Risiko- & [und] Schutzfaktoren der psychischen Gesundheit humanitärer Einsatzhelfer: eine systematische Literaturübersicht

En toute mission humanitaire, les participants sont confrontés à des situations difficiles. Cela peut avoir un impact négatif sur leur santé mentale. Un soutien efficace pour les participants est donc important.In jedem humanitären Einsatz werden die Teilnehmer mit herausfordernden Situationen konfrontiert. Diese können sich belastend auf deren psychische Gesundheit auswirken. Eine effektive Unterstützung der Einsatzteilnehmer ist deshalb wichtig

Competencies of nurse practitioners in family practices: A scoping review

Aims and objective To explore the existing literature related to nurse practitioner (NP) competencies in family practices and to examine the evidence and develop a list of competencies. Background The integration of NPs into the healthcare system is at different stages of progress around the world. Therefore, an overview and clarification of competencies are important to ensure successful implementation of new roles in existing healthcare systems. However, detailed knowledge is lacking about the competencies of NPs in adult care in family practices. Design and methods We conducted a scoping review in accordance with the JBI methodology for scoping reviews and the PRISMA-ScR guidelines. We considered studies published in English, German or French from 1965 to the present. Databases searched included MEDLINE, CINAHL, Web of Science and PsycINFO. Sources of grey literature that were searched included ProQuest Dissertations and Theses, OpenGrey and websites of national NP organisations. Two reviewers retrieved full-text studies and extracted data independently. We described the competencies using Hamric's model of advanced practice nursing. Results We included 23 publications. Competencies in direct clinical practice were described most often particularly pertaining to nursing or medical tasks. Indirect care activities were frequently mentioned. Less information was found regarding competencies in leadership, ethical decision-making and evidence-based practice. We found elementary and extended competencies required to perform the role in family practices. Depending on the country, the role was either emerging or already well-established. Conclusions and relevance to clinical practice This review provides insight into current knowledge about competencies of NP in family practices. The identified competencies can be used to develop job descriptions or to conceptualise professional development programmes in countries where such roles are just recently emerging. A list of competencies will promote a common understanding of the NP role and to help clarify interprofessional collaboration in clinical practice

Competencies and scope of practice of nurse practitioners in primary health care: a scoping review protocol

OBJECTIVE: The objective of this scoping review is to explore existing literature about nurse practitioners' competencies and scope of practice in primary health care in order to examine and conceptually map the evidence and identify gaps in the literature. INTRODUCTION: To meet growing health care needs, current primary health care models have expanded to include nurse practitioners. The integration of nurse practitioners in primary health care is challenging. This is mainly due to the lack of a unified definition of the role, competencies, or clear criteria to determine scope of practice. INCLUSION CRITERIA: This scoping review will consider studies addressing nurse practitioner practice in primary health care. The focus lies on nurse practitioner competencies (eg, core competencies or practice activities) and scope of practice (eg, areas of responsibility or legally defined professional boundaries). Studies that were conducted in primary health care settings in rural, urban, and suburban regions where nurse practitioners are employed will be included. METHODS: Studies published in English, German, or French from 1965 to present will be considered. The databases to be searched include PubMed, CINAHL, Web of Science, and PsycINFO. Sources of unpublished studies and gray literature to be searched will include ProQuest Dissertations and Theses, OpenGrey, and websites of national nurse practitioner organizations. Retrieval of full-text studies and data extraction will be performed independently by two reviewers. The extracted data will be presented in tables or graphs, with an accompanying narrative summary

Myocardial involvement in children with post-COVID multisystem inflammatory syndrome: a cardiovascular magnetic resonance based multicenter international study—the CARDOVID registry

BACKGROUND: Recent evidence shows an association between coronavirus disease 2019 (COVID-19) infection and a severe inflammatory syndrome in children. Cardiovascular magnetic resonance (CMR) data about myocardial injury in children are limited to small cohorts. The aim of this multicenter, international registry is to describe clinical and cardiac characteristics of multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19 using CMR so as to better understand the real extent of myocardial damage in this vulnerable cohort. METHODS AND RESULTS: Hundred-eleven patients meeting the World Health Organization criteria for MIS-C associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), having clinical cardiac involvement and having received CMR imaging scan were included from 17 centers. Median age at disease onset was 10.0 years (IQR 7.0–13.8). The majority of children had COVID-19 serology positive (98%) with 27% of children still having both, positive serology and polymerase chain reaction (PCR). CMR was performed at a median of 28 days (19–47) after onset of symptoms. Twenty out of 111 (18%) patients had CMR criteria for acute myocarditis (as defined by the Lake Louise Criteria) with 18/20 showing subepicardial late gadolinium enhancement (LGE). CMR myocarditis was significantly associated with New York Heart Association class IV (p = 0.005, OR 6.56 (95%-CI 1.87–23.00)) and the need for mechanical support (p = 0.039, OR 4.98 (95%-CI 1.18–21.02)). At discharge, 11/111 (10%) patients still had left ventricular systolic dysfunction. CONCLUSION: No CMR evidence of myocardial damage was found in most of our MIS-C cohort. Nevertheless, acute myocarditis is a possible manifestation of MIS-C associated with SARS-CoV-2 with CMR evidence of myocardial necrosis in 18% of our cohort. CMR may be an important diagnostic tool to identify a subset of patients at risk for cardiac sequelae and more prone to myocardial damage. Clinical trial registration: The study has been registered on ClinicalTrials.gov, Identifier NCT04455347, registered on 01/07/2020, retrospectively registered

Environmental and societal factors associated with COVID-19-related death in people with rheumatic disease: an observational study

Published by Elsevier Ltd.Background: Differences in the distribution of individual-level clinical risk factors across regions do not fully explain the observed global disparities in COVID-19 outcomes. We aimed to investigate the associations between environmental and societal factors and country-level variations in mortality attributed to COVID-19 among people with rheumatic disease globally. Methods: In this observational study, we derived individual-level data on adults (aged 18-99 years) with rheumatic disease and a confirmed status of their highest COVID-19 severity level from the COVID-19 Global Rheumatology Alliance (GRA) registry, collected between March 12, 2020, and Aug 27, 2021. Environmental and societal factors were obtained from publicly available sources. The primary endpoint was mortality attributed to COVID-19. We used a multivariable logistic regression to evaluate independent associations between environmental and societal factors and death, after controlling for individual-level risk factors. We used a series of nested mixed-effects models to establish whether environmental and societal factors sufficiently explained country-level variations in death. Findings: 14 044 patients from 23 countries were included in the analyses. 10 178 (72·5%) individuals were female and 3866 (27·5%) were male, with a mean age of 54·4 years (SD 15·6). Air pollution (odds ratio 1·10 per 10 μg/m3 [95% CI 1·01-1·17]; p=0·0105), proportion of the population aged 65 years or older (1·19 per 1% increase [1·10-1·30]; p<0·0001), and population mobility (1·03 per 1% increase in number of visits to grocery and pharmacy stores [1·02-1·05]; p<0·0001 and 1·02 per 1% increase in number of visits to workplaces [1·00-1·03]; p=0·032) were independently associated with higher odds of mortality. Number of hospital beds (0·94 per 1-unit increase per 1000 people [0·88-1·00]; p=0·046), human development index (0·65 per 0·1-unit increase [0·44-0·96]; p=0·032), government response stringency (0·83 per 10-unit increase in containment index [0·74-0·93]; p=0·0018), as well as follow-up time (0·78 per month [0·69-0·88]; p<0·0001) were independently associated with lower odds of mortality. These factors sufficiently explained country-level variations in death attributable to COVID-19 (intraclass correlation coefficient 1·2% [0·1-9·5]; p=0·14). Interpretation: Our findings highlight the importance of environmental and societal factors as potential explanations of the observed regional disparities in COVID-19 outcomes among people with rheumatic disease and lay foundation for a new research agenda to address these disparities.MAG is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (grant numbers K01 AR070585 and K24 AR074534 [JY]). KDW is supported by the Department of Veterans Affairs and the Rheumatology Research Foundation Scientist Development award. JAS is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (grant numbers K23 AR069688, R03 AR075886, L30 AR066953, P30 AR070253, and P30 AR072577), the Rheumatology Research Foundation (K Supplement Award and R Bridge Award), the Brigham Research Institute, and the R. Bruce and Joan M. Mickey Research Scholar Fund. NJP is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (T32-AR-007258). AD-G is supported by grants from the Centers for Disease Control and Prevention and the Rheumatology Research Foundation. RH was supported by the Justus-Liebig University Giessen Clinician Scientist Program in Biomedical Research to work on this registry. JY is supported by grants from the National Institutes of Health (K24 AR074534 and P30 AR070155).info:eu-repo/semantics/publishedVersio