Nurse-Led Interventions in Chronic Obstructive Pulmonary Disease Patients: A Systematic Review and Meta-Analysis.

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide, causing 3.32 million deaths in 2019. COPD management has increasingly become a major component of general and hospital practice and has led to a different model of care. Nurse-led interventions have shown beneficial effects on COPD patient satisfaction and clinical outcomes. This systematic review was conducted to identify and assess nurse-led interventions in COPD patients in terms of mental, physical, and clinical status. The review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. The relevance of each manuscript was assessed according to the inclusion criteria, and we retrieved full texts, as required, to reach our conclusions. Data extraction was performed independently by two reviewers, and the risk of bias was assessed using the Cochrane Risk of Bias tool. Forty-eight articles were included in the analysis, which focused on the management of COPD patients by hospital, respiratory and primary nursing care. Nursing management was shown to be highly effective in improving quality of life, emotional state, and pulmonary and physical capacity in COPD patients. In comparison, hospital and respiratory nurses carried out interventions with higher levels of effectiveness than community nurses.

Impact of sound levels on physiological and consciousness state of cardiovascular patients.

BACKGROUND: Patients treated in intensive care units (ICUs) experience life-threatening medical conditions but some external factors in ICUs do not help or even adversely affect and complicate their evolution. Among others, such factors include noise pollution due to alarms and medical clinical equipment, as well as the activities of the health care personnel themselves. AIM: This study aimed to evaluate the influence of elevated sound levels on physiological variables and the consciousness state of patients treated in a cardiovascular area in an ICU. DESIGN: A longitudinal study with several observations was carried out during 1 month in the cardiovascular area of an ICU of a third-level hospital in southern Spain. METHODS: Sound levels were monitored in different work shifts and patients' physiological data and consciousness status were recorded. Generalized additive mixed models (GAMMs) were developed to detect the variability of the sound levels together with the vital parameters of the patients in the ICU. RESULTS: Thirty-eight patients were included. The mean sound level was 54.09 dBA. The GAMM sound levels analysis showed a significant increase in sound levels from 4:30 p.m. to 8:00 p.m. (1.83 dBA; P < .001) and 8:00 p.m. to 11:30 p.m. (3.06 dBA; P < .001). An increase in heart rate (3.66 bpm; P < .001), respiratory rate (2.62 rpm; P < .001) and the Glasgow Coma Scale (0.50 units; P = .002) was detected during the 4:30 p.m.-8:30 p.m. CONCLUSIONS: Elevated sound levels in cardiovascular ICUs seem to influence positively the physiological and consciousness status of patients. Given the importance of the findings for patient safety, future intervention studies are recommended. RELEVANCE TO CLINICAL PRACTICE: The finding of this study could translate into structural changes in ICU facilities, as well as the development of clinical practice guidelines that influence the behaviour of health care professionals.

Constructing a de novo transcriptome and a reference proteome for the bivalve Scrobicularia plana: Comparative analysis of different assembly strategies and proteomic analysis.

Scrobicularia plana is a coastal and estuarine bivalve widely used in ecotoxicological studies. However, the underlying molecular mechanisms for S. plana pollutant responses are hardly known due to the lack of molecular databases. Thus, in this study we present a holistic approach to assess a robust reference transcriptome and proteome of this clam. A mixture of control and metal-exposed individuals was used for mRNA isolation. Four sets of high quality filtered preprocessed reads were generated (two quality scores and two sequenced lengths) and assembled with Mira, Ray and Trinity algorithms. The sixty-four generated assemblies were refined, filtered and evaluated for their proteomic quality. Eight assemblies presented top Detonate scores but one was selected due to its compactness and biological representation, which was generated: (i) from the highest quality dataset (Q20L100), (ii) using Trinity algorithm with all k-mers (AtKa), (iii) removing redundancy by CD-HIT (RR80), and (iv) filtering out poor contigs (F), that was subsequently named Q20L100AtKaRR80F. S. plana proteomic analysis revealed 10,017 peptide groups that corresponded to 2066 proteins with a wide coverage of molecular functions and biological processes, confirming the strength of the database generated.