Risultati per: Gestione del trauma renale dell’adulto

Botulino, anche per i casi più difficili di nevralgia trigemino

I risultati del progetto Iss “Veterani in Sella”

I risultati del progetto Iss “Veterani in Sella”

Tra gli effetti indesiderati le disfunzioni di tiroide e ipofisi

Objective
To examine the relationship between social support and psychological birth trauma among Chinese primiparous women and the mediating effects of childbirth readiness.

Design
A cross-sectional study was conducted between November 2021 and March 2022.

Setting
10 general tertiary hospitals and 3 specialised maternity hospitals in 7 provinces in China.

Participants
A total of 751 primiparous women were recruited for this study.

Outcome measures
The questionnaires consisted of questions on demographic characteristics, the Birth Trauma Scale, the Chinese Mandarin version of the Medical Outcomes Study Social Support Survey and the Childbirth Readiness Scale. Hierarchical multiple regression was used to explore the associated factors and mediating role of childbirth readiness in the relationship between social support and psychological birth trauma. The mediating model was examined by the PROCESS macro for SPSS.

Results
After adjusting for demographic variables, social support was negatively associated with psychological birth trauma (r=–0.242, p

Primo prodotto al mondo, arriva da mini caseificio Ogliastra

Primo prodotto al mondo, arriva da mini caseificio Ogliastra

Introduction
Breastfeeding is crucial in infant nutrition and bonding, recommended for at least 6 months and up to 2 years postpartum, providing health benefits for both infants and mothers. However, nipple trauma is common among lactating mothers. Moisturising therapies, such as hydrogel application, aim to promote the healing of nipple wounds. Despite various interventions proposed, comprehensive reviews evaluating the efficacy of moisturising therapies for nipple trauma are lacking. This review aims to appraise the effectiveness of moisturising therapy, particularly tailored for nipple trauma in lactating women.

Methods and analysis
This systematic review protocol adheres to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines and is registered in the International Prospective Register of Systematic Reviews. The focus will be on both randomised and non-randomised controlled trials addressing the treatment of nipple trauma in lactating women. In this context, ‘moisturising therapy’ is categorised as a non-pharmacological intervention applied directly to the nipple, excluding treatments for bacterial or fungal infections. The primary outcomes will include measures of the healing efficiency of nipple trauma and reduction in nipple pain. Searches will be conducted without date restrictions across multiple databases, including PubMed, CINAHL, the Cochrane Library, Web of Science, CiNii Research and Ichushi-Web, in addition to exploration of grey literature. Two independent reviewers will manage all stages of the review process, under the supervision of a third reviewer. Data extraction will encompass participant demographics, study methodologies, sample specifics and measured outcomes. Quality assessment will be conducted using the Joanna Briggs Institute Appraisal Checklist Tools.

Ethics and dissemination
Ethics approval is not required for this study. The findings of this review will be disseminated through academic publications, detailed reports and presentations at relevant conferences.

PROSPERO registration number
CRD42023481761.

Introduction
Poor communication about serious injury in older adults can lead to treatment that is inconsistent with patient preferences, create conflict and strain healthcare resources. We developed a communication intervention called Best Case/Worst Case-intensive care unit (ICU) that uses daily scenario planning, that is, a narrative description of plausible futures, to support prognostication and facilitate dialogue among patients, their families and the trauma ICU team. This article describes a protocol for a multisite, randomised, stepped-wedge study to test the effectiveness of the intervention on the quality of communication (QOC) in the ICU.

Methods and analysis
We will follow all patients aged 50 and older admitted to the trauma ICU for 3 or more days after a serious injury at eight high-volume level 1 trauma centres. We aim to survey one family or ‘like family’ member per eligible patient 5–7 days following their loved ones’ admission and clinicians providing care in the trauma ICU. Using a stepped-wedge design, we will use permuted block randomisation to assign the timing for each site to begin implementation of the intervention and routine use of the Best Case/Worst Case-ICU tool. We will use a linear mixed-effects model to test the effect of the tool on family-reported QOC (using the QOC scale) as compared with usual care. Secondary outcomes include the effect of the tool on reducing clinician moral distress (using the Measure of Moral Distress for Healthcare Professionals scale) and patients’ length of stay in the ICU.

Ethics and dissemination
Institutional review board (IRB) approval was granted at the University of Wisconsin, and all study sites ceded review to the primary IRB. We plan to report results in peer-reviewed publications and national meetings.

Trial registration number
NCT05780918.