Search

This article reviews seven facets of continuous glucose monitors (CGMs): how they work, advantages for patients and clinicians, device limitations, effect on outcomes in patients with diabetes, who should be prescribed these devices, their cost, and their accuracy. Four major CGMs marketed today are compared: Abbott's FreeStyle Libre, Medtronic's Guardian, Dexcom's G6, and Senseonic's Eversense.

En este artículo se pretende dar cuenta del proceso de creación y reflexión alrededor de la “Cartografía de las memorias familiares”, realizada durante el año 2018 por el semillero de investigación en Arte y Memoria “Incandescencias: del recuerdo a la Creación”, el cual se encuentra adscrito a la Licenciatura en Artes Visuales de la Universidad Pedagógica Nacional. A lo largo del texto, se narran algunos de los hallazgos encontrados en torno a unos vehículos que articulan las memorias, unos silencios que dialogan con los olvidos y las ausencias, unos recuerdos que muestran un entramado de la memoria y unas herencias que devienen de los procesos de transmisión generacional. Estas reflexiones parten de la necesidad de una aproximación a las memorias familiares desde el lugar de ese otro que dialoga con su pasado, lo cuestiona y resignifica en función del futuro.

Nurse managers play a significant role in the way care is provided by point-of-care nurses. Yet it is unclear what role nurse managers have in supporting nurses in using health information technologies (ITs) specifically. The objectives of this article are to (1) uncover the role of nurse managers in supporting point-of-care nurses to optimally use health ITs and (2) identify strategies that nurse managers can employ to support point-of-care nurses in using these technologies. A scoping review methodology was used, which resulted in the inclusion of 10 relevant articles. Concerning the role of the nurse manager, four themes were identified: (1) decision making, , (2) implementation planning, (3) supporting staff and (4) evaluation. With regard to strategies to support the use of health ITs, two themes were identified: (1) strategies that prepare nurse leaders in their role of supporting point-of-care staff in using health ITs and (2) strategies that directly support point-of-care staff in using health ITs. The results of this review will be of interest to nurse leaders, informatics researchers and nurse informaticians.

Transformation into a digitally enabled profession will maximize the benefits to patient care, write Richard Booth and colleagues

Background: After experiencing a life changing stroke, survivors are often faced with a challenging journey back to wellness. This is particularly trying for those with depression and poor access to healthcare. In this study, we seek to assess the degree of depression and health-related quality of life (QOL) in first-time ischemic stroke patients compared to post-myocardial infarction (MI) patients in a county hospital system. Methods: Consecutive patients admitted for stroke and MI at a Los Angeles County Hospital were reviewed. Patients who meet the inclusion criteria and consented for participation were assessed for quality of life with EQ-5D-3L, depression with Patient Health Questionnaire 9 (PHQ-9) and knowledge of mental health resources. Stroke and MI severity were ranked and compared by hospital length of stay and day 90 mRS. Dichotomized variables were computed via t-test for parametric and Wilcoxon for nonparametric values. Multivariate analysis of non-parametric values was computed via Spearman correlation. Results: 61 stroke patients (mean age 59.7±13.4) and 52 MI patients (mean age 60.5±9.9) were included. Hospital length of stay did not significantly differ (mean 3.9 vs 2.5 days p=0.11). Day 90 mRS was significantly higher in the stroke group (mean 1.62 vs 0.96, p=0.004). PHQ-9 (mean 5.97 vs 6.85 p=0.13) and EQ-5D-3L (mean 7.4 vs 6.60 p=0.06) scores did not significantly differ. Among stroke patients (mean NIHSS 4.8 ±5.7), age correlated with day 90 mRS (r s =0.36 ps =0.76 ps =0.65 ps =0.74 ps =0.78 p Conclusions: Stroke patients trended towards worse QOL scores, but lower depression scores than MI patients, though this did not reach statistical significance. Day 90 mRS correlated with worse QOL and depression scores in both groups. Despite high rates of depressive symptoms, very few patients had sought out mental health resources. This highlights the need to support mental health outreach, especially for vulnerable county patient populations.

Interoception, the multidimensional ability to sense the physiological condition of the body, is a key mechanism in emotional processing. However, the relationships between interoceptive dimensions and depressed mood and anxiety have not been widely studied. The aim of this secondary analysis, correlational and cross-sectional study, was to determine the relationships among interoceptive accuracy, interoceptive sensibility, depressed mood, and anxiety in adults with hypertension. The sample consisted of 76 adults, predominately African American women. Correlational analysis showed that most participants had low levels of interoceptive accuracy and relatively high levels of interoceptive sensibility. Interoceptive sensibility was negatively associated with depressed mood and anxiety. Interoceptive accuracy and interoceptive sensibility were not associated between each other. Further examination of the dimensions of interoception is needed to better understand the mechanisms by which it is associated with emotions that are known to have an influence on health behaviors and quality of life.

INTRODUCTION Density, public health and safety, quality of life, and sustainability are some of the most confounding issues that major cities face today as they expand in population and area. How do we bring urban populations closer together in the public realm, while still providing space for the individual psyche and also increasing the overall sense of positive connection to the natural world and to each other? Robust natural landscapes have sometimes been considered a luxury within a functioning city, but more and more they are being recognized for the vital role they play in making cities livable. The story of Corktown Common relates how a landscape built of necessity was also designed to deliver myriad public benefits, including enhanced urban ecology and sustainability.

Background: Clot propagation after initial occlusion may increase target thrombus burden and its pathophysiologic basis has not been extensively studied in acute human ischemic stroke. We investigated whether clot characteristics on MRI, catheter angiography, and thrombus histopathology indicated that impaired collaterals may be associated with extension of acute intracranial occlusions via stasis clotting in slow flow arterial segments. Methods: Analysis of consecutive AIS-LVO endovascular thrombectomy patients at 2 academic medical centers with: 1) pretreatment MRI, and 2) retrieved thrombi. GRE MR susceptibility vessel sign presence and extent of ASITN collateral scores were rated by blinded assessors. Extracted clots were fixed in formalin, stained by hematoxylin and eosin, and RBC, WBC and fibrin percent composition quantified by a neuropathologist blinded to clinical details. We evaluated the correlation of collateral grade with clot size by susceptibility vessel sign (SVS) and clot composition by RBC%. Non-parametric values were computed via Spearman correlation. Results: Among the 48 patients, mean age was 71.4 (SD 17.7), 56.3% female, and mean presenting NIHSS was 15.5 (SD 7.41). A susceptibility vessel sign was present in 65%, with mean SVS length 15.6 mm (SD 8.3). Collateral scores were mean 2.3 (SD 1.2). The number of passes per procedure was mean 1.98 (SD 1.30) The presence of a susceptibility vessel sign correlated with higher RBC% in retrieved thrombi (r s =0.36 p=0.011). Worse collateral grades correlated with longer SVS length (r s =-0.50 p=0.004) and greater SVS width (r s =-0.54 p=0.002). Worse collateral grade also trended toward correlation with higher RBC% in retrieved clots (r s =-0.19 p=0.18). Conclusion: Impaired angiographic collaterals are associated with longer RBC-rich thrombi on susceptibility imaging and trend toward association with higher RBC% in retrieved thrombi. These findings support that, in LVO acute ischemic stroke, clot propagation after initial occlusion occurs by stasis clotting accelerated by impaired collaterals.

Introduction: Emboli retrieved from stroke patients undergoing mechanical thrombectomy vastly differ in histopathologic appearance, likely reflecting varying etiologies of stroke. We investigated whether clot components correlated with clinical features and thrombectomy outcomes. Methods: Retrieved thrombi from endovascular thrombectomy in consecutive AIS-LVO patients at 2 academic medical centers were fixed in formalin and sections stained by hematoxylin and eosin. The RBC, WBC and fibrin percentages of the clot were quantified by a neuropathologist blinded to the clinical details. We evaluated the association of these clot components, patient demographic and clinical features, with TICI score (both ordinal and dichotomized at 2c), AOL score, number of thrombectomy passes, and first-pass substantial recanalization (≥TICI 2b result on the first thrombectomy device pass). Non-parametric values were computed via Spearman correlation and pairwise interaction of clinical features was analyzed by ordinal logistic regression. Results: Among the 75 analyzed patients, mean age was 71.4 (SD 17.7), 50.7% were female and presenting NIHSS mean was 16.1 (SD 7.6). Devices employed were stent retrievers in 71% of patients, aspiration in 10%, and both stent retrievers and aspiration in 19%. Number of passes per procedure was mean 2.16 (SD 1.21). Substantial reperfusion (TICI 2B-3) was achieved in 88% and excellent reperfusion (TICI 2C-3) in 44%. In retrieved thrombi, mean RBC% was 44.8% (SD 31.9) and mean fibrin% was 49.8% (SD 31.4). Rates of first-pass substantial reperfusion, final substantial reperfusion, and final excellent reperfusion were homogenous across wide ranges of retrieved thrombus RBC% and fibrin% in correlation analysis. Conclusion: RBC and fibrin composition range widely among retrieved thrombi causing acute ischemic stroke. Current generation thrombectomy devices perform well across a broad range of clot compositions.

Nurse managers play a significant role in the way care is provided by point-of-care nurses. Yet it is unclear what role nurse managers have in supporting nurses in using health information technologies (ITs) specifically. The objectives of this article are to (1) uncover the role of nurse managers in supporting point-of-care nurses to optimally use health ITs and (2) identify strategies that nurse managers can employ to support point-of-care nurses in using these technologies. A scoping review methodology was used, which resulted in the inclusion of 10 relevant articles. Concerning the role of the nurse manager, four themes were identified: (1) decision making, , (2) implementation planning, (3) supporting staff and (4) evaluation. With regard to strategies to support the use of health ITs, two themes were identified: (1) strategies that prepare nurse leaders in their role of supporting point-of-care staff in using health ITs and (2) strategies that directly support point-of-care staff in using health ITs. The results of this review will be of interest to nurse leaders, informatics researchers and nurse informaticians.

Objective: To analyze the relation between occupational psychosocial risks and quality of life related to health, felt by workers who work in oncology and palliative care units in a region of Chile. Method: Cross-sectional analytical study of quantitative approach, in which 110 health workers participated. Research met the ethical requirements of E. Emanuel. Results: Participants perceive greater exposure to psychosocial risks in the dimension of psychological demands and double presence. On the other hand, they see better results in the physical health component (��: 76.72; SD 9.75) versus the mental health component (��: 71.13; SD 6.38). In addition, there are relations with statistical significance, between psychosocial risks and quality of life related to Health (p≤0.05). Conclusions: This study shows that there the perception of psychosocial risks and quality of life are related, when considering the health of workers. RESUMO Objetivo: Analisar a relação entre os riscos psicossociais do trabalho e a qualidade de vida relacionada à saúde, identificada por profissionais que atuam em unidades de oncologia e cuidados paliativos em uma região do Chile. Método: Estudo analítico transversal, de abordagem quantitativa, em que participaram 110 profissionais da Saúde. A pesquisa atendeu os requisitos éticos de E. Emanuel. Resultados: Os participantes identificam uma maior exposição a riscos psicossociais na dimensão de demandas psicológicas e presença dupla; por outro lado, notam melhores resultados no componente da saúde física (��: 76,72; DE 9,75) versus o componente da saúde mental (��:71,13; DE:6,38). Além disso, há conexão, com estatísticas significantes, entre os riscos psicossociais e a qualidade de vida relacionada à Saúde (p ≤0,05). Conclusões: O presente estudo permite afirmar que há uma conexão entre a percepção de riscos psicossociais e a qualidade de vida relacionada com a saúde dos profissionais. RESUMEN Objetivo: analizar la relación entre riesgos psicosociales laborales y calidad de vida relacionada con salud, percibida por trabajadores que se desempeñan en unidades de oncología y cuidados paliativos de una región de Chile. Método: estudio analítico transversal de abordaje cuantitativo, en el cual participaron 110 trabajadores de salud. La investigación cumplió con los requisitos éticos de E. Emanuel. Resultados: los participantes perciben mayor exposición a riesgos psicosociales en la dimensión demandas psicológicas y doble presencia, por otra parte, perciben mejores resultados en el componente de salud física (��: 76,72; DE 9,75) versus el componente de salud mental (��:71,13; DE:6,38). Además, existen relaciones con significancia estadística, entre riesgos psicosocial y calidad de vida relacionada con Salud (p ≤0,05). Conclusiones: este estudio permite afirmar que hay una relación entre la percepción de riesgo psicosocial y calidad de vida relacionada con salud de los trabajadores.

Introducción: La Teoría de la Incertidumbre frente a la Enfermedad es una teoría de enfermería intermedia que explica los procesos que los individuos con enfermedades crónicas atraviesan con el objetivo de lograr la adaptación. Esta teoría describe antecedentes de la incertidumbre, mecanismos de valoración y estrategias de afrontamiento para adaptarse a nuevas condiciones. Objetivo: Demostrar la integración del proceso de enfermería, lenguaje estandarizado y la Teoría de la Incertidumbre en la Enfermedad en el cuidado de una persona con complicaciones físicas y psicosociales tras un macroadenoma hipofisiario. Metodología: Los datos fueron recolectados a través de entrevistas con el paciente, examen físico y el expediente médico. La Teoría de la Incertidumbre frente a la Enfermedad de Mishel, lenguajes estandarizado para describir los diagnósticos, intervenciones y resultados y evidencia científica fueron utilizados para desarrollar el plan de cuidados. Presentación del caso: La teoría de la incertidumbre permitió seleccionar el diagnóstico principal (Afrontamiento ineficaz relacionado con incertidumbre), el cual se abordó con los NIC: mejorar el afrontamiento y enseñanza: proceso de la enfermedad, los resultados medidos fueron NOC: nivel de estrés y conocimiento: manejo de la enfermedad crónica. La efectividad de este enfoque fue reflejado en la mejora de los indicadores. Conclusiones. La identificación de una teoría que pueda explicar los hallazgos y guiar las intervenciones fortalece la calidad del cuidado de enfermería. Esta integración facilita un cuidado de enfermería personalizado y basado en la evidencia.

Objective. The Self-Report Habit Index (SRHI) was originally reported as one-dimensional (Verplanken and Orbell, 2003). Nevertheless, habit has been described as characterized by several features, and one-dimensional models for the SRHI have shown poor fit. Therefore, we aimed to compare multi-dimensional models with a one-dimension model in both snacking and physical activity habits, besides examining further instrument characteristics. Design. A cross-sectional study was conducted with high school and university students (n = 555). Main outcome measure. The SRHI adapted for physical activity and for snaking habits was applied at one single time. Results. Nested models with one factor, two factors, and three factors were compared. Then, a hierarchical second-order model was tested, and further validity issues, as well as invariance between habits, were examined. Three-dimensional models represented a better fit for both habits. However, fit was still non-adequate in the snacking version. Also, discriminant validity concerns raised for the physical activity SRHI. Also, invariance between the snacking and the physical activity versions was not confirmed. Conclusions. Considering the SRHI as composed by the dimensions of “lack of awareness”, “lack of control”, and “history of behavioural repetition” seems to be more accurate. Nevertheless, our findings suggest that further research is needed. Universidad de Costa Rica/[723-B7-306]/UCR/Costa Rica UCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias Sociales::Instituto de Investigaciones Psicológicas (IIP)

Resumen Ortega Muñoz, A., Fumero Pérez, S. y Solano López, A.L. (2021). Autoeficacia, percepción de barreras y beneficios de la actividad física en estudiantes universitarios costarricenses. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 19(2), 1-17. Según la Teoría de Promoción de la Salud, aspectos como autoeficacia, percepción de beneficios y barreras podrían estar influyendo en la actividad física. En Costa Rica, se ha investigado poco este fenómeno en estudiantes universitarios de enfermería, por lo que el objetivo del estudio fue determinar la relación entre autoeficacia y percepción beneficios y barreras de la actividad física en estudiantes de Enfermería de la Universidad de Costa Rica. Esta investigación es un estudio de caso grupal, correlacional descriptivo. La muestra estuvo conformada por 42 estudiantes de segundo año de Enfermería. Los instrumentos utilizados fueron la Escala de Beneficios/Barreras para el ejercicio y la Escala de Autoeficacia para la actividad física. El análisis de datos se realizó mediante estadística descriptiva y la correlación de Pearson. Dentro de los resultados resalta que caminar obtuvo mayor autoeficacia, seguido de actividades de la vida diaria y, por último, el ejercicio físico programado. El estudiantado identifica más los beneficios de la actividad física que las barreras. Existe una asociación entre la autoeficacia total para la actividad física y la percepción de beneficios del ejercicio y la autoeficacia para el ejercicio programado y las barreras del ejercicio. Se debe trabajar en potenciar los beneficios de la actividad física, así como en crear intervenciones que ayuden a la población estudiantil de enfermería a superar las barreras por medio del fortalecimiento de la autoeficacia para la actividad física independientemente de su intensidad. Abstract Ortega Muñoz, A., Fumero Pérez, S. & Solano López, A.L. (2021). Self-effectiveness and perception of barriers and benefits of physical activity in Costa Rican university students. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 19(2), 1-17. According to Health Promotion Theory, factors such as self-effectiveness and the perception of benefits and barriers might be impacting physical activity. Since this phenomenon has been scarcely researched among nursing students, the purpose of this study has been to determine the relationship between self-effectiveness and perceived benefits and barriers of physical activity among nursing students at Universidad de Costa Rica. This research is a correlational, descriptive group case study. The sample was made up by 42 second-year students of the School of Nursing. The instruments used were the Scale of Benefits/Barriers for Exercise and the Self-Effectiveness Scale for Physical Activity. Data analysis was carried out through descriptive statistics and Pearson’s correlation. The most outstanding result was that walking showed higher self-effectiveness, followed by daily life activities and finally scheduled physical exercise. The student community identifies the benefits of physical activities more easily than the barriers. An association exists between total self-effectiveness for physical activity and the perception of benefits of exercise and self-effectiveness for scheduled exercise and the barriers of exercise. Efforts must be made in enhancing the benefits of physical activity, as well as in creating interventions that will help nursing students to overcome barriers by strengthening self-effectiveness for physical activity, regardless of its intensity. Resumo Ortega Muñoz, A., Fumero Pérez, S. e Solano López, A.L. (2021). Autoeficácia, percepção de barreiras e benefícios da atividade física entre universitários costarriquenhos. PENSAR EN MOVIMIENTO: Revista de Ciencias del Ejercicio y la Salud, 19(2), 1-17. De acordo com a Teoria de Promoção da Saúde, aspectos como autoeficácia, percepção de benefícios e barreiras podem estar influenciando a atividade física. Na Costa Rica, pouca pesquisa tem sido feita em estudantes universitários de enfermagem, portanto, o objetivo do estudo foi determinar a relação entre a autoeficácia e a percepção dos benefícios e das barreiras da atividade física entre estudantes de enfermagem da Universidade da Costa Rica. Esta pesquisa é um estudo de caso em grupo correlacional descritivo. A amostra foi composta por 42 estudantes de enfermagem do segundo ano. Os instrumentos utilizados foram a Escala de Benefícios/Barreiras para o Exercício e a Escala de Autoeficácia para Atividade Física. A análise dos dados foi realizada por meio de estatística descritiva e correlação de Pearson. Dentre os resultados, destaca-se que a caminhada alcançou maior autoeficácia, seguida das atividades da vida diária e, por fim, exercício físico programado. Os estudantes identificam mais os benefícios da atividade física do que as barreiras. Existe uma associação entre a autoeficácia total para a atividade física e a percepção de benefícios do exercício e a autoeficácia para o exercício programado e as barreiras do exercício. Deve-se potencializar os benefícios da atividade física, bem como criar intervenções que ajudem a população estudantil de enfermagem a superar barreiras, fortalecendo a autoeficácia para a atividade física, independentemente da intensidade.

Costa Rica is a small developing nation in Central America with a well-regarded universal health care system and a strong human rights tradition. In the latter part of the twentieth century, it became a popular site for clinical trials funded by multinational pharmaceutical companies. In light of concerns about ineffective oversight and alleged research abuses, the Constitutional Chamber of the Supreme Court passed a moratorium on all biomedical studies involving humans. This moratorium was in place between 2010 and 2014, when the Legislative Assembly passed a new national law to protect participants' rights and welfare. This case study reviews the history of human research protections in Costa Rica and provides recommendations for how Costa Rica can move forward responsibly as a leader in human research for the region.

Objective: To analyze the relation between occupational psychosocial risks and quality of life related to health, felt by workers who work in oncology and palliative care units in a region of Chile. Method: Cross-sectional analytical study of quantitative approach, in which 110 health workers participated. Research met the ethical requirements of E. Emanuel. Results: Participants perceive greater exposure to psychosocial risks in the dimension of psychological demands and double presence. On the other hand, they see better results in the physical health component (𝒙: 76.72; SD 9.75) versus the mental health component (𝒙: 71.13; SD 6.38). In addition, there are relations with statistical significance, between psychosocial risks and quality of life related to Health (p≤0.05). Conclusions: This study shows that there the perception of psychosocial risks and quality of life are related, when considering the health of workers.

INTRODUCTION In planning the George W. Bush Presidential Center in Dallas, Texas, former First Lady Laura Bush presented a very clear vision of what the Center should epitomize: “Because George was the first president of the new millennium, I wanted it to be forward and modern.” 1 For the president and Mrs. Bush this meant making the building and landscape environmentally responsible, beautiful, and welcoming. In particular, their love of native Texas landscapes was an important framework for transforming the project’s urban site into a park that was sustainable and experientially rich for visitors. Sustainability was addressed from the start with smart planning that privileged contiguous parkland over impermeable surfaces and structures. Simultaneous consideration of every landscape component—-stormwater, plants, soil, topography, and more—netted cohesive natural systems that are better able to succeed with short-term establishment and provide enduring long-term health, the ultimate goals for a sustainab...

Contenido: ¿Qué es Benchmarking y por qué de su utilidad para la Agenda Investigativa? Organizaciones con mejores prácticas Indicadores auscultados Ejes de reflexión y análisis Conclusiones y Recomendaciones