Jenkinsfreedman9459
Half of the deaths recorded in non-surgical patients attributable to venous thromboembolism (VTE) affect those with stroke. The uncertain benefit of anticoagulant therapy has increased interest in non-pharmacological intervention to prevent VTE.
To evaluate the efficacy and safety of non-pharmacological interventions to prevent VTE in stroke patients.
Overview of systematic reviews with retrieval of documents in compliance with the PICOS Framework and through a research strategy implemented on 4 April 2019 in six biomedical databases and in the PROSPERO registry. The tools used to assess the methodological quality and the risk of bias were the AMSTAR checklist and the ROBIS tool, respectively. The results have been synthesized with narrative modality.
Seven systematic reviews of different methodological quality and risk of bias met the inclusion criteria. The non-pharmacological interventions of prophylaxis used are graduated compression stockings (GCS) and intermittent pneumatic compression devices (IPCD). The first has no effect on VTE and has important side effects, the second is promising in reducing mortality from all causes and decreases the incidence of deep vein thrombosis.
The use of IPCD, despite the efficacy observed, should be reserved, after a risk assessment of VTE and a subgroup analysis, for patients who can derive the maximum benefit from the intervention.
In stroke patients the use of GCS to prevent VTE is not recommended because it is not superior to standard care and can cause damage. IPCD as a intervention of prophylaxis appears to be effective but further confirmation is needed from future studies.
In stroke patients the use of GCS to prevent VTE is not recommended because it is not superior to standard care and can cause damage. IPCD as a intervention of prophylaxis appears to be effective but further confirmation is needed from future studies.
The internship is fundamental for the training of future professionals during the degree course in Nursing. Therefore, it is useful to investigate stress and difficulties experienced by students during this activity.
to explore the students' experiences during their internships and identify the possible sources of related stress.
a mixed methods study with concurrent triangulation was designed. An ad hoc structured questionnaire was disseminated on the main social networks and conducted via in-depth, audiotaped, face-to-face interviews.
177 people responded to the questionnaire. The main sources of stress during training were "not having adequate feedback from the clinical tutors" (75%) and "not receiving support to meet patients' needs" (65%). The prevalent negative emotions were a "loneliness" (46%) and "impotence" (54%). 11 students were interviewed in depth. 5 fundamental themes and 13 related concepts emerged. The internship is considered fundamental, but there is the worry of not being able to learn what is necessary to carry out the profession in the future. The presence of competent and motivated clinical tutors and a greater involvement of university tutors in internship contexts are both considered important.
the results suggest the need to identify methods of involvement university and clinical tutors, and the organization of internship experiences in care settings that could be suitable for the course year.
the results suggest the need to identify methods of involvement university and clinical tutors, and the organization of internship experiences in care settings that could be suitable for the course year.
In February 2020 the first case of COVID-19 arrived in Canton Ticino. Since then, many things have changed at great speed, especially in health organizations, and these changes have had a strong impact on the nursing profession. The objective of this research was to investigate the experiences of nurses at different organizational levels who were confronted with the COVID pandemic in the first month in which it occurred.
Narrative Research. The data collection was carried out involving a group of 20 nurses working in different contexts and roles in Canton Ticino. The collected narrations were analyzed through a thematic analysis of their content using Nvivo 12®.
The thematic analysis of the narrations made it possible to define 26 themes and 6 macro-themes Pandemic, What changes, Communication, Emotions/experiences, Role and image, Interprofessional collaboration. The results of this research make it possible to understand how a heterogeneous group of nurses experienced the particular period of pandemic in Canton Ticino and which reflections were derived from it. Some of the aspects highlighted can be compared with what is present in the international literature on the subject in order to find common ways of action for the nursing leadership, in the different Countries, facing the need to organize, manage and support nursing professionals in this and future pandemic situations.
The results of this research can be used both at an organisational and educational level and can be the starting point for future research.
The results of this research can be used both at an organisational and educational level and can be the starting point for future research.
High-sensitivity cardiac troponin (hs-TnT) assays detect very low levels of cardiac troponin. click here This study examined the interval change between initial and subsequent hs-TnT levels and evaluated its ability to predict significant coronary stenosis.
The study analyzed 163 patients who presented with acute coronary syndrome (ACS) and underwent coronary angiography (CAG) between April 2014 and May 2018. The 0 and 3-hour hs-TnT were checked. The patients were subdivided into positive (n = 32) and negative (n = 131) interval change groups. The presence of significant coronary artery stenosis on CAG in the two groups was compared.
The positive interval change group was older and had higher 0 and 3-hour hs-TnT and blood glucose levels than the negative interval change group. Significant coronary stenosis was more common in the positive interval change group than in the negative interval change group (68.8% vs. 23.7%, p = 0.001). However, vasospasm was more common in the negative interval change group (6.3% vs. 31.
