1,720,972 research outputs found
Nursing care models in primary care and hospital settings: implementation and evaluation
In the last year, the COVID‐19 pandemic has made clear how vulnerabilities in health systems can have profound implications for the health of people. Thus, organizations are taking in place significant changes which are also influencing nursing staff and the nursing care model.
This dissertation aims to: 1) explore the effects of primary nursing on patient, -staff,-organizational-related outcomes in hospital settings; 2) identify barriers and facilitators of nursing role implementation in primary care; and 3) assess the effects of the family and community nursing (FCN) practice model on patient-, organizational-related outcomes.
Method. To reach aim 1 a multi-centre, prospective before-after study is performed. Primary outcome are healthcare-associated infections. Also, staff-related outcomes are included. To reach aim 2 an integrative literature review was conducted. It combines data from quantitative and qualitative studies from two databases searches (Medline and CINAHL) up to 09 June 2020. Data extraction and identification of emerging themes are performed using the Consolidating Framework for Research Implementation (CFIR).
To reach aim 3 a prospective controlled study was designed. The study will recruit older and frail residents in municipalities belonging to Community Health Centres (CHC) of Santhià and Gattinara (Local Health Authority of Vercelli). The Intervention is the FCN and it is allocating in one of the CHC. Primary outcome is hospitalization.
Results. In this dissertation, the results of the integrative literature review are listed. 56 papers met the inclusion criteria. The major barriers identified are related to: i) the limited availability of nursing special education, ii) legislations and regulations, iii) organizational setting in which nurse’s role implementation is embedded; and iv) lack of nurse’s role clarity among stakeholders.
Major facilitators include: i) prior planning for role introduction and nurses’ involvement in the early stage of role implementation, ii) job satisfaction and nurses’ access to high-quality education, iii) successful doctor-nurse collaboration.
Finally, the two study protocols were submitted to the Local Ethics Committee. The before-after study has begun in 2019 with 10 Centres enrolled. Actually, the study has recruited 422 patients and 94 nurses.
Discussion. Implementation and evaluation of the nurse’s role in primary care and hospital settings are complex interventions due to several components which interact with each other. In this regard, the Medical Research Council framework has been used to guide the development and evaluation of complex interventions, related to nursing research and practice. Despite using this framework, two different studies have been designed to explore how the nursing care model works and its effects. The studies are still suspended due to restrictions imposed by the ongoing COVID-19 pandemic
Wearable technology use in long-term-care facilities for older adults: a scoping review protocol
Objective: The objective of this scoping review is to explore how wearable technology is being used to care for older adults in long-term-care facilities. Introduction: The use of digital health technologies to support care delivery in long-term-care facilities for older adults has grown significantly in recent years, especially since the COVID-19 pandemic. Wearable technology refers to devices worn or attached to the body that can track a variety of health-related data, such as vital signs, falls, and sleep patterns. Despite the evidence that wearable devices are playing an increasing role in older adults' care, no review has been conducted on how wearable technology is being used in long-term-care facilities. Inclusion criteria: This review will consider studies that include people aged over 65, with any health condition or level of disability, who live in long-term-care facilities. Primary and secondary studies using quantitative, qualitative, and mixed-method study designs will be included. Dissertations and policy documents will also be considered. Methods: Data sources will include comprehensive searches of electronic databases (MEDLINE, Embase, CINAHL, and Scopus), gray literature, and reference scanning of relevant studies. Two independent reviewers will screen titles, abstracts, and full texts of the selected studies. Data extraction will be performed using a tool developed by the researchers. Data will be mapped and analyzed. Descriptive frequencies and content analysis will be included, along with the tabulated results, which will be used to present the findings with regard to the review objectives. Review registration: Open Science Framework osf.io/r9qtd
[Nosocomial infections during the COVID-19 outbreak. Observational study in an Italian ICU]
Introduction. Infections are common among ICU patients. Aim. The pur- pose of this study is to examine the incidence of nosoco- mial infections among patients admitted to the ICU with SARS-CoV-2 infection. Methods. A prospective observatio- nal study in adults with confirmed SARS-CoV-2 infection requiring intensive care unit (ICU) admission was performed. From May 2020 to October 2021, a total of 109 admitted patients were included. Results. The incidence rate of new infections was 39.4%. The main infections observed were multidrug-resistant germs infections (39.5%), catheter-rela- ted blood infections(24.4%), pneumonia (VAP)(18.6%), and urinary tract infections (17.4%). The overall mortality rate was 32.1% (n= 35) and was significantly higher in patients who had a new infection during hospitalization (n= 26/43, 60.4%) than in patients who did not have a new infection (n= 9/66, 13.6%) (RR = 4.43; 95% CI = 2.31-8.52; p <.001). Conclusions. Our data suggest that secondary infections are associated with a longer duration of mechanical ventilation and hospital stay and may negatively impact patient survi- val. However, larger studies are needed
Going Beyond Counting First Authors in Author Co-citation Analysis
The present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
We provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Bed rest after cardiovascular implantable electronic device placement: systematic review and meta-analysis
BACKGROUND:
Bed rest is prescribed for all patients after cardiovascular implantable electronic device (CIED) placement but to a varied extent. Different clinical protocols exist.
AIM:
To assess the effects of different lengths of bed rest on complications and patient comfort after CIED implantation.
METHODS:
We searched MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, CINAHL, SCOPUS. We included randomized and quasi-randomized controlled trials. Two of the authors independently selected trials, assessed the risk of bias, and extracted data.
RESULTS:
We included 2 RCTs. There was no evidence that shorter bed rest was more harmful than longer bed rest in terms of lead displacement (RR 0.681, 95% CI [0.063, 7.332]) and hematoma (RR 1.642, 95% CI [0.282, 9.560]). None of the studies reported the assessment of bleeding, back pain, or urinary discomfort.
CONCLUSIONS:
Shorter periods of bed rest appear to be as safe as longer ones. However, to confirm these results, further larger trials are needed
Long-term effects of Coronavirus 2 infection after intensive care: a prospective study
While the multi-organ manifestations of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection are now well-documented, the potential long-term implications of these manifestations remain to be uncovered. The aim was to study the level and predictors of post-traumatic stress, anxiety and depression symptoms, quality of life and functional disability in COVID-19 survivors during the first year post intensive care unit (ICU) discharge
Dispelling the Myths Behind First-author Citation Counts
We conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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