Conectar
by Claudia Castro, Jacquelyn Badillo, Melissa Tumen-Velasquez, Adam M. Guss, Thomas S. Collins, Frank Harmon, Devin Coleman-Derr
Recent wildfires near vineyards in the Pacific United States have caused devastating financial losses due to smoke taint in wine. When wine grapes (Vitis vinifera) are exposed to wildfire smoke, their berries absorb volatile phenols derived from the lignin of burning plant material. Volatile phenols are released during the winemaking process giving the finished wine an unpleasant, smokey, and ashy taste known as smoke taint. Bacteria are capable of undergoing a wide variety of metabolic processes and therefore present great potential for bioremediation applications in many industries. In this study, we identify two strains of the same species that colonize the grape phyllosphere and are able to degrade guaiacol, a main volatile phenol responsible for smoke taint in wine. We identify the suite of genes that enable guaiacol degradation in Gordonia alkanivorans via RNAseq of cells growing on guaiacol as a sole carbon source. Additionally, we knockout guaA, a cytochrome P450 gene involved in the conversion of guaiacol to catechol; ΔguaA cells cannot catabolize guaiacol in vitro, providing evidence that GuaA is necessary for this process. Furthermore, we analyze the microbiome of berries and leaves exposed to smoke in the vineyard to investigate the impact of smoke on the grape microbial community. We found smoke has a significant but small effect on the microbial community, leading to an enrichment of several genera belonging to the Bacilli class. Collectively, this research shows that studying microbes and their enzymes has the potential to identify novel tools for alleviating smoke taint.This study aimed to analyse the number of myocardial infarction (MI) admissions during the COVID-19 lockdown periods of 2020 and 2021 (March 15th to June 15th) and compare them with corresponding pre-pandemic period in 2019. The study also evaluated changes in critical treatment intervals: onset to door (O2D), door to balloon (D2B) and door to needle (D2N) and assessed 30-day clinical outcomes. This study examined MI care trends in India during the COVID-19 lockdown period, irrespective of patients’ COVID-19 infection status.
Multicentre retrospective cohort study
Twenty-three public and private hospitals across multiple Indian states, all with 24/7 interventional cardiology facilities.
All adults (>18 years) admitted with acute myocardial infarction between March 15 and June 15 in 2019 (pre-pandemic), 2020 (first lockdown) and 2021 (second lockdown). A total of 3614 cases were analysed after excluding duplicates and incomplete data.
Number of MI admissions, median O2D, D2B and D2N times.
30-day outcomes including death, reinfarction and revascularisation.
MI admissions dropped from 4470 in year 2019 to 2131 (2020) and 1483 (2021). The median O2D increased from 200 min (IQR 115–428) pre-COVID-19 to 390 min (IQR 165–796) in 2020 and 304 min (IQR 135–780) in 2021. The median D2B time reduced from 225 min (IQR 120–420) in 2019 to 100 min (IQR 53–510) in 2020 and 130 min (IQR 60–704) in 2021. Similarly, D2N time decreased from 240 min (IQR 120–840) to 35 min (IQR 25–69) and 45 min (IQR 24–75), respectively. The 30-day outcome of death, reinfarction and revascularisation was 4.25% in 2020 and 5.1% in 2021, comparable to 5.8% reported in the Acute Coronary Syndrome Quality Improvement in Kerala study.
Despite the expansion of catheterisation facilities across India, the country continues to fall short of achieving international benchmarks for optimal MI care.
Artificial intelligence (AI) technologies are increasingly being developed and deployed to support clinical decision-making, care delivery and patient monitoring in healthcare. However, the adoption of AI-driven solutions by nurses, who comprise the largest segment of the healthcare workforce and are central to patient care, has been limited to date. Understanding nurses’ perceptions of barriers and facilitators to AI adoption is critical for successful integration of AI in nursing practice. This systematic review aims to identify, appraise and synthesise qualitative evidence on nurses’ perceived barriers and facilitators to adopting AI-driven solutions in their clinical practice.
We will conduct systematic searches across eight electronic databases (PubMed, Web of Science, Embase, CINAHL, MEDLINE, The Cochrane Library, PsycINFO and Scopus) from inception to January 2025, supplemented by hand-searching reference lists and grey literature. Primary qualitative studies and qualitative components of mixed-methods studies exploring licensed/registered nurses’ perceptions of AI adoption in clinical settings will be included. Two independent reviewers will screen studies, extract data using standardised forms and assess methodological quality using the Critical Appraisal Skills Programme checklist. We will employ meta-ethnography to synthesise the qualitative evidence, involving systematic comparison and translation of concepts across studies to develop overarching themes and a theoretical framework. The Grading of Recommendations Assessment, Development and Evaluation Confidence in the Evidence from Reviews of Qualitative Research (GRADE-CERQual) approach will be used to assess confidence in review findings. The protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines and the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement.
No ethical approval is required as this systematic review will synthesise data from published studies only. The findings will provide valuable insights to inform the development, implementation and evaluation of nurse-oriented strategies for AI integration in healthcare delivery. Results will be disseminated through peer-reviewed publication, conference presentations and stakeholder engagement activities.
CRD42024602808.
While survival rates following neonatal surgery for congenital heart disease (CHD) have improved over the years, neurodevelopmental delays are still highly prevalent in these patients. After correcting for the CHD subtype, the severity of developmental impairment is dependent on multiple factors, including intraoperative brain injury, which is more frequent and more severe in those undergoing aortic arch repair with deep hypothermic circulatory arrest (DHCA). It is proposed that brain injury may be reduced if cooling is stopped at the point of electrocerebral inactivity (ECI) on electroencephalogram (EEG), but there is limited evidence to support this as few centres perform perioperative EEG routinely. This study aims to assess the feasibility of EEG monitoring during neonatal aortic arch repair and investigate the relationship between temperature and EEG to inform the design of a future clinical trial.
Single-centre prospective observational cohort study in a UK specialist children’s hospital, aiming to recruit 74 neonates (≤4 weeks corrected age) undergoing aortic arch repair with DHCA. EEG will be acquired at least 1–3 hours before surgery, and brain activity will be monitored continuously until 24 hours following admission to intensive care. Demographic, clinical, surgical and outcome variables will be collected. Feasibility will be measured by the number of patients recruited, data collection procedures, technically successful EEG recordings and adverse events. The main outcomes are the temperature at which ECI is achieved and its duration, EEG patterns at key perioperative steps and neurodevelopmental outcomes at 24 months postsurgery.
The study was approved by the Yorkshire and The Humber Sheffield National Health Service Research Ethics Committee (20/YH/0192) on 18 June 2020. Written informed consent will be obtained from the participant’s parent/guardian prior to surgery. Findings will be disseminated to the academic community through peer-reviewed publications and presentations at conferences. Parents/guardians will be informed of the results through a newsletter in conjunction with local charities.
Closed incision negative pressure therapy (ciNPT) with foam dressings has received broad recognition for its ability to support incision healing for a variety of surgical procedures. Over time, these dressings have evolved to include linear and ‘area’ shapes to better conform to different incision types and surface geometries. To address new studies on these configurations and provide guidance for dressing selection, an international, multidisciplinary panel of experts was convened. The panel reviewed recent publications on ciNPT with reticulated open cell foam (ROCF) dressings, shared their cases and experiences and engaged in roundtable discussions on benefits, drawbacks and technical challenges. Topics were ranked by importance and refined into potential consensus statements. These were shared for anonymous feedback, requiring 80% agreement for consensus. This manuscript establishes 12 consensus statements regarding risk factors supporting the use of ciNPT, conditions supporting preference of linear or area ciNPT dressings and tips for practical application of ciNPT with ROCF dressings. While this consensus panel expands on previous publications to aid clinicians' decision-making, further research is needed to refine recommendations and identify the strengths and limitations of ciNPT. Continued multidisciplinary collaboration will ensure ciNPT remains vital for improving surgical outcomes and patient care.
by Kristina Devi Singh-Verdeflor, Michelle M. Kelly, Gregory P. DeMuri, Gemma Warner, Sabrina M. Butteris, Mary L. Ehlenbach, Barbara Katz, Joseph A. McBride, Shawn Koval, Ryan J. Coller
BackgroundCOVID-19 testing safeguards the health of children with medical complexity (CMC) through several key mechanisms, such as the implementation of clinical action plans and COVID-19-directed therapies. However, testing utility is limited by barriers to access and perceptions surrounding use. This study investigated associations between rurality and COVID-19 testing access, intent, motivators, and concerns for caregivers of CMC.
MethodsWe conducted a cross-sectional survey (April – June 2022) of English- and Spanish-speaking caregivers of children with at least one complex chronic condition between ages 5–17 at an academic medical center in the Midwestern USA. Rurality was dichotomized using Rural-Urban Commuting Area codes. Outcomes represented COVID-19 testing access, intent, motivators, and concerns. Covariates included demographic and clinical characteristics. Unadjusted and adjusted logistic regression analyses examined associations between rurality and each outcome.
ResultsAmong 1,432 responses (response rate 49%), 359 (25%) were classified as rural. Respondents had varied education, income, and insurance levels. In the multivariable models, rural and urban caregivers reported similarly high testing access, but rural caregivers had significantly less testing intent (adjusted Odds Ratio [95% CI]: 0.53, [0.40, 0.71]). Notably, rural caregivers were significantly more likely to indicate “It will be difficult to get needed healthcare if my child has it” (2.49 [1.19, 5.18]).
ConclusionsWhile rural and urban CMC caregivers reported generally high access and ease of COVID-19 testing, potentially modifiable factors exist to improve testing intention and decrease barriers, including communication regarding testing utility and timing as well as access to effective treatment response upon testing positive.
To identify and describe nursing practices on the sexual health of people with neurological disorders.
Narrative review.
Data were extracted from 1 January 2002, to 20 May 2021. Inclusion criteria were nursing practices, sexual health and people with neurological disorders. The main outcome measures were: context of nursing practice implementation (assumptions, knowledge, strategies and skills), facilitators of and barriers to addressing and treating the sexual health of people with neurological disorders, and benefits of nursing practices in sexual health. PRISMA reporting guidelines were used.
PubMed, Embase, ScienceDirect and CINAHL.
In total, 926 articles were identified and nine were included. The involvement of nurses was recommended in most studies. Assumptions about the impact of neurology on sexuality and nurse's role in sexual healthcare, biopsychosocial knowledge, and skills (ethical, interpersonal, and technical) were highlighted. We found that the modes of knowledge proposed by Carper were mobilized in an unequal way. Sexual difficulties were the key focus and eroticization concerns were not addressed in any of the articles.
Several studies advocate nursing intervention; however, few accurately present, detail and evaluate sexual health nursing practices of patients with neurological pathologies. Literature describes practices structured around disorders rather than the potentials, fails to address the brake of eroticism and provides little information on the results of interventions.
Developing teaching programs on sexual health in nursing programs may be necessary if nurses are to support a diverse range of patients in an inclusive and positive manner. These programs should highlight the domain-specific knowledge that is mobilized.
Sexual health is a fundamental human right. Alterations in the nervous system have shown to affect sexual health, however, it is not often discussed among patients with neurological disorders, who are rarely provided with sexual health counselling. Our findings may impact healthcare professionals engaged in care with these patients.
PRISMA.
No patient or public contribution.
Nurse-reported missed care (NRMC) is considered as any significant delay or omission in provision of nursing care.
(i) Evaluate the frequency, types, and reasons for NRMC in the Post-anesthesia Care Unit (PACU). (ii) Evaluate associations between nurse demographic and workload factors with NRMC. (iii) Explore nurses' perception of NRMC in the PACU.
A cross-sectional study was conducted in the PACU in a tertiary acute care hospital over 3 months. Full-time PACU nurses were conveniently sampled to complete an anonymous survey after their daily shift over different shifts. It contained three sections: (i) nurse demographics; (ii) elements of NRMC; and (iii) reasons for NRMC. Qualitative interviews employed a semi-structured guide to explore perceptions and experiences of NRMC. Descriptive, inferential statistics, and thematic analyses were applied.
Sixty-six survey responses were collected. 48.5% of respondents indicated at least one NRMC activity. Activities more clinically sensitive were less missed. Eight nurses were interviewed. Four main themes were identified: (i) communication with patients; (ii) communication and teamwork with colleagues; (iii) dual role of documentation; and (iv) staffing inadequacy. Language barriers made communication challenging. Staff shortage exacerbates workload but effective teamwork and documentation facilitates nursing care.
Communication and staffing concerns aggravate NRMC. Teamwork and personal contentment were satisfactory. Nurses' turnover intention may worsen staffing.
Timeliness and quality of nursing care is impacted by elements such as manpower, allocation of resources, work processes, and workplace environmental or interpersonal factors such as culture and language fit. Re-evaluation of nursing resources and work processes may assist post-anesthesia care unit nurses in fulfilling their role, decreasing the prevalence of nurse-reported missed care.
To explore registered nurses' thinking strategies during the drug administration process in nursing homes.
An exploratory qualitative design.
Eight registered nurses, one male and seven female, in five nursing home wards in Mid-Norway were observed during 15 drug dispensing rounds (175 drug dispensing episodes). Think Aloud sessions with follow-up individual interviews were conducted. The Think Aloud data were analysed using deductive qualitative content analysis based on Marsha Fonteyn's description of 17 thinking strategies. Interview data were used to clarify missing information and validate the content of Think Aloud data.
The registered nurses used all 17 thinking strategies described by Fonteyn, including several variants of each strategy. The three most frequent were ‘providing explanations’, ‘setting priorities’ and ‘drawing conclusions’. In addition, we found two novel thinking strategies that did not fit into Fonteyn's template, which were labelled ‘controlling’ and ‘interacting’. Among all strategies, ‘controlling’ was by far the most used, serving as a means for the registered nurses to stay on track and navigate through various interruptions, while also minimising errors during drug dispensing.
The study highlights the diverse thinking strategies employed by registered nurses in nursing homes during medication administration. The findings emphasise the multifaceted nature of medication administration and underscore the importance of skilled personnel in ensuring medication safety. Recognising the significance of these findings is crucial for maintaining patient well-being and upholding medication safety standards in healthcare settings.
Understanding the thinking strategies employed by registered nurses can inform training programmes and enhance the clinical judgements of health care professionals involved in medication administration, ultimately leading to improved patient outcomes and reduced medication errors in practice.
Patients were involved in this study as recipients of drugs which the nurses distributed during the observations. The patients were involved as a third party and consent to the observations was either given by the patients themselves or relatives in cases where the patient was not competent to consent. No personal information was collected about the patients.
The reporting of this study adhered to the COREQ checklist.
Several studies have reported the prevalence of overweight and obesity in various countries but the global prevalence of nurses with overweight and obesity remains unclear. A consolidation of figures globally can help stakeholders worldwide improve workforce development and healthcare service delivery.
To investigate the global prevalence of overweight and obesity among nurses.
Systematic review with meta-analysis.
29 different countries across the WHO-classified geographical region.
Nurses.
Eight electronic databases were searched for articles published from inception to January 2023. Two independent reviewers performed the article screening, methodological appraisal and data extraction. Methodological appraisal was conducted using Newcastle-Ottawa Scale (NOS). Inter-rater agreement was measured using Cohen's Kappa. Meta-analyses were conducted to pool the effect sizes on overweight, obesity and waist circumference using random effects model and adjusted using generalised linear mixed models and Hartung–Knapp method. Logit transformation was employed to stabilise the prevalence variance. Subgroup analyses were performed based on methodological quality and geographical regions. Heterogeneity was assessed using the I 2 statistic.
Among 10,587 studies, 83 studies representing 158,775 nurses across 29 countries were included. Based on BMI, the global prevalence of overweight and obesity were 31.2% (n = 55, 95% CI: 29%–33.5%; p < .01) and 16.3% (n = 76, 95% CI: 13.7%–19.3%, p < .01), respectively. Subgroup analyses indicated that the highest prevalence of overweight was in Eastern Mediterranean (n = 9, 37.2%, 95% CI: 33.1%–41.4%) and that of obesity was in South-East Asia (n = 5, 26.4%, 95% CI: 5.3%–69.9%). NOS classification, NOS scores, sample size and the year of data collected were not significant moderators.
This review indicated the global prevalence of overweight and obesity among nurses along with the differences between regions. Healthcare organisations and policymakers should appreciate this increased risk and improve working conditions and environments for nurses to better maintain their metabolic health.
Not applicable as this is a systematic review.
PROSPERO (ref: CRD42023403785) https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=403785.
High prevalence of overweight and obesity among nurses worldwide.
Objetivo: identificar y cuantificar los efectos secundarios del tratamiento con Ig (Inmunoglobulinas) al 10% y 5% así como los factores de riesgo asociados a su administración, influencia del catéter utilizado y la existencia de asociación entre las reacciones adversas y factores de riesgo del paciente. Metodología: Se cumplimento un cuestionario ad-hoc con los pacientes receptivos de tratamiento con Ig en la unidad. Resultados: La flebitis fue de un 22,5 %, siendo mayor en Ig al 10% (25,6%), frente al de Ig al 5% (9,5%) Al analizar el catéter en relación con flebitis, el calibre 22 tuvo una incidencia del 41,9% frente 16% del calibre 20. Conclusiones: Uno de los efectos adverso destacados es la flebitis en la cual el sexo femenino, el ritmo de infusión elevado y el catéter influye como factor de riesgo.
FreshRSS 