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Self-management measurement instruments specific to individuals with cardiovascular diseases: a systematic review protocol using COSMIN methodology

Introduction

Cardiovascular diseases (CVDs) are the leading cause of death worldwide, making the development of self-management strategies crucial for preventing complications and improving clinical outcomes. This process involves symptom monitoring, treatment adherence, emotional management and a healthy lifestyle, among others. Reliable instruments are necessary to measure self-management, requiring robust psychometric properties. In this way, this COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN)-based systematic review aims to assess the quality of specific self-management instruments for adults with CVDs.

Methods and analysis

This systematic review will follow the COSMIN and be reported according to the Preferred Reporting Items for Systematic Review and Meta-analysis Protocol. Searches will be conducted in seven databases: MEDLINE, Web of Science, Scopus, PsycINFO, EMBASE and CINAHL. Additionally, a manual search will be performed on PROQOLID, PROMIS and The Medical Outcome Trust websites. Studies on the development and validation of patient-reported instruments measuring specific self-management for individuals with CVDs will be included, without language or date restrictions. The search will be performed in November 2025, with the final version of the review expected to be completed in October 2026. Data extraction will follow COSMIN recommendations. The Modified Grading of Recommendations, Assessment, Development and Evaluation approach will be used to determine the quality of evidence. Instruments will be categorised according to COSMIN recommendations. All steps will be conducted by two independent reviewers, with a third reviewer involved in case of discrepancies. Additionally, the content of the instruments will be analysed and linked to the International Classification of Functioning, Disability and Health, following international recommendations.

Ethics and dissemination

This study does not require ethics committee approval as it is a review of published data. The review results will be disseminated through peer-reviewed journal publications and presentations at scientific conferences.

PROSPERO registration number

CRD42024605969.

Ozoile‐Stable Ozonides, Derived From Organic Extravirgin Olive Oil, Enhance Wound Healing Process in Patients With Diabetic Chronic Ulcers

ABSTRACT

The article describes the outcomes of a single-centre investigation on the use of OZOILE to improve the healing process in patients with chronic diabetic ulcers. This is a non-randomised interventional study which aims to assess the differences between two groups (total 200 patients) by evaluating healing time at 15, 30, 45, 60, 75 and 90 days. Pain assessment with VAS scale at 15, 30 and 45 days, biofilm test and tissue regeneration by histological evaluation were also taken into consideration. The outcomes show faster healing, reduced pain, control of local infection, aesthetically pleasing and qualitatively better healing. Our treatment strategy involves applying OZOILE detergent without rinsing, Ozoile spray oil and Ozoile cream followed by a non-adherent dressing (paraffin gauze). This integrated protocol shows a safe and effective treatment for diabetic chronic wound healing in a cost-effective manner. The group treated with the Rigenoma/Ozoile protocol demonstrated significantly superior outcomes compared to the control group, including accelerated healing, reduced pain levels, effective management of unpleasant odour, and high levels of compliance from both patients and surgeons. Overall, Ozoile markedly reduced healing time compared with standard care, with results robust across multiple analytical approaches.

Photobiomodulation for postoperative pain relief following conventional periapical surgery: a randomised controlled study protocol

Por: Cirisola · R. W. C. · Moya · L. E. P. · Olazabal · M. V. G. · Wagmann · D. A. A. · Suarez · G. P. · Wince · C. · Bruno · M. L. H. · Salaberry · D. R. · Sobral · A. P. T. · Longo · P. L. · Motta · L. J. · Bussadori · S. K. · Duran · C. C. G. · Fernandes · K. P. S. · Mesquita-Ferrari
Introduction

Photobiomodulation (PBM) has shown promising effects in managing postoperative pain following conventional periapical surgery, although current evidence remains limited. This study aims to assess the effect of PBM on postoperative pain 24 hours after periapical surgery.

Methods and analysis

A randomised, controlled, double-blind trial will include 34 patients undergoing periapical surgery in the maxillary region, randomly assigned to an experimental group (n=17) or control group (n=17). The experimental group will receive PBM (GaAlAs diode laser, 808 nm, 100 mW, 4 J/cm², applied at five vestibular points) and placebo ibuprofen immediately and 24 hours postoperatively. The control group will receive simulated PBM and active ibuprofen. The primary outcome is postoperative pain assessed by the visual analogue scale at 24 hours. Secondary outcomes include pain at the seventh day, paracetamol intake, oedema, ecchymosis, soft tissue status and temperature at 24 hours and 7 days. Radiographic evaluation of healing will be performed at 1 and 3 months. Statistical analysis will be conducted based on data distribution, using repeated measures ANOVA (Analysis of Variance) or non-parametric equivalents for longitudinal outcomes, and appropriate tests for categorical variables. Significance will be set at p

Ethics and dissemination

The study was approved by the Human Research Ethics Committee of Universidad Católica del Uruguay (process no. 220914). Results will be disseminated to participants, healthcare professionals, the public and scientific communities.

Trial registration number

NCT05935306.

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.

A Digital Alert Feedback System (Aged Care Electronic Dashboard Information Tool, ACED‐IT) to Enhance Quality Nursing Care: Participatory Action Research

ABSTRACT

Aims

Develop and simulate test a digital alert dashboard drawing from existing data to support nurses, care workers and managers in residential aged care.

Design

Participatory action research, co-designing for an Australian 64-bed residential site.

Methods

Qualitative data were collected through focus groups and analysed using reflective thematic analysis.

Results

Nursing-theory and evidence-based Nursing Data Domain Standards (NDDS) were developed to support internal triaging of fundamental and clinical care in a non-clinical environment. A co-designed retrospective digital alert dashboard (Aged Care Electronic Dashboard Information Tool—ACED-IT) representing the Standards was created and tested. Twenty aged care nurses, care workers and managers found it had promise in enhancing quality of care, improving resident health and reducing adverse events.

Conclusions

Maximising efficient use of resident-level data with a system that empowers nurse decision-makers is crucial to support effective care design and harm prevention.

Implications for the Profession and/or Patient Care

ACED-IT has the potential to improve visibility of resident needs, support staff to adjust their workflow based on in-house triage, enhance supervision of staff and quality of care and reduce preventable complications.

Impact

Digital systems that enable nursing care escalation and triaging for early intervention are needed in residential aged care settings. The co-designed system was perceived by registered nurses, care workers and managers to have the potential to improve care quality and efficiency. Using an evidence-informed nursing framework to identify day-to-day care indicators can be widely implemented by government regulators, software providers and residential care providers on an international scale to improve resident experience.

Reporting Method

This study adhered to the relevant EQUATOR guidelines, specifically the COREQ (Consolidated Criteria for Reporting Qualitative Research) Checklist.

Patient or Public Contribution

A member of the public participated in the Advisory Group, observed and contributed to the co-design process and reviewed the manuscript.

Bringing together conceptualisations of the health advocacy competence across the continuum of medical education: a scoping review protocol

Por: Oosthoek · W. R. W. · Cecilio-Fernandes · D. · Engel · M. F. M. · van Prooijen · L. T. · Otto · S. J. · Woltman · A. M.
Introduction

Health advocacy (HA) is acknowledged as a core competence in medical education. However, varying and sometimes conflicting conceptualisations of HA exist, making it challenging to integrate the competence consistently. While this diversity highlights the need for a deeper understanding of HA conceptualisations, a comprehensive analysis across the continuum of medical education is absent in the literature. This protocol has been developed to clarify the conceptual dimensions of the HA competence in literature as applied to medical education.

Methods and analysis

The review will be conducted in line with the JBI (formerly Joanna Briggs Institute) methodology for scoping reviews. A comprehensive literature search was developed and already carried out in eight academic databases and Google Scholar, without restrictions on publication date, geography or language. Articles that describe the HA role among students and physicians who receive or provide medical education will be eligible for inclusion. Two independent reviewers will independently complete title and abstract screening prior to full-text review of selected articles and data extraction on the final set. A descriptive-analytical approach will be applied for summarising the data.

Ethics and dissemination

This scoping review does not involve human participants, as all evidence is sourced from publicly available databases. Therefore, ethical approval is not required for this study. The findings from this scoping review will be disseminated through submission to a high-quality peer-reviewed journal and presented at academic conferences. By clarifying the conceptualisations of HA, this review aims to contribute to a shared narrative that will strengthen the foundation for integrating the HA role into medical education.

Trial registration number

A preliminary version of this protocol was registered on the Open Science Framework on 9 December 2024, and can be accessed at the following link: https://osf.io/ed2br. We have also registered our scoping review protocol as a preprint at medRxiv: https://doi.org/10.1101/2024.12.09.24318699.

Reflexão acerca do imaginário social na ótica do cuidado religioso em enfermagem a partir do cinema moderno

RESUMEN 

Introducción: El cine moderno debuta en la década de 1940, contradiciendo la estética clásica en sus producciones y dando lugar a una reflexión sobre su validación como teoría artística. Así, esta investigación busca un acercamiento histórico-social a la enfermera religiosa retratada en la filmografía de Hollywood en este período. Objetivos: Describir y analizar el imaginario social sobre la representación de la enfermera religiosa retratada en la película “Uma Historia de una Monja”, de 1959, contextualizada en el período del cine moderno, considerando el contexto cultural, histórico y técnico. Metodología: Se trata de una investigación sociocultural cualitativa, analítica e histórica, sustentada en el marco teórico del "Imaginario Social" y el marco filosófico de la Teoría de los Valores, de Max Scheler, que tiene como objetivo refrendar el carácter emocional y racional de los religiosos. enfermera retratada en la película “Uma Historia de una Monja”, de 1959, desde una perspectiva modernista. Resultados: La enfermera religiosa asume la postura clerical en el cuidado como núcleo del cuidado caritativo. El cine llevó su narrativa emocional propensa al afecto cristiano, pero en la corriente moderna el racional actúa consciente de las limitaciones que le impone el dogma, interfiriendo en su ejercicio científico profesional. Conclusión: El lenguaje del cine nos permite transponer figuras verosímiles a sus narrativas bajo la tutela del imaginario social, la enfermera es una de ellas. En esta producción, la libertad ficcional analiza en formato visual sus valores morales en la sociedad actual, destacando el cine como un arte único por representar contextos atemporales de sus actores sociales. 

 

Escuela de Enfermería de la Universidad de São Paulo: 80 años desde la fundación hasta la construcción de puentes con la sociedad

La Escuela de Enfermería de la Universidad de São Paulo celebró su 80 aniversario en octubre de 2022 y consolida una trayectoria histórica de construcción de puentes con la sociedad. Pionera fue su marca registrada, comenzando con el edificio que alberga la Escuela en un estilo contemporáneo, al aceptar hombres y mujeres negras en el curso de enfermería en la década de 1940. La Escuela experimentó profundas transformaciones que elevaron a la institución al nivel de excelencia tanto a nivel nacional como internacional.

Using Digital Technology to Promote Patient Participation in the Rehabilitation Process in Hip Replacement: A Scoping Review

imageThe purpose of this scoping review was to identify and summarize how technology can promote patient participation in the rehabilitation process in hip replacement. We conducted a scoping review following the steps outlined by the Joanna Briggs Institute. The PRISMA Checklist (Preferred Reporting Items for Systematic reviews and Meta-Analyses) was utilized to systematically organize the gathered information. A thorough search of articles was performed on PubMed, Scopus, and CINAHL databases for all publications up to December 2022. Twenty articles were included in this study. Various technologies, such as mobile applications, Web sites, and platforms, offer interactive approaches to facilitate total hip replacement rehabilitation. The analyzed studies were based on the rehabilitation of total hip arthroplasty, which in most of them was developed in mobile applications and Web sites. The studies identified reflect trends in the application of digital health technologies to promote patient engagement in the rehabilitation process and provide risk monitoring and patient education.

COVID-19 Nursing Staff Sizing Technology

imageThis study shows the development of a software for calculating the number of nursing team members required for providing care during the coronavirus disease 2019 pandemic. Study about the development of a technology based on the literature about data and indicators. The indicators were systematized in the following dimensions: institutional, professional, and occupational structure, all with a focus on coronavirus disease 2019. The software was created to be used on the Web, client-server, in browsers such as Internet Chrome, Explorer, and/or Mozilla Firefox, accessing via an Internet address and also allowing access by Windows, Android, and Linux operating systems, with MySQL database used for data storage. The data and indicators related to the institutional structure for coronavirus disease 2019 were systematized with 10 dimensions and indicators, and the professional and occupational structure, with 14 dimensions and indicators. The construction of computer requirements followed the precepts of software engineering, with theoretical support from the area. In the evaluation of the software, data simulation revealed points that had to be adjusted to ensure security, data confidentiality, and easy handling. The software provides to calculate the size and quality of the team, nursing sizing required due to the needs generated by the coronavirus disease 2019 pandemic.

Proceso de enfermería en la asistencia a pacientes en terapia de hemodiálisis

Objetivo: identificar los diagnósticos de enfermería y las intervenciones más frecuentes en la asistencia a los pacientes en hemodiálisis. Método: se realizó un estudio descriptivo, transversal, retrospectivo con un enfoque cuantitativo, realizado con 175 prontuarios de pacientes en hemodiálisis, asistidos en el servicio por un período de seis meses. Para la recolección de los datos, se utilizó la plataforma Google Forms®, generando una hoja de trabajo en Microsoft Excel®, un software que permite organizar, describir y analizar los mismos. Resultados principales: se identificaron tres diagnósticos de enfermería como más frecuentes: Riesgo de sangrado (67,2%); Riesgo de caída (56,5%) y Exceso de volumen de líquido (54,8%), en más de la mitad de los pacientes de acuerdo con los registros en los prontuarios. Las intervenciones de enfermería están dirigidas por el protocolo del procedimiento de hemodiálisis y no por los diagnósticos de enfermería. Conclusión: los diagnósticos más frecuentes se centran en las condiciones clínicas de la población estudiada, y no subvencionan las intervenciones de enfermería, que se definen con base en técnica de hemodiálisis.

Evaluación y cuidado de la piel al final de la vida

Este artículo contempla una actualización con base a los diez puntos establecidos por el consenso Skin Changes at the Life's End [Cambios en la Piel en el Final de la Vida] (Scale, por su sigla en inglés) y tiene por objetivo discutir la evaluación de las condiciones y el cuidado de la piel en el final de la vida. Acerca de los pacientes y familiares, se propone la construcción de un plan de cuidados basándose en sus deseos que deben ser debidamente registrados. Para los profesionales de salud, las recomendaciones buscan la educación para la evaluación de los signos clínicos de falla e insuficiencia de la piel. Así pues, la prioridad es la comodidad del paciente. Se concluye que la utilización del consenso Scale va al encuentro de la filosofía de los cuidados paliativos y puede así mejorar los aspectos multidimensionales involucrados en la calidad del proceso de morir.

Transición segura del hospital a la comunidad: algoritmo para la prevención de caídas en ancianos

Este estudio tuvo como objetivos hacer que un panel de expertos diseñara y validara un algoritmo de soporte a la práctica clínica del enfermero promoviendo la transición segura entre el hospital y la comunidad. Se realizaron dos estudios: una revisión integrativa de literatura para diseñar el algoritmo, sometido a validación por un panel de 8 expertos, recurriendo a la técnica nominal. Fueron considerados los procedimientos éticos. El análisis y síntesis de los 30 estudios que conformaron la muestra bibliográfica permitió identificar las intervenciones eficaces para la prevención de caídas en la transición hospital-comunidad. El algoritmo final fue validado por el panel de expertos por unanimidad. La continuidad de los cuidados resulta vital para prevenir la caída o su recurrencia en los ancianos hospitalizados con alto riesgo de caída o que las sufrieron durante su internación. Las caídas después del alta hospitalaria requieren de investigación.

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