The aim was to analyse changes in the perceived quality of life of patients with an ostomy during the first year after surgery at two or three follow‐ups. This is a prospective study of a cohort of ...55 patients who were ostomised between June 2021 and September 2022 and cared for under the recommendations set out in the Registered Nurses' Association of Ontario® best practice guideline Supporting Adults Who Anticipate or Live with an Ostomy as part of the Best Practice Spotlight Organisation® (BPSO®) programme. The Stoma Quality of Life tool was used. A univariate analysis was performed to identify variables associated with a non‐improvement in quality of life. Variables showing p < 0.1 were included in a multivariate model. Patients with an ostomy exhibited a moderate‐to‐good perception of quality of life in both the personal and social dimensions, with no worsening over the first year. Being female (OR = 10.32) and being younger (OR = 0.89) were associated with a higher risk of no improvement in quality of life. The most frequent complications were urinary leakage (p = 0.027) and dermatitis (p = 0.052) at first follow‐up; and parastomal hernia (p = 0.009) and prolapse (p = 0.05) at third follow‐up. However, they did not lead to a worsening of quality of life, suggesting that these patients were adequately supported under the BPSO® programme.
Current resuscitation guidelines endorse placing the unconscious and normally breathing victims in the recovery position (RP), but this technique might hinder breathing evaluation.
To compare ...breathing evaluation and cardiac arrest detection: placing the victim in RP and checking breathing regularly, placing the victim in RP while re-evaluating breathing every minute, and placing the victim on his back, maintaining an open airway with the head-tilt-chin-lift technique and continuously checking breathing.
Schoolchildren aged 10–12 with no previous cardiopulmonary resuscitation (CPR) training, from three different primary schools were randomly allocated into groups to receive a CPR course involving one of the three strategies. Then a human simulation took place.
192 schoolchildren (64 per group) were randomly selected and received one of the courses. 182 participants who correctly assessed the victim were compared: 16 (26.2%) out of the 59 participants using RP and checking breathing regularly detected cardiac arrest before the end of the simulation, compared to 41 (67.20%) out of 61 using RP re-evaluating breathing every minute, and 56 (90.3%) out of 62 using head-tilt-chin-lift. Statistically significant differences were found between the RP groups (p < 0.001; OR = 5.766) as well as between the Head-tilt-chin-lift and both RP groups (p < 0.001; OR = 21.094), (p = 0.002; OR = 4.553).
The strategy involving head-tilt-chin-lift significantly increased the likelihood of detecting cardiac arrest. Re-evaluating every minute when the RP was used significantly increased the likelihood of detecting cardiac arrest.
Barriers to implementing training strategies for the improvement of evidence-based practice competence of nurses in hospital practice environments still persist.
The aim of the study was to evaluate ...the impact of a specific training within the framework of the Best Practice Spotlight Organization® programme, on nurses' evidence-based practice competence and the practice environment in two hospitals.
This is a observational cross-sectional study assessing evidence-based practice competence and perceptions of Practice Environments.
The study sample were 204 nurses working at medical and surgical inpatient units at two hospitals involved in the Best Practice Spotlight Organization® programme.
The study was conducted from February 2020 to May 2020. Three questionnaires were used to collect data: a sociodemographic/occupational questionnaire, a questionnaire exploring evidence-based practice skills, and a questionnaire exploring nurses' perceptions of their hospital practice environments.
A total of 204 nurses participated. They were classified into two groups: those who had received specific training within the framework of the programme, called trained-champions (n = 66), and those who had not yet received training, control group (n = 138). The trained-champions exhibited better evidence-based practice competence values than the control group in all dimensions (p < 0.001), with a higher difference in means in the “Utilisation” dimension (−0.80; CI:-0.99,-0.60) and the “Knowledge” dimension (−0.63; CI:-0.88,-0.38). Trained-champions also had a more positive perception of the practice environments than the controls in all dimensions (p ≤ 0.001). The largest differences in means were in the “Participation” dimension (−0.48; CI:-0.66,−0.31) and in the “Leadership” dimension (−0.41; CI:-0.59,-0.23).
Specific EBP training within the framework of the Best Practice Spotlight Organization® programme has succeeded in nurses (trained-champions) obtaining better EBP competence than others without this training. This could have contributed to increase nurses' abilities to integrate evidence into decision making in their clinical practice, while positively influencing them to perceive their PEs more favorably.
•Specific EBP training under the BPSO® program has improved nurses competence in EBP.•PE nurses perception has enhanced after Specific EBP training under BPSO® program.•Training in systematic implementation of evidence favors EBP competence and the PE.
Resumen: En el presente estudio se realizó una recopilación de los datos existentes sobre la riqueza de especies de vertebrados silvestres nativos, así como de taxones exóticos, además del endemismo ...y estado de conservación del primer grupo según la NOM-059-SEMARNAT-2010, en las 14 cuencas hidrográficas del estado de Nuevo León. Para analizar estos datos se usaron índices de aptitud de un área que se pueden construir a partir de la información de la historia de vida; o bien, mediante la modificación de los modelos existentes, basados en la importancia de las variables, a los cuales se les aplica normalización, ponderación y jerarquización de los valores de cada una de ellas. Las cuencas que presentaron los resultados positivos y mayores fueron: cuenca del Río Tamesí, cuenca Presa San José-Pilares y cuenca Sierra Madre Oriental (con índices de 19.65, 18.19 y 16.59 respectivamente) y las que registraron los valores negativos mayores fueron: cuenca Río Bravo-Nuevo Laredo, cuenca Río Bravo-Sosa y cuenca Río Bravo-Matamoros-Reynosa (con -22.07, -20.85 y -19.56 respectivamente). Se concluye que la cuenca Sierra Madre Oriental es la más importante en Nuevo León, por su mayor valor positivo y extensión territorial (13 % aproximadamente del total estatal) comparado con las primeras dos cuencas que sumadas ocupan menos de 1 % del territorio de Nuevo León.
Background: The COVID-19 pandemic has contributed to the occurrence of work-related stress on nursing staff. Being resilience an essential element to countering adversity. The aim of the study was to ...assess burnout syndrome as well as resilience in hospital-care nurses during the first outbreak of the COVID-19 pandemic. Methods: A cross-sectional descriptive study of burnout syndrome and resilience of 101 nurses during the first COVID-19 outbreak. The Maslach Burnout Inventory and the Scale of Resilience of Connor-Davidson were used. Results: The burnout average score was 74.35 ± 12.78 points, and resilience was 27.94 ± 5.84. Temporary nurses reached a lower average score for the emotional fatigue dimension (23.80 ± 10.39 points) p < 0.05. The emotional fatigue dimension correlated adversely with the average score of resilience (r = −0.271; p < 0.001). Conclusions: The level of burnout in nurses was high, being higher on those who took care of COVID-19 patients. Resilient nurses were able to better cope with stressful situations.
The use of the faecal immunochemical test (FIT) to stratify the risk of colorectal cancer (CRC) in symptomatic patients in primary healthcare enables improved referrals to colonoscopy. However, its ...effect on diagnostic delays or the prognosis of patients has been poorly evaluated in this setting. We performed a retrospective cohort study that included symptomatic patients with outpatient CRC diagnosis between 2009 and 2017. We identified whether FIT had been analysed between initial healthcare contact and diagnostic confirmation. We included 589 patients (male = 65%, 71.7 ± 11.6 years, TNM IV = 17.1%) in the analysis. FIT was performed in 411 (69.8%) patients with a positive result (≥10 µg/g of faeces) in 96.4% of the evaluated patients. The use of FIT was associated with increased diagnostic delay (yes = 159 ± 277 days, no = 111 ± 172 days;
= 0.01). At five years follow up, 193 (32.8%) patients died (151 due to CRC). Mean survival was not modified by the use of FIT or its result (not performed = 46.8 ± 1.5 months, FIT+ = 48.9 ± 1 months, FIT- = 45.6 ± 5.5 months;
= 0.5) in Kaplan-Meier analysis, and was confirmed later in multivariate Cox regression analysis. In conclusion, FIT determination in symptomatic patients in primary healthcare did not modify CRC prognosis.
Research on immunoassays and immunosensors is currently focused mainly on the development of strategies to amplify the resulting signal. In this sense, the development of new hapten tracers that ...allow simpler, more sensitive, and more reliable immunoassays is desirable. Therefore, we present the development of an electrochemical immunosensor using viral particles (phages) bound with dozens of CdS nanocrystals (CdS NCs) as an outperforming alternative to conventional competitive hapten conjugates. This allows us to obtain an multiplicator effect in signal obtained. Therefore, as proof of concept, an electrochemical immunosensor was developed for the detection of the molinate in river water samples, based on a noncompetitive immunoassay using recombinant M13 phage particles labeled with CdS NCs (CdS NCs-phage). The phage particles have on its surface peptides that recognize the molinate/antibody immune complex. Molinate determination was performed by square wave anodic stripping voltammetry of Cd2+ release from CdS NCs. The limit of detection and the midpoint sensitivity obtained were 34 pg mL-1 and 0.43 ng mL-1, respectively. In addition, other very good analytical parameters were obtained, where percent coefficient of variation (%CV) between 5 % and 25 %, and recovery percentages close to 99 % were found. Results obtained were compared with those determined by HPLC-UV visible, obtaining an excellent correlation between both methods. This electrochemical immunosensor was successfully used to analyze molinate in river water samples without pre-treatment, obtaining excellent recoveries.
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•Phage particles labeled with CdS nanocrystals are used as a novel alternative.•These conjugates allow increasing the signal amplification.•A glassy carbon electrode modified with p-nitroaniline was used as the base electrode.•An ultrasensitive electrochemical immunosensor to quantify molinate was developed.
The use of temporary stomas has been demonstrated to reduce septic complications, especially in high-risk anastomosis; therefore, it is necessary to reduce the number of complications secondary to ...ostomy takedowns, namely wound infection, anastomotic leaks, and intestinal obstruction.
To compare the rates of superficial wound infection and patient satisfaction after pursestring closure of ostomy wound vs conventional linear closure.
Patients undergoing colostomy or ileostomy closure between January 2010 and February 2011 were randomly assigned to linear closure (n = 30) or pursestring closure (n = 31) of their ostomy wound. Wound infection within 30 days of surgery was defined as the presence of purulent discharge, pain, erythema, warmth, or positive culture for bacteria. Patient satisfaction, healing time, difficulty managing the wound, and limitation of activities were analyzed with the Likert questionnaire.
The infection rate for the control group was 36.6% (n = 11) vs 0% in the pursestring closure group (p < 0.0001). Healing time was 5.9 weeks in the linear closure group and 3.8 weeks in the pursestring group (p = 0.0002). Seventy percent of the patients with pursestring closure were very satisfied in comparison with 20% in the other group (p = 0.0001).
This study was limited by the heterogeneity in the type of stoma in both groups.
The pursestring method resulted in the absence of infection after ostomy wound closure (shorter healing time and improved patient satisfaction).
Earliest known human burial in Africa Martinón-Torres, María; d'Errico, Francesco; Santos, Elena ...
Nature (London),
05/2021, Letnik:
593, Številka:
7857
Journal Article
Recenzirano
Odprti dostop
The origin and evolution of hominin mortuary practices are topics of intense interest and debate
. Human burials dated to the Middle Stone Age (MSA) are exceedingly rare in Africa and unknown in East ...Africa
. Here we describe the partial skeleton of a roughly 2.5- to 3.0-year-old child dating to 78.3 ± 4.1 thousand years ago, which was recovered in the MSA layers of Panga ya Saidi (PYS), a cave site in the tropical upland coast of Kenya
. Recent excavations have revealed a pit feature containing a child in a flexed position. Geochemical, granulometric and micromorphological analyses of the burial pit content and encasing archaeological layers indicate that the pit was deliberately excavated. Taphonomical evidence, such as the strict articulation or good anatomical association of the skeletal elements and histological evidence of putrefaction, support the in-place decomposition of the fresh body. The presence of little or no displacement of the unstable joints during decomposition points to an interment in a filled space (grave earth), making the PYS finding the oldest known human burial in Africa. The morphological assessment of the partial skeleton is consistent with its assignment to Homo sapiens, although the preservation of some primitive features in the dentition supports increasing evidence for non-gradual assembly of modern traits during the emergence of our species. The PYS burial sheds light on how MSA populations interacted with the dead.
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