Dry care versus chlorhexidine cord care for prevention of omphalitis. Systematic review with meta-analysis

Objective: to compare the effect of dry care and the application of chlorhexidine to the umbilical cord of newborns at risk of developing omphalitis. Method: systematic review with meta-analysis. Clinical trials comparing dry care with the application of clorexidine to evaluate omphalitis were selected. Methodological quality was evaluated using the Consolidated Standards of Reporting Trials. Results: the joint analysis of the studies shows a significant decrease in the risk of omphalitis in the chlorhexidine group compared to the dry care group (RR=0.58, CI: 0.53-0.64). However, in the analysis by subgroups, chlorhexidine umbilical cord care did not reduce the risk of omphalitis in hospital births (RR=0.82, CI: 0.64-1.05), in countries with a low infant mortality rate (RR=0.8, CI: 0.5-1.28), or at chlorhexidine concentrations below 4% (RR=0.55, CI: 0.31-1). Chlorhexidine acted as a protective factor at a concentration of 4% (RR=0.58, CI: 0.53-0.64), when applied in cases of home births (RR=0.57, CI: 0.51-0.62), in countries with a high infant mortality rate (RR=0.57, CI: 0.52-0.63). Conclusion: dry cord care is effective in countries with low infant mortality rate and in hospital births. However, 4% chlorhexidine for umbilical cord care protects against omphalitis in home births, in countries with a high infant mortality rate

Estudio estratigráfico y de correspondencia de los parámetros decorativos de la escalera de la Santa Cueva de Cádiz. Definición del proyecto de intervención

El templo de la Santa Cueva situado en la calle Rosario es un conjunto histórico artístico compuesto de una capilla baja o subterránea, dedicada a la meditación de la Pasión de Cristo, y de otra alta, u oratorio, consagrado al Santísimo Sacramento. Su construcción se llevó a cabo en la segunda mitad del siglo XVIII en estilo clasicista o neoclásico. El día 31 de marzo de 1796 se bendijo e inauguró el oratorio, culminándose la obra del conjunto

Sexuality and contraceptive knowledge in university students: instrument development and psychometric analysis using item response theory

Background As a consequence of biological, psychological and social changes during puberty, youth is a period characterized by impulsiveness and risk-taking. Members of this population often feel invulnerable and have a strong motivation to explore their identity. A good level of knowledge is necessary to allow young people to experience their sexuality in a healthy way, without associated risks. In our environment there is currently no valid Spanish-language tool to measure the level of knowledge about sexuality and contraception. This study sought to develop and test the psychometric properties of a new sexuality and contraception knowledge instrument. Methods This is a cross-sectional study to validate the sexuality and contraception knowledge instrument. The validation process followed four phases: (1) development of the instrument, (2) content validation by an expert panel, (3) pilot test and (4) psychometric analysis of the instrument using item response theory according to the Rasch model. The validation process took place from September 2017 to February 2018. Results The sample included 387 students enrolled at the Nursing and Law degrees from the University of Jaen. The final instrument was made up of 15 items. All of the items presented good adaptation values with respect to the model. The scale showed good fit and reliability: 0.99 for items and 0.74 for people. The temporal stability of the scale was calculated using test–retest, obtaining a value of 0.81 (CI 0.692–0.888). The construct validity showed the one-dimensionality of the construct, while the discriminant validity obtained good results, so the scale appears to be able to differentiate between participants with low or high levels of knowledge. Conclusion The results suggest the Sexuality and Contraception Knowledge Instrument is psychometrically valid and reliable for measuring the knowledge level concerning sexuality and contraceptive methods in young university students

Educational program on sexuality and contraceptive methods in nursing degree students

Background: Previous educational programs about sexuality and contraceptive methods are delivered through vertical teaching methodology and use an increase in knowledge level as an indicator of effectiveness; however, attitudes towards contraceptive use are not addressed. Objectives: This study aimed to evaluate the effect of a peer-educational intervention to improve knowledge level and attitudes regarding contraceptive methods in university students. Design: A pre-post quasi-experimental study. Settings: Young university students from a Spanish university. Participants: 131 students in their second year of the Nursing degree program. Methods: An intervention consisting of two 3-hour sessions was conducted. The first session introduced the main aspects of contraceptive methods and was conducted by the teacher. The second session began with student presentations about contraceptive methods, followed by clinical simulations of a family planning service that the students had to implement and solve. Results: There was a 71.43% improvement in the knowledge level scale score and a 2.17% improvement in the attitudes towards the use of contraceptive methods; both were statistically significant (p < 0.001). For 11 of the 15 items in the knowledge scale, a significantly higher proportion of success was found after the intervention. Conclusion: Peer-educational intervention was effective in improving knowledge level and attitudes about contraceptive methods

Psychometric Testing of the Spanish Modified Version of the Mini-Suffering State Examination

Background: The mini-suffering state examination is a valid and reliable measure that have been used to assess suffering in patients with advanced cancer. The aim of this study was to carry out a psychometric analysis of the Spanish version of the mini-suffering state examination. Method: A validation study was conducted. Seventy-two informal caregivers of deceased patients in palliative care were included in this study. A psychometric testing of content validity, internal consistency, and convergent validity with the Spanish version of the quality of dying and death questionnaire was performed. Results: The original instrument was modified to be used by informal caregivers. The content validity was acceptable (0.96), and the internal consistency was moderate (α = 0.67). Convergent validity was demonstrated (r = −0.64). Conclusion: The Spanish modified version of the MSSE showed satisfactory measurement properties. The Spanish modified version of MSSE can be useful to facilitate screening, monitor progress, and guide treatment decisions in end-of-life cancer patients

Knowledge, skills and attitudes related to evidence-based practice among undergraduate nursing students: A survey at three universities in Colombia, Chile and Spain

Teaching nursing students about the model of evidence-based practice is a challenge for university faculty. The aim of this study was to measure knowledge, skills and attitudes related to evidence-based practice among undergraduate nursing students, as well as associated factors. The study involved a cross-sectional design using a survey of all students enrolled in a Bachelor of Nursing programme (1st to 4th year) in three nursing faculties of universities in Chile, Colombia and Spain. The Spanish version of the Evidence-Based Competence Questionnaire was used to measure knowledge, skills, attitudes and overall competency. In total, 875 students completed the questionnaire. The overall score of competency in evidence-based practice was similar in all three universities (range 1–5) (3.63 in Chile, 3.58 in Colombia and 3.68 in Spain). The score of self-rated attitudes was strongly correlated with the overall competency measured. More hours of training in research methods and reading nursing journals articles in the last month were the factors associated with higher scores in evidence-based practice competency. The undergraduate nursing students at the three universities surveyed obtained a high score in overall competency in evidence-based practice. No differences were found among them, despite the different approaches used in educational programmes

Climate change effects in older people's health: Ascoping review

Background: Climate change has serious consequences for the morbidity and mortal-ity of older adults.Objective: To identify the effects of climate change on older people's health.Methods: A scoping review was conducted following the Joanna Briggs Instituteguidelines and the PRISMA-ScR checklist. Quantitative research and reports from or-ganizations describing the effects of climate change on older people were selected.Results: Sixty-three full-text documents were selected. Heat and air pollution werethe two factors that had the most negative effects on cardiovascular and respiratorymorbidity and mortality in older people. Mental health and cognitive function werealso affected.Conclusions: Climate change affects several health problems in older individuals,especially high temperatures and air pollution. Nursing professionals must have thenecessary skills to respond to the climate risks in older adults. More instruments arerequired to determine nursing competencies on climate change and the health of thispopulation group

Hospitalised patients with palliative care needs: Spain and Sweden compared

Objectives This study aimed to describe and compare symptoms, care needs and types of diagnoses in hospitalised patients with palliative care needs in Spain and Sweden. Methods A cross-sectional, population-based study was carried out at two hospitals in both Spain and Sweden. Using a questionnaire, we performed 154 one-day inventories (n=4213) in Spain and 139 in Sweden (n=3356) to register symptoms, care needs and diagnoses. Descriptive analyses were used. Results The proportion of patients with care needs in the two countries differed (Spain 7.7% vs Sweden 12.4%, p<0.001); however, the percentage of patients with cancer and non-cancer patients was similar. The most prevalent symptoms in cancer and non-cancer patients in both countries were deterioration, pain, fatigue and infection. The most common cancer diagnosis in both countries was lung cancer, although it was more common in Spain (p<0.01), whereas prostate cancer was more common among Swedish men (p<0.001). Congestive heart failure (p<0.001) was a predominant non-cancer diagnosis in Sweden, whereas in Spain, the most frequent diagnosis was dementia (p<0.001). Chronic obstructive pulmonary disease was common in both countries, although its frequency was higher in Spain (p<0.05). In total, patients with cancer had higher frequencies of pain (p<0.001) and nausea (p<0.001), whereas non-cancer patients had higher frequencies of deterioration (p<0.001) and infections (p<0.01). Conclusions The similarities in symptoms among the patients indicate that the main focus in care should be on patient care needs rather than diagnoses. Integrating palliative care in hospitals and increasing healthcare professional competency can result in providing optimal palliative care

Effectiveness of scenario‑based learning and augmented reality for nursing students’ attitudes and awareness toward climate change and sustainability

Background: Mainstreaming sustainable healthcare into the curricula of health professions is a key action to raise awareness and change attitudes. Therefore, the present study aimed to assess the contribution of scenario-based learning and augmented reality to the environmental awareness and attitudes toward climate change and sustainability among undergraduate nursing students. Methods: This study was designed as a time-series analysis. Undergraduate nursing students in their 3 years were introduced to sustainability and climate change in the context of healthcare through scenario-based learning sessions. Questionnaires were used to collect data on participants’ attitudes towards sustainability and climate change, the usefulness of the educational sessions and the extent to which students changed their clinical practice. A data summary, related sample Friedman and Wilcoxon signed-rank tests were used to test for differences in survey scores. Results: Attitudes and environmental awareness toward climate change and sustainability increased significantly as students received the learning sessions over the 3 years. After their first clinical training period, students already showed a high awareness of unsustainable practices in their working environment; however, they still struggled to apply sustainability and address unsustainable practices in healthcare settings. Most students felt that the scenarios helped them to make links between climate change, resources, and health. Conclusions: The scenario-based learning and augmented reality increase environmental awareness and attitudes toward climate change and sustainability among nursing students. Students are very aware of unsustainable practices in their work environment, but more work needs to be done on the application of sustainability principles to nursing practice

Effectiveness of the e-NurSus Children Intervention in the Training of Nursing Students.

The paediatric population is the most vulnerable to exposure to environmental risk factors. Institutions of higher education have to equip nursing students with the attitudes, knowledge, and skills to respond to this using blended learning. The aim of this study was to evaluate the effect of e-NurSus Children intervention on student nurses’ attitudes, knowledge, and skills. A quasi-experimental study of time series was designed using pre and post educational intervention evaluation in 2018. The participants were nursing students (N = 267) from Spain (n = 110) and the United Kingdom (n = 157). Three instruments were used: the Sustainability Attitudes in Nursing Survey, the Children’s Environmental Health Knowledge Questionnaire, and the Children’s Environmental Health Skills Questionnaire. The attitudes (15.81%), knowledge (39.02%), and skills (29.98%) of nursing students improved following the e-NurSus Children intervention. It is necessary to include topics on children’s environmental health in nurse education as students are aware of this issue but do not have the knowledge or skills required to manage problems or illness caused by the environment. The e-NurSus Children intervention is an effective tool to address this educational gap