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ABSTRACT: Sister Simone Roach, a noted philosopher of caring in nursing, left behind a significant body of theoretical and practical work highlighting the areas of nursing ethics, care/caring, and compassion. This article explores the integration of the moral foundation of agape love in Pauline theology and Roach's human caring in nursing (1992) as the action of agape love. A narrative literature review explores the relationship between the scriptural ethics of St. Paul (Pauline ethics) and Roach's caring in nursing.
Subject(s)
Christianity , Empathy , Humans , History, 20th Century , Philosophy, Nursing , Ethics, Nursing , Nursing Care/psychology , Nurse-Patient RelationsABSTRACT
Background: Assessing the professional interpersonal competency of novice nurses is crucial for preventing staff turnover and promoting effective work. However, none of the instruments identified in the literature specifically target novice nurses. Objective: This study aimed to develop and psychometrically test the perception dimension of the Professional Interpersonal Competency Assessment Scale for Novice nurses (PICASN) in Japan. Methods: The study comprised four steps: 1) concept identification, 2) item construction, 3) validity measure, and 4) reliability measure. A cross-sectional web-based questionnaire was administered from February to April 2023 and was completed by 203 novice nurses. Data quality was assessed using mean, item response, missing values, floor and ceiling effects, internal consistency, and item-rest correlations. Content validity index (CVI) was used to determine the instrument's validity, while exploratory factor analysis (EFA) using maximum likelihood estimation with Promax rotation was employed to assess the factor structure. Cronbach's alpha was used to evaluate reliability. Results: The 27-item PICASN demonstrated an Item-CVI of 0.94 and a Scale-CVI of 0.88. EFA revealed two factors: 1) Basic competencies as a novice nurse (15 items) and 2) Relationship building skills within the healthcare team (12 items), which explained 80% of the variance. Internal consistency reliability was excellent at 0.94 and 0.91 for the factors, and the overall scale reliability was 0.95. The item-rest (I-R) correlation values exceeding 0.6 were considered acceptable. Conclusion: The PICASN demonstrates satisfactory psychometric properties, making it an effective tool for measuring professional interpersonal competency among novice nurses in Japan. This instrument serves to assist novice nurses by promoting self-awareness and offering targeted insights into specific areas requiring improvement. Additionally, it provides experienced nurses and nurse managers with valuable insights into team dynamics, guiding interventions for continuous quality improvement.
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Introducción: El principal motivo de la alta mortalidad en el cáncer de mama es la recurrencia local y las metástasis, siendo la cirugía la primera opción terapéutica. La técnica anestésica utilizada en quirófano puede modificar la respuesta inmunológica del paciente. Métodos: Estudio prospectivo, comparativo y no aleatorizado en pacientes intervenidos de cáncer de mama en el Hospital Universitario de Getafe (Madrid) tras la aprobación del Comité Ético del Hospital.Dividimos a los pacientes en dos grupos: grupo A, que recibió anestesia general con propofol y fármacos opiáceos; grupo B, en el que además de la anestesia general, se realizaron tres bloqueos interfasciales (Pec I, Pec II y BRILMA) en todos los pacientes. Se obtuvieron tres muestras sanguíneas: 1) antes de la inducción anestésica; 2) 2h después de finalizar la cirugía y 3) 24-48h posquirúrgicas. En cada muestra, se analizaron el número de leucocitos, células CD3, CD4 y CD8, así como las células natural killer (NK). Resultados: Se incluyeron en el estudio un total de 103 pacientes; 59 (grupo A) recibieron anestesia general y 54 (grupo B) anestesia general y bloqueos interfasciales. Según las características basales, la edad fue significativamente superior en las pacientes que recibieron anestesia general. La mastectomía se realizó con más frecuencia en el grupo que recibió bloqueos interfasciales. Observamos que después de la cirugía hay un aumento en el número de leucocitos pero regresa a los niveles basales a las 48h, comportamiento que se repite a nivel inmunológico: disminuye después de la cirugía pero vuelve a niveles previos a las 48h de la cirugía. Los grupos A y B presentan resultados similares en el resto de parámetros estudiados, al igual que los subgrupos según los receptores hormonales (HER+, PR y/o ER+).(AU)
Introduction: The main reason for high mortality in breast cancer is local recurrence and metastasis, despite surgery as the first therapeutic option. The anesthesia used in the operation room can determine the immune response. Methods: A prospective, comparative and non-randomized study in patients undergoing breast cancer surgery was conducted in our hospital after obtaining approval from the Hospital's Institutional Review Board. Patients were divided in two groups: Group A received general anesthesia with propofol and opioids. Group B, in addition to general anesthesia, three interfascial blocks (Pec I, Pec II and BRILMA) were performed in all patients. Three blood samples were taken 1) previous anesthetic induction; 2) two hours after the end of the surgery and 3) 24-48hours after surgery. Leukocytes, CD3, CD4, CD8 and Natural Killer cells were determined at each time. Results: 103 patients were included. 59 (group A) received general anesthesia and 54 (group B) general anesthesia and interfascial blocks. Regarding baseline characteristics, age was significantly higher in the group that received general anesthesia and mastectomy was more frequent in the group that received interfascial blocks.We observed after surgery an increase in leukocytes level that returns close to baseline levels. On the other hand, a reduction in the immune response was observed that also returns to the previous level 48hours after surgery. Group A and B get similar results and also subgroups of hormonal receptors (HER+, PR and/or ER+). Conclusions: Interfascial blocks in chest wall added to general anesthesia in breast cancer surgery has not shown a significant difference in the inflammatory response or immunological depression compared to general anesthesia as the only anesthetic technique. It seems to trend less immunological depression in the interfascial block group.(AU)
Subject(s)
Humans , Female , Breast Neoplasms/diagnosis , Breast Neoplasms/mortality , Breast Neoplasms/surgery , Anesthesia, General , Immunosuppression Therapy , Analgesia , Propofol , Neoplasm Recurrence, Local , Clinical Laboratory Techniques , Anesthesiology , Prospective StudiesABSTRACT
OBJETIVO: Evaluar la relación de la inteligencia emocional (IE) con el síndrome de burnout (BO) en los médicos de Atención Primaria. MATERIAL Y MÉTODOS: Estudio descriptivo transversal. EMPLAZAMIENTO: todos los centros de salud y consultorios del Principado de Asturias. PARTICIPANTES: médicos de Atención Primaria que estén en activo. Intervención: en abril de 2018 se envió un cuestionario anónimo autoadministrado con variables sociodemográficas, laborales y las escalas validadas TMMS-24 (IE) y MBI (BO). VARIABLES: la variable dependiente fue el BO. Como variables independientes se tomaron las 3 dimensiones de la IE, la edad, el sexo, el estado civil, el número de hijos, el tipo de formación, el tipo de contrato, el tiempo trabajado, las horas de guardia, los pacientes al día, el cupo, el ámbito rural o urbano, el área sanitaria, la relación con enfermería/hospital y la docencia. Análisis estadístico: inferencia bayesiana. RESULTADOS: Se enviaron 647 encuestas, participando 374 sujetos (tasa de respuesta del 57,8%). La distribución posterior de la prevalencia de BO fue del 64,5% [índice de credibilidad 95%: 59,7 a 69,2]. Encontramos asociación del BO con las 3 dimensiones de la IE; tener más habilidades emocionales disminuye el riesgo de presentar BO. Mostraron, además, incrementar la odds de prevalencia de BO la edad, el tipo de contrato, el ámbito urbano y la media de pacientes/día. Mostraron disminuir la odds de prevalencia tener hijos y ser tutor. CONCLUSIONES: Cabe destacar el elevado BO de los médicos de Atención Primaria, más de uno de cada 2 médicos están quemados. Por tanto, según resultados obtenidos, proponemos profundizar en la adquisición de habilidades relacionadas con la IE y mejorar las condiciones laborales en Atención Primaria
AIM: The purpose of this study is to analyse the relationship between emotional intelligence (EI) and burnout syndrome (BOS) in doctors in Primary Health Care. MATERIAL AND METHODS: Cross-sectional descriptive study. SETTING: All healthcare centres and clinics in Asturias. PARTICIPANTS: Doctors of Primary Health Care who are active. INTERVENTION: In April 2018, an anonymous self-administered questionnaire was sent to all concerned. It included sociodemographic data, employment data, and TMMS-24 (EI) and MBI (BOS) validated scales. VARIABLES: BOS as a dependent variable. Three dimensions of EI, age, sex, marital status, number of children, form of training, contract type, time worked, on-call hours, number of patients per day, quota, rural or urban setting, healthcare area, relationship with nursing/hospital, and teaching as independent variables. Statistical analysis: Bayesian inference. RESULTS: A total of 647 questionnaires were sent, and 374 subjects took part in the study (response rate: 57.8%). The subsequent distribution of BOS prevalence was 64.5% [95% credibility index: 59.7-69.2]. BOS was associated with 3 dimensions of the EI, and to have higher social skills decreased the risk of presenting with BOS. Age, contract type, urban setting, and number of patients per day tended to increase the odds of prevalence of BOS. Having children or being a guardian tended to decrease the odds of prevalence. CONCLUSIONS: The high level of BOS in Primary Health Care doctors should be pointed out, with more than one out of 2 doctors having burnout. Therefore, we suggest looking into how emotional skills are achieved, and also how to improve working conditions in Primary Health Care
Subject(s)
Humans , Male , Female , Middle Aged , Primary Health Care , Burnout, Psychological/psychology , Emotional Intelligence , Socioeconomic Factors , Cross-Sectional Studies , PrevalenceABSTRACT
OBJETIVO: El objetivo principal de este estudio es analizar el manejo de las urgencias pediátricas en atención primaria por parte de los médicos de familia. El objetivo secundario es estimar el grado de adecuación de las derivaciones hospitalarias. MATERIAL Y MÉTODOS: Se realizó un estudio observacional descriptivo retrospectivo. Se analizaron las visitas realizadas por los menores de 14 años atendidos a lo largo de un año en horario de atención continuada en una zona básica de salud, tras un muestreo aleatorio por conglomerados monoetápico de 45 días. RESULTADOS: Se atendieron un total de 447 consultas urgentes por pacientes en edad pediátrica, con una media de edad de 6,83años (DE=3,82). Se resolvieron in situ el 92,8% de las consultas urgentes realizadas por menores de 14 años. El porcentaje de derivaciones al servicio hospitalario fue del 7,2% (IC95%: 4,9-10). Al 56% (IC95%: 37,7-73,6) de los niños derivados se les realizó algún tipo de intervención hospitalaria (pruebas, tratamientos, valoración por otros especialistas no pediatras, observación y/o ingreso). CONCLUSIONES: La tasa de derivación fue del 7,2%, que sitúa en el límite alto de lo encontrado en otros estudios. La mitad de los pacientes derivados requirieron algún tipo de intervención, por lo que podrían considerarse derivaciones justificadas. Además, se ha encontrado una buena concordancia (índice kappa=0,778) entre los diagnósticos desde atención primaria y el diagnóstico final de pediatría, por lo que se puede inferir que los diagnósticos realizados en edad pediátrica por médicos de familia son acertados
OBJECTIVE: The main objective of this study is to analyse the management of paediatric emergencies by Family Doctors in Primary Care. The secondary objective is to determine the appropriateness of hospital referrals. MATERIAL AND METHODS: A retrospective, observational, and descriptive study was performed. An analysis was carried out on the visits made by children less than 14years-old during one year in continued care opening hours in a basic health area, after single-stage cluster random sampling of 45 days. RESULTS: A total of 447 emergency consultations were made by paediatric patients with a mean age of 6.83years (SD=3.82). Almost all (92.8%) the emergency consultations made by children less than 14 years were resolved in situ. The referral rate to hospitals was 7.2% (95%CI: 4.9-10). Just over half (56%: 95%CI: 37.7-73.6) of the children referred had some type of hospital intervention (tests, treatments, assessments by other non-paediatric specialists, observation and or admission). CONCLUSIONS: The referral rate was 7.2%, which is in the upper limit of that found in other studies. Just over half of the children required some type of intervention, which could be considered as justified referrals. Furthermore, good agreement was found (Kappa index=0.778) between the diagnosis from Primary Care and the final diagnosis by paediatricians, inferring that the diagnosis made on paediatric patients by Family Doctors are correct
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Emergency Treatment , General Practice , Child Care/statistics & numerical data , Child Care/standards , Child Health Services/statistics & numerical data , Child Health Services/standards , Retrospective StudiesABSTRACT
Objetivo: Estimar la efectividad del cribado selectivo frente al universal en la detección de disfunción tiroidea (DT) en el embarazo en condiciones de práctica clínica. Material y métodos: Estudio de diseño transversal basado en la identificación de gestantes con factores de riesgo (FR) de DT en una cohorte de 220 mujeres con cribado poblacional positivo. El estudio se desarrolló en el Área Sanitaria de Oviedo entre abril del 2010 y marzo del 2011. Resultados: Se identificaron FR en el 83,6% de las gestantes con DT. Los FR más prevalentes fueron la edad ≥ 30 años (70,5%), la historia de abortos previos (21,8%) y la historia familiar de patología tiroidea (20,9%). Sin tener en cuenta la edad, solo el 51,8% de las gestantes presentaba FR. Conclusiones: El cribado selectivo logra identificar una elevada proporción de gestantes con DT pero a expensas de incluir en el cribado a un gran número de mujeres, por lo que no parece una estrategia efectiva
Objective: To estimate the effectiveness of selective versus universal screening for thyroid dysfunction (TD) during pregnancy. Material and methods: Cross-sectional study applying a selective screening protocol, based on the presence of TD risk factors (RF), in a cohort of pregnant women with a positive universal screening result in the Oviedo Healthcare District. Two hundred and twenty pregnant women with TD were studied between April 2010 and March 2011. Results: Selective screening identified 83.6% of pregnant women with TD. The most prevalent RF were maternal age ≥ 30 years (70.5%), history of miscarriage (21.8%) and family history of thyroid disease (20.9%). Excluding the age factor, only 51.8% of the pregnant women included in the group had risk factors. Conclusions: Selective screening identifies a high proportion of pregnant women with TD but at the expense of screening a large number of women, so it does not appear to be an effective strategy
Subject(s)
Humans , Female , Pregnancy , Thyroid Diseases/complications , Pregnancy Complications/diagnosis , Diagnostic Screening Programs , Cross-Sectional Studies , Risk Factors , Thyroid Function Tests/methods , Maternal Age , Hypothyroidism/complications , Odds RatioABSTRACT
La actinomicosis es una enfermedad crónica granulomatosa infrecuente causada por Actinomyces spp, una bacteria anaerobia gram positiva que normalmente coloniza la boca, genitales y tracto digestivo en humanos1. En la mayor parte de los casos, la enfermedad se manifiesta en la región cervicofacial. Sin embargo, se han descrito varios casos en los que la actinomicosis puede simular procesos malignos en localizaciones no comunes, como en el pulmón. Se presenta el caso de una paciente con un cuadro constitucional de 20 días de evolución con una masa paramediastínica, a la que se le diagnostica de actinomicosis pulmonar tras una lobectomía por sospecha clínica de malignidad
Actinomycosis is a rare chronic granulomatous disease caused by Actinomyces spp, an anaerobic gram positive bacteria that colonizes mouth, large bowel and genitals. Actinomycosis occurs most frequently at oral and cervicofacial region. Less commonly affected areas include thoracic, abdominal, pelvic and central nervous system. We report a case about a patient with constitucional syndrome and a paramediastinal ma ss who was diagnosed with pulmonary actinomycosis after a lobectomy because of clinical suspicion of malingnancy
Subject(s)
Humans , Female , Aged , Lung Diseases, Fungal , Lung Neoplasms/diagnosis , Actinomycosis/diagnosis , Diagnosis, DifferentialABSTRACT
Resumen Introducción: la enfermedad inflamatoria intestinal (EII) (colitis ulcerativa [CU], enfermedad de Crohn [EC]) es una patología inflamatoria crónica y recurrente del tracto digestivo, de causa aún incierta. La incidencia y prevalencia de esta enfermedad están en aumento a nivel mundial, especialmente en los países en vías de desarrollo. Objetivo: describir las características del fenotipo y el tipo de tratamiento administrado a 165 pacientes con diagnóstico de EII que consultaron durante el período comprendido entre el 5 de julio del 2013 y el 31 de diciembre del 2016 en un hospital universitario de la ciudad de Bogotá, Colombia. Materiales y métodos: se realizó un estudio descriptivo basado en frecuencias y proporciones de los pacientes con diagnóstico de EII atendidos en la Clínica Universitaria Colombia (Bogotá) entre el 5 de julio del 2013 y el 31 de diciembre del 2016. Resultados: el 75,8% de los casos correspondió a CU y el 24,2% a EC, con un leve predominio del sexo femenino en ambas (56% y 55%, respectivamente); la forma de presentación más frecuente de la CU fue la pancolitis en el 46,4%. Los pacientes con EC tuvieron un compromiso más frecuentemente ileocolónico (52,5%) e inflamatorio no estenosante ni fistulizante (60%), un mayor porcentaje de manifestaciones extraintestinales (35%), de uso de medicamentos biológicos (35%) y requirieron un mayor número de cirugías (27,5%) en comparación con los pacientes con CU.
Abstract Inflammatory bowel disease (IBD) includes ulcerative colitis and Crohn's disease which are chronic and recurrent inflammatory pathologies of the digestive tract whose causes are still uncertain. IBD's incidence and prevalence are increasing worldwide, especially in developing countries. Objectives: The objective of this study was to describe phenotypic characteristics and types of treatment of 165 patients diagnosed with IBD treated between July 5, 2013 and December 31, 2016 at a university hospital in Bogotá, Colombia. Methods: This is a descriptive study based on frequencies and proportions of patients diagnosed with IBD at the University Clinic Colombia in Bogotá between July 5, 2013 and December 31, 2016. Results: UC accounted for 75.8% of the cases while CD accounted for 24.2% of these cases. Women accounted for a slightly larger proportion of patients than did men: 56% of UC cases and 55% of CD cases. UC's most frequent form of presentation was pancolitis which was found 46.4% of the patients. Frequent forms of CD presentation were ileocolonic (52.5%) and inflammatory non-stenosing or fistulizing (60%). CD patients had a greater percentage of extraintestinal manifestations (35%), greater use of biological medications (35%) and required a greater number of surgeries (27.5%) than did UC patients.
Subject(s)
Humans , Male , Female , Inflammatory Bowel Diseases , Crohn Disease , Pathology , Gastrointestinal Tract , DiagnosisABSTRACT
Objetivo. Analizar resultados de consulta monográfica de enfermería para tratamiento del tabaquismo en un hospital de tercer nivel. Pacientes. Fumadores remitidos del propio centro, atención primaria, Salud Laboral y trabajadores del hospital. Método. Se diseña consulta monográfica con enfermera especializada en tabaquismo. Visitas protocolizadas, presenciales y telefónicas. Seguimiento total durante 12 meses. Apoyo médico para consulta y prescripción de tratamientos. Variables: edad, sexo, cigarrillos/día, edad de inicio, intentos de abandono, tabaquismo en entorno, peso, antecedentes y tratamiento, dependencia con test de Fagërstrom y cooximetría. Análisis estadístico: estudio de cohortes retrospectivo 2010-2013. Comparación entre grupos realizada mediante test de Logrank, y la probabilidad de abstinencia con método de Kaplan-Meier. Resultados. 362 fumadores (53 ± 12 años), test Fagërstrom de 7 ± 2, cooximetría 23,3 ± 14 ppm, media de 36 ± 11 años fumando, edad inicio 16 ± 4 años, e intentos previos abandono en 85% de casos. Tratamientos farmacológicos: vareniclina (65%) y TSN (25%) y solo apoyo en consulta (10%). Tras 12 meses de seguimiento, abstinencia del 33% de los pacientes, ganancia de peso media tras abandono: 2,5 kg en mujer y 3,3 en varón sin diferencias significativas según tratamiento. Conclusiones. La consulta protocolizada de enfermería obtiene resultados similares a los observados en unidades más complejas y de mayor coste, a pesar de ser pacientes reincidentes y con alta dependencia (AU)
Objective. Analyze results of monographic consultation from nursing department for treatment of smoking habit in a tertiary hospital. Patients. Smokers referred from the primary care, occupational health and hospital workers site of the center. Method. A monographic consultation was designed with nurses specialized in smoking habit. On-site protocolized and telephone visits. Total follow-up during 12 months. Medical support for treatment consultation and prescription. Variables: age, gender, cigarettes/day, age of initiation, attempts to quit smoking, smoking in the setting, weight, backgrounds and treatment, dependence with Fagërstrom test and cooximetry. Statistical analysis: 2010-2013 retrospective cohort study. Comparison between groups performed using Log rank Test and the likelihood of abstinence with the Kaplan-Meier method. Results. 362 smokers (53 ± 12 years), Fagërstrom test from 7 ± 2, cooximetry 23.3 ± 14 ppm, mean of 36 ± 11 years smoking, age of initiation 16 ± 4 years, and previous attempts to stop smoking in 85% of the cases. Drug treatments: varenicline (65%) and NRT (25%) and only support in consultation (10%). After 12 months of follow-up, abstinence in 33% of the patients, weight gain after quitting smoking: 2.5 kg in women and 3.3 in men, without significant differences according to the treatment. Conclusions. Protocolized nursing consultation obtains similar results to those observed in more complex units having a higher cost, in spite of being patients with recurrence and high dependence (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Office Nursing/organization & administration , Office Nursing/standards , Tobacco Smoke Pollution/prevention & control , Smoking/epidemiology , Smoking/prevention & control , Smoking Cessation/methods , Primary Health Care/methods , Primary Health Care/organization & administration , Occupational Health , Community Health Workers/organization & administration , Community Health Workers/statistics & numerical data , Health Personnel/organization & administration , Cohort Studies , Retrospective StudiesABSTRACT
Objetivo. Valorar la concordancia diagnóstica en la interpretación de retinografías entre el médico de atención primaria y el oftalmólogo, así como presentar los índices de validez de un programa de cribado de retinopatía diabética durante su fase de implantación. Material y métodos. Estudio descriptivo observacional de una muestra de 243 pacientes diabéticos (tipo 1 y 2) mayores de 14 años, de 2 centros de salud urbanos, captada de manera oportunista cuando acudían a consulta entre el 21/07/2011 y el 26/01/2012. Se les realizó retinografía digital bilateral de campo único a 45°, toma de presión intraocular y agudeza visual. Los médicos de atención primaria elaboraban un informe que se remitía junto con las retinografías telemáticamente al oftalmólogo, quien revisaba las imágenes y generaba un nuevo informe con su diagnóstico. La ausencia de retinografía y/o informe valorables se consideraron como pérdidas. Se estimaron la concordancia diagnóstica entre los observadores y los índices de validez del programa de cribado. Resultados. Se obtuvo un índice kappa de 0,62 (IC 95% 0,42-0,82) y un índice PABAK de 0,89 tras ajustar por prevalencia y sesgos. Se obtuvieron los siguientes índices de validez: sensibilidad 68,8%, especificidad 96,5%, valores predictivos positivo y negativo del 61,1 y 97,5%, respectivamente. El 57,2% de los pacientes no presentó enfermedad que requiriera derivación al oftalmólogo. Conclusiones. El grado de concordancia obtenido varía entre considerable/casi perfecto dependiendo del índice usado en el análisis (kappa/PABAK, respectivamente). La realización de retinografías en los centros de salud mejora la capacidad resolutiva del médico de atención primaria y la accesibilidad de los pacientes al cribado (AU)
Aim. To evaluate the diagnostic concordance in retinography interpretation between primary care and eye care practitioners and assess the soundness index of a diabetic retinography screening programme during its implementation stage. Material and methods. Descriptive, observational study was conducted on a sample of 243 patients with diabetes mellitus (type 1 and 2) over age 14, in 2 urban health care centers, gathered in an opportunistic manner between the dates of 21/07/2011 and 26/01/2012. A 45° digital bilateral retinography, intraocular pressure and visual acuity were obtained from each patient. The primary care practitioners prepared a report for each patient, which was telematically sent to the eye care doctor within the corresponding retinographies. A new diagnostic report was prepared then by the eye care doctor after revising the images. The lack of retinographies and/or reports were considered both as losses. The diagnostic concordance between the observers and the validity and reliability from the screening programme were estimated. Results. The kappa value obtained was 0.62 (95% CI 0.42-0.82) and 0.89 PABAK. The following validity indexes were obtained: Sensitivity 68.8%, specificity 96.5%, positive and negative predictive values: 61.1 and 97.5%, respectively. A percentage of 57.2 of the patients were not observed any pathology requiring referral to a eye care doctor. Conclusions. The concordance value obtained varied between considerable and almost perfect, depending on the index used for the analysis (kappa/PABAK, respectively). It's worth highlighting that carrying out retinographies in the primary care centers enhances patient-treatment capacity of the primary care doctors and the patients accessibility to screening (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Diabetic Retinopathy/complications , Diabetic Retinopathy/diagnosis , Diabetic Retinopathy/therapy , Primary Health Care/methods , Family Practice/methods , Diabetes Mellitus, Type 1/epidemiology , Diabetes Mellitus, Type 1/prevention & control , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/epidemiology , Mass Screening/methods , Ophthalmology , Ophthalmology/organization & administration , Reproducibility of Results , Reproducibility of Results/methods , Observer Variation , Diabetic Retinopathy , 28599ABSTRACT
This study determined the relationship between the academic performance and nursing licensure examination of graduates of a city-subsidized university and the nursing professional subjects that best predict the outcome of the nursing licensure examination. The study used a descriptive-correlation design. Academic records of two batches in 2012 and 2013 were used. Independent variables included the nursing professional subjects and the dependent variables were the subtests in the licensure examination. Means, standard deviations, Pearson r correlation, and Multiple Regression Analysis were used for the quantitative data. Findings reveal that graduates were average performers in their academics. This was inversely correlated with the nursing licensure examination. This still suggests direct relationship since the grading system in the university ranged from 1.0 to 5.0 where 1.0 is excellent. Critical Appraisal II, Nursing Care Management 104, and Nursing Care Management 106 were significant predictors of performance in the licensure examination.
Subject(s)
NursingABSTRACT
@#This study determined the relationship between the academic performance and nursing licensure examination of graduates of a city-subsidized university and the nursing professional subjects that best predict the outcome of the nursing licensure examination. The study used a descriptive-correlation design. Academic records of two batches in 2012 and 2013 were used. Independent variables included the nursing professional subjects and the dependent variables were the subtests in the licensure examination. Means, standard deviations, Pearson r correlation, and Multiple Regression Analysis were used for the quantitative data. Findings reveal that graduates were average performers in their academics. This was inversely correlated with the nursing licensure examination. This still suggests direct relationship since the grading system in the university ranged from 1.0 to 5.0 where 1.0 is excellent. Critical Appraisal II, Nursing Care Management 104, and Nursing Care Management 106 were significant predictors of performance in the licensure examination.
Subject(s)
Academic PerformanceABSTRACT
Objetivo Determinar los tiempos de asistencia, características extrahospitalarias e intrahospitalarias y supervivencia de las paradas cardiacas atendidas por una UVI móvil, al igual que los factores implicados en la supervivencia al ingreso y al alta hospitalaria. Diseño Estudio observacional retrospectivo desde el 1 de enero de 2010 al 31 de diciembre de 2010, con un seguimiento de un año desde la PCR. Ámbito Área sanitaria IV del Principado de Asturias, con 342.020 habitantes en 2010.PacientesSe incluyeron todos los pacientes que sufrieron una PCR en 2010 y fueron atendidos por la UVI móvil. Variables principales Datos demográficos, causa de la PCR, intervención por testigos, tiempos de asistencia y supervivencia al ingreso, al alta y un año después. Resultados Se atendieron un total de 177 paradas cardiacas. En 120 se indicó el soporte vital avanzado (SVA), siendo 66 de ellas (55%) de causa presumiblemente cardiaca. Recuperaron el pulso 63 pacientes (52,5%), llegando 51 de ellos con vida al hospital (42,5%). Se les dio el alta a 13 pacientes (10,8%). Al año 11 (9,2%) seguían vivos y 9 de ellos (7,5%) tenían una cerebral performance category (CPC) de 1. El ritmo inicial de fibrilación ventricular (FV) y los tiempos cortos en la asistencia se relacionaron con la supervivencia. Conclusiones La supervivencia fue superior a la publicada al ingreso al hospital y similar a la del alta. Como factores relacionados se encontraron los tiempos de asistencia y el ritmo inicial. La reanimación por el testigo fue escasa y no se usaron desfibriladores semiautomáticos (DEA) públicos (AU)
Objective To evaluate attendance timings, out- and in-hospital characteristics, and survival of cardiac arrests attended by an advanced life support unit in Asturias (Spain) in 2010. Factors related to survival upon admission and at discharge were also analyzed. Design A retrospective, observational trial was carried out involving a cohort of out-hospital cardiac arrests (OHCA) occurring between 1 January 2010 and 31 December 2010, with one year of follow-up from OHCA. Setting Health Care Area IV of the Principality of Asturias, with a population of 342,020 in 2010.PatientsAll patients with OHCA and attended by an advanced life support unit were considered. Main variables Demographic data, the etiology of cardiac arrest, bystander cardiopulmonary resuscitation (CPR), attendance timings and survival upon admission, at discharge and after one year. Results A total of 177 OHCA were included. Of these, 120 underwent CPR by the advanced life support team. Sixty-six of these cases (55%) were caused by presumed heart disease. A total of 63 patients (52.5%) recovered spontaneous circulation, and 51 (42.5%) maintained circulation upon admission to hospital. Thirteen patients (10.8%) were discharged alive. After one year, 11 patients were still alive (9.2%) - 9 of them (7.5%) with a Cerebral Performance Category (CPC) score of 1. Ventricular fibrillation and short attendance timings were related to increased survival. Conclusions The survival rate upon admission was better than in other series and similar at discharge. Initial rhythm and attendance timings were related. Public automated external defibrillators (AED) were not used, and bystander CPR was infrequent (AU)
Subject(s)
Humans , Out-of-Hospital Cardiac Arrest/epidemiology , Critical Care/methods , Survival Analysis , Bayes Theorem , Cardiovascular Diseases/epidemiology , Retrospective StudiesABSTRACT
Background: 2D7 and BB1 are thought to be basophil-specific markers. In this study, we tested both antibodies in different skin and mast cell disorders with the aim of determining whether it was possible to differentiate between benign and aggressive presentations of mastocytosis. Methods: Using the antibodies 2D7, BB1, and c-Kit, we performed an immunohistochemical study of skin biopsy specimens from patients with cutaneous mastocytosis (15 urticaria pigmentosa and telangiectatic macularis eruptive perstans) and liver or bone marrow biopsy specimens from patients with systemic mastocytosis. A basophil leukemia cell line was used as a reference. Peripheral blood basophils from healthy donors were used as controls. Results: We observed intense expression of 2D7 and BB1 in all skin biopsy specimens from patients with cutaneous mastocytosis. Immunostaining of liver and bone marrow specimens from patients with systemic mastocytosis with 2D7 and BB1 antibodies was negative. Specimens from patients with either type of mastocytosis showed similarly strong expression of c-Kit. The basophil cell line showed a 2D7 and a BB1 profile, with intense expression of c-Kit. Peripheral blood basophils exhibited notable immunostaining for 2D7, BB1, and c-Kit. Conclusions: 2D7 and BB1 are expressed in cutaneous mastocytosis, although this expression is lost when mast cell proliferation is systemic, thus reflecting either a different cellular differentiation stage or the presence of basophils in these skin diseases (AU)
Antecedentes: Los anticuerpos 2D7 y BB1 son marcadores específicos para basófilos. En el presente trabajo hemos estudiado el comportamiento de ambos marcadores en mastocitosis cutánea y sistémica, con el objeto de comprobar si las formas cutáneas benignas se podían diferenciar de las sistémicas. Métodos: Hemos realizado inminuhistoquímica de biopsias de 15 pacientes con matocitosis cutánea, empleando los anticuerpos c-Kit, 2D7 y BB1 y hemos comparado el resultado con biopsias hepáticas y de médula ósea de tres pacientes con mastocitosis sistémica frente a los mismos anticuerpos. Empleamos una línea celular de leucemia humana basofílica y basófilos aislados de un donante sano como controles. Resultados: Hallamos un patrón 2D7 y BB1 intensamente positivo en todas las muestras de mastocitosis cutánea y basófilos de donantes sanos. Sin embargo, tanto el anticuerpo 2D7 como BB1 fue negativo en las muestras hepáticas y de médula ósea de mastocitosis sistémica así como en la línea celular de leucemia basofílica. C-Kit se expresó intensamente en todas las muestras. Conclusión: 2D7 y BB1 se expresa en mastocitosis cutánea si bien se pierde cuando los mastocitos proliferan en su forma sistémica. Esto puede reflejar bien una diferenciación celular distinta o bien que los basófilos están presentes en las lesiones cutáneas de mastocitosis (AU)
Subject(s)
Humans , Basophils/immunology , Mastocytosis, Cutaneous/immunology , Mast Cells/immunology , Antibodies/isolation & purification , Immunohistochemistry/methods , BiopsyABSTRACT
OBJECTIVES: The aim of this study was to assess the applicability of knowledge discovery in database methodology, based upon data mining techniques, to the investigation of lung cancer surgery. METHODS: According to CRISP 1.0 methodology, a data mining (DM) project was developed on a data warehouse containing records for 501 patients operated on for lung cancer with curative intention. The modelling technique was logistic regression. RESULTS: The finally selected model presented the following values: sensitivity 9.68%, specificity 100%, global precision 94.02%, positive predictive value 100% and negative predictive value 93.98% for a cut-off point set at 0.5. A receiver operating characteristic (ROC) curve was constructed. The area under the curve (CI 95%) was 0.817 (0.740- 0.893) (p < 0.05). Statistical association with perioperative mortality was found for the following variables [odds ratio (CI 95%)]: age over 70 [2.3822 (1.0338-5.4891)], heart disease [2.4875 (1.0089-6.1334)], peripheral arterial disease [5.7705 (1.9296-17.2570)], pneumonectomy [3.6199 (1.4939-8.7715)] and length of surgery (min) [1.0067 (1.0008-1.0126)]. CONCLUSIONS: The CRISP-DM process model is very suitable for lung cancer surgery analysis, improving decision making as well as knowledge and quality management (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Knowledge , Lung Neoplasms/surgery , Models, Theoretical , Pulmonary Surgical Procedures , Data Mining , Decision Making , Quality of Health Care/statistics & numerical data , Logistic Models , Risk FactorsABSTRACT
La problemática conductual supone una parte significativa de la demanda de atención en salud mental infantil y juvenil. Presentamos los resultados de la experiencia de creación de un grupo de trabajo multidisciplinar que se constituyó con dos objetivos. Discutir sobre el abordaje clínico, social y escolar en Tarragona de los trastornos de conducta en la infancia y en la adolescencia: así como consensuar propuestas de intervención futuras que podrían mejorar tanto evolución como pronóstico de la psicopatología y las situaciones de riesgo social presente en estos menores y sus familias (AU)
Problematic behavior generates a strong demand for attention by child and juvenile mental health services. This paper presents the results obtained by a multidisciplinary work group created with two objectives. To discuss current clinical, social and school approaches in Tarragona concerning conduct disorders in childhood and adolescence, and to agree on proposals for future interventions so as to improve clinical evolution, prognosis and psychosocial adoptions (AU)