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Olagundoye O, Ross S, Gibson W, Wagg A. Defining and prioritizing modifiable risk factors towards the co-creation of a urinary incontinence self-management intervention for older men: A sequential multimethod study protocol. PLoS One 2024; 19:e0305052. [PMID: 39052594 PMCID: PMC11271917 DOI: 10.1371/journal.pone.0305052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 05/21/2024] [Indexed: 07/27/2024] Open
Abstract
Urinary incontinence (UI), characterized by involuntary urine leakage is a chronic, embarrassing and stigmatizing condition that is under-reported and under-treated). UI is under-prioritized and under-researched, particularly in older men (defined here as men 65+), and there have been calls for more targeted research focusing on this specific group. No existing self-management interventions focus on the needs of older men and none incorporate the perspectives of older men into their development. Furthermore, health inequalities and disparities in continence services for men, and a low level of health seeking behavior in men with UI make it crucial to incorporate their perspectives into intervention development to ensure optimal outcomes. The study will identify risk factors for UI that are potentially amenable to self-management in older men, assess their self-efficacy in managing UI, and determine what modifiable risk factors older men feel are pragmatic to include as part of a self-management program. We will conduct and report a sequential multi-method design consisting of a Delphi study among healthcare experts and a survey among older men with UI, according to the Guidance on Conducting and Reporting Delphi Studies (CREDES) Checklist and the Checklist for Reporting Of Survey Studies (CROSS). A geographically dispersed, multidisciplinary group of 30 health care professionals (urologists, geriatricians, family physicians, and nurses) involved in continence care and a representative sample of at least 128 ethnically diverse older men will participate in a Delphi survey and an older men's survey respectively. The healthcare experts will evaluate an evidence-synthesized list of UI risk factors to determine those potentially amenable to self-management. Delphi rounds will be repeated until consensus threshold of 75% is reached. Thereafter, older men recruited via stratified sampling of population subgroups will rate a list of expert-identified potentially modifiable risk factors to indicate which factors they deem practicable and can prioritize. Older men's survey questionnaires will capture information on patients' characteristics (socio-demographics and UI-related items). The Geriatric Self-Efficacy Index for UI (GSE-UI Index) as well as a Likert scale to assess perceived capability and willingness to modify the expert-identified UI modifiable risk factors will be included. Data will be analyzed quantitatively and qualitatively.
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Affiliation(s)
- Olawunmi Olagundoye
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine & Dentistry, College of Health Sciences, Edmonton, AB, Canada
| | - Shelley Ross
- Department of Family Medicine, Faculty of Medicine & Dentistry, College of Health Sciences, Edmonton, AB, Canada
| | - William Gibson
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine & Dentistry, College of Health Sciences, Edmonton, AB, Canada
| | - Adrian Wagg
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine & Dentistry, College of Health Sciences, Edmonton, AB, Canada
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Cotobal Rodeles S, Martín Sánchez FJ, Martínez-Selles M. [Characteristics of the new internal resident physicians from Madrid Region, their opinions regarding family and community medicine]. Semergen 2024; 50:102295. [PMID: 39053337 DOI: 10.1016/j.semerg.2024.102295] [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: 02/13/2024] [Revised: 05/22/2024] [Accepted: 05/27/2024] [Indexed: 07/27/2024]
Abstract
AIM To evaluate the opinions of the new internal resident physicians (IRP) on family and community medicine (FCM) and professional and personal issues. METHODS Anonymous survey of 837 new IRPs in the Madrid Region. RESULTS Mean age was 25.6±3.5 years, 525 (62.7%) had a specific subject of FCM during medical school, 799 (95.5%) did FCM practices during their medical degree, and 606 (72.4%) considered relevant to be some months in FCM during their medical residence. Only 103 (12.3%) consider becoming parents during residency, 416 (49.7%) have suffered from anxiety, 99 (11.8%) from depression, and 19 (2.3%) had previous suicidal thoughts. Although 638 (76.2%) have received training in ethical decisions, 345 (41.2%) did not know how to implement these decisions, 120 (14.3%) had studied artificial intelligence and 744 (88.9%) have a positive view of the College of Physicians. CONCLUSIóN: Most new medical residents of Madrid consider a Primary Care rotation relevant during their training, but only 63% have completed specific training in FCM as an undergraduate. A total of 12% reported previous depression and half anxiety.
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Affiliation(s)
- S Cotobal Rodeles
- Servicio de Geriatría, Hospital Universitario Severo Ochoa. Leganés, Madrid, España
| | - F J Martín Sánchez
- Hospital Universitario Clínico San Carlos. Madrid, España; Facultad de Medicina, Universidad Complutense, Madrid, España
| | - M Martínez-Selles
- Facultad de Medicina, Universidad Complutense, Madrid, España; Servicio de Cardiología, Hospital General Universitario Gregorio Marañón. CIBERCV. Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea, Madrid, España.
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53
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Song SY, Han HY, Park SY, Kim J, Park KM, Kyong T. Current Status of Hospitalist Practice and Factors Influencing Job Satisfaction in Korea. J Gen Intern Med 2024:10.1007/s11606-024-08910-8. [PMID: 39037519 DOI: 10.1007/s11606-024-08910-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 06/24/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND Although the roles and responsibilities of hospitalists have grown considerably in recent years, research on the current job status and satisfaction levels of Korean hospitalists is lacking. OBJECTIVE We investigate the present state of Korean hospitalists and the factors influencing their job satisfaction 6 years after the pilot program's launch. DESIGN This cross-sectional analysis was based on an online survey conducted from January 30 to February 18, 2023. PARTICIPANTS Korean hospitalists (N = 303) MAIN MEASURES: The survey encompassed participant demographics, hospital information, education, clinical practice, research involvement, and job satisfaction. We employed multiple logistic regression analyses to identify determinants of satisfaction as a hospitalist. KEY RESULTS The analysis was based on 79 hospitalists' responses (response rate 26%). Respondents had a median age of 39 years; approximately half were male internal medicine specialists, possessing over 3 years of hospitalist experience. Most respondents were interested in clinical work (94.4%), with only 21.5% interested in research and evidence-based medicine. Over two-thirds indicated that non-clinical duties occupied less than 20% of their time. Overall, job satisfaction among hospitalists averaged 51.9%. Notably, the availability of a research mentor was significantly associated with job satisfaction (P = .011). While hospitalists with more than 3 years of experience, more hospitalists per facility, and autonomy were associated with increased job satisfaction, these associations were not statistically significant. Furthermore, there was no association between night shift work, work type, or work hours and job satisfaction. CONCLUSIONS Although Korean hospitalists primarily focus on clinical practice, our study underscores the positive impact of mentorship from research mentors on job satisfaction, supported by comprehensive univariate and multivariate analyses. These findings signal a progressive transformation in the role of Korean hospitalists, as they increasingly engage in research alongside patient care.
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Affiliation(s)
- Song Yi Song
- Department of Hospital Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - Hee Youn Han
- Department of Hospital Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - Se Yoon Park
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
| | - Jaewoong Kim
- Department of Hospital Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea
| | - Kyung Mee Park
- Department of Hospital Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - Taeyoung Kyong
- Department of Hospital Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea.
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Suppan M, Suppan L, Beckmann TS, Samer CF, Savoldelli GL. Enhancing Response Rates in Web-Based Surveys: The Impact of Direct Participant Contact. Healthcare (Basel) 2024; 12:1439. [PMID: 39057582 PMCID: PMC11276369 DOI: 10.3390/healthcare12141439] [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: 06/15/2024] [Revised: 07/15/2024] [Accepted: 07/17/2024] [Indexed: 07/28/2024] Open
Abstract
Achieving a high participation rate is a common challenge in healthcare research based on web-based surveys. A study on local anesthetic systemic toxicity awareness and usage among medical practitioners at two Swiss university hospitals encountered resistance in obtaining personal email addresses from Heads of Departments. Participants were therefore divided into two groups: those who were directly invited via email (personal invitation group) and those who received a generic link through intermediaries (generic link group). The latter group was eventually excluded from survey data analysis. To determine whether one method of survey administration was more effective than another, we carried out a retrospective analysis of response rates and the proportion of new questionnaires completed after initial invitation and subsequent reminders. The results showed significantly higher response rates in the personal invitation group (40.2%, 313/779) compared to the generic link group (25.3%, 22/87), emphasizing the effectiveness of personal invitations on response rate (+14.9%, p = 0.007). The personal invitation group consistently yielded a higher number of completed questionnaires following the initial invitation and each reminder. The method of survey administration can greatly influence response rates and should be acknowledged as a quality criterion when conducting web-based surveys.
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Affiliation(s)
- Mélanie Suppan
- Division of Anaesthesiology, Department of Anaesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals and Faculty of Medicine, 1205 Geneva, Switzerland; (T.S.B.); (G.L.S.)
| | - Laurent Suppan
- Division of Emergency Medicine, Department of Anaesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals and Faculty of Medicine, 1205 Geneva, Switzerland;
| | - Tal Sarah Beckmann
- Division of Anaesthesiology, Department of Anaesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals and Faculty of Medicine, 1205 Geneva, Switzerland; (T.S.B.); (G.L.S.)
| | - Caroline Flora Samer
- Division of Clinical Pharmacology and Toxicology, Department of Anaesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals and Faculty of Medicine, 1205 Geneva, Switzerland;
| | - Georges Louis Savoldelli
- Division of Anaesthesiology, Department of Anaesthesiology, Clinical Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals and Faculty of Medicine, 1205 Geneva, Switzerland; (T.S.B.); (G.L.S.)
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Layne D, Beall C, Bryant WT, Morris L, Craven H. Experiences with Negative Behavior and Incivility: Perspectives of Unlicensed Assistive Personnel and Registered Nurses. NURSING REPORTS 2024; 14:1706-1721. [PMID: 39051363 PMCID: PMC11270354 DOI: 10.3390/nursrep14030127] [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: 07/01/2024] [Revised: 07/08/2024] [Accepted: 07/11/2024] [Indexed: 07/27/2024] Open
Abstract
Healthcare professionals experience negative behaviors such as incivility from various sources within the hospital environment. However, little is known regarding the experience of unlicensed assistive personnel with these behaviors. Using a cross-sectional survey design, the research team aimed to examine the presence, sources, and impact of negative behaviors among registered nurses and unlicensed assistive personnel within a US hospital. Descriptive and inferential statistics were used to analyze quantitative data, while thematic analysis was used to analyze the qualitative responses. A total of 309 participants completed the survey, and 135 participants responded to three qualitative questions. Most respondents identified inadequate staffing/resources to handle workload (87%) and job stress leading to loss of control over behavior as contributing factors to lateral/vertical aggression in the work environment (71%). Impacts of negative behavior on job performance were related to both personal well-being and the work environment. Demoralization was identified as a common consequence of negative behaviors for individuals and within the work environment. The results suggested that registered nurses, unlicensed assistive personnel, and nursing leadership may benefit from system-wide approaches addressing negative behaviors such as incivility within the clinical environment. Specifically, efforts and policies aimed at aiding clinicians in responding to negative behaviors could potentially improve the clinical environment.
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Affiliation(s)
- Diana Layne
- College of Nursing, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Christina Beall
- Department of Nursing, University of South Carolina-Beaufort, Bluffton, SC 29909, USA;
| | - William T. Bryant
- Ralph H. Johnson VA Health Care System, Health Equity and Rural Outreach Innovation Center, Charleston, SC 29425, USA;
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Lynnette Morris
- MUSC Health, Medical University of South Carolina, Charleston, SC 29425, USA; (L.M.); (H.C.)
| | - Heather Craven
- MUSC Health, Medical University of South Carolina, Charleston, SC 29425, USA; (L.M.); (H.C.)
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Andersen CR, Presseau J, Shea B, Marti ML, McCoy M, Fernie G, McIntyre L, Delaney A, Chassé M, Saigle V, Marshall S, Fergusson DA, Graham I, Brehaut J, Turgeon AF, Lauzier F, Tugwell P, Zha X, Talbot P, Muscedere J, Marshall JC, Thavorn K, Griesdale D, English SW. What to Measure in Aneurysmal Subarachnoid Haemorrhage Research-An International Delphi Survey. Transl Stroke Res 2024:10.1007/s12975-024-01271-8. [PMID: 38997598 DOI: 10.1007/s12975-024-01271-8] [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: 05/07/2024] [Revised: 06/13/2024] [Accepted: 06/17/2024] [Indexed: 07/14/2024]
Abstract
Aneurysmal subarachnoid haemorrhage (aSAH) is a devastating condition with high mortality and morbidity. The outcome measures used in aSAH clinical research vary making it challenging to compare and combine different studies. Additionally, there may be a mismatch between the outcomes prioritized by patients, caregivers, and health care providers and those selected by researchers. We conducted an international, online, multiple round Delphi study to develop consensus on domains (where a domain is a health concept or aspect) prioritized by key stakeholders including those with lived experience of aSAH, health care providers, and researchers, funders, or industry professionals. One hundred seventy-five people participated in the survey, 59% of whom had lived experience of aSAH. Over three rounds, 32 domains reached the consensus threshold pre-defined as 70% of participants rating the domain as being critically important. During the fourth round, participants ranked the importance of each of these 32 domains. The top ten domains ranked highest to lowest were (1) Cognition and executive function, (2) Aneurysm obliteration, (3) Cerebral infarction, (4) Functional outcomes including ability to walk, (5) Delayed cerebral ischemia, (6) The overall quality of life as reported by the SAH survivor, (7) Changes to emotions or mood (including depression), (8) The basic activities of daily living, (9) Vasospasm, and (10) ICU complications. Our findings confirm that there is a mismatch between domains prioritized by stakeholders and outcomes used in clinical research. Our future work aims to address this mismatch through the development of a core outcome set in aSAH research.
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Affiliation(s)
- Christopher R Andersen
- Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Sydney, Australia
- Critical Care Program, The George Institute for Global Health, University of New South Wales Sydney, Sydney, Australia
- Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Justin Presseau
- Methodological and Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Bev Shea
- Methodological and Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Maria Luisa Marti
- Methodological and Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Madeline McCoy
- Methodological and Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Gordon Fernie
- Methodological and Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Lauralyn McIntyre
- Methodological and Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Department of Critical Care, The Ottawa Hospital, Ottawa, ON, Canada
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Anthony Delaney
- Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Sydney, Australia
- Critical Care Program, The George Institute for Global Health, University of New South Wales Sydney, Sydney, Australia
- Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Michaël Chassé
- Department of Medicine, Division of Critical Care, Centre Hospitalier de L'Université de Montréal, Montréal, Québec, Canada
| | - Victoria Saigle
- Methodological and Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Shawn Marshall
- Methodological and Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Dean A Fergusson
- Methodological and Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Department of Critical Care, The Ottawa Hospital, Ottawa, ON, Canada
| | - Ian Graham
- Methodological and Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Jamie Brehaut
- Methodological and Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Alexis F Turgeon
- Department of Anesthesiology and Critical Care, Division of Critical Care Medicine, Université Laval, Québec City, Québec, Canada
- Population Health and Optimal Health Practice Research Unit (Trauma - Emergency - Critical Care Medicine) CHU de Québec-Université Laval Research Centre, Québec City, Québec, Canada
| | - François Lauzier
- Population Health and Optimal Health Practice Research Unit (Trauma - Emergency - Critical Care Medicine) CHU de Québec-Université Laval Research Centre, Québec City, Québec, Canada
- Department of Medicine, Department of Anesthesiology and Critical Care, Université Laval, Québec, Canada
| | - Peter Tugwell
- Methodological and Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
- Bruyère Research Institute, Ottawa, ON, Canada
| | - Xiaohui Zha
- Inflammation and Chronic Disease Program, Ottawa Hospital Research Institute, Ottawa, Canada
- Department of Biochemistry, Immunology & Microbiology, University of Ottawa, Ottawa, Canada
| | - Phil Talbot
- Critical Care Program, The George Institute for Global Health, University of New South Wales Sydney, Sydney, Australia
| | - John Muscedere
- Department of Critical Care Medicine, Queen's University, Kingston, ON, Canada
| | - John C Marshall
- Departments of Surgery and Critical Care Medicine, Unity Health Toronto, Toronto, ON, Canada
| | - Kednapa Thavorn
- Methodological and Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Donald Griesdale
- Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, BC, Canada
- Centre for Clinical Epidemiology & Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Shane W English
- Methodological and Implementation Research, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
- Department of Critical Care, The Ottawa Hospital, Ottawa, ON, Canada.
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
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Cordrey T, Thomas A, King E, Gustafson O. Evaluating the perceived impact and legacy of master's degree level research in the allied health professions: a UK-wide cross-sectional survey. BMC MEDICAL EDUCATION 2024; 24:750. [PMID: 38997702 PMCID: PMC11241887 DOI: 10.1186/s12909-024-05582-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 05/21/2024] [Indexed: 07/14/2024]
Abstract
BACKGROUND Post graduate master's degree qualifications are increasingly required to advance allied health profession careers in education, clinical practice, leadership, and research. Successful awards are dependent on completion of a research dissertation project. Despite the high volume of experience gained and research undertaken at this level, the benefits and impact are not well understood. Our study aimed to evaluate the perceived impact and legacy of master's degree training and research on allied health profession practice and research activity. METHODS A cross-sectional online survey design was used to collect data from allied health professionals working in the United Kingdom who had completed a postgraduate master's degree. Participants were recruited voluntarily using social media and clinical interest group advertisement. Data was collected between October and December 2022 and was analysed using descriptive statistics and narrative content analysis. Informed consent was gained, and the study was approved by the university research ethics committee. RESULTS Eighty-four responses were received from nine allied health professions with paramedics and physiotherapists forming the majority (57%) of respondents. Primary motivation for completion of the master's degree was for clinical career progression (n = 44, 52.4%) and formation of the research dissertation question was predominantly sourced from individual ideas (n = 58, 69%). Formal research output was low with 27.4% (n = 23) of projects published in peer reviewed journal and a third of projects reporting no output or dissemination at all. Perceived impact was rated highest in individual learning outcomes, such as improving confidence and capability in clinical practice and research skills. Ongoing research engagement and activity was high with over two thirds (n = 57, 67.9%) involved in formal research projects. CONCLUSION The focus of master's degree level research was largely self-generated with the highest perceived impact on individual outcomes rather than broader clinical service and organisation influence. Formal output from master's research was low, but ongoing research engagement and activity was high suggesting master's degree training is an under-recognised source for AHP research capacity building. Future research should investigate the potential benefits of better coordinated and prioritised research at master's degree level on professional and organisational impact.
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Affiliation(s)
- Terry Cordrey
- Oxford Allied Health Professions Research and Innovation Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK.
- Centre for Movement, Occupational, and Rehabilitation Sciences, Oxford Brookes University, Oxford, OX3 0BP, UK.
| | - Amanda Thomas
- Barts Health NHS Trust, Royal London Hospital, London, E1 1BB, UK
| | - Elizabeth King
- Oxford Allied Health Professions Research and Innovation Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
- Centre for Movement, Occupational, and Rehabilitation Sciences, Oxford Brookes University, Oxford, OX3 0BP, UK
| | - Owen Gustafson
- Oxford Allied Health Professions Research and Innovation Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
- Centre for Movement, Occupational, and Rehabilitation Sciences, Oxford Brookes University, Oxford, OX3 0BP, UK
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Xiong B, Stirling C, Bailey DX, Martin-Khan M. The implementation and impacts of the Comprehensive Care Standard in Australian acute care hospitals: a survey study. BMC Health Serv Res 2024; 24:800. [PMID: 38992627 PMCID: PMC11241846 DOI: 10.1186/s12913-024-11252-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 06/26/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND Comprehensive care (CC) is becoming a widely acknowledged standard for modern healthcare as it has the potential to improve health service delivery impacting both patient-centred care and clinical outcomes. In 2019, the Australian Commission on Safety and Quality in Health Care mandated the implementation of the Comprehensive Care Standard (CCS). However, little is known about the implementation and impacts of the CCS in acute care hospitals. Our study aimed to explore care professionals' self-reported knowledge, experiences, and perceptions about the implementation and impacts of the CCS in Australian acute care hospitals. METHODS An online survey using a cross-sectional design that included Australian doctors, nurses, and allied health professionals in acute care hospitals was distributed through our research team and organisation, healthcare organisations, and clinical networks using various methods, including websites, newsletters, emails, and social media platforms. The survey items covered self-reported knowledge of the CCS and confidence in performing CC, experiences in consumer involvement and CC plans, and perceptions of organisational support and impacts of CCS on patient care and health outcomes. Quantitative data were analysed using Rstudio, and qualitative data were analysed thematically using Nvivo. RESULTS 864 responses were received and 649 were deemed valid responses. On average, care professionals self-reported a moderate level of knowledge of the CCS (median = 3/5) and a high level of confidence in performing CC (median = 4/5), but they self-reported receiving only a moderate level of organisational support (median = 3/5). Only 4% (n = 17) of respondents believed that all patients in their unit had CCS-compliant care plans, which was attributed to lack of knowledge, motivation, teamwork, and resources, documentation issues, system and process limitations, and environment-specific challenges. Most participants believed the CCS introduction improved many aspects of patient care and health outcomes, but also raised healthcare costs. CONCLUSION Care professionals are confident in performing CC but need more organisational support. Further education and training, resources, multidisciplinary collaboration, and systems and processes that support CC are needed to improve the implementation of the CCS. Perceived increased costs may hinder the sustainability of the CCS. Future research is needed to examine the cost-effectiveness of the implementation of the CCS.
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Affiliation(s)
- Beibei Xiong
- Centre for Health Services Research, The University of Queensland, Brisbane, QLD, 4102, Australia.
| | | | - Daniel X Bailey
- Centre for Health Services Research, The University of Queensland, Brisbane, QLD, 4102, Australia
- Centre for Clinical Research, The University of Queensland, Brisbane, QLD, 4102, Australia
| | - Melinda Martin-Khan
- Centre for Health Services Research, The University of Queensland, Brisbane, QLD, 4102, Australia
- Department of Health and Life Sciences, University of Exeter, EX1 2HZ, Exeter, England, United Kingdom
- School of Nursing, University of Northern British Columbia, British Columbia, V2N 4Z9, Prince George, Canada
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Käufeler M, Beeler PE, Müller LS, Gemperli A, Merlo C, Hug BL. Hospitalists' perception of their communication with primary care providers - survey results from six hospitals in Central Switzerland. Swiss Med Wkly 2024; 154:3643. [PMID: 39137374 DOI: 10.57187/s.3643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2024] Open
Abstract
OBJECTIVES Due to the increasing complexity of the healthcare system, effective communication and data exchange between hospitalists (in-hospital physicians) and primary care physicians (PCPs) is both central and challenging. In Switzerland, little is known about hospitalists' perception of their communication with PCPs. The primary objective was to assess hospitalists' satisfaction with their communication with PCPs. Secondary objectives addressed all information about the referral process and communication with PCPs during and after the hospital encounter. Lastly, the results of a previous survey among PCPs were juxtaposed to compare their responses to similar questions. METHODS This study surveyed hospitalists in six hospitals in the Central Switzerland region. The survey was sent via email to hospitalists from November 2021 to February 2022. The questionnaire contained 17 questions with single- and multiple-choice answers and the option of free-text entry. Exploratory multivariable logistic regression was used to analyse independent associations. RESULTS In total, 276 of 1134 hospitalists responded (response rate 24.3%): (1) the majority of hospitalists are satisfied with the general communication (n = 162, 58.7%) as well as with referral letters (n = 145, 52.5%), (2) preferred information channels for referral letters are email (n = 212, 76.8%) and electronic portals (n = 181, 65.5%), (3) the three most important items of information in referrals are: medication list, diagnoses and reason for referral. In multivariable regression, compared to other clinicians, internists independently favoured informing PCPs of emergency admissions of their patients in a timely manner (OR 2.04; 95%CI 1.21-3.49). Comparing responses from PCPs (n = 109), the most prominent discrepancy was that 67% (n = 184) of hospitalists claimed to "always" inform after an encounter, whereas only 7% (n = 8) of PCPs agreed. CONCLUSION Most hospitalists are satisfied with the communication with PCPs and prefer electronic communication channels. Room for improvement was found around timely transmission of patient information before and after hospital encounters.
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Affiliation(s)
- Manuela Käufeler
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Patrick E Beeler
- Center for Primary and Community Care, University of Lucerne, Lucerne, Switzerland
| | - Lena S Müller
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland .
| | - Armin Gemperli
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Center for Primary and Community Care, University of Lucerne, Lucerne, Switzerland
| | - Christoph Merlo
- Center for Primary and Community Care, University of Lucerne, Lucerne, Switzerland
| | - Balthasar L Hug
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Center for Primary and Community Care, University of Lucerne, Lucerne, Switzerland
- Cantonal Hospital Lucerne, Lucerne, Switzerland
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Grailey K, Fernandez-Crespo R, Howitt P, Leis M, Darzi A, Neves AL. The cost of living crisis - how does it impact the health and life of individuals? A survey exploring perceptions in Italy, Germany, Sweden and the United Kingdom. BMC Public Health 2024; 24:1831. [PMID: 38982405 PMCID: PMC11234749 DOI: 10.1186/s12889-024-19330-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 07/01/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND The Cost of Living Crisis (CoLC), a real term reduction in basic income, risks individuals being unable to afford essentials such as heat, food and clothing. The impact of the CoLC is disproportionate - with different population sub-groups more likely to be negatively affected. The objective of this survey was to evaluate the perceived impact of the CoLC on the life and health of participants across four European countries. METHODS A survey housing two questions to investigate the relationship between the CoLC and its perceived impact on life and health was developed. Four European countries (U.K., Sweden, Italy and Germany) took part via the YouGov platform. Logistic regression models were created for each country and question to evaluate which population characteristics were associated with a negative reported impact of the CoLC. RESULTS A total of 8,152 unique individuals responded between 17th March and 30th March 2023. Each country was equally represented. Those aged 36-64 were more likely to report a negative impact of the CoLC on their life and health than younger participants (p < 0.001, p = 0.02 respectively). Across all countries, females were significantly more likely to report a negative impact on their life and health, however, when analysed according to country, in Sweden females were less likely to report a negative impact (p < 0.001). Those in lower income families or who reported poor health in the preceding 12 months were significantly more likely to report a negative impact of the CoLC on their life and health. There was no difference within the participant group on the reported impact of the CoLC based on location (rural vs. urban). CONCLUSIONS We demonstrate the disproportionate negative impact of the CoLC on both life and health in different population subgroups. Germany and Sweden appeared to be more resilient to the effects of the CoLC, particularly for certain population subgroups. It is important to understand the differing effects of a CoLC, and to learn from successful health and economic strategies in order to create targeted policy and create a population resilient to economic shocks.
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Affiliation(s)
- Kate Grailey
- Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, Room 1035, 10th Floor QEQM, St Mary's Campus, W2 1NY, London, U.K..
| | - Roberto Fernandez-Crespo
- Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, Room 1035, 10th Floor QEQM, St Mary's Campus, W2 1NY, London, U.K
| | - Peter Howitt
- Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, Room 1035, 10th Floor QEQM, St Mary's Campus, W2 1NY, London, U.K
| | - Melanie Leis
- Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, Room 1035, 10th Floor QEQM, St Mary's Campus, W2 1NY, London, U.K
- NIHR North West London Patient Safety Research Collaboration, Institute of Global Health Innovation, Imperial College London, London, U.K
| | - Ara Darzi
- Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, Room 1035, 10th Floor QEQM, St Mary's Campus, W2 1NY, London, U.K
- NIHR North West London Patient Safety Research Collaboration, Institute of Global Health Innovation, Imperial College London, London, U.K
| | - Ana Luisa Neves
- Department of Primary Care and Public Health, Imperial College London, London, U.K
- NIHR North West London Patient Safety Research Collaboration, Institute of Global Health Innovation, Imperial College London, London, U.K
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Franchi L, Nieri M, Marti P, Recupero A, Volpe A, Vichi A, Goracci C. Clinical Management of Facemasks for Early Treatment of Class III Malocclusion: A Survey among SIDO Members. Dent J (Basel) 2024; 12:207. [PMID: 39056994 PMCID: PMC11276424 DOI: 10.3390/dj12070207] [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: 05/26/2024] [Revised: 06/17/2024] [Accepted: 07/03/2024] [Indexed: 07/28/2024] Open
Abstract
To evaluate whether there are differences among orthodontists in the clinical management of facemask treatment for early treatment of Class III malocclusion, a survey consisting of 16 questions was conducted among members of the Italian Society of Orthodontics (SIDO). Sixty percent of the respondents were Specialists in Orthodontics (S) whereas 40% were General Dentists practicing Orthodontics (GD). Descriptive statistics were calculated to summarize the collected data. Differences in answers between S and GD were assessed with the Fisher's exact test for dichotomous variables, chi-square test for qualitative variables, and Mann-Whitney test for ordinal variables. A total of 151 clinicians participated in this survey. As for treatment timing, about 80% of the participants reported treating Class III patients with RPE and facemask between 5 and 8 years of age. Most of the participants requested the patients to wear the facemask in the afternoon and at night for a period of 9 or 12 months with recommended forces of 500 g per side. Comparisons between S and GD showed that S preferred the Petit facemask whereas GD favored the Delaire's type facemask (Fisher's Exact test, p = 0.0005). S and GD also differed significantly in their judgment of the most critical time of treatment, which for the majority of GD was the initial period but for the S was the final period (Chi-square test p = 0.0188). This survey showed that the facemask is not well received by the patients who, along with their parents, express concerns regarding its tolerability.
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Affiliation(s)
- Lorenzo Franchi
- Department of Experimental and Clinical Medicine, University of Florence, 50121 Florence, Italy;
| | - Michele Nieri
- Department of Experimental and Clinical Medicine, University of Florence, 50121 Florence, Italy;
| | - Patrizia Marti
- Santa Chiara Fab Lab, Department of Social Political and Cognitive Sciences, University of Siena, 53100 Siena, Italy; (P.M.); (A.R.)
| | - Annamaria Recupero
- Santa Chiara Fab Lab, Department of Social Political and Cognitive Sciences, University of Siena, 53100 Siena, Italy; (P.M.); (A.R.)
| | - Alessandra Volpe
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy; (A.V.); (C.G.)
| | - Alessandro Vichi
- Dental Academy, University of Portsmouth, Portsmouth PO1 2UP, UK;
| | - Cecilia Goracci
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy; (A.V.); (C.G.)
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Fung FW, Carpenter JL, Chapman KE, Gallentine W, Giza CC, Goldstein JL, Hahn CD, Loddenkemper T, Matsumoto JH, Press CA, Riviello JJ, Abend NS. Survey of Pediatric ICU EEG Monitoring-Reassessment After a Decade. J Clin Neurophysiol 2024; 41:458-472. [PMID: 36930237 PMCID: PMC10504411 DOI: 10.1097/wnp.0000000000001006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
PURPOSE In 2011, the authors conducted a survey regarding continuous EEG (CEEG) utilization in critically ill children. In the interim decade, the literature has expanded, and guidelines and consensus statements have addressed CEEG utilization. Thus, the authors aimed to characterize current practice related to CEEG utilization in critically ill children. METHODS The authors conducted an online survey of pediatric neurologists from 50 US and 12 Canadian institutions in 2022. RESULTS The authors assessed responses from 48 of 62 (77%) surveyed institutions. Reported CEEG indications were consistent with consensus statement recommendations and included altered mental status after a seizure or status epilepticus, altered mental status of unknown etiology, or altered mental status with an acute primary neurological condition. Since the prior survey, there was a 3- to 4-fold increase in the number of patients undergoing CEEG per month and greater use of written pathways for ICU CEEG. However, variability in resources and workflow persisted, particularly regarding technologist availability, frequency of CEEG screening, communication approaches, and electrographic seizure management approaches. CONCLUSIONS Among the surveyed institutions, which included primarily large academic centers, CEEG use in pediatric intensive care units has increased with some practice standardization, but variability in resources and workflow were persistent.
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Affiliation(s)
- France W Fung
- Departments of Pediatrics and Neurology, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, U.S.A
| | - Jessica L Carpenter
- Departments of Pediatrics and Neurology, University of Maryland School of Medicine, Baltimore, Maryland, U.S.A
| | - Kevin E Chapman
- Division of Neurology, Phoenix Children's Hospital and University of Arizona School of Medicine Phoenix, Arizona, U.S.A
| | - William Gallentine
- Division of Neurology, Stanford University and Lucile Packard Children's Hospital, Palo Alto, California, U.S.A
| | - Christopher C Giza
- Division of Neurology, Department of Pediatrics, Mattel Children's Hospital and UCLA Brain Injury Research Center, Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A
| | - Joshua L Goldstein
- Division of Neurology, Children's Memorial Hospital and Northwestern University Feinberg School of Medicine, Chicago, Illinois, U.S.A
| | - Cecil D Hahn
- Division of Neurology, The Hospital for Sick Children and University of Toronto, Toronto, U.S.A
| | - Tobias Loddenkemper
- Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, U.S.A.; and
| | - Joyce H Matsumoto
- Division of Neurology, Department of Pediatrics, Mattel Children's Hospital and UCLA Brain Injury Research Center, Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, California, U.S.A
| | - Craig A Press
- Departments of Pediatrics and Neurology, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, U.S.A
| | - James J Riviello
- Division of Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, U.S.A
| | - Nicholas S Abend
- Departments of Pediatrics and Neurology, Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, U.S.A
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Coughlin MC, Montemayor S, Dolman HS, Nava G, Riddell M, Tarras SL. Desire for Residency-Provided Education and Support for Fertility Concerns: An Institutional Survey. J Surg Res 2024; 299:76-84. [PMID: 38718687 DOI: 10.1016/j.jss.2024.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 02/23/2024] [Accepted: 03/16/2024] [Indexed: 06/22/2024]
Abstract
INTRODUCTION Medical careers increase infertility risks and pregnancy complications. Residents often postpone pregnancy, contributing to these risks. Limited data exist regarding residents' family planning concerns. This study aims to evaluate fertility concerns and family planning during residency via a survey of residents and attending physicians. METHODS Anonymous online surveys were distributed to all residents (n = 1030) and attending physicians (n = 1111) at a large, urban, single-campus academic hospital center. Data analysis was performed using chi-square analysis with significance at P < 0.05. RESULTS Two hundred nine residents and 111 attendings submitted responses. Most respondents were female (74.7%). Slightly more than one-quarter of respondents were from a surgical specialty (26.6%). Residents compared to attending physicians indicated a higher concern for infertility during (57.4% versus 38.3%, P = 0.006) and after residency (68.9% versus 51.9%, P = 0.011) and a greater concern about pregnancy complications (67.8% versus 38.0%, P < 0.001). Most respondents felt pregnancy could negatively affect their training (67.3%). Surgical respondents were more concerned about the negative effects on colleagues (68.8% versus 51.1%, P = 0.045). Residents considered oocyte preservation more (57.9% versus 20.3%, P < 0.001). Respondents in surgical specialties had more concerns for fertility after residency (72.6% versus 57.9%, P = 0.033). Those in surgical fields trended for consideration of oocyte preservation (53.4% versus 39.7%, P = 0.084). Most respondents reported a need for education on oocyte preservation during residency (94.5%). CONCLUSIONS Residents have increasing concerns about fertility and family planning related to their training. In addition to more institutional and residency program support, residents desire dedicated fertility and family planning education, such as oocyte preservation, as part of their curriculum.
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Affiliation(s)
- Michelle C Coughlin
- The Michael and Marian Ilitch Department of Surgery, Detroit Medical Center, Wayne State University School of Medicine, Detroit, Michigan
| | - Sabrina Montemayor
- The Michael and Marian Ilitch Department of Surgery, Detroit Medical Center, Wayne State University School of Medicine, Detroit, Michigan
| | - Heather S Dolman
- The Michael and Marian Ilitch Department of Surgery, Detroit Medical Center, Wayne State University School of Medicine, Detroit, Michigan
| | - Guillermina Nava
- The Michael and Marian Ilitch Department of Surgery, Detroit Medical Center, Wayne State University School of Medicine, Detroit, Michigan
| | - Madyson Riddell
- The Michael and Marian Ilitch Department of Surgery, Detroit Medical Center, Wayne State University School of Medicine, Detroit, Michigan
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Damery S, Lambie M, Williams I, Coyle D, Fotheringham J, Solis-Trapala I, Allen K, Potts J, Dikomitis L, Davies SJ. Centre variation in home dialysis uptake: A survey of kidney centre practice in relation to home dialysis organisation and delivery in England. Perit Dial Int 2024; 44:265-274. [PMID: 38445495 DOI: 10.1177/08968608241232200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Disparities in home dialysis uptake across England suggest inequity and unexplained variation in access. We surveyed staff at all English kidney centres to identify patterns in service organisation/delivery and explore correlations with home therapy uptake, as part of a larger study ('Inter-CEPt'), which aims to identify potentially modifiable factors to address observed variations. METHODS Between June and September 2022, staff working at English kidney centres were surveyed and individual responses combined into one centre-level response per question using predetermined data aggregation rules. Descriptive analysis described centre practices and their correlation with home dialysis uptake (proportion of new home dialysis starters) using 2019 UK Renal Registry 12-month home dialysis incidence data. RESULTS In total, 180 responses were received (50/51 centres, 98.0%). Despite varied organisation of home dialysis services, most components of service delivery and practice had minimal or weak correlations with home dialysis uptake apart from offering assisted peritoneal dialysis and 'promoting flexible decision-making about dialysis modality'. Moderate to strong correlations were identified between home dialysis uptake and centres reporting supportive clinical leadership (correlation 0.32, 95% Confidence Interval (CI): 0.05-0.55), an organisational culture that values trying new initiatives (0.57, 95% CI: 0.34-0.73); support for reflective practice (0.38, 95% CI: 0.11-0.60), facilitating research engagement (0.39, 95% CI: 0.13-0.61) and promoting continuous quality improvement (0.29, 95% CI: 0.01-0.53). CONCLUSIONS Uptake of home dialysis is likely to be driven by organisational culture, leadership and staff attitudes, which provide a supportive clinical environment within which specific components of service organisation and delivery can be effective.
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Affiliation(s)
- Sarah Damery
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Mark Lambie
- Renal Research Group, School of Medicine, Keele University, Keele, UK
| | - Iestyn Williams
- Health Services Management Centre, University of Birmingham, Birmingham, UK
| | - David Coyle
- NIHR Devices for Dignity, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - James Fotheringham
- Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, UK
| | | | - Kerry Allen
- Health Services Management Centre, University of Birmingham, Birmingham, UK
| | - Jessica Potts
- Renal Research Group, School of Medicine, Keele University, Keele, UK
| | - Lisa Dikomitis
- Kent and Medway Medical School, University of Kent, Canterbury, UK
| | - Simon J Davies
- Renal Research Group, School of Medicine, Keele University, Keele, UK
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Sorge A, Coletta M, Elli L, Bredenoord AJ. Clinical practices and adherence to guidelines for eosinophilic esophagitis: A European survey. Dig Liver Dis 2024; 56:1196-1203. [PMID: 38290961 DOI: 10.1016/j.dld.2023.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/17/2023] [Accepted: 12/19/2023] [Indexed: 02/01/2024]
Abstract
BACKGROUND We aimed to assess the clinical practices and adherence to guidelines for adult Eosinophilic Esophagitis (EoE) patients in Europe. METHODS A cross-sectional web survey containing 23 questions was distributed to members of the European Consortium for Eosinophilic Diseases of the Gastrointestinal Tract (EUREOS) and the Italian Association of Hospital Gastroenterologists and digestive endoscopists (AIGO). We conducted a subgroup analysis to assess the impact of EoE expertise and practice setting on clinical practices. RESULTS 228 physicians from 18 European countries participated. Adherence to guidelines varied from 72% to 98.6%. 83.4% of total respondents obtained ≥ 6 esophageal biopsies in suspected EoE. 42% of total respondents, 82.5% of EoE experts (vs. non-experts 33%; P < 0.0001), and 55% of academics (vs. 29.1 non-academics; P < 0.0001) routinely used the EREFS score. Regarding first-line therapy, 82.9% of total respondents prescribed proton pump inhibitors, 41.6% topical steroids, 20.6% elimination diets, and 9.2% combination therapies. Only 72% of respondents used symptoms and endoscopy with <15 Eosinophils/HPF to define treatment response. 21.5% of all respondents did not prescribe maintenance therapies and 12.7% discontinued therapy before response evaluation endoscopy. CONCLUSION Our findings revealed significant heterogeneity in practice patterns and suboptimal adherence to EoE guidelines across Europe. Expertise in EoE and working in an academic hospital positively influenced clinical practices and adherence to guidelines.
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Affiliation(s)
- Andrea Sorge
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
| | - Marina Coletta
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Luca Elli
- Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Albert J Bredenoord
- Department of Gastroenterology, Amsterdam University Medical Center, Amsterdam, the Netherlands
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Mariani GL, Konikoff LL. Withdrawing Assisted Nutrition in Neonates: A Survey on Attitudes and Insights in Argentina. Am J Perinatol 2024; 41:1417-1423. [PMID: 37003254 DOI: 10.1055/a-2067-5248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
OBJECTIVE This study aimed to assess beliefs and attitudes of Argentinean neonatologists and neonatal nurses regarding end-of-life care of newborn infants, including withdrawal of clinically assisted nutrition and hydration (CANH). STUDY DESIGN A five-domain survey was sent to 465 neonatal health care workers, which included demographic data, general ethical concepts, participation in end-of-life decisions, beliefs about end-of-life care practices, and presentation of four clinical scenarios. Standard statistical tests were used, and a multivariable analysis was done to evaluate variables independently associated with rejecting the withdrawal of CANH. RESULTS A total of 227 questionnaires were anonymously completed, 60% by physicians and 40% by nurses. More respondents agreed to withdraw mechanical ventilation in comparison to CANH in patients under certain circumstances (88 vs. 62%, p < 0.01). The most accepted variables when deciding to withdraw care were the quality of life perceived by parents (86%) and their religious beliefs (73%). A total of 93% agreed that parents should be included in the decision, but only 74% acknowledged they are included in real practice. Considering the scenario of a newborn with severe and irreversible neurological compromise, 46% of respondents were opposed to suspending enteral nutrition. No independent variables were found to be associated with opposing the withdrawal of CANH. Of those agreeing to withdraw enteral feeds under certain circumstances, for the severely neurologically affected neonate 58% would either refuse to limit enteral feeds or consult with an ethics committee before doing so. When given the scenario of their own severe and irreversible neurological compromise, 68% agreed to have enteral feeds withdrawn to themselves, and they were more likely to agree with withdrawing feeds for the severely compromised neonate (odds ratio: 7.2; 95% confidence interval: 2.7-24.1). CONCLUSION While most health care providers agreed to withdraw life-sustaining support under certain conditions, many were reluctant to suspend CANH. Many responses differed when being asked as general statements versus actual clinical scenarios. KEY POINTS · Withdrawal of assisted nutrition is supported by the American Academy of Pediatrics in certain scenarios.. · Many neonatal intensive care units health care providers from Argentina are reluctant to suspend assisted nutrition.. · There is a need to learn how to deal with complex bioethical issues..
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Affiliation(s)
- Gonzalo L Mariani
- Division of Neonatology, Department of Pediatrics, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
- Departamento de Postgrado, Instituto Universitario Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Laura L Konikoff
- Division of Neonatology, Department of Pediatrics, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
- Departamento de Postgrado, Instituto Universitario Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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Opgenorth D, Duquette DJ, Tyre L, Auld R, Crowder K, Gilchrist P, Young PJ, Bagshaw SM. Public perception of participation in low-risk clinical trials in critical care using waived consent: a Canadian national survey. Can J Anaesth 2024; 71:1015-1022. [PMID: 38459367 DOI: 10.1007/s12630-024-02723-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 12/04/2023] [Accepted: 12/04/2023] [Indexed: 03/10/2024] Open
Abstract
PURPOSE The acceptability of waiver of consent for participation in clinical research in intensive care unit (ICU) settings is uncertain. We sought to survey the Canadian public to assess levels of support, comfort, and acceptability for waived consent for low-risk clinical trials. METHODS We performed a prospective cross-sectional survey of the Canadian public aged 18 yr or older. The survey was conducted by Ipsos between 19 and 23 November 2020. The survey content was derived from a literature review and in consultation with a patient and family partnership committee. The survey focused on attitudes and beliefs on waived consent for participation in low-risk clinical trials in ICU settings. The survey contained 35 items focused on sociodemographics, general health status, participation in medical research, and levels of support and comfort with research and with waived consent. The survey used a case study of a low-risk clinical trial intervention in ICU patients. Analysis was descriptive. RESULTS We included 2,000 participants, 38% of whom reported experience with ICU and 16% with medical research. Participation in medical research was more common among those with postsecondary education, those with chronic disease, and those who were employed in health care. Most (80%) would support a model of waived consent for low-risk clinical trials, citing medical benefits (36%) and low perceived risk (34%). Most (77%) were comfortable with personally participating in a low-risk clinical trial. Most (80%) believed waived consent approaches were acceptable. Half (52%) believed the waived consent process should provide information about the research and include the option of opting out. When asked whether participants should always give full informed consent, regardless of the practicality or level of risk, 74% and 72% agreed, respectively. CONCLUSIONS There is public support for models of waived consent for participation in low-risk pragmatic clinical trials in ICU settings in Canada; however, this is not universal. This information can inform and guide education, ethics, policy, and legal discussion on consent models.
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Affiliation(s)
- Dawn Opgenorth
- Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, AB, Canada
- Intensive Care Patient and Family Partnership Committee, Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Critical Care Strategic Clinical Network™, Alberta Health Services, Edmonton, AB, Canada
| | - D'Arcy J Duquette
- Intensive Care Patient and Family Partnership Committee, Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Critical Care Strategic Clinical Network™, Alberta Health Services, Edmonton, AB, Canada
| | - Linda Tyre
- Intensive Care Patient and Family Partnership Committee, Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Robyn Auld
- Intensive Care Patient and Family Partnership Committee, Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Kim Crowder
- Intensive Care Patient and Family Partnership Committee, Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Peggy Gilchrist
- Intensive Care Patient and Family Partnership Committee, Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Paul J Young
- Intensive Care Unit, Wellington Hospital, Wellington, New Zealand
- Medical Research Institute of New Zealand, Wellington, New Zealand
| | - Sean M Bagshaw
- Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton, AB, Canada.
- Intensive Care Patient and Family Partnership Committee, Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
- Critical Care Strategic Clinical Network™, Alberta Health Services, Edmonton, AB, Canada.
- Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, 2-124E, Clinical Sciences Building, 8440-112 St. NW, Edmonton, AB, T6G 2B7, Canada.
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Kent JT, Ritchie LMP, Klaiman M, Dell EM, Garnett M, Landes M, Ginocchio GF, Alsefaou A. Barriers and facilitators to the implementation of rapid HIV testing in Canadian Emergency Departments: a mixed methods study. CAN J EMERG MED 2024; 26:463-471. [PMID: 38960973 DOI: 10.1007/s43678-024-00716-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 04/27/2024] [Indexed: 07/05/2024]
Abstract
OBJECTIVES 1 in 7 Canadians with Human Immunodeficiency Virus (HIV) do not know their status. Patients at increased risk of HIV routinely access the emergency department (ED), yet few are tested, representing a missed opportunity for diagnosis and linkage-to-care. Rapid HIV testing provides reliable results within the same ED encounter but is not routinely implemented. The objective of this study was to identify barriers and facilitators to rapid HIV testing in Ontario EDs. METHODS We employed a mixed-methods, convergent, parallel design study including online surveys and semi-structured interviews of physicians, nurses, and allied health across four hospitals in Toronto and Thunder Bay, Ontario. Data were analyzed in equal priority using descriptive statistics for quantitative data and thematic analysis for qualitative data guided by the Theoretical Domains framework and Capability, Opportunity, Motivation Behaviour change model. RESULTS Among 187 survey respondents, 150 (80%) felt implementing rapid HIV testing would be helpful in the ED. Facilitators included availability of resources to link patients to care after testing (71%), testing early in patient encounters (41%), and having dedicated staff with lived experience support testing (34%). Motivation to offer testing included opportunities to support an underserved population (66%). Challenges to implementation included limited time during ED patient encounters (51%) and a lack of knowledge around HIV testing (42%) including stigma. Interview themes confirmed education, and integration of people with lived experience being essential to provide rapid HIV testing and linkage-to-care in the ED. CONCLUSIONS Implementation of rapid HIV testing in the ED is perceived to be important irrespective of practice location or profession. Intrinsic motivations to support underserved populations and providing linkage-to-care are novel insights to facilitate testing in the ED. Streamlined implementation, including clear testing guidelines and improved access to follow-up care, is felt to be necessary for implementation.
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Affiliation(s)
- Jessica T Kent
- Department of Medicine, University of Toronto, Toronto, ON, Canada.
| | - Lisa M Puchalski Ritchie
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
- Department of Emergency Medicine, University Health Network, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Michelle Klaiman
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Emergency Medicine, St. Michael's Hospital, Toronto, ON, Canada
| | - Evelyn Marion Dell
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Emergency Medicine, St. Michael's Hospital, Toronto, ON, Canada
| | - Meghan Garnett
- Emergency and Critical Care Services, Thunder Bay Regional Health Sciences Centre, Thunder Bay, ON, Canada
- Division of Clinical Sciences, NOSM University, Thunder Bay, ON, Canada
| | - Megan Landes
- Department of Emergency Medicine, University Health Network, Toronto, ON, Canada
- Division of Emergency Medicine, Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Galo Fernando Ginocchio
- Emergency Department, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Department of Psychology, Faculty of Arts and Science, University of Toronto, Toronto, ON, Canada
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He Y, Liu Y, Zhang Z, Liu H, Hu D, Feng S, Li R, Wang Y, Ma W. Impact of airway devices and emergency airway techniques characteristics on airway adverse events in mainland China: a cross-sectional study. Minerva Anestesiol 2024; 90:607-617. [PMID: 39021136 DOI: 10.23736/s0375-9393.24.18035-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024]
Abstract
BACKGROUND Novel airway devices are becoming widely available, yet it is unclear whether the techniques or preferences of airway practitioners for airway management have been impacted. Given these facts, a cross-sectional study of the current status of airway management in mainland China was conducted and compared with previous survey findings. METHODS The national survey was conducted from November 7th to November 28th, 2022. An electronic survey was sent to the New Youth Anesthesia Forum to examine the availability of airway devices, preference for front-of-neck access (FONA) techniques, the incidence of adverse airway events, and the status of airway management training. RESULTS Questionnaires were completed by 3783 respondents, with a response rate of 72.14%. So far, the availability of optical airway devices has improved dramatically, with the availability of videolaryngoscopes reaching 97.18%. When encountering "cannot intubate, cannot ventilate" (CICV) scenarios, the majority of respondents would prefer needle cricothyrotomy to establish FONA. However, less than a quarter of respondents had actually performed it. Moreover, the incidence of airway adverse events from 2016 to 2022 was 11.48%, of which 5.13% were brain damage or death. Multivariate logistic regression analysis revealed that the ability to perform FONA techniques (odds ratio [OR] 0.23, 95% CI: 0.16, 0.32; P<0.001) and the availability of difficult airway management carts or kits (OR 0.59, 95% CI 0.41, 0.85; P=0.005) were associated with a lower incidence of airway adverse events. CONCLUSIONS Optical airway devices can overcome some of the challenges posed by difficult airways, yet the CICV scenario remains a major obstacle. The future focus of airway management should be training, particularly for complicated emergency airway techniques.
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Affiliation(s)
- Yuewen He
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- Department of Anesthesiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yurui Liu
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- Department of Anesthesiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zhengze Zhang
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- Department of Anesthesiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Hao Liu
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- Department of Anesthesiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Die Hu
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Siqi Feng
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Ruogen Li
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- Department of Anesthesiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yong Wang
- Department of Anesthesiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Wuhua Ma
- Department of Anesthesiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China -
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Liu E, D'Souza R, Lapinsky SE. Critical Care Services for Pregnant Patients in Ontario: A Province-Wide Survey. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2024; 46:102560. [PMID: 38754626 DOI: 10.1016/j.jogc.2024.102560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 04/24/2024] [Accepted: 04/26/2024] [Indexed: 05/18/2024]
Abstract
Critically ill pregnant patients require advanced critical care support, but access to these services is variable. We surveyed active Ontario obstetric facilities regarding critical care access. Responses were received from 44 of 80 obstetric units (55%), 13 (30%) being rural. Transport to another facility was required by 59% (majority >1 hour transport time), and differences were noted in the availability of specialty support services such as anesthesia and internal/obstetric medicine, as well as radiology and laboratory facilities, and use of massive transfusion protocols. Training in early supportive care of obstetric complications and optimized facility transport are areas for potential improvement.
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Affiliation(s)
- Emily Liu
- Department of Medicine, Sinai Health System, Toronto, ON
| | - Rohan D'Souza
- Department of Obstetrics and Gynaecology and Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON
| | - Stephen E Lapinsky
- Department of Medicine, Sinai Health System, and Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON.
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Fetz K, Rutetzki J, Lefering R. [How to: correctly read scientific articles : Research design and methodology]. DIE OPHTHALMOLOGIE 2024; 121:595-604. [PMID: 38926192 DOI: 10.1007/s00347-024-02075-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
Criteria for assessment of the significance of scientific articles are presented. The focus is on research design and methodology, illustrated by the classical study on prehospital volume treatment of severely injured individuals with penetrating torso injuries by Bickell et al. (1994). A well-thought out research design is crucial for the success of a scientific study and is documented in a study protocol beforehand. A hypothesis is a provisional explanation or prediction and must be testable, falsifiable, precise, and relevant. There are various types of randomization methods, with the randomized controlled trial being the gold standard for clinical interventional studies. When reading a scientific article it is important to verify whether the research design and setting align with the research question and whether potential sources of error have been considered and controlled. Critical scrutiny should also be applied to references, the funding and expertise of the researchers.
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Affiliation(s)
- Katharina Fetz
- Institut für Forschung in der Operativen Medizin, Universität Witten/Herdecke, Ostmerheimer Str. 200, 51107, Köln, Deutschland.
- Institut für Rettungs- und Notfallmedizin, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Holzkoppelweg 8-12, 24105, Kiel, Deutschland.
- Klinik für Anästhesiologie und Operative Intensivmedizin, Kliniken der Stadt Köln, Krankenhaus Merheim - Klinikum der Universität Witten/Herdecke, Ostmerheimer Str. 200, 51107, Köln, Deutschland.
- Lehrstuhl für Forschungsmethodik und Statistik, Department Psychologie, Universität Witten/Herdecke, Alfred-Herrhausen-Straße 50, 58455, Witten, Deutschland.
| | - Johanna Rutetzki
- Institut für Forschung in der Operativen Medizin, Universität Witten/Herdecke, Ostmerheimer Str. 200, 51107, Köln, Deutschland
| | - Rolf Lefering
- Institut für Forschung in der Operativen Medizin, Universität Witten/Herdecke, Ostmerheimer Str. 200, 51107, Köln, Deutschland
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Pasqualotto L, Driusso P, Dos Reis FJJ, Rodrigues JC, Catai CC, Riccetto C, Jorge CH, Botelho S. Low-Value Practices for Pelvic Floor Dysfunction-Choosing Wisely Recommendations from the Brazilian Association of Physiotherapy in Women's Health: Observational Study. Int Urogynecol J 2024; 35:1495-1502. [PMID: 38864858 DOI: 10.1007/s00192-024-05828-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 05/07/2024] [Indexed: 06/13/2024]
Abstract
INTRODUCTION AND HYPOTHESIS The Choosing Wisely campaign is an international initiative that is aimed at promoting a dialog between professionals, helping the population to choose an evidence-based, truly necessary and risk-free care. The aim of the study was to develop the Choosing Wisely Brazil list on Women's Health Physiotherapy in the area of the pelvic floor. METHODS A observational study was carried out between January 2022 and July 2023, proposed by the Brazilian Association of Physiotherapy in Women's Health, and developed by researchers working in the area of the pelvic floor. The development of the list consisted of six stages: a panel of experts, consensus building, national research, a review by the Choosing Wisely Brazil team, preparation of the list, and publication of the recommendations. Descriptive and content analyses were carried out in order to include evidence-based recommendations with over 80% agreement by physiotherapists in Brazil. RESULTS The expert panel was made up of 25 physiotherapists who submitted 63 recommendations. Seven physiotherapists/researchers carried out a critical analysis of the literature and refined the recommendations, resulting in 11 recommendations that were put to a national vote, in which 222 physiotherapists took part. After a review by the Choosing Wisely Brazil team, five recommendations with an average agreement of 88.2% agreement were chosen for publication. CONCLUSIONS The Choosing Wisely Brazil team in Physiotherapy in Women's Health/Pelvic Floor proposed a list of five recommendations that showed a high agreement among Brazilian physiotherapists working in the area.
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Affiliation(s)
- Luísa Pasqualotto
- University of Campinas, School of Medical Sciences, Postgraduate Program in Surgical Science (UNICAMP), Campinas, São Paulo, Brazil
| | - Patricia Driusso
- Women's Health Research Laboratory, Physical Therapy Department (UFSCar), São Carlos, Federal University of São Carlos, São Paulo, Brazil
| | - Felipe José Jandre Dos Reis
- Federal Institute of Rio de Janeiro, Physiotherapy Department (IFRJ), Rio de Janeiro, Brazil
- Department of Physiotherapy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brusselm Pain in Motion Research Group, Brussels, Belgium
| | - Jessica Cordeiro Rodrigues
- Women's Health Research Laboratory, Physical Therapy Department (UFSCar), São Carlos, Federal University of São Carlos, São Paulo, Brazil
| | - Camila Chiazuto Catai
- Department of Health Science, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Cassio Riccetto
- University of Campinas, School of Medical Sciences, Postgraduate Program in Surgical Science (UNICAMP), Campinas, São Paulo, Brazil
- Department of Health Science, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
- Women's Health Research Laboratory, Physical Therapy Department (UFSCar), São Carlos, Federal University of São Carlos, São Paulo, Brazil
- Federal Institute of Rio de Janeiro, Physiotherapy Department (IFRJ), Rio de Janeiro, Brazil
- Department of Physiotherapy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brusselm Pain in Motion Research Group, Brussels, Belgium
- Federal University of Alfenas, Motor Science Institute, Postgraduate Program in Rehabilitation Sciences (UNIFAL/MG), Alfenas, Minas Gerais, Brazil
| | - Cristine Homsi Jorge
- Department of Health Science, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Simone Botelho
- University of Campinas, School of Medical Sciences, Postgraduate Program in Surgical Science (UNICAMP), Campinas, São Paulo, Brazil.
- Federal University of Alfenas, Motor Science Institute, Postgraduate Program in Rehabilitation Sciences (UNIFAL/MG), Alfenas, Minas Gerais, Brazil.
- UroFisioterapia Laboratory of the Postgraduate Program in Rehabilitation Sciences, Federal University of Alfenas, UNIFAL/MG, Av. Jovino Fernandes Sales, 2600 Santa Clara, Building C, Room 101-K, Alfenas, MG, 37130-000, Brazil.
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Cool JA, Lai AR, Kramer H, Baduashvili A. SIMPLE procedures: Survey of Internal Medicine Providers' Limitations and Experiences with procedures and medical procedure services. J Hosp Med 2024. [PMID: 38946024 DOI: 10.1002/jhm.13443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 06/07/2024] [Accepted: 06/15/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND In response to a decline in bedside procedures performed by hospitalists, some hospital medicine groups have created medical procedure services (MPSs) concentrating procedures under the expertise of trained hospitalist-proceduralists. OBJECTIVES To characterize the structure, breadth, and heterogeneity of academic medical center MPSs, as well as compare the procedural landscape for groups with and without an MPS. METHODS The Survey of Internal Medicine Providers' Limitations and Experiences with Procedures and MPSs, is a cross-sectional study, conducted in the United States and Canada through a web-based survey administered from October 2022 to March 2023. We used convenience and snowball sampling to identify eligible study participants. The survey explored presence of MPS, procedure volumes, patient safety, and educational practices. For MPSs, we explored onboarding, staffing, skill maintenancy, funding, and barriers to growth. RESULTS Forty instututions (response rate 97.5%), represented by members of the Procedural Research and Innovation for Medical Educators (PRIME) consortum participated in the survey. MPSs were found in 75% of the surveyed institutions. Most MPSs (97%) involved trainees and were staffed by internists (100%) who often had additional clinical duties (70%). The majority (83%) of MPSs used checklists and procedural safety guidelines, but only 53% had a standardized process for tracking complications. There was significant variability in determining procedural competency and supervising trainees. Groups with an MPS reported higher procedure volume compared to those without. CONCLUSIONS MPSs were highly prevalent among the participating instutitions, offered a broad array of bedside procedures, and often included trainees. There was a high variability in funding models, procedure volumes, patient safety practices, and skill maintenance requirements.
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Affiliation(s)
- Joséphine A Cool
- Division of General Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Andrew R Lai
- Division of Hospital Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Henry Kramer
- Division of Hospital Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Amiran Baduashvili
- Division of Hospital Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
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Nielsen MS, Grejs AM, Nielsen AB, Konge L, Brøchner AC. Ultrasound in anesthesiology in the Nordic countries-Protocol of an international survey on availability, frequency of use, operator training, and certification. Acta Anaesthesiol Scand 2024. [PMID: 38939944 DOI: 10.1111/aas.14482] [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: 05/28/2024] [Accepted: 06/08/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND Over the past decade, ultrasound utilization has increased within anesthesia and intensive care medicine, enhancing patient safety and diagnostic accuracy. However, the frequency of ultrasound usage and operator training in the Nordic countries remain unclear. This project aims to perform a survey on ultrasound availability, daily clinical use, and how ultrasound skills are trained and assessed, among anesthesiologists. METHODS This online cross-sectional survey will include anesthesiologists from the Nordic countries. The survey will adhere to the CROSS checklist. Survey items will be developed based on a formative model with a conceptual model, consisting of three main parts, including demographics, ultrasound machines and use, and skills development and assessment. The clinical relevance of items will be secured by including anesthesiologists of various levels of experience in the development of the survey. Furthermore, experienced researchers in medical education will participate in the development, contributing with relevant medical educational perspectives. Data will be summarized using a non-parametric descriptive approach. A chi-squared test will examine relevant relationships between certain answers. RESULTS Results will be published in a peer-reviewed journal and presented at relevant scientific conferences and meetings. CONCLUSION This study may find a high availability of ultrasound machines and frequent use in the clinical departments. Despite this expected daily use of ultrasound, missing standardized structured skills acquisition and assessment could be uncovered. The results of this study may contribute to mapping various aspects of clinical ultrasound and skills development for further use in research.
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Affiliation(s)
- Martine S Nielsen
- Department of Anaesthesiology and Intensive Care, Lillebaelt University Hospital, Kolding, Denmark
- Research Unit of Medical Education, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Regional Health Research, Region of Southern Denmark, Odense, Denmark
| | - Anders M Grejs
- Department of Intensive Care Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Anders B Nielsen
- Research Unit of Medical Education, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Anesthesiology and Intensive Care, Odense University Hospital, Svendborg, Denmark
| | - Lars Konge
- Research Unit of Medical Education, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Copenhagen Academy for Medical Education and Simulation, Center for HR & Education, The Capital Region of Denmark, Copenhagen, Denmark
| | - Anne C Brøchner
- Department of Anaesthesiology and Intensive Care, Lillebaelt University Hospital, Kolding, Denmark
- Department of Regional Health Research, Region of Southern Denmark, Odense, Denmark
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Koenig A, Porzelt S, Behrens-Potratz A, Stratmeyer P, Schellhammer S, Schmage P, Konnopka C, Scherer M, Konnopka A, Zimmermann T. Assessing oral health-related quality of life among older people in home-based care - survey results of the InSEMaP study in Germany. BMC Oral Health 2024; 24:734. [PMID: 38926675 PMCID: PMC11209957 DOI: 10.1186/s12903-024-04500-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 06/17/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Older people receiving home-based care (HBC) often face barriers to access preventive oral health care (OHC) and dental treatments. Leading to deterioration of their oral healthcare. It is further deteriorated by factors such as increasing burden of systemic diseases, medicinal side effects, limited mobility, financial constraints and lack of professional OHC at home. Older people also struggle to maintain necessary daily oral hygiene, leading to malnutrition, weight loss, and a risk of a further health degradation. This cross-sectional survey aimed to investigate the oral health-related quality of life (OHRQoL) and their associated factors in HBC recipients. METHODS 5,280 older people (≥ 60 years) living in Hamburg, who were in need of care and insured with statutory health insurance DAK-Gesundheit received the questionnaire, which included the German version of the Oral Health Impact Profile (OHIP G-14) and, the EQ-5D health-related quality of life (HRQoL) measure as well as further questions regarding the extent of informal social support, subjective oral health status, oral health behaviour, subjective cognitive status, and socio-demographic variables. RESULTS The participants (n = 1,622) had a median age of 83.2 years, with 72.0% of the sample being female. Nearly two thirds of the sample reported that their independence or abilities were significantly impaired (care level 2). Regarding oral health impacts, 40.0% of the participants reported experiencing at least one of the fourteen possible prevalent impacts of the OHIP-G14 fairly often or very often. A multivariate regression model on the severity of oral health impacts revealed, that a better HRQoL, a positive perception of one's own dental status, fewer visits to dental practices, and no need for support in OHC were associated with better OHRQoL. Conversely, respondents with a negative perception of their oral health status, more frequent visits to a dental practice, a need for support in OHC, and subjective memory impairment showed poorer OHRQoL. CONCLUSIONS The results highlight the risk for poor oral health among older people in HBC. We conclude that there is an urgent need to prioritise oral health, especially as poor oral health can further compromise the systemic wellbeing of these already care dependent population.
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Affiliation(s)
- Alena Koenig
- Department of Nursing and Management, Cooperative Process Management in Social and Health Care RTC (KoPM-Zentrum), Faculty of Business and Social Sciences, Hamburg University of Applied Sciences, Alexanderstraße 1, 20099, Hamburg, Germany.
| | - Sarah Porzelt
- Department of General Practice and Primary Care, Centre for Psychosocial Medicine, University Medical Centre Hamburg- Eppendorf, Hamburg, Germany, Martinistraße 52, 20251
| | - Anja Behrens-Potratz
- Department of Nursing and Management, Cooperative Process Management in Social and Health Care RTC (KoPM-Zentrum), Faculty of Business and Social Sciences, Hamburg University of Applied Sciences, Alexanderstraße 1, 20099, Hamburg, Germany
| | - Peter Stratmeyer
- Department of Nursing and Management, Cooperative Process Management in Social and Health Care RTC (KoPM-Zentrum), Faculty of Business and Social Sciences, Hamburg University of Applied Sciences, Alexanderstraße 1, 20099, Hamburg, Germany
| | - Stefanie Schellhammer
- Department of Health Care Research and Innovation, Deutsche Angestellten Krankenkasse - Gesundheit (DAK-Gesundheit), Nagelsweg 27, 20097, Hamburg, Germany
| | - Petra Schmage
- Department of Periodontics, Preventive and Restorative Dentistry, Centre for Dental and Oral Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany, Martinistraße 52, 20251
| | - Claudia Konnopka
- Department of Health Economics and Health Services Research, Centre for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany, Martinistraße 52, 20251
| | - Martin Scherer
- Department of General Practice and Primary Care, Centre for Psychosocial Medicine, University Medical Centre Hamburg- Eppendorf, Hamburg, Germany, Martinistraße 52, 20251
| | - Alexander Konnopka
- Department of Health Economics and Health Services Research, Centre for Psychosocial Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany, Martinistraße 52, 20251
| | - Thomas Zimmermann
- Department of General Practice and Primary Care, Centre for Psychosocial Medicine, University Medical Centre Hamburg- Eppendorf, Hamburg, Germany, Martinistraße 52, 20251
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Kayal G, Oliveira KN, Haneef Z. Survey of Continuous EEG Monitoring Practices in the United States. J Clin Neurophysiol 2024:00004691-990000000-00142. [PMID: 38916934 DOI: 10.1097/wnp.0000000000001099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024] Open
Abstract
OBJECTIVE Continuous EEG (cEEG) practice has markedly changed over the last decade given its utility in improving critical care outcomes. However, there are limited data describing the current cEEG infrastructure in US hospitals. METHODS A web-based cEEG practice survey was sent to neurophysiologists at 123 ACGME-accredited epilepsy or clinical neurophysiology programs. RESULTS Neurophysiologists from 100 (81.3%) institutions completed the survey. Most institutions had 3 to 10 EEG faculty (80.0%), 1 to 5 fellows (74.8%), ≥6 technologists (84.9%), and provided coverage to neurology ICUs with >10 patients (71.0%) at a time. Round-the-clock EEG technologist coverage was available at most (90.0%) institutions with technologists mostly being in-house (68.0%). Most institutions without after-hours coverage (8 of 10) attributed this to insufficient technologists. The typical monitoring duration was 24 to 48 hours (23.0 and 40.0%), most commonly for subclinical seizures (68.4%) and spell characterization (11.2%). Larger neurology ICUs had more EEG technologists ( p = 0.02), fellows ( p = 0.001), and quantitative EEG use ( p = 0.001). CONCLUSIONS This survey explores current cEEG practice patterns in the United States. Larger centers had more technologists and fellows. Overall technologist numbers are stable over time, but with a move toward more in-hospital compared with home-based coverage. Reduced availability of EEG technologists was a major factor limiting cEEG availability at some centers.
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Affiliation(s)
- Gina Kayal
- Department of Neurology, Baylor College of Medicine, Houston, Texas, U.S.A.; and
| | - Kristen N Oliveira
- Department of Neurology, Baylor College of Medicine, Houston, Texas, U.S.A.; and
| | - Zulfi Haneef
- Department of Neurology, Baylor College of Medicine, Houston, Texas, U.S.A.; and
- Neurology Care Line, Michael E. DeBakey VA Medical Center, Houston, Texas, U.S.A
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Volpe M, Ralli M, Isidori A. "The impact of the COVID-19 pandemic on research activities: A survey of the largest Italian academic community". PLoS One 2024; 19:e0304078. [PMID: 38917126 PMCID: PMC11198756 DOI: 10.1371/journal.pone.0304078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 05/06/2024] [Indexed: 06/27/2024] Open
Abstract
PURPOSE The aim of the present work is to explore the impact of the COVID-19 pandemic on research activities in a vast multidisciplinary academic community to identify the most critical issues. METHOD To this purpose we planned a survey addressed to the entire academic research staff at "Sapienza" University of Rome, which represents the largest Italian academic community. A questionnaire consisting of both open and closed-ended questions was delivered to 4118 individuals in April 2021. RESULTS A total of 544 responses were collected. All academic roles were sufficiently represented in the study cohort. The median number of critical issues experienced by academic research staff was three. Among these, the three most frequently reported were related to: "Access to libraries / laboratories / research sites" (21.9%), "Limitation to stay abroad / study / research periods" (17.6%), "Progress of experimental work" (14.7%), with variable prevalence according to academic position and gender. Older subjects reported issues with "Projects' financial reporting" and "Expiration of acquired consumable material more frequently". The most common critical aspects reported in relation to the economic burden were: being "Unable to allocate funds" (31.4%), a "Reduction in clinical and scientific activity" (26.3%) and experiencing "Increased expenses (comprising private costs)" (21.2%) with no differences between genders. Researchers in Applied Sciences and Natural Sciences reported a higher frequency of problems in clinical and scientific activities, whereas increased expenses were reported also by researchers operating in the Humanities field. As a possible solution aimed at improving these issues, most subjects, especially those aged >45 years, indicated "Economic aid" (22.6%), "Reduction in bureaucracy" (19.9%) or "Enhancement of the scientific and clinical activities", whereas those aged ≤45 years felt that an increased duration and better access to PhD programs were to be prioritized. CONCLUSION Our findings highlight the most critical issues related to research activities during the COVID-19 pandemic in a large academic community. The information achieved may be useful to identify researchers' needs and to design appropriate policies aimed at preparing research institutions for unexpected catastrophic events and limiting the negative impact on academic research activities.
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Affiliation(s)
- Massimo Volpe
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Massimo Ralli
- Department of Sense Organs, Faculty of Medicine, Sapienza University of Rome, Rome, Italy
| | - Andrea Isidori
- Department of Experimental Medicine, Faculty of Medicine, Sapienza University of Rome, Rome, Italy
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Chen G, Lieberman MT, Shinkunas LA, Carlisle EM. "I Didn't Know What I Didn't Know:" Assessment of Adolescent Oncology Patient Engagement in Decision-Making. J Surg Res 2024; 301:146-153. [PMID: 38925101 DOI: 10.1016/j.jss.2024.04.088] [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: 02/16/2024] [Revised: 04/19/2024] [Accepted: 04/24/2024] [Indexed: 06/28/2024]
Abstract
INTRODUCTION Little is known about the best way to engage an adolescent oncology patient in decision-making. To integrate adolescent oncology patients most effectively in decision-making, it is important to understand their perceptions not only as adolescents but also as adult survivors who have had time to reflect upon their experience. The purpose of this study is to explore perceptions of survivors of pediatric cancer to better understand their attitudes toward participation in decision-making, decisional regret, and use of decision-support tools. METHODS An electronic survey tool, containing open- and closed-ended responses, was distributed to adult cancer survivors diagnosed and treated for cancer between the ages of 9 and 18 at a Midwestern, Comprehensive Cancer Center within a tertiary care academic hospital. RESULTS Seventy responses were received. Nearly all respondents (96%) reported that decisions made on their behalf were consistent with their desires most/all the time. Almost one-fifth felt that increased involvement would have intensified their anxiety. Eighty-five percent did not regret choices made about their cancer treatment, and 88% would have made the same choices again. Respondents desired more targeted information on the long-term impacts of treatment (i.e., infertility, memory difficulties, mental health concerns), and they highlighted the importance of communication in the decision-making process. CONCLUSIONS Adolescents want to participate in the decision-making process in a way that accommodates their understanding of the pathology and potential impacts of treatment. Our results suggest that developing a simple intervention to help facilitate provision of such anticipatory guidance may be helpful.
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Affiliation(s)
- Gloria Chen
- Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | | | - Laura A Shinkunas
- Program in Bioethics and Humanities, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Erica M Carlisle
- Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa; Program in Bioethics and Humanities, University of Iowa Carver College of Medicine, Iowa City, Iowa.
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Seizilles de Mazancourt E, Cotte J, Pinar U, Goujon A, Taha F, Seguier D, An Nguyen T, Lannes F, Deleuze C, Bardet F, Plassais C, Kaulanjan K. Barriers for pregnancy and perceptions of gender discrimination of urologists in training in France: Results of a national survey. THE FRENCH JOURNAL OF UROLOGY 2024; 34:102671. [PMID: 38909782 DOI: 10.1016/j.fjurol.2024.102671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 04/29/2024] [Accepted: 06/19/2024] [Indexed: 06/25/2024]
Abstract
INTRODUCTION Gender discrimination seems more prevalent in surgery than other medical specialties. In addition, female urologists are more likely to have obstetric complications and to be discouraged from starting a family during training. The objective of this study was to determine the prevalence of perceived gender discrimination and barriers for pregnancy during fellowship, among French urology residents and fellows. MATERIAL AND METHODS The French Association of Urologists in Training performed a national online survey between August and September 2022. Participants were assured that their participation was anonymous. Respondents were questioned on demographics, gender discrimination and on pregnancy barriers during fellowship. RESULTS In total, 153 members answered the questionnaire out of the 427 members of the association (36%), among which 75 women (49%). Thirty nine percent of the female respondents found that their gender was a barrier in their career advancement, versus 1% of the male (P<0.0001). Forty female respondents (53%) perceived that female urologists earned less respect than their male counterparts versus 22% of the male (P<0.0001). Among the female respondents, 19 (25%) have felt that it would not be possible to become pregnant at the time they would have wanted it and 7 (9%) reported having already been threatened to lose a fellowship position in case of a pregnancy. CONCLUSION This survey found a high prevalence of gender discrimination among French urologists in training, perceived in majority by women. Female urologists perceived obstacles and received threats when wanting to become pregnant during their training.
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Affiliation(s)
| | - Juliette Cotte
- Pitié Salpêtrière Hospital, Sorbonne university, Paris, France
| | - Ugo Pinar
- Pitié Salpêtrière Hospital, Sorbonne university, Paris, France
| | - Anna Goujon
- Department of urology, Rennes Hospital, Rennes, France
| | - Fayek Taha
- Department of urology, Reims Hospital, Reims, France
| | - Denis Seguier
- Department of urology, Lille Hospital, Lille, France
| | | | | | - Claire Deleuze
- Department of urology, Pointe-à-Pitre Hospital, Guadeloupe, France
| | | | | | - Kevin Kaulanjan
- Department of urology, Pointe-à-Pitre Hospital, Guadeloupe, France
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Graafsma J, Klopotowska JE, Derijks HJ, van de Garde EMW, Hoge RHL, Kruip MJHA, Meijer K, Karapinar-Carkit F, van den Bemt PMLA. Adoption of antithrombotic stewardship and utilization of clinical decision support systems-A questionnaire-based survey in Dutch hospitals. PLoS One 2024; 19:e0306033. [PMID: 38905283 PMCID: PMC11192363 DOI: 10.1371/journal.pone.0306033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 06/10/2024] [Indexed: 06/23/2024] Open
Abstract
Antithrombotics require careful monitoring to prevent adverse events. Safe use can be promoted through so-called antithrombotic stewardship. Clinical decision support systems (CDSSs) can be used to monitor safe use of antithrombotics, supporting antithrombotic stewardship efforts. Yet, previous research shows that despite these interventions, antithrombotics continue to cause harm. Insufficient adoption of antithrombotic stewardship and suboptimal use of CDSSs may provide and explanation. However, it is currently unknown to what extent hospitals adopted antithrombotic stewardship and utilize CDSSs to support safe use of antithrombotics. A semi-structured questionnaire-based survey was disseminated to 12 hospital pharmacists from different hospital types and regions in the Netherlands. The primary outcome was the degree of antithrombotic stewardship adoption, expressed as the number of tasks adopted per hospital and the degree of adoption per task. Secondary outcomes included characteristics of CDSS alerts used to monitor safe use of antithrombotics. All 12 hospital pharmacists completed the survey and report to have adopted antithrombotic stewardship in their hospital to a certain degree. The median adoption of tasks was two of five tasks (range 1-3). The tasks with the highest uptake were: drafting and maintenance of protocols (100%) and professional's education (58%), while care transition optimization (25%), medication reviews (8%) and patient counseling (8%) had the lowest uptake. All hospitals used a CDSS to monitor safe use of antithrombotics, mainly via basic alerts and less frequently via advanced alerts. The most frequently employed alerts were: identification of patients using a direct oral anticoagulant (DOAC) or a vitamin K antagonist (VKA) with one or more other antithrombotics (n = 6) and patients using a VKA to evaluate correct use (n = 6), both reflecting basic CDSS. All participating hospitals adopted antithrombotic stewardship, but the adopted tasks vary. CDSS alerts used are mainly basic in their logic.
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Affiliation(s)
- Jetske Graafsma
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Joanna E. Klopotowska
- Department of Medical Informatics Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health Institute, Amsterdam, the Netherlands
| | | | - Ewoudt M. W. van de Garde
- Department of Pharmacy, St. Antonius Hospital, Nieuwegein, Utrecht, the Netherlands
- Division Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, the Netherlands
| | - Rien H. L. Hoge
- Department of Pharmacy, Wilhelmina Hospital, Assen, the Netherlands
- Gaston Medical, Eindhoven, the Netherlands
| | - Marieke J. H. A. Kruip
- Department of Hematology, Erasmus MC, Erasmus University medical center, Rotterdam, the Netherlands
| | - Karina Meijer
- Department of Hematology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Fatma Karapinar-Carkit
- Department of Clinical Pharmacy & Toxicology, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | - Patricia M. L. A. van den Bemt
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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Karumbi J, Gorst S, Gathara D, Young B, Williamson P. Experiences of core outcome set developers on including stakeholders from low- and middle-income countries: An online survey. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003365. [PMID: 38900810 PMCID: PMC11189180 DOI: 10.1371/journal.pgph.0003365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 05/28/2024] [Indexed: 06/22/2024]
Abstract
Core outcome set (COS) development and use enhances comparability of research findings. It may also enhance the translation of research into practice and reduce research waste. However, there is limited involvement of stakeholders from low- and middle-income countries (LMICs) in COS development and use. In this study, we explored the experiences of researchers in COS development projects who included stakeholders from LMICs. Online survey conducted in English of 70 COS developers from HICs who had included LMIC stakeholders in the process of developing a COS, published before the end of 2019. Respondents were identified from the COMET database and sent a link to the survey via a personalised email. Quantitative data were analysed using simple descriptive statistics. Qualitative data analysis was based on qualitative content analysis. There were 37 respondents yielding a 53% overall response rate. Analysis was limited to the responses related to 29 COS developed in the years 2015 to 2019, to reduce the potential for recall bias for earlier COS. Most respondents 20/29 (69%) were researchers. Determining 'what to measure' was reported as the most common stage of inclusion of LMIC stakeholders. Respondents cited (24/29, 83%) their ongoing collaborations with LMIC stakeholders such as clinicians or researchers as their main rationale for including LMICs stakeholders and reported that translation of the Delphi into languages other than English may be useful to enhance wider stakeholder participation. Involvement of LMIC stakeholders only in the later stages of COS development, lack of adequate resources to support their involvement, and lack of networks and contacts were thought to limit fuller participation of stakeholders from LMICs. To improve the involvement of LMIC stakeholders in COS development and use, COS developers need to raise awareness on the utility of COS. The need for and feasibility of translation into multiple languages warrants further discussion.
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Affiliation(s)
- Jamlick Karumbi
- Department of Health Data Science, University of Liverpool, Liverpool, United Kingdom
- Health Systems Research, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Sarah Gorst
- Department of Health Data Science, University of Liverpool, Liverpool, United Kingdom
| | - David Gathara
- Health Systems Research, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- Centre for Maternal, Adolescent, Reproductive & Child Health (MARCH), London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Bridget Young
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, United Kingdom
| | - Paula Williamson
- Department of Health Data Science, University of Liverpool, Liverpool, United Kingdom
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Niemczyk W, Balicz A, Lau K, Morawiec T, Kasperczyk J. Factors Influencing Peri-Extraction Anxiety: A Cross-Sectional Study. Dent J (Basel) 2024; 12:187. [PMID: 38920888 PMCID: PMC11202872 DOI: 10.3390/dj12060187] [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: 04/09/2024] [Revised: 06/11/2024] [Accepted: 06/18/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Fear and anxiety are common psychological responses to unpleasant stimuli, with dental fear being the fourth most prevalent type of fear or phobia. However, not all dental procedures cause the same level of anxiety, with dental surgery and tooth extraction being among the top five most frightening procedures in the field. Tooth extractions are also the most common surgical procedure in dental surgery. It is important to manage anxiety in the dental office by identifying the main factors. METHODS The study was conducted on a group of 250 patients. The survey technique and the Beliefs about Pain Control Questionnaire (BPCQ) were used in the study. Pain and stress intensity on a Visual Analog Scale (VAS) were measured in each patient before and after tooth extraction procedures. RESULTS Young women and people from small towns had the highest levels of anxiety. The factor causing the highest level of anxiety was fear of complications. Patients undergoing extraction of retained teeth were characterized by higher levels of anxiety. CONCLUSIONS Perioperative stress is strongly dependent on numerous factors. For patient comfort, it may be crucial for dentists to have knowledge about these factors and the ability to utilize them to reduce stress before and after tooth extractions.
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Affiliation(s)
- Wojciech Niemczyk
- Department of Dental Surgery, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; (A.B.); (T.M.)
- Department of Environmental Medicine and Epidemiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; (K.L.); (J.K.)
| | - Agnieszka Balicz
- Department of Dental Surgery, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; (A.B.); (T.M.)
| | - Karolina Lau
- Department of Environmental Medicine and Epidemiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; (K.L.); (J.K.)
| | - Tadeusz Morawiec
- Department of Dental Surgery, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; (A.B.); (T.M.)
| | - Janusz Kasperczyk
- Department of Environmental Medicine and Epidemiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; (K.L.); (J.K.)
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Pioche M, Cunha Neves JA, Pohl H, Lê MQ, Grau R, Dray X, Yzet C, Mochet M, Jacques J, Wallenhorst T, Rivory J, Siret N, Peillet AL, Chevaux JB, Mion F, Chaput U, Jacob P, Grinberg D, Saurin JC, Baddeley R, Rodriguez de Santiago E, Cottinet PJ. The environmental impact of small-bowel capsule endoscopy. Endoscopy 2024. [PMID: 38657660 DOI: 10.1055/a-2313-5142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
INTRODUCTION The environmental impact of endoscopy, including small-bowel capsule endoscopy (SBCE), is a topic of growing attention and concern. This study aimed to evaluate the greenhouse gas (GHG) emissions (kgCO2) generated by an SBCE procedure. METHODS Life cycle assessment methodology (ISO 14040) was used to evaluate three brands of SBCE device and included emissions generated by patient travel, bowel preparation, capsule examination, and video recording. A survey of 87 physicians and 120 patients was conducted to obtain data on travel, activities undertaken during the procedure, and awareness of environmental impacts. RESULTS The capsule itself (4 g) accounted for < 6 % of the total product weight. Packaging (43-119 g) accounted for 9 %-97 % of total weight, and included deactivation magnets (5 g [4 %-6 %]) and paper instructions (11-50 g [up to 40 %]). A full SBCE procedure generated approximately 20 kgCO2, with 0.04 kgCO2 (0.2 %) attributable to the capsule itself and 18 kgCO2 (94.7 %) generated by patient travel. Capsule retrieval using a dedicated device would add 0.98 kgCO2 to the carbon footprint. Capsule deconstruction revealed materials (e. g. neodymium) that are prohibited from environmental disposal; 76 % of patients were not aware of the illegal nature of capsule disposal via wastewater, and 63 % would have been willing to retrieve it. The carbon impact of data storage and capsule reading was negligible. CONCLUSION The carbon footprint of SBCE is mainly determined by patient travel. The capsule device itself has a relatively low carbon footprint. Given that disposal of capsule components via wastewater is illegal, retrieval of the capsule is necessary but would likely be associated with an increase in device-related emissions.
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Affiliation(s)
- Mathieu Pioche
- Endoscopy and Gastroenterology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Joao A Cunha Neves
- Department of Gastroenterology, Algarve University Hospital Centre, Portimão, Portugal
| | - Heiko Pohl
- Departments of Gastroenterology, VA Medical Center, White River Junction, Vermont; and Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Minh-Quyen Lê
- Material Analysis Laboratory, INSA Lyon, Villeurbanne, France
| | - Raphaelle Grau
- Endoscopy and Gastroenterology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Xavier Dray
- Sorbonne University, Centre for Digestive Endoscopy, Hôpital Saint-Antoine, APHP, Paris, France
| | - Clara Yzet
- Endoscopy and Gastroenterology Unit, University Hospital, Amiens, France
| | - Mikael Mochet
- Endoscopy and Gastroenterology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Jérémie Jacques
- Gastroenterology and Endoscopy Unit, Dupuytren University Hospital, Limoges, France
| | - Timothée Wallenhorst
- Gastroenterology and Endoscopy Unit, University Hospital Pontchaillou, Rennes, France
| | - Jérôme Rivory
- Endoscopy and Gastroenterology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Nadège Siret
- Endoscopy and Gastroenterology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Anne-Laure Peillet
- Endoscopy and Gastroenterology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | | | - François Mion
- Digestive Physiology Department, Hospices Civils de Lyon, Lyon, France
| | - Ulriikka Chaput
- Sorbonne University, Centre for Digestive Endoscopy, Hôpital Saint-Antoine, APHP, Paris, France
| | - Philippe Jacob
- Endoscopy and Gastroenterology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
- Gastroenterology and Endoscopy Unit, Nimes Private Clinic, Nimes, France
| | - Daniel Grinberg
- Material Analysis Laboratory, INSA Lyon, Villeurbanne, France
- Cardiac Surgery, Cardiologic Hospital, Hospices Civils de Lyon, Lyon, France
| | - Jean-Christophe Saurin
- Endoscopy and Gastroenterology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Robin Baddeley
- Wolfson Unit for Endoscopy, St Mark's Hospital and Academic Institute; King's Health Partners Institute for Therapeutic Endoscopy, King's College Hospital; and Imperial College London, London, UK
| | - Enrique Rodriguez de Santiago
- Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBEREHD, Universidad de Alcalá, Madrid, Spain
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Thompson JH, Thompson J, Bailey S. Shared decision-making in advanced physiotherapy and first contact physiotherapy management of adults with musculoskeletal disorders in the United Kingdom: An online cross-sectional survey. J Eval Clin Pract 2024. [PMID: 38881399 DOI: 10.1111/jep.14043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 04/25/2024] [Accepted: 05/25/2024] [Indexed: 06/18/2024]
Abstract
RATIONALE Advanced practice physiotherapy roles (Advanced Physiotherapy Practitioners [APPs] and First Contact Physiotherapists [FCPs]) are pivotal in supporting patients to manage their musculoskeletal (MSK) conditions. Having a greater understanding of how decisions are made by these practitioners will inform competency frameworks and improve the provision of patient-centred care. AIM To evaluate the current knowledge, views and use of shared decision-making in MSK advanced physiotherapy practice in the United Kingdom. METHODS A cross-sectional survey using an online questionnaire was used to collect demographic information, knowledge, views and self-reported use of shared decision-making (SDM) of APPs and FCPs who work with adults with MSK disorders in the United Kingdom. RESULTS Responses from 49 participants (25 APPs and 24 FCPs) were included in the study. In total, 80% of participants had received SDM training and overall high levels of knowledge were shown. Only 12% of participants used a communication model to facilitate SDM. In total, 80% of participants reported making decisions together with the patient either always or most of the time. FCPs favoured a more patient-led approach to decision-making compared to APPs who favoured collaborative decision-making. The most commonly reported barriers to SDM included lack of time, lack of patient education resources, lack of access to patient decision aids and treatment pathway restrictions. CONCLUSIONS The responses in this study showed that overall APPs and FCPs have good knowledge of SDM and report routine use of collaborative and patient-led decision-making approaches.
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Steinhauser S, Haroz R, Jones I, Skelton W, Fuller BM, Roberts MB, Jones CW, Trzeciak S, Roberts BW. Emergency department staff compassion is associated with lower fear of enacted stigma among patients with opioid use disorder. Acad Emerg Med 2024. [PMID: 38881343 DOI: 10.1111/acem.14970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 04/15/2024] [Accepted: 04/21/2024] [Indexed: 06/18/2024]
Abstract
OBJECTIVES Fear of enacted stigma (fear of discrimination or being treated unfairly) is associated with decreased health care-seeking behaviors among patients with opioid use disorder (OUD). We sought to describe the prevalence of fear of enacted stigma among patients presenting to the emergency department (ED) with OUD and to test whether experiencing greater compassion from ED staff is associated with lower fear of enacted stigma. METHODS We conducted a cross-sectional study in the ED of an academic medical center between February and August 2023. We included adult patients with OUD presenting to the ED and assessed patient experience of compassion from ED staff using a previously validated 5-item compassion measure (score range 5-20). The primary outcome measure was fear of enacted stigma in the ED, measured using the validated 9-item subscale of the Substance Abuse Self-Stigma Scale (score range 9-45). RESULTS Of the 116 subjects enrolled, 97% (95% confidence interval [CI] 91%-99%) reported some degree of stigma, with a median (interquartile range) score of 23 (16-31). In a multivariable model adjusting for potential confounders, patient experience of greater ED compassion was independently associated with lower fear of enacted stigma, β = -0.66 (95% CI -1.03 to -0.29), suggesting that every 1-point increase in the 5-item compassion measure score is associated with a 0.66-point decrease in the fear of enacted stigma score. CONCLUSIONS Among ED patients with OUD, fear of enacted stigma is common. Patient experience of compassion from ED staff is associated with lower fear of enacted stigma. Future research is warranted to test if interventions aimed at increasing compassion from ED staff reduce patient fear of enacted stigma among patients with OUD.
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Affiliation(s)
- Savannah Steinhauser
- The Department of Emergency Medicine, Cooper University Health Care (CUHC), Cooper Medical School of Rowan University (CMSRU), Camden, New Jersey, USA
| | - Rachel Haroz
- The Department of Emergency Medicine, Cooper University Health Care (CUHC), Cooper Medical School of Rowan University (CMSRU), Camden, New Jersey, USA
- The Department of Emergency Medicine, Division of Toxicology and Addiction Medicine, CUHC/CMSRU, Camden, New Jersey, USA
- Cooper Center for Healing, CUHC/CMSRU, Camden, New Jersey, USA
| | - Iris Jones
- Cooper Center for Healing, CUHC/CMSRU, Camden, New Jersey, USA
| | - William Skelton
- The Department of Emergency Medicine, Cooper University Health Care (CUHC), Cooper Medical School of Rowan University (CMSRU), Camden, New Jersey, USA
- Department of Behavioral Medicine, CUHC/CMSRU, Camden, New Jersey, USA
| | - Brian M Fuller
- Division of Critical Care Medicine, Departments of Emergency Medicine and Anesthesia, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Michael B Roberts
- Institutional Research and Outcomes Assessment, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA
| | - Christopher W Jones
- The Department of Emergency Medicine, Cooper University Health Care (CUHC), Cooper Medical School of Rowan University (CMSRU), Camden, New Jersey, USA
| | | | - Brian W Roberts
- The Department of Emergency Medicine, Cooper University Health Care (CUHC), Cooper Medical School of Rowan University (CMSRU), Camden, New Jersey, USA
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Guenego A, Fahed R, Rouchaud A, Walker G, Faizy TD, Sporns PB, Aggour M, Jabbour P, Alexandre AM, Mosimann PJ, Dmytriw AA, Ligot N, Sadeghi N, Dai C, Hassan AE, Pereira VM, Singer J, Heit JJ, Taccone FS, Chen M, Fiehler J, Lubicz B. Diagnosis and endovascular management of vasospasm after aneurysmal subarachnoid hemorrhage - survey of real-life practices. J Neurointerv Surg 2024; 16:677-683. [PMID: 37500477 DOI: 10.1136/jnis-2023-020544] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 06/26/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Vasospasm and delayed cerebral ischemia (DCI) are the leading causes of morbidity and mortality after intracranial aneurysmal subarachnoid hemorrhage (aSAH). Vasospasm detection, prevention and management, especially endovascular management varies from center to center and lacks standardization. We aimed to evaluate this variability via an international survey of how neurointerventionalists approach vasospasm diagnosis and endovascular management. METHODS We designed an anonymous online survey with 100 questions to evaluate practice patterns between December 2021 and September 2022. We contacted endovascular neurosurgeons, neuroradiologists and neurologists via email and via two professional societies - the Society of NeuroInterventional Surgery (SNIS) and the European Society of Minimally Invasive Neurological Therapy (ESMINT). We recorded the physicians' responses to the survey questions. RESULTS A total of 201 physicians (25% [50/201] USA and 75% non-USA) completed the survey over 10 months, 42% had >7 years of experience, 92% were male, median age was 40 (IQR 35-46). Both high-volume and low-volume centers were represented. Daily transcranial Doppler was the most common screening method (75%) for vasospasm. In cases of symptomatic vasospasm despite optimal medical management, endovascular treatment was directly considered by 58% of physicians. The most common reason to initiate endovascular treatment was clinical deficits associated with proven vasospasm/DCI in 89%. The choice of endovascular treatment and its efficacy was highly variable. Nimodipine was the most common first-line intra-arterial therapy (40%). Mechanical angioplasty was considered the most effective endovascular treatment by 65% of neurointerventionalists. CONCLUSION Our study highlights the considerable heterogeneity among the neurointerventional community regarding vasospasm diagnosis and endovascular management. Randomized trials and guidelines are needed to improve standard of care, determine optimal management approaches and track outcomes.
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Affiliation(s)
- Adrien Guenego
- Interventional Neuroradiology Department, Hôpital Erasme - Hôpital Universitaire de Bruxelles (HUB) - Université Libre de Bruxelles (ULB), Bruxelles, Belgium
| | - Robert Fahed
- Department of Medicine - Division of Neurology, The Ottawa Hospital - Ottawa Hospital Research Institute and University of Ottawa, Ottawa, Ontario, Canada
| | - Aymeric Rouchaud
- Interventional neuroradiology, Centre Hospitalier Universitaire de Limoges, Limoges, France
- Univsersity of Limoges, CNRS, XLIM, UMR 7252, Limoges, France
| | - Gregory Walker
- Department of Medicine - Division of Neurology, Royal Columbian Hospital, New Westminster, British Columbia, Canada
- Department of Medicine - Division of Neurology, Royal Columbian Hospital, New Westminster, British Columbia, Canada
| | - Tobias D Faizy
- Radiology, Stanford University School of Medicine, Stanford, California, USA
| | - Peter B Sporns
- Department of Neuroradiology, University Hospital Basel, Basel, Switzerland
| | - Mohamed Aggour
- Department of Radiology, The Royal London Hospital, London, UK
| | - Pascal Jabbour
- Neurological surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Andrea M Alexandre
- UOSA Neuroradiologia Interventistica, Fondazione Policlinico Universitario A.Gemelli IRCCS, Roma, Italy
| | - Pascal John Mosimann
- Neuroradiology Division, University Medical Imaging TorontoJoint Department of Medical ImagingUniversity Health Networks and University of TorontoToronto Western Hospital, Toronto, Ontario, Canada
| | - Adam A Dmytriw
- Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Neurovascular Centre, Departments of Medical Imaging & Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Noémie Ligot
- Department of Neurology, Hôpital Erasme - Hôpital Universitaire de Bruxelles (HUB) - Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Niloufar Sadeghi
- Department of Radiology and Neuroradiology, Hôpital Erasme - Hôpital Universitaire de Bruxelles (HUB) - Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Chengbo Dai
- Department of Neurology, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Ameer E Hassan
- Department of Neurology, Valley Baptist Health System Inc, Harlingen, Texas, USA
| | - Vitor M Pereira
- Neurovascular Centre, Departments of Medical Imaging & Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Justin Singer
- Neurosurgery, Spectrum Health Michigan State University College of Human Medicine Internal Medicine Residency Program, Grand Rapids, Michigan, USA
| | - Jeremy J Heit
- Radiology, Neuroadiology and Neurointervention Division, Stanford University, Stanford, California, USA
| | - Fabio Silvio Taccone
- Department of Intensive Care, Hospital Erasme, Hôpital Erasme - Hôpital Universitaire de Bruxelles (HUB) - Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Michael Chen
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Jens Fiehler
- Department of Neuroradiology, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Boris Lubicz
- Interventional Neuroradiology Department, Hôpital Erasme - Hôpital Universitaire de Bruxelles (HUB) - Université Libre de Bruxelles (ULB), Bruxelles, Belgium
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Gaertner J, Boehlke C, Kreye G, Fusi-Schmidhauser T, Mueller E, Roch C. Pharmacological treatment of cancer pain and opioid induced nausea and vomiting: online survey and comparison with current guidelines. Support Care Cancer 2024; 32:436. [PMID: 38879720 PMCID: PMC11180006 DOI: 10.1007/s00520-024-08628-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 06/02/2024] [Indexed: 06/19/2024]
Abstract
PURPOSE We assumed that in Palliative Care, even in common clinical situations, the choice of drugs differs substantially between physicians. Therefore, we assessed the practice of pharmaceutical treatment choices of physicians for cancer pain and opioid-induced nausea and vomiting (OINV) and the rationale for their choices. METHODS An online survey was conducted with physicians covering the following domains: i) Cancer pain therapy: non-opioids in addition to opioids: choice of drug ii) prevention of OINV: choice of drug and mode of application. Current guidelines concerning cancer pain therapy and prevention of OINV were compared. RESULTS Two-hundred-forty European physicians responded to our survey. i) Use of non-opioids in addition to opioids for the treatment of cancer pain: Only 1.3% (n = 3) of respondents never used an additional non-opioid. Others mostly used: dipyrone/metamizole (49.2%, n = 118), paracetamol/acetaminophen (34.2%, n = 82), ibuprofen / other NSAIDs (11.3%, n = 27), specific Cox2-inhibitors (2.1%, n = 5), Aspirin (0.4%, n = 1), no answer (2.9%, n = 7). ii) Antiemetics to prevent OINV: The drugs of choice were metoclopramide (58.3%, n = 140), haloperidol (26.3%, n = 63), 5-HT3 antagonists (9.6%, n = 23), antihistamines (1.3%, n = 3) and other (2.9%, n = 7); no answer (1.7%, n = 4). Most respondents prescribed the substances on-demand (59.6%, n = 143) while others (36.3%, n = 87) provided them as around the clock medication. Over both domains, most physicians answered that their choices were not based on solid evidence from randomized controlled trials (RCTs). Guidelines were inconsistent regarding if and what non-opioid to use for cancer pain and recommend anti-dopaminergic drugs for prevention or treatment of OINV. CONCLUSIONS Physician's practice in palliative care for the treatment of cancer pain and OINV differed substantially. Respondents expressed the lack of high-quality evidence- based information from RCTs. We call for evidence from methodologically high-quality RCTs to be available to inform physicians about the benefits and harms of pharmacological treatments for common symptoms in palliative care.
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Affiliation(s)
- Jan Gaertner
- Palliative Care Center Basel, Basel, Switzerland
- Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Christopher Boehlke
- Palliative Care Center Basel, Basel, Switzerland.
- Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland.
| | - Gudrun Kreye
- Division of Palliative Care, Department of Internal Medicine, Karl Landsteiner University of Health Sciences, Krems, Austria
- Karl Landsteiner University of Health Sciences, University Hospital, Krems, Austria
| | - Tanja Fusi-Schmidhauser
- Palliative and Supportive Care Clinic and Department of Internal Medicine, Ente Ospedaliero Cantonale, Lugano, Switzerland
- Department of Rehabilitation and Geriatrics, University of Geneva, Geneva, Switzerland
| | - Evelyn Mueller
- Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Carmen Roch
- Interdisciplinary Center for Palliative Medicine, University Hospital Wuerzburg, Würzburg, Germany
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Liu H, Yao Y, Luo X, Yang N, Wang Z, Shen X, Li Z, Zhao W, Peng D, Zhang H, He H, Wang W, Liu X, Chen Y, Estill J. Mapping the awareness and knowledge about patient and public versions of guidelines among stakeholders in China: a cross-sectional survey. J Clin Epidemiol 2024; 173:111429. [PMID: 38880436 DOI: 10.1016/j.jclinepi.2024.111429] [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: 01/12/2024] [Revised: 06/05/2024] [Accepted: 06/10/2024] [Indexed: 06/18/2024]
Abstract
OBJECTIVES Patient and public versions of guidelines (PVGs) have gradually gained wide recognition and attention from the public and the society due to their scientific, professional, and authoritative characteristics. This study aims to survey the awareness and knowledge of PVGs among stakeholders in China. STUDY DESIGN AND SETTING This was a cross-sectional survey among stakeholders (guideline developers, clinicians, journal editors, patients, and the public) in China. We self-designed the questionnaire and distributed it through the Questionnaire Star platform. The primary outcomes were awareness of PVGs and opinions about the development methodology, writing, dissemination, and implementation of PVGs. The Kruskal-Wallis H test and post hoc multiple comparison tests were used to compare the levels of awareness of PVGs between different subgroups of respondents. RESULTS A total of 1319 valid questionnaires were collected: 722 from guideline developers, 136 from clinicians, 83 from journal editors, 284 from patients, and 94 from members of the public. Of all respondents, 253 (19.2%) had not heard of PVGs, 349 (26.5%) had heard of PVGs but had no further knowledge, 475 (36.0%) had some knowledge of PVGs, and 242 (18.3%) were familiar with or had participated in the development of PVGs. Guideline developers, clinicians, and journal editors had higher awareness than patients and the public. Higher education and older age also correlated with higher awareness of PVGs. More than half (52.9%) of guideline developers considered that both rewriting of the source guidelines and direct development as independent documents were appropriate methods for developing PVGs. The survey respondents agreed that clinicians (97.3%), guideline methodologists (76.6%), representatives of patients and the public (74.5%), and medical editors or writers (63.4%) should participate in the development of PVGs. More than 80% of the respondents agreed that the quality of evidence and strength of recommendations should be presented; however, there was no consensus in the form of presentation. CONCLUSIONS The level of awareness of PVGs among stakeholders in China is relatively low and differs between different stakeholder groups, but the majority of key stakeholders have a positive attitude toward PVGs. The collection of the perspectives and opinions on the development methods, writing, dissemination, and implementation provides a key reference and basis for the future optimization and improvement of PVGs development.
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Affiliation(s)
- Hui Liu
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China; Research Unit of Evidence-Based Evaluation and Guidelines (2021RU017), Chinese Academy of Medical Sciences, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Yuanyuan Yao
- Research Unit of Evidence-Based Evaluation and Guidelines (2021RU017), Chinese Academy of Medical Sciences, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China; School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Xufei Luo
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Nan Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China
| | - Zijun Wang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China; Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Xiping Shen
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Zhewei Li
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Wei Zhao
- Editor-in-Chief Office, Chinese Medical Association Publishing House, Key Laboratory of Knowledge Mining and Service for Medical Journals, Beijing, China
| | - Dongrui Peng
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Huayu Zhang
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Hongfeng He
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Wei Wang
- Department of Urology, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China; Center of Evidence-based Medicine and GRADE, Fudan University, Shanghai, China
| | - Xingrong Liu
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China.
| | - Yaolong Chen
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China; Research Unit of Evidence-Based Evaluation and Guidelines (2021RU017), Chinese Academy of Medical Sciences, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China; WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, Gansu, China; Institute of Health Data Science, Lanzhou University, Lanzhou, Gansu, China.
| | - Janne Estill
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China; Institute of Global Health, University of Geneva, Geneva, Switzerland
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Brekelmans M, Hopmans T, van Mourik M, de Greeff S, Swillens J, van Rooden S. Evaluation of a multifaceted implementation strategy for semi-automated surveillance of surgical site infections after total hip or knee arthroplasty: a multicentre pilot study in the Netherlands. Antimicrob Resist Infect Control 2024; 13:63. [PMID: 38872201 PMCID: PMC11170835 DOI: 10.1186/s13756-024-01418-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 06/01/2024] [Indexed: 06/15/2024] Open
Abstract
INTRODUCTION To promote the nation-wide implementation of semi-automated surveillance (AS) of surgical site infection after hip and knee arthroplasty, the Dutch National Institute for Public Health and the Environment (RIVM) deployed a decentralised multifaceted implementation strategy. This strategy consisted of a protocol specifying minimum requirements for an AS system, supported by a user manual, education module, individual guidance for hospitals and user-group meetings. This study describes an effect evaluation and process evaluation of the implementation strategy for AS in five frontrunner hospitals. METHODS To evaluate the effect of the implementation strategy, the achieved phase of implementation was determined in each frontrunner hospital at the end of the study period. The process evaluation consisted of (1) an evaluation of the feasibility of strategy elements, (2) an evaluation of barriers and facilitators for implementation and (3) an evaluation of the workload for implementation. Interviews were performed as a basis for a subsequent survey quantifying the results regarding the feasibility as well as barriers and facilitators. Workload was self-monitored per profession. Qualitative data were analysed using a framework analysis, whereas quantitative data were analysed descriptively. RESULTS One hospital finished the complete implementation process in 240 person-hours. Overall, the elements of the implementation strategy were often used, positively received and overall, the strategy was rated effective and feasible. During the implementation process, participants perceived the relative advantage of AS and had sufficient knowledge about AS. However, barriers regarding complexity of AS data extraction, data-infrastructure, and validation, lack of capacity and motivation at the IT department, and difficulties with assigning roles and responsibilities were experienced. CONCLUSION A decentralised multifaceted implementation strategy is suitable for the implementation of AS in hospitals. Effective local project management, including clear project leadership and ownership, obtaining commitment of higher management levels, active involvement of stakeholders, and appropriate allocation of roles and responsibilities is important for successful implementation and should be facilitated by the implementation strategy. Sufficient knowledge about AS, its requirements and the implementation process should be available among stakeholders by e.g. an education module. Furthermore, exchange of knowledge and experiences between hospitals should be encouraged in user-group meetings.
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Affiliation(s)
- Manon Brekelmans
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
- Department of Medical Microbiology and Infection Control, University Medical Centre Utrecht, Utrecht, the Netherlands.
| | - Titia Hopmans
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Maaike van Mourik
- Department of Medical Microbiology and Infection Control, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Sabine de Greeff
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Julie Swillens
- Scientific Centre for Quality of Healthcare (IQ Healthcare), Radboud Institute for Health Sciences (RIHS), Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Stephanie van Rooden
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
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90
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Hassan AHF, Barry HE, Hughes CM. An exploration of Northern Ireland general practice pharmacists' views on their role in general practice: a cross-sectional survey. BMC PRIMARY CARE 2024; 25:201. [PMID: 38844848 PMCID: PMC11157875 DOI: 10.1186/s12875-024-02457-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 05/31/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND There is limited research examining the views of general practice pharmacists (GPPs) on their role and their impact in general practice. The aim of this study was to explore GPPs' views regarding this role and its potential impact within general practice in Northern Ireland (NI). METHODS A paper-based self-administered questionnaire was mailed to 319 general practices in NI in 2022, directed to the GPP who spent most time at the practice. A variety of closed and open questions were included in six sections. Responses to closed questions were analysed descriptively whilst open question responses were analysed using content analysis. To ascertain associations between variables (e.g. GPP prescribing status, working arrangements and aspects of collaboration with GPPs), Fisher's exact test was employed with an a priori significance level of p < 0.05. RESULTS 155 responses were received equating to a response rate of 48.5%. Most participants (72.3%) were female, independent prescribers (71%), and 64.5% were currently using their independent prescriber qualification. Services that were provided by most GPPs were medication reconciliation (99.4%) and medication reviews (97.4%). The most common method of communication between GPPs and general practitioners (GPs) was face-to-face (89.0%). Telephone was the most common method of communication between GPPs, community pharmacists (97.4%) and patients (98.7%). Most GPPs (> 80%) showed positive attitudes towards collaboration with GPs and those who worked in multiple practices were more likely to agree with the Attitudes Towards Collaboration Instrument for pharmacists (ATCI-P) statements compared to those who worked in a single practice (p < 0.05). Less than 40% (36.8%) of GPPs agreed that patients were aware of the role they provided. The majority of GPPs (80.6%) expressed positive views on their impact on primary care. Analysis of the free-text comments revealed the need for more GPP patient-facing activities, GPP-specific training, and promotion of the GPP role. CONCLUSION The findings indicated that GPPs had largely positive views about their role and their impact on primary care. The results may be helpful for practices and service commissioners. Further research is necessary to explore the perspectives of patients regarding the role of the GPP and to enhance patients' awareness of the GPP.
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Affiliation(s)
- Abrar H F Hassan
- Primary Care Research Group, School of Pharmacy, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, Northern Ireland, UK
- Department of Clinical Pharmacy, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Heather E Barry
- Primary Care Research Group, School of Pharmacy, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, Northern Ireland, UK
| | - Carmel M Hughes
- Primary Care Research Group, School of Pharmacy, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, Northern Ireland, UK.
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91
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Leerling AT, Ueckert DA, Van der Giesen FJ, Vliet-Vlieland T, Winter EM. Role of physical therapy in adult chronic non-bacterial osteitis: patients' and therapists' perspectives. Scand J Rheumatol 2024:1-10. [PMID: 38832471 DOI: 10.1080/03009742.2024.2352965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 05/06/2024] [Indexed: 06/05/2024]
Abstract
OBJECTIVES Chronic nonbacterial osteitis (CNO) is a rare bone disease causing pain and functional impairment. We aimed to explore the application of physical therapy (PT) for adult CNO from the patients' and primary care therapists' perspective. METHOD Cross-sectional study among the Dutch adult CNO cohort (1992-present). A survey on PT-use for axial spondylarthritis was adapted for CNO. Patients using PT in the past 2 years (recent PT-users) were asked about modalities, perceived effects, satisfaction, and preferences for provision. Their current physical therapists were invited to complete a self-developed survey covering therapy details and educational preferences. RESULTS 80/199 invited patients and 14/16 invited therapists completed the survey respectively. 41 (51%) patients used PT for CNO in the preceding 2 years, 14 (18%) used PT >2 years back, and 25 (31%) never used PT. Recent PT-users (n=41) reported diverse treatment modalities, involving massage (61%), joint mobilizations (44%), breathing exercises (49%), muscle strengthening (32%) and counselling through of home-exercises (46%) and pain education (32%). 64% of all patients desired greater emphasis from physicians regarding the role of PT. Most therapists would appreciate referral letters with CNO-specific information (93%), and consultations with specialized therapists (86%). CONCLUSIONS In this study, two-third of adult CNO patients had -ever or recently- used PT, which involved variable therapeutic modalities. Most patients were receptive to a larger role of PT in CNO-management and most therapists preferred CNO-specific information to optimize their care. These findings provide a foundation for the development and systematic evaluation of CNO-specific PT.
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Affiliation(s)
- A T Leerling
- Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
- Center for Bone Quality, Leiden University Medical Center, Leiden, The Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - D A Ueckert
- Department of Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands
| | - F J Van der Giesen
- Department of Rheumatology, Zuyderland Ziekenhuis, Heerlen, The Netherlands
| | - Tpm Vliet-Vlieland
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands
| | - E M Winter
- Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
- Center for Bone Quality, Leiden University Medical Center, Leiden, The Netherlands
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Landry MJ, Ward CP, Koh LM, Gardner CD. The knowledge, attitudes, and perceptions towards a plant-based dietary pattern: a survey of obstetrician-gynecologists. Front Nutr 2024; 11:1381132. [PMID: 38895659 PMCID: PMC11183291 DOI: 10.3389/fnut.2024.1381132] [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: 02/06/2024] [Accepted: 05/15/2024] [Indexed: 06/21/2024] Open
Abstract
Background Obstetricians-gynecologists (OB/GYNs) play a critical role for their pregnant patients during their perinatal period, but research on OB/GYNs knowledge, attitudes, and perceptions regarding plant-based dietary patterns (PBDP) and how this may influence recommendations to patients is lacking. An online cross-sectional survey was conducted to examine OB/GYN's knowledge, attitudes, and perceptions towards a PBDP. Methods Postcards were mailed in June 2023 to a convenience sample of 5,000 OB/GYNs across the US using a mailing list provided by the American College of Obstetricians and Gynecologists. Postcards had a brief study description and a QR code that linked to an online survey asking questions about demographics, behavior (e.g., nutritional habits), and other factors that may influence knowledge, attitudes, and perceptions towards a PBDP for their patients. Results Ninety-six OB/GYNs completed the full questionnaire (~2% response rate). Most (92%) felt that it is within an OB/GYN's role to incorporate nutrition education and counseling within practice. However, 72% felt inadequately trained to discuss nutrition and diet-related issues with patients. Despite a perceived lack of nutrition training, 86% reported that a PBDP was safe and health-promoting, and 81% reported that a well-planned PBDP could adequately meet all nutritional needs of pregnant and lactating patients. Conclusion Findings suggest that OB/GYNs are generally knowledgeable about the components and health benefits of a plant-based diets. However, nutrient adequacy misconceptions and lack of sufficient training to discuss nutrition with patients may result in OB/GYNs not recommending PBDPs to patients. These findings underscore the need to enhance OB/GYN graduate medical education and training by integrating education on PBDPs, therefore improving a clinician's ability to confidently and effectively counsel pregnant persons on this aspect of perinatal care.
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Affiliation(s)
- Matthew J. Landry
- Department of Population Health and Disease Prevention, Program in Public Health, University of California, Irvine, Irvine, CA, United States
| | - Catherine P. Ward
- Stanford Prevention Research Center, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Linda M. Koh
- Stanford Prevention Research Center, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Christopher D. Gardner
- Stanford Prevention Research Center, School of Medicine, Stanford University, Palo Alto, CA, United States
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Ginzberg SP, Gasior JA, Passman JE, Stein J, Keddem S, Soegaard Ballester JM, Finn CB, Myers JS, Kelz RR, Shea JA, Wachtel H. Surgeon and Surgical Trainee Experiences After Adverse Patient Events. JAMA Netw Open 2024; 7:e2414329. [PMID: 38829617 PMCID: PMC11148685 DOI: 10.1001/jamanetworkopen.2024.14329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 04/01/2024] [Indexed: 06/05/2024] Open
Abstract
Importance Adverse patient events are inevitable in surgical practice. Objectives To characterize the impact of adverse patient events on surgeons and trainees, identify coping mechanisms, and assess whether current forms of support are sufficient. Design, Setting, and Participants In this mixed-methods study, a validated survey instrument was adapted and distributed to surgical trainees from 7 programs, and qualitative interviews were conducted with faculty from 4 surgical departments in an urban academic health system. Main Outcomes and Measures The personal impact of adverse patient events, current coping mechanisms, and desired forms of support. Results Of 216 invited trainees, 93 (43.1%) completed the survey (49 [52.7%] male; 60 [64.5%] in third postgraduate year or higher; 23 [24.7%] Asian or Pacific Islander, 6 [6.5%] Black, 51 [54.8%] White, and 8 [8.6%] other race; 13 [14.0%] Hispanic or Latinx ethnicity). Twenty-three of 29 (79.3%) invited faculty completed interviews (13 [56.5%] male; median [IQR] years in practice, 11.0 [7.5-20.0]). Of the trainees, 77 (82.8%) endorsed involvement in at least 1 recent adverse event. Most reported embarrassment (67 of 79 trainees [84.8%]), rumination (64 of 78 trainees [82.1%]), and fear of attempting future procedures (51 of 78 trainees [65.4%]); 28 of 78 trainees (35.9%) had considered quitting. Female trainees and trainees who identified as having a race and/or ethnicity other than non-Hispanic White consistently reported more negative consequences compared with male and White trainees. The most desired form of support was the opportunity to discuss the incident with an attending physician (76 of 78 respondents [97.4%]). Similarly, faculty described feelings of guilt and shame, loss of confidence, and distraction after adverse events. Most described the utility of confiding in peers and senior colleagues, although some expressed unwillingness to reach out. Several suggested designating a departmental point person for event debriefing. Conclusions and Relevance In this mixed-methods study of the personal impact of adverse events on surgeons and trainees, these events were nearly universally experienced and caused significant distress. Providing formal support mechanisms for both surgical trainees and faculty may decrease stigma and restore confidence, particularly for underrepresented groups.
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Affiliation(s)
- Sara P. Ginzberg
- Department of Surgery, University of Pennsylvania Health System, Philadelphia
- Center for Healthcare Improvement and Patient Safety, University of Pennsylvania, Philadelphia
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia
| | - Julia A. Gasior
- Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Jesse E. Passman
- Department of Surgery, University of Pennsylvania Health System, Philadelphia
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia
| | - Jacob Stein
- Sackler School of Medicine New York State/American Program, Tel Aviv University, Tel Aviv, Israel
| | - Shimrit Keddem
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia
- Department of Family Medicine and Community Health, University of Pennsylvania Health System, Philadelphia
| | | | - Caitlin B. Finn
- Department of Surgery, Weill Cornell Medicine, Philadelphia, Pennsylvania
| | - Jennifer S. Myers
- Center for Healthcare Improvement and Patient Safety, University of Pennsylvania, Philadelphia
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia
- Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Department of Medicine, University of Pennsylvania Health System, Philadelphia
| | - Rachel R. Kelz
- Department of Surgery, University of Pennsylvania Health System, Philadelphia
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia
- Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Judy A. Shea
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia
- Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Department of Medicine, University of Pennsylvania Health System, Philadelphia
| | - Heather Wachtel
- Department of Surgery, University of Pennsylvania Health System, Philadelphia
- Perelman School of Medicine, University of Pennsylvania, Philadelphia
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Pinto P, Valentin L, Borčinová M, Wiesnerová M, Filip F, Burgetova A, Masek M, Lambert L, Chiappa V, Franchi D, Testa AC, Moro F, Avesani G, Panico C, Alessi S, Pricolo P, Vigorito R, Calareso G, Kocian R, Slama J, Fagotti A, Urbinati AMV, Signorelli M, Bertolina F, Cibula D, Fischerova D. Patient satisfaction with ultrasound, whole-body CT and whole-body diffusion-weighted MRI for pre-operative ovarian cancer staging: a multicenter prospective cross-sectional survey. Int J Gynecol Cancer 2024; 34:871-878. [PMID: 38531539 DOI: 10.1136/ijgc-2023-005264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND In addition to the diagnostic accuracy of imaging methods, patient-reported satisfaction with imaging methods is important. OBJECTIVE To report a secondary outcome of the prospective international multicenter Imaging Study in Advanced ovArian Cancer (ISAAC Study), detailing patients' experience with abdomino-pelvic ultrasound, whole-body contrast-enhanced computed tomography (CT), and whole-body diffusion-weighted magnetic resonance imaging (WB-DWI/MRI) for pre-operative ovarian cancer work-up. METHODS In total, 144 patients with suspected ovarian cancer at four institutions in two countries (Italy, Czech Republic) underwent ultrasound, CT, and WB-DWI/MRI for pre-operative work-up between January 2020 and November 2022. After having undergone all three examinations, the patients filled in a questionnaire evaluating their overall experience and experience in five domains: preparation before the examination, duration of examination, noise during the procedure, radiation load of CT, and surrounding space. Pain perception, examination-related patient-perceived unexpected, unpleasant, or dangerous events ('adverse events'), and preferred method were also noted. RESULTS Ultrasound was the preferred method by 49% (70/144) of responders, followed by CT (38%, 55/144), and WB-DWI/MRI (13%, 19/144) (p<0.001). The poorest experience in all domains was reported for WB-DWI/MRI, which was also associated with the largest number of patients who reported adverse events (eg, dyspnea). Patients reported higher levels of pain during the ultrasound examination than during CT and WB-DWI/MRI (p<0.001): 78% (112/144) reported no pain or mild pain, 19% (27/144) moderate pain, and 3% (5/144) reported severe pain (pain score >7 of 10) during the ultrasound examination. We did not identify any factors related to patients' preferred method. CONCLUSION Ultrasound was the imaging method preferred by most patients despite being associated with more pain during the examination in comparison with CT and WB-DWI/MRI. TRIAL REGISTRATION NUMBER NCT03808792.
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Affiliation(s)
- Patrícia Pinto
- Department of Gynecology, Portuguese Institute of Oncology of Lisbon Francisco Gentil, Lisboa, Portugal
- First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Lil Valentin
- Department of Obstetrics and Gynaecology, Skane University Hospital, Malmo, Sweden
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Martina Borčinová
- Gynecologic Oncology Centre, Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Markéta Wiesnerová
- Masaryk University Institute of Biostatistics and Analyses, Brno, Czech Republic
| | - Fruhauf Filip
- Gynecologic Oncology Centre, Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Andrea Burgetova
- Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Martin Masek
- Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Lukas Lambert
- Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Valentina Chiappa
- Department of Gynecologic Oncology, Foundation IRCCS National Cancer Institute, Milan, Italy
| | - Dorella Franchi
- Preventive Gynecology Unit, Division of Gynaecology, European Institute of Oncology, Milan, Italy
| | - Antonia Carla Testa
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Lazio, Italy
| | - Francesca Moro
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Lazio, Italy
| | - Giacomo Avesani
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Lazio, Italy
| | - Camilla Panico
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Lazio, Italy
| | - Sarah Alessi
- Division of Radiology, Istituto Europeo di Oncologia, Milan, Italy
| | - Paola Pricolo
- Division of Radiology, Istituto Europeo di Oncologia, Milan, Italy
| | - Raffaella Vigorito
- Department of Radiology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Giuseppina Calareso
- Department of Radiology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Roman Kocian
- Gynecologic Oncology Centre, Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Jiri Slama
- Gynecologic Oncology Centre, Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Anna Fagotti
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Lazio, Italy
| | | | - Mauro Signorelli
- Department of Gynecologic Oncology, Foundation IRCCS National Cancer Institute, Milan, Italy
| | - Francesca Bertolina
- Department of Gynecologic Oncology, Foundation IRCCS National Cancer Institute, Milan, Italy
| | - David Cibula
- Gynecologic Oncology Centre, Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Daniela Fischerova
- Gynecologic Oncology Centre, Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
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95
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Cheng TY, Renaud DL, Proudfoot KL, Pempek JA, Habing GG. Dairy producers' colostrum practices, marketing, and attitudes toward male dairy calves. J Dairy Sci 2024; 107:3885-3898. [PMID: 38216040 DOI: 10.3168/jds.2023-24149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 12/03/2023] [Indexed: 01/14/2024]
Abstract
Optimal early-life care of surplus calves born on dairy farms is critical for health and welfare. This cross-sectional study aimed to describe the marketing practices of male dairy calves, differences in the colostrum management between male and female calves on dairy farms, and the relationship between discrepant colostrum practices and dairy producers' attitudes toward male calf care. United States dairy producers (n = 1,000) in the states of Florida, Michigan, Ohio, Vermont, and Wisconsin were selected using stratified random sampling. A questionnaire containing questions about farm demographics, colostrum management (including quantity and timeliness of colostrum delivery), and producers' attitudes toward male calf care was mailed in February 2021. Attitudes toward male calf care were assessed using 5-point Likert scales for 10 statements regarding perceptions of the value of male calves and barriers in providing optimal care. Producer responses to questions about the quantity and timeliness of colostrum delivery between male and female calves were compared using a nonparametric Wilcoxon rank-sum test. Multivariable logistic regression models were used to investigate the association between differences in colostrum management and producers' attitudes. By May 2021, 953 surveys were delivered and 315 (33.1%) were returned with complete responses. Most producers (>90%) reported feeding equal volumes of colostrum and performing the first postbirth feeding within a similar time frame for male and female calves. However, compared with females, male calves had a longer delay to the first colostrum feeding. Approximately 40% of producers marketed their male calves through auctions, and over half (54.6%) of farms sold the male calves between 3 and 10 d of age. Large farms (≥500 lactating cows) were found to market male calves at a younger age (≤3 d of age). Most producers (>78%) believed their male calves were receiving optimal care and did not consider the workload and financial costs as obstacles to providing good care to male calves. However, those who viewed the workload as an obstacle to good care and produced organic products were marginally more likely to feed a lower volume of colostrum to male calves in the first feeding after birth. These findings suggest that interventions to improve colostrum practices should be more broadly targeted to all calves born on dairy farms, and that age at transport is markedly different between large and small farms.
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Affiliation(s)
- Ting-Yu Cheng
- Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210
| | - David L Renaud
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada N1G 2W1
| | - Kathryn L Proudfoot
- Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Prince Edward Island, Canada C1A 4P3
| | - Jessica A Pempek
- Department of Animal Sciences, College of Food, Agricultural, and Environmental Sciences, The Ohio State University, Columbus, OH 43210
| | - Gregory G Habing
- Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210.
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96
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Fenech M, Miklas M, Hussein A, El-Abed Y, Moudgil D, Abdel-Nabi R, Touma K, Hossami M, Nassar R, Zaib F, Rim SC, Hirmiz R, Hilal O, Paunic M, Cavallo-Medved D, Hamm C. Identifying and addressing a new barrier to community-based patients accessing cancer clinical trials. Contemp Clin Trials Commun 2024; 39:101296. [PMID: 38660007 PMCID: PMC11039343 DOI: 10.1016/j.conctc.2024.101296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 08/21/2023] [Accepted: 03/27/2024] [Indexed: 04/26/2024] Open
Affiliation(s)
- Melissa Fenech
- Schulich School of Medicine & Dentistry, Windsor Regional Cancer Centre, N8W1L9, Windsor, Ontario, Canada
| | - Maegan Miklas
- Schulich School of Medicine & Dentistry, Windsor Regional Cancer Centre, N8W1L9, Windsor, Ontario, Canada
| | - Abdulkadir Hussein
- University of Windsor, Windsor Regional Cancer Centre, N8W1L9, Windsor, Ontario, Canada
| | - Youshaa El-Abed
- University of Windsor, Windsor Regional Cancer Centre, N8W1L9, Windsor, Ontario, Canada
| | - Devinder Moudgil
- Schulich School of Medicine & Dentistry, Windsor Regional Cancer Centre, N8W1L9, Windsor, Ontario, Canada
- WE-Spark Health Institute, N9B3P4, Ontario, Canada
| | - Rhonda Abdel-Nabi
- University of Windsor, Windsor Regional Cancer Centre, N8W1L9, Windsor, Ontario, Canada
- Clinical Trials Navigator, Canada
| | - Kayla Touma
- University of Windsor, Windsor Regional Cancer Centre, N8W1L9, Windsor, Ontario, Canada
- Clinical Trials Navigator, Canada
| | - Mahmoud Hossami
- University of Windsor, Windsor Regional Cancer Centre, N8W1L9, Windsor, Ontario, Canada
- Clinical Trials Navigator, Canada
| | | | - Farwa Zaib
- Schulich School of Medicine & Dentistry, Windsor Regional Cancer Centre, N8W1L9, Windsor, Ontario, Canada
| | - Sanghyuk Claire Rim
- Schulich School of Medicine & Dentistry, Windsor Regional Cancer Centre, N8W1L9, Windsor, Ontario, Canada
| | | | | | - Milica Paunic
- University of Windsor, Windsor Regional Cancer Centre, N8W1L9, Windsor, Ontario, Canada
| | - Dora Cavallo-Medved
- University of Windsor, Windsor Regional Cancer Centre, N8W1L9, Windsor, Ontario, Canada
- WE-Spark Health Institute, N9B3P4, Ontario, Canada
| | - Caroline Hamm
- Schulich School of Medicine & Dentistry, Windsor Regional Cancer Centre, N8W1L9, Windsor, Ontario, Canada
- University of Windsor, Windsor Regional Cancer Centre, N8W1L9, Windsor, Ontario, Canada
- WE-Spark Health Institute, N9B3P4, Ontario, Canada
- Clinical Trials Navigator, Canada
- Schulich School of Medicine & Dentistry, Windsor Regional Hospital, N8W2X3, Windsor, Ontario, Canada
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97
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Vasileva-Slaveva M, Morales-Espinosa D, Puccini A, Meissner M, Milic M, Lamberti G, Altena R. Tackling hurdles in front of young clinical investigators in oncology - Results from an international survey. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024; 50:108031. [PMID: 38552416 DOI: 10.1016/j.ejso.2024.108031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/08/2024] [Accepted: 02/14/2024] [Indexed: 05/26/2024]
Abstract
INTRODUCTION Cancer is a leading cause of morbidity and mortality worldwide, and coordinated research efforts are vital to improve global outcomes. Clinical or translational research is usually planned, coordinated and executed by clinical researchers. With this survey we aimed to identify the main hurdles in front of young clinical investigators in oncology. METHODS AND MATERIALS An anonymized survey was distributed using social media between April and November 2022. Target population were health-care professionals in the field of oncology - physicians, nurses and researchers. We divided participants according to working experience (<40 vs. >40 years of age) and country of practice (Europeans vs. non-Europeans). RESULTS We received 121 responses from participants practicing in 36 countries. Eighty-seven (72%) of the participants were under 40 years. Eighty-nine (74%) were from European countries and thirty-two (26%) were from non-European. Experienced and European professionals were more likely to be involved in all different aspects of clinical trials. The main source of funding - independently of geographic location - were industry grants. Investigators out of Europe have less participation in international grants. Over 50% of participants dedicate time for clinical research from their personal time and are not paid for it. Almost 50% of investigators don't have access to an experienced mentor in their institution. CONCLUSION The majority of respondents to our survey are active clinical researchers. Our data indicate that access to education and training as well as possibilities for appropriate networking, and specifically lack of mentorship, are key limiting factors in developing clinical research by healthcare professionals.
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Affiliation(s)
- Mariela Vasileva-Slaveva
- Bulgarian Breast and Other Gynecological Cancers Association, Sofia, Mladost 1, 1750, Block 122, Bulgaria; Shterev Hospital, Sofia, 1330, Hristo Blagoev 25, Bulgaria; Medical University Pleven, Pleven, 5800, Blvd Kliment Ohridski 1, Bulgaria.
| | | | - Alberto Puccini
- IRCCS, Humanitas Research Hospital, Humanitas Cancer Center, Medical Oncology and Hematology Unit Rozzano, Via Alessandro Manzoni, 56, 20089, Rozzano, Milan, Italy
| | - Magdalena Meissner
- Cardiff University - Division of Cancer and Genetics, School of Medicine, Cardiff University, Sir Geraint Evans Building, Heath Park, CF14 4XN, Cardiff, United Kingdom; Velindre NHS Trust, Velindre Cancer Centre, Velindre Road, Cardiff, CF14 2TL, United Kingdom
| | - Marina Milic
- University College London Hospitals NHS Foundation Trust, 250 Euston Road, NW1 2PG, London, United Kingdom
| | - Giuseppe Lamberti
- Department of Medical and Surgical Sciences, University of Bologna, Via Zamboni, 33, 40126, Bologna, Italy
| | - Renske Altena
- Medical Unit Breast, Endocrine Tumors and Sarcoma, Karolinska Comprehensive Cancer Center, Karolinska University Hospital, Eugeniavägen 3, 171 76, Solna, Sweden; Inst. Onk-Pat, Karolinska Institutet, Stockholm, Sweden
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98
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de Wit K, Tran A, Clayton N, Seeburruth D, Lim RK, Archambault PM, Chan TM, Rang LCF, Gray S, Ritchie K, Gérin-Lajoie C, Mercuri M. A Longitudinal Survey on Canadian Emergency Physician Burnout. Ann Emerg Med 2024; 83:576-584. [PMID: 38323951 DOI: 10.1016/j.annemergmed.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 12/11/2023] [Accepted: 01/04/2024] [Indexed: 02/08/2024]
Abstract
STUDY OBJECTIVE Since Canada eased pandemic restrictions, emergency departments have experienced record levels of patient attendance, wait times, bed blocking, and crowding. The aim of this study was to report Canadian emergency physician burnout rates compared with the same physicians in 2020 and to describe how emergency medicine work has affected emergency physician well-being. METHODS This longitudinal study on Canadian emergency physician wellness enrolled participants in April 2020. In September 2022, participants were invited to a follow-up survey consisting of the Maslach Burnout Inventory and an optional free-text explanation of their experience. The primary outcomes were emotional exhaustion and depersonalization levels, which were compared with the Maslach Burnout Inventory survey conducted at the end of 2020. A thematic analysis identified common stressors, challenges, emotions, and responses among participants. RESULTS The response rate to the 2022 survey was 381 (62%) of 615 between September 28 and October 28, 2022, representing all provinces or territories in Canada (except Yukon). The median participant age was 42 years. In total, 49% were men, and 93% were staff physicians with a median of 12 years of work experience. 59% of respondents reported high emotional exhaustion, and 64% reported high depersonalization. Burnout levels in 2022 were significantly higher compared with 2020. Prevalent themes included a broken health care system, a lack of societal support, and systemic workplace challenges leading to physician distress and loss of physicians from the emergency workforce. CONCLUSION We found very high burnout levels in emergency physician respondents that have increased since 2020.
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Affiliation(s)
- Kerstin de Wit
- Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada; Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
| | - Anna Tran
- School of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Natasha Clayton
- Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada; Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Emergency Department, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Darshana Seeburruth
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Rodrick K Lim
- Department of Pediatrics and Medicine, Western University, London, Ontario, Canada
| | - Patrick M Archambault
- Department of Family and Emergency Medicine, Université Laval, Québec City, Québec, Canada; Centre Intégré en Santé et Services Sociaux de Chaudière-Appalaches, Lévis, Québec, Canada
| | - Teresa M Chan
- Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada; McMaster Education Research, Innovation, and Theory (MERIT) program, McMaster University, Hamilton, Ontario, Canada; Dean of the School of Medicine, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Louise C F Rang
- Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada
| | - Sara Gray
- Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Kerri Ritchie
- People Health and Wellness and the Ottawa Hospital Research Institute, the Ottawa Hospital, Ottawa, Ontario, Canada
| | | | - Mathew Mercuri
- Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Institute for the Future of Knowledge, University of Johannesburg, Auckland Park, South Africa
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99
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Goldsmith S, Smithers-Sheedy H, Almasri N, Andersen GL, Diviney L, Gincota EB, Himmelmann K, Jahan I, Waight E, McIntyre S. Cerebral palsy registers around the world: A survey. Dev Med Child Neurol 2024; 66:765-777. [PMID: 37946559 DOI: 10.1111/dmcn.15798] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/28/2023] [Accepted: 10/04/2023] [Indexed: 11/12/2023]
Abstract
AIM To provide a description of cerebral palsy (CP) registers globally, identify which aim to report on CP epidemiology, and report similarities and differences across topics of importance for the sustainability and collaboration between registers. METHOD Representatives of all known CP registers globally (n = 57) were invited to participate. The online survey included 68 questions across aims, methodologies, output/impact, and stakeholder involvement. Responses were analysed using descriptive statistics. RESULTS Forty-five registers participated, including three register networks. Twenty were newly established or under development, including 12 in low- and middle-income countries (LMICs). An epidemiological aim was reported by 91% of registers. Funding is received by 85% of registers, most often from not-for-profit organizations. CP definitions are comparable across registers. While the minimum data set of a register network is used by most registers, only 25% of identified items are collected by all three register networks. Ninety per cent of registers measure research activities/output, and 64% measure research impact. People with lived experience are involved in 62% of registers. INTERPRETATION There has been a recent surge in CP registers globally, particularly in LMICs, which will improve understanding of CP epidemiology. Ongoing efforts to address identified methodological differences are essential to validate comparison of results and support register collaboration. WHAT THIS PAPER ADDS Cerebral palsy (CP) registers represent an increasing number of regions, including low- and middle-income, worldwide. Most registers collect the minimum data set of a CP register network. Research activities/output and impact are measured by most registers. The majority of registers involve people with lived experience in operation or research.
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Affiliation(s)
- Shona Goldsmith
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia
| | - Hayley Smithers-Sheedy
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia
| | - Nihad Almasri
- Department of Physiotherapy, The University of Jordan, Amman, Jordan
| | - Guro L Andersen
- Norwegian Quality and Surveillance Registry for Cerebral Palsy, Vestfold Hospital Trust, Tønsberg, Norway
| | - Leanne Diviney
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia
| | - Ecaterina Bufteac Gincota
- Republican Rehabilitation Center for Children, Chisinau, Moldova
- State Medical and Pharmaceutical University 'N. Testemitanu', Chisinau, Moldova
| | - Kate Himmelmann
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden
| | - Israt Jahan
- CSF Global, Dhaka, Bangladesh
- Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
- Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, Australia
| | - Emma Waight
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia
| | - Sarah McIntyre
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia
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100
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Conroy S, Gallagher PG. Survey research in perinatal medicine. J Perinatol 2024; 44:771-772. [PMID: 38538912 DOI: 10.1038/s41372-024-01940-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/08/2024] [Accepted: 03/12/2024] [Indexed: 06/09/2024]
Affiliation(s)
- Sara Conroy
- The Ohio Perinatal Research Network, Center for Perinatal Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- Center for Biostatistics, The Ohio State University Wexner Medical Center, Columbus, OH, USA
- Biostatistics Resource at Nationwide Children's Hospital, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Patrick G Gallagher
- Center for Biostatistics, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
- Departments of Pediatrics, Physiology and Cell Biology, Ohio State University, Columbus, OH, USA.
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