Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

In diesem Beitrag verdeutliche ich meine Besorgnis uber zahlreiche Umformungen der Grounded Theory (GT), die mit deren Rezeption durch Methodologien der qualitative Datenanalyse (QDA) einhergehen, und hieraus folgende Erosionen. Ich skizziere zunachst einige Beispiele hierfur, um danach die essentiellen Bestandteile der klassischen GT-Methodologie zusammenzufassen. Ich hoffe, dass dieser Beitrag meine Besorgnis uber die wachsende, aber meines Erachtens missverstandene Einvernahme von GT durch QDA-Methodologien veranschaulicht und zugleich als einfuhrender Leitfaden fur Novizen und Novizinnen dient, die daran interessiert sind, die grundlegenden Prinzipien der GT nachzuvollziehen. \nURN: urn:nbn:de:0114-fqs040245

Remodeling Grounded Theory

Use of simulation-based learning in undergraduate nurse education: An umbrella systematic review.

The value of simulation-based learning in pre-licensure nurse education: A state-of-the-art review and meta-analysis

The Evidence in Simulation-Based Learning Experiences in Nursing Education and Practice: An Umbrella Review

Background: In recent years, nursing education has undergone changes and restructuring due to changes that have occurred in clinical and academic settings. Currently, academic leaders are facing the challenges of an increasing number of students, the difficulty of recruiting teachers and preceptors to accompany students, and fewer clinical settings that can accommodate many interns at once. To come to terms with these changes, the idea of replacing clinical hours with simulation has emerged. On this issue, little conclusive data is available. The objective of this article is to clarify the contribution of simulation in clinical nursing education in preparation or substitution for clinical placement. Methods: The CIHNAL, MedLine, and PubMed databases, and Google and Google Scholar search engines were consulted between to conduct a systematic review of the literature between 2008 and 2014. Thirty-three articles were selected. Results: Students and teachers perceive the benefits of simulation as an adjunct to clinical placement in terms of effectiveness, self-confidence, and preparation for clinical practice. Substituting clinical placement with simulation does not seem to have a significant impact on clinical competency, critical thinking, knowledge acquisition, and self-confidence. Conclusions: The findings question the very concept of substitution and suggest that the strengths of clinical exposure through both simulation and clinical placement should be highlighted.

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Simulation in preparation or substitution for clinical placement: A systematic review of the literature

Dignity or Dignities? When a Concept Has Multiple Meanings.

Anticipatory grief is a concept commonly used by researchers and clinicians when talking about the experience before the death of a loved one. This article offers a critical perspective on the disciplinary, theoretical and philosophical foundations of three distinct and frequently used conceptualisations of anticipatory grief: Lindemann's, Rando's and one derived from sociology. Lindemann's perspective conceived anticipatory grief as an inevitable component of the grieving experience in the situation of impending death. Rando's perspective views anticipatory grief as a multidimensional experience that facilitates post-mortem mourning. The third perspective, offered by sociologists, defines anticipatory grief as an experience highly influenced by the social context of the individual. This review explains how these different perspectives influence research and concludes with a reflection for potential future research.

Theoretical and philosophical assumptions behind the concept of anticipatory grief.

La théorisation ancrée : une méthodologie, plurielle

Introduction : Depuis mars 2020, le Quebec (Canada), comme le reste du monde, vit une crise sanitaire majeure resultant de la pandemie de COVID-19. En plus des nombreux deces occasionnes par le virus, des personnes vivront leur fin de vie dans ces temps mouvementes ou les mesures d’urgence sanitaire forcent leur isolement et modifient en profondeur l’organisation et la pratique des soins de fin de vie. Au Quebec, 64 % des personnes qui sont decedees etaient des residents de Centre d’hebergement et de soins de longue duree (CHSLD), une population consideree hautement vulnerable. Cependant, le risque de mourir de la COVID-19 est inegal entre les regions sociosanitaires du Quebec, suggerant, par le fait meme, la possibilite que des mesures organisationnelles et cliniques differentes aient ete mises en place dans divers milieux. Objectif : L’article presente le protocole d’une etude visant a mieux comprendre les effets de la COVID-19 sur les soins de fin de vie en CHSLD par l’identification de transformations organisationnelles et cliniques ainsi que le contraste de deux regions differemment affectees, soit Montreal et l’Estrie. Methodes : Un devis descriptif-explicatif est utilise. Des entrevues sont realisees avec les coordonnateurs de site et les soignants ayant travaille en CHSLD durant la premiere vague de COVID-19 afin d’identifier les transformations vecues et leurs effets sur les soins offerts aux residents en fin de vie, ainsi que sur le personnel soignant. Discussion et conclusion : Les conclusions de ce projet meneront a des recommandations sur le plan organisationnel, clinique, politique et scientifique.

La COVID-19 et les soins de fin de vie en centre d’hébergement et de soins de longue durée (CHSLD) : protocole de recherche de type descriptif-explicatif dans deux régions différemment affectées du Québec

Emilie Allard

Papers

Simulation in preparation or substitution for clinical placement: A systematic review of the literature

Dignity or Dignities? When a Concept Has Multiple Meanings.

Theoretical and philosophical assumptions behind the concept of anticipatory grief.

La théorisation ancrée : une méthodologie, plurielle

La COVID-19 et les soins de fin de vie en centre d’hébergement et de soins de longue durée (CHSLD) : protocole de recherche de type descriptif-explicatif dans deux régions différemment affectées du Québec