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Bibliographical Review (bibliographical + review)
Selected AbstractsRisk assessment scales for pressure ulcer prevention: a systematic reviewJOURNAL OF ADVANCED NURSING, Issue 1 2006Pedro L. Pancorbo-Hidalgo PhD RN Aim., This paper reports a systematic review conducted to determine the effectiveness of the use of risk assessment scales for pressure ulcer prevention in clinical practice, degree of validation of risk assessment scales, and effectiveness of risk assessment scales as indicators of risk of developing a pressure ulcer. Background., Pressure ulcers are an important health problem. The best strategy to avoid them is prevention. There are several risk assessment scales for pressure ulcer prevention which complement nurses' clinical judgement. However, some of these have not undergone proper validation. Method., A systematic bibliographical review was conducted, based on a search of 14 databases in four languages using the keywords pressure ulcer or pressure sore or decubitus ulcer and risk assessment. Reports of clinical trials or prospective studies of validation were included in the review. Findings., Thirty-three studies were included in the review, three on clinical effectiveness and the rest on scale validation. There is no decrease in pressure ulcer incidence was found which might be attributed to use of an assessment scale. However, the use of scales increases the intensity and effectiveness of prevention interventions. The Braden Scale shows optimal validation and the best sensitivity/specificity balance (57·1%/67·5%, respectively); its score is a good pressure ulcer risk predictor (odds ratio = 4·08, CI 95% = 2·56,6·48). The Norton Scale has reasonable scores for sensitivity (46·8%), specificity (61·8%) and risk prediction (OR = 2·16, CI 95% = 1·03,4·54). The Waterlow Scale offers a high sensitivity score (82·4%), but low specificity (27·4%); with a good risk prediction score (OR = 2·05, CI 95% = 1·11,3·76). Nurses' clinical judgement (only considered in three studies) gives moderate scores for sensitivity (50·6%) and specificity (60·1%), but is not a good pressure ulcer risk predictor (OR = 1·69, CI 95% = 0·76,3·75). Conclusion., There is no evidence that the use of risk assessment scales decreases pressure ulcer incidence. The Braden Scale offers the best balance between sensitivity and specificity and the best risk estimate. Both the Braden and Norton Scales are more accurate than nurses' clinical judgement in predicting pressure ulcer risk. [source] A review of littoral tourism, sport and leisure activities: consequences on marine flora and faunaAQUATIC CONSERVATION: MARINE AND FRESHWATER ECOSYSTEMS, Issue 4 2001Gerard L. Bellan Abstract 1.,A report on the scientific aspects of the consequences of tourism and other leisure activities on the marine flora and fauna has been prepared on behalf of the French Ministry of the Environment. This involved an exhaustive bibliographical review resulting in a series of proposals to address some of the issues highlighted. 2.,Our knowledge is too often based on observations of the deeds and misdeeds of tourism along with only a small amount of experimental study. 3.,The main proposals are that there should be: (1) a compilation of all studies ordered by and for the State and its decentralized services, local communities and private companies; (2) definition of priority species and ecosystems; (3) observations on the direct and indirect impacts by tourists and sportsmen on the natural environment for each one of the large biotopes; (4) quantification of the impact of recreational fishing; (5) an integration of biological, sociological, economic and judicial disciplines in the management of the marine environment. Copyright © 2001 John Wiley & Sons, Ltd. [source] The P/Q-type voltage-dependent calcium channel: a therapeutic target in spinocerebellar ataxia type 6ACTA NEUROLOGICA SCANDINAVICA, Issue 5 2007J. Gazulla Background,,, Voltage-dependent calcium channels (VDCCs) are heteromultimeric complexes that mediate calcium influx into cells; the ,1A subunit is the pore-forming subunit specific to the neuronal P/Q-type VDCCs. Spinocerebellar ataxia type 6 (SCA 6) is caused by an abnormal expansion of a CAG repeat in CACNA1A, which encodes the ,1A subunit. Heterologous expression of mutated ,1A subunits resulted in increased channel inactivation in electrophysiological tests. Gabapentin and pregabalin interact with the ,2, subunit of the VDCCs and improved ataxia in cases of cortical cerebellar atrophy (CCA) and ataxia-telangiectasia. Materials and methods,,, A bibliographical review was performed in order to find out if gabapentin and pregabalin coud prove useful in the treatment of SCA 6. Results,,, Gabapentin and pregabalin slowed the rate of inactivation in recombinant P/Q-type VDCCs. SCA 6 shares neuropathological findings with CCA. Conclusions,,, On the basis of the neuropathological identity of SCA 6 with CCA, and of the effect of gabapentin and pregabalin on recombinant VDCCs the authors put forward the hypothesis that these drugs might prove beneficial in SCA 6, as the ataxia would be expected to improve. The authors hope that researchers working with this illness will be encouraged to undertake the appropriate clinical and experimental work. [source] Nurses' experiences with telephone triage and advice: a meta-ethnographyJOURNAL OF ADVANCED NURSING, Issue 3 2010Rebecca J. Purc-Stephenson purc-stephenson r.j. & thrasher c. (2010) Nurses' experiences with telephone triage and advice: a meta-ethnography. Journal of Advanced Nursing66(3), 482,494. Abstract Aims., This study is a meta-ethnography of nurses' experiences with telephone triage and advice and factors that facilitate or impede their decision-making process. Background., Telephone triage and advice services are a rapidly expanding development in health care. Unlike traditional forms of nursing practice, telenurses offer triage recommendations and advice to the general public without visual cues. Data sources., Published qualitative research on telephone triage and advice were sought from interdisciplinary research databases (1980,2008) and bibliographical reviews of retrieved studies. Review methods., Our systematic search identified 16 relevant studies. Two researchers independently reviewed, critically appraised, and extracted key themes and concepts from each study. We followed techniques of meta-ethnography to synthesize the findings, using both reciprocal and refutational translation to compare similar or contradictory findings, and a line-of-arguments synthesis. Results., We identified five major themes that highlight common issues and concerns experienced by telenurses: gaining and maintaining skills, autonomy, new work environment, holistic assessment, and stress and pressure. A line-of-arguments synthesis produced a three-stage model that describes the decision-making process used by telenurses and highlights how assessments largely depend on the ability to ,build a picture' of the patient and the presenting health issue. Conclusion., Telenurses experience a range of common concerns and issues which either impede or facilitate the decision-making process. Although ,building a picture' of the patient is key to making assessments over the telephone, final triage decisions are influenced by balancing the conflicting demands of being both carer and gatekeeper to limited healthcare services. [source] | ||||||||||