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1.
Artículo en Inglés | MEDLINE | ID: mdl-39086260

RESUMEN

ISSUE ADDRESSED: Inequitable health care access can be addressed by using community outreach programs. A collaborative, codesigned student-led pop-up health check clinic was conducted in three low-socioeconomic regional communities in Victoria, Australia. Supervised undergraduate nursing students conducted free health checks, practiced assessment and communication skills, and provided health education. METHODS: A mixed-method approach was used to evaluate the impact, outcome, and processes used to deliver health checks in three different community settings. Data included post-check surveys and follow-up interviews with community participants, which were analysed using descriptive statistics and thematic analysis. RESULTS: A total of 166 surveys were collected and 30 interviews conducted from community participants located in three different communities. Participants were very satisfied with the information provided in the clinics and the delivery process. Further analysis also identified three major themes: (1) Defining a need, (2) Reaching the Community, and (3) Health promotion benefits. CONCLUSIONS: Community outreach programs are effective in reaching vulnerable populations, improving community access to risk screening, reducing demands, supporting existing services, and providing excellent training opportunities for the future health care workforce within communities. SO WHAT?: Further planning and financial investment are required to support community outreach programs that provide disease prevention and risk screening. More investment is needed in promoting outreach services within vulnerable populations, where social determinants contribute to poor health outcomes and access to health care is limited. Collaborative programs such as student-led pop-up clinics, are one way outreach can make a difference to community health.

2.
Front Public Health ; 12: 1415916, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39086815

RESUMEN

Introduction: Metabolic syndrome is a global health concern. It is a condition that includes a cluster of various risk factors for type 2 diabetes and cardiovascular disease. This quasi-experimental study investigates the effect of a nurse-led low-carbohydrate regimen on anthropometric and laboratory parameters in metabolic syndrome patients. Methods: The study used a quasi-experimental design conducted at the University of Mosul; 128 participants meeting the metabolic syndrome criteria were recruited and divided into the intervention and control groups. The intervention group received personalized counseling and support in implementing a low-carb regime, while the control group received standard advice. The study participants were assessed by anthropometry, and laboratory parameters were evaluated pre- and post-intervention. Statistical data analysis was conducted using IBM-SPSS 27, including chi-square, Fisher's exact test, t-tests, and the Mcnemar test, which were performed to compare the changes within and between groups. Results: The mean age of the participants in the intervention and control groups was 50.72 ± 6.43 years and 49.14 ± 6.89 years, respectively. Compared to the control group, the intervention group experienced a significant positive reduction in anthropometric measures and laboratory parameters, including weight, body mass index (BMI), waist circumference, lipid profiles, and HbA1c. Conclusion: A tangible effect of nurse-led interventions based on low-carbohydrate regimens in managing metabolic syndrome was empirically authenticated. Positive changes were observed in the intervention group regarding anthropometric measures and laboratory parameters. However, future research may require a larger sample size and a longer follow-up to confirm these effects and evaluate long-term metabolic impacts.


Asunto(s)
Antropometría , Dieta Baja en Carbohidratos , Síndrome Metabólico , Humanos , Femenino , Persona de Mediana Edad , Masculino , Adulto , Índice de Masa Corporal
3.
R Soc Open Sci ; 11(7): 240275, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-39076354

RESUMEN

Personal science is the practice of addressing personally relevant health questions through self-research. Implementing personal science can be challenging, owing to the need to develop and adopt research protocols, tools and methods. While online communities can provide valuable peer support, tools for systematically accessing community knowledge are lacking. The objective of this study is to apply a participatory design process involving a community of personal science practitioners to develop a peer-produced knowledge base that supports the needs of practitioners as consumers and contributors of knowledge. The process led to the development of the Personal Science Wiki, an open repository for documenting and accessing individual self-tracking projects while facilitating the establishment of consensus knowledge. After initial design iterations and a field testing phase, we performed a user study with 21 participants to test and improve the platform, and to explore suitable information architectures. The study deepened our understanding of barriers to scaling the personal science community, established an infrastructure for knowledge management actively used by the community and provided lessons on challenges, information needs, representations and architectures to support individuals with their personal health inquiries.

4.
J Psychosom Obstet Gynaecol ; 45(1): 2362653, 2024 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38950574

RESUMEN

In the Netherlands adverse perinatal outcomes are also associated with non-medical factors which vary across geographical locations. This study analyses the presence of non-medical vulnerabilities in pregnant women in two regions with high numbers of psychosocial adversity using the same definition for vulnerability in both regions. A register study was performed in 2 regions. Files from women in midwife-led care were analyzed using a standardized case report form addressing non-medical vulnerability based on the Rotterdam definition for vulnerability: measurement A in Groningen (n = 500), measurement B in South-Limburg (n = 538). Only in South-Limburg a second measurement was done after implementing an identification tool for vulnerability (C (n = 375)). In both regions about 10% of pregnant women had one or more urgent vulnerabilities and almost all of these women had an accumulation of several urgent and non-urgent vulnerabilities. Another 10% of women had an accumulation of three or more non-urgent vulnerabilities. This study showed that by using the Rotterdam definition of vulnerability in both regions about 20% of pregnant women seem to live in such a vulnerable situation that they may need psychosocial support. The definition seems a good tool to determine vulnerability. However, without considering protective factors it is difficult to establish precisely women's vulnerability. Research should reveal whether relevant women receive support and whether this approach contributes to better perinatal and child outcomes.


Asunto(s)
Mujeres Embarazadas , Sistema de Registros , Poblaciones Vulnerables , Humanos , Femenino , Embarazo , Países Bajos/epidemiología , Adulto , Poblaciones Vulnerables/psicología , Poblaciones Vulnerables/estadística & datos numéricos , Mujeres Embarazadas/psicología
5.
Br J Nurs ; 33(13): 622-629, 2024 Jul 04.
Artículo en Inglés | MEDLINE | ID: mdl-38954441

RESUMEN

BACKGROUND: Young people receiving cancer treatment in the South Thames Children's, Teenagers' and Young Adults' Cancer Operational Delivery Network usually receive care across two or more NHS trusts, meaning transition into adult services can be challenging. AIM: To develop a planned, co-ordinated approach to transition across the network that meets National Institute for Health and Care Excellence guidance recommendations for transition and the cancer service specifications. METHODS: A 2-year, nurse-led quality improvement (QI) project, using the principles of experience-based co-design. OUTCOMES: The QI project resulted in the development of six key principles of practice; refining and testing of a benchmarking tool; initiatives to facilitate first transition conversations; and the launch of an information hub. CONCLUSION: Robust QI processes, cross-network collaboration and wide stakeholder involvement required significant resource, but enabled deeper understanding of existing pathways and processes, facilitated the establishment of meaningful objectives, and enabled the testing of interventions to ensure the project outcomes met the needs of all stakeholders.


Asunto(s)
Neoplasias , Mejoramiento de la Calidad , Medicina Estatal , Transición a la Atención de Adultos , Humanos , Adolescente , Neoplasias/terapia , Neoplasias/enfermería , Adulto Joven , Transición a la Atención de Adultos/organización & administración , Transición a la Atención de Adultos/normas , Medicina Estatal/organización & administración , Reino Unido
6.
Afr Health Sci ; 24(1): 42-58, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38962335

RESUMEN

Background: Community Client Led Anti-retroviral therapy Delivery (CCLAD) Model has been associated with increased community participation and ownership, which leads to better treatment outcomes with reduced workload and increased client satisfaction of health services. Aim: To explore the barriers to enrolment of eligible clients into CCLAD in selected health facilities in Kasese District, Uganda. Materials & methods: Analytical cross-sectional study utilizing mixed method approach was conducted among 384 PLWHIV attending public health facilities of Kasese District. Sampling was done by simple random sampling method. Data was collected using researcher-administered questionnaire method and interview guide. Results: Most of the respondents 253(65.9%) had not yet enrolled into CCLAD. This was due to some client-related factors such as non-disclosure of HIV sero-status (p=0.040), person to whom HIV sero-status was disclosed to (p=0.009), not having ever heard about CCLAD (p=0.000), incorrect description of CCLAD (p=0.000), limited knowledge of advantages of CCLAD (p=0.000) or disadvantages of CCLAD (p=0.003). Other barriers were; failure to have access to organizations or groups that support PLWHIV to get treatment (p=0.025) and duration of ART refills [AOR=1.637, 95% CI (0.820 - 3.270)]. Conclusion: Adoption of CCLAD model among PLWHIV in Kasese District is still low.


Asunto(s)
Infecciones por VIH , Humanos , Uganda , Estudios Transversales , Femenino , Masculino , Infecciones por VIH/tratamiento farmacológico , Adulto , Persona de Mediana Edad , Encuestas y Cuestionarios , Accesibilidad a los Servicios de Salud , Adulto Joven , Instituciones de Salud , Fármacos Anti-VIH/uso terapéutico , Antirretrovirales/uso terapéutico , Aceptación de la Atención de Salud/estadística & datos numéricos , Aceptación de la Atención de Salud/psicología , Servicios de Salud Comunitaria , Adolescente
7.
Patient Prefer Adherence ; 18: 1395-1408, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38974680

RESUMEN

Background: Asthma and Chronic obstructive pulmonary disease (COPD) are chronic respiratory conditions characterized by airflow obstruction and respiratory symptoms. Adherence to prescribed inhaler therapy and correct inhalation technique are essential for effective disease management and optimal disease control. However, non-adherence and incorrect inhalation technique are common challenges faced by patients with asthma and COPD, leading to suboptimal treatment outcomes and increased healthcare burden. Purpose: To study the impact of a pharmacist-led intervention on inhaler adherence, inhalation technique, and disease control among patients with asthma and COPD. Patients and Methods: A pre-post interventional design assessed the effects of pharmacist-led intervention on inhaler adherence, inhalation techniques, and disease control in asthma and COPD patients at Dhulikhel Hospital in Nepal. Inclusion criteria: adult patient clinically diagnosed with asthma or COPD patients of all genders. The intervention comprised counseling patients with aids like videos, and informational leaflets. Impact was measured using checklist method for inhalation technique, the Test of Adherence to Inhaler (TAI) questionnaire for adherence to inhaler, and "Asthma Control Test (ACT)" or "COPD Assessment Test (CAT)" for disease control. Results: The pharmacist-led intervention significantly increased adherence to inhalers, evidenced by a notable rise in the proportion of patients with good adherence (P<0.001). Sporadic, deliberate, and unwitting noncompliance pattern also improved significantly after the intervention (P<0.001, P<0.001 and P=0.001). Inhalation technique exhibited substantial improvement after intervention (P<0.001). The analysis indicated significant moderate negative correlations between "TIA" and "CAT" [ρ=-0.31; P=0.01], and between "inhalation technique score" and "CAT score" [ρ=-0.31; P=0.01] suggesting that as adherence to inhaler usage and inhalation technique improve, CAT scores tend to decrease, indicating reduced disease impact on the patient. Conclusion: This study shows the potential efficacy of pharmacist-led intervention in enhancing adherence to inhaler, inhalation technique, and disease control in respiratory conditions such as asthma and COPD.

8.
Hawaii J Health Soc Welf ; 83(7): 187-191, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38974804

RESUMEN

The outbreak of COVID-19 in 2020 brought significant challenges for Native Hawaiians (NH), Pacific Islanders (PI), and other communities of color worldwide. Rapidly increasing rates of infection and transmission of the virus in Native Hawaiian and Pacific Islander (NHPI) communities and incomplete or unavailable data signaled to Hawai'i's leaders that advocacy and action needed to take place to minimize the impact of COVID-19. The Native Hawaiian and Pacific Islander Response, Recovery, and Resilience team (NHPI 3R Team) emerged from an effort to lead and fill gaps in response to COVID-19. Through the swift, intentional, and collaborative work of the team and its partners, NHPI communities and the entities that serve them were better equipped to navigate the pandemic, improve health outcomes, and contribute to a reduction in the number of infections, a rise in vaccination uptake, and an increase in NH and PI representation on various levels of government agencies. As the world shifts its focus from COVID-19 to broader health topics, the NHPI 3R Team will continue to serve as a hub for the exchange of resources and a model of community-led work that can be used to tackle issues like COVID-19 and beyond.


Asunto(s)
COVID-19 , Nativos de Hawái y Otras Islas del Pacífico , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Hawaii , Conducta Cooperativa , SARS-CoV-2 , Pandemias/prevención & control
9.
Nurse Educ Pract ; 79: 104035, 2024 Jun 30.
Artículo en Inglés | MEDLINE | ID: mdl-38972251

RESUMEN

AIM: To evaluate healthcare professional (HCP) students clinical learning experiences' whilst undertaking placements in a student-led clinical learning environment (SLCLE) and any changes in self-reported ratings of confidence. BACKGROUND: The English NHS Long Term Workforce Plan (2023) highlights the need to expand domestic education of HCPs to meet workforce shortages. The demand for quality clinical placements to support the preparation of HCP students remains a challenge globally. A creative solution has been the development of student-led learning clinical environments in healthcare settings. SLCLEs provide high-quality learning experience, increase clinical placement capacity whilst maintaining patient care standards. A multisite NHS Trust adopted this model as evidence suggests HCP students will be better prepared on qualification to adopt registered practitioner professional responsibilities. This model has been integrated across three hospital sites within a large teaching hospital, providing care for a diverse population and designed to accommodate students from a range of HCP disciplines and higher educational institutions. DESIGN: A mixed methods convergent design. METHODS: An online survey was administered to SLCLE allocated nursing and allied health profession (AHP) undergraduate and graduate-entry first, second and third-year students (n=132). Face to face focus groups/individual interviews were undertaken with a purposive sample of student participants (n=80) to evaluate their experiences of clinical learning in SLCLEs. Survey data were analysed using descriptive statistics and paired t-tests, interviews using framework method. RESULTS: Undergraduate and graduate-entry students from four UK universities completed the survey (n=132), 103 students (78 %) responded. Most were year 2 students (n=43/42 %), pursuing nursing programmes (n=82/80 %). Most considered the SLCLE met their expectations (n=76/74 %), reported increased confidence post-placement (n=84/82 %), felt supported by staff (n=80/78 %), peers (n=93/90 %) and clinical educators (n=93/90 %). Self-reported confidence scores post-SLCLE were significantly higher than pre-SLCLE. On-line pre-placement information was infrequently accessed yet identified as an omission. Four themes were identified: (i) preconceptions and initial anxiety; (ii) empowerment, growth and a unique learning experience; (iii) collaborative inter-professional learning and support; and (iv) insights and anticipations. CONCLUSIONS: The SLCLE allocation enhanced students' confidence and knowledge. Support from clinical educators, ward staff and doctors was perceived as invaluable for creating a positive learning culture. Peer support and opportunities to lead care delivery contributed to students' professional development. The format and method for providing pre-placement information needs review as do strategies for avoiding delays in completing assessment documentation. Overall, the SLCLE experience offers much potential as a nurturing and effective learning environment for HCP students.

10.
Adv Sci (Weinh) ; : e2403835, 2024 Jul 08.
Artículo en Inglés | MEDLINE | ID: mdl-38973344

RESUMEN

Considerable focus on tin-based perovskites lies on substitution to leadhalide perovskites for the fabrication of eco-friendly optoelectronic devices.The major concern related to tin-based perovskite devices are mainly thestability and the efficiency. However, thinking on the final commercializationscope, other considerations such as precursor stability and cost are majorfactors to carry about. In this regard, this work presents a robust and facilesynthesis of 2D A2SnX4 (A = 4-fluorophenethylammonium(4-FPEA); X = I, Br, I/Br) and 3D FASnI3 perovskite microcrystals followinga developed synthesis strategy with low-cost starting materials. In thisdeveloped methodology, acetic acid is used as a solvent, which helps to protectfrom water by making a hydrophobic network over the perovskite surface, andhence provides sufficient ambient and long-term inert atmosphere stability ofthe microcrystals. Further, the microcrystals are recrystallized in thin filmsfor LED application, allowing the fabrication of orange, near-infrared and purered emitting LEDs. The two-step recrystallized devices show better performanceand stability in comparison to the reference devices made by using commercialprecursors. Importantly, the developed synthesis methodology is defined as ageneric method for the preparation of varieties of hybrid tin-based perovskitesmicrocrystals and application in optoelectronic devices.

11.
Front Public Health ; 12: 1390645, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39026596

RESUMEN

Introduction: Caregiver training is a key component of rehabilitation for children with complex lifelong disabilities such as cerebral palsy. However critical shortages of therapists in low- and middle-income countries like Malawi, reduce access to therapy. Introducing expert caregivers to assist with the provision of basic training on the condition for fellow caregivers offers a potential solution. However, there is a paucity of evidence regarding the implementation of such strategies in low-resource settings. The aim of this study was to explore perspectives of stakeholders regarding the feasibility of implementing a caregiver-led and delivered training program for caregivers of children with cerebral palsy in Malawi. Methods: Over 5 days in January 2023, a caregiver-led training program, the "Malamulele Onward Carer-to-Carer Training Program," was conducted in Blantyre, Malawi. A South African master trainer traveled to Malawi and delivered the program to potential stakeholders including caregivers of children with cerebral palsy; physiotherapists; and community-based organization representatives. Stakeholder perspectives regarding the acceptability, demand, practicality and adaptation of the program were obtained through a combination of focus group discussions, in-depth interviews, and daily field notes. Data from the focus group discussions and in-depth interviews were analyzed using thematic analysis. Results: The caregiver-led training program was deemed acceptable despite two areas identified as potential areas of concern; that the expert caregivers may cross practice boundaries and that their fellow caregivers may look down upon them. A demand for this program was expressed because of perceived relative advantages and relevance to caregiver needs. Participants indicated that the intervention could be easily delivered using local materials, absorbed and supported by existing community structures. Conclusion: A caregiver-led training program offers an innovative way of supporting caregivers of children with complex disabilities such as cerebral palsy in low-resource settings. The stakeholder engagement demonstrated the positive perspectives of all stakeholders. The areas for modification and adaptation highlighted by the stakeholders will be useful in strengthening the implementation of the program in Malawi.


Asunto(s)
Cuidadores , Parálisis Cerebral , Estudios de Factibilidad , Grupos Focales , Población Rural , Humanos , Malaui , Parálisis Cerebral/rehabilitación , Cuidadores/educación , Masculino , Femenino , Niño , Adulto , Investigación Cualitativa , Participación de los Interesados
12.
Heliyon ; 10(12): e33020, 2024 Jun 30.
Artículo en Inglés | MEDLINE | ID: mdl-39027448

RESUMEN

LED (Light Emitting Diode) lighting has the characteristics of efficiency, environmental protection, energy conservation, and so on. It is more and more widely used in the lighting system of urban rail vehicles. The research on the LED lighting system of rail vehicles has important practical significance. As the core of the LED lighting system of rail vehicles, the LED control system of urban rail vehicles is the key to ensure the stable operation of the entire LED lighting system. The lighting environment of urban rail vehicles needs LED lighting system with good power stability, long life of drive chip, high feedback accuracy, fast processing speed, intelligent algorithm efficiency and other characteristics to ensure continuous operation, and also should have strong anti-interference ability and excellent static performance. However, conventional lighting systems not only have low life, but also have poor stability. Therefore, this paper studied the uniqueness and functional module analysis of LED driving power supply by analyzing the causes and disadvantages of LED lighting, and finally optimized the design of LED lighting control system by using the adaptive PID (Proportional Integral Differential) algorithm. Through comparison, the brightness acquisition quality of LED lighting control system was 21.2 % higher than that of traditional lighting control system, and the lighting control effect was 18 % higher than that of traditional lighting control system. In short, the selection of LED lighting driving power affects the lighting effect of rail vehicles.

13.
Semin Oncol Nurs ; : 151677, 2024 Jul 15.
Artículo en Inglés | MEDLINE | ID: mdl-39013729

RESUMEN

OBJECTIVES: Provide an overview of research-derived insights aimed at elucidating best practices for enhancing mobility in patients with cancer throughout the entirety of the care continuum. Highlighting the value of a multidisciplinary approach involving various healthcare professionals to optimize mobility outcomes for patients with cancer and the benefits of different approaches. METHODS: A literature search was conducted in PubMed/Medline, CINAHL, Scopus, Embase, and on Google Scholar using search terms, mobility, exercise, cancer, nurs*, physical activity, pre-habilitation, rehabilitation, best practices. Systematic reviews, meta-analyses, peer reviewed research studies, exercise, and physical activity recommendations were reviewed to provide a comprehensive overview of strategies aimed at enhancing mobility in patients with cancer. RESULTS: Twenty-nine references were included in this overview of enhancing mobility in patients with cancer across the care continuum. CONCLUSIONS: Evidence-based strategies prioritize enhancing mobility for patients with cancer, aiming to boost physical functioning and overall quality of life. Healthcare providers should consider each patient's unique needs and limitations when implementing these evidence-based approaches, emphasizing a multidisciplinary approach involving oncologists, surgeons, nurses, physical therapists, occupational therapists, and other professionals to ensure comprehensive and personalized care focused on improving mobility. IMPLICATIONS FOR NURSING PRACTICE: Nurses advocate for incorporating exercise into cancer care plans throughout the entire treatment journey, collaborating with healthcare team members to tailor programs to individual patient needs. Working together as an interdisciplinary team, nurses help develop an overall care plan that emphasizes exercise as an important aspect of cancer care, using their expertise to create customized exercise routines to encourage and motivate patients to participate in physical activity.

14.
J Interprof Care ; : 1-14, 2024 Jul 24.
Artículo en Inglés | MEDLINE | ID: mdl-39045867

RESUMEN

Increasing chronic disease rates in regional Australian communities necessitates innovative models of healthcare. We evaluated the efficacy of an interprofessional chronic disease program, delivered within a regional student-led nursing and allied health clinic in Southern Queensland, Australia. Changes to anthropometric, aerobic fitness and strength, and quality of life outcomes were examined at four time points spanning 16 months: intake, program transition (4 months), 6 and 12 months (post-transition). Our primary aim was to investigate whether the health improvements achieved during the program were sustained at 12 months in a subset of participants who provided complete data. Significant improvements were found in 6 of 11 measures, including the 6-minute walk test, grip strength, and self-reported quality of life across physical and psychosocial dimensions, with these improvements maintained to final review. No significant changes were found in body mass index (BMI), waist circumference, fat mass, or muscle mass. This is the first health clinic in regional Australia to deliver a student-led model of interprofessional and collaborative service to tackle the increasing burden of chronic disease in the community. The cost-effectiveness of this service and other potential clinical and social benefits remain to be investigated.

15.
Reprod Health ; 21(1): 102, 2024 Jul 04.
Artículo en Inglés | MEDLINE | ID: mdl-38965578

RESUMEN

BACKGROUND: In recent decades, medical supervision of the labor and delivery process has expanded beyond its boundaries to the extent that in many settings, childbirth has become a medical event. This situation has influenced midwifery care. One of the significant barriers to midwives providing care to pregnant women is the medicalization of childbirth. So far, the policies and programs of the Ministry of Health to reduce medical interventions and cesarean section rates have not been successful. Therefore, the current study aims to be conducted with the purpose of "Designing a Midwife-Led Birth Center Program Based on the MAP-IT Model". METHODS/DESIGN: The current study is a mixed-methods sequential explanatory design by using the MAP-IT model includes 5 steps: Mobilize, Assess, Plan, Implement, and Track, providing a framework for planning and evaluating public health interventions in a community. It will be implemented in three stages: The first phase of the research will be a cross-sectional descriptive study to determine the attitudes and preferences towards establishing a midwifery-led birthing center focusing on midwives and women of childbearing age by using two researcher-made questionnaires to assess the participants' attitudes and preferences toward establishing a midwifery-led birthing center. Subsequently, extreme cases will be selected based on the participants' average attitude scores toward establishing a midwifery-led birthing center in the quantitative section. In the second stage of the study, qualitative in-depth interviews will be conducted with the identified extreme cases from the first quantitative phase and other stakeholders (the first and second steps of the MAP-IT model, namely identifying and forming a stakeholder coalition, and assessing community resources and real needs). In this stage, the conventional qualitative content analysis approach will be used. Subsequently, based on the quantitative and qualitative data obtained up to this stage, a midwifery-led birthing center program based on the third step of the MAP-IT model, namely Plan, will be developed and validated using the Delphi method. DISCUSSION: This is the first study that uses a mixed-method approach for designing a midwife-led maternity care program based on the MAP-IT model. This study will fill the research gap in the field of improving midwife-led maternity care and designing a program based on the needs of a large group of pregnant mothers. We hope this program facilitates improved eligibility of midwifery to continue care to manage and improve their health easily and affordably. ETHICAL CODE: IR.MUMS.NURSE.REC. 1403. 014.


In recent decades, medical management of the labor and delivery process has extended beyond its limitations to the extent that in many settings, childbirth has become a medical event. This situation has influenced midwifery care. The global midwifery situation indicates that one in every five women worldwide gives birth without the support of a skilled attendant. One of the significant barriers to midwives providing care to pregnant women is the medicalization of childbirth. In industrialized countries, maternal and infant mortality rates have decreased over the past 60 years due to medical or social reasons. So far, the policies and programs of the Ministry of Health to diminish medical interventions and cesarean section rates have not been successful. Midwifery models in hospital care contain midwives who support women's choices and diverse ideas about childbirth on the one hand, and on the other hand, they must adhere to organizational guidelines as employees, primarily based on a medical and pathological approach rather than a health-oriented and midwifery perspective. Therefore, the current study aims to be conducted with the purpose of "Designing a midwifery-led birth centered maternity program based on the MAP-IT model". It is a Model for Implementing Healthy People 2030, (Mobilize, Assess, Plan, Implement, Track), a step-by-step method for creating healthy communities. Using MAP-IT can help public health professionals and community changemakers implement a plan that is tailored to a community's needs and assets.


Asunto(s)
Centros de Asistencia al Embarazo y al Parto , Partería , Humanos , Femenino , Centros de Asistencia al Embarazo y al Parto/organización & administración , Centros de Asistencia al Embarazo y al Parto/normas , Partería/normas , Embarazo , Estudios Transversales , Adulto , Servicios de Salud Materna/normas , Servicios de Salud Materna/organización & administración , Parto Obstétrico/normas
16.
Discov Nano ; 19(1): 109, 2024 Jul 02.
Artículo en Inglés | MEDLINE | ID: mdl-38954158

RESUMEN

Light-emitting diodes (LEDs) are an indispensable part of our daily life. After being studied for a few decades, this field still has some room for improvement. In this regard, perovskite materials may take the leading role. In recent years, LEDs have become a most explored topic, owing to their various applications in photodetectors, solar cells, lasers, and so on. Noticeably, they exhibit significant characteristics in developing LEDs. The luminous efficiency of LEDs can be significantly enhanced by the combination of a poor illumination LED with low-dimensional perovskite. In 2014, the first perovskite-based LED was illuminated at room temperature. Furthermore, two-dimensional (2D) perovskites have enriched this field because of their optical and electronic properties and comparatively high stability in ambient conditions. Recent and relevant advancements in LEDs using low-dimensional perovskites including zero-dimensional to three-dimensional materials is reported. The major focus of this article is based on the 2D perovskites and their heterostructures (i.e., a combination of 2D perovskites with transition metal dichalcogenides, graphene, and hexagonal boron nitride). In comparison to 2D perovskites, heterostructures exhibit more potential for application in LEDs. State-of-the-art perovskite-based LEDs, current challenges, and prospects are also discussed.

17.
Cell Biochem Funct ; 42(5): e4086, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38956862

RESUMEN

Wounds represent a growing global issue demanding increased attention. To expedite wound healing, technologies are under development, and light emitting diode (LED) devices of varying wavelengths are being explored for their stimulating influence on the healing process. This article presents a systematic literature review aiming to compile, organize, and analyze the impacts of LED devices on wound healing. This review is registered on the PROSPERO platform [CRD42023403870]. Two blinded authors conducted searches in the Pubmed, Web of Science, Scopus, Embase, and ScienceDirect databases. In vitro and in vivo experimental studies assessing LED utilization in the wound healing process were included. The search yielded 1010 studies, of which 27 were included in the review. It was identified that LED stimulates different healing pathways, promoting enhanced cell proliferation and migration, angiogenesis stimulation, increased collagen deposition, and modulation of the inflammatory response. Thus, it can be concluded that the LED stimulates cellular and molecular processes contingent on the utilized parameters. The effects depend on the standards used. Cell migration and proliferation were better influenced by green and red LED. The extracellular matrix components and angiogenesis were regulated by all wavelengths and the modulation of inflammation was mediated by green, red, and infrared LEDs.


Asunto(s)
Proliferación Celular , Cicatrización de Heridas , Animales , Humanos , Movimiento Celular , Luz , Fototerapia
18.
Nutrients ; 16(13)2024 Jul 05.
Artículo en Inglés | MEDLINE | ID: mdl-38999893

RESUMEN

A multicenter cross-sectional study was conducted among 245 experienced Spanish paediatricians, who completed an online survey based on clinically relevant topics in nutrition during the first two years of life and their recommendations to parents in daily clinical practice. Most participants advise about the choking risk associated with baby-led weaning (BLW) and more than 60% consider that infants can receive an insufficient variety and quantity of nutrients with this practice. The general opinion is that there is a lack of evidence for delaying the introduction of gluten and other allergenic foods in the complementary feeding of healthy infants. Most participants agree/strongly agree that two servings of dairy products are the adequate daily amount in a diversified diet and 93.4% disagree/strongly disagree with the use of vegetal beverages under 1 year of life. There is a general agreement to avoid added salt and sugar before 12 months of life, the consideration that organic foods do not have a better nutritional profile than non-organic ones, and the limitations of vegetarian diets especially for adequate provision of micronutrients. Overall, there is an adequate knowledge of the new trends by paediatricians and younger ones seemed more in favor of them and interested in receiving more information on most topics.


Asunto(s)
Fenómenos Fisiológicos Nutricionales del Lactante , Pediatras , Humanos , Lactante , España , Estudios Transversales , Femenino , Masculino , Pediatras/estadística & datos numéricos , Encuestas y Cuestionarios , Atención Primaria de Salud , Adulto , Recién Nacido , Destete , Preescolar , Estado Nutricional
19.
ACS Appl Mater Interfaces ; 16(28): 37017-37027, 2024 Jul 17.
Artículo en Inglés | MEDLINE | ID: mdl-38968699

RESUMEN

In this work, the production of novel multishell silver indium selenide quantum dots (QDs) shelled with zinc selenide and zinc sulfide through a multistep synthesis precisely designed to develop high-quality red-emitting QDs is explored. The formation of the multishell nanoheterostructure significantly improves the photoluminescence quantum yield of the nanocrystals from 3% observed for the silver indium selenide core to 27 and 46% after the deposition of the zinc selenide and zinc sulfide layers, respectively. Moreover, the incorporation of the multishelled QDs in a poly(methyl methacrylate) (PMMA) matrix via in situ radical polymerization is investigated, and the role of thiol ligand passivation is proven to be fundamental for the stabilization of the QDs during the polymerization step, preventing their decomposition and the relative luminescence quenching. In particular, the role of interface chemistry is investigated by considering both surface passivation by inorganic zinc chalcogenide layers, which allows us to improve the optical properties, and organic thiol ligand passivation, which is fundamental to ensuring the chemical stability of the nanocrystals during in situ radical polymerization. In this way, it is possible to produce silver-indium selenide QD-PMMA composites that exhibit bright red luminescence and high transparency, making them promising for potential applications in photonics. Finally, it is demonstrated that the new silver indium selenide QD-PMMA composites can serve as an efficient color conversion layer for the production of red light-emitting diodes.

20.
J Int AIDS Soc ; 27(7): e26334, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-39034541

RESUMEN

INTRODUCTION: HIV self-testing (HIVST) is a promising strategy to improve diagnosis coverage among key populations (KP). The ATLAS (Auto Test VIH, Libre d'Accéder à la connaissance de son Statut) programme implemented HIVST in three West African countries, distributing over 380,000 kits up between 2019 and 2021, focussing on community-led distribution by KP to their peers and subsequent secondary distribution to their partners and clients. We aim to evaluate the cost-effectiveness of community-led HIVST in Côte d'Ivoire, Mali and Senegal. METHODS: An HIV transmission dynamics model was adapted and calibrated to country-specific epidemiological data and used to predict the impact of HIVST. We considered the distribution of HIVST among two KP-female sex workers (FSW), and men who have sex with men (MSM)-and their sexual partners and clients. We compared the cost-effectiveness of two scenarios against a counterfactual without HIVST over a 20-year horizon (2019-2039). The ATLAS-only scenario mimicked the 2-year implemented ATLAS programme, whereas the ATLAS-scale-up scenario achieved 95% coverage of HIVST distribution among FSW and MSM by 2025 onwards. The primary outcome is the number of disability-adjusted life-years (DALY) averted. Scenarios were compared using incremental cost-effectiveness ratios (ICERs). Costing was performed using a healthcare provider's perspective. Costs were discounted at 4%, converted to $USD 2022 and estimated using a cost-function to accommodate economies of scale. RESULTS: The ATLAS-only scenario was highly cost-effective over 20 years, even at low willingness-to-pay thresholds. The median ICERs were $126 ($88-$210) per DALY averted in Côte d'Ivoire, $92 ($88-$210) in Mali and 27$ ($88-$210) in Senegal. Scaling-up the ATLAS programme would also be cost-effective, and substantial epidemiological impacts would be achieved. The ICERs for the scale-up scenario were $199 ($122-$338) per DALY averted in Côte d'Ivoire, $224 ($118-$415) in Mali and $61 ($18-$128) in Senegal. CONCLUSIONS: Both the implemented and the potential scale-up of community-led HIVST programmes in West Africa, where KP are important to overall transmission dynamics, have the potential to be highly cost-effective, as compared to a scenario without HIVST. These findings support the scale-up of community-led HIVST to reach populations that otherwise may not access conventional testing services.


Asunto(s)
Análisis Costo-Beneficio , Infecciones por VIH , Autoevaluación , Trabajadores Sexuales , Humanos , Infecciones por VIH/diagnóstico , Infecciones por VIH/epidemiología , Infecciones por VIH/economía , Masculino , Femenino , Senegal/epidemiología , Malí/epidemiología , Côte d'Ivoire/epidemiología , Trabajadores Sexuales/estadística & datos numéricos , Adulto , Adulto Joven , Homosexualidad Masculina , Análisis de Costo-Efectividad
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