The Association Between Elevated Foot Skin Temperature and the Incidence of Diabetic Foot Ulcers: A Meta-Analysis.

Prior to the appearance of any foot ulcer, there is an increase in the local temperature due to the presence of an underlying inflammatory process. The use of thermometry to identify inflammation could make patients increase preventive measures until the inflammation disappears. We carried out a meta-analysis to determine the effectiveness of the daily measurement of the foot temperature in 6 points to prevent the occurrence of foot ulcers in patients with diabetes. Patients with temperature differences >4°F (2.2°C) between left and right corresponding sites should reduce activity and increase preventive measures until temperature is normalized. We searched the literature in MEDLINE, EMBASE, Cochrane Library, Web of Knowledge, and clinicaltrials.gov. We have only included randomized clinical trials where individuals were assigned to receive enhanced care (temperature measurement and standard care) versus standard care (education, self-care practices, and periodic clinical visits). We found 4 trials comprising 462 patients from the United States and Norway that met our inclusion criteria. The duration of follow-up varied from 4.5 to 15 months. Overall, 18 (7.9%) subjects in the enhanced foot care group and 53 (22.6%) in the standard foot care group developed foot ulcers (pooled risk ratio = 0.37; 95% confidence interval = 0.21-0.66; P = .0008; percentage of heterogeneity [I2], 25%; P = .26). The number needed to treat was 7 (95% confidence interval = 5-11). The results were robust after analysis by subgroups according to the potential risk of bias in the studies and the duration of follow-up.

"Falls prevention among older people and care providers: protocol for an integrative review".

AIM: To review the evidence about the role of care providers in fall prevention in older adults aged ≥ 65 years, this includes their views, strategies, and approaches on falls prevention and effectiveness of nursing interventions. BACKGROUND: Some fall prevention programmes are successfully implemented and led by nurses and it is acknowledged the vital role they play in developing plans for fall prevention. Nevertheless, there has not been a systematic review of the literature that describes this role and care providers' views on fall's prevention initiatives. DESIGN: A convergent synthesis of qualitative, quantitative, and mixed methods studies. The eligibility criteria will be based on participants, interventions/exposure, comparisons, and outcomes for quantitative studies and on population, the phenomena of interest and the context, for qualitative studies. To extract data and assess study qualities members of the research team will work in pairs according to their expertise. The review will follow the guidelines for integrative reviews and the proposed methods will adhere to the PRISMA statement checklist complemented by the ENTREQ framework. As qualitative synthesis are emergent, all procedures and changes in procedure will be documented. DISCUSSION: The review has a constructivist drive as studies that combine methods ought to be paradigmatic driven. Review questions are broad to allow issues emerge and have purposefully left the design flexible to allow for adjustments as the review progresses. The review seeks to highlight the roles that care providers play in fall prevention and their views on fall's prevention initiatives.

Influencia de la situación laboral materna en recién nacidos pretérmino y/o con bajo peso / Influence of maternal employment on neonatal prematurity and/or low birth weight

Objetivo: Realizar una revisión de los estudiosepidemiológicos sobre la influencia de la situaciónlaboral y el tipo de ocupación materna en elnacimiento de niños con bajo peso y pretérmino.Material y métodos: Se realizó una búsquedabibliográfica en las bases de datos Medline yEMBASE. Los artículos seleccionados se clasificaronsiguiendo un protocolo que recogía lascaracterísticas de los estudios, la situación laboralmaterna, el tipo de ocupación y el resultado delembarazo.Resultados: Se incluyeron 21 artículos en los quemayoritariamente no se observan diferenciassignificativas entre las amas de casa y las empleadasen ninguno de los 2 efectos. En las investigacionesen las que se evalúa el tipo de ocupación, seobserva un mayor riesgo entre las embarazadas quetrabajan en el sector servicios y manual.Conclusiones: Las evidencias encontradas apuntana la necesidad de protección en el embarazo a lastrabajadoras de estos sectores

Objectives: To review epidemiological studies onthe association between maternal employment andtype of occupation and neonatal prematurity andlow birth weight.Material and methods: We performed a literaturesearch in the Medline and EMBASE databases. Thearticles selected were classified according to aprotocol that included the study’s characteristics’,maternal employment, type of occupation, andreproductive outcome.Results: Twenty-one articles were included. Mostof these articles found no differences in neonatalprematurity or low birth weight between workingwomen and housewives. A higher risk ofprematurity and low birth weight was found inwomen working in manual occupations and theservice sector.Conclusions: The evidence found suggests theneed to protect working women during pregnancy,especially those working in the two abovementionedsectors