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ABSTRACT: Objective: To analyse differences in clinical presentation and outcome between bacteraemic pneumococcal community-acquired pneumonia (B-PCAP) and sSvere Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) pneumonia. Methods: This observational multi-centre study was conducted on patients hospitalized with B-PCAP between 2000 and 2020 and SARS-CoV-2 pneumonia in 2020. Thirty-day survival, predictors of mortality, and intensive care unit (ICU) admission were compared. Results: In total, 663 patients with B-PCAP and 1561 patients with SARS-CoV-2 pneumonia were included in this study. Patients with B-PCAP had more severe disease, a higher ICU admission rate and more complications. Patients with SARS-CoV-2 pneumonia had higher in-hospital mortality (10.8% vs 6.8%; P=0.004). Among patients admitted to the ICU, the need for invasive mechanical ventilation (69.7% vs 36.2%; P

Introduction: While preoperative urinary tract infection (UTI) has the potential to cause bacteremia and postsurgical acute prosthetic joint infections (APJIs), the influence of asymptomatic bacteriuria (AB) in these infections remains unclear. So the majority of guidelines not recommend the treatment of AB prior to the surgery. However, as patients with dementia usually cannot explain the symptoms of dysuria, the differential diagnosis between AB and UTI may be very difficult in this group of patients. The principal aim of the study was to compare the rate of positive urine culture at admission in patients with femoral neck fracture with and without dementia and secondarily try to assess the connection of positive urinoculture and postoperative acute gram-negative PJI. Methods: All patients with a femoral neck fracture underwent a urine culture on hospital admission and were prospectively recorded. Variables such as sex, age, institutionalization, dementia and other comorbidities, PJI rate, and in-hospital death were collected. The results of cultures were retrospectively revised. Patients who received postoperative antibiotics or had been diagnosed with UTI during hospital stay were excluded. Statistical comparisons between patients with and without dementia were performed using SPSS software version 17. Results: A total of 148 patients were included (52 with dementia). The rate of positive urine culture was 32% (n = 16) in patients with dementia and 11.5% in patients without dementia ( P = .003). Of these 16 patients with dementia and positive urine culture, 2 (12.5%) developed an acute gram-negative PJI, whereas there were no cases in the group without dementia ( P = .011). Discussion: The only difference between UTI and AB is the expression of symptoms by the patient. However, as patients with dementia have difficulties to explain UTI symptoms, some UTI may be underdiagnosed. Conclusion: Patients with dementia have a statistically higher rate of presurgical positive urine culture compared with patients without dementia.

What Is Known on the Subject: Adult psychiatric services typically focus on the mental health needs of the client but they do not support his or her parenting role. Many authors highlight the importance of a non-judgmental approach when providing support and care to clients with mental illness who are parents. Assessments frequently focus on the negative aspects while the strengths of these families were often overlooked. There is a lack of scientific literature exploring nurses' experiences when caring for parents with mental illness and their families., What This Paper Adds to Existing Knowledge: Trust is the basis that helps clients to be open to receiving care and answering parenting-related questions. Therefore, without adequate professional-client trust, some care and interventions addressed to parents with mental illness could be poorly received by the client. Tronto's phases of care facilitated the collection of data and exploration of mental health nurses' experiences of care., What Are the Implications for Practice: Mental health nurses should be aware of the potential needs of these families, as described in the scientific literature, so they can include them in their assessments. They also should consider the need to individualize each care since each situation of a family with parental mental illness is unique. Mental health nurses must take the person's environment into account (family, social and political aspects and different forms of stigma) since all these factors may influence how parents with mental illness receive and provide care., Abstract: Introduction Many authors highlight the importance of a non-judgmental approach when providing care to parents with mental illness. However, assessments frequently focus on the negative aspects while the strengths of such families were often overlooked. Aim To explore the lived experiences of mental health nurses who care for clients who are parents. Method We conducted a qualitative phenomenological study. The main data collection technique was in-depth interviews. Data were analysed according to Colaizzi model, subsequently, the main categories that arised were compared and related to the five phases of Tronto's care. Results The main categories identified from the analysis of the interviews were: (1) individualized care, (2) continuity of care, (3) psychoeducation and counselling, (4) trust and (5) context of the client. Discussion Trust is the basis that helps parents with mental illness to be open to receiving care and answering parenting-related questions. Without trust, some interventions could be poorly received by the client. Implications for Practice Mental health nurses should be aware of the potential needs of these families, so they can include them in their assessments. They also should consider the need to individualize each care since each situation of a family with parental mental illness is unique., (© 2024 The Authors. Journal of Psychiatric and Mental Health Nursing published by John Wiley & Sons Ltd.)

When a parent has a mental health problem, family members can be affected by it. Nursing professionals can provide care for the whole family, including children. Nurses can support the parental role of parents with mental illness. This integrative review aimed at the following: To identify and to synthesize the views and practices of nurses on parental mental illness (PMI). An integrative review methodology was employed, following PRISMA guidelines. Theoretical and empirical literature was included. Twenty-three articles were obtained to be analysed, using the Whittemore and Knafl approach. A lack of knowledge about nurses' views and practices on PMI was found. Especially, in some demographic areas such as Mediterranean countries and Central and South America. Different issues which influence how nurses perceive PMI were identified: subjective meaning of family concept, personal experience of being parent, and perceptions of mental illness, among others. The main findings on nurses' practices were as follows: guidelines to implement family-focused practices, knowledge, and skills; therapeutic relationship; and teamwork and interagency communication; among others. These issues are intimately related. They could act as enablers or barriers to support parental role of parents with mental illness. Adequate guidelines and policies are necessary to support parents with mental illness and their families. There is a need to include knowledge about PMI and family-focused approach in nursing education curricula. Training could include reflection on nurses' experiences and personal values to become aware of how these can affect their interventions and practices., (© 2021 The Authors. International Journal of Mental Health Nursing published by John Wiley & Sons Australia, Ltd.)

Wound complications are an important cause of postoperative morbidity among patients with gynaecologic malignancies. We evaluated whether the placement of closed-incisional negative pressure therapy (ciNPT) at the time of laparotomy for gynaecologic cancer surgery reduced wound complication rates. A retrospective cohort study with primary wound closure performed by a gynaecologic oncologist was carried out. We evaluated two cohorts of patients who underwent surgery in 2017 with standard closure and patients who underwent surgery in 2019 with the placement of prophylactic ciNPT. Postoperative outcomes were examined. A total of 143 patients were included, 85 (59.4%) vs 58 (40.6%) with standard closure and ciNPT, respectively. The total complication rate in our sample was 38.71%. The rate of surgical complications in patients treated with ciNPT was 6.9% compared with 31.8% (P = .000) in patients treated with standard closure. In the analysis of complications, a significant reduction in infections (17.1%), seromas (15.4%), and wound dehiscence (17.1%) were observed when ciNPT was applied. The median hospital stay was 8 vs 6 days in the standard closure vs ciNPT groups (P = .048). The use of the prophylactic ciNPT following a laparotomy may decrease wound complications and hospital stays in oncological patients. ciNPT could be considered as part of clinical practice in patients at high risk of wound complications, such as patients with gynaecological malignancies., (© 2021 The Authors. International Wound Journal published by Medicalhelplines.com Inc (3M) and John Wiley & Sons Ltd.)

Aim: Quality of life (QoL) has been widely studied in people with schizophrenia. In the early phases of psychosis, it remains often impaired even after the remission of psychotic symptoms. The aim of this study was to explore QoL and social functioning during the first year after a first-episode psychosis (FEP), and to study potential moderating effects of stress measures., Methods: Here, 61 FEP subjects and 55 healthy controls (HCs) were included. Sociodemographic data and clinical variables were collected through a semi-structured interview. Stress measures, social functioning and QoL were assessed with the Holmes-Rahe Social Readjustment Rating Scale, the Perceived Stress Scale, the Social Adaptation Self-Scale and the Euro-QoL-5D, respectively. Analysis of variance was employed with repeated measures and a mediation analysis at baseline and at 1-year follow-up was carried out., Results: Patients reported lower QoL, poorer social functioning and more stress than HC. FEP patients significantly improved in QoL and stress measures over time, but not in social functioning. Perceived stress mediated the association between poorer social functioning and lower QoL., Conclusions: Social functioning at baseline may determine QoL over a 1-year follow-up period. Despite the improvement in most measures, patients do not achieve the level of well-being as the healthy group., (© 2020 John Wiley & Sons Australia, Ltd.)

(1) Background: Sexual violence (SV) has become common in universities for reasons related to unwanted social/peer pressures regarding alcohol/drug use and sexual activities. Objectives: To identify perceptions of SV and alcohol use and estimate prevalence among nursing students in Catalonia, Spain. (2) Methods: Observational descriptive cross-sectional study of a convenience sample of nursing students attending public universities. (3) Results: We recruited 686 students (86.11% women), who reported as follows: 68.7% had consumed alcohol, 65.6% had been drunk at least once in the previous year, 62.65% had experienced blackouts and 25.55% had felt pressured to consume alcohol. Drunkenness and blackouts were related ( p < 0.000). Of the 15.6% of respondents who had experienced SV, 47.7% experienced SV while under the influence of alcohol and were insufficiently alert to stop what was happening, while 3.06% reported rape. SV was more likely to be experienced by women (OR: 2.770; CI 95%: 1.229-6.242; p = 0.014), individuals reporting a drunk episode in the previous year (OR: 2.839; 95% CI: 1.551-5.197; p = 0.001) and individuals pressured to consume alcohol (OR: 2.091; 95% CI: 1.332-3.281; p = 0.001). (4) Conclusions: Nursing instructors need to raise student awareness of both the effects of alcohol use and SV, so as to equip these future health professionals with the knowledge and skills necessary to deal with SV among young people.

The COVID-19 pandemic has had an important impact on the academic world. It is known that university studies can influence the mental health of students, and especially those studying health sciences. In this study, we therefore sought to analyse whether the current pandemic has affected the mental well-being of final-year nursing students. This was a multi-centre study, with a descriptive, longitudinal, and prospective design. Mental well-being was evaluated using the General Health Questionnaire. A total of 305 participants were included in the study, of whom 52.1% had experienced the COVID-19 pandemic. Statistically significant differences were found between the two groups analysed in terms of age, access to university, average marks, mental well-being self-esteem, emotional exhaustion, and sense of coherence. In the case of mental well-being, a direct association was found with both the pandemic situation (OR = 2.32, P = 0.010) and emotional exhaustion scores (OR = 1.20, P < 0.001), while an inverse association was found with sense of coherence scores (OR = 0.45, P < 0.001). This study shows that the mental health of students is a significant factor and one that must be taken into consideration when training nursing staff at university. There is a need to promote healthy habits and provide appropriate coping strategies. It is also important to train and prepare students for pandemic situations as these can have an important impact on the mental health of both the members of the public who will be treated by these future nursing professionals and the students themselves., (© 2021 John Wiley & Sons Australia, Ltd.)

In addition to complying with strict academic standards, nursing students must acquire relevant knowledge and skills, and learn how to carry themselves in different and often stressful professional settings. These obligations could severely affect their mental health. The purpose of this study was to examine the mental health status of undergraduate nursing students and related factors. A total of 1368 nursing students from different universities in Spain and Chile were included in this study, which took place over the 2018-2019 academic year. We assessed their levels of stress related to specific learning methodologies and determined their mental health status using the General Health Questionnaire (GHQ-28). The results revealed that the more advanced the course was, the lower the total GHQ-28 score. The stress generated by different types of training activities had a significant effect on the total GHQ-28 score. These results suggest that nursing education could act as a protective factor against mental health disorders. Although a heavy academic workload could lead to higher levels of stress, overall, it seems that mental health is better in more advanced courses than in initial academic years.

BACKGROUND: The excess of mortality in people with severe mental illness is due to unnatural causes such as accidents or suicides and natural causes such as metabolic syndrome. The presence of modifiable risk factors like tobacco consumption increases cardiovascular and metabolic risk. AIMS: The purpose of this study was to identify the prevalence of metabolic syndrome and other cardiovascular risk factors in people with severe mental illness. This study also aimed to identify the prevalence of patients receiving treatment for any metabolic syndrome risk factor. METHOD: A cross-sectional descriptive study was performed. A total of 125 participants from two community mental health centers in Spain were recruited. RESULTS: More than half of the participants (58.4%) were active smokers. The prevalence of metabolic syndrome was 60%. A total of 16.8% received previous treatment for hypertension, 17.6% for hypertriglyceridemia, and 11.2% for diabetes. No differences were found between centers (22.7% vs. 18.7%, p = .9). CONCLUSIONS: The findings underscore the importance of monitoring the physical health of patients on antipsychotic therapy. The identification and management of cardiovascular and metabolic risks factors is an essential part of nursing care for people with severe mental illness. Mental health nurses are ideally positioned to carry out this task by performing physical health screening, health education, and lifestyle interventions.

Background: Intimate partner violence (IPV) is one of the most important challenges facing today's society. Health professionals, and nurses in particular, play a leading role in addressing this problem. Having an instrument to study Nursing students' perception of this type of violence may enable appropriate and necessary educational strategies for their pre-service training and help them identify and address IPV in their future careers., Objectives: To adapt and validate the IPV scale of Beccaria et al. (2011) in order to study nursing students' perception of IPV., Method: The original instrument (63 items) underwent back-translation. Statistical and metrical analysis in a sample of 1064 students of the four-year Nursing degree program at four public universities in Catalonia (Spain) were based on their responses to the Spanish version., Results: The results of the exploratory factorial analysis and subsequent confirmatory analysis showed that the data had an adequate fit for a four-factor model. The reliability analysis showed adequate internal consistency for each subscale in the instrument: Education (0.83); Identification of the Victim (0.72); Nursing Role and Values (0.78), and Identification of the Perpetrator (0.66)., Conclusion: The translation, cultural adaptation and validation process of the original IPV scale resulted in a Spanish-language instrument (IPV scale Spanish version) with 32 items in four subscales. We concluded that the Spanish version of the instrument is reliable and valid, and that its implementation would enable the assessment of nursing students' perception of IPV situations., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Targeted therapies in endometrial cancer (EC) using kinase inhibitors rarely result in complete tumor remission and are frequently challenged by the appearance of refractory cell clones, eventually resulting in disease relapse. Dissecting adaptive mechanisms is of vital importance to circumvent clinical drug resistance and improve the efficacy of targeted agents in EC. Sorafenib is an FDA-approved multitarget tyrosine and serine/threonine kinase inhibitor currently used to treat hepatocellular carcinoma, advanced renal carcinoma and radioactive iodine-resistant thyroid carcinoma. Unfortunately, sorafenib showed very modest effects in a multi-institutional phase II trial in advanced uterine carcinoma patients. Here, by leveraging RNA-sequencing data from the Cancer Cell Line Encyclopedia and cell survival studies from compound-based high-throughput screenings we have identified the lysosomal pathway as a potential compartment involved in the resistance to sorafenib. By performing additional functional biology studies we have demonstrated that this resistance could be related to macroautophagy/autophagy. Specifically, our results indicate that sorafenib triggers a mechanistic MAPK/JNK-dependent early protective autophagic response in EC cells, providing an adaptive response to therapeutic stress. By generating in vivo subcutaneous EC cell line tumors, lung metastatic assays and primary EC orthoxenografts experiments, we demonstrate that targeting autophagy enhances sorafenib cytotoxicity and suppresses tumor growth and pulmonary metastasis progression. In conclusion, sorafenib induces the activation of a protective autophagic response in EC cells. These results provide insights into the unopposed resistance of advanced EC to sorafenib and highlight a new strategy for therapeutic intervention in recurrent EC.

Objectives: to analyse the knowledge, beliefs and perception of the professional role that nursing students have, about exerted violence against women in relationships., Method: a descriptive qualitative study following the ecological model through 16 focus groups realized with 112 students from four nursing courses of four Spanish universities., Results: the analytical categories were: knowledge, professional role, and beliefs about ones behaviour before the victim and the abuser. Students are unfamiliar with the characteristics of abuse, guidelines, protocols and screening questions and demand patterns for specific intervention. They do not identify their own professional role, be it delegated or specialized. Beliefs regarding their behaviour with the victim, not guided by professional criteria, perceive violence as a specific situation and disassociate the prevention of health care. They perceive the abuser as mentally ill, justifying the tolerance or delegation of performances., Conclusions: students define preconceived ideas about couples' violence. Speeches reproduce and reinforce stereotypical myths, values indicative of inadequate training for nursing studies which raises the need to fortify the competencies in relation to intimate couples' violence in the curriculum.