A narrative review of patients' lived experience of having a pressure injury

AIM

To explore patients' experiences of living with pressure injuries.

DESIGN

A qualitative narrative review and thematic synthesis of qualitative research studies.

DATA SOURCES

Six electronic databases were searched: Medline, CINAHL, Scopus, Web of Science, Embase, and Google Scholar (for grey literature). The search was conducted between October 2022 and April 2023. Setting: Acute, community and care home settings across the UK, France, Belgium and the US.

REVIEW METHODS

The PRISMA checklist for reporting systematic reviews was used. The included studies were evaluated for quality using the CASP tool. The Joanna Briggs Institute data extraction tool was used to extract data from the included studies. Thematic synthesis was used to identify themes to present a coherent and nuanced understanding of patients' experiences of living with pressure injuries.

RESULTS

Nine studies involving 244 participants, aged 21 to 101, with pressure injuries, met the inclusion criteria. Three key themes emerged using thematic analysis: physiological, emotional and psychological, and social effects. Within these themes, subthemes such as endless pain and discomfort, loss of mobility and independence, and social isolation were dominant in all aspects of the lives of patients living with pressure injuries.

CONCLUSIONS

This narrative review gives clear and multifaceted insight into the impact of pressure injuries on individuals' lives, emphasising the necessity for patient-centred care and the integration of evidence-based tools for effective pain management and risk assessment. The impact of pain on emotional and psychological wellbeing was significant, and the financial implications are scarcely known. Future research is needed to explore the experiences of younger adults and the financial consequences of living with pressure injuries.

COVID-19 Outbreak Challenges in Indian Migrant Pregnant and Lactating Mothers: Learnt Lesson Demands Phronesis and Hierarchical Strategies for Such Future Pandemics

INTRODUCTION

The coronavirus disease (COVID-19) has been found to influence almost all sectors starting from socio-religious to educational and environmental levels. However, the systematically planned or unplanned implementation of sudden lockdown across the globe, including India, has pushed the migrant workers into huge troubles. Without savings and transport systems, food security and other problems pushed migrant workers to walk to home from working places covering over 1000 km. Walking under the hot sun with heavy luggage and child in the womb or arm has affected the lactating mothers or pregnant women the most. The objective of this review article was to analyse the problems faced especially by the women migrant workers in India in order to point out and to adapt future strategies for their protection.

METHODS

All published relevant literature from scientific sources and reputed news channels are considered to write the current review.

RESULTS

Tremendous adverse effects of COVID-19 have been observed at social/cultural/religious/economic levels and other sectors of the society albeit its huge progressive but temporary effects are also observed on environment. The environment is self-regenerating, while the economy is pushed to an unseen manner. This is because many countries including India have adopted social lockdowns as a measure of prevention against the highly contagious disease. The results of lockdowns are encourageable as far as the reduced infection and death rate is concerned. For example, India being the second largest populous country with less advanced healthcare system is enjoying a comparatively low rate of death in COVID-19. However, sudden lockdowns followed by shutdowns mediated by industrial closure have pushed many migrant workers to walk to home by passing over even >1000 kilometres of distance on barefoot. Without transport systems, proper food and medications, many migrant workers faced un-imaginary difficulties, and some of them have also died on the way. Pregnant women and lactating mothers were also in the list and found to face unseen problems while migrating to their home from their working places with a load of child in the womb or on arm. So, phronesis of such problems and hierarchical strategies are suggested.

CONCLUSION

Since such zoonotic pandemics cannot be avoided in the near future, solid future strategies must be adopted by different nations especially under developed and poor countries to tackle the problem of the migrant workers including the pregnant women and the lactating mothers.

Using news coverage and community-based impact assessments to understand and track social effects using the perspectives of affected people and decisionmakers

This paper applies an innovative approach to monitoring social effects occurring before and during construction of two hydroelectric dams in Canada. The two studied dams, Site C and Keeyask, are under construction in Canada and underwent community-based impact assessment (CBIA). News coverage and the CBIA documents were analyzed to understand and compare how those two groups perceive social effects induced by the two projects. CBIAs contain concerns expressed by affected people, whereas news coverage can include quotes from both affected people and decisionmakers involved in the assessment process. By contrasting these datasets, we found that the documents are complementary: while CBIAs are comprehensive in assessing community concerns, news outlets can reveal how those concerns evolved throughout different phases of the projects' implementation. This approach fills a gap in SIA around monitoring of key social effects around local conflicts and disputes, psychosocial effects, socioeconomic effects, and cumulative effects on a daily life. Furthermore, by contrasting the views identified within the impact assessments and the media, the study demonstrates how specific concerns diverged: affected people focus on local social effects while decisionmakers' interests lie in a broader political perspective grounded in local sacrifices 'for the good of the whole province'. Our analysis emphasizes the role of political power over decision making that can inhibit CBIA and social impact assessment practice from contributing to socially sustainable projects.

"A perfect society"- Swedish policymakers' ethical and social views on preconception expanded carrier screening

To improve healthcare policymaking, commentators have recommended the use of evidence, health technology assessment, priority setting, and public engagement in the process of policymaking. Preconception expanded carrier screening, according to the World Health Organization's definition, is a novel health technology and therefore warrants assessment, part of which involves evaluating ethical and social implications. We examined ten Swedish policymakers' perspectives on ethical and social aspects of preconception expanded screening through in-depth expert interviewing, using a semi-structured questionnaire. Respondents were affiliated to governmental and non-governmental institutions that directly influence healthcare policymaking in Sweden. The interviews were recorded, transcribed verbatim, and analyzed via inductive thematic analysis method, which generated seven themes and several subthemes. Policymakers harbored concerns regarding the economics, Swedish and international political respects, implementation procedures, and societal effects, which included long-term ones. Moreover, participants detailed the role of public engagement, research, and responsibility in regard to preconception expanded carrier screening implementation. Since this is a qualitative study, with a small non-random sample, the results may not be generalizable to all policymakers in Sweden. However, the results give a profound insight into the process and interpretative knowledge of experts, in the Swedish milieu and the extent of readiness of Sweden to implement a preconception expanded carrier screening program.

Methods to identify linear network models: a review

In many contexts we may be interested in understanding whether direct connections between agents, such as declared friendships in a classroom or family links in a rural village, affect their outcomes. In this paper, we review the literature studying econometric methods for the analysis of linear models of social effects, a class that includes the 'linear-in-means' local average model, the local aggregate model, and models where network statistics affect outcomes. We provide an overview of the underlying theoretical models, before discussing conditions for identification using observational and experimental/quasi-experimental data.

A Qualitative Study on the Interconnected Nature of HIV, Water, and Family

Human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS) and poor access to water are two primary global health issues. Poor access to water may significantly affect families infected with HIV and result in adverse social and health consequences. A qualitative study used semi-structured interviews to understand health and social outcomes of families after the implementation of water interventions in rural Kenya. One major sub-theme emerged during this research, which included the effects of water on an HIV-affected family. Prior to the water interventions, common adverse health effects from lack of nutrition, water, and poor hygiene were experienced. After receiving access to water, nutrition and hygiene were improved and additional time was gained and used to reinforce relationships and spread awareness about HIV/AIDS. This study provides need-based evidence for access to safe drinking water in order to decrease adverse health outcomes and improve the quality of life for HIV-affected individuals.

Psychological, behavioral and social effects of disclosing Alzheimer's disease biomarkers to research participants: a systematic review

BACKGROUND

Current Alzheimer's disease (AD) research initiatives focus on cognitively healthy individuals with biomarkers that are associated with the development of AD. It is unclear whether biomarker results should be returned to research participants and what the psychological, behavioral and social effects of disclosure are. This systematic review therefore examines the psychological, behavioral and social effects of disclosing genetic and nongenetic AD-related biomarkers to cognitively healthy research participants.

METHODS

We performed a systematic literature search in eight scientific databases. Three independent reviewers screened the identified records and selected relevant articles. Results extracted from the included articles were aggregated and presented per effect group.

RESULTS

Fourteen studies met the inclusion criteria and were included in the data synthesis. None of the identified studies examined the effects of disclosing nongenetic biomarkers. All studies but one concerned the disclosure of APOE genotype and were conducted in the USA. Study populations consisted largely of cognitively healthy first-degree relatives of AD patients. In this group, disclosure of an increased risk was not associated with anxiety, depression or changes in perceived risk in relation to family history. Disclosure of an increased risk did lead to an increase in specific test-related distress levels, health-related behavior changes and long-term care insurance uptake and possibly diminished memory functioning.

CONCLUSION

In cognitively healthy research participants with a first-degree relative with AD, disclosure of APOE ε4-positivity does not lead to elevated anxiety and depression levels, but does increase test-related distress and results in behavior changes concerning insurance and health. We did not find studies reporting the effects of disclosing nongenetic biomarkers and only one study included people without a family history of AD. Empirical studies on the effects of disclosing nongenetic biomarkers and of disclosure to persons without a family history of AD are urgently needed.

TRIAL REGISTRATION

PROSPERO international prospective register for systematic reviews CRD42016035388 . Registered 19 February 2016.

Evolutionary genetics of maternal effects

Maternal genetic effects (MGEs), where genes expressed by mothers affect the phenotype of their offspring, are important sources of phenotypic diversity in a myriad of organisms. We use a single‐locus model to examine how MGEs contribute patterns of heritable and nonheritable variation and influence evolutionary dynamics in randomly mating and inbreeding populations. We elucidate the influence of MGEs by examining the offspring genotype‐phenotype relationship, which determines how MGEs affect evolutionary dynamics in response to selection on offspring phenotypes. This approach reveals important results that are not apparent from classic quantitative genetic treatments of MGEs. We show that additive and dominance MGEs make different contributions to evolutionary dynamics and patterns of variation, which are differentially affected by inbreeding. Dominance MGEs make the offspring genotype‐phenotype relationship frequency dependent, resulting in the appearance of negative frequency‐dependent selection, while additive MGEs contribute a component of parent‐of‐origin dependent variation. Inbreeding amplifies the contribution of MGEs to the additive genetic variance and, therefore enhances their evolutionary response. Considering evolutionary dynamics of allele frequency change on an adaptive landscape, we show that this landscape differs from the mean fitness surface, and therefore, under some condition, fitness peaks can exist but not be “available” to the evolving population.