Research on missed nursing care during the COVID-19 pandemic: A scoping review.

BACKGROUND: Missed nursing care is defined as care that is delayed, partially completed, or not completed at all. The scenario created by the COVID-19 pandemic may have influenced multifactorial determinants related to the care environment, nursing processes, internal processes, and decision-making processes, increasing missed nursing care. AIM: This scoping review aimed to establish the quantity and type of research undertaken on missed nursing care during the COVID-19 pandemic. METHODS: This review was conducted following the Joanna Briggs Institute methodology for scoping reviews. We searched CINAHL, MEDLINE, Scopus, two national and regional databases, two dissertations and theses databases, a gray literature database, two study registers, and a search engine from November 1, 2019, to March 23, 2023. We included quantitative, qualitative, and mixed studies carried out in all healthcare settings that examined missed nursing care during the COVID-19 pandemic. Language restrictions were not applied. Two independent reviewers conducted study selection and data extraction. Disagreements between the reviewers were resolved through discussion or with an additional reviewer. RESULTS: We included 25 studies with different designs, the most common being acute care cross-sectional survey designs. Studies focused on determining the frequency and reasons for missed nursing care and its influence on nurses and organizational outcomes. LINKING EVIDENCE TO ACTION: Missed nursing care studies during the COVID-19 pandemic were essentially nurses-based prevalence surveys. There is an urgent need to advance the design and development of longitudinal and intervention studies, as well as to broaden the focus of research beyond acute care. Further research is needed to determine the impact of missed nursing care on nursing-sensitive outcomes and from the patient's perspective.

Understanding knee osteoarthritis from the patients' perspective: a qualitative study.

BACKGROUND: No studies of Health Coach Interventions for knee OA sufferers that include patients' perspectives have been published. The study assesses current clinical practice and primary care professionals' advice from the patients' perspective, in order to obtain a participative design for a complex intervention based on coaching psychology. Moreover, wants to analyse the experiences, perceptions, cognitive evaluation, values, emotions, beliefs and coping strategies of patients with knee osteoarthritis, and secondly the impact of these factors in the Self-management of this condition. METHODS: It is an interpretative qualitative study. The study included patients with diagnosis of knee osteoarthritis (OA) from 4 primary health care centres in Barcelona. A theoretical sampling based on a prior definition of participants' characteristics was carried out. Ten semi-structured interviews with knee OA patients were carried out. A content thematic analysis was performed following a mixed-strategy text codification in Lazarus framework and in emerging codes from the data. RESULTS: The results are structured in two blocks: Experiences and perceptions of informants and Experiences of knee osteoarthritis according to the Lazarus model. Regarding experiences and perceptions of informants: Some participants reported that the information was mostly provided by health professionals. Informants know which food they should eat to lose weight and the benefits of weight loss. Moreover, participants explained that they like walking but that sometimes it is difficult to put into practice. Regarding experiences of knee osteoarthritis according Lazarus model: Cognitive evaluation is influenced by cognitive distortions such as obligation, guilt, dramatization and catastrophism. VALUES: Family is the value most associated with wellbeing. Helping others is another recurring value. Emotions: Most participants explain that they feel anxiety, irritability or sadness. Beliefs: To some, physiotherapy helps them feel less pain. However, others explain that it is of no use to them. Participants are aware of the association overweight- pain. Coping strategies: The strategies for coping with emotions aim to reduce psychological distress (anxiety, sadness, anger) and some are more active than others. CONCLUSIONS: The study highlights that patients with knee osteoarthritis require a person-centered approach that provides them with strategies to overcome the psychological distress caused by this condition.

Effectiveness and cost-effectiveness of a health coaching intervention to improve the lifestyle of patients with knee osteoarthritis: cluster randomized clinical trial.

BACKGROUND: The prevalence of osteoarthritis and knee osteoarthritis in the Spanish population is estimated at 17% and 10.2%, respectively. The clinical guidelines concur that the first line treatment for knee osteoarthritis should be non-pharmacological and include weight loss, physical activity and self-management of pain. Health Coaching has been defined as an intervention that facilitates the achievement of health improvement goals, the reduction of unhealthy lifestyles, the improvement of self-management for chronic conditions and quality of life enhancement. The aim of this study is to analyze the effectiveness, cost-effectiveness and cost-utility of a health coaching intervention on quality of life, pain, overweight and physical activity in patients from 18 primary care centres of Barcelona with knee osteoarthritis. METHODS/DESIGN: Methodology from the Medical Research Council on developing complex interventions. Phase 1: Intervention modelling and operationalization through a qualitative, socioconstructivist study using theoretical sampling with 10 in-depth interviews to patients with knee osteoarthritis and 4 discussion groups of 8-12 primary care professionals, evaluated using a sociological discourse analysis. Phase 2: Effectiveness, cost-effectiveness and cost-utility study with a community-based randomized clinical trial. PARTICIPANTS: 360 patients with knee osteoarthritis (180 in each group). Randomization unit: Primary Care Centre. Intervention Group: will receive standard care plus 20-hour health coaching and follow-up sessions. CONTROL GROUP: will receive standard care. MAIN OUTCOME VARIABLE: quality of life as measured by the WOMAC index. Data Analyses: will include standardized response mean and multilevel analysis of repeated measures. Economic analysis: based on cost-effectiveness and cost-utility measures. Phase 3: Evaluation of the intervention programme with a qualitative study. Methodology as in Phase 1. DISCUSSION: If the analyses show the cost-effectiveness and cost-utility of the intervention the results can be incorporated into the clinical guidelines for the management of knee osteoarthritis in primary care. TRIAL REGISTRATION: ISRCTN57405925. Registred 20 June 2014.

Determination of polycyclic aromatic hydrocarbons extracted from lichens by gas chromatography-mass spectrometry.

Lichens are well-known biomonitors for semi-volatile pollutants, due to their ability to absorb and retain different chemical compounds such as Polycyclic Aromatic Hydrocarbons (PAHs), directly linked to levels in the atmosphere. Based on that, this paper proposes an analytical method capable of quantifying 16 EPA-PAHs from lichens found in an intertropical zone, as a natural alternative to typical capture methods, with the aim of monitoring atmospheres polluted by toxic compounds. An analytical protocol, including sample pre-treatment, followed by ultrasound extraction, clean-up in a chromatographic column, concentration and quantification by Gas Chromatography-Mass Spectrometry (GC-MS) using Selective Ion Monitoring has been developed. Additionally, a set of guidelines on lichen collection and sample handling is given, in order to achieve representative samples.•Limits of quantification (LOQ) and detection (LOD) varied from 2.0 to 16 µg/L and 1.0 to 5.0 µg/L, respectively. Calibration curves had correlation coefficients higher than 0.99 in all cases.•Validation of the method for determining PAHs concentration associated to 30 lichen samples collected along two roads, with high and low traffic volumes was carried out.•The method showed good performance according to the sources of PAHs, traffic patterns and gradient in roads.

The Tilburg Frailty Indicator: A psychometric systematic review.

BACKGROUND: The Tilburg Frailty Indicator (TFI) is one of the most prominent multidimensional frailty assessment instruments. This review aimed to critically appraise and summarise its measurement properties. METHODS: Reports were eligible if they included results of studies aimed at developing the TFI or evaluating its measurement properties. We performed a literature search in MEDLINE, CINAHL, and PsycINFO databases from their inception until December 8, 2021. We also searched grey literature databases. We assessed the methodological quality of the included studies using the "COSMIN Risk of Bias". The measurement properties were evaluated using specific criteria. We graded the quality of the evidence using a GRADE approach. RESULTS: Sixty-three studies were included. We found moderate sufficient evidence for TFI content validity, although it is still insufficient for the comprehensiveness of its items. TFI construct validity was based on sufficient evidence from two studies of its structural validity as well as multiple hypothesis-testing for construct validity studies with inconsistent results. We did not find any studies that assessed cross-cultural validity. Only one of TFI's three dimensions showed sufficient evidence for the internal consistency of its scores, and results in test-retest reliability were inconsistent. The TFI showed high sufficient concurrent validity with the comprehensive geriatric assessment. We identified several studies assessing its predictive validity for adverse frailty-related outcomes, although most of the evidence from these studies was insufficient. We did not find any studies that assessed the responsiveness of TFI scores. CONCLUSIONS: The TFI had evidence gaps in several relevant measurement properties. Further research is needed to strengthen its usefulness as a clinical decision-making tool.

Culture system and long-term storage of culture media in the in vitro production of bovine embryos.

The optimum culture system for in vitro matured and fertilised oocytes still remains to be clarified. Culture media (CM) for mammalian embryos are routinely prepared fresh for use and preserved under refrigeration during one or two weeks. The purposes of this work were (1) to compare the efficiency of a synthetic oviduct fluid (SOF) with two different bovine serum albumin (BSA) concentrations (3 and 8 g/L) for the in vitro production of bovine blastocysts, (2) to test the effect of timing on adding fetal calf serum (FCS) to the SOF, and (3) to evaluate the effects on bovine embryo development of freezing and lyophilisation as procedures for preserving the SOF. Supplementation of SOF with 3 g/L BSA increased Day-7 blastocyst expansion rates (18.3 ± 1.6 vs. 14.4 ± 0.7; P < 0.05), although no differences in hatching rates were found. Addition of FCS to SOFaa (SOF with amino acids) medium supplemented with sodium citrate (SOFaaci) at 48 and at 72 h post-insemination (PI) allowed obtaining higher Day-6 embryo development rates than when FCS was added at 18 or 96 h PI (Day-6 morulae + blastocyst rate: 30.0 ± 1.1, 40.8 ± 1.1, 43.9 ± 2.3 and 39.3 ± 0.5 for FCS addition at 18, 48, 72 and 96 h, respectively). Hatching rates were significantly improved when serum was added at 72 h PI. Finally, both refrigeration and lyophilisation appeared as useful cryopreservation procedures for SOFaaci, although a significant loss of its ability to support embryo development, compared to the control fresh culture medium, was observed.

Multidimensional instruments with an integral approach to identify frailty in community-dwelling people: protocol for a systematic psychometric review.

INTRODUCTION: An increasing number of investigations highlight the complex nature of frailty; therefore, the use of multidimensional assessment instruments could be useful in clinical decision-making. Frail people are found mainly in the community setting which is why this is the ideal environment for early screening and intervention. For this purpose, it is necessary to have valid, time-effective and easy-to-use frailty assessment instruments. The aim of this review is to critically appraise, compare and summarise the quality of the measurement properties of all multidimensional instruments with an integral approach to identify frailty in community-dwelling people. METHODS AND ANALYSIS: Medline, Psychological Information Database (PsycINFO) and Cumulative Index to Nursing and Allied Health Literature (CINAHL) will be searched from their inception dates. We will also conduct searches in databases of grey literature. No limits will be applied for language. A highly sensitive validated search filter will be used for finding studies on measurement properties. An additional search including the names of the instruments found in the initial search will also be undertaken. Studies aiming at the development of a measurement instrument, the evaluation of one or more measurement properties or the evaluation of its interpretability will be included. The instrument should have an integral approach (physical, psychological and social) and it should measure all three domains. The context of use should be a community setting. Two reviewers independently will screen the references and assess the risk of bias by consensus-based standards for the selection of health measurement instruments checklist. To assess the overall evidence for the measurement properties of the identified instruments, the results of the different studies, adjusted for their methodological quality, will be combined. ETHICS AND DISSEMINATION: Ethical approval and patient consent are not required as this is a psychometric review based on published studies. The results of this review will be disseminated at conferences and published in an international peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42019120212.

Safety of the reuse of needles for subcutaneous insulin injection: A systematic review and meta-analysis.

OBJECTIVE: Many people with diabetes often reuse disposable needles for subcutaneous insulin injection. We aimed to identify, critically appraise and summarize the available evidence about the safety of this practice. DESIGN: Systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. DATA SOURCES: MEDLINE (via PubMed), CINALH (via EBSCO), SCOPUS, Web of Science, Cochrane Central Register of Controlled Trials and Open Grey were searched from their inception to December 2015, with no language restrictions. REVIEW METHODS: Epidemiologic and experimental studies assessing adverse effects of reusing needles in people of any age or sex, with or without diabetes, were included. Two reviewers independently assessed the methodological quality of included studies using a multi-design tool. RESULTS: In total, 25 studies were included. All studies had a high risk of bias and data from only nine studies could be pooled. Five studies showed no association between infection at site of injection and reuse of needles (risk difference=-0.00; 95% confidence interval=-0.12-0.11; P=0.99); heterogeneity between these studies was substantial (I(2)=66%; P=0.02). Five cross-sectional studies showed an association between lipohypertrophy and needle reuse (risk difference=0.16, 95% confidence interval=0.05-0.28, P=0.006); there was strong evidence of heterogeneity between these studies (I(2)=87%; P<0.001). Pooled data of two studies with no evidence of heterogeneity between them showed more perceived pain among reusers (risk difference=0.24; 95% confidence interval=0.06-0.43; P=0.006). Reusing a pen needle or disposable syringe-needle was not associated with worse glycaemic control. CONCLUSIONS: There is currently no clear scientific evidence to suggest for or against the reuse of needles for subcutaneous insulin injection. This practice is very common among people with diabetes; consequently, further research is necessary to establish its safety.

Bovine oocyte vitrification before or after meiotic arrest: effects on ultrastructure and developmental ability.

The nuclear stage at which oocytes are cryopreserved influences further development ability and cryopreservation affects ultrastructure of both cumulus cells and the oocyte. In this work, we analyze the effects of vitrification at different nuclear and cytoplasmic maturation stages on the oocyte ultrastructure and developmental ability. Culture in TCM199 + PVA with roscovitine 25 M during 24h led to meiotic arrest (MA) in cumulus-oocyte complexes (COCs), while permissive in vitro maturation (IVM) was performed in TCM199, 10% FCS, FSH-LH and 17beta-estradiol for 24 h. Oocytes were vitrified using the open pulled straw method (OPS) with minor modifications. Fresh and vitrified/warmed COCs were fixed as immature, after IVM, after meiotic arrest (MA) and after MA + IVM. Vitrification combined with MA followed by IVM produced the highest rates of degeneration, regardless of the vitrification time. As a consequence, lower proportions of embryos cleaved in these groups, although differences were eliminated at the five-eight cell stage. Development rates up to day 8 were similar in all experimental groups, being significantly lower than those in fresh controls. Only oocytes vitrified after IVM were able to give blastociysts. The morphological alterations observed can be responsible for compromised development. More research is needed to explain the low survival rates of the bovine oocyte after vitrification and warming.

Pregnancy rates and metabolic profiles in cattle treated with propylene glycol prior to embryo transfer.

The objective of this study was to determine the effect of a sustained propylene glycol administration to recipients of frozen/thawed in vivo derived bovine embryos. Heifers were treated with oral propylene glycol for the last 20 days before embryo transfer (n = 142), and untreated as controls (n = 133). Progesterone, insulin, insulin-like growth factor-I, glucose, urea and triglyceride were analysed in blood on Day 0 and Day 7 of the estrous cycle corresponding to embryo transfer. The heifers were selected as recipients when showing progesterone levels <2.0 ng/ml (Day 0) and >2.5 ng/ml (Day 7), according to corpus luteum quality on Day 7 by technicians unaware of animals treated. Within treated animals, significantly more recipients were selected, and increased progesterone, corpus luteum quality, pregnancy and calving rates were recorded. Day 7 progesterone concentrations were higher in heifers treated and transferred. Propylene glycol increased insulin and insulin-like-growth factor-I, but glucose, urea and triglyceride did not vary. Furthermore, insulin-like-growth factor-I, glucose and triglyceride increased at estrous time, but urea decreased and insulin remained unaltered. Together with the sustained gain in pregnancy rates throughout the experiment (2 years), other evidences suggested that the observed effects did not rely on nutritional deficiency. Thus, propylene glycol improved pregnancy rates after embryo-transfer, and progesterone, insulin and insulin-like-growth factor-I are probably involved in this effect.

Management and perioperative outcomes of traumatic brain injury: retrospective study / Manejo y desenlaces perioperatorios del traumatismo craneoencefálico: estudio retrospectivo

Abstract Introduction: Cranioencephalic traumatism (CET) is a cause of mortality and morbidity in the surgical patient. However, the perioperative management of this entity has not been evaluated in the country's health institutions, despite its high disease burden and potential adverse clinical outcomes. Objective: To evaluate the clinical characteristics of surgical TBI and perioperative outcomes. Methods: Descriptive study of historical review conducted at the Hospital San Vicente Fundación, Medellín, Colombia. Data were collected from the medical records of patients over 13 years of age diagnosed with moderate-severe TBI between 2011 and 2014. Clinical variables, perioperative management, and clinical outcomes up to discharge were analyzed. An exploratory analysis was performed between perioperative management and postoperative mortality or neurological dysfunction. Results: CET was most common in the young male population (89.3%). Severe trauma occurred in 71.1% of patients. Perioperative mortality was 16%, and 54% presented neurological disability at discharge. A strong association was found between mortality or neurological dysfunction and severity of injury and perioperative hypotension. Conclusion: The study found that surgical CET was a high morbidity and perioperative mortality event, highly related to the severity of the injury and the hemodynamic stability of the patient. Despite this, intraoperative hemodynamic and metabolic monitoring remains limited in more than 50% of these patients' surgical procedures.

Resumen Introducción: El traumatismo craneoencefálico (TEC) es una causa de mortalidad y morbilidad en el paciente quirúrgico. No obstante, el manejo perioperatorio de esta entidad no ha sido evaluado en las instituciones de salud del país, a pesar de su alta carga de enfermedad y potenciales desenlaces clínicos adversos. Objetivo: Evaluar las características clínicas del TEC quirúrgico y de los desenlaces perioperatorios. Método: Estudio descriptivo de revisión histórica realizado en el Hospital San Vicente Fundación, de Medellín, Colombia. Se recolectaron datos a partir de las historias clínicas de los pacientes mayores de 13 años con diagnóstico de TEC moderado-grave entre 2011 y 2014. Se analizaron las variables clínicas, el manejo perioperatorio y los desenlaces clínicos hasta el alta. Se realizó un análisis exploratorio entre el manejo perioperatorio y mortalidad o disfunción neurológica posquirúrgica. Resultados: El TEC fue más común en la población masculina joven (89,3%). El traumatismo grave ocurrió en el 71,1% de los pacientes. La mortalidad perioperatoria fue del 16%, y el 54% presentó discapacidad neurológica al alta. Se encontró una asociación fuerte entre mortalidad o disfunción neurológica y gravedad de la lesión e hipotensión perioperatoria. Conclusión: El estudio encontró que el TEC quirúrgico fue un evento con alta morbilidad y mortalidad perioperatoria, altamente relacionado con la gravedad de la lesión y la estabilidad hemodinámica del paciente. A pesar de ello, la monitoria intraoperatoria de tipo hemodinámico y metabólico sigue siendo limitada en más del 50% de los procedimientos quirúrgicos de estos pacientes.

Amiloidosis sistémica primaria asociada a mieloma múltiple / Primary sistemic amyloidosis asociated with multiple myeloma

Revisamos los casos de Mieloma múltiple con amiloidosis primaria en el período comprendido entre 1973 y 1990, encontrando cuatro casos con esta asociación. En todos los pacientes encontramos que el primer motivo de consulta fue la presencia de lesiones en piel caracterizadas por púrpura, nódulos eritemato-violáceos y pápulas normacrómicas o xantocrómicas en piel y mucosas. El propósito de este trabajo es llamar la atención de los dermatólogos acerca de las manifestaciones cutáneas y su importancia como marcador temprano de MM

La psicología infantil aplicada en estomatología pediátrica: primera parte / Infantile psychology aplied in pediatric stomatology: first part

Se realiza una revisión bibliográfica sobre la aplicación de la Psicología Infantil en Estomatología Pediátrica, con el objetivo de profundizar en el conocimiento del desarrollo psíquico del niño y que nos permita enfrentar con mayor sabiduría los problemas de conducta ante el tratamiento estomatológico. Por su extensión se ha dividido en dos partes. En esta primera parte se abordan las actividades que caracterizan las diferentes etapas cronológicas del desarrollo psicológico del niño desde la lactancia hasta la adolescencia, así como las reacciones emocionales que con más frecuencia se evidencian en la consulta