CHRONOFALLS: A multicentre nurse-led intervention in the chronoprevention of in-hospital falls in adults

Background: Falls are among the most common and serious adverse events for hospitalised patients. In-hospital falls pose a major medical and economic challenge for public health worldwide. Nevertheless, the issue is often addressed without regard to certain relevant variables such as the time of the fall. The aim of this study was to determine the effect of the implementation of a nurse-led intervention based on the temporal patterns of falls and their aetiology on the occurrence of falls. Methods: A mixed-method research design was carried out in three phases: a) a longitudinal prospective study (audits, chronobiological analyses and implementation of a multicentre nurse-led intervention based on temporal patterns of falls); b) a retrospective study of fall records; and c) a qualitative study based on focus groups. The protocol was published in 2021. Results: A difference was observed in the number of fall records before and after the chronopreventive intervention (retrospective: 64.4% vs. 35.6%; p < 0,001). According to the interrupted series analysis, considering the influence of the COVID-19 pandemic, a reduction in falls of 2.96% (95% CI 1.70%-4.17%) was observed. The concepts of falls, the COVID-19 pandemic and the causes of non-registration have emerged as categories for qualitative analysis. Conclusions: A multicentric nurse-led program based on tailored organisational, educational and behavioural chronopreventive measures seems to lead to a reduction in the number of in-hospital falls. The findings of the present study, highlighting the implementation of chronopreventive measures, can serve as a basis for future health policies

CORRELACIÓN ENTRE CARGA DE TRABAJO, SÍNDROME DE BURNOUT Y CALIDAD DE VIDA EN UNA UNIDAD DE CRÍTICOS

Objetives To detect Burnout Syndrome in nurses working in the resuscitation unit; Assessing their life quality, and correlating work load, Burnout Syndrome and life quality. Methods Descriptive and cross section study. Sample: Nursing personnel of the resuscitation unit at the CHUS hospital. Two questionnaires were used: Test of Life quality, Satisfaction and Pleasure, and Maslach Burnout Inventory (MBI). Results According to the MBI average obtained in the three sections: Emotional Tiredness, Depersonalization, and Personal Fulfillment, the following facts were observed: On average a higher MBI score in women than in men, as well as a higher score in married persons than in singles. Emotional tiredness and personal fulfillment are lower in men than in women. Meanwhile, depersonalization is higher in men. Conclusions Personnel with 3 to 6 years of experience in the unit: higher emotional tiredness; from 6 to 9 years: Higher level of depersonalization; More than 9 years: maximum level of personal fulfillment.Objetivos Detectar Síndrome de Burnout entre los DUE de Reanimación; evaluar calidad de vida y correlacionar carga de trabajo, S. Burnout y calidad de vida. Métodos Estudio descriptivo y transversal. Muestra: plantilla de DUE de Reanimación CHUS. Se emplearon dos cuestionarios: Test de Calidad de Vida, Satisfacción y Placer y el Maslach Burnout Inventory (MBI). Resultados Según la media obtenida del MBI en los tres apartados (cansancio emocional, despersonalización, realización personal) se observó: una media de puntuación del MBI superior en la mujer que en el hombre; mayor en casados que en solteros. El cansancio emocional y la realización personal son menores en el hombre que en la mujer y la despersonalización es superior en el hombre. Conclusiones De 3 a 6 años, mayor cansancio emocional; de 6 a 9, mayor nivel de despersonalización; personal con más de 9 años de antigüedad en el servicio, máximo grado de realización personal

GLUCONATO CÁLCICO 10% ENDOVENOSO: CUIDADOS DE LAS VÍAS DE INFUSIÓN EN PREMATUROS

Administration of 10% calcium gluconate in premature neonates and at due time is a habitual technique, which takes place in neonatal and neonatology ICUs as a complement of the parenteral nutrition administration and when dealing with certain pathologies. In spite of being a usual technique, it can lead to a series of complications which must be controlled. The creation of this protocol allows us to administrate 10% calcium gluconate in a safe way and to try to control the complications that can be associated with it such as extravasation and later calcification.La administración de gluconato cálcico al 10% en neonatos prematuros y a término es una técnica habitual que se desarrolla en las unidades de UCI neonatal y neonatología como complemento a la administración de nutriciones parenterales y ante algunas patologías. A pesar de ser una técnica habitual, puede llevar asociada una serie de complicaciones que debemos controlar. La creación de este protocolo nos permite administrar el gluconato cálcico 10% de forma segura y tratar de controlar las complicaciones que pueden asociarse como la extravasación y posterior calcificación

Estudio preliminar de la ingesta de nutrientes de niños deportistas de Sierra Nevada

A study was conducted of the diet of a child Alpine ski competition team (Monachil Club, Sierra Nevada). The children,aged between 7-12 years old, were divided into two groups. One of which were residents at a ski resort and the other,residents from different cities, who practised skiing at the same resort at weekends only.A 24-hour recall questionnaire was carried out, from which the following data was collected: The mean energy valuefrom diet intake was determined at 3,218 ± 819 Kcal/day (ski resort group) and 2,485 ± 600 Kcal/day (city group). Nosignificant differences between the groups was observed (p≥0.3). The distribution of energy from energetic nutrients wascorrect for the ski resort group, both at the weekend and during the week; the city group had an excessive intake oflipids (43%) and proteins (17%), and the energy from carbohydrates did not reach 55%. A modification in the diet andintake of energy and nutrients was observed when the children moved from their family home to the ski resortSe ha realizado un estudio de la dieta del equipo de competición infantil en esquí alpino (Club Monachil, SierraNevada). Son niños con edades entre 7-12 años. Se consideran dos grupos, los residentes en la estación de esquí ylos de ciudad que esquían en fin de semana.Se han realizado encuestas de recuerdo 24 horas. El valor medio de energía, es 3218 Kcal/dia ± 819 (grupo de lasierra) y 2485 Kcal/dia ± 600 (grupo de ciudad), no existen diferencias significativas entre grupos (p≥0,3). Ladistribución de energía a partir de los nutrientes energéticos es correcta para los niños deportistas de la sierra, tantoen el fin de semana como entre semana; los niños deportistas de ciudad tienen un consumo excesivo de lípidos (43%)y prótidos (17%), el aporte de energía de carbohidratos no llega al 55%. Se observa una modificación de la dietay del consumo de energía y nutrientes cuando los niños pasan del hogar familiar a la practica del deporte

Sublittoral soft bottom communities and diversity of Mejillones Bay in northern Chile (Humboldt Current upwelling system)

The macrozoobenthos of Mejillones Bay (23°S; Humboldt Current) was quantitatively investigated over a 7-year period from austral summer 1995/1996 to winter 2002. About 78 van Veen grab samples taken at six stations (5, 10, 20 m depth) provided the basis for the analysis of the distribution of 60 species and 28 families of benthic invertebrates, as well as of their abundance and biomass. Mean abundance (2,119 individuals m-2) was in the same order compared to a previous investigation; mean biomass (966 g formalin wet mass m-2), however, exceeded prior estimations mainly due to the dominance of the bivalve Aulacomya ater. About 43% of the taxa inhabited the complete depth range. Mean taxonomic Shannon diversity (H', Log e) was 1.54 ± 0.58 with a maximum at 20 m (1.95 ± 0.33); evenness increased with depth. The fauna was numerically dominated by carnivorous gastropods, polychaetes and crustaceans (48%). About 15% of the species were suspensivorous, 13% sedimentivorous, 11% detritivorous, 7% omnivorous and 6% herbivorous. Cluster analyses showed a significant difference between the shallow and the deeper stations. Gammarid amphipods and the polychaete family Nephtyidae characterized the 5-mzone, the molluscs Aulacomya ater, Mitrella unifasciata and gammarids the intermediate zone, while the gastropod Nassarius gayi and the polychaete family Nereidae were most prominent at the deeper stations. The communities of the three depth zones did not appear to be limited by hypoxia during non-El Niño conditions. Therefore, no typical change in community structure occurred during El Niño 1997–1998, in contrast to what was observed for deeper faunal assemblages and hypoxic bays elsewhere in the coastal Humboldt Current system

Towns with extremely low mortality due to ischemic heart disease in Spain

BACKGROUND: The cause of coronary disease inframortality in Spain is unknown. The aim of this study is to identify Spanish towns with very low ischemic heart disease mortality, describe their health and social characteristics, and analyze the relationship with a series of contextual factors. METHODS: We obtained the number of deaths registered for each of 8,122 Spanish towns in the periods 1989-1998 and 1999-2003. Expected deaths, standardized mortality ratio (SMR), smoothed Relative Risk (RR), and Posterior Probability (PP) of RR > 1 were calculated using Bayesian hierarchical models. Inframortality was defined as any town that displayed an RR below the 10th percentile, an SMR of under 1 for both sexes, and a PP of RR > 1 less than or equal to 0.002 for male and 0.005 for female mortality, during the two periods covered. All the remaining towns, except for those with high mortality classified as "tourist towns", were selected as controls. The association among socioeconomic, health, dietary, lifestyle and vascular risk factors was analyzed using sequential mixed logistic regression models, with province as the random-effects variable. RESULTS: We identified 32 towns in which ischemic heart disease mortality was half the national rate and four times lower than the European Union rate, situated in lightly populated provinces spread across the northern half of Spain, and revealed a surprising pattern of geographic aggegation for 23 of the 32 towns. Variables related with inframortality were: a less aged population (OR 0.93, 95% CI 0.89-0.99); a contextual dietary pattern marked by a high fish content (OR 2.13, 95% CI 1.38-3.28) and wine consumption (OR 1.50, 95% CI 1.08-2.07); and a low prevalence of obesity (OR 0.47, 95% CI 0.22-1.01); and, in the case of towns of over 1000 inhabitants, a higher physician-population ratio (OR 3.80, 95% CI 1.17-12.3). CONCLUSIONS: Results indicate that dietary and health care factors have an influence on inframortality. The geographical aggregation suggests that other factors with a spatial pattern, e.g., genetic or environmental might also be implicated. These results will have to be confirmed by studies in situ, with objective measurements at an individual level.This study was funded by research study grant no. PI06/0656 from Spain's Health Research Fund (Fondo de Investigación Sanitaria).S