Non-invasive hemodynamic monitoring in critical care units: Review article

ABStRAct Aims and backgrounds : Hemodynamic monitoring of critical patients in intensive care units is the cornerstone of care. It constitutes an extensive part of care and is helpful in determination of the causes and the response to treatment of hemodynamic instability. The aim of this review article is to evaluate non invasive hemodynamic monitoring in critical care units. Materials and Methods: 61 articles were allocated to this study with the time frame covered from 1890 to 2010. The references of this review article were obtained from Pubmed, Elsevier, Google scholar, Elsevier mason, Science direct, and JAMA. The authors have also used the keywords including: cardiac output, non-invasive, intensive care unit, oxygenation, upstream, downstream markers,hemodynamic monitoring, minimally invasive methods, and circulatory shock. Findings: The results of this study show that the desirable and premium monitoring of serious patients in intensive care units have yet remained as a challenge. Awareness of cardiac output which is the most important indicator of cardiac function is of vital importance for deciding on the method of clinical management, selecting treatment method, clinical assessment, and prognosis of the patients suffering from cardiac problems. conclusions: A lot of such studies show that the Non-invasive monitoring system of cardiac output is easier, safer, cheaper, and more effective than the invasive monitoring system .If this method is used properly,it could reduce the mortality and morbidity rate

Development and Testing of the Psychometric Properties of the Attitude Towards Medical Device-related Pressure Ulcers/Injuries Questionnaire

BACKGROUND: Medical device-related pressure ulcers/injuries (MDRPU/Is) are a serious concern in health care. PURPOSE: To develop and assess the psychometric testing of a questionnaire to measure nursing students' attitudes about the care and prevention of MDRPU/Is. METHODS: Based on a review of the literature, a 26-item questionnaire was developed; face validity was assessed by ten (10) nursing students. The modified Lawshe's model was used, and both the content validity index (CVI) and content validity ratio were calculated. Items with a CVI more than 0.63 were retained. The minimum optimal CVI for the new instrument was 79%. Qualitative assessments were performed by 10 experienced faculty members. One-hundred-andeighty seven (187) nursing students participated in the construct validity testing of the 11-item questionnaire. The Kaiser-Meyer-Olkin test of sampling adequacy and Bartlett's test of sphericity were performed. Following analysis of the main components and the varimax rotation, the factor analysis was determined. Internal consistency (Cronbach's alpha) and test-retest were determined using Pearson's correlation and intraclass correlation coefficient to evaluate reliability. RESULTS: During the face validity phase of the initial 26 items, 7 items had impact scores less than 1.5. After calculating the CVI and content validity ratio for all items, 8 items did not achieve the desirable score. After performing exploratory factor analysis on the remaining 11 items, the Kaiser-MeyerOlkin test value was 0.789, and Bartlett's test of sphericity was 0.0001, which was statistically significant. Internal consistency of items (Cronbach's alpha of 0.77) showed that all items had a high correlation. The reliability of test-retest was significant using an intraclass correlation coefficient of 0.75 and Pearson's correlation coefficient of 0.86 at P < .005. CONCLUSION: In this sample of nursing students, the Attitude Towards Medical-device Related Pressure Ulcers/Injuries Questionnaire was valid and reliable. Studies including licensed clinicians are needed to confirm these results

Burden of breast cancer and attributable risk factors in the North Africa and Middle East region, 1990–2019:a systematic analysis for the Global Burden of Disease Study 2019

Background: Breast cancer (BC) is the most common cancer in women globally. The North Africa and Middle East (NAME) region is coping hard with the burden of BC. We aimed to present the latest epidemiology of BC and its risk factors in this region. Methods: We retrieved the data on BC burden and risk factors from the Global Burden of Disease Study 2019 to describe BC status in the 21 countries of the NAME region from 1990 to 2019. We explored BC incidence, prevalence, deaths, disability-adjusted life years (DALYs), and attributable burden to seven risk factors of female BC, namely, alcohol use, diet high in red meat, low physical activity, smoking, secondhand smoke, high body mass index, and high fasting plasma glucose. Decomposition analysis on BC incidence trend was done to find out the contributing factors to this cancer’s growth. Results: In 2019, there were 835,576 (95% uncertainty interval: 741,968 to 944,851) female and 10,938 (9,030 to 13,256) male prevalent cases of BC in the NAME region. This number leads to 35,405 (30,676 to 40,571) deaths among female patients and 809 (654 to 1,002) deaths in male patients this year. BC was responsible for 1,222,835 (1,053,073 to 1,411,009) DALYs among female patients in 2019, with a greater proportion (94.9%) of burden in years of life lost (YLLs). The major contributor to female BC incidence increase in the past three decades was found to be increase in age-specific incidence rates of BC (227.5%), compared to population growth (73.8%) and aging (81.8%). The behavioral risk factors were responsible for majority of attributable female BC burden (DALYs: 106,026 [66,614 to 144,247]). High fasting plasma glucose was found to be the risk factor with the largest effect (DALYs: 84,912 [17,377 to 192,838]) on female BC burden. Conclusion: The increasing incidence and burden of BC in the NAME region is remarkable, especially when considering limited resources in the developing countries of this region. Proper policies like expanding screening programs and careful resource management are needed to effectively manage BC burden