Pyoderma gangrenosum developing over an arteriovenous fistula scar

A 47-year-old man was admitted to our hospital for a radiocephalic arteriovenous fistula (AVF) in the right arm for dialytic treatment. His past medical history included Wegener granulomatosis diagnosed 8 years previously and chronic kidney disease for which he was receiving kidney replacement therapy in the form of haemodialysis for 7 years. Twenty-four hours after the operation, the patient complained of pain, fever, general discomfort and inflammation in the surgical area. He was admitted to hospital for monitoring and observation. The AVF was dismounted and ligatured and the aneurysmatic area removed and debrided. Response was positive for the first 24 h

Prevalence, Related Factors, and Levels of Burnout Syndrome Among Nurses Working in Gynecology and Obstetrics Services: A Systematic Review and Meta-Analysis

Background: Although burnout levels and the corresponding risk factors have been studied in many nursing services, to date no meta-analytical studies have been undertaken of obstetrics and gynecology units to examine the heterogeneity of burnout in this environment and the variables associated with it. In the present paper, we aim to determine the prevalence, levels, and related factors of burnout syndrome among nurses working in gynecology and obstetrics services. Methods: A systematic review and meta-analysis of the literature were carried out using the following sources: CINAHL (Cumulative Index of Nursing and Allied Health Literature), LILACS (Latin American and Caribbean Health Sciences Literature), Medline, ProQuest (Proquest Health and Medical Complete), SciELO (Scientific Electronic Library Online), and Scopus. Results: Fourteen relevant studies were identified, including, for this meta-analysis, n = 464 nurses. The following prevalence values were obtained: emotional exhaustion 29% (95% CI: 11–52%), depersonalization 19% (95% CI: 6–38%), and low personal accomplishment 44% (95% CI: 18–71%). The burnout variables considered were sociodemographic (age, marital status, number of children, gender), work-related (duration of the workday, nurse-patient ratio, experience or number of miscarriages/abortions), and psychological (anxiety, stress, and verbal violence). Conclusion: Nurses working in obstetrics and gynecology units present high levels of burnout syndrome. In over 33% of the study sample, at least two of the burnout dimensions considered are apparent.This research was funded by the Excellence Research Project (P11HUM-7771) provided by the Andalusian Government (Spain)

Compassion Fatigue, Compassion Satisfaction, and Burnout in Oncology Nurses: A Systematic Review and Meta-Analysis

Professionals working in cancer care are exposed to strong sources of stress. Due to the special characteristics of this unit, the appearance of burnout, compassion fatigue, and low compassion satisfaction is more likely. The principal aim was to analyze the levels and prevalence of burnout, compassion fatigue, and low compassion satisfaction in oncology nurses and interventions for its treatment. The search for the systematic review was done in Medline, ProQuest, Lilacs, CINAHL, Scopus, Scielo, and PsycINFO databases, with the search equation “burnout AND nurs* AND oncology AND compassion fatigue”. The results obtained from the 15 studies confirmed that there are levels of risk of suffering burnout and compassion fatigue among nursing professionals, affecting more women and nurses with more years of experience, with nurses from oncology units having one of the highest levels of burnout and compassion fatigue. The oncology nurse sample was n = 900. The meta-analytic estimations were 19% for low compassion satisfaction, 56% for medium and high burnout, BO, and 60% for medium and high compassion fatigue. The increase in cases of burnout and compassion fatigue in nursing staff can be prevented and minimized with a correct evaluation and development of intervention programs, considering that there are more women than men and that they seem to be more vulnerable

Análisis bayesiano de variables relacionadas con el desarrollo del síndrome de Burnout en profesionales sanitarios

Burnout syndrome has a high incidence among professional healthcare and social workers. This leads to deterioration in the quality of their working life and affects their health, the organization where they work and, via their clients, society itself. Given these serious effects, many studies have investigated this construct and identified groups at increased risk of the syndrome. The present work has 2 main aims: to compare burnout levels in potential risk groups among professional healthcare workers; and to compare them using standard and Bayesian statistical analysis. The sample consisted of 108 psycho-social care workers based at 2 centers run by the Granada Council in Spain. All par-ticipants, anonymously and individually, filled in a booklet that included questions on personal information and the Spanish adaptation of the Maslach Burnout Inventory (MBI). Standard and Bayesian analysis of variance were used to identify the risk factors associated with different levels of burnout. It was found that the information provided by the Bayesian procedure complemented that provided by the standard procedure.El síndrome de Burnout tiene una alta incidencia en profesionales que realizan una labor asistencial o social, lo que implica que el deterioro de su calidad de vida laboral afecta a su propia salud, a la organización en la que desarrollan su trabajo y también, a través de los beneficiarios del mismo, a la sociedad. Las graves consecuencias de padecer Burnout justifican la existencia de muchas investigaciones sobre dicho constructo y sobre la identificación de los grupos de riesgo asociados al mismo. El presente trabajo tiene un doble objetivo, por una parte comparar los niveles de Burnout en posibles grupos de riesgo entre los profesionales sanitarios; y por otra, realizar las comparaciones utitizando procedimientos de análisis estadístico clásico y bayesiano. Participan 108 profesionales que trabajan en atención psicosocio-sanitaria, en dos centros de la Diputación de Granada. Todos ellos respondieron, de forma anónima e individual, a un cuadernillo en el que se incluyen datos personales así como la adaptación a población española del Maslach Burnout Inventory (MBI). Se utilizan análisis de varianza clásico y bayesiano en la identificación de factores de riesgo asociados a diferentes niveles de Burnout. Se comprueba que la información ofrecida por el procedimiento bayesiano permite complementar la ofrecida por el procedimiento clásico

Explanatory Models of Burnout Diagnosis Based on Personality Factors and Depression in Managing Nurses

This study forms part of the Doctoral Thesis of the first-named author (Maria Jose Membrive-Jimenez). Funding for this study was provided by the Andalusian Government Excellence Project (P11-HUM-7771).Nurse managers are affected by burnout due to the high degree of interaction between managers with their registered nurses. Explanatory models based on psychological, and personality related variables purvey an estimation to level changes in the three dimensions of the burnout syndrome. A categorical-response logistic ordinal regression model, supported on a quantitative, crosscutting, multicentre, descriptive study with 86 nursing managers in the Andalusian Health Service in Granada, Spain is performed for each dimension. The three models included different variables related to personality, as well as depression as the only explanatory variable included in all the models. The risk factor neuroticism was significant at population level and related to emotional exhaustion, whilst responsibility was significant in the model estimated to personal accomplishment dimension. Finally, depression was significant for the three dimensions of Burnout. This analysis provides useful information to help the diagnosis and evolution of this syndrome in this collective.Andalusian Government Excellence Project P11-HUM-777

Burnout syndrome and work engagement in nursing staff: a systematic review and meta-analysis

BackgroundA difficult and demanding work environment, such as that often experienced in healthcare, can provoke fatigue, anxiety, distress, and discomfort. This study considers factors that may influence levels of burnout and work engagement among nurses and seeks to determine the relationship between these conditions.MethodA systematic scoping review was performed, in accordance with the PRISMA Extension for Scoping Reviews, based on data obtained from a search of the PubMed/MEDLINE and Scopus databases carried out in 2022 using the search equation: “work engagement AND nurs* AND burnout.” This search identified nine quantitative primary studies suitable for inclusion in our analysis.ResultsWork overload, type of shift worked, and/or area of hospital service, among other elements, are all relevant to the development of burnout. This syndrome can be countered by social support and appropriate personal resources and values, which are all positively associated with work engagement. Our analysis revealed a significant correlation between work engagement and the different domains of burnout. The correlation effect size between burnout and work engagement was −0.46 (95% CI −0.58, −0.31), with p < 0.001.ConclusionWell-targeted interventions in the healthcare work environment can reduce burnout levels, strengthen work engagement, and enhance the quality of healthcare

Efecto de un programa de capacitación en competencias de investigación en estudiantes de ciencias de la salud

The European Higher Education Area implies a change to the Health Science education in Spain. Spanish university system must promote the acquisition of competences in research habits, such as the information management or scientific dissemination. This article presents the findings of a study to evaluate the level of effectiveness and satisfaction of an educational training program on research skills geared towards Health Science students. A hundred and eight students of Physical Therapy degree, Occupational Therapy degree and Nursing degree were participated into a quasi-experimental study. Educational needs were first detected by a questionnaire based on different research skills. A semi-distance educational training program was designed and implemented after defining the above-mentioned needs. This program significantly improved the perception of knowledge and skills in research competences. As well as the level of theory and practical content assimilated by the students significantly increased after the program. These findings suggest that incorporation of specific training that allow for students to come in contact with research, are effective at improving research competences for Health Sciences students.El Espacio Europeo de Educación Superior implica un cambio en la formación universitaria de Ciencias de la Salud en España. El sistema universitario debe promover desde el grado la adquisición de competencias básicas en investigación, como la gestión de información y la comunicación científica. Este artículo presenta los hallazgos de un estudio cuyo objetivo fue evaluar el nivel de eficacia y satisfacción de un programa de capacitación educativa en competencias de investigación dirigido a estudiantes de Ciencias de  la Salud. Se diseñó un estudio cuasiexperimental en el que participaron ciento ocho estudiantes de grado de Fisioterapia, Terapia ocupacional y Enfermería. En una primera fase se detectaron las necesidades educativas en competencias de investigación a través de un cuestionario; a continuación se implementó un programa de capacitación semipresencial y se evaluó el efecto alcanzado en las necesidades antes detectadas.  Este programa mejoró significativamente la percepción de los participantes en relación a su conocimiento y habilidad en competencias de investigación. Del mismo modo, las destrezas cognitivas y prácticas mejoraron considerablemente tras el programa. Estos hallazgos evidencian que la puesta en marcha de programas específicos de capacitación en investigación es efectiva para mejorar la adquisición de competencias a este respecto en estudiantes de Ciencias de la Salud

Emergency and critical care professionals' opinion on escape room as a health sciences evaluation game: A cross-sectional descriptive study

New teaching and evaluation methods are growing in health sciences. The escape room is a game that is showing benefits for assessing knowledge and important competencies in healthcare professionals. The aim of this study is to analyse the opinion of emergency and critical care professionals on the use of escape rooms as an evaluation game.A quantitative, descriptive, cross-sectional study was conducted using an ad-hoc questionnaire with a Likert-type scale. The study included emergency and critical care professionals who participated in the escape room "The Frustrated Emergency and Critical Care Professional," that took place during an emergency and critical care national congress. Data collection was carried out in June 2019.The sample was composed of n = 50 emergency and critical care professionals, 52% of whom were physicians and 48% were nurses. Professionals believe that this is a good teaching game for evaluation and useful for strengthen knowledge (4.7 points), as well as to improve teamwork and the ability to work under pressure (4.9).The escape room is a useful evaluation game in the context of emergency and critical care units that also allows training the teamwork and working under pressure competencies.The authors want to thank SEMES for the opportunity of developing and executing the escape room during their congress

Assessing the Risk of Hypertension in Chronic, Elderly Patients during the COVID-19 Pandemic: A Prospective Study

Background: This study considers care management for older chronic patients during and after the COVID-19 pandemic. Aims: To identify groups of variables at previous time points as a basis for deriving efficient classification models during and after a pandemic situation and to quantify the effect of each variable within the model to predict levels of worsening risk in diastolic and systolic arterial hypertension (AHT). Material and Methods: In this prospective longitudinal study, data were collected at three time points: before, during, and after the COVID-19 pandemic period. Results: The study included 148 patients with an average age of 81.6 years. During the study period, mean systolic blood pressure among this population rose by 5 mmHg to 128.8 mmHg; the number of patients with systolic blood pressure > 140 mmHg rose by 45.3%; among those with diastolic blood pressure > 90, the number rose by 41.2%; mean triglycerides levels rose to 152.6 mg/dL; cholesterol levels rose to 147 mg/dL; and LDL cholesterol rose to 112.2 mg/dL. Meanwhile, mean levels of HDL cholesterol decreased to 46.5 mg/dL. Binary-response logistic regression models were constructed to identify the most relevant variables for predicting AHT risk during and after the pandemic. The heart rate (OR = 1.79; 95% CI: 1.22–2.72) and body mass index (OR = 1.75; 95% CI: 1.08–2.94) variables were significant at the population level (p < 0.05) for diastolic and systolic AHT in the pandemic period risk models. The body mass index variable was also significant for diastolic AHT in the post-pandemic period risk model (OR = 1.97; 95% CI: 1.32–2.94), whilst the triglycerides variable was significant in the systolic AHT post-pandemic period risk model (OR = 1.49; 95% CI: 1.01–1.86). Conclusions: Bad control of arterial hypertension in older patients with chronic disease is associated with elevated levels of LDL cholesterol, total cholesterol, systolic blood pressure, heart rate and triglycerides, and lower levels of HDL cholesterol

Efficacy and Safety of New B Cell-Targeted Biologic Agent for the Treatment of Systemic Lupus Erythematosus: A Systematic Review and Meta-Analysis

Background: B cells are central to the pathogenesis of systemic lupus erythematosus (SLE). We aimed to analyze the efficacy and safety of new B cell-targeted drug therapies for SLE. Methods: A systematic review of randomized controlled trials (RCTs) and reference lists of relevant articles published from inception to 2022 were selected from PubMed, Scopus andWeb of Science databases. Random effects meta-analyses were performed to estimate an overall effect size for the risk of adverse events (AEs) and serious adverse events (SAEs) with belimumab and tabalumab treatment. Heterogeneity was assessed using the I2 statistic and meta-regression. Funnel asymmetry was evaluated using Egger’s test. Results: This study included 13 RCTs, of which three showed high risk of bias. Egger’s test showed no asymmetry. The risk of SAEs and AEs was lower in the treatment group with belimumab treatment. The risk of AEs for tabalumab treatment was lower in the treatment group and lower for SAEs. Conclusion: Belimumab and tabalumab therapies are effective and safe in the treatment of SLE, although tabalumab does not show sufficient statistical power. Advances in understanding the underlying mechanisms of SLE will be directed towards correlating clinical manifestations with specific pathogenic pathways and the development of precision medicine