Promoting workplace retention during global crises: An international survey of the preventive role of psychological support among victims of social discrimination in long-term care facilities.

This international cross-sectional survey examined the potential role of organizational psychological support in mitigating the association between experiencing social discrimination against long-term care (LTC) facilities' healthcare professionals (HCPs) and their intention to stay in the current workplace during the COVID-19 pandemic. Participants included a convenience sample of 2,143 HCPs (nurses [21.5 %], nurse aids or residential care workers [40.1 %], social workers [12.1 %], and others [26.4 %]) working at 223 LTC facilities in 13 countries/regions. About 37.5 % of the participants reported experiencing social discrimination, and the percentage ranged from 15.3 % to 77.9 % across countries/regions. Controlling for socio-demographic and work-related variables, experiencing social discrimination was significantly associated with a lower intention to stay, whereas receiving psychological support showed a statistically significant positive association (p-value=0.015 and <0.001, respectively). The interaction term between social discrimination and psychological support showed a statistically significant positive association with the intention to stay, indicating a moderating role of the psychological support.

Efficacy of Therapeutic Exercise in Reducing Pain in Instrumental Musicians: Systematic Review and Meta-Analysis.

Playing-related pain poses a significant health concern for musicians, often impacting their ability to perform. Therapeutic exercise emerges as a viable approach to alleviate these symptoms, offering a low-cost intervention with minimal side effects. This review seeks to examine and assess the efficacy of therapeutic exercise in reducing pain intensity among instrumental musicians. Three major databases (PubMed, Web of Science, and Scopus) were systematically searched from November 2023 to June 2024. The inclusion criteria required studies to be randomized clinical trials focusing on pain intensity in instrumental musicians, published in the last 10 years. Two independent researchers assessed the characteristics and methodological quality of the selected studies. Out of 305 identified studies, 15 underwent full-text reviews, with 5 ultimately included in the analysis. The total participant count was 273, with an average intervention duration of 32.5 min per session, twice weekly for eight weeks. Overall, therapeutic exercise interventions demonstrated favorable effects, with three studies exhibiting good methodological quality. The meta-analysis revealed significant positive results favoring exercise in reducing pain intensity, with positive responses observed across all clinical populations, so therapeutic exercise appears to be an effective approach for reducing pain intensity in musicians experiencing playing-related pain.

Instruments to measure complexity of care based on nursing workload in intensive care units: A systematic review.

OBJECTIVE: To establish an evidence-based recommendation on the use of validated scoring systems that measure nursing workload in relation to the complexity of care in adult Intensive Care Units. METHODS: A systematic review based on the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) was conducted (PROSPERO registration: CRD42021251272). We searched for validation studies until July 2023 using the bibliographic databases CINAHL, Scopus, Pubmed, WOS, Cochrane Database, SCIELO, Cuiden and Cuidatge. Reference selection and data extraction was performed by two independent reviewers. The assessment of risk of bias was performed using QUADAS-2 and the overall quality according to COSMIN and GRADE approach. RESULTS: We included 22 articles identifying 10 different scoring systems. Reliability, criterion validity and hypothesis testing were the most frequently measurement properties reported. The NAS was the only tool to demonstrate a Class A recommendation (the best performing instrument). CONCLUSIONS: NAS is the best currently available scoring system to assess complexity of care from nursing workload in ICU. However, it barely met the criteria for a class A recommendation. Future efforts should be made to develop, evaluate, and implement new systems based on innovative approaches such as intensity or complexity of care. IMPLICATIONS FOR CLINICAL PRACTICE: The results facilitate decision making as it establishes a ranking of which instruments are recommended, promising or not recommended to measure the nursing workload in the intensive care units.

Effects of the PREMEN-CALM® in the Management of the Premenstrual Syndrome: A Randomized, Double-Blind, Placebo-Controlled Pilot Study.

Premenstrual syndrome is a common disorder in women of reproductive age characterized by a variety of cyclical symptoms with a great impact on their lifestyle. Available pharmacological options include both antidepressants and oral contraceptives, both of which have side effects, are expensive and not always effective. Vitamins, minerals and plant extracts have been proven to alleviate the symptomatology of the premenstrual syndrome. For this reason, the purpose of this study was to test the effectiveness of a commercial phytotherapeutic dietary supplement (PREMEN-CALM®: γ-aminobutyric acid, Rhodiola rosea L., Vitex agnus-castus, vitamin B6 and melatonin) as an alternative treatment for this condition. A randomized, double-blind, and placebo-controlled pilot study was performed. Participants (n = 42) were assessed before and after 3 months of taking the supplement (n = 21) or the placebo (n = 21). Outcome measures include antioxidant and inflammatory biomarkers, body composition, subjective sleep quality, mood state profile, quality of life, and certain characteristics of the menstrual cycle. The within-group analysis revealed a significant improvement in the total antioxidant status (1.49 ± 0.34 vs reference value 1, p = 0.002), mood state profile (p = 0.02), and affective symptoms (p = 0.01) in the women receiving the commercial phytotherapeutic dietary supplement PREMEN-CALM®. On the contrary, the between-group analysis showed no statistical differences, suggesting a plausible placebo effect. The phytotherapeutic supplement PREMEN-CALM® might be effective in treating or alleviating the symptoms of the premenstrual syndrome without adverse events. Integrative medicine approaches in the clinical practice may help improve the health of women suffering from this and other gynecological conditions.

Long-term care facilities' response to the COVID-19 pandemic: An international, cross-sectional survey.

AIMS: To (i) assess the adherence of long-term care (LTC) facilities to the COVID-19 prevention and control recommendations, (ii) identify predictors of this adherence and (iii) examine the association between the adherence level and the impact of the pandemic on selected unfavourable conditions. DESIGN: Cross-sectional survey. METHODS: Managers (n = 212) and staff (n = 2143) of LTC facilities (n = 223) in 13 countries/regions (Brazil, Egypt, England, Hong Kong, Indonesia, Japan, Norway, Portugal, Saudi Arabia, South Korea, Spain, Thailand and Turkey) evaluated the adherence of LTC facilities to COVID-19 prevention and control recommendations and the impact of the pandemic on unfavourable conditions related to staff, residents and residents' families. The characteristics of participants and LTC facilities were also gathered. Data were collected from April to October 2021. The study was reported following the STROBE guidelines. RESULTS: The adherence was significantly higher among facilities with more pre-pandemic in-service education on infection control and easier access to information early in the pandemic. Residents' feelings of loneliness and feeling down were the most affected conditions by the pandemic. More psychological support to residents was associated with fewer residents' aggressive behaviours, and more psychological support to staff was associated with less work-life imbalance. CONCLUSIONS: Pre-pandemic preparedness significantly shaped LTC facilities' response to the pandemic. Adequate psychological support to residents and staff might help mitigate the negative impacts of infection outbreaks. IMPACT: This is the first study to comprehensively examine the adherence of LTC facilities to COVID-19 prevention and control recommendations. The results demonstrated that the adherence level was significantly related to pre-pandemic preparedness and that adequate psychological support to staff and residents was significantly associated with less negative impacts of the pandemic on LTC facilities' staff and residents. The results would help LTC facilities prepare for and respond to future infection outbreaks. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution.

Sex, cognitive state and falls as factors associated with malnutrition: a cross-sectional study of institutionalized older adults living in a rural area of Portugal.

BACKGROUND: Malnutrition is an underestimated geriatric problem, with a high prevalence in institutionalized older adults. The identification of risk factors for malnutrition in elderly individuals must be a priority for governmental organizations worldwide. METHODS: A total of 98 institutionalized seniors were enrolled in a cross-sectional study. For the assessment of risk factors, sociodemographic characteristics and health-related information were collected. The Mini-Nutritional Assessment Short-Form test was used to assess malnutrition in the sample population. RESULTS: A significantly greater proportion of women than men were malnourished or at risk of malnutrition. In addition, the comparative analysis revealed that comorbidity, arthritis, balance impairment, dementia and fall episodes with serious injuries were significantly more frequent in the older adults categorized as malnourished or at risk of malnutrition than in those categorized as well-nourished. CONCLUSIONS: Multivariable regression analysis revealed that being female, having a poor cognitive status and experiencing falls with injuries are the main independent factors influencing nutritional status in institutionalized older adults living in a rural area of Portugal.

Allograft and Autologous Reconstruction Techniques for Neglected Achilles Tendon Rupture: A Mid-Long-Term Follow-Up Analysis.

Achilles tendon ruptures that are not immediately recognized and treated are sometimes diagnosed as delayed injuries and may require different surgical repair options based on gap size. The potential complications associated with using an allograft for reconstruction may lead some surgeons to prefer the use of autologous techniques. However, allografts are often considered a salvagement option when large defects are present. In this study, we examined the long-term clinical outcomes and complications of 17 patients who underwent surgical repair for chronic ruptures with large gaps using both autologous and allograft techniques. During an 11-year period, nine patients were treated with autologous techniques (mean gap of 4.33 ± 1.32 cm) and Achilles allograft reconstruction was performed in eight patients (47.1%) (mean gap of 7.75 ± 0.89 cm). At a mean of 82 ± 36.61 months of follow-up, all 17 patients (100%) were able to perform a single heel rise and improved AOFAS (American Orthopaedic Foot and Ankle Society) and ATRS (Achilles Tendon Total Rupture Score) scores. No infections, complications, or re-ruptures were recorded at the end of the follow-up. No significant differences were found in the AOFAS and ATRS scales between both techniques. When an extensive defect is present, the reconstruction with an Achilles tendon allograft can be considered a proper treatment option, as it does not show a higher rate of complications than autologous techniques achieving similar functional outcomes.

A Big Five-Based Multimethod Social and Emotional Skills Assessment: The Mosaic™ by ACT® Social Emotional Learning Assessment.

A focus on implementing social and emotional (SE) learning into curricula continues to gain popularity in K-12 educational contexts at the policy and practitioner levels. As it continues to be elevated in educational discourse, it becomes increasingly clear that it is important to have reliable, validated measures of students' SE skills. Here we argue that framework and design are additional important considerations for the development and selection of SE skill assessments. We report the reliability and validity evidence for The Mosaic™ by ACT® Social Emotional Learning Assessment, an assessment designed to measure SE skills in middle and high school students that makes use of a research-based framework (the Big Five) and a multi-method approach (three item types including Likert, forced choice, and situational judgment tests). Here, we provide the results from data collected from more than 33,000 students who completed the assessment and for whom we have data on various outcome measures. We examined the validity evidence for the individual item types and the aggregate scores based on those three. Our findings support the contribution of multi-method assessment and an aggregate score. We discuss the ways the field can benefit from this or similarly designed assessments and discuss how the assessment results can be used by practitioners to promote programs aimed at stimulating students' personal growth.

Effects of Lycopene-enriched, Organic, Extra Virgin Olive Oil on Benign Prostatic Hyperplasia: A Pilot Study.

Context: Epidemiological evidence has shown that lycopene consumption may be effective in both the prevention and treatment of various diseases, particularly prostate cancer. However, the influence of this dietary carotenoid on some of the most basic aspects of human health remains unknown. Objectives: The aim of the study was to determine the effects of consumption of a lycopene-enriched commercial product of organic, extra virgin olive oil (EVOO) on prostate health, sleep quality, antioxidant status, and anxiety. Design: The research team designed a pilot study with two intervention groups. Setting: The study took place in the city of Badajoz (Extremadura, Spain). Participants: Participants were 20 men aged ≥50, some of whom were healthy and some of whom had received a diagnosis of benign prostatic hyperplasia. Intervention: Participants were divided into a healthy-men (HM) group (n = 10) and a benign prostatic hyperplasia (BPH) group (n = 10). Both groups consumed 20 ml of lycopene (0.4 mg/ml) daily in a lycopene-enriched commercial product of organic extra virgin olive oil, at breakfast and/or lunch, for 30 days. Outcome Measures: Sleep quality, prostate markers-prostatic specific antigen and protein C reactive-and symptomatology, urine total antioxidant status, and emotional health were assessed at baseline and postintervention. Results: The level of prostatic specific antigen and symptomatology remarkably improved in men with benign prostatic hyperplasia, although the changes wasn't statistically significant, and the total antioxidant status was significantly increased in healthy men (P < .05). Sleep quality in terms of nocturnal activity was significantly improved in both groups (P < .05). No adverse events were reported. Conclusion: The consumption of a lycopene-enriched, organic, EVOO positively influenced prostate health and other physiological variables. These findings may help to advance the development of new preventive and/or chemotherapeutic strategies based on lycopene.

Development and validation of a continuous fall risk score in community-dwelling older people: an ecological approach.

BACKGROUND: Fall risk assessment in older people is of major importance for providing adequate preventive measures. Current predictive models are mainly focused on intrinsic risk factors and do not adjust for contextual exposure. The validity and utility of continuous risk scores have already been demonstrated in clinical practice in several diseases. In this study, we aimed to develop and validate an intrinsic-exposure continuous fall risk score (cFRs) for community-dwelling older people through standardized residuals. METHODS: Self-reported falls in the last year were recorded from 504 older persons (391 women: age 73.1 ± 6.5 years; 113 men: age 74.0 ± 6.1 years). Participants were categorized as occasional fallers (falls ≤1) or recurrent fallers (≥ 2 falls). The cFRs was derived for each participant by summing the standardized residuals (Z-scores) of the intrinsic fall risk factors and exposure factors. Receiver operating characteristic (ROC) analysis was used to determine the accuracy of the cFRs for identifying recurrent fallers. RESULTS: The cFRs varied according to the number of reported falls; it was lowest in the group with no falls (- 1.66 ± 2.59), higher in the group with one fall (0.05 ± 3.13, p < 0.001), and highest in the group with recurrent fallers (2.82 ± 3.94, p < 0.001). The cFRs cutoff level yielding the maximal sensitivity and specificity for identifying recurrent fallers was 1.14, with an area under the ROC curve of 0.790 (95% confidence interval: 0.746-0.833; p < 0.001). CONCLUSIONS: The cFRs was shown to be a valid dynamic multifactorial fall risk assessment tool for epidemiological analyses and clinical practice. Moreover, the potential for the cFRs to become a widely used approach regarding fall prevention in community-dwelling older people was demonstrated, since it involves a holistic intrinsic-exposure approach to the phenomena. Further investigation is required to validate the cFRs with other samples since it is a sample-specific tool.

Factors influencing physical activity: A cross-sectional study of the community-dwelling older adults in a Portuguese rural area.

BACKGROUND: There are a variety of intrinsic determinants which are key to understand the reasons for older people to stay (or not) active. OBJECTIVES: To identify and analyse the factors underlying the physical activity engagement in older Portuguese living in a rural area. METHODS: A total of 504 community-dwelling older adults (aged ≥65 years) were enrolled in this cross-sectional study. Sociodemographic data, physical activity levels, physical fitness and body composition were analysed. RESULTS: Gender, age, income level, lower body strength, overweight, muscle mass and sedentarism (sitting time) were significantly associated with different physical activity levels. The multinomial logistic regression pointed out that dynamic balance, BMI and sitting time for moderate levels, as well as muscle mass for high levels, were the main independent factors that seem to influence the engagement in these levels compared to low physical activity levels. Additionally, classification tree analysis confirmed sitting time, dynamic balance and gender as discriminating factors for physical activity levels. CONCLUSION: Physical fitness-related variables seem to mainly determine the levels of physical activity in the studied population. Thus, nursing care must promote the integration of physical activity into daily life routines of community-dwelling older adults, especially in rural areas. IMPLICATIONS FOR PRACTICE: The diverse nature of factors influencing physical activity must be taken into account in primary health care, particularly in rural areas. Nursing care for older people must promote the integration of physical activity into daily life routines of community-dwelling older adults.

Adjectives vs. Statements in Forced Choice and Likert Item Types: Which Is More Resistant to Impression Management in Personality Assessment?

Our objective was to compare individuals' ability to intentionally make a positive impression when responding to a Five-Factor Model personality measure under adjective vs. statement and forced choice vs. Likert conditions. Participants were 1,798 high school students who were randomly assigned to either a condition receiving normal instructions or instructions to make a positive impression. We compared the groups' scores and validity estimates under the various conditions. Although impression management occurred on all item types, participants could more easily manipulate their responses to Likert items vs. forced choice items, and statements vs. adjectives. Item type made little difference in terms of convergent and discriminant validity and criterion-related validity for all outcomes but one, ACT scores, which suggests cognitive ability plays a role in impression management ability.

Neumotórax bilateral espontáneo secundario y neumomediastino en paciente con EPID por artritis reumatoide / Bilateral secondary spontaneous pneumothorax and pneumomediastinum in a patient with rheumatoid arthritis-induced DILD

No disponible

A clinician's perspective on yellow fever vaccine-associated neurotropic disease.

Yellow fever (YF) causes high fever, liver dysfunction, renal failure, hypercoagulopathy and platelet dysfunction and can lead to shock and death with a case-fatality ratio of 20-50%. YF vaccination results in long-lasting protective immunity. Serious adverse events (SAEs), such as YF vaccine-associated neurotropic disease (YEL-AND) are rare. We present a case of a 56-year-old Caucasian man with fever, headache, cognitive problems at the emergency department. He received a primary YF vaccination 4 weeks prior to symptom onset. Cerebrospinal fluid tested positive (POS) for YF virus by reverse transcriptase polymerase chain reaction and confirmed diagnosis of YEL-AND. The patient recovered with symptomatic treatment. We reviewed published clinical reports on YEL-AND indexed for MEDLINE. We identified and analyzed 53 case reports. Forty-five patients were male and eight were female. Twenty-nine cases met criteria for definite YEL-AND and twenty-four for suspected YEL-AND according to YF Vaccine Safety Working Group. We applied the Brighton Collaboration diagnostic criteria to assess the diagnostic accuracy of the clinical diagnoses and found meningoencephalitis in 38 reported YEL-AND cases, Guillain Barré Syndrome (GBS) in seven, Acute Disseminated Encephalomyelitis (ADEM) in six and myelitis in five. Thirty-five patients recovered or improved; however, not all cases had a complete follow-up. The prognosis of YEL-AND presenting with GBS, ADEM or myelitis was poor. Fourteen patients received therapy (corticosteroids, intravenous immunoglobulins and/or plasmapheresis). In conclusion, YF vaccine-associated neurotropic disease is a very rare but SAE after YF vaccination. We described a case of YEL-AND and propose a standardized clinical workup of this condition based on a review of the literature. Centralized registration of complications of YF vaccination is encouraged.

Measuring achievement striving via a situational judgment test: the value of additional context / Medición del esfuerzo hacia el logro mediante de un test de juicio situacional: el valor del contexto adicional

The study extends personality and situational judgment test (SJT) research by using an SJT to measure achievement striving in a contextualized manner. Employed students responded to the achievement striving SJT, traditional personality scales, and workplace performance measures. The SJT was internally consistent, items loaded on a single factor, and scores converged with other measures of achievement striving. The SJT provided incremental criterion-related validity for the performance criteria beyond less-contextualized achievement striving measures. Findings suggest that achievement-related work scenarios may provide additional criterion-relevant information not captured by measures that are less contextualized

Este estudio extiende la investigación sobre los tests de juicio situacional (TJS) y la personalidad, usando un TJS para medir el esfuerzo hacia el logro de una manera contextualizada. Estudiantes con empleo respondieron el TJS de esfuerzo hacia el logro, escalas típicas de personalidad y medidas de desempeño en el trabajo. El TJS fue internamente consistente, los ítems cargaron en un único factor y las puntuaciones convergieron con otras medidas de esfuerzo hacia el logro. El TJS añadió validez relacionada con el criterio, para los criterios de desempeño, a la validez de las medidas menos contextualizadas de esfuerzo hacia el logro. Los hallazgos sugieren que escenarios de trabajo relacionados con el logro pueden proporcionar información adicional relevante para el criterio no capturada por medidas menos contextualizadas

Tidal volumes at birth as predictor for adverse outcome in congenital diaphragmatic hernia.

OBJECTIVE: To assess the predictive value of tidal volume (Vt) of spontaneous breaths at birth in infants with congenital diaphragmatic hernia (CDH). DESIGN: Prospective study. SETTING: Tertiary neonatal intensive care unit. PATIENTS: Thirty infants with antenatally diagnosed CDH born at Hospital Sant Joan de Déu in Barcelona from September 2013 to September 2015. INTERVENTIONS: Spontaneous breaths and inflations given in the first 10 min after intubation at birth were recorded using respiratory function monitor. Only expired Vt of uninterrupted spontaneous breaths was included for analysis. Receiver operating characteristics (ROC) analysis was performed and the area under the curve (AUC) was estimated to assess the predictive accuracy of Vt. MAIN OUTCOME MEASURES: Mortality before hospital discharge and chronic lung disease (CLD) at day 28 of life. RESULTS: There were 1.233 uninterrupted spontaneous breaths measured, and the overall mean Vt was 2.8±2.1 mL/kg. A lower Vt was found in infants who died (n=14) compared with survivors (n=16) (1.7±1.6 vs 3.7±2.1 mL/kg; p=0.008). Vt was lower in infants who died during admission or had CLD (n=20) compared with survivors without CLD (n=10) (2.0±1.7 vs 4.3±2.2 mL/kg; p=0.004). ROC analysis showed that Vt ≤2.2 mL/kg predicted mortality with 79% sensitivity and 81% specificity (AUC=0.77, p=0.013). Vt ≤3.4 mL/kg was a good predictor of death or CLD (AUC=0.80, p=0.008) with 85% sensitivity and 70% specificity. CONCLUSION: Vt of spontaneous breaths measured immediately after birth is associated with mortality and CLD. Vt seems to be a reliable predictor but is not an independent predictor after adjustment for observed/expected lung to head ratio and liver position.

Understanding fall risk factors in community-dwelling older adults: A cross-sectional study.

AIM AND OBJECTIVE: Ageing is associated with an increased risk of falling. Identification of risk factors is crucial for the prevention of falls in older people. METHODS: A total of 508 older adults enrolled in a cross-sectional study. For the assessment of risk factors, the research team collected basic data and health-related information and performed morphofunctional evaluations (strength and flexibility of lower body and dynamic balance). RESULTS: A significantly greater proportion of women experienced fall episodes within the past year. Additionally, certain chronic diseases were significantly more prevalent in the fall subgroup compared to the non-fall subgroup. The non-fall subgroup showed significantly better scores of lower body strength and dynamic balance than the fall subgroup. CONCLUSION: Multivariable regression analysis revealed that gender and lower body strength seem to be the main risk factors for fall event (s) within the past year in community-dwelling older adults from the Portuguese region of Alentejo. IMPLICATIONS FOR PRACTICE: Differences in fall risk factors due to gender, ethnicity and geography must be taken into account in clinical practice. Nurses must identify the environmental, social and individual risks that constitute health threats and trigger protective intervention programs. Nursing care for older people must also meet needs related to physical activity (e.g., strength-training exercise), since lower body weakness is strongly associated with falls.

Changes in Mediterranean dietary pattern of university students: a comparative study between Spain and Algeria / Cambios en el patrón dietético mediterráneo de estudiantes universitarios: un estudio comparativo entre España y Argelia

AIM: Assess and compare the diet quality of university students living in two different Mediterranean countries (Algeria and Spain). METHODS: 303 university students from two different Mediterranean areas (Algeria and Spain) were enrolled in this cross-sectional study. The data collection of students' diet and other personal variables was based on a self-reported method; a nutritional evaluation was carried out using the DIAL(R) nutritional software. RESULTS: There were found significant differences in the diets, not only because of gender but also nationality, probably due to inherent cultural and socioeconomic characteristics of each country resulting in variants of Mediterranean diet. CONCLUSIONS: Nutrition education programs based on the promotion of Mediterranean lifestyle must be aimed at all ages, but especially in university stage

OBJETIVO: evaluar y comparar la calidad de la dieta de los estudiantes universitarios que viven en dos países mediterráneos diferentes (Argelia y España). MÉTODO: 303 estudiantes universitarios de dos áreas mediterráneas diferentes (Argelia y España) se inscribieron en este estudio transversal. La recopilación de datos de la dieta de los estudiantes y otras variables personales se recogío mediante en un cuestionario autoinformado; Se realizó una evaluación nutricional utilizando el software nutricional DIAL(R). RESULTADOS: Se encontraron diferencias significativas en las dietas, no solo debido al género sino también a la nacionalidad, probablemente debido a las distintas características culturales y socioeconómicas de cada país que se reflejan en algunas variantes de la dieta mediterránea. CONCLUSIÓN: los programas de educación nutricional basados en la promoción del estilo de vida mediterráneo deben estar dirigidos a todas las edades, pero especialmente en la etapa universitaria