Care Actions Research Articles

Investigation of the correlation between the distribution of surface nucleons and incompressibility of nuclear matter in the 40Ca+40Ca reaction

Investigation of the correlation between the distribution of surface nucleons and incompressibility of nuclear matter in the 40Ca+40Ca reaction

Effectiveness of Hypothermia Prevention Protocol Among Patients Subjected to Major Surgeries at KMCH, Coimbatore.

Hypothermia is a significant risk factor for peri-operative complications. Whatever method is used for maintaining normothermia, first and foremost, it should be remembered that careful and thoughtful actions directed at maintaining normothermia can significantly affect the course of the patient’s peri-operative experience. Objective of the study is to assess the incidence and extent of hypothermia among patients subjected to major surgeries, to determine the effectiveness of hypothermia prevention protocol among patients subjected to major surgeries and to associate the demographic, clinical variables and risk factors of hypothermia with core body temperature among patients subjected to major surgeries. The methodology adopted for this study was a Quasi-experimental one group pre test and post test design. Hypothermia prevention management strategies (active and passive warming as per core body temperature) were implemented and were observed by using Hypothermia prevention protocol checklist by the investigator. Descriptive and inferential statistics were used to analyze the data. Repeated measures ANOVA of core body temperature, heart rate, respiratory rate, blood pressure and SPO2 over a period of time revealed that there is a statistically significant difference in the mean scores of vitals parameters were measured at various time periods in peri-operative period at the level of p<.05. Keywords: hypothermia, peri-operative period, active warming device, passive warming device.

Factors associated with functional health literacy and the quality of life of riverside residents served by the primary care network in the Brazilian amazon: a cross-sectional study

Backgroundthe riverside population lives in a vulnerable social situation, shaped by geographical, economic, social, and educational aspects that have repercussions on health literacy, the limitations of which can compromise Quality of Life. These specificities influence the actions of Primary Health Care, especially in the rural context. This study aimed to assess the factors associated with Functional Health Literacy and Quality of Life among riverside residents of the Brazilian Amazon who use Primary Health Care.Methodsa cross-sectional study with 312 users of a riverside Family Health Team, using the Health Literacy Test, classified as adequate, limited, and inadequate, and the Study Short Form 12 Health Survey questionnaire, analyzing the physical and mental components in isolation. A theoretical model was built to assess the associations between sociodemographic and environmental variables and the Functional Health Literacy and Quality of Life outcomes. The Functional Health Literacy outcome was considered as two dichotomous variables (inadequate versus adequate; limited versus adequate), while the Quality of Life outcomes were considered as counts, with a Poisson distribution. Thus, a structural equation model was used to adjust the proposed theoretical model.Resultsthere was a worsening in inadequate Functional Health Literacy, associated with females, aged over 40, elementary school education, living close to the health service, and using only a cell phone for communication. Factors that compromised physical Quality of Life: livelihood problems; inadequate literacy; age range 40–59; and having two children or more. And those that worsened mental Quality of Life: age over 40; having a family allowance; and being in control of their medication.Conclusionssociodemographic, environmental, and economic factors and adherence to medication by river communities have been shown to be associated with Health Literacy and Quality of Life. Knowing these implications is fundamental for health provision. These findings can support the formulation of strategies in health services to improve Health Literacy and Quality of Life.

Community participation through co-production and social accountability in Zambia: mapping primary health care actors and interfaces

Introduction: Community participation is central to primary health care (PHC). However, there remains limited research on the practices of community involvement in PHC. This study aimed to inform the Zambian PHC agenda, by documenting key actors, their roles, interactions and available spaces or interfaces for engaging in community participation, as well as to identify the enabling conditions/mechanisms, and barriers underpinning community participation. Methods: We used exploratory qualitative methods consisting semi-structured interviews with Community Health Assistants (CHAs) (n=10), healthcare workers (n=7) and traditional leaders (n=7). Additionally, focus group discussions were conducted with Neighbourhood Health Committees (NHCS) members (n=53) and community members (n=57). Data were analysed using thematic analysis. Results: The CHAs, health workers and traditional leaders acted as the key intermediaries between health facilities and communities, driving co-production and social accountability processes. Traditional leaders and civil society organizations often served as initial catalysts of community participation, enabling the subsequent roles of the CHAs, while health centres and NHCs provided the spaces and platforms for community members to shape their involvement in participatory activities. Co-production entailed community contributions such as labour and participation in decision-making at health facilities. Social accountability took the form of suggestion boxes and informal feedback from traditional leaders. Several contextual barriers limited participation, including undefined roles for processes of community engagement, the lack of a comprehensive engagement strategy, and the exclusion of CHAs in health facility processes. Conclusion: The CHAs and their roles, alongside those of other actors, were pivotal in supporting both co-production and social accountability processes. Strengthening community participation in primary health requires clearly defining the roles of various actors through the development of comprehensive community engagement strategies.

PROJETO DE EXTENSÃO “MÃOS DE VIDA”: ESPIRITUALIDADE NATURAL NAS PRÁTICAS EDUCATIVAS NO CUIDADO ÀS CRIANÇAS

The extension project "Mãos de Vida" of the University of Vale do Itajaí (UNIVALI) develops practices with children in a transdisciplinary perspective and integrates education and health themes. Among the proposals, we highlight the eco-formative workshops on natural care and spirituality. The activities integrated therapeutic processes of health and social care with children from Lar Padre Jacó, located in the city of Itajaí/SC. The general objective of the study seeks to understand the promotion of care for children through educational practices that integrate natural spirituality in the Hands of Life extension project. This is a qualitative study, supported by the phenomenological hermeneutics method. It was carried out through workshops planned and developed weekly, between the years 2022 and 2023, with the participation of children between 6 and 11 years old. The results showed that in the educational practices the children recognized living nature as an expansion of themselves, involved in care actions that strengthened life and natural spirituality. The eco-formative backyard has become a place of contact and creative expression, of care for oneself and the other. The experiences with natural resources stimulated the sensory and reflective body, expressed in the art of modeling, the cultivation of plants and the construction of toys. The manifestations of care and healthy living occurred in the games that integrated human multidimensionality and enabled bodily and social well-being.

Aksi Peduli Lindungi: Kegiatan Membersihkan Pantai Kunyit Kecamatan Bumi Waras Kota Bandar Lampung

The cleanliness condition of Kunyit Beach, Bumi Waras sub-district, has recently become increasingly concerning, with a lot of litter scattered around and no one willing to clean it up. There is trash caught in the rocks along the beach, most of which is inorganic waste such as plastic, bottles, styrofoam, and other discarded items, as well as some organic waste like wood and leaves. This is caused by the lack of public awareness about the importance of maintaining cleanliness and the absence of government support, such as the lack of adequate waste disposal facilities and Environmental Cleanliness Operations Units. (SOKLI). Therefore, a care and protection action was carried out to address the issues arising in the Kunyit Beach area. Environmental care actions through beach cleaning activities are a concrete effort to preserve marine and coastal ecosystems, as well as to raise public awareness about the importance of a clean environment. This action was carried out by the local community who voluntarily assisted, as well as members of Group 1 of the Natural Resources and Environmental Economics course, to fulfill the assignment given by the course instructor, with permission from the Head of the Development Economics Department, the District Head of Bumi Waras, and the Village Head of Bumi Waras. Through this action, it is hoped that collective awareness will be created to maintain environmental cleanliness and the habit of not littering so that coastal areas can be sustainably preserved.

Identifying relevant diabetes and hypertension control management guidelines in primary healthcare and community settings in Indonesia: A Delphi survey.

The burden of non-communicable diseases (NCDs) in Indonesia is increasing, as evidenced by the latest Indonesian National Health Research, which shows an increase in diabetes prevalence, from 6.9% in 2013 to 10.9% in 2018, and hypertension, from 25.8% in 2013 to 34.1% in 2018. Hence, effective actions in community and primary health care (PHC) facility settings are necessary to tackle the burden of diabetes and hypertension, especially in low- and middle-income countries. The Indonesian government has issued numerous guidelines regarding NCDs. However, not all these guidelines can be applied to communities or PHCs. This study aimed to identify priority guidelines to support the community and PHC for NCD management using the Delphi survey method. These prioritized guidelines will serve as valuable resources for developing relevant, operational and comprehensive modules for community cadres and PHC staff involved in NCD management. The Delphi survey involved 25 experts and comprised three rounds using a questionnaire: 1) identification and assessment of guidelines, 2) assessment of the importance of guidelines, and 3) nomination of the three main priority guidelines. The results revealed three priority guidelines: NCD management guidelines, technical guidelines for Pos Pembinaan Terpadu (POSBINDU) NCDs, and integrated services for NCDs in PHC facilities. Additionally, priority guidelines were used to develop operational modules for community cadres and PHC staff in NCDs management. In conclusion, utilizing the Delphi method serves as a scientific approach to identify priority guidelines crucial for supporting the community and PHC in managing NCDs, particularly in countries with contexts similar to Indonesia.

Family Needs of Patients Admitted in The Intensive Care Unit: A Meta-Synthesis

The life threats for patients admitted in the Intensive Care Unit (ICU) is higher compared to other care units. The magnitude of the life threats in the ICU not only causes anxiety for patients but also for other families. The family has crucial roles in supporting the patient's recovery, so the holistic needs of the patient's family also require to be considered. This meta-synthesis aimed to synthesize findings from qualitative studies that explored and described the needs of families while accompanying patients in the ICU. A systematic literature search from online databases was used to conduct a qualitative meta-synthesis, which was then evaluated using Critical Appraisal Skill Programme (CASP) checklist for Qualitative Study. Literature that fit the requirements was further analyzed. Three main themes that were fundamental for families were revealed including the need for information, the need for family involvement in patient care, and the need for visiting time for the family. Understanding the family as a unit brings benefits to the patient. It is essential to adapt professional practice strategies that involve families in the daily care of critical patients. Further research is required on how to carry out interventions that translate this knowledge into nursing care practices and actions.

Competitive effect and mechanism analysis of spectrophotometric detection of Ca2+ in metal cations-containing coal slurry water system

Ca2+ is an important ion in industrial wastewater such as coal slurry water. The concentration of Ca2+ directly affects the water quality of recycled water, the physicochemical properties of particle surfaces, and the effectiveness of coal beneficiation. However, the determination of Ca2+ in coal slurry water is influenced by other coexisting metal ions (M: K+, Na+, Mg2+, and Al3+) in the system. The complexation color development – visible spectrophotometry (CCDVS) has been proven to be a rapid and accurate way to determine Ca2+. This study investigates the impact and mechanism analysis of factors such as the concentrations of coexisting ions (K+: 0–15 mg/L, Na+: 0–2000 mg/L, Mg2+: 0–20 mg/L, Al3+: 0–0.05 mg/L) and valence states (monovalent, divalent, trivalent) on the accurate determination of Ca2+ using the CCDVS method. All ions are interested in the indicator, with the light absorption intensity order of Al3+ (Abs = −1.783) > Mg2+(Abs = −1.723) > Ca2+(Abs = −1.248) > K+(Abs = −0.268) > Na+(Abs = −0.075) under the same ions concentration (e.g. 16 mg/L). Interestingly, the absorbance of Ca–M mixed solutions shows different trends. For example, adding Na+ decreases the absorbance value of Ca2+, with a decrease in Abs of 0.065 when the Na+ concentration is 2000 mg/L. This indicates a competitive relationship between the complexation color development reaction of Ca and Na due to the same reaction mechanism. However, for Ca–Mg mixed solutions, when the Mg2+ concentration increases to 15 mg/L, the increase in Abs is 0.078, attributed to the stronger absorption of Mg2+ occupying the adsorption sites of Ca2+. On the contrary, at industrial concentrations, the influence of K+ (0–20 mg/L) and Al3+ (0–0.05 mg/L) on Ca2+ detection can be ignored. Complementary characterization (XRD, XPS) and DFT theoretical calculations indicate that complexation color development reaction depends on the adsorption of metal ions on the sulfonic acid sites on the indicator. Other metal cations compete with Ca2+ for the same adsorption sites, and the reactivity of metal ions with the indicator is as follows Al3+ > Mg2+ > Ca2+ > K+ > Na+. Therefore, this study provides technical and theoretical support for the development of highly selective Ca2+ detection methods, aiding in the rational control of chemical agent dosages.

Ecospiritual Praxis: Cultivating Connection to Address the Climate Crisis

This article suggests ecospirituality as a connection point between religion, science, and other disciplines, as well as the relationships between people, the land and waters, the community of all life, and the Divine. Ecospirituality connects different disciplines and highlights the interconnectedness between people and the rest of the natural world, and it also catalyzes action through spiritual experience and meaning-making. A review of different disciplines’ research on ecospirituality is provided. A description of an ecospiritual praxis cycle is offered, based on interviews and survey data. This ecospiritual praxis cycle may be able to help move people toward practical and efficacious actions of care for the community of all life to participate in the collective transformation that needs to occur in order to address the climate and ecological crises. This article identifies disconnection between theory and action regarding climate and environmental knowledge and collective action as one of the main problems, which “undisciplining” religion and science can help overcome.

‘It's good what we're doing and it's scary what we're facing’: young people’s care-ful environmental action in the UK

ABSTRACT In this paper, we argue for greater recognition of young people’s contributions to environmental action through social and environmental justice. It draws on findings from research based on eleven organisations in the UK exploring young people’s connection with environment-related collective action and activism in the UK landscape. Building on theoretical arguments of ethics of care and implicit activism and capturing a range of practices of young people, the paper explores young people’s multiple framing(s) of activisms – towards the environment and each other. Drawing on the experiences of young people and facilitators within these organisations, we unpack the experiences and representation of minoritised groups in the climate movement and other forms of environmental engagement. The findings demonstrate thoughtful and effective approaches towards inclusion within the UK context and in terms of global climate justice but also highlight a need for more intersectional approaches and awareness of enduring barriers often relating to racialised identities.

The "Doing" of Compassionate Care in the Context of Childbirth From a Women's Perspective.

Women who are giving birth need to be met with compassion and understanding from healthcare professionals. However, there are growing concerns about the perceived lack of compassion in the delivery of healthcare services in general and maternity care in particular. We conducted 15 qualitative interviews with women who had given birth in Norway within the previous year, asking them to describe their experiences of compassionate care. We aimed to explore what healthcare professionals "do" that is experienced as compassionate. The analysis was informed by Paul Gilbert's theory of compassion and a concept analysis of compassionate midwifery undertaken by Ménage and colleagues. The compassionate caring actions of healthcare professionals that were identified in the women's narratives generated five themes: attuning actions, validating actions, contextualizing actions, empowering actions, and small acts of kindness. The findings build on the prior theoretical concepts used for the study and provide a nuanced account of how women perceive compassionate care from healthcare professionals. They could contribute to understanding more of the meaning and nature of compassionate care during childbirth. The analysis indicates the importance of ensuring that compassionate care is at the very core of maternity care services.

HEALTH IN THE WORKPLACE: POSTURE, ERGONOMICS AND MUSCULAR DISORDERS

Objective: The study aimed to map the epidemiological profile of chronic musculoskeletal disorders and the ergonomic risks of body posture in the office environment. Methods: Data were collected using an electronic form consisting of sociodemographic questions and adapted versions of the Nordic Musculoskeletal Symptom and Rapid Office Strain Assessment questionnaires. Results: The mean age of the 73 participants in the extension project was 25.3 years and most had higher education. Of these, 86.3% felt pain, numbness or tingling in the last 12 months and of these, 90.5% had more than one body part affected by the symptoms. Of the thirteen body postures evaluated (sitting, leaning, position of the knees, feet, elbows, forearms and head), all were identified as ergonomically inadequate, especially those related to the chair used. Conclusion: There is a clear need for immediate health care actions for this population, since the office environments were not ergonomically adequate and the workers were already ill. Ergonomic intervention and health education actions are essential to guide the risks of this environment and propose behavioral changes to reduce/prevent musculoskeletal disorders. A limitation of the study may be that the sample was affected by the healthy worker effect, that is, those who were already affected by chronic musculoskeletal disorders were interested in participating in the project.

FAMILY PLANNING AND MENTAL HEALTH IN PRIMARY CARE: NURSES' PERSPECTIVES

Family planning is among the actions in Primary Care that are relevant and impactful in terms of women's quality of life indicators, but the particularities of women with mental disorders are still invisible to health professionals. The study aims to evaluate family planning performed by Primary Care nurses aimed at women with mental disorders. This is a qualitative and cross-sectional study using Alceste Software for content analysis. The results showed that Primary Care nurses who perform family planning have difficulties in managing the program in their routines. When women with mental disorders are highlighted, these difficulties are accentuated, and in many cases, they are not even identified during the care, which remains fragmented in terms of the demand presented, without considering the woman's comprehensiveness. The nurses also pointed out that they feel a lack of matrix support and collaboration from CAPS in implementing the program. We conclude that family planning should have a prominent place in ongoing training and integrate nurses working in Mental Health, to achieve comprehensive care for women, demystifying myths about pathologies and providing quality of life for this population.

Series on The Lancet Oncology Commission on Global Cancer Surgery-Action 1: Clinical Care and Access to Cancer Surgery.

The second Lancet Oncology Commission on Global Cancer Surgery was conceived to develop a roadmap of pragmatic solutions to address inequities and propel improvements in access to cancer surgery on the global stage. This Commission included nine solutional domains and eight Actions to help catalyze improvements in access to cancer surgery. The Annals of Surgical Oncology series on The Lancet Oncology Commission on Global Cancer Surgery will highlight these eight Actions individually with additional refinements. The first article will highlight the Action of clinical care and access to cancer surgery. To increase the likelihood of success in implementing the recommendations within this Action, we incorporated the principles of implementation science taken from the Consolidated Framework for Implementation Research (CFIR). The CFIR identifies several steps to implementing new changes in health care that include the intervention, outer setting, inner setting, people involved, and the process. We enhanced this framework by including two additional steps: barriers and time to implement the new change. Cascading along the CFIR pathway, we outline initiatives and other details to improve access to and address inequities in access to cancer surgical care. The Annals of Surgical Oncology Series on the second Lancet Oncology Commission on Global Cancer Surgery hopes to enhance the visibility of the eight critical Actions within this important Commission to the primary stakeholders, the surgeons. We hope this article of the Series will help to amplify the message and serve as a catalyst for implementing efforts to improve cancer surgical care on the global stage.

State, public policy and care: a methodology for the analysis of state policy on care

In this article, a methodological proposal for the analysis of the state’s actions on care is developed. We consider care as a way of inhabiting the world, and from this conception, we further argue it is a way of governing. Then, we elaborate on some considerations on the state’s field of action in care matters. Next, we propose a methodology to identify and classify those state actions that can be considered care actions. Finally, we exemplify its use with the Mexican federal budget of 2022. We find that care policies receive only 0.4 per cent of the total budget.

Beyond Detection: Towards Actionable Sensing Research in Clinical Mental Healthcare.

Researchers in ubiquitous computing have long promised that passive sensing will revolutionize mental health measurement by detecting individuals in a population experiencing a mental health disorder or specific symptoms. Recent work suggests that detection tools do not generalize well when trained and tested in more heterogeneous samples. In this work, we contribute a narrative review and findings from two studies with 41 mental health clinicians to understand these generalization challenges. Our findings motivate research on actionable sensing, as an alternative to detection research, studying how passive sensing can augment traditional mental health measures to support actions in clinical care. Specifically, we identify how passive sensing can support clinical actions by revealing patients' presenting problems for treatment and identifying targets for behavior change and symptom reduction, but passive data requires additional contextual information to be appropriately interpreted and used in care. We conclude by suggesting research at the intersection of actionable sensing and mental healthcare, to align technical research in ubiquitous computing with clinical actions and needs.

The Essential Role of Primary Health Care for Health Security.

In July 2023, primary health care experts from more than 20 countries, the World Health Organization (WHO), and most agencies within the US Department of Health and Human Services (HHS) met at the National Academy of Sciences in Washington, DC, to catalyze action toward revitalizing primary care in the United States align efforts to advance primary health care worldwide, and improve health and security for all.1 This meeting was informed by the NASEM's critical primary care report, which highlighted the need for federal leadership to strengthen primary care services in the United States, especially for underserved populations, and to inform primary care systems around the world. To that end, this meeting was designed to explore the challenges and opportunities of investing in primary health care as a common good and critical for health security and resilience across the globe.2 In this issue, you will find {number} special communications from this conference that highlight the need to evolve from primary care to primary health care, the importance of primary care and public health collaboration, and the necessity for ongoing external scientific expertise to inform US federal government coordination efforts.Despite the clear consensus among global stakeholders regarding the importance of Primary Health Care to health equity, behavioral health, health security, and pandemic resilience, a year later the anticipated HHS Action Plan to guide implementation of the NASEM primary care recommendations has yet to be launched. While some agencies are moving ahead with initiatives and programs within their purview, the lack of a Primary Care Action Plan remains a missed opportunity to coalesce politically powerful stakeholders around a united and much-needed vision for a US health system centered on Primary Health Care, particularly in light of our challenges in responding to COVID-19.

Particularities of manic crisis in bipolar disorder

The manic phase is part of bipolar disorder I. It is characterized by pronounced elevated phases (euphoria and irritability) in the manic pole and lowered mood (sadness and despair) in the depressive pole. Bipolar disorders affect about 1% of the population, and approximately 80-90% are manic-depressive forms. The average age of onset of bipolar disorder is around thirty years, and after the first onset, the chances of recurrence are 90%, while the number of episodes throughout life is, on average, higher than in major depressive disorder. A manic crisis is a delicate situation, as the person may put themselves in danger or forget their basic needs, even spending several days without sleep, without eating, and neglecting themselves. For this reason, we decided to deepen our understanding of the patient’s needs, to better understand the patient during the manic crisis in order to implement a relevant response to what the person perceives. Therefore, the main focus of this paper is to understand the patient's needs before/during/after the manic episode and to correlate them with care actions to raise caregiver awareness, so that better care can be provided during this phase.

Challenges posed by climate hazards to cardiovascular health and cardiac intensive care: implications for mitigation and adaptation.

Global warming, driven by increased greenhouse gas emissions, has led to unprecedented extreme weather events, contributing to higher morbidity and mortality rates from a variety of health conditions, including cardiovascular disease (CVD). The disruption of multiple planetary boundaries has increased the probability of connected, cascading, and catastrophic disasters with magnified health impacts on vulnerable populations. While the impact of climate change can be manifold, non-optimal air temperatures (NOTs) pose significant health risks from cardiovascular events. Vulnerable populations, especially those with pre-existing CVD, face increased risks of acute cardiovascular events during NOT. Factors such as age, socio-economic status, minority populations, and environmental conditions (especially air pollution) amplify these risks. With rising global surface temperatures, the frequency and intensity of heatwaves and cold spells are expected to increase, emphasizing the need to address their health impacts. The World Health Organization recommends implementing heat-health action plans, which include early warning systems, public education on recognizing heat-related symptoms, and guidelines for adjusting medications during heatwaves. Additionally, intensive care units must be prepared to handle increased patient loads and the specific challenges posed by extreme heat. Comprehensive and proactive adaptation and mitigation strategies with health as a primary consideration and measures to enhance resilience are essential to protect vulnerable populations and reduce the health burden associated with NOTs. The current educational review will explore the impact on cardiovascular events, future health projections, pathophysiology, drug interactions, and intensive care challenges and recommend actions for effective patient care.