regarding basic science and brings real-world evidence regarding the use of orthobiologics in the treatment of chronic wounds, irrespective of aetiology. The discussion highlights the regenerative properties of PRP, PRF, BMA, BMAC and SVF, showcasing their potential to enhance wound healing. Despite advancements, further research is essential to elucidate the specific roles of each orthobiologic and determine optimal applications for different wound types. The conclusion underscores the evolving landscape in chronic wound management, with a call for more comprehensive studies to refine treatment strategies and maximize the benefits of regenerative medicine.

Experiencias de las enfermeras en primera línea contagiadas con COVID-19 que recibieron atención domiciliaria

Introducción: Las enfermeras han brindado cuidados a los pacientes con COVID-19, y muchas tuvieron que lidiar con este virus al ser infectadas. Objetivo: Describir las experiencias de las enfermeras en primera línea contagiadas con COVID-19 que recibieron atención domiciliaria. Método: Investigación cualitativa descriptiva, el tamaño de la muestra fue con 12 enfermeras infectadas con COVID-19 que recibieron tratamiento domiciliario en Chiclayo, Perú. El muestreo fue por la técnica de bola de nieve. Para recolectar los datos se utilizó la entrevista semiestructurada a través de los medios virtuales previo consentimiento informado. Resultados: Surgieron tres categorías: a) Incertidumbre ante modo de contagio, medios de diagnóstico, sintomatología y evolución por la COVID-19, b) Cuidados recuperativos en el hogar: tratamiento médico, uso de medicina tradicional y medidas de bioseguridad, y c) Impacto en la vida familiar, laboral, social, emocional y espiritual al sufrir de la COVID-19. Conclusiones: Las enfermeras presentaron síntomas leves de la COVID-19 y se recuperaron en su domicilio, cumplieron con el tratamiento médico, algunas usaron remedios caseros. Practicaron estrictamente las medidas de bioseguridad para evitar que su familia se contagie. Utilizaron la tecnología digital y reforzaron su fe para afrontar el impacto familiar, emocional y social.

Conocimientos, actitudes y prácticas sobre el autoexamen de mamas en mujeres de una zona rural

Objetivo principal: Describir los conocimientos, actitudes y prácticas sobre el autoexamen de mamas en mujeres de una zona rural. Metodología: Estudio cuantitativo de diseño no experimental, descriptivo, transversal. La muestra fue de 139 mujeres que viven en una zona rural en Lambayeque-Perú. Para la recolección de datos se empleó un cuestionario adaptado, validado por juicio de expertos y con α de Cronbach 0,88. Los datos fueron procesados y analizados mediante el uso del programa SPSS versión 25. Resultados principales: Se encontró que el 94,96% desconocen sobre el autoexamen de mamas, 93,6% de las participantes tienen actitud positiva para realizarlo, sin embargo, el 64,7% nunca se lo ha realizado. Conclusión principal: Las mujeres del estudio presentan conocimientos incorrectos sobre el autoexamen de mamas, una actitud positiva hacia esta técnica, pero una práctica inadecuada. Es necesario ampliar las coberturas y estrategias educativas en salud para que esta población conozca y practique el autoexamen de mama.

Efecto de la dieta libre de gluten en adolescentes y adultos jóvenes con enfermedad celíaca: una revisión sistemática

Objetivo principal: analizar de manera sistemática la evidencia disponible sobre el efecto de la dieta libre de gluten en adolescentes y adultos jóvenes con enfermedad celíaca. Metodología: Para la elaboración de esta revisión sistemática se siguió con la formulación de una pregunta, establecimiento de criterios de inclusión y exclusión, desarrollo de estrategias de búsqueda, la selección de artículos para ser incluidos en la revisión, extracción de datos y síntesis de los datos. Resultados principales: Se observó en todos los estudios incluidos que los síntomas, así como la presencia de anticuerpos específicos, disminuyeron en las personas con Enfermedad Celiaca que se adhirieron a la dieta libre de gluten. Conclusión principal: Respecto al efecto de la dieta libre de gluten en la enfermedad celíaca, se puede decir que los pacientes celíacos tienden a mejorar en los síntomas de esta patología. Sin embargo, algunos pacientes pueden no mostrar una mejoría significativa.

Enfermedad renal crónica como causa de disfunción familiar: análisis fenomenológico desde una perspectiva holística

Objetivo principal: Evaluar la disfunción familiar desde una perspectiva holística en enfermos renales en terapia sustitutiva en un hospital de Monterrey, México. Metodología: Diseño mixto, analítico, transversal. Población conformada por 634 enfermos renales en terapias de sustitución de un hospital de segundo nivel en Monterrey. Se usó estadística descriptiva e inferencial para datos cuantitativos. Para la parte cualitativa se usó metodología fenomenológica conforme a la teoría fundamentada y análisis de dominios. Resultados principales: Alta prevalencia de disfuncionalidad familiar (70%). Según los enfermos renales en etapas avanzadas, el abandono por parte del cónyuge, la infidelidad marital, la exclusión familiar y los problemas económicos, son los principales factores que fracturan los lazos y la estruc-tura familiar. Conclusión principal: La enfermedad renal puede ser factor de disfuncionalidad familiar, hecho que compromete las relacio-nes entre los miembros familiares y afecta el apego a los tratamientos sustitutivos, al ser estos dependientes de un cuidador primario.

Percepción de los profesionales sanitarios sobre cómo afecta la luz y ruido al sueño/descanso de los pacientes en el Servicio de Urgencias

Objetivo principal: Mejorar la calidad del sueño y descanso de los pacientes en el servicio de urgencias mediante la participación y cono-cimiento de las percepciones de los profesionales sanitarios. Metodología: Un total de 173 profesionales sanitarios (79 enfermeras/os, 33 TCAE, 29 médicos/as y 32 celadores/as) cumplimentaron el cuestionario ad hoc de percepción de los profesionales sobre cómo afecta la luz y ruido al sueño y descanso de los pacientes. Resultados principales: Aspectos relacionados con la organización y dinámicas de trabajo, las competencias, habilidades y cuidados llevados a cabo por los profesionales daban lugar a distinciones en la participación de responder al cuestionario y en las percepciones de los profesionales sobre cómo la luz y ruido afecta al sueño y descanso de los pacien-tes, lo cual remarcaba la necesidad de evaluar factores perturbadores ambientales y establecer estrategias, medidas, intervenciones y cuidados para mejorar la calidad de sueño de los pacientes. Por tanto, los resultados de este trabajo aportaban nuevos datos en compa-ración con los datos de escasos estudios sobre la necesidad de conocer la percepción de los profesionales sanitarios sobre factores perturbadores ambientales que afectan al sueño/descanso de los pacientes, particularmente en el servicio de urgencias. Conclusión principal: Existe una variabilidad de las diferentes categorías de profesionales sanitarios en relación a la participación en contestar al cuestionario ad hoc, así como diferencias significativas entre las percepciones sobre cómo afecta la luz y ruido sobre el sueño/descanso de los pacientes. Por tanto, se plantean perspectivas de futuro y se alude a estrategias dirigidas a los pacientes, profesionales y organi-zación/entorno de trabajo para mejorar la calidad de sueño de los pacientes en el servicio de urgencias.

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