Association between intrapartum fetal pulse oximetry and adverse perinatal and long-term outcomes: a systematic review and meta-analysis protocol [version 2; peer review: 2 approved]

Background Current methods of intrapartum fetal monitoring based on heart rate, increase the rates of operative delivery but do not prevent or accurately detect fetal hypoxic brain injury. There is a need for more accurate methods of intrapartum fetal surveillance that will decrease the incidence of adverse perinatal and long-term neurodevelopmental outcomes while maintaining the lowest possible rate of obstetric intervention. Fetal pulse oximetry (FPO) is a technology that may contribute to improved intrapartum fetal wellbeing evaluation by providing a non-invasive measurement of fetal oxygenation status. Objective This systematic review and meta-analysis aims to synthesise the evidence examining the association between intrapartum fetal oxygen saturation levels and adverse perinatal and long-term outcomes in the offspring. Methods We will include randomised control trials (RCTs), cohort, cross-sectional and case-control studies which examine the use of FPO during labour as a means of measuring intrapartum fetal oxygen saturation and assess its effectiveness at detecting adverse perinatal and long-term outcomes compared to existing intrapartum surveillance methods. A detailed systematic search of PubMed, EMBASE, CINAHL, The Cochrane Library, Web of Science, ClinicalTrials.Gov and WHO ICTRP will be conducted following a detailed search strategy until February 2024. Three authors will independently review titles, abstracts and full text of articles. Two reviewers will independently extract data using a pre-defined data extraction form and assess the quality of included studies using the Risk of Bias tool for RCTs and Newcastle-Ottawa Scale for observational studies. The grading of recommendations, assessment, development, and evaluation (GRADE) approach will be used to evaluate the certainty of the evidence. We will use random-effects meta-analysis for each exposure-outcome association to calculate pooled estimates using the generic variance method. This systematic review will follow the Preferred Reporting Items for Systematic reviews and Meta-analyses and MOOSE guidelines. PROSPERO registration CRD42023457368 (04/09/2023

Uma visão da produção científica internacional sobre a classificação internacional para a prática de enfermagem

A Classificação Internacional para a Prática de Enfermagem (CIPE®) é um sistema classificatório que visa padronizaruma linguagem universal para Enfermagem. Este artigo propõe identificar os estudos desenvolvidos noâmbito mundial abordando a CIPE®, categorizando-os segundo suas finalidades. Trata-se de uma revisão de literatura,em base de dados da Biblioteca Virtual em Saúde, pelo o termo “ICNP”, com abrangência até 2009. Foramencontrados 124 artigos; 65 analisados, cujo conteúdo foi agrupado em nove categorias: abordagens gerais;aplicabilidade à prática; avaliação de classificações; experiências com recursos computacionais; desenvolvimento einclusão de termos; abordagem sobre sistemas classificatórios; uso para ancorar a construção de declarações deenfermagem; traduções; e outros. Verificou-se que poucos trabalhos apresentam projetos ou avaliam resultados deaplicações práticas da CIPE®; a maioria aborda aspectos conceituais ou realiza comparações com outras classificações.Diversos trabalhos concluem sobre a adequação e relevância da CIPE®, mas apontam a necessidade de aperfeiçoamento

Health informatics : transforming healthcare with technology

In today's healthcare system the most pervasive and transformational tool is information technology - its efficient use is an essential skill for all health workers. Health Informatics: Transforming Healthcare with Technology discusses health information systems and contains diverse case studies and stories from policy makers, managers, academics, clinicians and those working in outback clinics. The text concludes by pushing the boundaries into genomics and by outlining the future direction of information technology in the healthcare system. Health Informatics is essential reading for students and healthcare workers across all health disciplines and is a valuable resource for those considering implementing health information systems into their practices or institutions. Technology is one of the most pervasive and ubiquitous tools in healthcare today. It is not only transforming healthcare but also the professions within it. This book provides the background and skills necessary to understand the collection, storage, retrieval, communication and optimal use of health-related data, information and knowledge. - publisher description

Behavioral Health and Criminal Legal System Interactions of Extreme Risk Protection Order Respondents: A Statewide Mixed-Methods Study

Extreme Risk Protection Orders (ERPOs) are designed to reduce the lethality of dangerous behavior involving firearms; as such, several respondents interact with the behavioral health system. Additionally, while ERPOs are civil orders, several respondents also interface with the criminal legal system. These interactions may initiate or perpetuate a cycle of entanglement with the legal system or serve as an intervention point to address root causes of crisis. Understanding these intersecting pathways is essential for optimizing the long-term support available to ERPO respondents who have experienced a crisis. This knowledge could inform judicial decisions, guide policy change, and enable more targeted interventions, ultimately contributing to broader goals of public safety and individual well-being. We propose a statewide project to improve our understanding of ERPO implementation and process by characterizing interactions of ERPO respondents with behavioral health and criminal legal systems in Washington. We will: (1) Determine circumstances of EPRO petitions when a respondent is ordered behavioral health evaluation or arrested during the events surrounding ERPO filing; (2) Examine changes in behavioral health and criminal legal system encounters before and after becoming an ERPO respondent, comparing those who were ordered to have a behavioral health evaluation and/or arrested during the events surrounding ERPO filing to those who were not; and (3) Identify factors influencing the decision-making processes of law enforcement officers, prosecutors, and judges when deciding to order a behavioral health evaluation or arrest ERPO respondents. Few studies have quantified changes in behavioral health and criminal legal system interactions among ERPO respondents or conducted qualitative analyses on ERPO petitions. Previously, our team has qualitatively analyzed ERPO petitions, investigated the socioecological factors influencing respondent behaviors that led to ERPO filing, and identified patterns in the process of risk assessment and interventions among healthcare providers and social workers involved in ERPOs. This statewide study represents a partnership between a multidisciplinary group of academic researchers from the University of Washington and applied practitioners from the King County Regional Domestic Violence Firearms Enforcement Unit (RDVFEU) with longstanding history of collaboration. RDVFEU is one of the first units of its kind in the country dedicated to enforcing firearm prohibitions with substantial expertise in ERPO implementation. Our research team collectively has notable experience in studying and implementing ERPOs and seeks to address important gaps in knowledge and practice through this project which is responsive to Priority Topic 3 of the National Collaborative on Gun Violence Research Request for Research Proposals. We will also convene an Advisory Board to provide guidance, help monitor our progress, and advise on the dissemination of our findings with highest standards of objectivity. This multidisciplinary board will collectively represent perspectives from practitioners within the criminal legal and health systems, policy makers, legal experts, and community members. The rigorous quantitative and qualitative approaches proposed in this new project will contribute valuable insights into the implementation of ERPOs, leading to improvements in policies and processes that involve behavioral health and criminal legal systems

Issues of Ethics and Law

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