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Frontiers in Psychiatry 2024The concept of caring stress and its specific management has received less attention than other dimensions of stress in nurses. Therefore, to clarify the concept of...
OBJECTIVE
The concept of caring stress and its specific management has received less attention than other dimensions of stress in nurses. Therefore, to clarify the concept of caring stress, a scoping review study was designed. This scoping review aimed to investigate the concept of caring stress among clinical nurses and examine the strategies used for its management.
METHODS
This review employed a scoping review methodology to comprehensively map the essential concepts and attributes of the phenomenon by drawing on a wide range of sources. International databases including PubMed, Scopus, Web of Science, Google Scholar, and Scientific Information Database (SID) were searched to gather relevant studies published until October 1, 2023. MESH terms included "caring stress", "care", "stress", "nurse", and "stress management" were used. Two reviewers independently collected data from full-text papers, ensuring that each paper underwent assessment by at least two reviewers.
RESULTS
Out of 104,094 articles initially searched, 22 articles were included in this study. High workloads, transmitting the infection, stressful thoughts, stressful emotions, and stressful communications were the significant concepts and factors of caring stress among nurses. Also, rest breaks during patient care shifts, playing music in the ward, and denial of critical situations were examples of positive and negative coping and management ways to reduce caring stress.
CONCLUSION
Effective stress management strategies can lead to better patient care and safety. Stressed nurses are more likely to make errors or become less vigilant in their duties, impacting patient outcomes. By addressing caring stress, clinical practice can prioritize patient well-being. Further research is required to delve deeper into this critical issue concerning nurses in the future.
PubMed: 38863606
DOI: 10.3389/fpsyt.2024.1337938 -
Micromachines Jul 2023The application of an ultra-wideband (UWB) positioning system in a Global Positioning System (GPS) denial environment such as an underground coal mine, mainly focuses on...
The application of an ultra-wideband (UWB) positioning system in a Global Positioning System (GPS) denial environment such as an underground coal mine, mainly focuses on position information and rarely involves information such as direction attitude. Position accuracy is often affected by multipath, non-visible ranges, base station layout, and more. We proposed an IMU-assisted UWB-based positioning system for the provision of positioning and orientation services to coal miners in underground mines. The Error-State Kalman Filter (ESKF) is used to filter the errors in the measured data from the IMU-assisted UWB positioning system to obtain the best estimate of the error for the current situation and correct for inaccuracies due to approximations. The base station layout of the IMU-assisted UWB positioning system was also simulated. The reasonable setting of the reference base station location can suppress multi-access interference and improve positioning accuracy to a certain extent. Numerous simulation experiments have been conducted in GPS denial environments, such as underground coal mines. The experimental results show the effectiveness of the method for determining the position, direction, and attitude of the coal miner under the mine, which provides a better reference value for positioning and orientation in a GPS rejection environment such as under the mine.
PubMed: 37512792
DOI: 10.3390/mi14071481 -
Journal of Clinical Medicine Nov 2023Crohn's disease affects 2.5 million people in Europe (more than 100,000 people in France) and often occurs between the ages of 15 and 30, a period marked by...
Crohn's disease affects 2.5 million people in Europe (more than 100,000 people in France) and often occurs between the ages of 15 and 30, a period marked by self-construction. However, few studies have focused on the experience of the diagnosis during this sensitive developmental stage. This study aimed to qualitatively explore the experience of Crohn's disease in young adults since their diagnosis. Fifteen young adults (18-35 years) diagnosed with Crohn's disease participated in a semi-directive interview. Narrative data were subjected to a thematic analysis, and thirty percent of the interviews were double-coded. The results revealed an evolution of four main themes since diagnosis: (1) course of care, (2) illness perceptions, (3) disease management and (4) self-perception. For most participants, the onset of the disease was difficult, marked by severe symptoms requiring hospitalization, numerous medical examinations and sometimes several consultations before diagnosis. This journey was more difficult when it was associated with negative relations with the medical staff, who were sometimes perceived as unsupportive. Thus, some people described this diagnostic period as an "ordeal", while others experienced it as a "relief" from their suffering. The announcement of the diagnosis was often a "shock", an "upheaval" or a "downfall", followed by phases of denial associated with a desire to maintain a "normal life" and not to be defined by the disease. Despite a difficult start, most participants grew from their experience with CD, with a sense of a personal development that was made possible by self-regulation processes that enabled them to draw on their own experience and resources to adjust to their illness. By highlighting positive possibilities for evolution, this study suggests the importance of supporting the psychological resources of young adults by proposing, at an early stage, psychological support or therapies focused on acceptance and engagement.
PubMed: 38002740
DOI: 10.3390/jcm12227128 -
BMC Public Health Sep 2023Ending AIDS by 2030 would depend on how successful health systems are in linking people living with HIV (PLHIV) into care. The World Health Organization recommended the...
Enhancing linkage to HIV care in the "Universal Test and Treat" era: Barriers and enablers to HIV care among adults in a high HIV burdened district in KwaZulu-Natal, South Africa.
Ending AIDS by 2030 would depend on how successful health systems are in linking people living with HIV (PLHIV) into care. The World Health Organization recommended the 'Universal Test and Treat' (UTT) strategy - initiating all individuals testing positive on antiretroviral therapy (ART) irrespective of their CD4 count and clinical staging. This study aimed to explore the enablers and barriers to linkage to HIV care among adults with a new HIV diagnosis in a high-HIV prevalent rural district in South Africa. A qualitative study was undertaken to explore patients' perceptions of enablers and barriers of linkage-to-care, using a life-story narration and dialogue approach. In-depth interviews were conducted with 38 HIV-positive participants sampled from a cohort of 1194 HIV-positive patients recruited from December 2017 to June 2018. Participants were selected based on whether they had been linked to care or not within 3 months of positive HIV diagnosis. Interviews were thematically analysed using a general inductive approach. Of the 38 participants, 22 (58%) linked to care within three months of HIV-positive diagnosis. Factors that facilitated or inhibited linkage-to-care were found at individual, family, community, as well as health systems levels. Enablers included a positive HIV testing experience, and assistance from the fieldwork team. Support from family, and friends, as well as prior community-based education about HIV and ART were also noted. Individual factors such as acceptance of HIV status, previous exposure to PLHIV, and fear of HIV progressing, were identified. Barriers to linkage included, denial of HIV status, dislike of taking pills, and preference for alternative medicine. Negative experiences with counselling and health systems inefficiency were also noted as barriers. Perceived stigma and socio-economic factors, such as lack of food or money to visit the clinic were other barriers. Community-based and health system-level interventions would need to focus on clinic readiness in providing patients with necessary and effective health services such as proper and adequate counselling. This could increase the number of patients who link to care. Finally, interventions to improve linkage-to-care should consider a holistic approach, including training healthcare providers, community outreach and the provision of psychological, social, and financial support.
Topics: Humans; Adult; South Africa; Ambulatory Care Facilities; CD4 Lymphocyte Count; Economic Factors; Fear
PubMed: 37689667
DOI: 10.1186/s12889-023-16576-w -
JAMA Health Forum Mar 2024
Topics: Artificial Intelligence; Insurance Coverage
PubMed: 38451493
DOI: 10.1001/jamahealthforum.2024.0622 -
Health Research Policy and Systems Oct 2023This research article retrospectively analyses the agenda-setting approach of policies concerning high-risk sexual behaviours, stimulant and alcohol abuse among Iranian...
BACKGROUND
This research article retrospectively analyses the agenda-setting approach of policies concerning high-risk sexual behaviours, stimulant and alcohol abuse among Iranian adolescents.
METHODS
This qualitative case study policy analysis involved analysing 51 national documents and conducting interviews with 49 policy-makers and executives. Purposive sampling with a snowball strategy and semi-structured interviews were used. The data was analysed using the framework analysis method, with Kingdon's multiple streams framework serving as the analytical framework.
RESULTS
The study has identified the confluence of several factors, including the problem stream, the policy stream and the political stream. Within the problem stream, several factors contributed, such as the prevalence of high-risk behaviours, strong scientific evidence on these behaviours, changes in human immunodeficiency virus (HIV) transmission patterns, increased statistics of poisoning and deaths related to alcohol abuse, and the visit of Iran's supreme leader to the slums of Mashhad city. The policy stream has two periods of denial and acceptance. The denial period includes considering these high-risk behaviours to be the consequences of western culture, emphasis on the religious aspects and sinfulness of these behaviours, resisting the prevalence of anomalous behavioural patterns, abstinence and religious obligation of chastity, and avoiding ethical corruption. The acceptance period includes adolescents training, fear messages, promotional and cultural activities, parent training, school staff training, providing psychiatric services for withdrawal, counselling and reference to receive specialized services. The political stream involves global attention towards non-communicable diseases and high-risk behaviours, and the significant impact of preventing these behaviours during adolescence on the health status of society. Also, the supreme leader's attention to social harms, and the establishment of the National Committee for Prevention and Control of Alcohol, have played significant roles.
CONCLUSIONS
While the problem stream helped to highlight the problem and increase policy-makers' attention, the politics stream played a significant role. Despite international evidence on the effectiveness of training in sexual issues in reducing high-risk behaviours, it did not succeed in being added to the agenda. The policy stream was heavily influenced by ideology and the political parties in power, affecting evidence-based policy-making. In countries with an ideological approach, the political stream plays a vital role in setting problems on the agenda.
Topics: Adolescent; Humans; Health Policy; Iran; Alcoholism; Retrospective Studies; Policy Making; Politics
PubMed: 37814264
DOI: 10.1186/s12961-023-01050-1 -
Sensors (Basel, Switzerland) Sep 2023The increasing network speeds of today's Internet require high-performance, high-throughput network devices. However, the lack of affordable, flexible, and readily...
The increasing network speeds of today's Internet require high-performance, high-throughput network devices. However, the lack of affordable, flexible, and readily available devices poses a challenge for packet classification and filtering. This problem is exacerbated by the increase in volumetric Distributed Denial-of-Service (DDoS) attacks, which require efficient packet processing and filtering. To meet the demands of high-speed networks and configurable network processing devices, this paper investigates a hybrid hardware/software packet filter prototype that combines reconfigurable FPGA technology and high-speed software filtering on commodity hardware. It uses a novel approach that offloads filtering rules to the hardware and employs a Longest Prefix Matching (LPM) algorithm and allowlists/blocklists based on millions of IP prefixes. The hybrid filter demonstrates improvements over software-only filtering, achieving performance gains of nearly 30%, depending on the rulesets, offloading methods, and traffic types. The significance of this research lies in developing a cost-effective alternative to more-expensive or less-effective filters, providing high-speed DDoS packet filtering for IPv4 traffic, as it still dominates over IPv6. Deploying these filters on commodity hardware at the edge of the network can mitigate the impact of DDoS attacks on protected networks, enhancing the security of all devices on the network, including Internet of Things (IoT) devices.
PubMed: 37688092
DOI: 10.3390/s23177636 -
Journal of Personalized Medicine Aug 2023Despite the OlympiA trial demonstrating that early-stage, high-risk, HER2- germline and mutation (g) positive breast cancer patients can benefit from PARPi in the...
Despite the OlympiA trial demonstrating that early-stage, high-risk, HER2- germline and mutation (g) positive breast cancer patients can benefit from PARPi in the adjuvant setting, the g testing rate in early-stage HR+/HER2- patients remains suboptimal compared to that in early-stage TNBC patients. To better understand the perceived barriers associated with g testing in HR+/HER2- disease, a quantitative survey was conducted across stakeholders ( = 430) including medical oncologists, surgeons, nurses, physician assistants, payers, and patients. This study revealed that while payers claim to cover g testing, poor clinician documentation and overutilization are key challenges. Therefore, payers place utilization management controls on g testing due to their impression that clinicians overtest. These controls have led to healthcare professionals experiencing payer pushback in the form of reimbursement limitations and denials. The perceived challenges to g testing stem from the lack of consensus dictating which patients are high risk and should be tested. While payers define high risk based on the CPS + EG score from the OlympiA trial, HCPs adopt a broader definition including genomic risk scores, lymph node involvement, and tumor grade and size. A dialogue to harmonize risk classification and testing eligibility across stakeholders is critical to address this disconnect and increase g testing in appropriate patients.
PubMed: 37623478
DOI: 10.3390/jpm13081228 -
Ciencia & Saude Coletiva Mar 2024We quilombola women, a documentary that considers the quilombola identity and the right to COVID-19 vaccination, evokes notions of priority, rights, privileges and...
We quilombola women, a documentary that considers the quilombola identity and the right to COVID-19 vaccination, evokes notions of priority, rights, privileges and identity during the process of matching the number of vaccine doses available to citizens' arms. Omission by a Brazilian federal government grounded in necro-politics and denial, plus a lack of information, led quilombo communities to take it on themselves to draw up lists of those eligible for vaccination. The production team's aim was to use images as political language in the health field, so as to document and give visibility to these issues as one illustration of combating social and health inequalities and inequities rooted in structural racism. By combining science and art and interlacing references from the sociology of images, visual anthropology, plus the work and aesthetic devices of Eduardo Coutinho, the audiovisual production method brought out three key categories: I, We, and They, quilombola women. This article explores these categories underpinning construction of the documentary narrative, which drew on the potential of images, which in turn served as anti-racist, political and educational devices, both in the course of the production process and during the public screenings.
Topics: Humans; Female; COVID-19; COVID-19 Vaccines; Vaccination; Brazil; Educational Status
PubMed: 38451642
DOI: 10.1590/1413-81232024293.04482023 -
Blood Advances Mar 2024Patients undergoing hematopoietic cell transplantation (HCT) must cope with physical and psychological symptoms. Yet, studies examining pre-HCT coping are limited. We...
Patients undergoing hematopoietic cell transplantation (HCT) must cope with physical and psychological symptoms. Yet, studies examining pre-HCT coping are limited. We aimed to characterize pre-HCT coping, evaluate the association of coping with baseline quality of life (QOL) and psychological distress, and identify sociodemographic factors associated with pre-HCT coping. We conducted a cross-sectional analysis of baseline data from a multisite randomized supportive care intervention trial among patients with hematologic malignancies undergoing allogeneic or autologous HCT. We assessed patient-reported QOL, psychological distress, and coping within 72 hours of admission for HCT. We used the median split method to dichotomize coping and multivariate regression analyses to characterize the association of coping with psychological distress and QOL. Of patients awaiting HCT (n = 360; mean age, 55.4 years; 49.7% autologous), 43.5% were high users of approach-oriented coping, whereas 31.3% were high users of avoidant coping. Patients reported high use of emotional support (60.9%), acceptance (51.2%), self-blame (33%), and denial (31.3%). Older age (≥65 years) was associated with less frequent use of avoidant coping (odds ratio, 0.5; P = .01). Approach-oriented coping was associated with better pre-HCT QOL (Beta(B) = 6.7; P = .001), and lower depression (B = -1.1; P = .001) and anxiety (B = -0.9; P = .02) symptoms. Avoidant coping was associated with worse pre-HCT QOL (B = -13.3; P < .001) and symptoms of depression (B = 1.9; P < .001), anxiety (B = 3.1; P < .001), and posttraumatic stress disorder (B = 8.1; P < .001). Pre-HCT coping is strongly associated with psychological distress and QOL. These data support the need for interventions to address coping during HCT hospitalization. This clinical trial was registered at www.clinicaltrials.gov as #NCT03641378.
Topics: Humans; Middle Aged; Quality of Life; Cross-Sectional Studies; Depression; Hematologic Neoplasms; Coping Skills; Hematopoietic Stem Cell Transplantation
PubMed: 38181820
DOI: 10.1182/bloodadvances.2023011081