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Autistic children and adolescents experience a range of co-morbidities, including diagnoses of mental illness. Animal-assisted therapies have advanced rapidly over recent years as an effective and accessible intervention for autistic children and adolescents with various health issues. Horses offer a unique opportunity for interaction as the young person can physically ride the animal, thus creating a therapy with different physical interactions from other animals. This qualitative study had two main aims: first, to understand parents' experiences of their autistic child's involvement with horse-based therapies; and second, to understand the experiences of the staff of organisations offering horse-based therapies to those on the autism spectrum. Twelve interviews were conducted with six parents across four interviews (four mothers and two fathers), and eight staff of equine therapy services in eight individual interviews, to understand their perceptions of the child's experience with horse riding and the perceived mental health impacts. Three emergent themes were prominent among parents and service providers alike: physical and social benefits, including health, self-management skills and social skills; protecting mental health; and recommendations for improvements and accessibility of horse-based therapies. Specifically, service providers with long-standing associations with horse-based therapies saw the actual and potential benefits of horse-based therapies for autistic children, particularly in promoting happiness, calm, resilience, and good mental health.
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Animals are increasingly being utilized to assist with therapies for people with various health conditions. Horses are often used as a mechanism of engagement and development for autistic children and adolescents. Horses offer a unique opportunity for interaction as the child or adolescent can physically ride and interact with the animal, thus creating a therapy that involves contact that is different to other animals. Benefits derived from equine-assisted therapies can be physical, social, behavioral, emotional, sensory, and cognitive. However, a current and specific research gap exists in understanding the potential mental health impacts of horse riding on autistic children and adolescents, as perceived and experienced by their parents, carers, and horse-riding service providers. This scoping review examined research on parents' and service providers' perceptions of the benefits of horse-related therapies, with a particular focus on perceptions of positive mental health impacts. A comprehensive electronic search across PubMed, Scopus and Cumulative Index to Nursing and Allied Health Literature identified 16 articles from 15 studies which met the inclusion criteria. Findings included non-mental health-related benefits (as perceived by parents and service providers), mental health-related benefits (as perceived by parents and service providers), benefits for those other than the child/adolescent, and limitations of equine-assisted therapies. With the increased use of equine therapy, and the mounting evidence of its positive impacts on mental health, it is timely to expand research on how to better harness interventions and maximize the mental health benefits for autistic children and adolescents.
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Encompassing many crafts, needlecraft has been popular, particularly amongst women, for centuries. This scoping review mapped and explored primary research on sewing, crocheting, knitting, lacemaking, embroidery and quilting and its impact on mental health and well-being. A comprehensive systematic search across PubMed, CINAHL, Scopus and Google Scholar was conducted in January 2024, identifying 25 studies that met the inclusion criteria. Four themes (and 15 subthemes) emerged from the data: (1) mental well-being; (2) social connection, sense of value and belonging; (3) sense of purpose, achievement and satisfaction; and (4) self-identity, family, culture and legacy. The review showed that needlecraft has an overwhelmingly positive effect on mental health and general well-being. This scoping review may be used to inform mental health nurses and other professionals of the benefits of needlecraft for a wide variety of consumers and may also find application in the well-being of healthcare workers.
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BACKGROUND: Multiplatform messaging applications also referred to as cross-platform instant messaging play an important role in delivery of healthcare and education with its low cost, ease of use and accessibility. AIM: To evaluate the existing evidence regarding the use of multiplatform messaging applications in facilitating consultations and decision-making processes in the context of burns care, as well as to assess the impact of such applications on burns care and rehabilitation. METHOD: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and PROSPERO protocol CRD42021265203. The CASP and JBI tools were used to evaluate the quality of the studies. Eight hundred fifty-three papers were retrieved from PubMed, CINAHL, Scopus, EMBASE and LILACS published up to July 2022 (updated August 2023) with no time restrictions applied. RESULTS: An analysis of the seven studies included in this review, inclusive of 16 Multiplatform messaging applications, revealed six themes. These encompassed the utilization of social media for directing and managing clinical practice, as a mode of communication, for evaluating the quality-of-care provision, for investigating available platforms and their technological features, measuring quality of life and for examining issues related to confidentiality. CONCLUSION: Multiplatform messaging applications offer a solution for individuals with burn injuries to stay in direct contact with burn specialist clinicians for their follow-up and subsequent rehabilitation phase of recovery.
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Quemaduras , Envío de Mensajes de Texto , Humanos , Quemaduras/rehabilitación , Quemaduras/terapia , Aplicaciones Móviles , Medios de Comunicación SocialesRESUMEN
Autistic students experience elevated rates of school exclusion, whether this be through expulsion, suspension, informal suspension, refusal of enrolment, or school refusal. This exclusion can come about from a range of factors, including sensory or cognitive overload, a lack of training in neurodiversity for teachers, an absent sense of safety by the student at school, or poor attitudes towards the inclusion of autistic students in schools. The impacts of this exclusion on parents can be logistical, financial, and psychological, with a range of mental health outcomes. This Australian qualitative study presents case studies of seven parents of autistic students, as well as four themes that capture the recommendations of parents to address school exclusion. The findings demonstrate that parents experience stress in finding a suitable school for their child, working with staff to meet the needs of the child, and attempting to maintain employment and other commitments when the child experiences exclusion. Parents recommend greater acceptance of autism by education systems, better communication and use of neuro-affirming language, the option for flexible learning, and individualised support by the school for the student.
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Padres , Investigación Cualitativa , Humanos , Padres/psicología , Padres/educación , Australia , Niño , Masculino , Femenino , Adulto , Trastorno Autístico/psicología , Adolescente , Instituciones Académicas , Estudiantes/psicologíaRESUMEN
Burns are serious injuries associated with significant morbidity and mortality. In Israel, burn patients are often transferred between facilities. However, unstructured and non-standardized transfer processes can compromise the quality of patient care and outcomes. In this retrospective study, we assessed the impact of implementing a transfer form for burn management, comparing two populations: those transferred before and after the transfer form implementation. This study included 47 adult patients; 21 were transferred before and 26 after implementing the transfer form. We observed a statistically significant improvement in reporting rates of crucial information obtained by Emergency Room clinicians and inpatient management indicators. Introducing a standardized transfer form for burn patients resulted in improved communication and enhanced primary management, transfer processes, and emergency room preparation. The burns transfer form facilitated accurate and comprehensive information exchange between clinicians, potentially improving patient outcomes. These findings highlight the importance of structured transfer processes in burn patient care and emphasize the benefits of implementing a transfer form to streamline communication and optimize burn management during transfers to specialized burn centers.
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Unidades de Quemados , Quemaduras , Transferencia de Pacientes , Humanos , Quemaduras/terapia , Israel , Transferencia de Pacientes/organización & administración , Unidades de Quemados/organización & administración , Adulto , Estudios Retrospectivos , Masculino , Femenino , Persona de Mediana Edad , Servicio de Urgencia en Hospital/organización & administración , Anciano , Adulto Joven , ComunicaciónRESUMEN
Partial-thickness burns are the most common form of burns, affecting the dermis and possibly resulting in scarring and infection. The Spincare System is a new device that uses electrospinning technology to create a temporary skin-like matrix that can be applied to wounds. This study evaluated the performance, safety, and efficacy of Spincare in treating superficial to partial-thickness burns not considered for surgery. A prospective single-arm, open-label, multicenter study was conducted in 3 adult burn units across Israel. Forty-four patients with superficial to intermediate burns of up to 10% of TBSA were enrolled. Spincare was applied to the wounds, and follow-up visits were performed on days 7, 14, and 21 and months 3 and 6 posttreatment. Thirty-one patients with 36 wounds completed the day 21 visit. The mean wound healing area on day 21 was 97.26 ± 9.41%, and the mean healing time was 12.8 ± 4.3 days. Only one moderate adverse event was observed concerning the treatment, and it is important to acknowledge the potential progression of this hypertrophic scar into a keloid. This study demonstrated that Spincare is a safe and effective device for treating superficial to intermediate partial-thickness burns. Spincare achieved rapid and complete wound healing with a low incidence of adverse events.
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Quemaduras , Cicatrización de Heridas , Humanos , Quemaduras/terapia , Masculino , Femenino , Adulto , Estudios Prospectivos , Persona de Mediana Edad , Resultado del Tratamiento , Israel , Anciano , Piel Artificial , Adulto JovenRESUMEN
Despite legislative and policy mechanisms that promote inclusion in education for children with disabilities, many students still experience exclusion from the education setting. For example, autistic children are more likely than their neurotypical counterparts to be expelled or suspended from school or to refuse to attend school on an ongoing basis. This situation gives rise to various challenges for their parents. This discursive paper synthesizes current knowledge on school exclusion involving autistic children, including the causes and consequences of exclusionary practices. The paper also considers the negative impacts of these exclusionary practices on the emotional and psychological well-being of parents and caregivers. Mental health nurses who understand the issues related to school exclusion can better support the educational, social, and developmental needs of autistic children and the mental health needs of parents or caregivers.
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Trastorno Autístico , Salud Mental , Niño , Humanos , Padres , Estudios Longitudinales , Instituciones AcadémicasRESUMEN
An accurate and comprehensive histopathology report is essential for cutaneous melanoma management, providing critical information for accurate staging and risk estimation and determining the optimal surgical approach. In many institutions, a review of melanoma biopsy specimens by expert dermatopathologists is considered a necessary step. This study examined these reviews to determine the critical primary histopathology Breslow score in which a histopathology review would be most beneficial. Histopathology reports of patients referred to our institute between January 2011 and September 2019 were compared with our in-house review conducted by an expert dermatopathologist. The review focused on assessing fundamental histologic and clinical prognostic features. A total of 177 specimens underwent histopathology review. Significant changes in the Breslow index were identified in 103 cases (58.2%). Notably, in many of these cases (73.2%), the revised Breslow was higher than the initially reported score. Consequently, the T-stage was modified in 51 lesions (28.8%). Substantial discordance rates were observed in Tis (57%), T1b (59%), T3a (67%) and T4a (50%) classifications. The revised histopathology reports resulted in alterations to the surgical plan in 15.3% of the cases. These findings emphasize the importance of having all routine pathologies of pigmented lesions referred to a dedicated cancer center and reviewed by an experienced dermatopathologist. This recommendation is particularly crucial in instances where the histopathology review can potentially alter the diagnosis and treatment plan, such as in melanoma in situ and thinner melanomas measuring 0.6-2.2 mm in thickness. Our study highlights the significant impact of histopathology reviews in cutaneous melanoma cases. The observed changes in Breslow scores and subsequent modifications in T-stage classification underline the need for thorough evaluation by an expert dermatopathologist, especially in cases of melanoma in situ and thin melanomas. Incorporating such reviews into routine practice within dedicated cancer centers can improve diagnostic accuracy and guide appropriate treatment decisions, ultimately leading to better patient outcomes.
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Outcomes of discrimination for autistic people include masking, social isolation and exclusion, trauma, and mental health problems. This discursive paper discusses the discrimination experienced by autistic people in health, education, employment, and media settings; and considers how to reduce the impact of discrimination. Addressing the impact of discrimination requires an improved understanding of the lived experience of the autistic person, the embedding of inclusive practices in communities, developing the person's life skills and supports, and enabling the person to work through their psychological trauma. Further research can aid in minimizing and preventing discrimination against people with autism.
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Trastorno Autístico , Humanos , Empleo , EscolaridadRESUMEN
Nearly four decades after cultured epidermal autografts (CEA) were first used for the treatment of extensive burn wounds, the current gold standard treatment remains grafting healthy autologous skin from a donor site to the damaged areas, with current skin substitutes limited in their clinical use. We propose a novel treatment approach, using an electrospun polymer nanofibrous matrix (EPNM) applied on-site directly on the CEA-grafted areas. In addition, we propose a personalised treatment on hard-to-heal areas, in which we spray suspended autologous keratinocytes integrated with 3D EPNM applied on-site, directly onto the wound bed. This method enables the coverage of larger wound areas than possible with CEA. We present the case of a 26-year-old male patient with full-thickness burns covering 98% of his total body surface area (TBSA). We were able to show that this treatment approach resulted in good re-epithelialisation, seen as early as seven days post CEA grafting, with complete wound closure within three weeks, and to a lesser extent in areas treated with cell spraying. Moreover, in vitro experiments confirmed the feasibility of using keratinocytes embedded within the EPNM: cell and culture viability, identity, purity and potency were determined. These experiments show that the skin cells are viable and can proliferate within the EPNM. The results presented are of a promising novel strategy for the development of personalised wound treatment, integrating on-the-spot 'printed' EPNM with autologous skin cells, which will be applied at the bedside, over deep dermal wounds, to accelerate healing time and wound closure.
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Quemaduras , Nanofibras , Adulto , Humanos , Masculino , Quemaduras/cirugía , Células Cultivadas , Queratinocitos , Piel , Trasplante de Piel/métodos , Trasplante AutólogoRESUMEN
Background: Psychological resources have been shown to play a prominent role in buffering against stress and are associated with various positive constructs, including grit, defined as having the disposition to pursue long-term goals with both passion and perseverance. Objective: The objective of this study was to validate a new scale developed to measure the psychological resources of grit. Methods: A quantitative research study was conducted online with an international sample of 277 adults from a range of professional backgrounds. The psychometric properties of the 20-item Grit Psychological Resources Scale (GPRS) were evaluated by performing tests of reliability and validity. Results: Reliability tests provided evidence of high internal consistency (α = 0.91) and test-retest reliability (r = 0.75). Demographic variables did not significantly predict scores or influence survey completion. Face, content and convergent validity provided additional psychometric support for the GPRS with this sample. Confirmatory factor analysis results supported a second-order model with four sub-scales. The first-order factors loaded highly onto the second-order factor, with correlations ranging from 0.80 to 0.97. Conclusion: The GPRS showed satisfactory psychometric properties, indicating that the scale is a reliable and valid instrument for measuring the psychological resources of grit. This scale can be used to identify more targeted developmental approaches for personal and professional growth. Further, the tool enables information to be gathered on changes pre- and post-improvement initiatives to assess their effectiveness in training and continuing education.
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This scoping review brings together existing studies on the use of cats in animal-assisted interventions, as assistance animals and as companion animals for autistic people. A systematic search across PubMed, CINAHL and Scopus in September 2022 identified 13 articles from 12 studies meeting the selection criteria with analysis revealing two key findings, cat-assisted therapeutic interventions, and cats as companion animals. There were five themes that emerged: the characteristics and behaviours of cats that make them suitable for inclusion in homes with autistic people; the bond between the cat and the autistic person; the use of cats as human-substitutes; the multiple ways in which cats improved the lives and social functioning of autistic people; and, some noted drawbacks or considerations of cat ownership. The review generates a comprehensive knowledge base upon which to promote feline therapy in autism and to advocate for further targeted research.
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Trastorno Autístico , Humanos , Animales , Gatos , Adulto , Niño , Trastorno Autístico/terapia , Relaciones Interpersonales , PropiedadRESUMEN
BACKGROUND: Academic mentorship usually involves an ongoing, supportive relationship between experienced academics and research candidates, and is fundamental to establishing and nurturing scholarship and the skills for dealing with the changing demands of the academic environment. Mentoring is a valuable strategy for the development of students enrolled in doctoral nursing programs (Doctor of Philosophy in Nursing - PhD, Doctor of Nursing Practice - DNP, Doctor of Nursing Science - DNS, and Doctoral Education in Nursing - EdD). PURPOSE: To report mentorship experiences among doctoral nursing students and academic mentors, identify positive and negative attributes of mentors and the relationship between mentors and students, and assess the benefits and barriers of mentoring. METHODS: Relevant empirical studies published until September 2021 were identified using PubMed, CINAHL and Scopus electronic databases. Quantitative, qualitative, and mixed method studies published in English language which reported on mentorship among doctoral nursing students were included. Data were synthesized into a scoping review with findings presented as a narrative summary. RESULTS: The review included 30 articles, mostly from the USA, which reported on the mentoring relationship, experiences, benefits, and barriers of mentoring for the student and the mentor. Students valued mentor attributes such as being a role model, respectful, supportive, inspiring, approachable, accessible, a content expert and a good communicator. Benefits of mentoring included enhanced experience of research endeavours, scholarly writing and scientific publication, networking support, improved student retention, timely completion of the project, and career readiness, as well as developing one's own mentoring skills for future mentoring of others. Despite the identified benefits, there are a number of barriers related to mentoring including access to mentorship support, limited mentoring skills among faculty, and lack of compatibility between students and mentors. CONCLUSIONS: This review highlighted students' expectations versus their reality of mentoring, which suggested areas for improvement in mentoring doctoral nursing students, in particular the need for mentorship competency, support, and compatibility. Additionally, there is a need for more robust research designs to understand the nature and characteristics of mentorship programs for doctoral nursing students and to assess the expectations and wider experiences of mentors.
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Educación de Postgrado en Enfermería , Tutoría , Estudiantes de Enfermería , Humanos , Mentores , Educación de Postgrado en Enfermería/métodos , Docentes de EnfermeríaRESUMEN
OBJECTIVES: To experimentally compare two fractional ablative CO2 laser handpieces intended for the treatment of large area burn scars. Each handpiece coverage rate, depth of penetration and application time were measured and compared in a simulation model of large area burns scars using a dynamic/roller handpiece (small footprint) and a stationary/stamping handpiece (large footprint). METHODS: A 30â¯W fractional ablative CO2 laser was applied using 2 different handpieces and footprints on a A4 size paper stack. The handpieces were a stationary (stamping) handpiece with 7â¯×â¯7 (49 pixels/square shape) and dynamic (roller) handpiece with 7â¯×â¯1 (7 pixels/single row shape). For both handpieces the laser settings were fixed at "High" power (30â¯W), providing an energy level of 100â¯mJ/pixel. Both handpieces were applied perpendicular to the surface, with the process repeated for the dynamic handpiece with an angled operation. The depth of laser penetration was assessed by the number of pages of paper having visible holes and burn area coverage time measured under each handpiece/condition. RESULTS: The application time was faster and the penetration deeper for the dynamic handpiece compared to the stationary handpiece in both the perpendicular and angled conditions. This study has practical implications for lasers operators to improve time efficacy in large area scars with improved clinical endpoints. CONCLUSION: The fractional ablative dynamic handpiece demonstrated superior application efficiency compared to the stationary handpiece in the simulated treatment of large surface area burn scars, reducing treatment time with improved depth of penetration.