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Suicide is among the leading causes of preventable death worldwide. The impact of suicide affects the personal, social and economic levels. Therefore, its prevention is a priority for public health systems. Previous studies seem to support the efficacy of providing active contact to people who have made a suicide attempt. The current systematic review and meta-analysis aims to investigate the efficacy of distance suicide prevention strategies implemented through synchronous technology-based interventions.
This protocol is designed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. The bibliographical searches were conducted in the databases PubMed, PsycINFO, Scopus and Web of Science in April 2022, with no restrictions on the time of publication and limited to publications in English or Spanish. The search strategy was performed using free-text terms and Medical Subject Headings terms: suicide, follow-up, synchronous, remote, telehealth, telephone, hotline, video-conference and text message. Two reviewers will independently conduct study screening, selection process, data extraction and risk of bias assessment. The analysis and synthesis of the results will be both qualitative and quantitative. A narrative synthesis, presented in a comprehensive table, will be performed and meta-analysis will be conducted, as appropriate, if sufficient data are provided.
The present review and meta-analysis will not require ethical approval, as it will use data collected from previously published primary studies. The findings of this review will be published in peer-reviewed journals and widely disseminated.
CRD42021275044.
Introducción. Las relaciones durante la infancia/adolescencia son fundamentales para la construcción psíquica. La familia y el colegio son inicialmente los medios de socialización donde la calidad de la experiencia relacional predetermina un modelo futuro. Las dificultades en el ámbito relacional tienen una repercusión en la salud mental de los menores. Existe un incremento de las conductas conflictivas e inhibidas en el alumnado, al igual que un aumento en prevalencia de trastornos psiquiátricos, siendo necesaria una evaluación de los recursos. Metodología. Este estudio cuasi-experimental unicéntrico, pre-post sin grupo control, tipo longitudinal de carácter prospectivo tiene como objeto evaluar los cambios en el desempeño del rol de padres y las habilidades de interacción social y resiliencia personal de la población atendida en la Unidad Terapéutica Educativa de Ortuella, desde una perspectiva enfermera, durante un curso escolar. La prueba Kolmogorov-Smirnov o Shapiro-Wilk determinará si la distribución de la variable es normal. Se utilizará la t de Student para muestras pareadas o Wilcoxon cuando la distribución de la variable no fuese normal y McNemar para comparación de proporciones, con un intervalo de confianza del 95%, considerándose significativo una p<0.05. Utilidad práctica. Los resultados permitirán comprobar si la permanencia de un curso escolar en la Unidad Terapéutica Educativa se relaciona con una mejora de las variables a estudio.
ABSTRACT
Introduction. Relationships during childhood/adolescence are fundamental for the psyche construction. The family and the school are the initial means of socialization and it is there where the quality of the relational experience predetermines a future model. Difficulties in the relational sphere have an impact on the mental health of minors. There is an increase in conflictive and inhibited behaviors in students, as well as an increase in the prevalence of psychiatric disorders, making an evaluation of resources necessary. Methodology. This unicentric quasi-experimental study, pre-post without control group, longitudinal type of prospective nature, aims to evaluate the changes in the performance of the parental role and the social interaction skills and personal resilience of the population served in the Educational Therapeutic Unit of Ortuella, from a nursing perspective, during a school year. The Kolmogorov-Smirnov or Shapiro-Wilk test will determine whether the distribution of the variable is normal. Student's t test will be used for paired samples or Wilcoxon when the distribution of the variable is not normal and McNemar for comparison of proportions, with a confidence interval of 95%, with p<0.05 being considered significant. Utility in practice. The results will allow us to verify whether the permanence of a school year in the Educational Therapeutic Unit is related to an improvement in the variables under study.
The aim was to explore the association of demographic and prehospital parameters with short-term and long-term mortality in acute life-threatening cardiovascular disease by using a hazard model, focusing on elderly individuals, by comparing patients under 75 years versus patients over 75 years of age.
Prospective, multicentre, observational study.
Emergency medical services (EMS) delivery study gathering data from two back-to-back studies between 1 October 2019 and 30 November 2021. Six advanced life support (ALS), 43 basic life support and five hospitals in Spain were considered.
Adult patients suffering from acute life-threatening cardiovascular disease attended by the EMS.
The primary outcome was in-hospital mortality from any cause within the first to the 365 days following EMS attendance. The main measures included prehospital demographics, biochemical variables, prehospital ALS techniques used and syndromic suspected conditions.
A total of 1744 patients fulfilled the inclusion criteria. The 365-day cumulative mortality in the elderly amounted to 26.1% (229 cases) versus 11.6% (11.6%) in patients under 75 years old. Elderly patients (≥75 years) presented a twofold risk of mortality compared with patients ≤74 years. Life-threatening interventions (mechanical ventilation, cardioversion and defibrillation) were also related to a twofold increased risk of mortality. Importantly, patients suffering from acute heart failure presented a more than twofold increased risk of mortality.
This study revealed the prehospital variables associated with the long-term mortality of patients suffering from acute cardiovascular disease. Our results provide important insights for the development of specific codes or scores for cardiovascular diseases to facilitate the risk of mortality characterisation.
by Jordi Olivella Nadal, Gema Calleja Sanz, Ignacio Fuentes Ribas, Pedro Rodriguez Mondelo
In most countries, a government agency or collaborating organization gathers information on occupational accidents. Comparisons based on a single factor such as autonomous community, activity sector or others, often leads to contradictory conclusions. The use of this information for comparison is not immediate because the different characteristics considered give place to different possible comparisons. The elaboration of a single baseline for each set of characteristics is addressed. The method proposed comes from the data available in Spain but could be applied to other cases. The method consists of: (1) selecting factors–those selected are age, sex, autonomous community and activity; (2) the generation of a synthetic population based on data from a survey and general proportions by applying the Optimal Representative Sample Weighting (rsw); and (3) the prediction of the accidents ratio for each set of characteristic by using a XGBoost decision trees ensemble. The results confirm the appropriateness of the method.This study aimed at evaluating refractive changes in German school-aged children before and after the COVID-19 pandemic.
Cross-sectional study.
414 eye care professional centres from Germany.
Refractive data from 59 926 German children aged 6–15 years were examined over a 7-year period (2015–2021).
Spherical equivalent refraction was assessed as a function of year, age and gender. The refractive values concerning 2020 and 2021 were compared with those assigned to prior years (2015–2019).
The refractive data associated with 2020 and 2021 showed a myopic refractive shift of approximately –0.20D compared with the 2015–2019 range. The refractive change was statistically considerable in the 6 to 11-year range (p
Disruption of normal lifestyle due to pandemic-related home confinement appears to lead to a myopic refractive shift in children aged 6–11 years in Germany. The greater effect observed at younger ages seems to emphasise the importance of refractive development in this age group.
Adverse childhood experiences (ACEs) are associated with higher risk of chronic disease, but little is known about the association with late life cognitive decline. We examined the longitudinal association between ACEs and late-life cognitive decline in the Study of Healthy Aging in African Americans (STAR).
Linear mixed models with random intercepts and slope examined the association of individual and composite ACEs with cognitive change adjusting for years from baseline (timescale), baseline age, sex, parental education, childhood socioeconomic status and childhood social support. Participants reported whether they had experienced nine types of ACEs. Executive function and verbal episodic memory were measured up to three times over a 3-year period using the Spanish and English Neuropsychological Assessment Scales.
Kaiser Permanente Northern California members living in the Bay Area.
STAR is a cohort study of cognitive ageing launched in 2018 that has enrolled 764 black Americans ages ≥50 years (mean age=67.5; SD=8.5).
Twenty-one per cent of participants reported no ACEs, 24% one ACE, 20% two ACEs, 17% three ACEs and 17% four or more ACEs. Compared with no ACEs, two ACEs (β=0.117; 95% CI 0.052 to 0.182), three ACEs (β=0.075; 95% CI 0.007 to 0.143) and four or more ACEs (β=0.089; 95% CI 0.002 to 0.158) were associated with less decline in executive function. There were no significant associations between number of ACEs and baseline or longitudinal verbal episodic memory or between individual ACEs and executive function or verbal episodic memory.
In this cohort of older black Americans, there was no association between ACEs and baseline cognition or cognitive change in verbal episodic memory; however, experiencing ≥ 2 ACEs was associated with less decline in executive function. These results may indicate that participants who survived to age 50+ and experienced ACEs may have cognitive resilience that warrants further investigation.
To psychometrically assess the Spanish version of the Self-Care of Chronic Illness Inventory (SC-CII-Sp) in community-dwelling older adults with chronic multimorbidity.
A methodological study.
A total of 1260 older adults participated in the study between May 2020 and February 2022. The data were analysed using SPSS Statistics® 26 and AMOS® 24. The items' content validity index and the Fleiss' kappa were calculated to assess the SC-CII-Sp's content validity. Convergent validity was assessed by calculating the Pearson correlation coefficient between the participants' scores on the SC-CII-Sp and their scores on the Spanish Chronic Disease Self-Efficacy scale (SCD-SE). Construct validity was tested by performing a confirmatory factor analysis (CFA). The SC-CII-Sp's reliability was tested by computing the Cronbach's alpha.
The SC-CII-Sp showed good content and convergent validity. The CFA showed that the SC-CII-Sp has three sub-scales. The 8-item Self-Care Maintenance sub-scale has good internal consistency and is comprised of two dimensions: illness-related and health-promoting behaviour. The Self-Care Monitoring sub-scale had excellent internal consistency and its five loaded items belonged to a single dimension. The 6-item Self-Care Management sub-scale has adequate internal consistency and two dimensions: autonomous and consulting behaviour.
The Spanish version of SC-CII is a valid and reliable instrument to be used in the assessment of self-care behaviours amongst Spanish-speaking, community-dwelling older adults with chronic multimorbidity.
Nurses need valid and reliable tools to assess self-care behaviours in Spanish-speaking community-dwelling older adults with chronic multimorbidity. This study provides a 19-item tool that allows for the comprehensive evaluation of self-care behaviours in healthy and ill states.
Using the SC-CII-Sp in clinical or research settings could help nurses to examine the effects of different interventions on self-care behaviours amongst Spanish-speaking, community-dwelling older adults with chronic multimorbidity.
None to be reported.
Objetivo. Analizar factores relacionados con la conducta suicida en pacientes con enfermedad mental para orientar la prevención y cuidados de salud mental especializados. Material y métodos. Estudio descriptivo transversal de una muestra de 44 pacientes hospitalizados por conducta suicida en psiquiatría. Durante 12 meses se registraron variables sociodemográficas y clínicas, se aplicaron la escala Columbia de cribado del riesgo suicida, la de Desesperanza de Beck, la de Impulsividad de Plutchik y el Inventario de Razones para Vivir. Se usó estadística descriptiva e inferencial para una significación estadística de p<0,05. Resultados. El 84% (n=37) presentó ideación suicida, el 63,3% (n=28) tentativa y el 2,3% (n=1) suicidio consumado. Realizaron más intentos previos las mujeres (60%/n=15) que los hombres (38%/n=7). La intoxicación medicamentosa fue el método más utilizado por ambos sexos seguido de autolesiones por mujeres (p<0,05) y precipitación por hombres (p<0,05). La depresión, trastorno más prevalente, se asoció a la edad y al medio rural (p<0,05). El trastorno de ansiedad fue el más predictivo para la intención/plan y tentativas suicidas (p<0,05). El 80% (n=16) de los intentos padecía enfermedad médica (p<0,05). Se evidenció la relación inversa entre las creencias de supervivencia/afrontamiento y la conducta suicida. Discusión. La conducta suicida supone más del 20% de los ingresos de una unidad psiquiátrica. No es posible determinar un perfil único de riesgo, se han evidenciado diferencias según el espectro suicida. Todos los factores relacionados deben ser valorados.
ABSTRACT
Objective. To analyze factors related to suicidal behavior in patients with mental illness to guide prevention and specialized mental health care. Methodology. A descriptive cross-sectional study carried out in a sample of 44 inpatients at a psychiatric unit who attempted suicide. Sociodemographic and clinical variables were registered during 12 months. The scales applied were the Columbia-Suicide Severity Rating Scale (C-SSRS), Beck Hopelessness Scale, Plutchik’s Impulsivity Scale and the Reasons for Living Inventory. A descriptive and inferential statistic has been applied for a statistical significance of p<0,05. Results. 84% (n=37) had suicidal thinking, 63,3% (n=28) attempted suicide and 2,3% (n=1) committed suicide. More women (60%; n=15) than men (38%; n=7) attempted suicide. Medication overdose was the main suicidal approach by both sexes followed by self-harm by women (p<0,05) and deliberate fall by men (p<0,05). Depression, the most prevalent disorder, was associated with age and rural environment (p<0,05). Anxiety had the highest predictive value of suicidal attempt (p<0,05). 80% (n=16) of those who attempted suicide suffered from a medical illness (p<0,05). There is evidence of inverse relationship between the survival and coping beliefs and the suicidal behaviour. Discussion. Suicidal behaviour surpasses 20% of the admissions at a psychiatric unit. It is not possible to determine a specific risk profile as differences according to the suicidal spectrum have been acknowledged. Every possible cause must be evaluated.
La histeroscopia es un procedimiento con finalidad terapéutica y de diagnóstico, permitiendo una visión directa de la cavidad uterina. Es relativamente sencillo pero no exento de complicaciones. La solución más comúnmente utilizada para la distensión es glicina 1.5% debi-do a su baja viscosidad, bajo costo, transparencia y compatibilidad con electrocirugía. Una de las complicaciones más temidas durante la cirugía histeroscópica es hemodilución por absorción de medios de distensión. Presentamos el caso de una mujer de 64 años, con ab-sorción excesiva de glicina durante una histeroscopia. Destacamos la importancia de una vigilancia continua y una comunicación efectiva entre el equipo quirúrgico: ginecólogo, anestesiólogo y equipo de enfermería. Sin duda, esto nos permite identificar los factores de riesgo que pueden prevenir la absorción intraoperatoria de estos fluidos, así como establecer un diagnóstico temprano y aplicar un tratamiento oportuno y eficaz para minimizar complicaciones.
La histeroscopia es un procedimiento con finalidad terapéutica y de diagnóstico, permitiendo una visión directa de la cavidad uterina. Es relativamente sencillo pero no exento de complicaciones. La solución más comúnmente utilizada para la distensión es glicina 1.5% debi-do a su baja viscosidad, bajo costo, transparencia y compatibilidad con electrocirugía. Una de las complicaciones más temidas durante la cirugía histeroscópica es hemodilución por absorción de medios de distensión. Presentamos el caso de una mujer de 64 años, con ab-sorción excesiva de glicina durante una histeroscopia. Destacamos la importancia de una vigilancia continua y una comunicación efectiva entre el equipo quirúrgico: ginecólogo, anestesiólogo y equipo de enfermería. Sin duda, esto nos permite identificar los factores de riesgo que pueden prevenir la absorción intraoperatoria de estos fluidos, así como establecer un diagnóstico temprano y aplicar un tratamiento oportuno y eficaz para minimizar complicaciones.
Objetivo principal: El objetivo perseguido en esta investigación es estudiar la relevancia y características de la administración oral de fármacos, y sus implicaciones para los cuidados de enfermería, buscando aumentar la seguridad y efectividad de la misma. Metodología: Realizamos un estudio descriptivo en un servicio de medicina interna, concretamente de 194 episodios de ingreso correspondientes al año 2014. A continuación, se analizaron los principios activos y formas farmacéuticas más empleados por vía oral, revisando en la evidencia científica cuáles de ellos requerían recomendaciones especiales para garantizar la seguridad y eficacia en su administración. Resultados principales: La mayoría de los principios activos empleados poseen recomendaciones especiales, y se cometen errores e interacciones significativas como consecuencia de no aplicarlas. Conclusión principal: La administración de medicamentos oral entraña una serie de características, en la que los cuidados de enfermería, permiten al profesional garantizar que un proceso interdisciplinario como el tratamiento farmacológico, conduzca a una administración personalizada, segura y eficaz.
Rev Enferm;41(3): 210-216, mar. 2018. graf. [Artículo]
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