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NeuroMusic: protocol for a randomised-controlled trial of keyboard and singing music training programmes for older adults with mild cognitive impairment

Por: Menczel Schrire · Z. · Mitchell · H. F. · Low · L.-F. · Espinosa · N. · Eames · P. · Toltz · J. · Walsh · P. · Mowszowski · L. · Espinoza · D. · Lin · C. S.-Y. · Peres Da Costa · N. · Naismith · S. L.
Introduction

Music-based training programmes, such as learning how to play an instrument or sing in a choir, have been suggested as potential interventions for promoting healthy brain ageing in older adults at risk of cognitive decline because of their ability to enhance cognitive functions and potentially promote neuroplasticity. However, there is limited empirical evidence in older adults at risk of dementia, especially that evaluates both piano and singing interventions and their effects on cognition and neuroplasticity. In this protocol, we outline a study to assess the efficacy of keyboard and singing music training programmes on reducing cognitive decline and other outcomes in older adults with Mild Cognitive Impairment (MCI).

Methods and analysis

This randomised, single-blind, controlled, parallel-group trial aims to enrol 432 individuals with MCI from the community in Sydney, Australia. Participants are randomly allocated to participate in either keyboard lessons, singing lessons or a film discussion control group once a week for 3 months. The primary objective is to assess the effectiveness of two music training programmes (keyboard and choral singing) for enhancing verbal memory after 3 months compared with control. Additionally, we will examine how these music-based interventions affect other aspects of cognition, mood, sleep, overall well-being, markers of brain plasticity and blood biomarkers of Alzheimer’s disease and neurodegeneration. Tertiary objectives are to identify factors that impact the success of the interventions, such as participation rates, engagement levels and key demographic and clinical features. Outcomes are collected at baseline and at 3 and 9 months. The primary endpoint analysis will include all randomised participants to estimate the treatment effect using intention-to-treat principles. Primary and secondary outcomes will be analysed using linear mixed models and effect size measures will be calculated.

This study will be the first robust, randomised controlled trial to assess the potential and relative value of music engagement for cognitive decline in high-risk MCI individuals, as well as broader effects on other markers of mental health, well-being and neurodegeneration. Co-designed with implementation in mind, the music interventions can potentially be delivered within memory clinic or community settings.

Ethics and dissemination

The Sydney University Human Research Ethics Committee (2023-026) has approved this protocol. The trial findings will be shared through conferences, publications and media.

Trial registration number

Australian and New Zealand Clinical Trials Registry (ACTRN12623000407695), Registered 21/04/2023 https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=385552

Protocol version

2.02 29/11/2024.

Predictive Capacity of the Integrated Care for Older People Screening Tool to Assess Fall Risk in Older Adults in Geriatric Care

ABSTRACT

Aim

To evaluate the predictive capacity of the Integrated Care for Older People screening tool for the risk of falls in older people receiving care at a healthcare service.

Design

A cross-sectional study.

Method

This study was conducted in a geriatric healthcare service in the southeast region of Brazil. The convenience sample included older people aged 60 and over living at home. The study used the Fall Risk Score to assess the risk of falls and the Integrated Care for Older People screening tool to track intrinsic capacity. The data was analysed using logistic regression to analyse the association between the six Intrinsic Capacity domains, for the early detection of impairment and risk of falls.

Results

A total of 253 older adults participated in the study, most of whom were identified as having a high risk of falls. Logistic regression analysis across six association models revealed that the models including the Intrinsic Capacity domains of locomotion and hearing had a significant association with having a higher risk of falls. Care plans should prioritise the domains most strongly associated with fall risk, guiding targeted strategies to enhance older adults' safety.

Conclusion

The Integrated Care for Older People screening tool, in the locomotion and hearing domains, is associated with the risk of falls in older people from the community receiving care in a geriatric healthcare service. Future longitudinal studies could show whether other domains of intrinsic capacity can predict the occurrence of falls.

Relevance to Clinical Practice

This study highlights the Integrated Care for Older People screening tool as essential in nursing practice, especially for assessing the locomotion and hearing domains of intrinsic capacity. Early detection of impairments helps identify increased fall risk in older adults, enabling nurses to implement targeted, person-centred interventions that enhance safety, autonomy and overall quality of life.

Patient or Public Contribution

No patient or public contribution.

Reporting Method

This study complied with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines for cross-sectional studies.

Canadian Adaptive Platform Trial of Treatments for COVID in Community Settings (CanTreatCOVID): protocol for a randomised controlled adaptive platform trial of treatments for acute SARS-CoV-2 infection in community settings

Por: Hosseini · B. · Condon · A. · da Costa · B. R. · Daley · P. · Greiver · M. · Jüni · P. · Lee · T. C. · McBrien · K. · McDonald · E. G. · Murthy · S. · Selby · P. · Andrew · M. · Aubrey-Bassler · K. · Barber · D. · Barrett · B. · Butler · C. C. · Crampton · N. · Dahrouge · S. · Damji · A.
Introduction

SARS-CoV-2 is now endemic and expected to remain a health threat, with new variants continuing to emerge and the potential for vaccines to become less effective. While effective vaccines and natural immunity have significantly reduced hospitalisations and the need for critical care, outpatient treatment options remain limited, and real-world evidence on their clinical and cost-effectiveness is lacking. In this paper, we present the design of the Canadian Adaptive Platform Trial of Treatments for COVID in Community Settings (CanTreatCOVID). By evaluating multiple treatment options in a pragmatic adaptive platform trial, this study will generate high-quality, generalisable evidence to inform clinical guidelines and healthcare decision-making.

Methods and analysis

CanTreatCOVID is an open-label, individually randomised, multicentre, national adaptive platform trial designed to evaluate the clinical and cost-effectiveness of therapeutics for non-hospitalised SARS-CoV-2 patients across Canada. Eligible participants must present with symptomatic SARS-CoV-2 infection, confirmed by PCR or rapid antigen testing (RAT), within 5 days of symptom onset. The trial targets two groups that are expected to be at higher risk of more severe disease: (1) individuals aged 50 years and older and (2) those aged 18–49 years with one or more comorbidities. CanTreatCOVID uses numerous approaches to recruit participants to the study, including a multifaceted public communication strategy and outreach through primary care, outpatient clinics and emergency departments. Participants are randomised to receive either usual care, including supportive and symptom-based management, or an investigational therapeutic selected by the Canadian COVID-19 Outpatient Therapeutics Committee. The first therapeutic arm evaluates nirmatrelvir/ritonavir (Paxlovid), administered two times per day for 5 days. The second therapeutic arm investigates a combination antioxidant therapy (selenium 300 µg, zinc 40 mg, lycopene 45 mg and vitamin C 1.5 g), administered for 10 days. The primary outcome is all-cause hospitalisation or death within 28 days of randomisation.

Ethics and dissemination

The CanTreatCOVID master protocol and subprotocols have been approved by Health Canada and local research ethics boards in the participating provinces across Canada. The results of the study will be disseminated to policy-makers, presented at conferences and published in peer-reviewed journals to ensure that findings are accessible to the broader scientific and medical communities. This study was approved by the Unity Health Toronto Research Ethics Board (#22-179) and Clinical Trials Ontario (Project ID 4133).

Trial registration number

NCT05614349

NutriNet-Brasil, a web-based prospective study on dietary patterns and risk of chronic diseases: cohort profile

Por: Costa · C. d. S. · Gabe · K. T. · dos Santos · F. S. · Leite · M. A. · Quinta · F. P. · Torquato · B. M. d. A. · Martinez Steele · E. · Rauber · F. · Rezende · L. F. M. · da Costa Louzada · M. L. · Levy · R. B. · Monteiro · C. A.
Purpose

Non-communicable diseases (NCDs), such as diabetes, cardiovascular diseases and cancer, are major global public health concerns. Diet quality—particularly the consumption of ultra-processed foods—has been associated with increased risk of NCDs. Traditional cohort studies are often expensive and logistically complex. The NutriNet-Brasil cohort leverages a web-based approach, offering a cost-effective and practical solution for comprehensive data collection and long-term follow-up.

Participants

Recruitments began in January 2020 through mass media, social media campaigns and collaborations with health organisations. Eligible participants are adults (aged ≥18 years) living in Brazil with internet access. Participants complete self-administered online questionnaires covering dietary intake, health status and other health determinants. Dietary assessment is based on the Nova classification system, which categorises foods by their level of processing.

Findings to date

Over 88 000 participants have completed the initial questionnaire. The cohort is predominantly women (79.9%) and highly educated (67.9% had completed higher education). The web-based design enabled the development and application of innovative dietary assessment tools, including the Nova24h and the Nova24hScreener, specifically designed to evaluate food processing levels. These tools have shown good performance in capturing dietary patterns and are central to the cohort’s aim. The online platform facilitates efficient recruitment, data collection and participant retention.

Future plans

NutriNet-Brasil is pioneering the development of web-based cohort methodologies and instruments tailored to food processing research. Future work includes leveraging collaborations with national and international research centres to conduct multidisciplinary analyses and inform public health policies.

Necesidades humanas básicas en gestantes con alto riesgo obstétrico analizado bajo la Teoría de Wanda Horta

Objetivo: identificar las necesidades humanas básicas de las embarazadas de alto riesgo hospitalizadas con base en la Teoría de Wanda Horta. Método: investigación asistencial realizada con dieciséis gestantes de alto riesgo hospitalizadas en una maternidad de referencia en Ceará entre septiembre y noviembre de 2019. Se recolectó información a través de diario de campo y ficha de caracterización de las gestantes y registros de necesidades humanas básicas. Los resultados se analizaron mediante estadística descriptiva simple y un enfoque integral a la luz del marco de Wanda Horta. Resultados: las gestantes presentaron necesidades psicobiológicas, psicosociales y psicoespirituales, siendo prevalentes: ausencia de actividades de ocio, inseguridad emocional, escaso conocimiento, sueño y descanso perjudicados, y actividades físicas restringidas por indicación de descanso. Consideraciones finales: se cree que el razonamiento crítico y el juicio clínico de los enfermeros se centraron en la individualidad de las gestantes, identificando necesidades en los tres niveles propuestos por la teoría, apuntando caminos para cualificar el cuidado de enfermería a las gestantes de alto riesgo.

Acciones de la enfermería láser y la estomaterapia: revisión integradora

Objetivo principal: Identificar en la literatura las acciones de la enfermería en láser y estomaterapia.Metodología:Revisión integradora de la literatura realizada en abril de 2022, mediante consulta de las Bases de Datos Biblioteca Virtual en Salud (BVS) a partir de los cruces de los descriptores, se realizó una encuesta bibliográfica en las siguientes bases de datos: Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS) y Biblioteca Nacional de Medicina (MEDLINE). Resultados principales: Se incluyeron once artículos en la muestra, que destacan el uso de la terapia láser de baja intensidad en la cicatrización de heridas con efectos positivos, su uso por parte de la enfermera profesional y la especialización en estomaterapia, poniendo al profesional en el punto de mira. Conclusión principal:La importancia del uso de las nuevas tecnologías en la cicatrización de heridas, como el láser siendo la enfermera el pilar de esta atención, pudiendo especializarse en el área de la estomaterapia, pero es necesario profundizar en la investigación en esta área por parte de las enfermeras.

Papel del equipo de enfermería durante la atención al paciente con sospecha de Infarto Agudo de miocardio

Objetivos: Describir el papel del equipo de enfermería en el cuidado de pacientes con sospecha de infarto agudo del miocardio. Metodo-logía: revisión integradora de la literatura, utilizando las bases de datos MEDLINE, PUBMED, LILACS, CUIDEN, CINAHL, y las Prácticas Recomendadas de la Sociedad Brasileña de Cardiología. Se incluyeron publicaciones de 2010 a 2021, que estuvieran en portugués y de acceso gratuito. Resultados: se obtuvo una muestra final de 26 artículos, siendo seleccionados y agrupados en tres categorías temáti-cas: A) Conocimiento del equipo de enfermeria sobre los protocolos para el atendimiento a los pacientes con sospecha de Infarto agudo de miocardio B) la Sistematización de la asistencia de enfermeria durante el atendimiento inicial; C) Papel del equipo de enfermeria. Conclusiones: el equipo de enfermeria es visto como parte fundamental en las unidades de atención, por lo tanto, es necesario actualizar a estos profesionales para un mejor soporte técnico y científico, basado en la evidencia.

Eventos adversos en la atención de pacientes en hemodiálisis en unidades de cuidados intensivos

Objetivo principal: El objetivo fue identificar y analizar eventos adversos en la atención de pacientes en hemodiálisis en la Unidad de Cuidados Intensivos. Metodología: Estudio descriptivo y retrospectivo desarrollado en una clínica de hemodiálisis, que subcontrata el servicio de hemodiálisis a 10 unidades de cuidados intensivos en hospitales de Goiânia, Goiás, Brasil. Se realizó una evaluación de los indicadores de evaluación de los servicios de hemodiálisis con el fin de elevar los eventos adversos en los últimos seis meses. Resultados principales: La mayoría de los pacientes fueron sometidos a hemodiálisis mediante catéter venoso central de doble lumen, con predominio del sexo masculino y mayores de 60 años. En los seis meses se identificaron 1.988 sesiones de hemodiálisis, 228 eventos adversos que generaron interrupción del tratamiento, producto de fallas en tecnología sanitaria, fallas en el acceso vascular, alteración hemodinámica y metabólica del paciente o por orden médica. Conclusión principal: Los eventos adversos identificados en la atención de pacientes en hemodiálisis en una unidad de cuidados intensivos provocaron la interrupción de la sesión de tratamiento de diálisis. Fueron: fallas en la tecnología de la salud, fallas en el acceso vascular y cambios hemodinámicos y metabólicos.

Business Intelligence como herramienta de apoyo en la identificación de casos de suicidio en RS – Brasil

Introducción: Actualmente, el uso de tecnologías innovadoras ha ayudado a los profesionales a gestionar mejor el volumen de información de manera inteligente, para facilitar y optimizar el uso de acciones y prácticas preventivas. Entendido como un recurso capaz de expandir o acceder a datos, nuestro objetivo es analizar el tema del suicidio en Rio Grande do Sul, en el período de 2010 a 2019, desde el portal municipal de Business Intelligence. Método: Una investigación es de naturaleza cuantitativa, de tipo descriptivo, basada en los registros de muertes por suicidio en el estado de Rio Grande do Sul, escuchada por el portal público de inteligencia empresarial (BI). Los datos fueron analizados, basados en el número bruto de muertes por suicidio en la macro-región del Sur, registrada en el Portal BI / DGTI. Se realizó una descripción del número de muertes según el año, el sexo, el grupo de edad y la tasa de suicidios. Resultados: un total de 11,774 muertes por suicidio, registradas en los últimos 10 años, o el número más alto que ocurrió en los años 2017 y 2019, entre los hombres, con tasas más altas en los grupos de edad entre 20 y 69 años. Una tasa más alta registrada fue en 2019, con 12.41 muertes por cada 100,000 habitantes. Concluimos con este estudio sobre el uso de Bussiness Intelligence, que permite acciones más efectivas en la prevención del suicidio.

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