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1.
Int J Nurs Stud ; 123: 104071, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34520886

RESUMO

BACKGROUND: Misplacement of the nasogastric tube in the respiratory tract could cause serious complications and even death. Thus, nasogastric tube verification is necessary for optimal patient safety and comfort. Although end-tidal carbon dioxide detection is considered an effective approach to determine nasogastric tube location, there is a paucity of up-to-date evidence. OBJECTIVES: To review the diagnostic accuracy of end-tidal carbon dioxide detection in determining inadvertent airway intubation and verifying correct placement of nasogastric tubes. DESIGN: A systematic review and meta-analysis. METHODS: We searched clinical trials that evaluated the diagnostic accuracy of colorimetric capnometry or capnography in detecting nasogastric tubes located in the airway and differentiating between inadvertent airway intubation and correct nasogastric tube placement in any adult care setting. Four English language databases - Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and CINAHL - and four Chinese language databases - China Biomedical Literature Database, WanFang Data, China National Knowledge Infrastructure, and Airiti Library - were searched from July 2009 to March 2021. Clinical trial registration databases and reference lists of included studies and relevant reviews were also searched. Two reviewers extracted the data of all included studies using a data extraction form. Two reviewers assessed the methodological quality independently with the Quality Assessment of Diagnostic Accuracy Studies-2 tool. We conducted meta-analysis using the hierarchical bivariate model and estimated the pool sensitivity and specificity of capnography and colorimetric capnometry. Forest plots were generated to display the results. Heterogeneity was investigated by meta-regression. The certainty of evidence was evaluated with the Grading of Recommendations Assessment, Development and Evaluations framework. RESULTS: Of 1,155 records identified, seven new studies were added to this update and a total of 16 studies were analysed in the systematic review. The total absolute number of true positive, false negative, true negative, and false positive observations were 142, 6, 1,500, and 65 respectively. Low to very low certainty of evidence indicated that the use of colorimetric capnometry or capnography is potentially an effective method in differentiating between respiratory and nasogastric tube placement for critically ill adult patients. Pooled results (13 studies, 1,541 intubations) for sensitivity and specificity were 0.96 (95% confidence interval [0.88, 0.99]) and 0.99 (95% confidence interval [0.96, 1.00]), respectively. CONCLUSIONS: Colorimetric capnometry and capnography may have the potential to be of high sensitivity and specificity for the detection of inadvertent airway nasogastric tube placements in critically ill adults. More evidence is required to generalize the updated findings to different types of patients and settings.

2.
J Stroke Cerebrovasc Dis ; 30(11): 106076, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34507255

RESUMO

OBJECTIVES: To explore the relationship between participation self-efficacy, sociodemographic and clinical characteristics, and post-stroke depression in stroke survivors and provide insights into the development of rehabilitation programmes. MATERIALS AND METHODS: A cross-sectional descriptive study was conducted with 336 participants recruited from five hospitals in Kunming, China. Measures included the Chinese version of the Participation Strategies Self-Efficacy Scale (PS-SES-C), Geriatric Depression Scale (GDS), modified Barthel Index, Rivermead Mobility Index (RMI), Reintegration to Normal Living Index (RNLI), and the Social Support Questionnaire (SSQ6). Logistic regression analyses were performed using SPSS 25.0. RESULTS: Nearly half (44.6%) of the sample was found to have depression. The mean participation self-efficacy score of stroke survivors with depression was significantly lower than that of those without depression. Logistic regression analyses suggested that participation self-efficacy is a constant and major factor negatively associated with depression, with every 10-pt increase in the PS-SES-C score associated with decreased odds of depression (p<0.001). Other features associated with depression prevalence to varying degrees included education level, marital status, pre-morbid financial role in family, stroke symptom severity, history of heart disease, frequency of stroke, lesion side, stroke type, and use of assistive aids. CONCLUSIONS: Participation self-efficacy is negatively associated with depression in stroke survivors. Rehabilitation programmes might consider incorporating interventions aimed at boosting participation self-efficacy in order to promote positive recovery outcomes among survivors.

3.
Glob Chang Biol ; 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34478589

RESUMO

Droughts in a warming climate have become more common and more extreme, making understanding forest responses to water stress increasingly pressing. Analysis of water stress in trees has long focused on water potential in xylem and leaves, which influences stomatal closure and water flow through the soil-plant-atmosphere continuum. At the same time, changes of vegetation water content (VWC) are linked to a range of tree responses, including fluxes of water and carbon, mortality, flammability, and more. Unlike water potential, which requires demanding in situ measurements, VWC can be retrieved from remote sensing measurements, particularly at microwave frequencies using radar and radiometry. Here, we highlight key frontiers through which VWC has the potential to significantly increase our understanding of forest responses to water stress. To validate remote sensing observations of VWC at landscape scale and to better relate them to data assimilation model parameters, we introduce an ecosystem-scale analog of the pressure-volume curve, the non-linear relationship between average leaf or branch water potential and water content commonly used in plant hydraulics. The sources of variability in these ecosystem-scale pressure-volume curves and their relationship to forest response to water stress are discussed. We further show to what extent diel, seasonal, and decadal dynamics of VWC reflect variations in different processes relating the tree response to water stress. VWC can also be used for inferring belowground conditions-which are difficult to impossible to observe directly. Lastly, we discuss how a dedicated geostationary spaceborne observational system for VWC, when combined with existing datasets, can capture diel and seasonal water dynamics to advance the science and applications of global forest vulnerability to future droughts.

4.
Artigo em Inglês | MEDLINE | ID: mdl-34360420

RESUMO

Acceptance and commitment therapy (ACT) is an adapted form of cognitive behavioural therapy. ACT focuses on how thinking affects behaviour and promotes psychological flexibility. The prevalence of psychological distress among people living with cardiovascular disease (CVD) and/or type 2 diabetes mellitus (T2DM) is high, and ACT may offer an alternative treatment approach. This scoping review explored the use of ACT as an intervention to support adults living with CVD and/or T2DM. A systematic search of the literature resulted in the inclusion of 15 studies. Studies were reviewed using the Joanna Briggs Institute approach to conducting scoping reviews. Most studies (n = 13) related to people living with T2DM, and most (n = 10) used a pre-post design, four studies were randomised controlled trials, and one was a qualitative study. Eight studies reported an improvement in the outcome(s) assessed post-intervention, suggesting that ACT was an acceptable and valid intervention to support people living with CVD or T2DM. However, studies were underpowered and only limited studies involved people living with CVD. ACT was assessed as a valuable approach to improve a range of patient-reported outcomes for those living with CVD or T2DM, and further research involving robust study designs and larger cohorts are warranted.


Assuntos
Terapia de Aceitação e Compromisso , Doenças Cardiovasculares , Terapia Cognitivo-Comportamental , Diabetes Mellitus Tipo 2 , Adulto , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/terapia , Atenção à Saúde , Diabetes Mellitus Tipo 2/terapia , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
5.
Glob Chang Biol ; 2021 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-34386992

RESUMO

Ocean circulation connects geographically distinct ecosystems across a wide range of spatial and temporal scales via exchanges of physical and biogeochemical properties. Remote oceanographic processes can be especially important for ecosystems in the Southern Ocean, where the Antarctic Circumpolar Current transports properties across ocean basins through both advection and mixing. Recent tracking studies have indicated the existence of two large-scale, open ocean habitats in the Southern Ocean used by grey petrels (Procellaria cinerea) from two populations (i.e., Kerguelen and Antipodes islands) during their nonbreeding season for extended periods during austral summer (i.e., October to February). In this work, we use a novel combination of large-scale oceanographic observations, surface drifter data, satellite-derived primary productivity, numerical adjoint sensitivity experiments, and output from a biogeochemical state estimate to examine local and remote influences on these grey petrel habitats. Our aim is to understand the oceanographic features that control these isolated foraging areas and to evaluate their ecological value as oligotrophic open ocean habitats. We estimate the minimum local primary productivity required to support these populations to be much <1% of the estimated local primary productivity. The region in the southeast Indian Ocean used by the birds from Kerguelen is connected by circulation to the productive Kerguelen shelf. In contrast, the region in the south-central Pacific Ocean used by seabirds from the Antipodes is relatively isolated suggesting it is more influenced by local factors or the cumulative effects of many seasonal cycles. This work exemplifies the potential use of predator distributions and oceanographic data to highlight areas of the open ocean that may be more dynamic and productive than previously thought. Our results highlight the need to consider advective connections between ecosystems in the Southern Ocean and to re-evaluate the ecological relevance of oligotrophic Southern Ocean regions from a conservation perspective.

6.
BMJ Open ; 11(8): e052683, 2021 08 23.
Artigo em Inglês | MEDLINE | ID: mdl-34426473

RESUMO

OBJECTIVES: Nurses are the largest group of healthcare workers on the front line of efforts to control the COVID-19 pandemic. An understanding of their nursing experiences, the challenges they encountered and the strategies they used to address them may inform efforts to better prepare and support nurses and public health measures when facing a resurgence of COVID-19 or new pandemics. This study aimed to explore the experiences of nurses caring for people with suspected or diagnosed COVID-19 in Hong Kong. DESIGN: A qualitative study was conducted using individual, semistructured interviews. All interviews were audio-recorded and transcribed verbatim for thematic analysis. SETTING: Participants were recruited from acute hospitals and a public health department in Hong Kong from June 2020 to August 2020. PARTICIPANTS: A purposive sample of registered nurses (N=39) caring for people with COVID-19 in Hong Kong were recruited. RESULTS: Two-thirds of the nurses had a master's degree and over a third had 6-10 years of nursing experience. Around 40% of the nurses cared for people with COVID-19 in isolation wards and a quarter performed COVID-19-related work for 31-40 hours/week. Most (90%) had training in COVID-19 and three-quarters had experience of working in infection control teams. Six key themes emerged: confronting resource shortages; changes in usual nursing responsibilities and care modes; maintaining physical and mental health; need for effective and timely responses from relevant local authorities; role of the community in public health protection and management; and advanced pandemic preparedness. CONCLUSIONS: Our study found that nurses possessed resilience, self-care and adaptability when confronting resource shortages, changing nursing protocols, and physical and mental health threats during the COVID-19 pandemic. However, coordinated support from the clinical environment, local authorities and community, and advanced preparedness would likely improve nursing responses to future pandemics.


Assuntos
COVID-19 , Enfermeiras e Enfermeiros , Hong Kong , Humanos , Pandemias , SARS-CoV-2
7.
Heart Lung ; 50(6): 857-862, 2021 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-34333221

RESUMO

BACKGROUND: Mobility is a major determinant of social participation after stroke and the relationship between the two may be mediated by participation self-efficacy. OBJECTIVE: To investigate the hypothesis that participation self-efficacy mediates the association between mobility and social participation among stroke survivors. METHODS: A secondary data analysis of a cross-sectional study aiming to validate the Chinese version of the Participation Strategies Self-Efficacy Scale was conducted. Three hundred and thirty-six stroke survivors were recruited. With mobility as the predictor variable and social participation as the outcome, path analysis was utilized to assess the mediating effect of participation self-efficacy on the association between the two factors. RESULTS: Mobility was significantly associated with social participation (B=2.773, p<0.001) and participation self-efficacy (B=6.060, p<0.001). After adjusting for mobility, participation self-efficacy was significantly associated with social participation. The association between mobility and social participation was mediated by participation self-efficacy. CONCLUSIONS: When aiming to improve stroke survivor community reintegration, interventions targeted at boosting participation self-efficacy must be considered given its beneficial mediatory effect on mobility and social participation.

8.
J Nurs Educ ; 60(7): 367-368, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34232821
9.
Health Qual Life Outcomes ; 19(1): 177, 2021 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-34246255

RESUMO

BACKGROUND: Caregivers are major contributor to the self-care of patients with heart failure. The Caregiver Contribution to Self-Care of Heart Failure Index (CC-SCHFI) measures these contributions across three scales: self-care maintenance (symptom monitoring and treatment adherence); self-care management (dealing with symptoms); and confidence in contributing to the self-care (self-efficacy in managing self-care) of patients with heart failure. Informal caregivers play a vital role in supporting family members with heart failure in Thailand, yet no validated tool exists to measure their contribution. We examined the psychometric properties of the CC-SCHFI in a Thai population. METHODS: The CC-SCHFI was translated into Thai using a standard forward and backward translation procedure. A cross-sectional design was used to examine the psychometric properties of the Thai version of the CC-SCHFI in 100 family caregivers of heart failure patients in Southern Thailand. Confirmatory factor analysis was used to assess construct validity, and factor score determinacy coefficients were computed to evaluate internal consistency reliability. RESULTS: The Thai version of the CC-SCHFI demonstrated acceptable internal consistency (composite reliability of each scale ranged from 0.76 to 0.99). Reliability estimates were adequate for each scale (McDonald's omega ranged from 0.75 to 0.96). Confirmatory factor analysis supported the original factor structure of the instrument, with good fit indices for all three scales (comparative fit index = 0.98-1.00; root-mean-square error of approximation = 0.00-0.07). CONCLUSIONS: The Thai version of the CC-SCHFI appears to be a valid and reliable instrument for measuring caregiver contributions to self-care maintenance and self-care management as well as contributing to caregiver confidence in the self-care of Thai heart failure patients.


Assuntos
Cuidadores , Insuficiência Cardíaca/enfermagem , Autocuidado/métodos , Inquéritos e Questionários/normas , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria/instrumentação , Qualidade de Vida , Reprodutibilidade dos Testes , Tailândia , Traduções
10.
Disabil Rehabil ; : 1-7, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34061687

RESUMO

PURPOSE: To examine the psychometric properties of a Chinese version of the Participation Strategies Self-Efficacy Scale (PS-SES) among stroke survivors. METHODS: The PS-SES was translated into Chinese. A cross-sectional descriptive study was conducted with 336 stroke survivors recruited from the neurology departments of five hospitals in China. Reliability, concurrent validity, and construct validity of the scale were determined. RESULTS: The Chinese version of the PS-SES (PS-SES-C) showed good internal consistency and test-retest reliability, with a Cronbach's α of 0.98 and an intraclass correlation coefficient of 0.79. There was a moderate to strong positive correlation between the PS-SES-C and Chinese version of the General Self-Efficacy Scale (r = 0.59, p < .001), positive correlations between the PS-SES-C and Chinese versions of the Modified Barthel Index (r = 0.59, p < .001), Rivermead Mobility Index (r = 0.70, p < .001), and Reintegration to Normal Living Index (r = 0.70, p < .001), and a negative correlation between the PS-SES-C and National Institutes of Health Stroke Scale (r = -0.63, p < .001). Known-group validity and factorial validity were also supported. CONCLUSIONS: The PS-SES-C is a reliable and valid instrument for assessing self-efficacy in managing the participation of Chinese stroke survivors.Implications for rehabilitationSelf-efficacy significantly predicts activity and participation in stroke survivors and is a major outcome measure in many stroke rehabilitation programmes.The translated Chinese version of the Participation Strategies Self-efficacy Scale is a valid and reliable tool to evaluate stroke survivors' self-efficacy in managing participation.The Chinese version of the Participation Strategies Self-efficacy Scale can be used to assess stroke recovery among the Chinese population in clinical and research settings.

11.
J Nurs Manag ; 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34062033

RESUMO

In our combined 90+ years in nursing we have published over 700 papers. Nothing, however, evoked responses like "Academic nursing's killer elite'' (Thompson & Darbyshire, 2013). To say that we 'touched a nerve' is an understatement, but we understated the malignant narcissist, corporate psychopath, dimensions of the 'killer elite' and extend that discussion now. We received then and continue to receive, harrowing 'testimonies' (Hartin et al., 2020) from nurses describing, not linguistically sanitised 'incivility', but sustained bullying, gaslighting and corrosive narcissism by some senior academics who made their lives intolerable.

12.
Artigo em Inglês | MEDLINE | ID: mdl-34063298

RESUMO

This paper describes the development of the 'Brain-Fit' app, a digital secondary prevention intervention designed for use in the early phase after transient ischaemic attack (TIA) or minor stroke. The aim of the study was to explore perceptions on usability and relevance of the app in order to maximise user engagement and sustainability. Using the theory- and evidence-informed person-based approach, initial planning included a scoping review of qualitative evidence to identify barriers and facilitators to use of digital interventions in people with cardiovascular conditions and two focus groups exploring experiences and support needs of people (N = 32) with a history of TIA or minor stroke. The scoping review and focus group data were analysed thematically and findings were used to produce guiding principles, a behavioural analysis and explanatory logic model for the intervention. Optimisation included an additional focus group (N = 12) and individual think-aloud interviews (N = 8) to explore perspectives on content and usability of a prototype app. Overall, thematic analysis highlighted uncertainty about increasing physical activity and concerns that fatigue might limit participation. Realistic goals and progressive increases in activity were seen as important to improving self-confidence and personal control. The app was seen as a useful and flexible resource. Participant feedback from the optimisation phase was used to make modifications to the app to maximise engagement, including simplification of the goal setting and daily data entry sections. Further studies are required to examine efficacy and cost-effectiveness of this novel digital intervention.


Assuntos
Ataque Isquêmico Transitório , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Humanos , Ataque Isquêmico Transitório/prevenção & controle , Estilo de Vida , Prevenção Secundária , Acidente Vascular Cerebral/prevenção & controle
13.
BMJ Open ; 11(6): e046160, 2021 06 16.
Artigo em Inglês | MEDLINE | ID: mdl-34135043

RESUMO

OBJECTIVE: Heart failure is a growing challenge to healthcare systems worldwide. Technological solutions have the potential to improve the health of patients and help to reduce costs. Acceptability is a prerequisite for the use and a successful implementation of new disruptive technologies. This qualitative study aimed to explore determinants that influence the acceptance of patients and their informal caregivers regarding a patient-oriented digital decision-making solution-a doctor-at-home system. DESIGN: We applied a semistructured design using an interview guide that was based on a theoretical framework influenced by established acceptance theories. The interviews were analysed using a content analysis. SETTING: A multicentred study in four European countries. PARTICIPANTS: We interviewed 49 patients and 33 of their informal caregivers. Most of the patients were male (76%) and aged between 60 and 69 years (43%). Informal caregivers were mostly female (85%). The majority of patients (55%) suffered from heart failure with mild symptoms. RESULTS: Four main categories emerged from the data: needs and expectations, preferences regarding the care process, perceived risk and trust. Participants expressed clear wishes and expectations regarding a doctor-at-home, especially the need for reassurance and support in the management of heart failure. They were receptive to changes to the current healthcare processes. However, trust was identified as an important basis for acceptance and use. Finally, perceived risk for decision-making errors is a crucial topic in need of attention. CONCLUSION: Patients and informal caregivers see clear benefits of digitalisation in healthcare. They perceive that an interactive decision-making system for patients could empower and enable effective self-care. Our results provide important insights for development processes of patient-centred decision-making systems by identifying facilitators and barriers for acceptance. Further research is needed, especially regarding the influence and mitigation of patients and informal caregivers' perceived risks.


Assuntos
Cuidadores , Insuficiência Cardíaca , Idoso , Europa (Continente) , Feminino , Insuficiência Cardíaca/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Autocuidado
15.
Artigo em Inglês | MEDLINE | ID: mdl-34008005

RESUMO

AIMS: Exercise promotes functional recovery among stroke survivors and is recommended to be commenced as soon as is feasible. However, little is known about stroke survivors' perception of participation in exercise or sitting Tai Chi, a more culturally appropriate and popular movement in China. To explore Chinese stroke survivors' perceptions of participation in exercise or sitting Tai Chi. METHODS AND RESULTS: Face-to-face semi-structured interviews and content analysis of transcripts were conducted with a purposive sample of 30 stroke survivors. The qualitative study explored perceptions of post-stroke participation in exercise or sitting Tai Chi. The consolidated criteria for reporting qualitative research checklist was used to report findings. Perceived facilitators of exercise participation were healthcare professionals' encouragement and recommendations, family and peer support and survivors' motivation, intention, and self-perceived benefits. Perceived barriers were fear of falling, physical discomfort, and challenges in standing. Despite some reservations, most participants were willing to try sitting Tai Chi. CONCLUSIONS: Encouragement and support, motivation, and perceived benefits were important for exercise participation after stroke. With the premise that all medical and nursing students in China are trained in Tai Chi, for stroke survivors with no access to formal exercise programmes, sitting Tai Chi may offer an appropriate alternative.

16.
BMC Endocr Disord ; 21(1): 96, 2021 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-33964904

RESUMO

BACKGROUND: Mental health problems are highly prevalent in people with type 1 diabetes mellitus (T1DM), which adversely impact physical health and quality of life. This study aimed to explore the experiences of people with T1DM who had completed the Mental health IN DiabeteS Optimal Health Program (MINDS OHP), a novel intervention developed to bridge the gap between physical and mental health care. METHOD: Participants with T1DM were invited to take part in a focus group or semi-structured interviews. Participants were recruited from outpatient and community settings. The focus group and interviews were audio-recorded and transcribed verbatim. Thematic content analysis was used and identified themes were cross-validated by researchers and member-checked by participants. RESULTS: Ten people with T1DM were included. Two key themes emerged: 'MINDS OHP experiences' and 'lived experiences of diabetes'. MINDS OHP experiences included five sub-themes: program benefits, follow-up and timing, suggested improvements, collaborative partners, and materials suitability. Lived experiences also included five sub-themes: bridging the gap between mental and physical health, support networks, stigma and shame, management intrusiveness, and adolescence and critical life points. CONCLUSIONS: The MINDS OHP for people with T1DM was generally well received, though study findings suggest a number of improvements could be made to the program, such as including family members, and consideration being given to its routine early inclusion in diabetes management, ideally in primary care.

17.
Prev Med ; 149: 106608, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33984372

RESUMO

Family-based eHealth interventions to reduce cardiovascular disease risk have potential as a primary prevention strategy to improve the health of parents and their children. This systematic review evaluated the effectiveness of such interventions in modifying parent and child/adolescent risk factors such as body mass index, physical activity, dietary intakes and alcohol use. Five electronic databases were searched up to April 2020. Of 2193 articles identified, seven randomised controlled trials met inclusion criteria and were reviewed. Data were extracted regarding study setting, design, methods, eHealth technology used, intervention and control group components, retention rates, outcome measures, incentives and limitations. Risk of bias and quality assessment were carried out using Cochrane methods. A qualitative narrative data synthesis of the studies was conducted. Our review found that three studies showed an improvement in alcohol use among parents and adolescents as a result of the eHealth intervention. Among children/adolescents, two studies showed an improvement in dietary intake, one study showed an improvement in physical activity, and one study showed an improvement in body mass index as a result of the eHealth intervention. Interventions appeared more likely to be effective if they were theory-based, had longer follow-up periods, were incentivised and included regular interaction. Our findings suggest that, despite a paucity of high-quality trials, there is some evidence that family-based eHealth interventions have potential to reduce cardiovascular disease risk. However, more sufficiently powered, higher-quality trials with theory driven, clearly described interventions and unambiguous outcomes are needed.


Assuntos
Doenças Cardiovasculares , Telemedicina , Adolescente , Doenças Cardiovasculares/prevenção & controle , Criança , Exercício Físico , Humanos , Pais , Comportamento de Redução do Risco
18.
Eur J Cardiovasc Nurs ; 20(5): 515-519, 2021 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-34007994

RESUMO

Although systematic reviews are the method of choice to synthesize scientific evidence, they can take years to complete and publish. Clinicians, managers, and policy-makers often need input from scientific evidence in a more timely and resource-efficient manner. For this purpose, rapid reviews are conducted. Rapid reviews are performed using an accelerated process. However, they should not be less systematic than standard systematic reviews, and the introduction of bias must be avoided. In this article, we describe what rapid reviews are, present their characteristics, give some examples, highlight potential pitfalls, and draw attention to the importance of evidence summaries in order to facilitate adoption in clinical decision-making.

19.
Nurs Inq ; 28(2): e12412, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33858032

RESUMO

Nursing and nursing education face a paradox whereby the world's most trusted profession seems not to trust its own students and practitioners. Much of nursing education has adopted what has been memorably described as the 'cop shit' approach. This is the panoply of surveillance, anti-plagiarism and proctoring technologies that appear to be used more for policing and punishment of an inherently dishonest student body than to develop ethical and scholarly writing among future peers and colleagues. Nurses in practice may experience similar levels of distrust as they face growing micromanagement and control of both their appearance and nursing practice. We propose that these practices of distrust emerge, not from malice, but rather from the omnipresent neoliberalism and managerialism that engulf almost every aspect of health and university life. Neoliberalism's success has been to reformat academia and practice to the point where such ingrained mistrust has become merely a neutral recognition of 'the real world'. Dismantling nursing and education's 'cop shit' culture and replacing it with the trust and respect that the world's most trusted profession is accorded by wider society will not be easy, but it is vital for the future of nursing.


Assuntos
Docentes de Enfermagem/psicologia , Bacharelado em Enfermagem/métodos , Bacharelado em Enfermagem/normas , Humanos , Confiança/psicologia
20.
Curr Opin Support Palliat Care ; 15(2): 141-146, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-33905386

RESUMO

PURPOSE OF REVIEW: To review the application of intersectionality to heart failure. Intersectionality refers to the complex ways in which disenfranchisement and privilege intersect to reproduce and influence health and social outcomes. RECENT FINDINGS: Intersectionality challenges approaches that focus on a single or small number of socio-demographic characteristics, such as sex or age. Instead, approaches should take account of the nature and effects of a full range of socio-demographic factors linked to privilege, including: race and ethnicity, social class, income, age, gender identity, disability, geography, and immigration status. Although credible and well established across many fields - there is limited recognition of the effects of intersectionality in research into heart disease, including heart failure. This deficiency is important because heart failure remains a common and burdensome syndrome that requires complex pharmacological and nonpharmacological care and collaboration between health professionals, patients and caregivers during and at the end-of-life. SUMMARY: Approaches to heart failure clinical care should recognize more fully the nature and impact of patients' intersectionality- and how multiple factors interact and compound to influence patients and their caregivers' behaviours and health outcomes. Future research should explicate the ways in which multiple factors interact to influence health outcomes.

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