Current Issue : July-September Volume : 2025 Issue Number : 3 Articles : 5 Articles
Candidemia infection remains a critical challenge in intensive care units (ICUs), with high morbidity and mortality rates despite advances in therapeutic practices. This multicenter prospective surveillance study assessed the epidemiology, clinical management, and mortality predictors of candidemia in critically ill patients across two periods (2010–2012 and 2017–2018) in 11 tertiary hospitals in Brazil. Among 314 ICU patients with candidemia, the overall mortality rate was 60.2%, with no significant reduction over time (58.8% vs. 62.6%, p = 0.721). Candida albicans was the predominant pathogen (43.6%), followed by C. tropicalis (20%) and C. glabrata (13.7%). The use of echinocandins increased significantly in the second period (21.1% to 41.7%, p < 0.001); however, 70% of patients still did not receive these agents as first-line therapy. Catheter removal due to candidemia was performed in only 52.1% of cases but was associated with improved 30-day survival (p < 0.001). Multivariate analysis identified cancer, inadequate treatment, and vasoactive drug use as independent predictors of mortality. Our findings underscore persistent gaps in adherence to guidelines, particularly regarding timely echinocandin initiation and catheter removal. Strengthening therapeutic strategies focused on these key interventions is essential to improving outcomes for ICU patients with candidemia....
Artificial intelligence (AI) can potentially enhance cognitive assessment practices in maternal and child health nursing education. Objectives: To evaluate the reliability, accuracy and precision, and external validity of an AI-assisted answer assessment (4A) program for cognitive assessments in nursing education. Methods: This study is a validation study. Initially, 170 nursing students from northern Thailand participated, with 52 randomly selected for detailed testing. Agreement testing between the 4A program and human experts was conducted using the intraclass correlation coefficient (ICC). Accuracy and precision testing compared 4A scores with human expert assessments via the McNemar test. External validation involved 138 participants to compare the 4A program’s assessments against national examination outcomes using logistic regression. Results: Results indicated a high level of consistency between the 4A program and human experts (ICC = 0.886). With an accuracy of 0.808 and a precision of 0.913, compared to the human expert’s accuracy of 0.923 and precision of 1.000. The McNemar test (χ2 = 0.4, p = 0.527) showed no significant difference in evaluation performance between AI and human experts. Higher scores on the 4A program significantly predicted success in the national nursing examination (OR: 1.124, p = 0.031). Conclusions: The 4A program demonstrates potential in reliably assessing nursing students’ cognitive abilities and predicting exam success. This study advocates for the continued integration of AI in educational assessments and the importance of refining AI systems to better align with traditional assessment methods....
Background/Objectives: Effective diabetes self-management requires useful knowledge and health-related literacy based on a positive attitude toward seeking health information on the Internet. Therefore, this study aimed to determine the relationship of e-health literacy (eHL) with diabetes knowledge and attitudes toward internet health information in middle-aged patients with diabetes and to identify factors influencing patient eHL. Methods: This descriptive correlational study included 185 middle-aged patients with diabetes being followed-up with in the outpatient endocrinology department at a South Korean university hospital between 14 January and 29 February 2024. Data were collected using self-report structured questionnaires and were analyzed using IBM SPSS 27.0. Results: eHL was positively correlated with diabetes knowledge (r = 0.31, p < 0.001) and attitudes toward internet health information (r = 0.62, p < 0.001). Diabetes knowledge was also positively correlated with attitudes toward internet health information (r = 0.25, p < 0.001). Attitudes toward internet health information (β = 0.55, p = <0.001), diabetes knowledge (β = 0.13, p = 0.040), and drinking status (β = 0.12, p = 0.044) were significant variables affecting eHL. Conclusions: The most influencing factor in eHL in middle-aged patients with diabetes is the patient’s attitudes toward internet health information; diabetes knowledge was identified as a significant predictor. To improve eHL in middle-aged patients with diabetes, it is important to develop nursing intervention strategies to help promote diabetes knowledge and positive attitudes toward internet health information. Healthcare providers should continuously monitor patients to ensure they acquire and utilize correct information....
This study focused on the experiences and perceptions of geriatric healthcare professionals. The research aimed to identify ageism, examine the influencing factors, explore the desired attitudes of geriatric healthcare professionals, and identify institutional changes required for age-integrated efforts and strategies to eliminate these barriers. Interviews with two physicians and eight nurses were conducted in South Korea from August to November 2023, with each session lasting about 1 h, and the transcripts were analyzed using the grounded theory by Strauss and Corbin. The analysis yielded 11 categories, 20 subcategories, and 120 concepts. The central phenomenon was “Ageism that is conducted implicitly and covertly”. Causal conditions affecting the development of ageism were “Difficulties related to the perceived characteristics of older adults” and “Extra burden for older patients and their families”. Contextual conditions were “Provider’s aging anxiety” and “Personal experience about older patients”, and interventional conditions were “Insufficient regular education aimed at ageism prevention” and “Insufficient staffing and resources”. The action/interaction strategies were “Not perceived as a critical issue” and “Perception that it is difficult to change”. After a thorough analysis and materializing of these concepts, the following prevention measures were proposed: “Need for regular education regarding the care of older patients (including ageism) in the nursing educational curriculum” and the “Need for sufficient staffing and resources”. According to the results of this study, medical professionals must satisfy the healthcare needs of the elderly by understanding the proper aging process and tailoring their approach to the specific characteristics of older individuals. To achieve this, organizations should provide adequate resources and personnel....
Background: School nurses play a crucial role in promoting student health, addressing issues such as substance use, mental health, physical health, violence, and sexual health. However, their job satisfaction has been understudied, particularly in relation to the challenges they face. Objective: This study evaluates the job satisfaction and professional quality of life among school nurses and nurses working in educational settings in Spain. Methods: A descriptive cross-sectional study was conducted (November 2023– February 2024) with 553 nurses from various regions of Spain, using the Font-Roja job satisfaction and CPV-35 professional quality of life questionnaires. Results: Our results showed significant differences in job satisfaction between nurses in healthcare and educational settings, influenced by factors such as workload and institutional support. Most participants (97.5% women, median age ~40 years) had less than 5 years of experience. The lack of a dedicated nurse in half of the schools highlights disparities in service provision. Discussion: This study emphasizes the need for supportive policies and work environments to improve the well-being and job satisfaction of nurses in school settings....
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