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The ‘time-limited trial’ for patients with critical illness is a collaborative plan made by clinicians, patients and families to use life-sustaining therapies for a defined duration. After this period, the patient’s response to therapy informs decisions about continuing recovery-focused care or transitioning to comfort-focused care. The promise of time-limited trials to help navigate the uncertain limits and benefits of life-sustaining therapies has been extensively discussed in the palliative and critical care literature, leading to their dissemination into clinical practice. However, we have little evidence to guide clinicians in how to conduct time-limited trials, leading to substantial variation in how and why they are currently used. The overall purpose of this study is to characterise the features of an optimal time-limited trial through a rich understanding of how they are currently shaping critical care delivery.
We are conducting an observational, multicentre, focused ethnography of time-limited trials in patients with acute respiratory failure receiving invasive mechanical ventilation in six intensive care units (ICUs) within five hospitals across the US. Study participants include patients, their surrogate decision makers and ICU clinicians. We are pursuing two complementary analyses of this rich data set using the open-ended, inductive approach of constructivist grounded theory and, in parallel, the structured, deductive methods of systems engineering. This cross-disciplinary, tailored approach intentionally preserves the tension between time-limited trials’ conceptual formulation and their heterogeneous, real-world use.
This study has been reviewed and approved by the University of Wisconsin Institutional Review Board (IRB) as the single IRB (ID: 2022-1681; initial approval date 23 January 2023). Our findings will be disseminated through peer-reviewed publication, conference presentations, and summaries for the public.
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.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.
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
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.
There is limited evidence on how to effectively treat individuals from marginalised populations with dependence on amphetamine and/or methamphetamine (collectively referred to hereafter as amphetamine dependence). The disease burden is extremely high in this population, especially related to psychiatric comorbidities, cardiovascular complications, injection-related infections and poor social functioning. ATLAS4Dependence is a multi-centre randomised, placebo-controlled, double-blind trial that will investigate the effectiveness and safety of substitution treatment with dextroamphetamine compared with placebo in people with amphetamine dependence.
The trial will recruit 226 adult patients in several outpatient clinics in Norway.Inclusion criteria comprise individuals with amphetamine dependence, defined as use on three or more days per week during the past 28 days, who currently inject or have formerly injected drugs. This includes individuals both with and without comorbid opioid dependence, as well as those currently receiving or not receiving opioid agonist treatment. Participants will be randomly assigned 1:1 to receive either dextroamphetamine or placebo for 12 weeks. Flexible doses within the range of 30–120 mg daily will be provided based on individual assessments. The participants in both arms will be offered standard psychosocial and medical follow-up in accordance with current clinical practice. The endpoint assessments will be conducted at 12 weeks with weekly self-reports and safety assessments and a follow-up assessment at 52 weeks. The primary objective of the study is to assess the impact of 12 weeks daily prescribed oral dextroamphetamine versus placebo on the use of illicit amphetamines as well as on the total amount of amphetamines used (including both illicit and prescribed sources). Secondary outcomes are the differences between the groups at 12 weeks regarding psychological distress, symptoms of psychosis, quality of life, cardiovascular risk factors, injection-related infections, executive functioning, attention-deficit hyperactivity disorder-related symptoms, sleep, violence risk, fatigue, symptoms of craving and withdrawal, treatment retention, days of use of illicit amphetamines and use at 4 weeks and 8 weeks during the intervention period, use of other illicit substances and alcohol, as well as a cost-effectiveness analysis (using private economy, criminal activity and health service utilisation) and a qualitative approach to assess overall experiences with the study intervention. Analysis and reporting will follow the Consolidated Standards of Reporting Trials guidelines. All tests will be two-sided. Descriptive results and the estimated effectiveness will be presented with 95% CIs. The difference between the groups at the primary time point (at the end of the 12-week trial) will be assessed using 2 test (for use of illicit amphetamines measured by monthly urine tests) and Analysis of Covariance (ANCOVA) (for weekly self-reported total amount of amphetamines). Analyses for the primary endpoint will be undertaken on an intention-to-treat basis and reported on as such, but sensitivity analyses with per protocol analyses will also be presented.
The study is approved by European Medicines Agency, Clinical Trial Information System (CTIS). Written informed consent will be obtained from all patients. Study results will be published in international peer-reviewed medical journals.
CTIS 2023-510404-44-00.
To assess the feasibility of conducting a definitive randomised controlled trial (RCT) to test the clinical and cost-effectiveness of a tailored exercise intervention compared with usual care for people aged 80 years and older with hip and/or knee osteoarthritis (OA) and comorbidities.
Two-arm, parallel-design, multicentre, pragmatic, feasibility RCT.
Four National Health Service outpatient physiotherapy services across England.
Adults aged 80 years and over with clinical hip and/or knee OA and ≥1 comorbidity.
Participants were randomised 1:1 via a central web-based system to be offered: (1) a 12-week tailored exercise programme or (2) usual care. Participants and outcome assessors were not blinded to treatment allocation.
(1) Ability to screen and recruit participants; (2) retention of participants at 14-week follow-up; (3) intervention fidelity (proportion of participants who received ≥4 intervention sessions as per protocol) and (4) participant engagement (assessed by home exercise adherence).
Between 12 May 2022 and 26 January 2023, 133 potential participants were screened, of whom 94 were eligible. The main reasons for ineligibility were symptoms not consistent with hip or knee OA (10/39, 25.6%) or already having had a physiotherapy appointment (8/39, 20.5%). 51 of 94 (54%) eligible participants were recruited. Participants had a mean age of 84 years (SD 3.5), 31 (60.8%) were female and 96.1% reported their ethnicity as White British (n=49/51). 45 of 51 participants (88%) provided outcome data at the 14-week follow-up time point. Four or more intervention sessions were attended by 13/25 (52%) participants. Home exercise log completion declined over time: 6/23 participants (26.1%) returned completed exercise logs for all 12 weeks. The median number of days home exercises were recorded each week was 5 (range 0–7).
This study demonstrated that a definitive trial would be feasible. Before proceeding, modifications to ensure recruitment of a diverse population and intervention fidelity should be addressed.
Smoking is the leading cause of preventable deaths. The training of professionals on brief tobacco interventions (BTIs) increases the effectiveness of these interventions.
To assess the effectiveness of an online training program on BTI based on the 5As and 5Rs model in acquiring anti-tobacco brief advice competencies among nurses.
Quasi-experimental study with a pre-test and post-test design, with a control group and without random assignment. In the experimental group (EG), online training was provided in three sections: BTI theoretical content and methodology, clinical scenario videos, and feedback. Each scenario assessed the 5As and 5Rs as a validated instrument (BTI-Prof(C)). The control group (CG) only assessed the three videos of clinical scenarios. In both groups, competence was measured at the following points in time: T0 (before the training), T1 (at the end of the training), and T2 (after 90 days). The efficacy of the intervention was measured through a two-way ANOVA, and the variation rate was calculated from T0 to T1 and from T0 to T2.
236 nurses participated (157 EG; 79 CG). The mean age was 42.9 years, and 76.7% were women. There was a significant group*time interaction in the three cases, indicating that the online BTI training increases the competence of these professionals in clinical scenario 1 (F = 10.210; p ≤ 0.001; η 2 = 0.081), clinical scenario 2 (F = 6.235; p = 0.002; η 2 = 0.051), and clinical scenario 3 (F = 11.271; p ≤ 0.001; η 2 = 0.090).
A brief, asynchronous, and online intervention using standardized video-based cases is effective in improving nurses' BTI competence. This type of training can be a useful option for the National Health System as part of a global and continuous strategy for nurses to perform BTI.
An asynchronous online training program provides nurses with standardized, evidence-based tools to implement brief tobacco interventions in routine care, offering a scalable and practical solution to strengthen preventive strategies in health systems.
Early childhood development (ECD) lays the foundation for lifelong health, academic success and social well-being, yet over 250 million children in low- and middle-income countries are at risk of not reaching their developmental potential. Traditional measures fail to fully capture the risks associated with a child’s development outcomes. Artificial intelligence techniques, particularly machine learning (ML), offer an innovative approach by analysing complex datasets to detect subtle developmental patterns.
To map the existing literature on the use of ML in ECD research, including its geographical distribution, to identify research gaps and inform future directions. The review focuses on applied ML techniques, data types, feature sets, outcomes, data splitting and validation strategies, model performance, model explainability, key themes, clinical relevance and reported limitations.
Scoping review using the Arksey and O‘Malley framework with enhancements by Levac et al.
A systematic search was conducted on 16 June 2024 across PubMed, Web of Science, IEEE Xplore and PsycINFO, supplemented by grey literature (OpenGrey) and reference hand-searching. No publication date limits were applied.
Included studies applied ML or its variants (eg, deep learning (DL), natural language processing) to developmental outcomes in children aged 0–8 years. Studies were in English and addressed cognitive, language, motor or social-emotional development. Excluded were studies focusing on robotics; neurodevelopmental disorders such as autism spectrum disorder, attention-deficit/hyperactivity disorder and communication disorders; disease or medical conditions; and review articles.
Three reviewers independently extracted data using a structured MS Excel template, covering study ML techniques, data types, feature sets, outcomes, outcome measures, data splitting and validation strategies, model performance, model explainability, key themes, clinical relevance and limitations. A narrative synthesis was conducted, supported by descriptive statistics and visualisations.
Of the 759 articles retrieved, 27 met the inclusion criteria. Most studies (78%) originated from high-income countries, with none from sub-Saharan Africa. Supervised ML classifiers (40.7%) and DL techniques (22.2%) were the most used approaches. Cognitive development was the most frequently targeted outcome (33.3%), often measured using the Bayley Scales of Infant and Toddler Development-III (33.3%). Data types varied, with image, video and sensor-based data being most prevalent. Key predictive features were grouped into six categories: brain features; anthropometric and clinical/biological markers; socio-demographic and environmental factors; medical history and nutritional indicators; linguistic and expressive features; and motor indicators. Most studies (74.1%) focused solely on prediction, with the majority conducting predictions at age 2 years and above. Only 41% of studies employed explainability methods, and validation strategies varied widely. Few studies (7.4%) conducted external validation, and only one had progressed to a clinical trial. Common limitations included small sample sizes, lack of external validation and imbalanced datasets.
There is growing interest in using ML for ECD research, but current research lacks geographical diversity, external validation, explainability and practical implementation. Future work should focus on developing inclusive, interpretable and externally validated models that are integrated into real-world implementation.
Dementia education is critical for equipping informal carers with the necessary skills and knowledge to provide effective care. However, delivering comprehensive and accessible education remains challenging, particularly in resource-limited settings. Digital tools have emerged as innovative solutions to bridge these gaps, yet limited attention has been given to how such interventions are implemented in diverse caregiving contexts.
This scoping review aims to identify, synthesise and critically map the implementation strategies employed in digital education programmes designed for informal carers of people living with dementia. It also explores the contextual challenges and enabling factors associated with adopting and delivering such interventions across different care settings.
A scoping review was conducted following the PRISMA-ScR and JBI guidelines. The study adheres to the PRISMA-ScR checklist to ensure transparent and comprehensive reporting. Comprehensive searches were performed in eleven databases, covering studies published up to February 2024. Out of 2747 identified records, duplicates were removed and studies were screened based on predefined inclusion criteria. Ultimately, 18 studies were included in the review.
The findings revealed three core areas: (a) types of digital tools used, including online platforms, video conferencing, mobile applications and SMS services; (b) educational domains addressed, such as knowledge and skills, psychological support, communication and social interaction, and environmental and technological adaptation; and (c) implementation strategies and outcomes, highlighting personalisation, cultural sensitivity and technological adaptability, which improved knowledge, emotional well-being and carer self-efficacy. Based on these findings, a theoretical framework was developed that proposed a progressive model—Foundational, Competency and Growth—that aligns digital tools with carers' evolving needs and caregiving stages.
The scoping review demonstrates the potential of digital tools in informal carers' dementia education. To optimise their effectiveness, educational strategies should integrate active, adaptive and culturally tailored approaches, addressing carers' needs at both individual and systemic levels. Future research should explore the scalability, inclusivity and long-term impact of digital dementia education programmes to enhance carer support and patient outcomes.
Pain is under-assessed and under-treated among people living with dementia. This study aims to explore the perspectives of people with dementia, family carers, and healthcare professionals regarding their experiences and needs for pain assessment and management.
A qualitative descriptive approach.
Between May and August 2023, people with early-stage dementia (n = 6), their family carers (n = 7), and healthcare professionals (n = 10) from four Australian states participated in semi-structured interviews, online or by telephone. Most of the participants were female. Work experience of healthcare professionals and caring experience of carers ranged from 3–40 and 2–8 years, respectively. Following transcription, the data were analysed using inductive thematic analysis.
Four main themes and 10 subthemes were identified. Main themes were (1) communications to identify pain in people with dementia, (2) pain assessment in people with dementia, (3) pain management strategies, and (4) training in pain and dementia care. Healthcare professionals and family carers reported challenges in pain identification. People with dementia also mentioned their pain being unrecognised by carers. Facilitators included familiarity and communication with people with dementia and family carers. Non-verbal cues and unusual behaviours were commonly used to identify pain, and a personalised pain assessment approach was highlighted. Non-pharmacological strategies were used as the first-line therapy to manage pain. However, a lack of knowledge and training in pain and dementia care indicated the need for a training program (e.g., a self-paced online short course).
Pain assessment and management in people with dementia is challenging, primarily due to communication barriers and a lack of skill training. Formal pain assessment and management training and efficient, easy-to-use pain assessment tools are needed to address this.
Limited communication capacity in people with dementia and lack of training in carers are key challenges regarding pain assessment and management in people with dementia. Improved training in communication, pain assessment, and management skills may help to address these challenges.
This study addressed a lack of knowledge and skills for healthcare professionals and family carers in effective pain assessment and management in people with dementia. Collaborative communication among different stakeholders and skills training may overcome the challenges and barriers.
COREQ guidelines were followed when reporting this study.
Healthcare professionals, people with dementia, and family carers contributed to the design of interview questions and data collection.
Objetivo. Analizar la prevalencia de la automedicación y su relación con la capacidad de autocuidado en estudiantes del Centro de Ciencias de la Salud de una universidad pública. Metodología. Se llevó a cabo un estudio cuantitativo, relacional y observacional con una muestra de 330 estudiantes seleccionados aleatoriamente. Se utilizaron dos instrumentos validados para medir la automedicación y la capacidad de autocuidado, además de un formulario para variables sociodemográficas. Los datos se analizaron con SPSS versión 25, utilizando pruebas de normalidad, independencia y Chi-cuadrado de Pearson. Resultados. El 81,5% de los estudiantes presentó una capacidad media de autocuidado, mientras que el 18,5% tuvo una capacidad alta. No se encontraron estudiantes con baja capacidad de autocuidado. La prevalencia de la automedicación fue del 73,9%, siendo los fármacos más comunes antidiarreicos (10,6%), anfetaminas (10%), anticonceptivos orales y acetaminofén (7,6% cada uno). Los síntomas principales para automedicarse fueron dolor estomacal (9,7%), desgano/agotamiento (9,4%) y dolor de cabeza (9,1%). La carrera de Enfermería mostró la mayor prevalencia de automedicación (80,6%), seguida de Terapia Física (78,6%) y Medicina (76,4%). Se identificó dependencia estadísticamente significativa entre automedicación y capacidad de autocuidado. Discusión. Existe alta prevalencia de automedicación entre los estudiantes del área de salud. Es crucial reevaluar la independencia de ambas variables y abordar los factores que llevan a los estudiantes a automedicarse, ya que este comportamiento podría afectar su capacidad para proporcionar cuidados seguros y adecuados a los pacientes. Aun cuando no hay independencia entre variables.
ABSTRACT
Objective. To analyze the prevalence of self-medication and its relationship with the capacity of self-care among students of the Health Sciences Center in a public university. Methodology. A quantitative, relational and observational study was performed to a sample group of 330 students randomly selected. Two validated instruments were used to measure self-medication and self-care capacity, as well as a form for sociodemographic variables. All data were analyzed utilizing SPSS version 25, and using tests of normality, independence, and Pearson's Chi-square. Results. 81.5% of the students showed having a medium capacity of self-care, while 18.5% showed having a high capacity. Students with low self-care capacity were not found. The prevalence of self-medication was 73.9%, with the most common drugs being antidiarrheals (10.6%), amphetamines (10%), oral contraceptives, and acetaminophen (7.6% each). The main symptoms for self-medication resulted being stomach pain (9.7%), apathy / exhaustion (9.4%), and headache (9.1%). The Nursing career resulted with the highest prevalence of self-medication (80.6%), followed by Physical Therapy (78.6%) and Medicine (76.4%). A statistically significant dependency was identified between self-medication and self-care capacity. Discussion. There is a high prevalence of self-medication among health students. It is crucial to reevaluate the independence of both variables and address the factors that lead students to self-medication, as this behavior could affect their ability to provide safe and appropriate care to patients. Even when there is no independence between variables.
To explore registered nurses' beliefs regarding pain assessment in people living with dementia.
A descriptive exploratory qualitative study informed by the Theory of Planned Behaviour.
Online semi-structured in-depth interviews were conducted from January to April 2023 with a purposive sample of 15 registered nurses caring for people with dementia. Following transcription, data were analysed using direct content analysis.
Registered nurses believe pain assessment improves the well-being of people with dementia and informs and evaluates practice. However, there is a possibility of misdiagnosing pain as agitation or behavioural problems, leading to inaccurate pain management. Interpersonal factors, such as registered nurses' knowledge and experience, beliefs and motivation to improve care provision, were the primary facilitators of pain assessment. Physical and behavioural dimensions of the pain of the dementia syndrome were the most reported barriers to pain assessment. Registered nurses reported that multidisciplinary team members expect them to do pain assessments. Most did not experience disapproval when performing pain assessments.
Registered nurses hold beliefs about pain assessment benefits, consequences, enablers, barriers, approvals and disapprovals regarding dementia. The findings could inform interventions to enhance pain assessment practices.
Policymakers should provide education opportunities for registered nurses to improve their knowledge, skills and beliefs about pain assessment in dementia. Future research should develop and implement multidisciplinary, multifaceted pain assessment protocols to enhance the accuracy of pain assessment practices.
Pain is underassessed in dementia, and this could stem from registered nurses' beliefs about pain assessment in dementia. The findings could inform interventions to enhance pain assessment beliefs and practices.
This study adhered to the COREQ criteria.
Registered nurses caring for people living with dementia participated as interview respondents.
There is increased interest in implementing structured clinical handover frameworks to improve clinical handover processes. Research postulates that structured clinical handover frameworks increase the quality of handovers; yet inconsistencies enacting these frameworks exist which has a potential to jeopardise the quality of communication during handovers thereby defeating the purpose of these frameworks.
This scoping review aims to analyse and synthesise what is currently known of the nurses' experiences and perceptions in implementing structured clinical handover frameworks and identify knowledge gaps in relation to this topic area.
A scoping review guided by the PRISMA-ScR checklist.
A systematic search of five electronic databases was undertaken to identify peer-reviewed primary research studies which met the predetermined eligibility criteria. In total, 301 studies were imported into COVIDENCE, screened and assessed for eligibility resulting in 23 studies remaining. From the eligible studies, data was extracted, collated, appraised, summarised and interpreted.
MEDLINE, CINHAL, ProQuest, EMCARE, Web of Science and Informit.
Twenty three studies were included in this review which yielded the following major themes: (1) quality and completeness of information transfer; (2) interprofessional collaboration; (3) challenges impacting the experience of implementing the structured clinical handover frameworks and (4) perceived impacts on quality, patient safety and health outcomes.
There are key benefits and issues experienced and perceived by nurses implementing structured clinical handover frameworks and this review identifies opportunities for further improvements. Future research should explore the perceived associations with patient outcomes.
This review highlights the importance of structured clinical handover frameworks, the nurses' experiences in implementing these frameworks and strategies to improve the effectiveness of these frameworks.
No Patient or Public Contributions as this study is a review of published primary evidence.
Objetivo. Conocer la calidad de vida y la satisfacción con los cuidados que expresan los pacientes de 65 o más años, con diagnóstico reciente de cáncer, que reciben quimioterapia de forma ambulatoria en Hospital de Día de Adultos del Hospital Universitario Son Espases. Comparando la atención habitual de cuidados estándar, con la incorporación de una enfermera experta, denominada Enfermera de Práctica Avanzada. Metodología. El diseño del estudio es cuasiexperimental pre-post. Tiene 2 grupos aleatorios que realizarán 2 cuestionarios específicos para pacientes con cáncer validados para hospitales españoles: cuestionario de calidad de vida de pacientes con cáncer (Quality of life questionnaire), QLQ-C30 (versión 3) y cuestionario de valoración de la satisfacción con la atención expresada por pacientes ambulatorios con cáncer que reciben quimioterapia (Cancer Out-Patient Satisfaction with Care Questionnaire), OUT-PATSAT35 CT. Los cuestionarios se pasarán a ambos grupos antes del inicio de los tratamientos, y pasados 3-4 meses del inicio. Relevancia. Este proyecto pretende poner en valor la aportación de la figura de Enfermera de Práctica Avanzada en la mejora de la Satisfacción de los Cuidados recibidos por el paciente de edad avanzada con cáncer en el servicio de Hospital de Día de Adultos, así como la mejora en la Calidad de Vida de los mismos, para poder extrapolar la utilidad de esta figura en la coordinación de los cuidados de otros pacientes dentro de la propia unidad y de otras unidades hospitalarias.
ABSTRACT
Objective. To assess the quality of life and satisfaction with care reported by patients aged 65 or older with a recent cancer diagnosis receiving ambulatory chemotherapy at the Adult Day Hospital of the Son Espases University Hospital. This study compares standard. care with the incorporation of an expert nurse, referred to as an Advanced Practice Nurse.Methodology. The study design is a quasi-experimental pre-post approach. It consists of two randomly groups that will complete two specific questionnaires for cancer patients validated for Spanish hospitals: the Quality of Life Questionnaire for Cancer Patients (QLQ-C30, version 3) and the Cancer Out-Patient Satisfaction with Care Questionnaire (OUT-PATSAT35 CT). Both groups will complete questionnaires before the start of treatments and after 3-4 months after initiation. Relevance. This project aims to highlight the contribution of the Advanced Practice Nurse in improving the satisfaction with care received by elderly cancer patients in the Adult Day Hospital service, as well as enhancing their quality of life. This may help extrapolate the utility of this role in coordinating care of other patients within the unit and in other hospital units.
To assess the prevalence of malnutrition in hospitalised adult patients, and to evaluate the accuracy of the most commonly used nutritional screening tools for identifying individuals at risk of malnutrition.
A prospective cross-sectional study was conducted on a total of 248 hospitalised patients in internal medicine wards (mean age: 75.2 years; 39.5% females). Nutritional screening was performed within 48 h of admission using the following tools: Malnutrition Universal Screening Tool (MUST), Nutrition Risk Screening Tool (NRS-2002), Malnutrition Screening Tool (MST), Short Nutritional Assessment Questionnaire (SNAQ), and Mini Nutritional Assessment Short Form (MNA-SF). The criteria of the European Society for Clinical Nutrition and Metabolism (ESPEN) were used as the gold standard for defining malnutrition. Patients were also evaluated using the Subjective Global Assessment (SGA) and the Global Leadership Initiative on Malnutrition (GLIM) criteria. Accuracy was determined by examining sensitivity, specificity, and positive and negative predictive values, and diagnostic agreement was determined by calculation of Cohen's kappa (κ). The study is reported as per the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.
The ESPEN criteria classified 20.2% of the hospitalised patients as malnourished. Overall, the MUST had the highest sensitivity (80.0%), specificity (74.7%) and positive predictive value (44.4%). For the subgroup of patients aged >65 years, the MNA-SF had high sensitivity (94.4%) but low specificity (39.0%). Based on Cohen's κ, the SGA and GLIM criteria showed low agreement with the ESPEN criteria.
The MUST was the most accurate nutritional screening tool, through the MST is more easily applied in many clinical settings. A comprehensive assessment of malnutrition that considers muscle mass is crucial for the reliable diagnosis of malnutrition.
The present findings underscore the importance of accurate assessment of the malnutrition status of hospitalised patients and the need for a reliable screening tool.
No patient or public contribution.
To evaluate registered nurses' beliefs and related factors regarding pain assessment in people living with dementia.
A descriptive cross-sectional survey was conducted between July 2022 and April 2023.
An online survey comprised of demographics, knowledge scale, and beliefs scale relating to pain assessment in dementia was distributed to registered nurses (RNs) caring for people living with dementia in Australia.
RNs (N = 131) completed the survey. Most respondents were females (87.0%) and self-identified as Caucasian (60.3%). The mean beliefs score was 72.60 (±6.39) out of a maximum possible score of 95. RNs' beliefs about pain assessment varied based on their education, dementia pain assessment knowledge, nursing experience, and ethnicity. Hierarchical multiple regression analysis revealed factors significantly related to the beliefs score (i.e. education and dementia pain assessment knowledge).
The relationship between education and knowledge, and the beliefs score indicates the potential to improve RNs' knowledge and overcome their erroneous beliefs about pain assessment in dementia.
Education and training in assessing pain in people living with dementia should be tailored to overcome RNs' misconceived beliefs. These programmes should be integrated into continuous learning programmes.
Some RNs' beliefs about pain assessment in dementia were not evidence-based, and knowledge and educational status were the strongest factors related to RNs' beliefs. RNs' erroneous beliefs about pain assessment in dementia need to be addressed to improve pain assessment and management. Researchers should explore the potential of educational interventions to overcome RNs' misconceived beliefs about pain assessment in dementia.
This study was reported adhering to the Strengthening the Reporting of Observational Studies in Epidemiology checklist.
RNs caring for people living with dementia participated as survey respondents. Additionally, RNs were involved in the pre-testing of the study's survey instrument.
Objetivo: Describir la representación de la enfermedad que tienen las personas adultas costarricenses con hipertensión arterial. Metodología: Estudio descriptivo, con muestreo por conveniencia de 81 personas adultas con hipertensión arterial. La representación de la enfermedad se midió con el Cuestionario Breve de Percepción de la Enfermedad. Los datos se analizaron con estadística descriptiva. Resultados principales: Se evidenció una representación de la enfermedad poco amenazante. La dimensión duración presentó mayor grado de amenaza y la emocional, control personal y del tratamiento, y coherencia menor grado de amenaza. Las principales causas de hipertensión arterial percibidas fueron estrés, genética y nutrición. Conclusión principal: Las personas perciben la hipertensión arterial poco amenazante, lo cual podría llevarlos a tener dificultades para adoptar conductas saludables. Una mejor comprensión de las representaciones de las enfermedades en la población costarricense tiene el potencial de dirigir futuras intervenciones para mejorar el bienestar.
FreshRSS 