Implementing the NCTSN Trauma-Informed Organizational Assessment (TIOA) for Improving Trauma-Informed Care in Inpatient Child Psychiatry.

BACKGROUND: Children and adolescents receiving inpatient psychiatric services have disproportionately high levels of exposure to trauma and adversity. The National Child Traumatic Stress Network Trauma-Informed Organizational Assessment (TIOA) is a comprehensive tool intended to guide implementation of trauma-informed care, but it has not yet been applied in inpatient settings. AIMS: The purpose of this quality improvement project was to describe trauma-informed care in inpatient child/adolescent psychiatry with the TIOA, examine relatedness among trauma-informed care domains, and explore barriers or facilitators to applying trauma-informed care. METHODS: This quality improvement project used mixed methods. We conducted a web-based survey in Summer 2022 with staff members (clinical and administrative) at two inpatient child/adolescent psychiatric units in California to assess trauma-informed care practices with the TIOA (87 items). Qualitative follow-up interviews were offered to interested participants. A correlation matrix and cluster analyses were used to examine relationships among TIOA domains; qualitative data were analyzed thematically. RESULTS: There were 69 survey respondents and seven qualitative interviews. TIOA domain scores ranged from a low of 2.3 to a high of 3.2, indicating that practices were occurring only "rarely" to "sometimes." There were two major themes identified from qualitive interviews: (a) barriers to trauma-informed care in an inpatient context that can be resource-constrained or coercive; and (b) discovering strategies to provide trauma-informed care despite structural barriers. CONCLUSION: Organizational interventions targeting any domains of trauma-informed care are needed in inpatient settings given limited uptake of trauma-informed care.

Caracterización de pacientes con mieloma múltiple y afectación de la columna vertebral atendidos en un hospital de tercer nivel de Medellín, Colombia / Characterization of patients with multiple myeloma and spinal cord involvement treated at a tertiary care center in Medellín, Colombia

Introducción: el mieloma múltiple (MM) es un tipo de cáncer que se genera en células plasmáticas y puede provocar la destrucción del tejido óseo. Aproximadamente el 50% de los pacientes con esta enfermedad experimentarán fracturas vertebrales secundarias. Objetivo: describir las características de pacientes con MM y afectación de la columna vertebral atendidos en un hospital de tercer nivel.Metodología: estudio descriptivo retrospectivo realizado con los datos de pacientes con MM y afectación de la columna vertebral atendidos entre 2014 y 2018 en un hospital de tercer nivel de atención de Medellín, Colombia. Se obtuvieron datos sociodemográficos y clínicos. Las variables cuantitativas se describen usando medias y desviaciones estándar, mientras que las cualitativas, frecuencias absolutas y porcentajes con su respectivo intervalo de confianza (IC95%).Resultados: la muestra consistió de 109 pacientes. La edad media fue 63 años, la distribución de sexo fue 1:1, el 78,9% de los participantes fue diagnosticado de novo y el síntoma más frecuente fue dolor lumbar (47%). Además, se encontró una media de 5 niveles (cuerpos vertebrales) afectados, el método de diagnóstico de estas lesiones más frecuente fue la tomografía (62%) y solo el 26% de los pacientes presentaron algún tipo de lesión neurológica. En lo que respecta al tratamiento, 95%, 46%, 55% y 13% fueron tratados con quimioterapia, radioterapia, bifosfonatos e intervención quirúrgica, respectivamente.Conclusiones: las características de la muestra son similares a las reportadas en otras investigaciones, a excepción de la distribución del sexo. Además, se identificó una baja frecuencia de tratamiento quirúrgico

Introduction: Multiple myeloma (MM) is a type of cancer that originates in plasma cells and can lead to the destruction of bone tissue. Approximately 50% of patients with this condition will experience secondary vertebral fractures. Objective: To characterize patients with MM and spine involvement treated at a tertiary care center.Methodology: Retrospective, descriptive study conducted using data from patients with MM and spinal involvement treated between 2014 and 2018 in a tertiary care center in Medellín, Colombia. Sociodemo-graphic and clinical data were obtained. Quantitative variables are described using means and standard deviations, while qualitative variables are presented as absolute frequencies and percentages with their respective confidence interval (CI95%).Results: The sample consisted of 109 patients, with a mean age of 63 years and a sex ratio of 1:1. In addition, 78.9% of the participants were newly diagnosed and the most frequent symptom was low back pain (47%). It was also found that an average of 5 sections (vertebral bodies) were affected, that the most frequent method of diagnosis of these lesions was tomography (62%), and that only 26% of the patients presented with some type of brain lesion. Regarding treatment, 95%, 46%, 55%, and 13% were treated with chemotherapy, radiotherapy, bisphosphonates, and surgery, respectively.Conclusions: The characteristics of the sample are similar to those reported in other studies, with the exception of sex ratio. Moreover, a low frequency of surgical treatment was observed

Service-learning: experience of teacher-tutors in the nursing career. / Aprendizaje servicio: experiencia de docentes-tutores en la carrera de enfermería.

INTRODUCTION: The learning process demands appropriate and effective strategies. Furthermore, the service-learning methodology implies significant challenges for both the student and the teacher-tutor. OBJECTIVE: To reveal the experience of community-based teacher-tutors work with nursing students from the Austral University of Chile, using the service-learning methodology. METHOD: Descriptive and exploratory qualitative research through an intrinsic case study. Non-probabilistic and intentional sample of cases by criteria and convenience. Five teachers from the Austral University of Chile Nursing Institute hired by the university were interviewed. They fulfilled the role of teacher-tutor after signing the informed consent. The information was obtained through semi-structured interviews, and the analysis was carried out through the data reduction methodology, which considers the analysis of results at three levels. The Scientific Ethics Committee of the Austral University of Chile School of Medicine approved the study. RESULTS: At level 1: One hundred and seven (107) units of meaning were identified, grouped into five descriptive categories. At level 2, three meta-categories were formed: "opinion of the tutor-teachers on working with the service-learning methodology", "factors that influence working with the service-learning methodology" and "generic competencies developed with the service-learning methodology. Finally, at level 3, two qualitative domains were identified: "Teacher-tutors appreciation for the development of the service-learning methodology" and "Contributions of the service-learning methodology for developing generic competencies". CONCLUSIONS: The efficient implementation of the methodology requires training and motivation of tutors, teachers, students and community partners.

INTRODUCCIÓN: El proceso de aprendizaje demanda la utilización de estrategias pertinentes y efectivas. La utilización de la metodología aprendizaje servicio implica grandes desafíos tanto para el estudiante como para el docente-tutor. OBJETIVO: Develar la experiencia de docentes-tutores a partir del trabajo comunitario con estudiantes de enfermería de la Universidad Austral de Chile, utilizando la metodología aprendizaje servicio. MÉTODO: Investigación cualitativa descriptiva y exploratoria mediante un estudio intrínseco de casos. Muestra no probabilística e intencionada de casos por criterios y conveniencia. Se entrevistaron a cinco docentes del Instituto de Enfermería de la Universidad Austral de Chile contratados por la universidad, que cumplieron el rol de docente-tutor previa firma del consentimiento informado. La información fue obtenida mediante entrevistas semiestructuradas. El análisis se realizó a través de la metodología de reducción de datos, que considera el análisis de resultados en tres niveles. El estudio fue aprobado por el Comité Ético Científico de la Facultad de Medicina de la Universidad Austral de Chile. RESULTADOS: En el nivel 1 se identificaron 107 unidades de significado, agrupadas en cinco categorías descriptivas. En el nivel 2 se formaron tres metacategorías: “opinión de las docentes-tutoras con relación al trabajo con la metodología aprendizaje servicio”, “factores que inciden en el trabajo con la metodología aprendizaje servicio” y “competencias genéricas desarrolladas con la metodología aprendizaje servicio”. En el nivel 3 se identificaron dos dominios cualitativos: “apreciación de las docentes-tutoras para el desarrollo de la metodología aprendizaje servicio” y “aportes de la metodología aprendizaje servicio para el desarrollo de competencias genéricas”. CONCLUSIONES: La implementación de la metodología de manera eficiente requiere de capacitación y motivación de docentes-tutores, estudiantes y socios comunitarios.

Aprendizaje servicio: experiencia de docentes-tutores en la carrera de enfermería / Service-learning: experience of teacher-tutors in the nursing career

Introducción El proceso de aprendizaje demanda la utilización de estrategias pertinentes y efectivas. La utilización de la metodología aprendizaje servicio implica grandes desafíos tanto para el estudiante como para el docente-tutor. Objetivo Develar la experiencia de docentes-tutores a partir del trabajo comunitario con estudiantes de enfermería de la Universidad Austral de Chile, utilizando la metodología aprendizaje servicio. Método Investigación cualitativa descriptiva y exploratoria mediante un estudio intrínseco de casos. Muestra no probabilística e intencionada de casos por criterios y conveniencia. Se entrevistaron a cinco docentes del Instituto de Enfermería de la Universidad Austral de Chile contratados por la universidad, que cumplieron el rol de docente-tutor previa firma del consentimiento informado. La información fue obtenida mediante entrevistas semiestructuradas. El análisis se realizó a través de la metodología de reducción de datos, que considera el análisis de resultados en tres niveles. El estudio fue aprobado por el Comité Ético Científico de la Facultad de Medicina de la Universidad Austral de Chile. Resultados En el nivel 1 se identificaron 107 unidades de significado, agrupadas en cinco categorías descriptivas. En el nivel 2 se formaron tres metacategorías: "opinión de las docentes-tutoras con relación al trabajo con la metodología aprendizaje servicio", "factores que inciden en el trabajo con la metodología aprendizaje servicio" y "competencias genéricas desarrolladas con la metodología aprendizaje servicio". En el nivel 3 se identificaron dos dominios cualitativos: "apreciación de las docentes-tutoras para el desarrollo de la metodología aprendizaje servicio" y "aportes de la metodología aprendizaje servicio para el desarrollo de competencias genéricas". Conclusiones La implementación de la metodología de manera eficiente requiere de capacitación y motivación de docentes-tutores, estudiantes y socios comunitarios.

Introduction The learning process demands appropriate and effective strategies. Furthermore, the service-learning methodology implies significant challenges for both the student and the teacher-tutor. Objective To reveal the experience of community-based teacher-tutors work with nursing students from the Austral University of Chile, using the service-learning methodology. Method Descriptive and exploratory qualitative research through an intrinsic case study. Non-probabilistic and intentional sample of cases by criteria and convenience. Five teachers from the Austral University of Chile Nursing Institute hired by the university were interviewed. They fulfilled the role of teacher-tutor after signing the informed consent. The information was obtained through semi-structured interviews, and the analysis was carried out through the data reduction methodology, which considers the analysis of results at three levels. The Scientific Ethics Committee of the Austral University of Chile School of Medicine approved the study. Results At level 1: One hundred and seven (107) units of meaning were identified, grouped into five descriptive categories. At level 2, three meta-categories were formed: "opinion of the tutor-teachers on working with the service-learning methodology", "factors that influence working with the service-learning methodology" and "generic competencies developed with the service-learning methodology. Finally, at level 3, two qualitative domains were identified: "Teacher-tutors appreciation for the development of the service-learning methodology" and "Contributions of the service-learning methodology for developing generic competencies". Conclusions The efficient implementation of the methodology requires training and motivation of tutors, teachers, students and community partners.

Apoyo social: Uso del concepto en enfermería / Social support: Use of the concept in nursing

El interés de enfermería por estudiar el apoyo social surge a partir de los efectos positivos que tiene sobre la salud y el bienestar, pues se ha logrado demostrar que el apoyo social facilita la adopción de conductas de adaptación, frente a situaciones de estrés. Al considerar al usuario como un ser integral, las dimensiones sociales y psicológicas que participan del continuo salud-enfermedad pueden ser consideradas y optimizadas. OBJETIVO: identificar el uso que se ha dado al concepto apoyo social en estudios cualitativos y cuantitativos de enfermería. METODOLOGÍA: Revisión integrativa de la literatura, entre los años 1990 y 2015, en la que se utilizan palabras clave "apoyo social" y "enfermería". En bases de datos Web of Science, Pubmed (National Library of Medicine), Scopus, Ebsco host web y Bireme (LILACS, IBECS, MEDLINE, La Biblioteca Cochrane, SciELO), se seleccionaron 17 artículos para su análisis. RESULTADOS: fueron revisados 17 artículos realizados por enfermeros. Un 76% corresponde a estudios cuantitativos, 12% cualitativos y 12% a revisiones sistemáticas. Se establecieron cuatro categorías: perspectiva de género, grupos etarios, portadores de patologías crónicas, cuidador familiar y profesionales de enfermería. CONCLUSIONES: el concepto Apoyo Social se utiliza en los estudios de enfermería como una herramienta que permite mejorar el cuidado de Enfermería otorgado, dada su influencia en la calidad de vida, bienestar y salud de las personas, lo que permite deducir que en el cuidado de Enfermería estos conceptos están íntimamente relacionados.

The interest in studying nursing social support arises from the positive effects on health and well-being, as it has demonstrated that social support facilitates the adoption of adaptive behaviors, in situations of stress. When considering the user as an integral being, social and psychological dimensions, involved the health-disease continuum, can be considered and optimized throughout the process. Deepen the knowledge of these areas can generate best suited nursing strategies for developing with users. OBJECTIVE: to identify the use that has been given to the concept social support in qualitative and quantitative nursing studies. METHODOLOGY: integrative review of the literature, between 1990 and 2015, using the keywords "social support" and "nursing". Bases Web of Science, PubMed (National Library of Medicine), Scopus, Ebsco web host and term (LILACS, IBECS, MEDLINE, The Cochrane Library, SciELO), selected 17 items for analysis. RESULTS: they were reviewed 17 studies made by nurses, 76% are quantitative studies, 12% qualitative studies and 12% systematic reviews. Four categories in which the concept of social support were established. CONCLUSIONS: the concept of social support is used in nursing studies as an implement to assess the nursing care given, given is influence on the quality of life, well-being and health of people, deducing that in nursing care these concepts are inextricably related.

Influence of lipophilia and of the vehicle used in the transdermal absorption of novel benzimidazole compounds with possible anti-HIV activity.

The molecules 2-pyridin-3-yl-1H-benzimidazole and 2-pyridin-3-yl-1-(3,4,5-trimethoxybenzoyl)-1H-benzimidazole are compounds that have been synthesized with the aim of finding new inhibitors of the reverse transcriptase enzyme, which is key in the process of cellular contagion of HIV. Because of the possible biological activity of these molecules, it is important to determine if some factors exist that condition their absorption across membranes. In this article, we studied the transdermal absorption of both molecules when included in solutions and microemulsions; the latter of these systems is known for their capacity to promote absorption. On the basis of the results obtained, it was determined that the absorption of 2-pyridin-3-yl-1H-benzimidazole is better in solutions than in microemulsions. This is attributed to the system of microemulsions used (myristic isopropyl ester/water/Tween 80: Span 80: 1.2 Octanediol 3:1:1.2 v/v/v), which does not provide an adequate thermodynamic activity for this molecule. In contrast, the absorption of 2-pyridin-3-yl-1-(3,4,5-trimethoxybenzoyl)-1H-benzimidazole is independent of the vehicle in which it is in, a fact attributable to the limitation of absorption due to parameters proper to this molecule, such as the value of its Log Poct, its molecular weight, or its low solubility in water. In addition, it was possible to implement a methodology based on HPLC to determine the Log P of these compounds. In this way, it was determined that the inclusion of 3,4,5-trimethoxybenzoyl moiety to the molecule 2-pyridin-3-yl-1H-benzimidazole, despite increasing the Log Poct value of this molecule up to a value considered optimal for absorption through membranes, did not produce an increase in transdermal absorption. In fact, its molar absorption diminished by more than 50%, which is attributable to the increase of molecular weight and the decrease of affinity for water that the inclusion of this group causes.