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Duong Doan TT, Binns C, Lee A, Minh Pham N, Phuong Hoa Dinh T, Zhao Y, Ha Bui TT. Effect of a mobile app on breastfeeding among cesarean deliveries: A randomized controlled trial. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Aim
Cesarean section has negative impacts on breastfeeding rates. This study is to evaluate the effect of a mobile application on breastfeeding outcomes among mothers who had cesarean section using a randomized control trial in Vietnam in 2020 - 2022.
Methods
A triple-blinded randomized trial of a mobile application was conducted. The mobile application was tailored to Vietnamese culture with two separate versions for the intervention and the control group. The intervention version auto-generated three messages per week and linked the information in the library content to improve breastfeeding while the control version sent messages on maternal and child health care. Pregnant mothers were recruited during their antenatal visits and randomly assigned to two groups. Outcomes of interest included early initiation of breastfeeding and exclusive breastfeeding rates.
Results
A total of 275 mothers in the control and 293 in the intervention group who had undergone a cesarean section were included in the analyses. Significant increases were observed for early initiated breastfeeding within two hours (aOR= 1.51, 95%CI: 1.01 to 2.27) and exclusive breastfeeding during hospital stay (aOR=1.59, 95%CI: 1.02 to 2.49).
Conclusions
Our results support the use of a theory-based design mobile phone application as a part of a promising intervention to improve breastfeeding outcomes.
Key messages
• A mobile phone application could be a widely accessible, acceptable, and effective intervention to improve breastfeeding outcomes.
• To improve exclusive breastfeeding rates, comprehensive interventions at different levels of sociocultural and market contexts, settings, and individuals are needed.
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Lee A, Badran A, Alzetani A. 420 Thoracic Physiotherapy Requirements in Anatomical Lung Resections. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Objective
Consideration of the effectiveness of thoracic physiotherapy interventions in anatomical lung resections.
Method
Prospective cohort of 119 anatomical lung resections and assessment of physiotherapy interventions in a busy teaching hospital over a 6-month period.
Results
119 patients were included, with median age of 69 (28–89). There was no obvious difference between genders (F: 52% vs M: 48%). 56% were assessed to be of performance status 0. Most were resections for adenocarcinoma (48%) and squamous cell carcinoma (10%). 61% were resected by VATS and 39% through other approaches (including open thoracotomies). A minority had no comorbidities (18%), with hypertension (41%) and previous solid tumours (33%) being most common. Average length of stay was 4 days for the cohort (3.4 for VATS and 4.9 for others). The average length of stay for patients who were seen day 1 post-op on a weekend is 4.4 (vs 5.1 if there were not seen on day 1). This is also in contrast with the average length of stay of 3.5 days if they were seen day 1 post-op on a weekday, as opposed to 4 days of average stay if they were not seen. The biggest barrier to closing this discrepancy remains weekend physiotherapy staffing.
Conclusion
We found that elective thoracic patients are more likely to have a reduced length of stay when reviewed day 1 post-op. This highlights the need for potential service developments within our weekend and Level 2/3 elective thoracic caseloads to optimise our care.
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Fox SN, McMeekin LJ, Savage CH, Joyce KL, Boas SM, Simmons MS, Farmer CB, Ryan J, Pereboeva L, Becker K, Auwerx J, Sudarshan S, Ma J, Lee A, Roberts RC, Crossman DK, Kralli A, Cowell RM. Estrogen-related receptor gamma regulates mitochondrial and synaptic genes and modulates vulnerability to synucleinopathy. NPJ Parkinsons Dis 2022; 8:106. [PMID: 35982091 PMCID: PMC9388660 DOI: 10.1038/s41531-022-00369-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 07/12/2022] [Indexed: 11/17/2022] Open
Abstract
Many studies implicate mitochondrial dysfunction as a key contributor to cell loss in Parkinson disease (PD). Previous analyses of dopaminergic (DAergic) neurons from patients with Lewy-body pathology revealed a deficiency in nuclear-encoded genes for mitochondrial respiration, many of which are targets for the transcription factor estrogen-related receptor gamma (Esrrg/ERRγ). We demonstrate that deletion of ERRγ from DAergic neurons in adult mice was sufficient to cause a levodopa-responsive PD-like phenotype with reductions in mitochondrial gene expression and number, that partial deficiency of ERRγ hastens synuclein-mediated toxicity, and that ERRγ overexpression reduces inclusion load and delays synuclein-mediated cell loss. While ERRγ deletion did not fully recapitulate the transcriptional alterations observed in postmortem tissue, it caused reductions in genes involved in synaptic and mitochondrial function and autophagy. Altogether, these experiments suggest that ERRγ-deficient mice could provide a model for understanding the regulation of transcription in DAergic neurons and that amplifying ERRγ-mediated transcriptional programs should be considered as a strategy to promote DAergic maintenance in PD.
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Abu-Shawareb H, Acree R, Adams P, Adams J, Addis B, Aden R, Adrian P, Afeyan BB, Aggleton M, Aghaian L, Aguirre A, Aikens D, Akre J, Albert F, Albrecht M, Albright BJ, Albritton J, Alcala J, Alday C, Alessi DA, Alexander N, Alfonso J, Alfonso N, Alger E, Ali SJ, Ali ZA, Alley WE, Amala P, Amendt PA, Amick P, Ammula S, Amorin C, Ampleford DJ, Anderson RW, Anklam T, Antipa N, Appelbe B, Aracne-Ruddle C, Araya E, Arend M, Arnold P, Arnold T, Asay J, Atherton LJ, Atkinson D, Atkinson R, Auerbach JM, Austin B, Auyang L, Awwal AS, Ayers J, Ayers S, Ayers T, Azevedo S, Bachmann B, Back CA, Bae J, Bailey DS, Bailey J, Baisden T, Baker KL, Baldis H, Barber D, Barberis M, Barker D, Barnes A, Barnes CW, Barrios MA, Barty C, Bass I, Batha SH, Baxamusa SH, Bazan G, Beagle JK, Beale R, Beck BR, Beck JB, Bedzyk M, Beeler RG, Beeler RG, Behrendt W, Belk L, Bell P, Belyaev M, Benage JF, Bennett G, Benedetti LR, Benedict LX, Berger R, Bernat T, Bernstein LA, Berry B, Bertolini L, Besenbruch G, Betcher J, Bettenhausen R, Betti R, Bezzerides B, Bhandarkar SD, Bickel R, Biener J, Biesiada T, Bigelow K, Bigelow-Granillo J, Bigman V, Bionta RM, Birge NW, Bitter M, Black AC, Bleile R, Bleuel DL, Bliss E, Bliss E, Blue B, Boehly T, Boehm K, Boley CD, Bonanno R, Bond EJ, Bond T, Bonino MJ, Borden M, Bourgade JL, Bousquet J, Bowers J, Bowers M, Boyd R, Bozek A, Bradley DK, Bradley KS, Bradley PA, Bradley L, Brannon L, Brantley PS, Braun D, Braun T, Brienza-Larsen K, Briggs TM, Britten J, Brooks ED, Browning D, Bruhn MW, Brunner TA, Bruns H, Brunton G, Bryant B, Buczek T, Bude J, Buitano L, Burkhart S, Burmark J, Burnham A, Burr R, Busby LE, Butlin B, Cabeltis R, Cable M, Cabot WH, Cagadas B, Caggiano J, Cahayag R, Caldwell SE, Calkins S, Callahan DA, Calleja-Aguirre J, Camara L, Camp D, Campbell EM, Campbell JH, Carey B, Carey R, Carlisle K, Carlson L, Carman L, Carmichael J, Carpenter A, Carr C, Carrera JA, Casavant D, Casey A, Casey DT, Castillo A, Castillo E, Castor JI, Castro C, Caughey W, Cavitt R, Celeste J, Celliers PM, Cerjan C, Chandler G, Chang B, Chang C, Chang J, Chang L, Chapman R, Chapman T, Chase L, Chen H, Chen H, Chen K, Chen LY, Cheng B, Chittenden J, Choate C, Chou J, Chrien RE, Chrisp M, Christensen K, Christensen M, Christopherson AR, Chung M, Church JA, Clark A, Clark DS, Clark K, Clark R, Claus L, Cline B, Cline JA, Cobble JA, Cochrane K, Cohen B, Cohen S, Collette MR, Collins G, Collins LA, Collins TJB, Conder A, Conrad B, Conyers M, Cook AW, Cook D, Cook R, Cooley JC, Cooper G, Cope T, Copeland SR, Coppari F, Cortez J, Cox J, Crandall DH, Crane J, Craxton RS, Cray M, Crilly A, Crippen JW, Cross D, Cuneo M, Cuotts G, Czajka CE, Czechowicz D, Daly T, Danforth P, Darbee R, Darlington B, Datte P, Dauffy L, Davalos G, Davidovits S, Davis P, Davis J, Dawson S, Day RD, Day TH, Dayton M, Deck C, Decker C, Deeney C, DeFriend KA, Deis G, Delamater ND, Delettrez JA, Demaret R, Demos S, Dempsey SM, Desjardin R, Desjardins T, Desjarlais MP, Dewald EL, DeYoreo J, Diaz S, Dimonte G, Dittrich TR, Divol L, Dixit SN, Dixon J, Dodd ES, Dolan D, Donovan A, Donovan M, Döppner T, Dorrer C, Dorsano N, Douglas MR, Dow D, Downie J, Downing E, Dozieres M, Draggoo V, Drake D, Drake RP, Drake T, Dreifuerst G, DuBois DF, DuBois PF, Dunham G, Dylla-Spears R, Dymoke-Bradshaw AKL, Dzenitis B, Ebbers C, Eckart M, Eddinger S, Eder D, Edgell D, Edwards MJ, Efthimion P, Eggert JH, Ehrlich B, Ehrmann P, Elhadj S, Ellerbee C, Elliott NS, Ellison CL, Elsner F, Emerich M, Engelhorn K, England T, English E, Epperson P, Epstein R, Erbert G, Erickson MA, Erskine DJ, Erlandson A, Espinosa RJ, Estes C, Estabrook KG, Evans S, Fabyan A, Fair J, Fallejo R, Farmer N, Farmer WA, Farrell M, Fatherley VE, Fedorov M, Feigenbaum E, Feit M, Ferguson W, Fernandez JC, Fernandez-Panella A, Fess S, Field JE, Filip CV, Fincke JR, Finn T, Finnegan SM, Finucane RG, Fischer M, Fisher A, Fisher J, Fishler B, Fittinghoff D, Fitzsimmons P, Flegel M, Flippo KA, Florio J, Folta J, Folta P, Foreman LR, Forrest C, Forsman A, Fooks J, Foord M, Fortner R, Fournier K, Fratanduono DE, Frazier N, Frazier T, Frederick C, Freeman MS, Frenje J, Frey D, Frieders G, Friedrich S, Froula DH, Fry J, Fuller T, Gaffney J, Gales S, Le Galloudec B, Le Galloudec KK, Gambhir A, Gao L, Garbett WJ, Garcia A, Gates C, Gaut E, Gauthier P, Gavin Z, Gaylord J, Geissel M, Génin F, Georgeson J, Geppert-Kleinrath H, Geppert-Kleinrath V, Gharibyan N, Gibson J, Gibson C, Giraldez E, Glebov V, Glendinning SG, Glenn S, Glenzer SH, Goade S, Gobby PL, Goldman SR, Golick B, Gomez M, Goncharov V, Goodin D, Grabowski P, Grafil E, Graham P, Grandy J, Grasz E, Graziani F, Greenman G, Greenough JA, Greenwood A, Gregori G, Green T, Griego JR, Grim GP, Grondalski J, Gross S, Guckian J, Guler N, Gunney B, Guss G, Haan S, Hackbarth J, Hackel L, Hackel R, Haefner C, Hagmann C, Hahn KD, Hahn S, Haid BJ, Haines BM, Hall BM, Hall C, Hall GN, Hamamoto M, Hamel S, Hamilton CE, Hammel BA, Hammer JH, Hampton G, Hamza A, Handler A, Hansen S, Hanson D, Haque R, Harding D, Harding E, Hares JD, Harris DB, Harte JA, Hartouni EP, Hatarik R, Hatchett S, Hauer AA, Havre M, Hawley R, Hayes J, Hayes J, Hayes S, Hayes-Sterbenz A, Haynam CA, Haynes DA, Headley D, Heal A, Heebner JE, Heerey S, Heestand GM, Heeter R, Hein N, Heinbockel C, Hendricks C, Henesian M, Heninger J, Henrikson J, Henry EA, Herbold EB, Hermann MR, Hermes G, Hernandez JE, Hernandez VJ, Herrmann MC, Herrmann HW, Herrera OD, Hewett D, Hibbard R, Hicks DG, Hill D, Hill K, Hilsabeck T, Hinkel DE, Ho DD, Ho VK, Hoffer JK, Hoffman NM, Hohenberger M, Hohensee M, Hoke W, Holdener D, Holdener F, Holder JP, Holko B, Holunga D, Holzrichter JF, Honig J, Hoover D, Hopkins D, Berzak Hopkins L, Hoppe M, Hoppe ML, Horner J, Hornung R, Horsfield CJ, Horvath J, Hotaling D, House R, Howell L, Hsing WW, Hu SX, Huang H, Huckins J, Hui H, Humbird KD, Hund J, Hunt J, Hurricane OA, Hutton M, Huynh KHK, Inandan L, Iglesias C, Igumenshchev IV, Izumi N, Jackson M, Jackson J, Jacobs SD, James G, Jancaitis K, Jarboe J, Jarrott LC, Jasion D, Jaquez J, Jeet J, Jenei AE, Jensen J, Jimenez J, Jimenez R, Jobe D, Johal Z, Johns HM, Johnson D, Johnson MA, Gatu Johnson M, Johnson RJ, Johnson S, Johnson SA, Johnson T, Jones K, Jones O, Jones M, Jorge R, Jorgenson HJ, Julian M, Jun BI, Jungquist R, Kaae J, Kabadi N, Kaczala D, Kalantar D, Kangas K, Karasiev VV, Karasik M, Karpenko V, Kasarky A, Kasper K, Kauffman R, Kaufman MI, Keane C, Keaty L, Kegelmeyer L, Keiter PA, Kellett PA, Kellogg J, Kelly JH, Kemic S, Kemp AJ, Kemp GE, Kerbel GD, Kershaw D, Kerr SM, Kessler TJ, Key MH, Khan SF, Khater H, Kiikka C, Kilkenny J, Kim Y, Kim YJ, Kimko J, Kimmel M, Kindel JM, King J, Kirkwood RK, Klaus L, Klem D, Kline JL, Klingmann J, Kluth G, Knapp P, Knauer J, Knipping J, Knudson M, Kobs D, Koch J, Kohut T, Kong C, Koning JM, Koning P, Konior S, Kornblum H, Kot LB, Kozioziemski B, Kozlowski M, Kozlowski PM, Krammen J, Krasheninnikova NS, Kraus B, Krauser W, Kress JD, Kritcher AL, Krieger E, Kroll JJ, Kruer WL, Kruse MKG, Kucheyev S, Kumbera M, Kumpan S, Kunimune J, Kustowski B, Kwan TJT, Kyrala GA, Laffite S, Lafon M, LaFortune K, Lahmann B, Lairson B, Landen OL, Langenbrunner J, Lagin L, Land T, Lane M, Laney D, Langdon AB, Langer SH, Langro A, Lanier NE, Lanier TE, Larson D, Lasinski BF, Lassle D, LaTray D, Lau G, Lau N, Laumann C, Laurence A, Laurence TA, Lawson J, Le HP, Leach RR, Leal L, Leatherland A, LeChien K, Lechleiter B, Lee A, Lee M, Lee T, Leeper RJ, Lefebvre E, Leidinger JP, LeMire B, Lemke RW, Lemos NC, Le Pape S, Lerche R, Lerner S, Letts S, Levedahl K, Lewis T, Li CK, Li H, Li J, Liao W, Liao ZM, Liedahl D, Liebman J, Lindford G, Lindman EL, Lindl JD, Loey H, London RA, Long F, Loomis EN, Lopez FE, Lopez H, Losbanos E, Loucks S, Lowe-Webb R, Lundgren E, Ludwigsen AP, Luo R, Lusk J, Lyons R, Ma T, Macallop Y, MacDonald MJ, MacGowan BJ, Mack JM, Mackinnon AJ, MacLaren SA, MacPhee AG, Magelssen GR, Magoon J, Malone RM, Malsbury T, Managan R, Mancini R, Manes K, Maney D, Manha D, Mannion OM, Manuel AM, Mapoles E, Mara G, Marcotte T, Marin E, Marinak MM, Mariscal C, Mariscal DA, Mariscal EF, Marley EV, Marozas JA, Marquez R, Marshall CD, Marshall FJ, Marshall M, Marshall S, Marticorena J, Martinez D, Maslennikov I, Mason D, Mason RJ, Masse L, Massey W, Masson-Laborde PE, Masters ND, Mathisen D, Mathison E, Matone J, Matthews MJ, Mattoon C, Mattsson TR, Matzen K, Mauche CW, Mauldin M, McAbee T, McBurney M, Mccarville T, McCrory RL, McEvoy AM, McGuffey C, Mcinnis M, McKenty P, McKinley MS, McLeod JB, McPherson A, Mcquillan B, Meamber M, Meaney KD, Meezan NB, Meissner R, Mehlhorn TA, Mehta NC, Menapace J, Merrill FE, Merritt BT, Merritt EC, Meyerhofer DD, Mezyk S, Mich RJ, Michel PA, Milam D, Miller C, Miller D, Miller DS, Miller E, Miller EK, Miller J, Miller M, Miller PE, Miller T, Miller W, Miller-Kamm V, Millot M, Milovich JL, Minner P, Miquel JL, Mitchell S, Molvig K, Montesanti RC, Montgomery DS, Monticelli M, Montoya A, Moody JD, Moore AS, Moore E, Moran M, Moreno JC, Moreno K, Morgan BE, Morrow T, Morton JW, Moses E, Moy K, Muir R, Murillo MS, Murray JE, Murray JR, Munro DH, Murphy TJ, Munteanu FM, Nafziger J, Nagayama T, Nagel SR, Nast R, Negres RA, Nelson A, Nelson D, Nelson J, Nelson S, Nemethy S, Neumayer P, Newman K, Newton M, Nguyen H, Di Nicola JMG, Di Nicola P, Niemann C, Nikroo A, Nilson PM, Nobile A, Noorai V, Nora R, Norton M, Nostrand M, Note V, Novell S, Nowak PF, Nunez A, Nyholm RA, O'Brien M, Oceguera A, Oertel JA, Okui J, Olejniczak B, Oliveira J, Olsen P, Olson B, Olson K, Olson RE, Opachich YP, Orsi N, Orth CD, Owen M, Padalino S, Padilla E, Paguio R, Paguio S, Paisner J, Pajoom S, Pak A, Palaniyappan S, Palma K, Pannell T, Papp F, Paras D, Parham T, Park HS, Pasternak A, Patankar S, Patel MV, Patel PK, Patterson R, Patterson S, Paul B, Paul M, Pauli E, Pearce OT, Pearcy J, Pedrotti B, Peer A, Pelz LJ, Penetrante B, Penner J, Perez A, Perkins LJ, Pernice E, Perry TS, Person S, Petersen D, Petersen T, Peterson DL, Peterson EB, Peterson JE, Peterson JL, Peterson K, Peterson RR, Petrasso RD, Philippe F, Phipps TJ, Piceno E, Ping Y, Pickworth L, Pino J, Plummer R, Pollack GD, Pollaine SM, Pollock BB, Ponce D, Ponce J, Pontelandolfo J, Porter JL, Post J, Poujade O, Powell C, Powell H, Power G, Pozulp M, Prantil M, Prasad M, Pratuch S, Price S, Primdahl K, Prisbrey S, Procassini R, Pruyne A, Pudliner B, Qiu SR, Quan K, Quinn M, Quintenz J, Radha PB, Rainer F, Ralph JE, Raman KS, Raman R, Rambo P, Rana S, Randewich A, Rardin D, Ratledge M, Ravelo N, Ravizza F, Rayce M, Raymond A, Raymond B, Reed B, Reed C, Regan S, Reichelt B, Reis V, Reisdorf S, Rekow V, Remington BA, Rendon A, Requieron W, Rever M, Reynolds H, Reynolds J, Rhodes J, Rhodes M, Richardson MC, Rice B, Rice NG, Rieben R, Rigatti A, Riggs S, Rinderknecht HG, Ring K, Riordan B, Riquier R, Rivers C, Roberts D, Roberts V, Robertson G, Robey HF, Robles J, Rocha P, Rochau G, Rodriguez J, Rodriguez S, Rosen M, Rosenberg M, Ross G, Ross JS, Ross P, Rouse J, Rovang D, Rubenchik AM, Rubery MS, Ruiz CL, Rushford M, Russ B, Rygg JR, Ryujin BS, Sacks RA, Sacks RF, Saito K, Salmon T, Salmonson JD, Sanchez J, Samuelson S, Sanchez M, Sangster C, Saroyan A, Sater J, Satsangi A, Sauers S, Saunders R, Sauppe JP, Sawicki R, Sayre D, Scanlan M, Schaffers K, Schappert GT, Schiaffino S, Schlossberg DJ, Schmidt DW, Schmitt MJ, Schneider DHG, Schneider MB, Schneider R, Schoff M, Schollmeier M, Schölmerich M, Schroeder CR, Schrauth SE, Scott HA, Scott I, Scott JM, Scott RHH, Scullard CR, Sedillo T, Seguin FH, Seka W, Senecal J, Sepke SM, Seppala L, Sequoia K, Severyn J, Sevier JM, Sewell N, Seznec S, Shah RC, Shamlian J, Shaughnessy D, Shaw M, Shaw R, Shearer C, Shelton R, Shen N, Sherlock MW, Shestakov AI, Shi EL, Shin SJ, Shingleton N, Shmayda W, Shor M, Shoup M, Shuldberg C, Siegel L, Silva FJ, Simakov AN, Sims BT, Sinars D, Singh P, Sio H, Skulina K, Skupsky S, Slutz S, Sluyter M, Smalyuk VA, Smauley D, Smeltser RM, Smith C, Smith I, Smith J, Smith L, Smith R, Sohn R, Sommer S, Sorce C, Sorem M, Soures JM, Spaeth ML, Spears BK, Speas S, Speck D, Speck R, Spears J, Spinka T, Springer PT, Stadermann M, Stahl B, Stahoviak J, Stanton LG, Steele R, Steele W, Steinman D, Stemke R, Stephens R, Sterbenz S, Sterne P, Stevens D, Stevers J, Still CB, Stoeckl C, Stoeffl W, Stolken JS, Stolz C, Storm E, Stone G, Stoupin S, Stout E, Stowers I, Strauser R, Streckart H, Streit J, Strozzi DJ, Suratwala T, Sutcliffe G, Suter LJ, Sutton SB, Svidzinski V, Swadling G, Sweet W, Szoke A, Tabak M, Takagi M, Tambazidis A, Tang V, Taranowski M, Taylor LA, Telford S, Theobald W, Thi M, Thomas A, Thomas CA, Thomas I, Thomas R, Thompson IJ, Thongstisubskul A, Thorsness CB, Tietbohl G, Tipton RE, Tobin M, Tomlin N, Tommasini R, Toreja AJ, Torres J, Town RPJ, Townsend S, Trenholme J, Trivelpiece A, Trosseille C, Truax H, Trummer D, Trummer S, Truong T, Tubbs D, Tubman ER, Tunnell T, Turnbull D, Turner RE, Ulitsky M, Upadhye R, Vaher JL, VanArsdall P, VanBlarcom D, Vandenboomgaerde M, VanQuinlan R, Van Wonterghem BM, Varnum WS, Velikovich AL, Vella A, Verdon CP, Vermillion B, Vernon S, Vesey R, Vickers J, Vignes RM, Visosky M, Vocke J, Volegov PL, Vonhof S, Von Rotz R, Vu HX, Vu M, Wall D, Wall J, Wallace R, Wallin B, Walmer D, Walsh CA, Walters CF, Waltz C, Wan A, Wang A, Wang Y, Wark JS, Warner BE, Watson J, Watt RG, Watts P, Weaver J, Weaver RP, Weaver S, Weber CR, Weber P, Weber SV, Wegner P, Welday B, Welser-Sherrill L, Weiss K, Widmann K, Wheeler GF, Whistler W, White RK, Whitley HD, Whitman P, Wickett ME, Widmayer C, Wiedwald J, Wilcox R, Wilcox S, Wild C, Wilde BH, Wilde CH, Wilhelmsen K, Wilke MD, Wilkens H, Wilkins P, Wilks SC, Williams EA, Williams GJ, Williams W, Williams WH, Wilson DC, Wilson B, Wilson E, Wilson R, Winters S, Wisoff J, Wittman M, Wolfe J, Wong A, Wong KW, Wong L, Wong N, Wood R, Woodhouse D, Woodruff J, Woods DT, Woods S, Woodworth BN, Wooten E, Wootton A, Work K, Workman JB, Wright J, Wu M, Wuest C, Wysocki FJ, Xu H, Yamaguchi M, Yang B, Yang ST, Yatabe J, Yeamans CB, Yee BC, Yi SA, Yin L, Young B, Young CS, Young CV, Young P, Youngblood K, Zacharias R, Zagaris G, Zaitseva N, Zaka F, Ze F, Zeiger B, Zika M, Zimmerman GB, Zobrist T, Zuegel JD, Zylstra AB. Lawson Criterion for Ignition Exceeded in an Inertial Fusion Experiment. PHYSICAL REVIEW LETTERS 2022; 129:075001. [PMID: 36018710 DOI: 10.1103/physrevlett.129.075001] [Citation(s) in RCA: 63] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 06/24/2022] [Accepted: 07/06/2022] [Indexed: 06/15/2023]
Abstract
For more than half a century, researchers around the world have been engaged in attempts to achieve fusion ignition as a proof of principle of various fusion concepts. Following the Lawson criterion, an ignited plasma is one where the fusion heating power is high enough to overcome all the physical processes that cool the fusion plasma, creating a positive thermodynamic feedback loop with rapidly increasing temperature. In inertially confined fusion, ignition is a state where the fusion plasma can begin "burn propagation" into surrounding cold fuel, enabling the possibility of high energy gain. While "scientific breakeven" (i.e., unity target gain) has not yet been achieved (here target gain is 0.72, 1.37 MJ of fusion for 1.92 MJ of laser energy), this Letter reports the first controlled fusion experiment, using laser indirect drive, on the National Ignition Facility to produce capsule gain (here 5.8) and reach ignition by nine different formulations of the Lawson criterion.
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Kouli O, Murray V, Bhatia S, Cambridge WA, Kawka M, Shafi S, Knight SR, Kamarajah SK, McLean KA, Glasbey JC, Khaw RA, Ahmed W, Akhbari M, Baker D, Borakati A, Mills E, Thavayogan R, Yasin I, Raubenheimer K, Ridley W, Sarrami M, Zhang G, Egoroff N, Pockney P, Richards T, Bhangu A, Creagh-Brown B, Edwards M, Harrison EM, Lee M, Nepogodiev D, Pinkney T, Pearse R, Smart N, Vohra R, Sohrabi C, Jamieson A, Nguyen M, Rahman A, English C, Tincknell L, Kakodkar P, Kwek I, Punjabi N, Burns J, Varghese S, Erotocritou M, McGuckin S, Vayalapra S, Dominguez E, Moneim J, Salehi M, Tan HL, Yoong A, Zhu L, Seale B, Nowinka Z, Patel N, Chrisp B, Harris J, Maleyko I, Muneeb F, Gough M, James CE, Skan O, Chowdhury A, Rebuffa N, Khan H, Down B, Fatimah Hussain Q, Adams M, Bailey A, Cullen G, Fu YXJ, McClement B, Taylor A, Aitken S, Bachelet B, Brousse de Gersigny J, Chang C, Khehra B, Lahoud N, Lee Solano M, Louca M, Rozenbroek P, Rozitis E, Agbinya N, Anderson E, Arwi G, Barry I, Batchelor C, Chong T, Choo LY, Clark L, Daniels M, Goh J, Handa A, Hanna J, Huynh L, Jeon A, Kanbour A, Lee A, Lee J, Lee T, Leigh J, Ly D, McGregor F, Moss J, Nejatian M, O'Loughlin E, Ramos I, Sanchez B, Shrivathsa A, Sincari A, Sobhi S, Swart R, Trimboli J, Wignall P, Bourke E, Chong A, Clayton S, Dawson A, Hardy E, Iqbal R, Le L, Mao S, Marinelli I, Metcalfe H, Panicker D, R HH, Ridgway S, Tan HH, Thong S, Van M, Woon S, Woon-Shoo-Tong XS, Yu S, Ali K, Chee J, Chiu C, Chow YW, Duller A, Nagappan P, Ng S, Selvanathan M, Sheridan C, Temple M, Do JE, Dudi-Venkata NN, Humphries E, Li L, Mansour LT, Massy-Westropp C, Fang B, Farbood K, Hong H, Huang Y, Joan M, Koh C, Liu YHA, Mahajan T, Muller E, Park R, Tanudisastro M, Wu JJG, Chopra P, Giang S, Radcliffe S, Thach P, Wallace D, Wilkes A, Chinta SH, Li J, Phan J, Rahman F, Segaran A, Shannon J, Zhang M, Adams N, Bonte A, Choudhry A, Colterjohn N, Croyle JA, Donohue J, Feighery A, Keane A, McNamara D, Munir K, Roche D, Sabnani R, Seligman D, Sharma S, 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Wyn-Griffiths F, Brew A, Kaur G, Soni D, Tickle A, Akbar Z, Appleyard T, Figg K, Jayawardena P, Johnson A, Kamran Siddiqui Z, Lacy-Colson J, Oatham R, Rowlands B, Sludden E, Turnbull C, Allin D, Ansar Z, Azeez Z, Dale VH, Garg J, Horner A, Jones S, Knight S, McGregor C, McKenna J, McLelland T, Packham-Smith A, Rowsell K, Spector-Hill I, Adeniken E, Baker J, Bartlett M, Chikomba L, Connell B, Deekonda P, Dhar M, Elmansouri A, Gamage K, Goodhew R, Hanna P, Knight J, Luca A, Maasoumi N, Mahamoud F, Manji S, Marwaha PK, Mason F, Oluboyede A, Pigott L, Razaq AM, Richardson M, Saddaoui I, Wijeyendram P, Yau S, Atkins W, Liang K, Miles N, Praveen B, Ashai S, Braganza J, Common J, Cundy A, Davies R, Guthrie J, Handa I, Iqbal M, Ismail R, Jones C, Jones I, Lee KS, Levene A, Okocha M, Olivier J, Smith A, Subramaniam E, Tandle S, Wang A, Watson A, Wilson C, Chan XHF, Khoo E, Montgomery C, Norris M, Pugalenthi PP, Common T, Cook E, Mistry H, Shinmar HS, Agarwal G, Bandyopadhyay S, Brazier B, Carroll L, Goede A, Harbourne A, Lakhani A, Lami M, Larwood J, Martin J, Merchant J, Pattenden S, Pradhan A, Raafat N, Rothwell E, Shammoon Y, Sudarshan R, Vickers E, Wingfield L, Ashworth I, Azizi S, Bhate R, Chowdhury T, Christou A, Davies L, Dwaraknath M, Farah Y, Garner J, Gureviciute E, Hart E, Jain A, Javid S, Kankam HK, Kaur Toor P, Kaz R, Kermali M, Khan I, Mattson A, McManus A, Murphy M, Nair K, Ngemoh D, Norton E, Olabiran A, Parry L, Payne T, Pillai K, Price S, Punjabi K, Raghunathan A, Ramwell A, Raza M, Ritehnia J, Simpson G, Smith W, Sodeinde S, Studd L, Subramaniam M, Thomas J, Towey S, Tsang E, Tuteja D, Vasani J, Vio M, Badran A, Adams J, Anthony Wilkinson J, Asvandi S, Austin T, Bald A, Bix E, Carrick M, Chander B, Chowdhury S, Cooper Drake B, Crosbie S, D Portela S, Francis D, Gallagher C, Gillespie R, Gravett H, Gupta P, Ilyas C, James G, Johny J, Jones A, Kinder F, MacLeod C, Macrow C, Maqsood-Shah A, Mather J, McCann L, McMahon R, Mitham E, Mohamed M, Munton E, Nightingale K, O'Neill K, Onyemuchara I, Senior R, Shanahan A, Sherlock J, Spyridoulias A, Stavrou C, Stokes D, Tamang R, Taylor E, Trafford C, Uden C, Waddington C, Yassin D, Zaman M, Bangi S, Cheng T, Chew D, Hussain N, Imani-Masouleh S, Mahasivam G, McKnight G, Ng HL, Ota HC, Pasha T, Ravindran W, Shah K, Vishnu K S, Zaman S, Carr W, Cope S, Eagles EJ, Howarth-Maddison M, Li CY, Reed J, Ridge A, Stubbs T, Teasdaled D, Umar R, Worthington J, Dhebri A, Kalenderov R, Alattas A, Arain Z, Bhudia R, Chia D, Daniel S, Dar T, Garland H, Girish M, Hampson A, Kyriacou H, Lehovsky K, Mullins W, Omorphos N, Vasdev N, Venkatesh A, Waldock W, Bhandari A, Brown G, Choa G, Eichenauer CE, Ezennia K, Kidwai Z, Lloyd-Thomas A, Macaskill Stewart A, Massardi C, Sinclair E, Skajaa N, Smith M, Tan I, Afsheen N, Anuar A, Azam Z, Bhatia P, Davies-kelly N, Dickinson S, Elkawafi M, Ganapathy M, Gupta S, Khoury EG, Licudi D, Mehta V, Neequaye S, Nita G, Tay VL, Zhao S, Botsa E, Cuthbert H, Elliott J, Furlepa M, Lehmann J, Mangtani A, Narayan A, Nazarian S, Parmar C, Shah D, Shaw C, Zhao Z, Beck C, Caldwell S, Clements JM, French B, Kenny R, Kirk S, Lindsay J, McClung A, McLaughlin N, Watson S, Whiteside E, Alyacoubi S, Arumugam V, Beg R, Dawas K, Garg S, Lloyd ER, Mahfouz Y, Manobharath N, Moonesinghe R, Morka N, Patel K, Prashar J, Yip S, Adeeko ES, Ajekigbe F, Bhat A, Evans C, Farrugia A, Gurung C, Long T, Malik B, Manirajan S, Newport D, Rayer J, Ridha A, Ross E, Saran T, Sinker A, Waruingi D, Allen R, Al Sadek Y, Alves do Canto Brum H, Asharaf H, Ashman M, Balakumar V, Barrington J, Baskaran R, Berry A, Bhachoo H, Bilal A, Boaden L, Chia WL, Covell G, Crook D, Dadnam F, Davis L, De Berker H, Doyle C, Fox C, Gruffydd-Davies M, Hafouda Y, Hill A, Hubbard E, Hunter A, Inpadhas V, Jamshaid M, Jandu G, Jeyanthi M, Jones T, Kantor C, Kwak SY, Malik N, Matt R, McNulty P, Miles C, Mohomed A, Myat P, Niharika J, Nixon A, O'Reilly D, Parmar K, Pengelly S, Price L, Ramsden M, Turnor R, Wales E, Waring H, Wu M, Yang T, Ye TTS, Zander A, Zeicu C, Bellam S, Francombe J, Kawamoto N, Rahman MR, Sathyanarayana A, Tang HT, Cheung J, Hollingshead J, Page V, Sugarman J, Wong E, Chiong J, Fung E, Kan SY, Kiang J, Kok J, Krahelski O, Liew MY, Lyell B, Sharif Z, Speake D, Alim L, Amakye NY, Chandrasekaran J, Chandratreya N, Drake J, Owoso T, Thu YM, Abou El Ela Bourquin B, Alberts J, Chapman D, Rehnnuma N, Ainsworth K, Carpenter H, Emmanuel T, Fisher T, Gabrel M, Guan Z, Hollows S, Hotouras A, Ip Fung Chun N, Jaffer S, Kallikas G, Kennedy N, Lewinsohn B, Liu FY, Mohammed S, Rutherfurd A, Situ T, Stammer A, Taylor F, Thin N, Urgesi E, Zhang N, Ahmad MA, Bishop A, Bowes A, Dixit A, Glasson R, Hatta S, Hatt K, Larcombe S, Preece J, Riordan E, Fegredo D, Haq MZ, Li C, McCann G, Stewart D, Baraza W, Bhullar D, Burt G, Coyle J, Deans J, Devine A, Hird R, Ikotun O, Manchip G, Ross C, Storey L, Tan WWL, Tse C, Warner C, Whitehead M, Wu F, Court EL, Crisp E, Huttman M, Mayes F, Robertson H, Rosen H, Sandberg C, Smith H, Al Bakry M, Ashwell W, Bajaj S, Bandyopadhyay D, Browlee O, Burway S, Chand CP, Elsayeh K, Elsharkawi A, Evans E, Ferrin S, Fort-Schaale A, Iacob M, I K, Impelliziere Licastro G, Mankoo AS, Olaniyan T, Otun J, Pereira R, Reddy R, Saeed D, Simmonds O, Singhal G, Tron K, Wickstone C, Williams R, Bradshaw E, De Kock Jewell V, Houlden C, Knight C, Metezai H, Mirza-Davies A, Seymour Z, Spink D, Wischhusen S. Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study. Lancet Digit Health 2022; 4:e520-e531. [PMID: 35750401 DOI: 10.1016/s2589-7500(22)00069-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 01/07/2022] [Accepted: 04/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. METHODS We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). FINDINGS In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]). INTERPRETATION In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. FUNDING British Journal of Surgery Society.
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Ashtree DN, Osborne DA, Lee A, Umstad MP, Craig JM, Scurrah KJ. Three trajectories of gestational weight gain identified in an Australian twin study. Eur J Obstet Gynecol Reprod Biol 2022; 275:24-30. [PMID: 35714501 DOI: 10.1016/j.ejogrb.2022.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/19/2022] [Accepted: 06/07/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Gestational weight gain (GWG) has been associated with maternal and child health outcomes, but knowledge of appropriate GWG for twin gestations is limited. STUDY DESIGN The Peri/Postnatal Epigenetic Twins Study is a prospective twin cohort study of 250 women and their twin children in Melbourne, Australia. We modeled trajectories of GWG using group-based growth modeling and compared these trajectories to GWG categories (within, above, or below current GWG recommendations for twin pregnancy). We fitted robust linear and Poisson regression models to assess associations of maternal pre-pregnancy and gestational exposures with risk of gaining weight outside the recommendations. RESULTS Of the 250 women enrolled in the PETS, GWG measures were available for 172 women. Forty-seven percent of women had GWG within the current recommendations. We identified three GWG trajectories - 23.6% of women had low GWG throughout pregnancy, 34.5% had average GWG throughout pregnancy, and 42.0% had average initial GWG, followed by high GWG from trimester two until delivery. Gestational diabetes mellitus (GDM) was associated with increased risk of inadequate GWG (RR: 2.40, 95%CI: 1.53, 3.75). Pre-pregnancy obesity (RR: 1.88, 95%CI: 1.09, 3.26) and hypertensive disorders of pregnancy (RR: 2.64, 95%CI: 1.20, 5.81) were associated with increased risk of excessive GWG. CONCLUSIONS More than half of the women in the PETS did not meet the current GWG recommendations. Women with GDM or hypertensive disorders were more likely to gain weight outside these guidelines. More research is needed to establish comprehensive guidelines for twin pregnancies.
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Elarabi H, Marsden J, Alghafri H, Adem A, Lee A. Personalized Care in Opioid Use Disorder maintained on Buprenorphine. Eur Psychiatry 2022. [PMCID: PMC9567902 DOI: 10.1192/j.eurpsy.2022.2116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Effectiveness of buprenorphine (BUP) is moderated by medication misuse diversion and non-adherence, and poor retention and high cost. Contingency Managment has added benefit to BUP with Take-home doses as the most preferred reward by Opioid Use Disorder patients. Objectives Examine the clinical effectiveness of a novel incentivised medication adherence and abstinence monitoring to enable contingent access to increasing BUP take-home doses.Explore associations with opioid use and retention. Contrast characteristics of polysubstance abusers (PSA) and response to BUP, with single opioid users. Methods Two-arm, pragmatic, 16-week outpatient RCT of BUP maintenance.Takehome doses were provided as stepped-approach upto 4-weeks contingent of abstinence (UDS) and adherence according to Therapeutic Drug Monitoring-TDM. Primary outcome and secondard outcomes were % negative UDS for opioids anx retention, respectively. - Results Opioid % negative UDS was 76.7% (SD 25.0%) in I-AAM versus 63.5% (SD 34.7%) in TAU (13.3%; 95% [CI] 3.2%–23.3%; Cohen’s d 0.44; 95% CI 0.10–0.87). In I-AAM, 40 participants (57.1%) were retained versus 33 (46.4%) in TAU [OR: 1.54; 95% CI 0.79–2.98). PSA (73.7%, n=104) and carisprodol use increases non-fatal overdose (OR) 3.83, 95% CI 1.25 to 11.71) and 5.31, 95% CI 1.92 to 14.65], respectively. Opioid and non-opioid UDS are positively associated. BUP elimination rate (BUP-EL.R) predicts 26.5% to 65% of negative opioid UDS [Beta - 89.95, 95% CIl -154.20 to -25.70, R2 0.22]. Family enagement increases retention by 3-fold. Conclusions BUP + incentivised TDM for contingent access to increasing take-home doses increased abstinence. BUP-EL.R seems promising in BUP treatment precision and BUP is clinically valuable in polysubstance abusers.Engaging family enhances retention. Disclosure No significant relationships.
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Lee A, Klinkradt S, McCombe P, Pow D. Cloning of a new form of EAAT2/GLT-1 from human and rodent brains. Neurosci Lett 2022; 780:136637. [DOI: 10.1016/j.neulet.2022.136637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 04/08/2022] [Accepted: 04/13/2022] [Indexed: 11/15/2022]
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Lee A, Wang X, Wang H, Moreno A, Reddy J, Spiotto M, Gunn G, Rosenthal D, Fuller C, Morrison W, Frank S, Ferrarotto R, Gross N, Goepfert R, Gillenwater A, Hessel A, Su S, Hanna E, Garden A, Phan J. Stereotactic Body Radiation Therapy (SBRT) Following Salvage Surgery for Previously Irradiated Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2021.12.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Lee GY, Shin GW, Park HY, Yoon HK, Kim TH, Lee A, Heo YJ, Lee YJ, Han JY, Park YM. Sonographic Features of Breast Fibroepithelial Masses: Distinguishing Fibroadenoma from Phyllodes Tumour. HONG KONG JOURNAL OF RADIOLOGY 2022. [DOI: 10.12809/hkjr2217333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Lee A, Dean C, Labagnara K, Jun Yun D, Pinkas A, Mishall PL. A rare unreported bilateral thoracic muscle on the inferior and posteromedial aspect of the rib cage: case report and literature review. Folia Morphol (Warsz) 2022; 82:422-423. [DOI: 10.5603/fm.a2022.0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 11/25/2022]
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Killeen E, Horan S, Pollock A, Lee A, Martin A. 744 3 YEAR FOLLOW-UP OF SEDATIVE PRESCRIBING FOR RESPONSIVE BEHAVIOURS IN NURSING HOME RESIDENTS, AN IRISH STUDY. Age Ageing 2022. [DOI: 10.1093/ageing/afac034.744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Sedative medications are commonly prescribed for older adults; these include neuroleptics, benzodiazepines, opioids, ‘z’ drugs and trazadone. The prevalence of sedative drug prescriptions is increasing (1). Nursing home residents are three times more likely to be prescribed benzodiazepines (2). Regular medication review and education have been shown to reduce rates of sedative use in nursing homes (3). We previously demonstrated a significant reduction in prescription of these target medications at an Irish nursing home with specific focus, within scheduled medication reviews, on reduction or discontinuation of the target drugs in combination with education on management of Behavioural and Psychological symptoms (BPSD). This audit examines the prescribing patterns 3 years on from the initial audit.
Methods
Point prevalence study of sedative prescriptions and BPSD of all 95 nursing home residents on 6/5/21. Comparison with data from two previous audits in the same unit. All data was anonymised. Data analysed with SPSS statistical software.
Results
Sustained significant drop in quetiapine use from 30% of residents to 14% post-intervention in 2018 and three-year follow-up (p = 0.06). Borderline significant reduction in overall neuroleptics (from 39% to 25%, p = 0.06). Significant rise in ‘z’ drug prescription (from 8% to 17%, p = 0.03). BPSD reported in 33%, compared to 49% pre-intervention.
Conclusion
Regularly scheduled medication reviews can effectively rationalise sedative prescription rates in nursing home residents. Increasing ‘z’ drug prescription likely represents the appropriate replacement of neuroleptics. Reduced BPSD may be due to reporting bias of staff since regular education has been introduced or changing cohort of residents. References numbered above not included given limited word count.
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Ford J, Lee A. Climate justice: modern parallels with the slave trade. Public Health 2022; 204:82-83. [DOI: 10.1016/j.puhe.2021.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Stewart K, Vu N, Redmon C, Nguyen C, Jackson E, Lee A, Kilic S. Knowledge of pelvic floor disorders among reproductive aged women a cross sectional study. Am J Obstet Gynecol 2022. [DOI: 10.1016/j.ajog.2021.12.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hoffmann B, Erwood K, Ncomanzi S, Fischer V, O'Brien D, Lee A. Management strategies for adult patients with dental anxiety in the dental clinic: a systematic review. Aust Dent J 2022; 67 Suppl 1:S3-S13. [PMID: 35735746 PMCID: PMC9796536 DOI: 10.1111/adj.12926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2022] [Indexed: 01/01/2023]
Abstract
Anxiety is an adaptive emotional response to potentially threatening or dangerous situations; moderated by the sympathetic nervous system. Dental anxiety is common and presents before, during or after dental treatment. The physiological response includes an increase in heart rate, blood pressure, respiratory rate, and cardiac output. Consequently, extensive distress leads to avoidance of dental treatment and multiple failed appointments, impacting both oral and general health. Dental anxiety can generate a variety of negative consequences for both the dentist and the patient. Evidence-based strategies are essential for mitigating and relieving anxiety in the dental clinic. Psychotherapeutic behavioural strategies can modify the patient's experience through a minimally invasive approach with nil or negligible side effects, depending on patient characteristics, anxiety level and clinical situations. These therapies involve muscle relaxation, guided imagery, physiological monitoring, utilizing biofeedback, hypnosis, acupuncture, distraction and desensitization. Pharmacological intervention utilizes either relative analgesia (nitrous oxide), conscious intravenous sedation or oral sedation, which can have undesirable side effects, risks and contraindications. These modalities increase the cost and availability of dental treatment.
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Juniper DT, Kliem KE, Lee A, Rymer C. The effect of stocking rate and supplementary selenium on the fatty acid composition and subsequent peroxidisability of poultry muscle tissues. Animal 2022; 16:100459. [PMID: 35217413 DOI: 10.1016/j.animal.2022.100459] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 11/19/2022] Open
Abstract
Selenium (Se) plays a crucial role in protecting biological materials from oxidative damage through the action of the selenoprotein glutathione peroxidase (GSH-Px), and the effectiveness of this protection is often dependent upon Se supply. Recent evidence has indicated that GSH-Px mRNA expression can be upregulated in response to potential oxidative damage risk, and that this upregulation is independent of Se supply. The current study aimed to determine the effect of Se supplementation, stocking rate and tissue fatty acid profile on GSH-Px activity in breast and thigh tissue of commercial broilers. A total of 168 Ross 308 broiler chicks were enrolled onto the study. Prior to enrolment, birds were brooded as a single group and received a starter diet containing no additional Se. The study was a 2 × 2 factorial design comprising of two levels of dietary Se (high Se, 0.5 mg/kg total Se, low Se background Se only), and two stocking rates (high, 30 kg/m2, and low, 15 kg/m2). At 15 days of age, birds were blocked by live weight and randomly allocated to one of the four treatments, with six pen replicates per treatment. At 42 days of age, one bird was randomly selected from each pen replicate, euthanased and breast and thigh tissue harvested. GSH-Px activity, thiobarbituric acid reactive substances (TBARS), and fatty acid (FA) content of these tissues were determined. There was no effect (P > 0.05) of stocking rate on GSH-Px activity or TBARS. GSH-Px activity did not differ between tissue types but was greater in high Se birds (P < 0.001) compared to low Se. TBARS concentrations were greater in thigh tissue (P < 0.001), and these thigh concentrations were greater in high Se birds (P < 0.05). There were marked differences between breast and thigh tissue in most FAs (P < 0.001), with breast generally containing greater proportions of polyunsaturated FA, so that breast tissue had a higher (P < 0.001) peroxidisability index (PI) than thigh. A positive correlation between GSH-Px activity and PI in the thigh tissue of high Se birds (Pearson Correlation 0.668; P = 0.025) may indicate that increasing susceptibility to peroxidisation in lipid-rich tissues may also upregulate GSH-Px activity in Se-replete birds. This study suggests that ensuring adequate dietary selenium could be a useful tool to mitigate adverse effects on meat quality caused by oxidation, particularly in lipid-rich meat.
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Al Ahmad J, Norman S, Tierney M, Hansen T, Lee A, Shetty P, Yeung A, Danson E, Nguyendang T, Owensby D. 10 Years of ST Elevation Myocardial Infarctions (STEMIs) in the Illawarra Shoalhaven Local Health District (ISLHD) – Patient Demographics. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Stubbs R, Merrett E, Lee A. Use of Intravenous Digoxin on General Inpatient Wards. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Stubbs R, Lee A, Bezzina A, MacLeod S, Cousins H, Caldwell J. In-Situ Cardiac Arrest Simulation in the Cardiac Catheterisation Laboratory. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Hansen T, Norman S, Al AJ, Tierney M, Nguyendang T, Yeung A, Danson E, Owensby D, Lee A, Shetty P. Single Centre Experience of Primary PCI: 10-Year Procedural Outcomes. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Johnson G, Vergis A, Unger B, Park J, Gillman L, Hickey K, Pace D, Azin A, Guidolin K, Lam-Tin-Cheung K, Chadi S, Quereshy F, Guidolin K, Catton J, Rubin B, Bell J, Marangos J, Heesters A, Stuart-McEwan T, Quereshy F, Shariff F, Wright F, Ahmed N, Nadler A, Hallet J, Gentles J, Chen L, Hwang H, Parapini M, Hirpara D, Sidhu R, Scott T, Karimuddin A, Guo R, Nguyen A, Osborn J, Wiseman S, Nabata K, Ertel E, Hwang H, Lenet T, Baker L, Park L, Vered M, Zahrai A, Shorr R, Davis A, McIsaac D, Tinmouth A, Fergusson D, Martel G, Nabata K, Rummel S, Stefic-Cubic M, Karimuddin A, Stewart M, Melck A, McKechnie T, Anpalagan T, Ichhpuniani S, Lee Y, Ramji K, Eskicioglu C, Zhu A, Deng S, Greene B, Tsang M, Palter V, Jayaraman S, McKechnie T, Mann A, Tittley J, Cadeddu M, Nguyen M, Madani A, Pasternak J, McKechnie T, Ramji K, Hong D, Qu L, Istl A, Tang E, Gray D, Zuckerman J, Coburn N, Callum J, McLeod R, Pearsall E, Lin Y, Turgeon A, Martel G, Hallet J, Mahar A, Kammili A, Kriviraltcheva-Kaneva P, Lee L, Cools-Lartigue J, Ferri L, Mueller C, Zuckerman J, Haas B, Tillman B, Guttman M, Chesney T, Zuk V, Mahar A, Hsu A, Chan W, Vasdev R, Coburn N, Hallet J, D'Souza K, Huynh C, Ling LCJ, Warburton R, Hwang H, Hameed M, Glass L, Williamson H, Murphy P, Tang E, Leslie K, Hawel J, Kerr L, Zablotny S, Roldan H, He W, Jiang X, Zheng B, Lee L, Fiore J, Feldman L, Fried G, Mueller C, Valanci S, Balvardi S, Cipolla J, Kaneva P, Demyttenaere S, Boutros M, Lee L, Feldman L, Fiore J, Balvardi S, Alhashemi M, Cipolla J, Lee L, Fiore J, Feldman L, Miles A, Purich K, Verhoeff K, Shapiro J, Bigam D, Kung J, Fecso A, Chesney T, Mosko J, Skubleny D, Hamilton P, Ghosh S, Widder S, Schiller D, Do U, El Kefraoui C, Pook M, Barone N, Balvardi S, Montgomery H, Nguyen-Powanda P, Rajabiyazdi F, Elhaj H, Lapointe-Gagner M, Olleik G, Kaneva P, Antoun A, Safa N, Di Lena E, Meterissian S, Meguerditchian A, Fried G, Alhashemi M, Lee F, Baldini G, Feldman L, Fiore J, Serrano Aybar PE, Parpia S, Ruo L, Tywonek K, Lee S, O'Neill C, Faisal N, Alfayyadh A, Gundayao M, Meyers BM, Habashi R, Kruse C, McKechnie T, Levin M, Aldrich K, Grantcharov T, Langerman A, Forbes H, Anantha R, Fawcett V, Hetherington A, Pravong V, Gervais M, Rakovich G, Selvam R, Hu R, Musselman R, Raiche I, Moloo H, Liu R, Elnahas A, Alkhamesi N, Hawel J, Tang E, Alnumay A, Schlachta C, Walser E, Zhang C, Cristancho S, Ott M, Lee A, Niu B, Balaa F, Gawad N, Ren K, Qiu Y, Hamann K, How N, Leveille C, Davidson A, Eqbal A, Sardiwalla Y, Korostensky M, McKechnie T, Lee E, Yang I, Ren K, Muaddi H, Stukel T, de Mestral C, Nathens A, Karanicolas P, Frigault J, Lemieux S, Breton D, Bouchard P, Bouchard A, Grégoire R, Letarte F, Bouchard G, Drolet S, Frigault J, Avoine S, Drolet S, Letarte F, Bouchard A, Gagné J, Thibault C, Grégoire R, Jutras Bouthillette N, Gosselin M, Bouchard P, Rosenzveig A, Stuleanu T, Jarrar A, Kolozsvari N, Skelhorne-Gross G, Nenshi R, Jerath A, Gomez D, Singh K, Amir T, Liu E, Farquharson S, Mao R, Lan L, Yan J, Allard-Coutu A, Mierzwa A, Tin R, Brisebois R, Bradley N, Wigen R, Walser E, Hartford L, Van Koughnett J, Vogt K, Hilsden R, Parry N, Allen L, Leslie K, Raskin R, Jones J, Neumann K, Dwyer C, Strickland M, Bradley N, O'Dochartaigh D, Lobay K, Kabaroff A, Chang E, Widder S, Anantha R, Sun W, Beck J, Anantha R, Liu R, Davidson J, Jones S, Van Hooren T, Van Koughnett J, Ott M, Schmitz E, Raiche I, Sun W, El Hafid M, Dang J, Mocanu V, Lutzak G, Sultanian R, Wong C, Karmali S, Schmitz E, Petrera M, Pickell M, Auer R, Patro N, Li B, Lee Y, Wilson H, Mocanu V, Sun W, Dang J, Jogiat U, Kung J, Switzer N, Karmali S, Wong C, Li C, Al Hinai A, Cieply A, Hawes H, Joos E, Saleh A, Li C, Saleh A, Engels P, Drung J, Allen L, Leslie K, Pang G, Kwong M, Schlachta C, Alkhamesi N, Hawel J, Elnahas A, Guidolin K, Ellsmere J, Chadi S, Quereshy F, Chang D, Hutter M, Spence R, Abou Khalil M, Boutros M, Vasilevsky C, Morin N, Longtin Y, Liberman S, Demyttenaere S, Montpetit P, Poirier M, Mukherjee K, 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Kidane B, Louie A, Zuk V, Darling G, Rousseau M, Chesney T, Coburn N, Hallet J, Lee Y, Samarasinghe Y, Lee M, Thiru L, Shargall Y, Finley C, Hanna W, Levine O, Juergens R, Agzarian J, Nayak R, Brogly S, Li W, Lougheed D, Petsikas D, Mistry N, Gatti A, Churchill I, Patel Y, Hanna W, Abdul S, Anestee C, Gilbert S, Sundaresan S, Seely A, Villeneuve P, Maziak D, Razzak R, Ashrafi A, Tregobov N, Hassanzadeh N, Stone S, Panjwani A, Bong T, Bond R, Hafizi A, De Meo M, Rayes R, Milette S, Vagai M, Usatii M, Chandrasekaran A, Giannias B, Bourdeau F, Sangwan V, Bertos N, Moraes C, Huang S, Quail D, Walsh L, Camilleri-Broet S, Fiset P, Cools-Lartigue J, Ferri L, Spicer J, Kammili A, Bilgic E, Quaiattini A, Maurice-Ventouris M, Najmeh S, Mueller C, Esther L, Begum H, Agzarian J, Hanna W, Finley C, Shargall Y, Lee Y, Lu J, Malhan R, Shargall Y, Finley C, Hanna W, Agzarian J, Brophy S, Brennan K, French D, Resende V, Momtazi M, Solaja O, Gilbert S, Maziak D, Seely A, Sundaresan S, Villeneuve P, Sisson D, Donahoe L, Bedard P, Hansen A, De Perrot M, Alghamedi A, Simone A, Begum H, Hanna W, Shargall Y, Turner S, Huang J, Lai H, Bedard E, Shargall Y, Murthy S, Lin J, Darling G, Malthaner R, Kidane B, Seely A, Li H, Crowther M, Linkins L, Lau E, Schneider L, Hanna W, Finley C, Agzarian J, Douketis J, Greenberg B, Gupta V, Allen-Avodabo C, Davis L, Zhao H, Kidane B, Darling G, Coburn N, Huynh C, Cools-Lartigue J, Ferri L, Najmeh S, Sirois C, Mulder D, Spicer J, Al Rawahi A, Aftab Abdul S, Nguyen D, Anstee C, Delic E, Gilbert S, Maziak D, Villeneuve P, Seely A, Sisson D, Sasewich H, Islam T, Low D, Darling G, Turner S, Humer M, Abdul S, Nguyen D, Al Rawahi A, Anstee C, Delic E, Gilbert S, Villeneuve P, Maziak D, Seely A, Le Nguyen D, Aftab Abdul S, Al Rawahi A, Anstee C, Delic E, Gilbert S, Villeneuve P, Maziak D, Seely A, Patel Y, Kay M, Churchill I, Sullivan K, Shargall Y, Shayegan B, Adili A, Hanna W, Kaafarani M, Huynh C, Chouiali F, Muthukrishnan N, Maleki F, Ovens K, Gold M, Sorin M, Falutz R, Rayes R, Forghani R, Spicer J, Hunka N, Kennedy R, Bigsby R, Bharadwaj S, Gowing S, Churchill I, Gatti A, Hylton D, Sullivan K, Patel Y, Farrokhyar F, Leontiadis G, Hanna W, Finley C, Begum H, Pearce K, Agzarian J, Hanna W, Shargall Y, Akhtar-Danesh N, Jones D, Anstee C, Kumar S, Gingrich M, Simone A, Ahmadzai Z, Thavorn K, Seely A, Gupta V, Namavarian A, Mohammed A, Uddin S, Jones D, Behzadi A, Brar A, Qu L, Qiabi M, Nayak R, Malthaner R, Peters E, Buduhan G, Tan L, Liu R, Srinathan S, Kidane B, Gupta V, Levy J, Kidane B, Mahar A, Ringash J, Sutradhar R, Darling G, Coburn N, Robinson M, Bednarek L, Buduhan G, Liu R, Tan L, Srinathan S, Kidane B, Wang H, French D, MacDonald D, Graham K, Enns S, Buduhan G, Srinathan S, Liu R, Tan A, Kidane B, Bruinooge A, Poole E, Pascoe C, Karakach T, Buduhan G, Tan L, Srinathan S, Halayko A, Kidane B, Verhoeff K, Mocanu V, Fang B, Dang J, Kung J, Switzer N, Birch D, Karmali S, Johnson G, Singh H, Vergis A, Park J, Hershorn O, Hochman D, Helewa R, Johnson G, Robertson R, Vergis A, Johnson G, Vergis A, Singh H, Park J, Helewa R, Azin A, Cahill C, Lipson M, Afzal A, Maclean A, Wong C, Roen S, Buie W, McKechnie T, Anpalagan T, Chu M, Lee Y, Amin N, Hong D, Eskicioglu C, McKechnie T, Ramji K, Kruse C, Jaffer H, Rebello R, Amin N, Doumouras A, Hong D, Eskicioglu C, Hajjar R, Oliero M, Cuisiniere T, Fragoso G, Calvé A, Djediai S, Annabi B, Richard C, Santos M, Purich K, Zhou Y, Dodd S, Ring B, Yuan Y, White J, Garfinkle R, Dell'Aniello S, Bhatnagar S, Morin N, Ghitulescu G, Faria J, Vasilevsky C, Brassard P, Boutros M, Garfinkle R, Salama E, Amar-Zifkin A, Morin N, Ghitulescu G, Faria J, Vasilevsky C, Boutros M, Talwar G, Daniel R, McKechnie T, Levine O, Eskicioglu C, AlSulaim H, Alqahtani M, Garfinkle R, Al-Masrouri S, Vasilevsky C, Morin N, Boutros M, McKechnie T, Chen A, Patel A, Lee Y, Doumouras A, Hong D, Eskicioglu C, Brissette V, Al Busaidi N, Rajabiyazdi F, Moon J, Demian M, Vasilevsky C, Morin N, Boutros M, Selvam R, Moloo H, MacRae H, Alam F, Raiche I, Holland J, Cwintal M, Rigas G, Vasilevsky C, Morin N, Ghitulescu G, Faria J, Pang A, Boutros M, Holland J, Moon J, Marinescu D, Morin N, Ghitulescu G, Pang A, Vasilevsky C, Boutros M, Brown C, Karimuddin A, Raval M, Phang P, Ghuman A, Li M, Muncner S, Mihajlovic I, Dykstra M, Snelgrove R, Wang H, Monton O, Smith A, Moon J, Demian M, Garfinkle R, Vasilevsky C, Rajabiyazdi F, Boutros M, AlAamer O, AlSelaim N, AlMalki M, Al-Osail A, Ruxton R, Manuel P, Mohamed F, Motamedi MK, Serahati S, Rajendran L, Brown C, Raval M, Karimuddin A, Ghuman A, Phang T, Caminsky N, Moon J, Rajabiyazdi F, Chadi S, Alavi K, Paquette I, MacLean T, Wexner S, Liberman S, Steele S, Park J, Patel S, Bordeianou L, Auer R, Sylla P, Morin N, Ghuman A, Boutros M, Bayat Z, Kennedy E, Victor C, Govindarajan A, Liang J, Vasilevsky C, Pang A, Ghitulescu G, Faria J, Morin N, Boutros M, Marinescu D, Roy H, Baig Z, Karimmudin A, Raval M, Brown C, Phang T, Gill D, Ginther N, Moon J, Marinescu D, Pang A, Ghitulescu G, Faria J, Morin N, Vasilevsky C, Boutros M, Moon J, Pang A, Ghitulescu G, Faria J, Morin N, Vasilevsky C, Boutros M, Salama E, Alrashid F, Vasilevsky C, Ghitulescu G, Faria J, Morin N, Boutros M, Wiseman V, Zhang L, MacDonald P, Merchant SM, Wattie Barnett K, Caycedo-Marulanda A, Patel SV, Harra Z, Vasilevsky C, Ghitulescu G, Morin N, Boutros M, Pang A, Hegagi M, Alqahtani M, Morin N, Ghitulescu G, Vasilevsky C, Boutros M, Alghaithi N, Marinescu D, Al-Masrouri S, Pang A, Vasilevsky C, Boutros M, Papillon E, Kasteel N, Kaur G, Bindra S, Malhotra A, Graham C, MacLean A, Beck P, Jijon H, Ferraz J, Buie W, Szwimer R, Moon J, Demian M, Pang A, Morin N, Vasilevsky C, Rajabiyazdi F, Boutros M, Azin A, Merchant S, Kong W, Gyawali B, Hanna T, Chung W, Nanji S, Patel S, Booth C, Li V, Awan A, Serrano P, Jacobson M, Chanco M, Wen V, Singh N, Peiris L, Pasieka J, Ghatage P, Buie D, MacLean T, Bouchard-Fortier A, Mack L, Marini W, Zheng W, Swallow C, Reedijk M, DiPasquale A, Peiris L, Prus-Czrnecka Z, Delmar L, Gagnon N, Villiard R, Martel É, Cadrin-Chênevert A, Ledoux É, Racicot C, Mysuria S, Bazzarelli A, Pao J, Chen L, Zhang M, McKevitt E, Warburton R, Kuusk U, Van Laeken N, Bovill E, Isaac K, Dingee C, Hunter-Smith A, Cuthbert C, Fergus K, Barbera L, Efegoma Y, Howell D, Isherwood S, Levasseur N, Scheer A, Simmons C, Srikantham A, Temple-Orberle C, Xu Y, Metcalfe K, Quan M, Alqaydi A, la J, Merchant S, Digby G, Pravong V, Brind'Amour A, Sidéris L, Dubé P, De Guerke L, Fortin S, Auclair M, Trilling B, Tremblay J, Di Lena É, Hopkins B, Wong S, Meterissian S, Di Lena É, Barone N, Hopkins B, Dumitra S, Kaneva P, Fiore J, Meterissian S, Mysuria S, McKevitt E, Warburton R, Chen L, Bazzarelli A, Pao J, Bovill E, Zhang M, Kuusk U, Isaac K, Van Laeken N, Dingee C, Kapur H, McKevitt E, Warburton R, Pao J, Dingee C, Bazarelli A, Kuusk U, Chen L, Cadili L, DeGirolamo K, McKevitt E, Pao J, Dingee C, Bazzarelli A, Warburton R, Ng D, Ali A, Eymae D, Lee K, Brar S, Conner J, Magalhaes M, Swallow C, Allen K, Baliski C, Cyr D, Sari A, Messenger D, Driman D, Assarzadegan N, Juda A, Swallow C, Kennedy E, Brar M, Conner J, Kirsch R, Allard-Coutu A, Singh K, Lamontagne A, Gamache Y, Allard-Coutu A, Mardinger C, Lee C, Duckworth R, Brindle M, Fraulin F, Austen L, Kortbeek J, Hyndman M, Nguyen D, Jamjoum G, Meguerditchian A, Langer S, Yuan Xu Y, Kong S, Quan M, Lim D, Retrouvey H, Kerrebijn I, Butler K, O'Neill A, Cil T, Zhong T, Hofer S, McCready D, Metcalfe K, Lim D, Greene B, Look Hong N, Parapini M, Skipworth J, Mah A, Desai S, Chung S, Scudamore C, Segedi M, Vasilyeva E, Li J, Kim P, Verhoeff K, Deprato A, Purich K, Kung J, Bigam D, Dajani K, Lenet T, Gilbert R, Smoot R, Martel G, Tzeng C, Rocha F, Yohanathan L, Cleary S, Bertens K, Reyna-Sepulveda F, Badrudin D, Gala-Lopez B, Hanna N, Brogly S, Wei X, Booth C, Nanji S, Zuckerman J, Coburn N, Mahar A, Callum J, Kaliwal Y, Jayaraman S, Wei A, Martel G, Hallet J, Zuckerman J, Jayaraman S, Wei A, Mahar A, Kaliwal Y, Martel G, Coburn N, Hallet J, Henault D, Barrette B, Pelletier S, Thebault P, Beaudry-Simoneau E, Rong Z, Plasse M, Dagenais ARM, Létourneau R, Lapointe R, Vandenbroucke-Menu F, Nguyen B, Soucy G, Turcotte S, Lemke M, Waugh E, Leslie K, Quan D, Skaro A, Tang E, Lund M, Allen L, Glinka J, Jada G, Quan D, Skaro A, Tang E, Park L, Daza J, Li V, Msallak H, Zhang B, Workneh A, Faisal S, Faisal R, Fabbro M, Gu C, Claassen M, Zuk V, Hallet J, Martel G, Sapisochin G, Serrano P, Glinka J, Skaro A, Leslie K, Jada G, Quan D, Tang E, Waugh E, Lemke M, Glinka J, Skaro A, Leslie K, Tang E, Waugh E, Breadner D, Liu R, Tang E, Allen L, Welch S, Skaro A, Leslie K, Glinka J, Waugh E, Tang E, Jada G, Quan D, Skaro A, Webb A, Lester E, Shapiro A, Eurich D, Bigam D, Essaji Y, Shrader H, Nayyar A, Suraju M, Williams-Perez S, Ear P, Chan C, Smith V, Rivers-Bowerman M, Costa A, Stueck A, Campbell N, Allen S, Gala-Lopez B, Gilbert R, Lenet T, Cleary S, Smoot R, Tzeng C, Rocha F, Martel G, Bertens K, Mir Z, Golding H, McKeown S, Nanji S, Flemming J, Groome P, Mir Z, Djerboua M, Nanji S, Flemming J, Groome P, Elbekri S, Turcotte S, Girard E, Morency-Potvin P, Lapointe R, Vandenbroucke-Menu F, Dagenais M, Roy A, Letourneau R, Plasse M, Simoneau E, Rong Z, Zuker N, Oakley M, Chartrand G, Misheva B, Bendavid Y, Frigault J, Lemieux S, Breton D, Bouchard G, Drolet S, Melland-Smith M, Smith L, Tan J, Kahn U, McLean C, Mocanu V, Birch D, Karmali S, Switzer N, Fortin M, Paré X, Doyon A, Keshavjee S, Schwenger K, Yadav J, Fischer S, Jackson T, Allard J, Okrainec A, Lee Y, Anvari S, Chu M, Lovrics O, Aditya I, Malhan R, Khondker A, Walsh M, Doumouras A, Hong D, He W, Vergis A, Hardy K, Romanescu R, Deaninck F, Linton J, Fowler-Woods M, Fowler-Woods A, Shingoose G, Vergis A, Hardy K, Zmudzinski M, Cloutier Z, McKechnie T, Lee Y, Archer V, Doumouras A, Shiroky J, Abu Halimah J, Ramji K, Boudreau V, Mierzwa A, Mocanu V, Marcil G, Dang J, Switzer N, Birch D, Karmali S, Mierzwa A, Jarrar A, Hardy-Henry A, Kolozsvari N, Lin W, Hagen J, Connell M, Sun W, Dang J, Mocanu V, Kung J, Switzer N, Birch D, Karmali S. 2021 Canadian Surgery Forum01. Design and validation of a unique endoscopy simulator using a commercial video game03. Is ethnicity an appropriate measure of health care marginalization?: A systematic review and meta-analysis of the outcomes of diabetic foot ulceration in the Aboriginal population04. Racial disparities in surgery — a cross-specialty matched comparison between black and white patients05. Starting late does not increase the risk of postoperative complications in patients undergoing common general surgical procedures06. Ethical decision-making during a health care crisis: a resource allocation framework and tool07. Ensuring stability in surgical training program leadership: a survey of program directors08. Introducing oncoplastic breast surgery in a community hospital09. Leadership development programs for surgical residents: a review of the literature10. Superiority of non-opioid postoperative pain management after thyroid and parathyroid operations: a systematic review and meta-analysis11. Timing of ERCP relative to cholecystectomy in patients with ductal gallstone disease12. A systematic review and meta-analysis of randomized controlled trials comparing intraoperative red blood cell transfusion strategies13. Postoperative outcomes after frail elderly preoperative assessment clinic: a single-institution Canadian perspective14. Selective opioid antagonists following bowel resection for prevention of postoperative ileus: a systematic review and meta-analysis15. Peer-to-peer coaching after bile duct injury16. Laparoscopic median arcuate ligament release: a video abstract17. Retroperitoneoscopic approach to adrenalectomy19. Endoscopic Zenker diverticulotomy: a video abstract20. Variability in surgeons’ perioperative management of pheochromocytomas in Canada21. The contribution of surgeon and hospital variation in transfusion practice to outcomes for patients undergoing elective gastrointestinal cancer surgery: a population-based analysis22. Perioperative transfusions for gastroesophageal cancers: risk factors and short- and long-term outcomes23. The association between frailty and time alive and at home after cancer surgery among older adults: a population-based analysis24. Psychological and workplace-related effects of providing surgical care during the COVID-19 pandemic in British Columbia, Canada25. Safety of venous thromboembolism prophylaxis in endoscopic retrograde cholangiopancreatography: a systematic review26. Complications and reintervention following laparoscopic subtotal cholecystectomy: a systematic review and meta-analysis27. Synchronization of pupil dilations correlates with team performance in a simulated laparoscopic team coordination task28. Receptivity to and desired design features of a surgical peer coaching program: an international survey9. Impact of the COVID-19 pandemic on rates of emergency department utilization due to general surgery conditions30. The impact of the current COVID-19 pandemic on the exposure of general surgery trainees to operative procedures31. Association between academic degrees and research productivity: an assessment of academic general surgeons in Canada32. Laparoscopic endoscopic cooperative surgery (LECS) for subepithelial gastric lesion: a video presentation33. Effect of the COVID-19 pandemic on acute care general surgery at an academic Canadian centre34. Opioid-free analgesia after outpatient general surgery: a pilot randomized controlled trial35. Impact of neoadjuvant immunotherapy or targeted therapies on surgical resection in patients with solid tumours: a systematic review and meta-analysis37. Surgical data recording in the operating room: a systematic review of modalities and metrics38. Association between nonaccidental trauma and neighbourhood socioeconomic status during the COVID-19 pandemic: a retrospective analysis39. Laparoscopic repair of a transdiaphragmatic gastropleural fistula40. Video-based interviewing in medicine: a scoping review41. Indocyanine green fluorescence angiography for prevention of anastomotic leakage in colorectal surgery: a cost analysis from the hospital payer’s perspective43. Perception or reality: surgical resident and faculty assessments of resident workload compared with objective data45. When illness and loss hit close to home: Do health care providers learn how to cope?46. Remote video-based suturing education with smartphones (REVISE): a randomized controlled trial47. The evolving use of robotic surgery: a population-based analysis48. Prophylactic retromuscular mesh placement for parastomal hernia prevention: a retrospective cohort study of permanent colostomies and ileostomies49. Intracorporeal versus extracorporeal anastomosis in laparoscopic right hemicolectomy: a retrospective cohort study on anastomotic complications50. A lay of the land — a description of Canadian academic acute care surgery models51. Emergency general surgery in Ontario: interhospital variability in structures, processes and models of care52. Trauma 101: a virtual case-based trauma conference as an adjunct to medical education53. Assessment of the National Surgical Quality Improvement Program Surgical Risk Calculator for predicting patient-centred outcomes of emergency general surgery patients in a Canadian health care system54. Sustainability of a narcotic reduction initiative: 1 year following the Standardization of Outpatient Procedure (STOP) Narcotics Study55. Barriers to transanal endoscopic microsurgery referral56. Geospatial analysis of severely injured rural patients in a geographically complex landscape57. Implementation of an incentive spirometry protocol in a trauma ward: a single-centre pilot study58. Impostor phenomenon is a significant risk factor for burnout and anxiety in Canadian resident physicians: a cross-sectional survey59. Understanding the influence of perioperative education on performance among surgical trainees: a single-centre experience60. The effect of COVID-19 pandemic on current and future endoscopic personal protective equipment practices: a national survey of 77 endoscopists61. Case report: delayed presentation of perforated sigmoid diverticulitis as necrotizing infection of the lower limb62. Investigating disparities in surgical outcomes in Canadian Indigenous populations63. Fundoplication is superior to medical therapy for Barrett esophagus disease regression and progression: a systematic review and meta-analysis64. Development of a novel online general surgery learning platform and a qualitative preimplementation analysis65. Hagfish slime exudate as a potential novel hemostatic agent: developing a standardized assessment protocol66. The effect of the first wave of the COVID-19 pandemic on surgical oncology case volumes and wait times67. Safety of same-day discharge in high-risk patients undergoing ambulatory general surgery68. External validation of the Codman score in colorectal surgery: a pragmatic tool to drive quality improvement69. Improved morbidity and gastrointestinal restoration rates without compromising survival rates for diverting loop ileostomy with colonic lavage versus total abdominal colectomy for fulminant Clostridioides difficile colitis: a multicentre retrospective cohort study70. Potential access to emergency general surgical care in Ontario71. Immersive virtual reality (iVR) improves procedural duration, task completion and accuracy in surgical trainees: a systematic review01. Clinical validation of the Canada Lymph Node Score for endobronchial ultrasound02. Venous thromboembolism in surgically treated esophageal cancer patients: a provincial population-based study03. Venous thromboembolism in surgically treated lung cancer patients: a population-based study04. Is frailty associated with failure to rescue after esophagectomy? A multi-institutional comparative analysis of outcomes05. Routine systematic sampling versus targeted sampling of lymph nodes during endobronchial ultrasound: a feasibility randomized controlled trial06. Gastric ischemic conditioning reduces anastomotic complications in patients undergoing esophagectomy: a systematic review and meta-analysis07. Move For Surgery, a novel preconditioning program to optimize health before thoracic surgery: a randomized controlled trial08. In case of emergency, go to your nearest emergency department — Or maybe not?09. Does preoperative SABR increase the risk of complications from lung cancer resection? A secondary analysis of the MISSILE trial10. Segmental resection for lung cancer: the added value of near-infrared fluorescence mapping diminishes with surgeon experience11. Toward competency-based continuing professional development for practising surgeons12. Stereotactic body radiotherapy versus surgery in older adults with NSCLC — a population-based, matched analysis of long-term dependency outcomes13. Role of adjuvant therapy in esophageal cancer patients after neoadjuvant therapy and curative esophagectomy: a systematic review and meta-analysis14. Evaluation of population characteristics on the incidence of thoracic empyema: an ecological study15. Determining the optimal stiffness colour threshold and stiffness area ratio cut-off for mediastinal lymph node staging using EBUS elastography and AI: a pilot study16. Quality assurance on the use of sequential compression stockings in thoracic surgery (QUESTs)17. The relationship between fissureless technique and prolonged air leak for patients undergoing video-assisted thoracoscopic lobectomy18. CXCR2 inhibition as a candidate for immunomodulation in the treatment of K-RAS-driven lung adenocarcinoma19. Assessment tools for evaluating competency in video-assisted thoracoscopic lobectomy: a systematic review20. Understanding the current practice on chest tube management following lung resection among thoracic surgeons across Canada21. Effect of routine jejunostomy tube insertion in esophagectomy: a systematic review and meta-analysis22. Recurrence of primary spontaneous pneumothorax following bullectomy with pleurodesis or pleurectomy: a retrospective analysis23. Surgical outcomes following chest wall resection and reconstruction24. Outcomes following surgical management of primary mediastinal nonseminomatous germ cell tumours25. Does robotic approach offer better nodal staging than thoracoscopic approach in anatomical resection for non–small cell lung cancer? A single-centre propensity matching analysis26. Competency assessment for mediastinal mass resection and thymectomy: design and Delphi process27. The contemporary significance of venous thromboembolism (deep venous thrombosis [DVT] and pulmonary embolus [PE]) in patients undergoing esophagectomy: a prospective, multicentre cohort study to evaluate the incidence and clinical outcomes of VTE after major esophageal resections28. Esophageal cancer: symptom severity at the end of life29. The impact of pulmonary artery reconstruction on postoperative and oncologic outcomes: a systematic review30. Association with surgical technique and recurrence after laparoscopic repair of paraesophageal hernia: a single-centre experience31. Enhanced recovery after surgery (ERAS) in esophagectomy32. Surgical treatment of esophageal cancer: trends in surgical approach and early mortality at a single institution over the past 18 years34. Adverse events and length of stay following minimally invasive surgery in paraesophageal hernia repair35. Long-term symptom control comparison of Dor and Nissen fundoplication following laparoscopic para-esophageal hernia repair: a retrospective analysis36. Willingness to pay: a survey of Canadian patients’ willingness to contribute to the cost of robotic thoracic surgery37. Radiomics in early-stage lung adenocarcinoma: a prediction tool for tumour immune microenvironments38. Effectiveness of intraoperative pyloric botox injection during esophagectomy: how often is endoscopic intervention required?39. An artificial intelligence algorithm for predicting lymph node malignancy during endobronchial ultrasound40. The effect of major and minor complications after lung surgery on length of stay and readmission41. Measuring cost of adverse events following thoracic surgery: a scoping review42. Laparoscopic paraesophageal hernia repair: characterization by hospital and surgeon volume and impact on outcomes43. NSQIP 5-Factor Modified Frailty Index predicts morbidity but not mortality after esophagectomy44. Trajectory of perioperative HRQOL and association with postoperative complications in thoracic surgery patients45. Variation in treatment patterns and outcomes for resected esophageal cancer at designated thoracic surgery centres46. Patient-reported pretreatment health-related quality of life (HRQOL) predicts short-term survival in esophageal cancer patients47. Analgesic efficacy of surgeon-placed paravertebral catheters compared with thoracic epidural analgesia after Ivor Lewis esophagectomy: a retrospective noninferiority study48. Rapid return to normal oxygenation after lung surgery49. Examination of local and systemic inflammatory changes during lung surgery01. Implications of near-infrared imaging and indocyanine green on anastomotic leaks following colorectal surgery: a systematic review and meta-analysis02. Repeat preoperative endoscopy after regional implementation of electronic synoptic endoscopy reporting: a retrospective comparative study03. Consensus-derived quality indicators for operative reporting in transanal endoscopic surgery (TES)04. Colorectal lesion localization practices at endoscopy to facilitate surgical and endoscopic planning: recommendations from a national consensus Delphi process05. Black race is associated with increased mortality in colon cancer — a population-based and propensity-score matched analysis06. Improved survival in a cohort of patients 75 years and over with FIT-detected colorectal neoplasms07. Laparoscopic versus open loop ileostomy reversal: a systematic review and meta-analysis08. Posterior mesorectal thickness as a predictor of increased operative time in rectal cancer surgery: a retrospective cohort study09. Improvement of colonic anastomotic healing in mice with oral supplementation of oligosaccharides10. How can we better identify patients with rectal bleeding who are at high risk of colorectal cancer?11. Assessment of long-term bowel dysfunction in rectal cancer survivors: a population-based cohort study12. Observational versus antibiotic therapy for acute uncomplicated diverticulitis: a noninferiority meta-analysis based on a Delphi consensus13. Radiotherapy alone versus chemoradiotherapy for stage I anal squamous cell carcinoma: a systematic review and meta-analysis14. Is the Hartmann procedure for diverticulitis obsolete? National trends in colectomy for diverticulitis in the emergency setting from 1993 to 201515. Sugammadex in colorectal surgery: a systematic review and meta-analysis16. Sexuality and rectal cancer treatment: a qualitative study exploring patients’ information needs and expectations on sexual dysfunction after rectal cancer treatment17. Video-based interviews in selection process18. Impact of delaying colonoscopies during the COVID-19 pandemic on colorectal cancer detection and prevention19. Opioid use disorder associated with increased anastomotic leak and major complications after colorectal surgery20. Effectiveness of a rectal cancer education video on patient expectations21. Robotic-assisted rectosigmoid and rectal cancer resection: implementation and early experience at a Canadian tertiary centre22. An online educational app for rectal cancer survivors with low anterior resection syndrome: a pilot study23. The effects of surgeon specialization on the outcome of emergency colorectal surgery24. Outcomes after colorectal cancer resections in octogenarians and older in a regional New Zealand setting — What are the predictors of mortality?25. Long-term outcomes after seton placement for perianal fistulae with and without Crohn disease26. A survey of patient and surgeon preference for early ileostomy closure following restorative proctectomy for rectal cancer — Why aren’t we doing it?27. Crohn disease independently associated with longer hospital admission after surgery28. Short-stay (≤ 1 d) diverting loop ileostomy closure can be selectively implemented without an increase in readmission and complication rates: an ACS-NSQIP analysis29. A comparison of perineal stapled rectal prolapse resection and the Altemeier procedure at 2 Canadian academic hospitals30. Mental health and substance use disorders predict 90-day readmission and postoperative complications following rectal cancer surgery31. Early discharge after colorectal cancer resection: trends and impact on patient outcomes32. Oral antibiotics without mechanical bowel preparation prior to emergency colectomy reduces the risk of organ space surgical site infections: a NSQIP propensity score matched study33. The impact of robotic surgery on a tertiary care colorectal surgery program, an assessment of costs and short-term outcomes — a Canadian perspective34. Should we scope beyond the age limit of guidelines? Adenoma detection rates and outcomes of screening and surveillance colonoscopies in patients aged 75–79 years35. Emergency department admissions for uncomplicated diverticulitis: a nationwide study36. Obesity is associated with a complicated episode of acute diverticulitis: a nationwide study37. Green indocyanine angiography for low anterior resection in patients with rectal cancer: a prospective before-and-after study38. The impact of age on surgical recurrence of fibrostenotic ileocolic Crohn disease39. A qualitative study to explore the optimal timing and approach for the LARS discussion01. Racial, ethnic and socioeconomic disparities in diagnosis, treatment and survival of patients with breast cancer: a SEER-based population analysis02. First-line palliative chemotherapy for esophageal and gastric cancer: practice patterns and outcomes in the general population03. Frailty as a predictor for postoperative outcomes following pancreaticoduodenectomy04. Synoptic electronic operative reports identify practice variation in cancer surgery allowing for directed interventions to decrease variation05. The role of Hedgehog signalling in basal-like breast cancer07. Clinical and patient-reported outcomes in oncoplastic breast conservation surgery from a single surgeon’s practice in a busy community hospital in Canada08. Upgrade rate of atypical ductal hyperplasia: 10 years of experience and predictive factors09. Time to first adjuvant treatment after oncoplastic breast reduction10. Preparing to survive: improving outcomes for young women with breast cancer11. Opioid prescription and consumption in patients undergoing outpatient breast surgery — baseline data for a quality improvement initiative12. Rectal anastomosis and hyperthermic intraperitoneal chemotherapy: Should we avoid diverting loop ileostomy?13. Delays in operative management of early-stage, estrogen-receptor positive breast cancer during the COVID-19 pandemic — a multi-institutional matched historical cohort study14. Opioid prescribing practices in breast oncologic surgery15. Oncoplastic breast reduction (OBR) complications and patient-reported outcomes16. De-escalating breast cancer surgery: Should we apply quality indicators from other jurisdictions in Canada?17. The breast cancer patient experience of telemedicine during COVID-1918. A novel ex vivo human peritoneal model to investigate mechanisms of peritoneal metastasis in gastric adenocarcinoma (GCa)19. Preliminary uptake and outcomes utilizing the BREAST-Q patient-reported outcomes questionnaire in patients following breast cancer surgery20. Routine elastin staining improves detection of venous invasion and enhances prognostication in resected colorectal cancer21. Analysis of exhaled volatile organic compounds: a new frontier in colon cancer screening and surveillance22. A clinical pathway for radical cystectomy leads to a shorter hospital stay and decreases 30-day postoperative complications: a NSQIP analysis23. Fertility preservation in young breast cancer patients: a population-based study24. Investigating factors associated with postmastectomy unplanned emergency department visits: a population-based analysis25. Impact of patient, tumour and treatment factors on psychosocial outcomes after treatment in women with invasive breast cancer26. The relationship between breast and axillary pathologic complete response in women receiving neoadjuvant chemotherapy for breast cancer01. The association between bacterobilia and the risk of postoperative complications following pancreaticoduodenectomy02. Surgical outcome and quality of life following exercise-based prehabilitation for hepatobiliary surgery: a systematic review and meta-analysis03. Does intraoperative frozen section and revision of margins lead to improved survival in patients undergoing resection of perihilar cholangiocarcinoma? A systematic review and meta-analysis04. Prolonged kidney procurement time is associated with worse graft survival after transplantation05. Venous thromboembolism following hepatectomy for colorectal metastases: a population-based retrospective cohort study06. Association between resection approach and transfusion exposure in liver resection for gastrointestinal cancer07. The association between surgeon volume and use of laparoscopic liver resection for gastrointestinal cancer08. Immune suppression through TIGIT in colorectal cancer liver metastases09. “The whole is greater than the sum of its parts” — a combined strategy to reduce postoperative pancreatic fistula after pancreaticoduodenectomy10. Laparoscopic versus open synchronous colorectal and hepatic resection for metastatic colorectal cancer11. Identifying prognostic factors for overall survival in patients with recurrent disease following liver resection for colorectal cancer metastasis12. Modified Blumgart pancreatojejunostomy with external stenting in laparoscopic Whipple reconstruction13. Laparoscopic versus open pancreaticoduodenectomy: a single centre’s initial experience with introduction of a novel surgical approach14. Neoadjuvant chemotherapy versus upfront surgery for borderline resectable pancreatic cancer: a single-centre cohort analysis15. Thermal ablation and telemedicine to reduce resource utilization during the COVID-19 pandemic16. Cost-utility analysis of normothermic machine perfusion compared with static cold storage in liver transplantation in the Canadian setting17. Impact of adjuvant therapy on overall survival in early-stage ampullary cancers: a single-centre retrospective review18. Presence of biliary anaerobes enhances response to neoadjuvant chemotherapy in pancreatic ductal adenocarcinoma19. How does tumour viability influence the predictive capability of the Metroticket model? Comparing predicted-to-observed 5-year survival after liver transplant for hepatocellular carcinoma20. Does caudate resection improve outcomes in patients undergoing curative resection for perihilar cholangiocarcinoma? A systematic review and meta-analysis21. Appraisal of multivariable prognostic models for postoperative liver decompensation following partial hepatectomy: a systematic review22. Predictors of postoperative liver decompensation events following resection in patients with cirrhosis and hepatocellular carcinoma: a population-based study23. Characteristics of bacteriobilia and impact on outcomes after Whipple procedure01. Inverting the y-axis: the future of MIS abdominal wall reconstruction is upside down02. Progressive preoperative pneumoperitoneum: a single-centre retrospective study03. The role of radiologic classification of parastomal hernia as a predictor of the need for surgical hernia repair: a retrospective cohort study04. Comparison of 2 fascial defect closure methods for laparoscopic incisional hernia repair01. Hypoalbuminemia predicts serious complications following elective bariatric surgery02. Laparoscopic adjustable gastric band migration inducing jejunal obstruction associated with acute pancreatitis: aurgical approach of band removal03. Can visceral adipose tissue gene expression determine metabolic outcomes after bariatric surgery?04. Improvement of kidney function in patients with chronic kidney disease and severe obesity after bariatric surgery: a systematic review and meta-analysis05. A prediction model for delayed discharge following gastric bypass surgery06. Experiences and outcomes of Indigenous patients undergoing bariatric surgery: a mixed-methods scoping review07. What is the optimal common channel length in revisional bariatric surgery?08. Laparoscopic management of internal hernia in a 34-week pregnant woman09. Characterizing timing of postoperative complications following elective Roux-en-Y gastric bypass and sleeve gastrectomy10. Canadian trends in bariatric surgery11. Common surgical stapler problems and how to correct them12. Management of choledocholithiasis following Roux-en-Y gastric bypass: a systematic review and meta-analysis. Can J Surg 2021; 64:S80-S159. [PMID: 35483046 PMCID: PMC8677574 DOI: 10.1503/cjs.021321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Krishnappa V, George E, Oravec M, Jones R, Lee A, Sweet D. Quality improvement project to improve providers' goal-setting activity for chronic disease self-management. J Healthc Qual Res 2021; 37:79-84. [PMID: 34844905 DOI: 10.1016/j.jhqr.2021.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/06/2021] [Accepted: 10/05/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Patient-centered medical home (PCMH) places patients at the center of care and actively considers patients' goals, preferences and skill levels in caring for their disease while developing a care plan. We implemented a quality improvement (QI) project to improve internal medicine resident goal-setting activity with patients for chronic disease self-management. METHODS The plan-do-study-act (PDSA) model was used and a root cause analysis was conducted with internal medicine residents (n=20) and faculty (n=7) to identify barriers to patient goal setting. Two main causes were identified - lack of awareness and lack of knowledge about where and how to set patient goals in the electronic medical record (EMR). Reminders during daily morning huddles, discussions with faculty, educational video presentation and organizational policy change interventions were implemented in four serial PDSA cycles. RESULTS The goal setting activity documentation rate by resident providers increased to 14% following inclusion of patient goal setting reminders during daily morning huddles. There was notable increase in the goal setting documentation rate to 29% following discussion in faculty meeting. The goal setting documentation rate remained the same (29%) despite educational video and policy change intervention. However, goal setting documentation rate increased to 33% by the end of the study. CONCLUSION Our QI project resulted in a measurable increase in the use of methods of healthcare delivery associated with improved outcomes. This model worked well in our setting, and sharing our success may benefit others seeking to achieve similar goals.
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Killeen E, Horan S, Pollock A, Lee A, Martin A. 98 SCHEDULED MEDICATION REVIEWS AND EDUCATION ON SEDATIVE PRESCRIBING FOR RESPONSIVE BEHAVIOURS IN NURSING HOME RESIDENTS, A 3 YEAR FOLLOW-UP STUDY. Age Ageing 2021. [DOI: 10.1093/ageing/afab219.98] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
Abstract
Background
Sedative medications including neuroleptics, benzodiazepines, opioids, ‘z’ drugs and trazadone are commonly prescribed for older adults. Nursing home residents are three times more likely to be prescribed benzodiazepines. Sedative medications are associated with significant risks including falls and delirium in older adults. Neuroleptics also increase risk of cerebrovascular disease and functional decline. Regular medication review and education have been shown to reduce rates of sedative use in nursing homes. Scheduled medication reviews were introduced in an Irish nursing home with a specific focus on reduction or discontinuation of these target medications in combination with education of management of Behavioural and Psychological symptoms (BPSD). We demonstrated previously a significant reduction in prescribing following these interventions. This audit examines the prescribing patterns 3 years on from the initial audit.
Methods
Point prevalence study of sedative prescriptions and BPSD on 6/5/21 of all 95 nursing home residents. Data compared with two preceding audits in 2018 in the same unit. All data anonymised. Data analysed with SPSS statistical software.
Results
Significant reduction in quetiapine use sustained from 30% of residents pre-intervention to 14% post-intervention in 2018 and 2021 (p = 0.06).
Neuroleptic prescription reduced from 39% to 25% (p = 0.06).
‘Z’ drug prescribing increased from 8% to 17% (p = 0.03).
33% of residents had BPSD reported compared to 49% pre-intervention.
Conclusion
3 year follow-up showed regularly scheduled medication reviews and education in a nursing home can effectively rationalise sedative prescription rates. Sustained reduction in neuroleptics and increased ‘z’ drug prescriptions may represent appropriate replacement. Reduced BPSD may be due to changing nursing home resident cohort or reporting bias of staff since the introduction of regular education.
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Li V, Wang Z, Yu V, Dams R, Philipson R, Lee P, Kishan A, Lee A, Qi X. Multivariate Model for Predicting Overall Survival in Malignant Pleural Mesothelioma After Adjuvant Radiotherapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Moreno A, Wang X, Mohamed A, Wang H, Wang C, Tung S, Yang J, Reddy J, Lee A, Spiotto M, Fuller C, Gunn G, Frank S, Rosenthal D, Morrison W, Garden A, Phan J. Patterns of Failure After SBRT Reirradiation for Recurrent Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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