Conectar
Self-treatment of benign symptoms using hot water bottles, steam inhalation or hot tea is common in households and poses risks of severe scald injuries. This study aims to investigate associated hazards and identify high-risk patient groups to facilitate targeted prevention. A retrospective, single-center descriptive study was conducted on adult burn patients with scald injuries from hot water bottles, steam inhalation or hot tea. Demographic information, injury mechanism and outcomes were analysed. A total of 43 patients (mean age: 37.5 years; female:male ratio 23:20) were included. Injuries were caused by hot water/tea (37.2%), steam (34.9%) and hot water bottles (27.9%). The average burned total body surface area (TBSA) was 4%, with 79.1% of injuries being superficial partial-thickness burns. Surgical intervention was required in 13.9% of cases. Hot water bottle injuries predominantly affected young females (75%, mean age 32.6 years), with a high incidence of genital burns (58.3%). Hot tea-related injuries were more frequent in older males (62.5%, mean age 41.6 years), involving greater TBSA (6.5%) and a higher necessity for skin grafting (18.8%). Common self-treatment strategies can cause serious scalds, particularly in specific demographic groups, thereby burdening healthcare systems. Awareness of these risks is pivotal for effective education and prevention.
by Jakub Jamárik, Jiří Vitouš, Radovan Jiřík, Daniel Schwarz, Eva Koriťáková
Neuropsychiatric malignancies frequently manifest at the level of individual cortical layers. The resolutions currently available for medical magnetic resonance imaging (MRI) prevent the study of these pathologies at clinically available field strengths of 3 T. Previous studies have claimed to have overcome these issues by extensions of quantitative MRI. Following this, the feasibility of multiexponential T1 relaxometry was assessed as a basis for in vivo delineation of cortical lamination. Three methods of non-linear least-squares-based multiexponential analysis were examined across key degrees of freedom identified in the literature. The methods employ a wide variety of ways to overcome the common pitfalls of multiexponential analysis, such as regularization, bound constraints, and repeated optimization from multiple starting points. A custom MRI phantom was 3D-printed and filled with various MnCL2 mixtures that represent the spin-lattice relaxation times that commonly occur in neocortical gray and white matter at 3 T. A 96 × 96-voxel image consisting of a single slice was acquired using a FLASH sequence and used to create 10 composite datasets with known distributions of T1 decay constants. The results showed that lowest relative error achieved across multiexponential models was approximately 20%. As achieving even this level of estimation accuracy requires either T1 ratios that rarely occur in the cerebral cortex or knowledge of the number of relaxation components and their expected values to a degree that is seldom feasible, the visualization of cortical layers based on these estimates is unlikely to represent their true distribution. In conclusion, the current methodological approaches do not allow for sufficiently precise estimation of T1 decay constants spanning the range of cortical gray and white matter.The aim was to validate the stoma self-efficacy scale and assess the psychometric properties of the Czech version of the scale in patients with intestinal stoma. Another aim was to assess self-efficacy in patients with intestinal stoma.
Descriptive, cross-sectional and validation study.
Two hundred and ninety patients with intestinal stoma participated in the study during 2023. The original SSES instrument was linguistically validated into Czech. Content validity of the scale, test–retest, intraclass coefficient, Cronbach's alpha, McDonald's ω, construct and convergent validity were assessed for psychometric properties. The study followed STROBE guidelines.
The stoma self-efficacy scale was adopted into Czech, demonstrating excellent content validity. An intraclass correlation coefficient was calculated to establish test–retest reliability, showing excellent reliability of the Czech version. Cronbach's alpha and McDonald's ω showed high reliability. Factor analysis was applied for construct validity. Exploratory factor analysis was used to extract three factors on the Czech version of the scale: Stoma care self-efficacy, social self-efficacy and burden self-efficacy. The factors accounted for 62.05% of the total variance and showed strong internal consistency. Confirmatory factor analysis was applied separately to the data of respondents with colostomy and respondents with ileostomy. The fit indices were satisfactory for respondents with colostomy after adjustment. The composite reliability coefficient showed acceptable values in each factor.
The Czech version of the stoma self-efficacy scale has excellent psychometric properties in patients with intestinal stoma. It is a reliable tool for use in patients with intestinal stoma to assess self-efficacy. The scale can also be used by nurses who care for these patients and based on this, meet the individual needs related to patients' self-efficacy.
Nurses' burnout, work instability (WI), and job satisfaction (JS) in their practice environment (PE) are well established in the literature. However, perinatal missed care (PMC), a subset of missed nursing care, remains underreported among maternity nurses.
To examine the mediating role of PE and burnout in the associations of WI, JS, and PMC among maternity nurses.
A cross-sectional and correlational study employed consecutive sampling to recruit maternity nurses (n = 312) from five hospitals in Saudi Arabia (three government and two private hospitals in Hail and Makkah regions, respectively). Maternity staff nurses, regardless of their sex, years of professional nursing experience, or nationality, who met inclusion criteria were included in this study. Data was collected from July to September 2024 using four standardized self-report scales. Structural equation modeling was utilized for statistical analyses.
Maternity nurses' WI negatively influenced PE (β = −0.23, p = 0.014), while positively affected PMC (β = 0.15, p = 0.031). The PE positively affected JS (β = 0.24, p = 0.034) but had a negative effect on burnout (β = −0.24, p = 0.007) and PMC (β = −0.21, p = 0.038). Burnout negatively affected JS (β = −0.25, p = 0.028), while positively associated with PMC (β = 0.20, p = 0.022). PE mediated the associations between WI and burnout (β = 0.05, p = 0.019), JS (β = −0.07, p = 0.020), and PMC (β = −0.06, p = 0.008). Meanwhile, burnout mediated between PE and JS (β = 0.05, p = 0.030) and PMC (β = −0.04, p = 0.023).
Understanding the relationships among maternity nurses' burnout, JS, PE, and PMC is key to improving the quality of perinatal care and ensuring the patients' well-being. By focusing on strategies to enhance the PE (e.g., adequate staffing and resources, improved nurse–patient ratio), reduce burnout (e.g., meditation and mindfulness programs, coping intervention programs), and improve JS (e.g., work schedule flexibility, facilitate work-life balance, staff professional development), healthcare organizations can mitigate the occurrence of PMC.
by Georgia Black, Reena Besa, Daniel Blumberger, Heather Brooks, Graham Collingridge, John Georgiou, Evelyn K. Lambe, Clement Ma, Bernadette Mdawar, Tarek K. Rajji, Sanjeev Sockalingam, Cara Sullivan, Quincy Vaz, Zhengbang Yao, Branka Agic
IntroductionIntegrated knowledge translation (iKT) is a collaborative research approach that emphasizes the meaningful and active participation of knowledge users throughout the research process. Evidence suggests that integrated knowledge translation has the potential to increase the relevance, applicability, and use of research findings. This approach has been increasingly utilized in health research in recent years. However, the extent to which it has been applied in preclinical research and its effectiveness are unknown. To address this gap, we will conduct a scoping review to map the current use, potential benefits, and challenges of iKT in preclinical research.
MethodsGuided by a modified Arksey and O’Malley’s scoping review framework, we will systematically search reference lists and key research databases including Medline, Embase, PsycINFO, Cochrane CENTRAL, Cochrane Database of Systematic Reviews, and Web of Science. Peer-reviewed articles written or translated in English that focus on iKT or approaches that align with iKT within the context of preclinical research will be included. This review will be conducted as part of the Improving Neuroplasticity through Spaced Prefrontal intermittent-Theta-Beta-Stimulation REfinement in Depression (INSPiRE-D) project, which features preclinical research from mouse models to human work (Grant number CAMH File No.22-060). The project’s multidisciplinary team and knowledge user advisory committee will be consulted at key points throughout the scoping review process. A person with lived experience co-chairs the project advisory committee, co-authored this manuscript, and will be routinely included in the decision-making process of the scoping review.
To examine the direct and indirect predictors of thriving at work and its impact on intention to leave the organisation or profession among early career nurses.
A repeated cross-sectional design.
A sub-study of early career nurses as part of an Australian longitudinal follow up study, commenced in 2018, was conducted. The sub-study asked early career nurses between their second and sixth year after graduating to complete a structured online questionnaire assessing thriving at work and several predictor variables. Data were analysed using Pearson's correlation, multiple linear regression, and path analysis.
Among the 67 participants (response rate of 42.9%), thriving at work was positively correlated with occupational hardiness, social support from colleagues, and wellbeing, while negatively correlated with compassion fatigue. Thriving at work and perceived organisational support were the significant predictors of intention to leave the organisation, while perceived organisational support was the only significant predictor of intention to leave the profession.
The importance of strong collegial relationships, compassion fatigue, and improving wellbeing to enhance thriving at work are highlighted. Fostering an environment where employees can thrive is crucial to reduce the intentions to leave an organisation. Relationships with the managers and quality of care provision also play a crucial role in reducing turnover and leave intentions. Perceived organisational support enhances employee wellbeing, thereby reducing turnover intentions. Future strategies should focus on comprehensive support systems to retain nurses in their organisation and the profession.
Enhancing thriving at work and perceived organisational support can reduce early career nurses' intention to leave their organisation. However, job stressors and interpersonal conflicts also influence professional leave decisions.
This study has adhered to the STROBE guidelines.
No Patient or Public Contribution.
by Mansuk Daniel Han, Thomas Yates, Kamlesh Khunti, Cameron Razieh, Francesco Zaccardi
Multimorbidity, or multiple long-term conditions (MLTC), is a growing public health concern with implications for quality of life, healthcare utilisation, and premature mortality. Classical explanations for MLTC often treat sociodemographic categories as independent predictors, overlooking the relational dynamics of health inequalities. This systematic review examines how MLTC outcomes vary at the intersections of sociodemographic factors within their relational context. We conducted a systematic search of PubMed, Medline, and Scopus to identify 792 studies. Four studies met inclusion criteria but none were longitudinal, which limits our ability to examine the role of intersectional effects on MLTC outcomes over the life course from this review. A narrative synthesis was conducted due to their wide heterogeneity among the MLTC outcomes of the studies included in this review. The limited evidence may potentially suggest that MLTC outcomes can vary considerably at the intersections of sociodemographic factors. All four studies in this review suggested that the association of income with MLTC outcomes can vary by what other sociodemographic factors it intersects with. The role of disability on MLTC outcomes varied when intersected with ethnicity, at least in the US racial context. A low level of education is a known MLTC risk factor, but when intersected with ethnicity for both men and women in the South African setting, definitive cumulative disadvantages were not found in the projected life expectancy. Future intersectionality-informed quantitative MLTC research should prioritise using longitudinal data and solution-linked variables to inform context-responsive interventions.by Ariene Silva do Carmo, Paulo César Pereira de Castro Júnior, Thais Cristina Marquezine Caldeira, Daniela Silva Canella, Rafael Moreira Claro, Luiza Delazari Borges, Larissa Loures Mendes
The present study analyzed the prices of food sold in canteens of Brazilian private schools and described price-based marketing strategies, according to the NOVA food classification system. This is a mixed methods study combining a cross-sectional component and time series analysis, with data from 2,241 canteens in private elementary and secondary schools in the 26 capitals of Brazil and the Federal District, collected between June 2022 and June 2024. Price data collected for unprocessed, minimally processed, or processed foods and culinary preparations based on these foods (UMPCP), and ultra-processed foods and culinary preparations based on these foods (UpCP) sold in school canteens and from the National System of Consumer Price Indices (SNIPC), were used to create a data set containing deflated monthly prices for food and beverages sold between August 2022 and July 2024. Calculations were made for adjusted prices (R$/100 g or ml) and absolute prices (R$ per portion), and frequency of use of strategies such as combos and promotions. UMPCP showed lower adjusted price, but higher absolute price than UpCP, especially for solid foods. About 27% of the study canteens implemented pricing strategies for both food groups. Most of these strategies did not exclusively favor healthy foods, indicating that promotions and combos were used without distinction. The affordability of healthy foods is disadvantaged in school canteens when considering the price per portion, which may negatively influence students’ food choices. The findings show that current prices for food sold in most canteens discourage the purchase of healthy items, but favor the purchase of unhealthy ones. These results reinforce the importance of interventions for promoting healthy foods and making them more affordable.To implement an overview of reviews that discuss the current state of syntheses (such as systematic reviews) of only observational studies on health risk behaviours (HRBs), including smoking, alcohol intake, poor sleep, poor quality diet, common mental health problems (depression and anxiety), and glycated haemoglobin (HbA1c), while excluding synthesis of clinical trials.
Overview of reviews or umbrella review following Preferred Reporting Items for Overviews of Reviews (PRIOR) guidelines.
PubMed, Scopus, Web of Science, PsycINFO-PsychArticles and Epistemonikos, searched from January 2013 to 30 June 2025.
We included systematic reviews and meta-analyses of observational studies that assessed the relationship between HRBs—including smoking, alcohol intake, poor sleep, poor quality diet, physical activity and common mental health problems such as depression and anxiety—and HbA1c. Reviews of clinical trials were excluded.
We synthesised systematic reviews and meta-analyses on the above topic from five databases following the PRIOR protocol. Two independent reviewers screened titles, abstracts and full texts using standardised methods. Data extracted included study design, exposures, outcomes and population characteristics. Risk of bias was assessed using the AMSTAR-2 tool. Overlap across reviews was evaluated using the corrected covered area metric.
Eight systematic reviews were included in the final synthesis, encompassing a total sample size of around 307 019 individuals. The study highlights a significant paucity of systematic reviews of observational studies in this area, with no reviews on alcohol and exercise. The existing evidence on poor sleep, poor quality diet and smoking points towards these HRBs leading to worse HbA1c. A bidirectional relationship was found between depression and HbA1c.
This umbrella review highlights the significant association between HbA1c and key health risk factors underscoring the importance of observational studies, highlighting their ability to capture real-world conditions and complex interactions. While in agreement with existing study designs, this review provides convergent evidence of the critical role of HRBs in managing HbA1c levels.
by Daniel Bekele Ketema, Min Jun, Sradha Kotwal, Workagegnehu Hailu, Martin Gallagher, Rohina Joshi
BackgroundChronic kidney disease (CKD) is a growing public health problem in Ethiopia. However, evidence on the health system and contextual factors influencing CKD care remains limited. This study explored the barriers and facilitators to CKD care from the perspectives of healthcare providers and other stakeholders.
MethodsA descriptive qualitative study was conducted using purposive and maximum variation sampling to recruit healthcare providers (including general practitioners, nephrologists/internists, nurse) and non-communicable disease (NCD) officers and program coordinators. Interviews were audio recorded, transcribed, and thematically analysed, underpinned by the Theoretical Domains Framework version 2.
ResultsFifteen participants (six general practitioners, five nephrologists/internists, one nurse, and three NCD program officers and coordinators) were included. About 40% of participants had over six years’ experience. Key barriers to CKD care included patient misconceptions, low patient and healthcare provider awareness, shortage of health workforce, knowledge gaps among junior healthcare providers, limited resources, high out-of-pocket costs, absence of registries for CKD, weak referral systems, inconsistent access to medicines and diagnostics, lack of structured training, and conflict-related disruptions. Facilitators included adherence to guidelines by senior staff, inclusion of CKD into national non-communicable disease strategies, and increased use of media for public health education.
ConclusionsAddressing key barriers and enhancing prioritisation of CKD by clinicians and policymakers is critical. Strengthening workforce capacity, awareness, referral systems, and integration into national strategies offers opportunities to improve CKD care.
To examine the potential mediating role of social support and depression between loneliness and quality of life among long-term care facility residents.
A cross-sectional study.
A convenience sample of 121 long-term care facility residents was recruited between June 2024 and March 2025. Validated instruments assessed loneliness, social support, depression, and quality of life. Multivariable regression and mediation analyses explored relationships and mediation effects among these variables.
Participants had a mean age of 80.6 years. Loneliness was reported by 80.2% of residents, poor social support by 82.6%, depressive symptoms by 33.1%, and reduced quality of life by 52.1%. Multivariable analysis identified loneliness and depression as significant predictors of diminished quality of life. Mediation analysis revealed that depression partially mediated the relationship between loneliness and quality of life, while social support did not.
Loneliness and depression significantly influence quality of life in long-term care facility residents, with depression as a partial mediator. Targeted interventions addressing both loneliness and depression are essential to enhance residents' well-being.
Nursing practice must prioritise interventions for loneliness and depression to improve quality of life in long-term care facilities, with a particular focus on managing depressive symptoms.
This work informs nursing practice and policy to enhance well-being in long-term care facilities by highlighting the critical role of loneliness and depression. Nursing interventions should prioritise targeted mental health support and personalised care plans to address these issues effectively. Further research is needed to clarify the contextual role of social support in this population to improve intervention effectiveness.
The authors have followed the STROBE checklist for reporting methods.
No patient or public contribution outside of the participation in the actual study for purposes of data collection.
by Maria Cecilia Rasuk, Alfonsina Palladini, Andrea Moyano, Viviana Díaz, Antonella Giudice, Gisela Castillo, Solana Abraham, Juan Rull, Anja Poehlein, Rolf Daniel, Julian Rafael Dib
The Mediterranean fruit fly (Ceratitis capitata Wied.) is an agricultural pest of significant economic importance. This species has been globally managed using the Sterile Insect Technique (SIT). Insects, including tephritid flies, harbor a diverse gut microbiota that plays critical roles in their physiology, behavior, and overall fitness, suggesting that microbial communities may profoundly influence the biology of this pest. The aim of this study was to characterize the fungal and bacterial gut microbial communities of C. capitata from Tucumán, Argentina, and to assess their response to antimicrobial treatment using amplicon-based 16S rRNA gene and ITS region sequencing. Both control and treated flies were dominated by Proteobacteria (bacteria) and Zygosaccharomyces (fungi). Antimicrobial treatment induced significant shifts in bacterial and fungal composition, reducing diversity and altering gut community structure. Untreated flies exhibited a diverse and structured bacterial gut community dominated by the family Enterobacteriaceae, while antibiotic-treated communities were dominated by Rhizobiaceae. Despite these shifts, fungal communities in both treated and untreated groups were consistently dominated by the genus Zygosaccharomyces. Functional predictions revealed notable changes in metabolic pathways following antibiotic treatment, including increased gene abundance for ABC transporters and the phosphotransferase system, and decreased representation of genes involved in antibiotic biosynthesis and two-component systems. These results indicate significant alterations in bacterial metabolism and stress response mechanisms induced by the treatment. Such changes may help explain the underperformance of irradiated, mass-reared males within the context of SIT. This study provides new insights into the structural and functional dynamics of the C. capitata gut microbiome under disturbance. These findings have implications for understanding the ecological roles of microbial communities in this pest and their potential impact on fly health and fitness. Identification of dominant gut bacterial and fungal groups may support the development of probiotic diets, enhancing the efficiency of SIT application.In 2023, 21% of deaths occurred in residential aged care facilities (RACFs), a setting expected to play an increasing role in palliative and end-of-life care (PEoLC). General practitioners (GPs) oversee and deliver PEoLC in residential and nursing homes, yet little is known about their practice. We conducted a systematic review of the published evidence concerning how GPs provide this care: what they do and the quality, challenges and facilitators of that care.
Systematic review and narrative synthesis using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Medline, Embase, CINAHL, PsycINFO, Web of Science, Scopus and NHS Evidence and grey literature via Google Scholar were searched through 9 October 2024.
We included studies presenting new empirical data from qualitative, quantitative or mixed methods, were published in the English language and conducted in the UK, the European Union, Australia, New Zealand and Canada. We excluded studies with no new empirical data, discussion papers, conference abstracts, opinion pieces, study participants under 18 years old and in care settings other than RACF.
One independent reviewer used standardised methods to search and screen study titles for inclusion. This reviewer assessed all abstracts of the included papers, and a second independent reviewer screened 60% of the abstracts to validate inclusion. Risk of bias was assessed using Gough’s Weight of Evidence assessment. Thematic analysis was used to describe the contents of the included papers; a narrative synthesis approach was taken to report the findings at a more conceptual level.
The search identified 5936 titles: 35 papers were eligible and included in the synthesis. This is a nascent evidence base, lacking robust research designs and characterised by small sample sizes; the results describe the factors observed to be important in the delivery of care. Care provision is extremely variable; no models of optimal care have been put forward or tested. Challenges to care provision occur at every level of the care system. At macro level, service-level agreements and policies vary: at meso level, team-working, communication technology solutions and equipment availability vary: at micro level, GPs’ interests in providing PEoLC vary as does their training. No study addresses residents’ and relatives’ experiences and expectations of GPs' involvement in PEoLC in RACFs.
The limited evidence base highlights that GP care at end of life for RACF residents varies greatly, with enablers and challenges at all levels in the existing care systems. Little research has examined GP PEoLC for RACF residents in its own right; insight is derived from studies that report on this issue as an adjunct to the main focus. With national policies focused on moving more PEoLC into community settings, these knowledge deficits require urgent attention.
In Tanzania, acute myocardial infarction (AMI) is underdiagnosed, and uptake of evidence-based care is suboptimal. Using an implementation science approach, an intervention was developed to address local barriers to care: the Multicomponent Intervention for Improving Myocardial Infarction Care in Tanzania (MIMIC).
This sequential cohort design trial was conducted in a single northern Tanzanian emergency department (ED). During the preintervention phase (February–August 2023) and the postintervention phase (September 2023–August 2024), adults presenting with chest pain and/or dyspnoea were prospectively enrolled and their ED care was observed. AMI was defined by the Fourth Universal Definition criteria. Telephone follow-ups were conducted to ascertain 30-day mortality. Pearson’s ² was used to compare care before and after MIMIC implementation.
A total of 275 participants were enrolled in the preintervention phase and 577 were enrolled in the postintervention phase. Following MIMIC implementation, significant increases were observed in ECG testing (89.4% of postintervention participants vs 55.3% preintervention, OR 6.82, 95% CI 4.79 to 9.79, p
The MIMIC intervention was associated with large increases in uptake of AMI testing, case identification and evidence-based treatment in a single Tanzanian ED. Multisite studies are needed to evaluate the effect of MIMIC on AMI care in diverse settings across Tanzania.
With the global population ageing rapidly, older adults face increased risks of physical and cognitive decline. Despite the well-documented benefits of physical activity (PA), many older adults fail to meet PA guidelines. Mobile health (mHealth) apps offer promising tools to promote PA, but user engagement remains a challenge. In response, the MIA app was co-created with older adults using the Behavior Change Wheel framework to enhance usability, relevance and sustained engagement. A feasibility study showed promising results in usability and user satisfaction, supporting further evaluation. The goal of this study is to evaluate the effectiveness of MIA on PA promotion in older adults.
A randomised controlled trial conducted in Belgium at a university college will assess the effectiveness of the MIA app in promoting PA in older adults. Participants will be randomly assigned in a 1:1 ratio to either the intervention group (MIA app use) or the control group (no use of MIA) for 8 weeks. The primary outcome is moderate-to-vigorous PA, measured via Garmin wearable devices. Secondary outcomes include self-reported measures (PA, well-being, user satisfaction), clinical assessments (physical and cognitive functioning) and time series assessments (daily steps). A total of 75 participants will be recruited to ensure sufficient power, accounting for dropout. Eligible participants must be ≥65 years, medically stable, have no significant cognitive or physical limitations, understand and speak Dutch and have access to a smartphone and/or computer. Exclusion criteria include an active lifestyle, participation in other exercise programmes or clinical trials, or any condition deemed by a healthcare professional to compromise safety or study validity.
The study was approved by the UHasselt Medical Ethics Committee (B1152025000012) and complies with Belgian legislation on human research. Written informed consent will be obtained from all participants prior to enrolment. Data will be securely stored for up to 25 years. Results will be disseminated via peer-reviewed publications and conference presentations.
The aim of review was to describe and synthesise the evidence on the use of tourniquets to control haemorrhages, summarising both civilian and military use.
Trauma-related haemorrhage constitutes one of the most preventable deaths among injured patients, particularly in multi-casualty incidents and disasters. In this context, safe instruments such as tourniquets are essential to help healthcare professionals to minimise loss of life and maximise patient recovery.
An integrative review was conducted in Medline, Nursing & Allied Health Premium, and Health & Medical Collection, using published data until March 2021 and following the PRISMA guidelines.
A total of 25 articles were included. Evidence has been synthesised to understand the use of different types of tourniquets, environment of application, indication for their placement and potential complications associated with tourniquet placement.
Commercial tourniquets such as Combat Application Tourniquet or Emergency Tourniquet models are a valuable and safe instrument for haemorrhage control in both military and civilian out-of-hospital care settings. Nurses, as part of emergency teams, and other professionals should be aware that there is a possibility of adverse complications, but they are directly proportional to the time of tourniquet placement and generally temporary. In addition, national and international guidelines ensure the need for all civilian emergency services to be equipped with these devices, as well as for the training of healthcare professionals and first responders in their use.
Despite the lack of complications in the use of tourniquets in these cases, their use has been a matter of debate for decades. In this sense, this review yields up-to-date guidelines in the use of tourniquets, their recommendations and their significance among professionals to manage complicated situations.
To identify interventions and strategies to prevent patient- and visitor-perpetrated violence against nurses working in acute hospital Emergency Departments. Design Scoping review following the Joanna Briggs Institute guidelines.
A comprehensive literature search was conducted in PubMed and CINAHL to identify relevant studies published up to June 2024. The review included primary research studies employing quantitative, qualitative, and mixed-method approaches. Eligibility criteria focused on interventions aimed at preventing physical and verbal violence in acute hospital emergency settings, explicitly targeting nurses. The selection process followed PRISMA-ScR guidelines, with independent screening and data extraction by two reviewer pairs. Data Sources PubMed and CINAHL databases were searched for studies published up to June 2024.
A total of 40 studies were included, covering interventions across 11 countries, mostly from the United States. Interventions were categorised as organisational, environmental, or individual-focused. Training programs were the most common strategy, followed by risk assessment tools, defense strategies, multidisciplinary briefings, and technology-assisted interventions. Most interventions (73%) were implemented before violent incidents, 23% during, and 5% after. Healthcare workers, particularly nurses, were the primary target group, highlighting the need for effective preventive strategies.
Violence prevention interventions in Emergency Departments focus on pre-incident strategies, mainly organisational and individual-focused. Limited attention has been given to environmental interventions despite their role in mitigating workplace violence. Further research is needed to assess the long-term effectiveness of these strategies.
Addressing workplace violence in EDs ensures a safer work environment, improves staff retention, and enhances patient care quality.
This study did not include patient or public involvement in its design, conduct, or reporting.
by Jasmine J. Su, Vasco S. Kupua, Daniel Cummings, Kathryn H. Jacobsen
ObjectivesAngola is one of the countries with the highest prevalence of sickle cell disease (SCD). Neonatal SCD testing is recommended by the Angolan government, but it is not routinely performed. Nearly all previous studies of SCD have been conducted in cities. We implemented a neonatal SCD screening program in a referral hospital in Huíla province to examine the epidemiology of SCD in this Umbundu-speaking population and to demonstrate the feasibility of using point-of-care (POC) tests for SCD in a rural setting.
MethodsBetween October 2024 and February 2025, we screened 353 infants less than one month old at Hospital Evangélico de Caluquembe for the hemoglobin S (HbS) gene using HemoTypeSC rapid diagnostic tests. We also reviewed all pediatric outpatient visits from 2024 to identify newly-diagnosed SCD cases.
ResultsTwenty-one (6.0%) of the 353 neonates had sickle cell trait (HbAS); none had SCD (HbSS). The outpatient register review identified 26 incident cases of SCD.
ConclusionsThe prevalence of HbS is lower in Caluquembe than in Luanda and Cabinda, but the combined results of our newborn screening and pediatric records provide evidence that there is a burden of disease from SCD in Caluquembe and the surrounding areas. Sickle cell screening and treatment programs should be available in all high-burden areas, not just large cities. The per-test costs may still be too expensive for universal newborn screening to be scaled up nationwide, but our pilot study demonstrates that POC tests can be a cost-effective method that yields immediate results.
FreshRSS 