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Jacob S, Schust SA, Angele M, Werner J, Guba M, Börner N. A long road ahead. A German national survey study on awareness and willingness of surgeons towards the carbon footprint of modern surgical procedures. Heliyon 2024; 10:e25198. [PMID: 38327395 PMCID: PMC10847866 DOI: 10.1016/j.heliyon.2024.e25198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/09/2024] Open
Abstract
Background Climate change may well be the "largest threat" to humankind. Changes to our climate system lead to a decrease in global health. The healthcare sector presents one of the largest carbon footprints across all industries. Since surgical departments have one of the largest carbon footprints within the healthcare sector, they represent an area with vast opportunities for improvement. To drive change, it is vital to create awareness of these issues and encourage engagement in changes among people working in the healthcare industry. Methods We conducted an anonymous cross-sectional survey study to assess awareness among surgeons regarding the impact of healthcare systems on climate change. The questions were designed to investigate surgeons' willingness to accept and promote changes to reduce carbon footprints. Participants included surgical professionals of all ages and levels of expertise. Results A total of 210 participants completed the survey in full and were included in the evaluation. Sixty percent emphasized a lack of information and the need for personal education. Over 90 % expressed concern for the environment and a strong desire to gain new insights. Provided that clinical performance remains the same, more than 70 % are willing to embrace carbon-friendly alternatives. In this context, all participants accepted the additional time required for training and initially increased personal efforts to achieve equal performance. Conclusion Limited awareness and information about carbon footprints were observed in surgical departments in German hospitals. Nevertheless, the vast majority of surgeons across all age groups are more than willing to acquire new insights and adapt to changes in order to reduce energy consumption and carbon dioxide production.
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Affiliation(s)
- Sven Jacob
- Ludwig-Maximilians-University, Department of General, Visceral and Transplantation Surgery, Munich, Germany
| | - Sophie Anne Schust
- Ludwig-Maximilians-University, Department of General, Visceral and Transplantation Surgery, Munich, Germany
| | - Martin Angele
- Ludwig-Maximilians-University, Department of General, Visceral and Transplantation Surgery, Munich, Germany
| | - Jens Werner
- Ludwig-Maximilians-University, Department of General, Visceral and Transplantation Surgery, Munich, Germany
| | - Markus Guba
- Ludwig-Maximilians-University, Department of General, Visceral and Transplantation Surgery, Munich, Germany
| | - Nikolaus Börner
- Ludwig-Maximilians-University, Department of General, Visceral and Transplantation Surgery, Munich, Germany
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202
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Alnasser A, Abaalkhail A. Digital food behaviours, motivations, and delivery application usage among saudis during COVID-19: A mixed-methods study. Heliyon 2024; 10:e24903. [PMID: 38317926 PMCID: PMC10840008 DOI: 10.1016/j.heliyon.2024.e24903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 01/16/2024] [Accepted: 01/17/2024] [Indexed: 02/07/2024] Open
Abstract
Food delivery apps (FDAs) and smartphones in Saudi Arabia have become ubiquitous and increasingly popular methods for food ordering and consumption. Such app use during the COVID-19 pandemic has become a convenient and popular response to pandemic restrictions. However, the motivations and preferences behind FDA use are complex, as are the perceptions of FDA users regarding nutrition and healthy foods. To explore FDA usage, motivations, perceptions, and food behaviours in the unique cultural context of Saudi Arabia at the intersection of two epidemics, COVID-19 and obesity, a convergent parallel mixed-methods study design was used with 566 Saudis in the quantitative phase and 17 continuing to the qualitative phase. Of the respondents, 71.9 % reported using FDA typically once a week. Frequent FDA usage was reported by 33.3 % of the participants aged 30-40 years (P = .049). Nearly two-thirds of the sample (62 %) reported that time and convenience were the driving factors in using FDAs. Qualitatively, six main themes were identified: 'Perceived benefits and drawbacks', 'Effects of Promotions and Food Preferences', 'Nutritional information and dietary guidelines', 'Concepts of healthy food', 'Obstacles to healthy food consumption', and 'Maintaining Customs and Traditions'. Although convenience and taste were the primary drivers of FDA usage, the roles of tradition and culture in Saudi Arabia were also important FDA usage factors. Overall, understanding the determinants of how Saudis engage with FDAs, in concert with a deeper understanding of food preferences, perceptions, and nutritional knowledge, should help guide future efforts in nutrition education, app development, and public health policy.
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Affiliation(s)
- Aroub Alnasser
- Food Science and Nutrition Dept., College of Food and Agriculture Sciences, King Saud University, Riyadh, 11495, Saudi Arabia
| | - Alreem Abaalkhail
- Food Science and Nutrition Dept., College of Food and Agriculture Sciences, King Saud University, Riyadh, 11495, Saudi Arabia
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203
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Fishman J, O’Connell T, Parrinello CM, Woolley JJ, Bercaw E, Charlton MR. Prevalence of Nonalcoholic Steatohepatitis and Associated Fibrosis Stages Among US Adults Using Imaging-Based vs Biomarker-Based Noninvasive Tests. JOURNAL OF HEALTH ECONOMICS AND OUTCOMES RESEARCH 2024; 11:32-43. [PMID: 38370007 PMCID: PMC10871169 DOI: 10.36469/001c.92223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 01/10/2024] [Indexed: 02/20/2024]
Abstract
Introduction: Nonalcoholic fatty liver disease (NAFLD) is believed to be the most common chronic liver disease worldwide. Therapies are under development for nonalcoholic steatohepatitis (NASH), the progressive form of NAFLD, such that the prevalence of NASH with liver fibrosis, which is likely to require treatment, may be of interest to healthcare decision makers. Noninvasive tests are used in initial screening for NASH, as well as in observational studies of NASH prevalence. However, existing evidence does not address how estimated prevalence varies with different noninvasive tests. This analysis estimated the prevalence of NASH among US adults and assessed variation with different noninvasive tests. Methods: A cross-sectional analysis was conducted using the 2017-March 2020 National Health and Nutrition Examination Survey cycle. Participants with presumed NAFLD (steatosis and without alternative causes of liver disease) were identified, among whom NASH was predicted based on FAST score, Fibrosis-4 (FIB-4), and AST-to-Platelet Ratio Index (APRI) cutoffs across 11 scenarios. Among NASH participants, fibrosis stages were explored based on distribution across the spectrum of liver-stiffness measurements. Results: Among participants with complete data for the analysis (N=6969), prevalence of presumed NAFLD was 25.6%. Within presumed NAFLD, prediction of NASH using imaging-based NIT cutoffs yielded estimated prevalence of 1.3%-4.8% (3.3 million-12.2 million) based on FAST score cutoffs from 0.35-0.67. Using biomarker-based NIT cutoffs yielded estimated prevalence of 0.4%-12.3% (1.0 million-14.5 million) based on FIB-4 cutoffs from 0.90-2.67, and 0.1%-1.9% (0.2-5.0 million) based on APRI cutoffs from 0.50-1.50. Conclusion: Prevalence of NASH among US adults was estimated to range from 1.3% to 4.8% when predicted using imaging-based noninvasive test values for participants with presumed NAFLD, generally aligning with estimates in the literature of prevalence of biopsy-confirmed NASH. Use of biomarker-based noninvasive test values for prediction of NASH yielded a wider range of estimates with FIB-4, and a considerably lower range of estimates with APRI.
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Affiliation(s)
- Jesse Fishman
- Madrigal Pharmaceuticals, West Conshohocken, Pennsylvania, USA
| | | | | | | | - Eric Bercaw
- Medicus Economics, Boston, Massachusetts, USA
| | - Michael R. Charlton
- Center for Liver Diseases, The University of Chicago Medicine, Chicago, Illinois, USA
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Augustin M, Reinders P, Janke TM, Strömer K, von Kiedrowski R, Kirsten N, Zink A, Otten M. Attitudes Toward and Use of eHealth Technologies Among German Dermatologists: Repeated Cross-Sectional Survey in 2019 and 2021. J Med Internet Res 2024; 26:e45817. [PMID: 38345855 PMCID: PMC10897787 DOI: 10.2196/45817] [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: 01/20/2023] [Revised: 06/29/2023] [Accepted: 10/17/2023] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND In recent years, legal and infrastructural conditions have been set to improve the adoption of digital applications in health care in Germany. The impact of these actions was amplified by the COVID-19 pandemic. So far, no studies have confirmed this progress in dermatology. OBJECTIVE The aim of this study was to measure changes in knowledge, interest, expectation, and use of digital applications in health care among dermatologists in Germany in 2019 and 2021. METHODS We administered a repeated cross-sectional survey among dermatologists in medical practices and clinics in Germany at 2 time points: t1 (2019; before the COVID-19 pandemic) and t2 (2021; during the COVID-19 pandemic). We used a standardized questionnaire, including items on respondents' knowledge, interest, expectation, and use of digital applications, as well as their demographics. The survey was distributed by post and email. The data were analyzed descriptively as well as with multiple logistic regressions. RESULTS At t1, 585 (272/571, 47.6% female; mean age 52.4, SD 8.9 years) dermatologists and at t2, 792 (360/736, 48.9% female; mean age 54.3, SD 8.6 years) dermatologists participated in this survey. Interest in digital medicine was higher at t1 than at t2 (381/585, 65.1% vs 458/792, 57.8%; P≤.001). Nevertheless, 38.6% (306/792) had used digital applications more often since the beginning of the pandemic. For example, real-time telemedicine with patients (12/585, 2.1% vs 160/792, 7.6%; P≤.001) and other specialists did increase (33/385, 5.7% vs 181/792, 22.8%; P≤.001). Almost one-third expressed great concerns about digitalization (272/792, 34.3% vs 294/792, 37.1%; P=.21). Spatial analysis revealed higher interest in, more positive expectations toward, and higher use of digital applications in urban areas in comparison to rural areas. For instance, dermatologists from urban areas assessed future applications as having less risk (adjusted odds ratio [aOR] 0.51, 95% CI 0.35-0.76) than did dermatologists from rural areas. The situation was similar with the age groups, as, for example, dermatologists aged <50 years also expected lower risks (aOR 0.51, 95% CI 0.34-0.77) than those aged ≥50 years. There were no differences between sexes in use, but there were differences in knowledge and expectation; for example, male participants assessed their confidence in using digital applications as higher (aOR 1.44, 95% CI 1.01-2.04) than did female participants. CONCLUSIONS During the pandemic, the use of digital applications in dermatology increased but still remained at a moderate level. The regional and age-related disparities identified indicate the need for further action to ensure equal access to digital care.
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Affiliation(s)
- Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Patrick Reinders
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Toni Maria Janke
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | | | | | - Natalia Kirsten
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Alexander Zink
- Department of Dermatology and Allergy, School of Medicine Technical University of Munich, Munich, Germany
| | - Marina Otten
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Khursheed T, Ovseiko P, Dyball S, Nakashima R, Gonzalez AMA, Babini A, Kalla AA, Hill C, Danda D, Dey D, Traboco L, Nikiphorou E, Harifi G, Badshah H, Hmamouchi I, Marie Von Feldt J, Farani JB, Andreoli L, Guimarães MP, Toro Gutiérrez CE, Sieiro Santos C, Duftner C, Alpizar Rodriguez D, Ziadé N, Palominos PE, Haq SA, Bautista-Molano W, Tanaka Y, Gossec L, Agarwal V, Wright GC, Coates L, Gupta L. Coalition for Health and Gender Equity (CHANGE)-a protocol for a global cross-sectional survey of health and gender equity in rheumatology. Rheumatol Adv Pract 2024; 8:rkae021. [PMID: 38560641 PMCID: PMC10980588 DOI: 10.1093/rap/rkae021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 12/31/2023] [Indexed: 04/04/2024] Open
Abstract
Objectives The primary aim of the CHANGE survey is to determine the current state of gender equity within rheumatology, and secondarily, to review the physician perspective on bullying, harassment and equipoise of opportunities within rheumatology. Methods The CHANGE e-survey is a cross-sectional self-reported questionnaire adapted from EULAR's gender equity in academic rheumatology task force. The survey was launched in January 2023; it is available in six languages and distributed widely via rheumatology organizations and social media. Eligible participants include rheumatologist physicians and rheumatology health-care professionals. Survey responses will undergo descriptive analysis and inter-group comparison aiming to explore gender-based discrimination using logistic regression, with subgroup analyses for country/continent variations. Conclusion This e-survey represents a comprehensive global initiative led by an international consortium, aimed at exploring and investigating the gender-related disparities and obstacles encountered by rheumatologists and rheumatology health-care professionals across diverse communities and health-care environments. By pursuing this initiative, we aim to take the broader rheumatology community a step closer to understanding the underlying origins of inequities and their determinants. Such insights are pivotal in identifying viable interventions and strategies to foster gender equity within the field. Ultimately, our collective objective is to ensure equitable access to opportunities for every individual, irrespective of gender, thereby promoting inclusivity and fairness across the entire spectrum of professional practice and career development.
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Affiliation(s)
- Tayyeba Khursheed
- Department of Rheumatology, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | - Pavel Ovseiko
- Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Sarah Dyball
- Centre for Musculoskeletal Research, The University of Manchester, Manchester, UK
| | - Ran Nakashima
- Department of Rheumatology and Clinical Immunology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ana Maria Arredondo Gonzalez
- Colombian Association of Rheumatology, Bogotá, Colombia
- Department of Rheumatology, Faculty of Medicine, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia
| | - Alejandra Babini
- Rheumatology Unit, Hospital Italiano de Cordoba, Cordoba, Argentina
| | - Asgar Ali Kalla
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Catherine Hill
- Rheumatology Unit, The Queen Elizabeth and Royal Adelaide Hospitals, Adelaide, SA, Australia
- Discipline of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Debashish Danda
- Department of Clinical Immunology and Rheumatology, Christian Medical College, Vellore, India
| | - Dzifa Dey
- Rheumatology Unit Department of Medicine and Therapeutics, Korle bu Teaching Hospital, University of Ghana Medical School, Accra, Ghana
| | - Lisa Traboco
- Department of Medicine, Section of Rheumatology, St Luke’s Medical Center-Global City, Taguig, Philippines
| | - Elena Nikiphorou
- Centre for Rheumatic Diseases, King’s College London, London, UK
- Rheumatology Department, King’s College Hospital, London, UK
| | - Ghita Harifi
- Department of Rheumatology, Mediclinic Parkview Hospital, Dubai, United Arab Emirates
- Department of Medicine and Therapeutics, The Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Humeira Badshah
- Dr Humeira Badsha Medical Center, Dubai, United Arab Emirates
| | - Ihsane Hmamouchi
- Clinical Epidemiology, Health Sciences College, International University of Rabat (UIR), Rabat, Morocco
- Department of Rheumatology, Provincial Hospital of Temara, Temara, Morocco
| | | | - Júlia Boechat Farani
- Division of Rheumatology, Hospital Santa Casa de Misericórdia de Juiz de Fora, Juiz de Fora, Brazil
| | - Laura Andreoli
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili di Brescia, Brescia, Italy
| | | | - Carlos Enrique Toro Gutiérrez
- General Director, Reference Center for Osteoporosis, Rheumatology and Dermatology, Pontifica Universidad Javeriana Cali, Cali, Colombia
| | | | - Christina Duftner
- Internal Medicine, Clinical Division of Internal Medicine II, Medizinische Universität Innsbruck, Innsbruck, Austria
| | | | - Nelly Ziadé
- Rheumatology Department, Hôtel-Dieu de France Hospital, Saint Joseph’s University, Beirut, Lebanon
| | | | | | - Wilson Bautista-Molano
- Rheumatology Division, University Hospital Fundación Santa Fé de Bogotá, Bogota, Colombia
- School of Medicine, Universidad El Bosque, Bogotá, Colombia
| | - Yoshiya Tanaka
- First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Laure Gossec
- Sorbonne Université, INSERM, IPLESP, AP-HP, Pitié-Salpetrière Hospital, Paris, France
| | - Vikas Agarwal
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Grace C Wright
- Association of Women in Rheumatology; United Rheumatology, New York, NY, USA
| | - Laura Coates
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Latika Gupta
- Division of Musculoskeletal and Dermatological Sciences, Centre for Musculoskeletal Research, School of Biological Sciences, The University of Manchester, Manchester, UK
- Department of Rheumatology, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
- Department of Rheumatology, City Hospital, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
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206
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Bidonde J, Lauvrak V, Ananthakrishnan A, Kingkaew P, Peacocke EF. Topic identification, selection, and prioritization for health technology assessment in selected countries: a mixed study design. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2024; 22:12. [PMID: 38321468 PMCID: PMC10848436 DOI: 10.1186/s12962-024-00513-8] [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: 08/19/2022] [Accepted: 01/10/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND There is limited evidence-informed guidance on TISP processes for countries where health technology assessment (HTA) is in a nascent phase. We aimed to explore the range of topic identification, selection and prioritization (TISP) processes and practices for HTA in selected countries and identify aspects relevant to emerging HTA systems. METHODS This mixed design study included a systematic literature review, an electronic survey, and individual interviews. We conducted a systematic literature review with criteria that were developed a priori to identify countries deemed to have a recently formalized HTA system. Based on the literature review, a twenty-three item online survey was shared with the identified countries, we completed follow-up interviews with ten participants who have experience with HTA. We analyzed documents, survey responses and interview transcripts thematically to identify lessons related to TISP processes and practices. RESULTS The literature review identified 29 nine candidate countries as having a "potential" recently formalized HTA system. Twenty-one survey responses were analyzed and supplemented with ten individual interviews. We found variation in countries' approaches to TISP - particularly between pharmaceutical and non-pharmaceutical interventions. Results indicate that TISP is heavily driven by policy makers, expert involvement, and to a lesser extent, relevant stakeholders. The use of horizon-scanning and early warning systems is uncommon. Interviewee participants provided further insight to the survey data, reporting that political awareness and an institutional framework were important to support TISP. TISP can be optimized by stronger national regulations and legislative structures, in addition to education and advocacy about HTA among politicians and decision-makers. In some settings regional networks have been useful, particularly in the development of TISP guidelines and methodologies. Additionally, the technical capacity to conduct TISP, and access to relevant local data were factors limiting TISP in national settings. Increased network collaboration and capacity building were reported as future needs. CONCLUSIONS This study provides current insights into a topic where there is limited published peer reviewed literature. TISP is an important first step of HTA, and topics should be selected and prioritized based on local need and relevance. The limited capacity for TISP in settings where HTA is emerging may be supported by local and international collaboration to increase capacity and knowledge. To succeed, both TISP and HTA need to be embedded within national health care priority setting and decision-making. More in-depth understanding of where countries are situtated in formalizing the TISP process may help others to overcome factors that facilitate or hinder progress.
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Affiliation(s)
- Julia Bidonde
- Division of Health Services, Norwegian Institute of Public Health, Skøyen, Postbox 222, 0213, Oslo, Norway
- School of Rehabilitation Science, University of Saskatchewan, Saskatoon, Canada
| | - Vigdis Lauvrak
- Evidence and Health Technology Assessment, EviHTA, Oslo, Norway
| | - Aparna Ananthakrishnan
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand
| | - Pritaporn Kingkaew
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand
| | - Elizabeth F Peacocke
- Division of Health Services, Norwegian Institute of Public Health, Skøyen, Postbox 222, 0213, Oslo, Norway.
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Merovitz-Budning L, Wexler A, Vance J, Dam J, Yan J, Saba N, Coulter L, Lemay JF, Musselman KE, Cheung L. Investigating adaptive sport participation for adults aged 50 years or older with spinal cord injury or disease: A descriptive cross-sectional survey. J Spinal Cord Med 2024:1-20. [PMID: 38315149 DOI: 10.1080/10790268.2024.2304920] [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] [Indexed: 02/07/2024] Open
Abstract
CONTEXT Spinal cord injury or disease (SCI/D) can lead to health challenges that are exacerbated with aging. Adaptive sport is understood to provide health benefits for the SCI/D population. Prior literature investigating adaptive sport in this population pertains to adults with SCI/D who are <50 years of age. However, most Canadians with SCI/D are >50 years of age. OBJECTIVES This study aimed to: (1) Compare demographics of those who do and do not participate in adaptive sport; (2) Describe the characteristics of adaptive sport that adults aged ≥50 years with SCI/D participate in; and (3) Identify barriers and facilitators to adaptive sport participation in this age group. METHODS This descriptive, cross-sectional survey was carried out using an online survey. Analytical statistics were used to address objective one, while descriptive statistics were employed for objectives two and three. PARTICIPANTS Responses from 72 adults aged ≥50 years, residing in Canada, living with a SCI/D for >6 months were included in the analysis. RESULTS Findings revealed that adaptive sport participants aged ≥50 years with SCI/D were more likely to identify as men, be younger individuals (50-59 years), and report greater satisfaction with physical health (P < 0.05). Adaptive sport participants most commonly played individual sports at the recreational level. Common barriers pertained to physical capacity, travel, and COVID-19; common facilitators included social support, desire to improve health, and having friends/peers who also participate. CONCLUSION Future research should investigate strategies to enhance facilitators and mitigate barriers to adaptive sport participation in order to improve access.
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Affiliation(s)
- Lily Merovitz-Budning
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Aaron Wexler
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Jessica Vance
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Jessica Dam
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Jiaqi Yan
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Nadine Saba
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Lee Coulter
- Islanders Sledge Hockey Club, Markham, Canada
| | - Jean-François Lemay
- School of Physical and Occupational Therapy, Faculty of Medicine, Université de Montréal, Montréal, Canada
- CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montréal, Canada
| | - Kristin E Musselman
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Lovisa Cheung
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
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Pawliuk C, Cheng S, Zheng A, Siden HH. Librarian involvement in systematic reviews was associated with higher quality of reported search methods: a cross-sectional survey. J Clin Epidemiol 2024; 166:111237. [PMID: 38072177 DOI: 10.1016/j.jclinepi.2023.111237] [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: 08/11/2023] [Revised: 11/27/2023] [Accepted: 12/04/2023] [Indexed: 01/14/2024]
Abstract
OBJECTIVES Systematic reviews (SRs) are considered the gold standard of evidence, but many published SRs are of poor quality. This study identifies how librarian involvement in SRs is associated with quality-reported methods and examines the lack of motivation for involving a librarian in SRs. STUDY DESIGN AND SETTING We searched databases for SRs that were published by a first or last author affiliated to a Vancouver hospital or biomedical research site and published between 2015 and 2019. Corresponding authors of included SRs were contacted through an e-mail survey to determine if a librarian was involved in the SR. If a librarian was involved in the SR, the survey asked at what level the librarian was involved and if a librarian was not involved, the survey asked why. Quality of reported search methods was scored independently by two reviewers. A linear regression model was used to determine the association between quality of reported search methods scores and the level at which a librarian was involved in the study. RESULTS One hundred ninety one SRs were included in this study and 118 (62%) of the SRs authors indicated whether a librarian was involved in the SR. SRs that included a librarian as a co-author had a 15.4% higher quality assessment score than SRs that did not include a librarian. Most authors (27; 75%) who did not include a librarian in their SR did not do so because they did not believe it was necessary. CONCLUSION Higher level of librarian involvement in SRs is correlated with higher scores in reported search methods. Greater advocacy or changes at the policy level is necessary to increase librarian involvement in SRs and as a result the quality of their search methods.
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Affiliation(s)
- Colleen Pawliuk
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada; BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada.
| | - Shannon Cheng
- Library Services, BC Cancer, Vancouver, British Columbia, Canada
| | - Alex Zheng
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Harold Hal Siden
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada; BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada; Canuck Place Children's Hospice, Vancouver, British Columbia, Canada
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Kelley K, Campbell E, Steiber A, Yakes Jimenez E. Repeated Cross-Sectional Surveys of Registered Dietitian Nutritionists Demonstrate Rapid Practice Changes to Address Food Insecurity During the Coronavirus Disease 2019 Pandemic. J Acad Nutr Diet 2024; 124:268-278.e13. [PMID: 35963532 PMCID: PMC9364914 DOI: 10.1016/j.jand.2022.08.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 07/08/2022] [Accepted: 08/05/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND The coronavirus disease 2019 pandemic had worldwide economic impact, exacerbating food insecurity risk for vulnerable populations. OBJECTIVE To describe changes in practice and challenges and areas of need related to addressing food insecurity during the coronavirus disease 2019 pandemic for registered dietitian nutritionist survey respondents. DESIGN A cross-sectional, anonymous, online survey distributed via the Academy of Nutrition and Dietetics e-mail communication platform and social media accounts from April through May 2020 (Wave 1 [W1]) and December 2020-February 2021 (Wave 2 [W2]). PARTICIPANTS AND SETTING Participants were US-based registered dietitian nutritionists practicing in community-based settings to address food insecurity (W1: n = 454; W2: n = 331). STATISTICAL ANALYSES Responses were descriptively summarized using means ± SD, medians and interquartile ranges, or number of observations and percentages. Open-ended responses were manually reviewed and organized into major themes. RESULTS Respondents had about 10 years of experience in addressing food insecurity and were most commonly involved with the Special Supplemental Nutrition Program for Women, Infants and Children, federal school nutrition programs, or food banks. Participants described increased demand for food security assistance (W1: 68%; W2: 60%). Among respondents involved in food preparation and handling (W1: n = 183; W2: n = 110), supply chain (W1: 61%; W2: 56%) and staffing (W1: 37%; W2: 50%) challenges were commonly reported. Child nutrition program professionals (W1: n = 143; W2: n = 84) reported widespread implementation of optional program waivers, with the most commonly implemented waivers allowing noncongregate meal service (W1: 83%; W2: 81%), caregivers to pick up meals (W1: 69%; W2: 85%), and flexibility in mealservice times (W1: 75%; W2: 87%). CONCLUSIONS Respondents quickly adapted programs to ensure staff and client safety while continuing to provide essential food security services. They identified the need for ongoing nutrition program policy advocacy and timely access to best practice resources during public health emergencies.
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Affiliation(s)
- Kathryn Kelley
- Nutrition Research Network, Research, International, and Scientific Affairs, Academy of Nutrition and Dietetics, Chicago, Illinois.
| | - Elizabeth Campbell
- Legislative and Government Affairs, Academy of Nutrition and Dietetics, Chicago, Illinois
| | - Alison Steiber
- Research, International, and Scientific Affairs, Academy of Nutrition and Dietetics, Chicago, Illinois
| | - Elizabeth Yakes Jimenez
- Nutrition Research Network, Research, International, and Scientific Affairs, Academy of Nutrition and Dietetics, Chicago, Illinois; Department of Pediatrics and Internal Medicine and College of Population Health, University of New Mexico Health Sciences Center, Albuquerque, New Mexico
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Scodras S, Yeung E, Colquhoun H, Jaglal SB, Salbach NM. Pelvic Health Content in Canadian Entry-To-Practice Physiotherapy Programs: An Online Survey. Physiother Can 2024; 76:25-33. [PMID: 38465315 PMCID: PMC10919374 DOI: 10.3138/ptc-2023-0030] [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: 05/01/2023] [Revised: 07/10/2023] [Accepted: 07/27/2023] [Indexed: 03/12/2024]
Abstract
Purpose Pelvic health physiotherapy is an emerging and sensitive area of practice that offers effective conservative treatment for pelvic health conditions. Canadian entry-to-practice curriculum guidelines accord programs considerable flexibility regarding incorporating pelvic health content, which may lead to differences between programs and diverse levels of competence among new graduates. The purpose of this study was to determine the nature and extent to which pelvic health content is incorporated in entry-to-practice physiotherapy programs in Canada. Method We conducted a descriptive cross-sectional e-survey of representatives from Canadian entry-to-practice physiotherapy programs. Results Ten out of 15 Canadian programs participated. Programs incorporated pelvic health content throughout the required curriculum (n = 9) and in optional courses (n = 6). All participating programs covered musculoskeletal-related conditions, urinary incontinence, and pelvic pain conditions, and included anatomy and physiology, clinical reasoning, subjective assessment and pelvic floor muscle training topics. Three programs trained students in internal pelvic floor techniques in elective courses. All programs covered cisgender women populations, however, transgender populations were seldom covered. Conclusions This study provides an understanding of pelvic health curricular content that can serve as a first step towards standardizing and improving entry-level pelvic health training in Canada.
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Affiliation(s)
- Stephanie Scodras
- From the:
Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Euson Yeung
- From the:
Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Heather Colquhoun
- From the:
Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Susan B. Jaglal
- From the:
Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- The KITE Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Nancy M. Salbach
- From the:
Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- The KITE Research Institute, University Health Network, Toronto, Ontario, Canada
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Mc Carthy L, Mathew B, Blank LJ, Van Hyfte G, Gotlieb E, Goldstein J, Agarwal P, Kwon CS, Singh A, Fields M, Marcuse L, Yoo JY, Sivarak E, Gururangan K, Navis A, Jetté N. Health care access, psychosocial outcomes and mental health in adults living with epilepsy during the COVID-19 pandemic. Epilepsy Behav 2024; 151:109617. [PMID: 38219607 DOI: 10.1016/j.yebeh.2023.109617] [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: 09/16/2023] [Revised: 12/01/2023] [Accepted: 12/27/2023] [Indexed: 01/16/2024]
Abstract
PURPOSE People living with epilepsy (PLWE) have a higher prevalence of mental health comorbidities and poorer psychosocial outcomes compared to the general population. The aim of this study was to examine psychosocial outcomes, mental health, healthcare accessibility, and seizure burden in PLWE during the COVID-19 pandemic. METHODS We conducted a cross-sectional study of adults with epilepsy treated in an urban multicenter health system from 2021 to 2022. A standardized questionnaire assessed for COVID-19 history, comorbidities, access to antiseizure medications (ASMs) and neurological care, seizure burden, and psychosocial outcomes (e.g., employment, social and financial support). The Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were administered to evaluate for depression and anxiety. Frequency and proportions for categorical variables and median and interquartile ranges for continuous variables were calculated. RESULTS Fifty-five PLWE participated (95 % response rate). Median age was 40 years (IQR 31.5-66.5), 61.8 % were women, 47.3 % had a bachelor's degree or higher and 29.1 % each had Medicaid and Medicare insurance. Race (from highest to lowest %) was: 32.7 % White, 20 % Black, 20 % Latinx, 14.5 % Asian, and 12.7 % selected "other" or "prefer not to say." COVID-19 had been diagnosed in 21.8 % of participants. Symptoms of anxiety and depression were self-reported by 43.6 % and 34.5 % of patients, respectively, with many describing this symptom as new post-pandemic (37.5 % and 31.6 %, respectively). Using validated scales, 52.7 % had depression (PHQ-9 score ≥ 5) with 30.9 % having moderate/severe depression (PHQ-9 score ≥ 10), while 29.1 % had probable generalized anxiety disorder (GAD-7 score ≥ 8). Seizure burden increased in 21.8 % of participants, while 20 % reported fewer seizures and 29.1 % were seizure free since the COVID-19 pandemic. Economic impacts of the pandemic included job loss (25 % amongst those employed at onset of pandemic), new or worsened financial difficulties (40 %), and new or worsened social support issues (30.9 %). Of all participants, 18.2 % reported difficulties accessing ASMs and 25.5 % cancelled visits, but of those with cancelled visits, 78.6 % had their appointments rescheduled as a telehealth visit. CONCLUSION Our cohort of PLWE experienced some challenges during the COVID-19 pandemic including poorer mental health and financial and employment-related stressors. Encouragingly, healthcare access was relatively spared during the COVID-19 crisis, with some patients even reporting a reduction in seizure burden. However, PLWE require ongoing psychosocial support with particular attention to decompensation of mental health and social stressors that may be exacerbated by the COVID-19 pandemic.
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Affiliation(s)
- L Mc Carthy
- Department of Neurology, Icahn school of Medicine at Mount Sinai, New York, NY, USA
| | - B Mathew
- Department of Neurology, Icahn school of Medicine at Mount Sinai, New York, NY, USA
| | - L J Blank
- Department of Neurology, Icahn school of Medicine at Mount Sinai, New York, NY, USA; Institute for Healthcare Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - G Van Hyfte
- Institute for Healthcare Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - E Gotlieb
- Department of Neurology, Icahn school of Medicine at Mount Sinai, New York, NY, USA
| | - J Goldstein
- Department of Neurology, Icahn school of Medicine at Mount Sinai, New York, NY, USA
| | - P Agarwal
- Department of Neurology, Icahn school of Medicine at Mount Sinai, New York, NY, USA; Institute for Healthcare Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - C S Kwon
- Department of Neurology, Icahn school of Medicine at Mount Sinai, New York, NY, USA; Department of Neurosurgery, Icahn school of Medicine at Mount Sinai, New York, NY, USA
| | - A Singh
- Department of Neurology, Icahn school of Medicine at Mount Sinai, New York, NY, USA
| | - M Fields
- Department of Neurology, Icahn school of Medicine at Mount Sinai, New York, NY, USA
| | - L Marcuse
- Department of Neurology, Icahn school of Medicine at Mount Sinai, New York, NY, USA
| | - J Y Yoo
- Department of Neurology, Icahn school of Medicine at Mount Sinai, New York, NY, USA
| | - E Sivarak
- Department of Neurology, Icahn school of Medicine at Mount Sinai, New York, NY, USA
| | - K Gururangan
- Department of Neurology, Icahn school of Medicine at Mount Sinai, New York, NY, USA
| | - A Navis
- Department of Neurology, Icahn school of Medicine at Mount Sinai, New York, NY, USA
| | - N Jetté
- Department of Clinical Neurosciences, Calgary Zone, Alberta Health Services, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 2T9, Canada.
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Brady A, Hughes E, Besharatian Y, Tan T, Popivanov P. Postnatal recall of epidural information compared between patients who attended an anaesthesiologist-led virtual antenatal epidural class and those who did not: A single-centre, cross-sectional survey. Eur J Anaesthesiol 2024; 41:148-150. [PMID: 37431290 DOI: 10.1097/eja.0000000000001878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Affiliation(s)
- Aoife Brady
- From the Department of Perioperative Medicine, Coombe Women & Infants University Hospital, Dublin, Ireland (AB, EH, YB, TT, PP)
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Hill J, Chuko J, Ogle K, Gottlieb M, Santen SA, Artino AR. Best practices for reporting survey-based research. AEM EDUCATION AND TRAINING 2024; 8:e10929. [PMID: 38504803 PMCID: PMC10950005 DOI: 10.1002/aet2.10929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 10/03/2023] [Accepted: 10/18/2023] [Indexed: 03/21/2024]
Affiliation(s)
| | | | - Kathleen Ogle
- George Washington University School of Medicine and Health SciencesWashingtonDCUSA
| | | | - Sally A. Santen
- University of Cincinnati College of MedicineCincinnatiOhioUSA
- Virginia Commonwealth University School of MedicineRichmondVirginiaUSA
| | - Anthony R. Artino
- George Washington University School of Medicine and Health SciencesWashingtonDCUSA
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Krutikov M, Stirrup O, Fuller C, Adams N, Azmi B, Irwin-Singer A, Sethu N, Hayward A, Altamirano H, Copas A, Shallcross L. Built Environment and SARS-CoV-2 Transmission in Long-Term Care Facilities: Cross-Sectional Survey and Data Linkage. J Am Med Dir Assoc 2024; 25:304-313.e11. [PMID: 38065220 PMCID: PMC11139658 DOI: 10.1016/j.jamda.2023.10.027] [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: 07/20/2023] [Revised: 10/27/2023] [Accepted: 10/27/2023] [Indexed: 12/25/2023]
Abstract
OBJECTIVES To describe the built environment in long-term care facilities (LTCF) and its association with introduction and transmission of SARS-CoV-2 infection. DESIGN Cross-sectional survey with linkage to routine surveillance data. SETTING AND PARTICIPANTS LTCFs in England caring for adults ≥65 years old, participating in the VIVALDI study (ISRCTN14447421) were eligible. Data were included from residents and staff. METHODS Cross-sectional survey of the LTCF built environment with linkage to routinely collected asymptomatic and symptomatic SARS-CoV-2 testing and vaccination data between September 1, 2020, and March 31, 2022. We used individual and LTCF level Poisson and Negative Binomial regression models to identify risk factors for 4 outcomes: incidence rate of resident infections and outbreaks, outbreak size, and duration. We considered interactions with variant transmissibility (pre vs post Omicron dominance). RESULTS A total of 134 of 151 (88.7%) LTCFs participated in the survey, contributing data for 13,010 residents and 17,766 staff. After adjustment and stratification, outbreak incidence (measuring infection introduction) was only associated with SARS-CoV-2 incidence in the community [incidence rate ratio (IRR) for high vs low incidence, 2.84; 95% CI, 1.85-4.36]. Characteristics of the built environment were associated with transmission outcomes and differed by variant transmissibility. For resident infection incidence, factors included number of storeys (0.64; 0.43-0.97) and bedrooms (1.04; 1.02-1.06), and purpose-built vs converted buildings (1.99; 1.08-3.69). Air quality was associated with outbreak size (dry vs just right 1.46; 1.00-2.13). Funding model (0.99; 0.99-1.00), crowding (0.98; 0.96-0.99), and bedroom temperature (1.15; 1.01-1.32) were associated with outbreak duration. CONCLUSIONS AND IMPLICATIONS We describe previously undocumented diversity in LTCF built environments. LTCFs have limited opportunities to prevent SARS-CoV-2 introduction, which was only driven by community incidence. However, adjusting the built environment, for example by isolating infected residents or improving airflow, may reduce transmission, although data quality was limited by subjectivity. Identifying LTCF built environment modifications that prevent infection transmission should be a research priority.
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Affiliation(s)
- Maria Krutikov
- Institute of Health Informatics, University College London, London, UK.
| | - Oliver Stirrup
- Institute for Global Health, University College London, London, UK
| | - Chris Fuller
- Institute of Health Informatics, University College London, London, UK
| | - Natalie Adams
- Institute of Health Informatics, University College London, London, UK
| | - Borscha Azmi
- Institute of Health Informatics, University College London, London, UK
| | - Aidan Irwin-Singer
- Surveillance Testing and Immunity, UK Health Security Agency, London, UK
| | - Niyathi Sethu
- Institute for Environmental Design and Engineering, University College London, London, UK
| | - Andrew Hayward
- Institute of Epidemiology and Health Care, University College London, London, UK
| | - Hector Altamirano
- Institute for Environmental Design and Engineering, University College London, London, UK
| | - Andrew Copas
- Institute for Global Health, University College London, London, UK
| | - Laura Shallcross
- Institute of Health Informatics, University College London, London, UK
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Iliff HA, Baxter A, Chakladar A, Endlich Y, McGuire B, Peyton J. Airway topicalization in pediatric anesthesia: An international cross-sectional study. Paediatr Anaesth 2024; 34:145-152. [PMID: 37818989 DOI: 10.1111/pan.14783] [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: 06/13/2023] [Revised: 09/17/2023] [Accepted: 09/21/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND There is no national or international consensus or guideline on recommended dosing of lidocaine for airway topicalization in children. Doses quoted in the literature vary substantially. AIMS The primary aim of the study was to ascertain current international dosing practices (mg.kg-1 and concentration of solution) for lidocaine airway topicalization in children. The secondary aims included examining aftercare instructions for those receiving lidocaine airway topicalization and instances of local anesthetic systemic toxicity secondary to the use of lidocaine for airway topicalization in pediatric patients. METHODS This cross-sectional study consisted of 11-20 questions across three domains-population demographics, clinical practice, and local anesthetic systemic toxicity. It adhered to the consensus-based checklist for reporting of survey studies. Responses were collected over 14 weeks using a combination of probability (cluster and simple random) and nonprobability (purposive, convenience and snowball) sampling. Data were analyzed based on the response rate per question with proportions expressed as percentages and nonparametric data expressed as median (interquartile range [range]) in an effort to minimize nonresponse error. No weighting of items or propensity scoring was applied. RESULTS After initial exclusions, 1501 participants from 69 countries, across six continents, were included. Consultant anesthetists or those with an equivalent level of experience accounted for 1262/1501 (84.1%) of responses. Results showed heterogeneity in dosing and timing regimens and evidence that dosing may contribute to adverse outcomes. The maximum dose reported by participants who use lidocaine for airway topicalization as part of their normal practice was 5 mg.kg-1 (4-6 mg.kg-1 [0.5-50]) median (interquartile range [range]) over 2 h (1-4 h [0-30]). CONCLUSION The results support the need for further research and consensus in this area, in order to provide safe provision of lidocaine airway topicalization in children. It is hoped the results of this study can support future collaborative work in this area.
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Affiliation(s)
- H A Iliff
- Department of Anaesthesia, Cardiff and Vale University Health Board, Cardiff, UK
- Health Education and Improvement Wales, Cardiff, UK
| | - A Baxter
- Department of Anaesthesia, Royal Hospital for Children and Young People, Edinburgh, UK
| | - A Chakladar
- Department of Anaesthesia, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | - Y Endlich
- Department of Anaesthesia, Royal Adelaide Women's and Children's Hospital, South Australia, Adelaide, Australia
| | - B McGuire
- Department of Anaesthesia, Ninewells Hospital, Dundee, UK
| | - J Peyton
- Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
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Ananda RA, Gwini SM, Long KM, Lai JH, Chen G, Russell GM, Stowasser M, Fuller PJ, Yang J. Diagnostic Delay and Disease Burden in Primary Aldosteronism: An International Patient Survey. Hypertension 2024; 81:348-360. [PMID: 38095087 DOI: 10.1161/hypertensionaha.123.21965] [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: 08/24/2023] [Accepted: 11/14/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND Primary aldosteronism (PA) is a common but underdiagnosed cause of hypertension. Many patients experience preventable end-organ injury due to delayed or missed diagnosis but data on the experience of patients are limited. METHODS We evaluated the lived experience of PA and determines factors associated with diagnostic delay through an international anonymous online cross-sectional survey, codesigned by researchers and PA consumers. We distributed the survey through academic medical centers, Amazon Mechanical Turk, Twitter, PA patient advocacy groups, and hypertension support groups on Facebook between March 21 and June 5, 2022. RESULTS Of 684 eligible respondents, 66.5% were women. Diagnostic delay (defined as ≥5 years between the diagnosis of hypertension and PA) was reported in 35.6%. Delay was more likely in women than in men (odds ratio, 1.55 [95% CI, 1.10-2.20]) and respondents with ≥3 comorbidities versus none (odds ratio, 1.77 [95% CI, 1.05-3.02]), ≥10 symptoms versus none (odds ratio, 2.73 [95% CI, 1.74-4.44]), and on ≥4 antihypertensive medications versus none (odds ratio, 18.23 [95% CI, 6.24-77.72]). Three-quarters of patients (74.4%) experienced reduced symptom burden following targeted PA treatment. Quality of life improved in 62.3% of patients, and greater improvement was associated with being a woman (odds ratio, 1.42, [95% CI, 1.02-1.97]), receiving adrenalectomy (odds ratio, 2.36 [95% CI, 1.67-3.35]), and taking fewer antihypertensive medications following diagnosis (odds ratio, 5.28 [95% CI, 3.55-7.90]). CONCLUSIONS One-third of patients with PA experienced prolonged diagnostic delays. Targeted treatment led to reduced symptom burden and improved quality of life. Gender differences in diagnostic delay and symptom burden are prominent. These findings suggest that routine screening for PA at the onset of hypertension may reduce diagnostic delay and facilitate timely diagnosis.
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Affiliation(s)
- Roshan A Ananda
- Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, VIC, Australia (R.A.A., J.H.L., P.J.F., J.Y.)
- School of Public Health, Imperial College London, United Kingdom (R.A.A.)
| | - Stella May Gwini
- School of Public Health and Preventive Medicine Monash University, Melbourne, VIC, Australia (S.M.G.)
- Department of Biostatistics, University Hospital Geelong, Barwon Health, VIC, Australia (S.M.G.)
| | - Katrina M Long
- National Centre for Healthy Ageing, Frankston, VIC, Australia (K.M.L.)
| | - Jordan H Lai
- Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, VIC, Australia (R.A.A., J.H.L., P.J.F., J.Y.)
| | - Gang Chen
- School of Primary and Allied Health Care (K.M.L.), Centre for Health Economics, Monash Business School (G.C.), Monash University, Frankston, VIC, Australia
| | - Grant M Russell
- Department of General Practice (G.M.R.), Monash University, Frankston, VIC, Australia
| | - Michael Stowasser
- Endocrine Hypertension Research Centre, University of Queensland, Brisbane, QLD, Australia (M.S.)
| | - Peter J Fuller
- Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, VIC, Australia (R.A.A., J.H.L., P.J.F., J.Y.)
- Department of Endocrinology, Monash Health, Clayton, VIC, Australia (P.J.F., J.Y.)
| | - Jun Yang
- Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, VIC, Australia (R.A.A., J.H.L., P.J.F., J.Y.)
- Department of Endocrinology, Monash Health, Clayton, VIC, Australia (P.J.F., J.Y.)
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Fleming J, Prescott S, Claridge L, Doig E, Copley A, Finch E, Kerr C, Henry J. Capacity building for providers of cognitive rehabilitation in Queensland: a needs analysis survey. BRAIN IMPAIR 2024; 25:IB23062. [PMID: 38566286 DOI: 10.1071/ib23062] [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: 06/07/2023] [Accepted: 01/28/2024] [Indexed: 04/04/2024]
Abstract
Background Cognitive rehabilitation of people with traumatic brain injury is a complex and challenging area of practice. Practitioners working in cognitive rehabilitation require ongoing training to stay abreast of new research and best practice interventions. A needs analysis was conducted to inform the development of a capacity building program for cognitive rehabilitation providers. Methods A cross-sectional online survey of providers of cognitive rehabilitation services in Queensland collected data on demographic information, perceptions of knowledge, skills and confidence in cognitive rehabilitation, previously completed training, desired training opportunities and delivery methods, and barriers and facilitators to engaging in training. Results The 103 respondents included 67 occupational therapists, 17 speech pathologists, 12 psychologists and seven social workers with a broad range of practice experience. Participants perceived a need for further training, with executive function and functional cognition the most desired topics. The number of topics previously trained on was significantly correlated with levels of knowledge, skills and confidence (P Conclusion Cognitive rehabilitation providers in Queensland reported a need for further training, delivered flexibly, with a focus on managing complex cognitive impairments.
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Affiliation(s)
- Jennifer Fleming
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Sarah Prescott
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Larissa Claridge
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Emmah Doig
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia; and Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Health, Brisbane, Australia
| | - Anna Copley
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Emma Finch
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia; and Speech Pathology, Princess Alexandra Hospital, Brisbane, Qld, Australia; and Research and Innovation, West Moreton Health, Ipswich, Qld, Australia
| | | | - Julie Henry
- School of Psychology, The University of Queensland, Brisbane, Australia
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Hamilton DG, Page MJ, Everitt S, Fraser H, Fidler F. Cancer researchers' experiences with and perceptions of research data sharing: Results of a cross-sectional survey. Account Res 2024:1-28. [PMID: 38299475 DOI: 10.1080/08989621.2024.2308606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 01/18/2024] [Indexed: 02/02/2024]
Abstract
BACKGROUND Despite wide recognition of the benefits of sharing research data, public availability rates have not increased substantially in oncology or medicine more broadly over the last decade. METHODS We surveyed 285 cancer researchers to determine their prior experience with sharing data and views on known drivers and inhibitors. RESULTS We found that 45% of respondents had shared some data from their most recent empirical publication, with respondents who typically studied non-human research participants, or routinely worked with human genomic data, more likely to share than those who did not. A third of respondents added that they had previously shared data privately, with 74% indicating that doing so had also led to authorship opportunities or future collaborations for them. Journal and funder policies were reported to be the biggest general drivers toward sharing, whereas commercial interests, agreements with industrial sponsors and institutional policies were the biggest prohibitors. We show that researchers' decisions about whether to share data are also likely to be influenced by participants' desires. CONCLUSIONS Our survey suggests that increased promotion and support by research institutions, alongside greater championing of data sharing by journals and funders, may motivate more researchers in oncology to share their data.
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Affiliation(s)
- Daniel G Hamilton
- MetaMelb Research Group, School of BioSciences, University of Melbourne, Melbourne, Australia
- Melbourne Medical School, Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, Melbourne, Australia
| | - Matthew J Page
- Methods in Evidence Synthesis Unit, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Sarah Everitt
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - Hannah Fraser
- MetaMelb Research Group, School of BioSciences, University of Melbourne, Melbourne, Australia
| | - Fiona Fidler
- MetaMelb Research Group, School of BioSciences, University of Melbourne, Melbourne, Australia
- School of History & Philosophy of Sciences, University of Melbourne, Melbourne, Australia
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Patel R, Bannister SL, Degelman E, Sharma T, Beran TN, Lewis M, Novak C. Online Learning in Medical Student Clerkship: A Survey of Student Perceptions and Future Directions. Cureus 2024; 16:e54541. [PMID: 38516469 PMCID: PMC10956628 DOI: 10.7759/cureus.54541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2024] [Indexed: 03/23/2024] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic had a major impact on medical education with clerkship students abruptly removed from clinical activities in 2020 and hastily immersed in online learning to maintain medical education. In 2022, students returned to in-person clinical experiences, but synchronous learning sessions continued online with extensive use of asynchronous online resources. This change offers a unique opportunity to gather information about students' perspectives regarding the acceptability and effectiveness of online learning strategies. This study aims to explore the clerkship student experience with the integration of online learning and in-person learning into formalized educational sessions in clerkship. Methodology The authors administered an online survey to clerkship students at the Cumming School of Medicine at the University of Calgary, Canada in spring 2022. The survey consisted of primarily Likert-style questions to explore the perceived effectiveness of various online learning strategies. Results are reported as the proportion selecting "quite effective" or "extremely effective." Results A total of 89 students responded to the survey (57.4% of graduating class). For synchronous online learning, case-based learning was perceived as the most effective teaching strategy (61.8%), and audience response systems were the most effective strategy for improving audience engagement (70.1%). For asynchronous online learning, interactive cases (84.9%) and student-developed online study guides (83.6%) were perceived as the most effective. Students held varying perceptions regarding how online learning impacted their well-being. When considering future clerkship curricula, the majority of clerkship students preferred a blend of in-person and online learning. Conclusions This study identified that most clerkship students prefer a hybrid of in-person and online learning and that ideal online learning curricula could include case-based learning, audience response systems, and a variety of asynchronous learning resources. These results can guide curriculum development and design at other medical institutions.
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Affiliation(s)
- Rina Patel
- Postgraduate Medical Education, University of Calgary, Calgary, CAN
| | | | - Erin Degelman
- Postgraduate Medical Education, University of Calgary, Calgary, CAN
| | - Tejeswin Sharma
- Postgraduate Medical Education, University of Manitoba, Winnipeg, CAN
| | - Tanya N Beran
- Community Health Sciences, University of Calgary, Calgary, CAN
| | | | - Chris Novak
- Pediatrics, University of Calgary, Calgary, CAN
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Haneef Z, Patel K, Nguyen A, Kayal G, Martini SR, Sullivan-Baca E. Epilepsy surgery perceptions among general neurologists and epilepsy specialists: A survey. Clin Neurol Neurosurg 2024; 237:108151. [PMID: 38340429 DOI: 10.1016/j.clineuro.2024.108151] [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: 10/11/2023] [Accepted: 01/29/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVE Surgical intervention for drug-resistant epilepsy (DRE) is a safe and efficacious evidence-based treatment. Yet, neurologists have historically revealed hesitance in referring patients for surgical evaluations. The present study surveyed general neurologists and epilepsy specialists to assess their views and process in referring patients for specialized epilepsy care and epilepsy surgery. METHODS A 14-item survey assessing epilepsy referrals and views of epilepsy surgery was distributed to all neurologists currently practicing in a large national integrated health system using REDCap. Responses were qualitatively analyzed and differences between general neurologists and epileptologists were assessed using chi-squared tests. RESULTS In total, 100 responses were received from 67 general neurologists and 33 epileptologists with several similarities and differences emerging between the two groups. Both groups endorsed surgery and neuromodulation as treatment options in DRE, felt that seizure frequency rather than duration was relevant in considering epilepsy surgery, and indicated patient preference as the largest barrier limiting epilepsy surgery. General neurologists were more likely to require ≥ 3 ASMs to fail to diagnose DRE compared to epileptologists (45% vs. 15%, p < 0.01) who more often required ≥ 2 ASMs to fail. Epileptologists were also more likely than neurologists to try a new ASM (75.8% vs. 53.7%, p < 0.05) or optimize the current ASM (75.8% vs. 49.3%, p < 0.05) in DRE. General neurologists were more likely to consider epilepsy surgery to be less efficacious (p = 0.001) or less safe (p < 0.05). SIGNIFICANCE Overall, neurologists appear to have generally positive opinions of epilepsy surgery, which is a change from prior literature and represents a changing landscape of views toward this intervention. Furthermore, epileptologists and general neurologists endorsed more similarities than differences in their opinions of surgery and steps to referral, which is another encouraging finding. Those gaps that remain between epileptologists and general neurologists, particularly in standards of ASM prescription, may be addressed by more consistent education about DRE and streamlining of surgical referral procedures.
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Affiliation(s)
- Zulfi Haneef
- Epilepsy Centers of Excellence, Veteran's Health Administration, USA; Department of Neurology, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA; Neurology Care Line, Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd, Houston, TX 77030, USA.
| | - Kamakshi Patel
- Department of Neurology, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA; Neurology Care Line, Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd, Houston, TX 77030, USA
| | - Angela Nguyen
- University of Houston, 4800 Calhoun Road, Houston, TX 77204, USA
| | - Gina Kayal
- Department of Neurology, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA; Neurology Care Line, Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd, Houston, TX 77030, USA
| | - Sharyl R Martini
- Department of Neurology, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA; Neurology Care Line, Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd, Houston, TX 77030, USA
| | - Erin Sullivan-Baca
- Department of Neurology, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA; Neurology Care Line, Michael E. DeBakey VA Medical Center, 2002 Holcombe Blvd, Houston, TX 77030, USA
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Boisselier Q, Pinar U, Durand X, Tabourin T, Salin A, Baboudjian M, Murez T, Roupret M, Pradère B. Patients and general practitioner knowledge and perception of testicular self-examination for cancer. World J Urol 2024; 42:58. [PMID: 38279983 DOI: 10.1007/s00345-023-04707-2] [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: 04/05/2023] [Accepted: 10/22/2023] [Indexed: 01/29/2024] Open
Abstract
PURPOSE Testicular cancer (TC) predominantly affects young men and early detection enhances survival. However, uncertainty surrounds the impact of population-wide screening. Testicular self-examination (TSE) is a simple detection method but there is a gap in current practices that needs to be assessed. Our goal was to assess the perceptions and knowledge of male subjects in the general population (MP) and general practitioners (GPs) regarding TSE for TC. METHODS Two distinct surveys evaluating knowledge and perceptions of TSE for TC were administered to GPs and MP, aged 15‒45-years. Factors that could favour the realisation of TSE or improve the knowledge of TC were evaluated by multivariable logistic regression. RESULTS Overall, 1048 GPs (mean (SD) age: 35.1 ± 10.3 years) and 1032 MP (mean (SD) age: 27 ± 8.2 years) answered the survey. Among the GPs, only 93 (8.9%) performed scrotal examination for TC screening. Although the majority (n = 993, 94.8%) were aware of the age of onset of TC, most (n = 768, 73.3%) did not know the overall survival rate from TC. GPs familiar with the guidelines were more likely to explain TSE to their patients (OR = 2.5 [95% CI 1.5‒4.1]; p < 0.01). Among the MP, 800 (77.5%) admitted that they did not know how to perform TSE and 486 (47.1%) did not know the main symptoms associated with TC. MP who had already undergone TC screening were more likely to be familiar with the main symptoms (OR = 2.1 [95% CI 1.6‒2.7]; p < 0.001) and MP who knew someone with TC or who had already undergone TC screening were more likely to be aware of the correct prevalence of TC (OR = 1.9 [95% CI 1.3‒2.7], p < 0.01; and OR = 1.6 [95% CI 1.2‒2.1], p < 0.01; respectively). CONCLUSION The knowledge of both GPs and MP regarding TC could be improved. TSE screening and knowing someone close with TC improved the awareness of our subjects.
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Affiliation(s)
| | - Ugo Pinar
- GRC n°5, Predictive Onco-Urology, APHP, Sorbonne University, Hôpital Pitié-Salpêtrière, Urology, 75013, Paris, France
| | - Xavier Durand
- Urology Department, Hôpital Saint-Joseph, Paris, France
| | - Thomas Tabourin
- GRC n°5, Predictive Onco-Urology, APHP, Sorbonne University, Hôpital Pitié-Salpêtrière, Urology, 75013, Paris, France
| | - Ambroise Salin
- Department of Urology, La Croix du Sud Hospital, 31130, Quint Fonsegrives, France
| | - Michael Baboudjian
- Department of Urology, North Hospital, Aix-Marseille University, APHM, Marseille, France
| | - Thibaut Murez
- Urology and Renal Transplantation Department, CHU Lapeyronie, Montpellier, France
| | - Morgan Roupret
- GRC n°5, Predictive Onco-Urology, APHP, Sorbonne University, Hôpital Pitié-Salpêtrière, Urology, 75013, Paris, France
| | - Benjamin Pradère
- Department of Urology, La Croix du Sud Hospital, 31130, Quint Fonsegrives, France.
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Sawadogo A, Sogbossi ES, Everard GJ, Kpadonou T, Batcho CS. Use of standardised outcome measures among physiotherapists in French-speaking sub-Saharan Africa. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2024; 80:1981. [PMID: 38322653 PMCID: PMC10839157 DOI: 10.4102/sajp.v80i1.1981] [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: 08/30/2023] [Accepted: 10/19/2023] [Indexed: 02/08/2024] Open
Abstract
Background The use of standardised assessment tools is a fundamental aspect of good clinical practice. However, to our knowledge, no study has documented the use of standardised assessment tools in physiotherapy in French-speaking sub-Saharan Africa. Objectives Documenting the use of standardised outcome measures in physiotherapy in French-speaking sub-Saharan Africa. Method Our cross-sectional survey used an online self-questionnaire on facilitators and barriers to the use of standardised outcome measures, distributed to physiotherapists in French-speaking sub-Saharan Africa. Results A total of 241 physiotherapists working in French-speaking sub-Saharan Africa responded to the survey. The most represented countries were Benin (36.9%), Cameroon (14.1%), and Burkina Faso (10.8%). Although 99% of participants reported using standardised outcome measures, only 27% of the respondents used them systematically (all the time). The most reported facilitators included the recognition that standardised outcome measures help to determine whether treatment is effective, help to guide care, and improve communication with patients. The most significant barriers were the lack of time, unavailability of the standardised outcome measures, and non-sensitivity of measures to patients' cultural and ethnic concerns. There was a higher proportion of use in the middle age group (30-40) (p = 0.02) and a lower proportion of use in physiotherapists simultaneously working in public and private sectors (p = 0.05). Conclusion Standardised outcome measures are still not widely used by physiotherapists in French-speaking sub-Saharan Africa. Clinical implications The perceived barriers and facilitators could help to develop strategies to improve the systematic use of outcome measures in French-speaking sub-Saharan Africa.
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Affiliation(s)
- Abdoulaye Sawadogo
- School of Physiotherapy, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
| | - Emmanuel Segnon Sogbossi
- School of Physiotherapy, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
- University Clinic of Physical Medicine and Rehabilitation, Centre National Hospitalier Universitaire Hubert Koutoukou MAGA, Cotonou, Benin
| | - Gauthier J. Everard
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec, Canada
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, Université Laval, Quebec, Canada
- Department of Neuro Musculo Skeletal Lab, Institut de Recherche Expérimentale et Clinique, Secteur des Sciences de la Santé, UCLouvain, Brussels, Belgium
| | - Toussaint Kpadonou
- University Clinic of Physical Medicine and Rehabilitation, Centre National Hospitalier Universitaire Hubert Koutoukou MAGA, Cotonou, Benin
| | - Charles Sèbiyo Batcho
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec, Canada
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, Université Laval, Quebec, Canada
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Kadakia Z, Lansang RP, Ball P, Kuspinar A, VanderKaay S, Packham T. Reliability, validity and responsiveness of composite finger flexion in patients with traumatic hand injuries: A clinical measurement study. J Hand Ther 2024:S0894-1130(23)00175-8. [PMID: 38278698 DOI: 10.1016/j.jht.2023.12.001] [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: 05/11/2023] [Revised: 10/27/2023] [Accepted: 12/08/2023] [Indexed: 01/28/2024]
Abstract
BACKGROUND Composite finger flexion (CFF) is proposed to be a convenient alternative to total active motion (TAM) and total passive motion (TPM). Passive CFF (PCFF) may be useful for early monitoring in post-operative rehabilitation of traumatic hand injuries. PURPOSE To determine whether active and passive CFF are reliable, valid, and responsive measures of hand motion and of higher utility to the tester. STUDY DESIGN Cross-sectional observational clinical measurement study. METHODS Fifty hand injury patients were recruited from a hospital-based out-patient clinic. TAM, TPM, repeated measures of active CFF (ACFF) and PCFF, self-reported stiffness, patient reported wrist/hand evaluation (PRWHE) scores, and grip strength were recorded. Intraclass correlation coefficients (ICCs) and standard error of measurement were calculated for inter-rater and test-retest reliability. Criterion and construct validity were assessed using correlation coefficients. Responsiveness was explored by calculating correlation coefficients of change scores, effect sizes, and standardized response means. Time taken to measure CFF and TAM/TPM was recorded to consider utility. RESULTS The average age of participants was 47 years and 36% were female. Inter-rater and test-retest reliability estimates for ACFF and PCFF were excellent (ICCs = 0.95-98). Standard error of measurement values ranged from 0.21 to 0.33. The correlation coefficient for criterion validity between ACFF and TAM was -0.69; PCFF and TPM was -0.65; and ACFF and PCFF was 0.83. For construct validity, ACFF and TAM were similarly correlated with PRWHE. Correlations between changes in stiffness with ACFF and PCFF were 0.43 and 0.26, respectively. Effect sizes of ACFF and PCFF were small at 0.1 and 0.2. Time taken to measure CFF was much shorter than TAM/TPM. CONCLUSIONS The results of this study support the use of active and passive CFF as a reliable, valid, and efficient tool in the clinical setting. Further study is required to verify the responsiveness of CFF.
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Affiliation(s)
- Zeal Kadakia
- School of Rehabilitation Sciences, McMaster University, Ontario, Canada.
| | | | - Pam Ball
- Regional Rehabilitation Centre, Hamilton Health Sciences, Ontario, Canada
| | - Ayse Kuspinar
- School of Rehabilitation Sciences, McMaster University, Ontario, Canada
| | - Sandra VanderKaay
- School of Rehabilitation Sciences, McMaster University, Ontario, Canada
| | - Tara Packham
- School of Rehabilitation Sciences, McMaster University, Ontario, Canada
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Whitcroft KL, Kelly C, Andrews P. Patient Experience and Preferences for the Assessment of Olfaction: The Patient International Clinical Assessment of Smell Survey. ORL J Otorhinolaryngol Relat Spec 2024; 86:16-31. [PMID: 38266502 PMCID: PMC10880803 DOI: 10.1159/000535794] [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: 07/13/2023] [Accepted: 12/10/2023] [Indexed: 01/26/2024]
Abstract
INTRODUCTION Olfactory dysfunction (OD) is common and carries significant personal and societal burden of disease. Accurate assessment of olfaction is required for good clinical care and affords patients insight into their condition. However, the accuracy of assessment varies with technique used, and there is presently little standardisation of clinical practice. We therefore aimed to determine experience of and preferences for olfactory assessment in healthcare-seeking adults. METHODS An anonymous patient co-produced survey was developed in collaboration with a UK-based OD charity. Distribution was via their social media patient forum. "Healthcare seeking" adults (i.e., who had undergone olfactory assessment by a healthcare professional [any care level/speciality] or may do so in the future) were included. RESULTS 576 people (88.5% female, mean 46 years) responded. Hyposmia, parosmia, and retronasal OD were most frequently reported. 55.2% had been assessed by a healthcare professional - GP most commonly, followed by ENT. Importantly, only 15.6% and 16.9% of respondents had undergone systematic assessment with smell tests or symptom questionnaires, respectively. Most respondents had not undergone imaging. Mean satisfaction was higher in those seen by ENT. Interestingly, respondents prioritise orthonasal odour identification over other forms of smell test. Unfortunately, many felt that healthcare professionals (across specialities) were dismissive towards OD and lacked appropriate knowledge of both its pathophysiology and effects. We propose simple steps that can be taken to improve olfactory assessment, including education and establishment of robust referral networks. CONCLUSION We hope these results and supporting practical recommendations will inform future service planning, funding allocation and research, as well as better aligning patient and clinician priorities.
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Affiliation(s)
- Katherine L. Whitcroft
- UCL Ear Institute, University College London, London, UK
- Department of Otolaryngology, Smell and Taste Clinic, TU Dresden, Dresden, Germany
- Centre for Olfactory Research Applications (CORA), IP, School of Advanced Study, London, UK
- ENT Department, The Rotherham NHS Foundation Trust, Rotherham, UK
| | | | - Peter Andrews
- UCL Ear Institute, University College London, London, UK
- Department of Rhinology and Facial Plastics, Royal National Throat Nose and Ear Hospital, London, UK
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Chelbi R, Thabet F, Ennouri E, Meddeb K, Toumi R, Zghidi M, Ben Saida I, Boussarsar M. The Ability of Critical Care Physicians to Identify Patient-Ventilator Asynchrony Using Waveform Analysis: A National Survey. Respir Care 2024; 69:176-183. [PMID: 38267232 PMCID: PMC10898468 DOI: 10.4187/respcare.11360] [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: 01/26/2024]
Abstract
BACKGROUND Improved patient-ventilator asynchrony (PVA) identification using waveform analysis by critical care physicians (CCPs) may improve patient outcomes. This study aimed to assess the ability of CCPs to identify different types of PVAs using waveform analysis as well as factors related to this ability. METHODS We surveyed 12 university-affiliated medical ICUs (MICUs) in Tunisia. CCPs practicing in these MICUs were asked to visually identify 4 clinical cases, each corresponding to a different PVA. We collected the following characteristics regarding CCPs: scientific grade, years of experience, prior training in mechanical ventilation, prior exposure to waveform analysis, and the characteristics of the MICUs in which they practice. Respondents were categorized into 2 groups based on their ability to correctly identify PVAs (defined as the correct identification of at least 3 of the 4 PVA cases). Univariate analysis was performed to identify factors related to the correct identification of PVA. RESULTS Among 136 included CCPs, 72 (52.9%) responded to the present survey. The respondents comprised 59 (81.9%) residents, and 13 (18.1%) senior physicians. Further, 50 (69.4%) respondents had attended prior training in mechanical ventilation. Moreover, 21 (29.2%) of the respondents could correctly identify PVAs. Double-triggering was the most frequently identified PVA type, 43 (59.7%), followed by auto-triggering, 36 (50%); premature cycling, 28 (38.9%); and ineffective efforts, 25 (34.7%). Univariate analysis indicated that senior physicians had a better ability to correctly identify PVAs than residents (7 [53.8%] vs 14 [23.7%], P = .044). CONCLUSIONS The present study revealed a significant deficiency in the accurate visual identification of PVAs among CCPs in the MICUs. When compared to residents, senior physicians exhibited a notably superior aptitude for correctly recognizing PVAs.
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Affiliation(s)
- Rym Chelbi
- University of Sousse, Faculty of Medicine of Sousse, 4002, Sousse, Tunisia; and Farhat Hached University Hospital, Medical Intensive Care Unit, Research Laboratory "Heart Failure," LR12SP09, 4000, Sousse, Tunisia
| | - Farah Thabet
- University of Monastir, Faculty of Medicine of Monastir, Monastir, Tunisia; and Pediatric Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia; University of Medicine of Monastir, Monastir, Tunisia
| | - Emna Ennouri
- University of Sousse, Faculty of Medicine of Sousse, 4002, Sousse, Tunisia; and Farhat Hached University Hospital, Medical Intensive Care Unit, Research Laboratory "Heart Failure," LR12SP09, 4000, Sousse, Tunisia
| | - Khaoula Meddeb
- University of Sousse, Faculty of Medicine of Sousse, 4002, Sousse, Tunisia; and Farhat Hached University Hospital, Medical Intensive Care Unit, Research Laboratory "Heart Failure," LR12SP09, 4000, Sousse, Tunisia
| | - Radhouane Toumi
- University of Sousse, Faculty of Medicine of Sousse, 4002, Sousse, Tunisia; and Farhat Hached University Hospital, Medical Intensive Care Unit, Research Laboratory "Heart Failure," LR12SP09, 4000, Sousse, Tunisia
| | - Marwa Zghidi
- University of Sousse, Faculty of Medicine of Sousse, 4002, Sousse, Tunisia; and Farhat Hached University Hospital, Medical Intensive Care Unit, Research Laboratory "Heart Failure," LR12SP09, 4000, Sousse, Tunisia
| | - Imen Ben Saida
- University of Sousse, Faculty of Medicine of Sousse, 4002, Sousse, Tunisia; and Farhat Hached University Hospital, Medical Intensive Care Unit, Research Laboratory "Heart Failure," LR12SP09, 4000, Sousse, Tunisia
| | - Mohamed Boussarsar
- University of Sousse, Faculty of Medicine of Sousse, 4002, Sousse, Tunisia; and Farhat Hached University Hospital, Medical Intensive Care Unit, Research Laboratory "Heart Failure," LR12SP09, 4000, Sousse, Tunisia.
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Di Maira T, Vinaixa C, Izzy M, Paolo Russo F, Kirchner VA, Rammohan A, Belli LS, Polak WG, Berg T, Berenguer M. Worldwide variations in COVID-19 vaccination policies and practices in liver transplant settings: results of a multi-society global survey. FRONTIERS IN TRANSPLANTATION 2024; 2:1332616. [PMID: 38993892 PMCID: PMC11235330 DOI: 10.3389/frtra.2023.1332616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 12/15/2023] [Indexed: 07/13/2024]
Abstract
Background Despite the WHO's report of 24 available SARS-CoV-2 vaccines, limited data exist regarding vaccination policies for liver transplant (LT) patients. To address this, we conducted a global multi-society survey (EASL-ESOT-ELITA-ILTS) in LT centers. Methods A digital questionnaire assessing vaccine policies, safety, efficacy, and center data was administered online to LT centers. Results Out of 168 responding centers, 46.4%, 28%, 13.1%, 10.7%, and 1.8% were from European, American, Western Pacific, Southeast Asian, and Eastern Mediterranean Regions. Most LT centers prioritized COVID-19 vaccine access for LT patients (76%) and healthcare workers (86%), while other categories had lower priority (30%). One-third of responders recommended mRNA vaccine exclusively, while booster doses were widely recommended (81%). One-third conducted post-vaccine liver function tests post COVID-19 vaccine. Only 16% of centers modified immunosuppression, and mycophenolate discontinuation or modification was the main approach. Side effects were seen in 1 in 1,000 vaccinated patients, with thromboembolism, acute rejection, and allergic reaction being the most severe. mRNA showed fewer side effects (-3.1, p = 0.002). Conclusion COVID-19 vaccines and booster doses were widely used among LT recipients and healthcare workers, without a specific vaccine preference. Preventative immunosuppression adjustment post-vaccination was uncommon. mRNA vaccines demonstrated a favorable safety profile in this population.
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Affiliation(s)
- Tommaso Di Maira
- Liver Transplantation and Hepatology Unit, Hospital Universitari I Politècnic La Fe, Valencia, Spain
- Biomedical Research Network Center for Hepatic and Digestive Diseases (CIBEREHD), Madrid, Spain
- La Fe Health Research Institute, Valencia, Spain
| | - Carmen Vinaixa
- Liver Transplantation and Hepatology Unit, Hospital Universitari I Politècnic La Fe, Valencia, Spain
- Biomedical Research Network Center for Hepatic and Digestive Diseases (CIBEREHD), Madrid, Spain
- La Fe Health Research Institute, Valencia, Spain
| | - Manhal Izzy
- Department of Medicine, Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Francesco Paolo Russo
- Department of Surgery, Oncology and Gastroenterology, University Hospital Padua, Padua, Italy
| | - Varvara A. Kirchner
- Division of Abdominal Transplantation, Department of Surgery, Stanford University, Stanford, CA, United States
| | - Ashwin Rammohan
- The Institute of Liver Disease & Transplantation, Dr. Rela Institute & Medical Centre, Bharath Institute of Higher Education and Research, Chennai, India
| | - Luca Saverio Belli
- Department of Hepatology and Gastroenterology, Niguarda Hospital, Milan, Italy
| | - Wojciech Grzegorz Polak
- Department of Surgery, Division of HPB and Transplant Surgery, Erasmus MC Transplant Institute, University Medical Centre, Rotterdam, Netherlands
| | - Thomas Berg
- Division of Hepatology, Department of Medicine II, Leipzig University, Medical Center, Leipzig, Germany
| | - Marina Berenguer
- Liver Transplantation and Hepatology Unit, Hospital Universitari I Politècnic La Fe, Valencia, Spain
- Biomedical Research Network Center for Hepatic and Digestive Diseases (CIBEREHD), Madrid, Spain
- La Fe Health Research Institute, Valencia, Spain
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Mutsekwa RN, Campbell KL, Canavan R, Angus RL, McBride LJ, Byrnes JM. Measuring performance in allied health professional role substitution models of care: a clinician survey. BMC Health Serv Res 2024; 24:79. [PMID: 38229130 DOI: 10.1186/s12913-024-10556-5] [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: 02/13/2023] [Accepted: 01/03/2024] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Professional role substitution models of care have emerged as a key strategy to address increasing healthcare demand. Gaining insights from those actively engaged in the process of these models' implementation and evaluation is pivotal to ensuring sustainability and further successful implementation. The purpose of this study was to describe allied-health clinicians' perceptions, practice, and experiences of healthcare performance evaluation in professional role substitution models of care. METHODS Data were collected via an online platform between 22 June - 22 July 2022 using a combination of convenience and network-based sampling of allied-health clinicians involved or interested in the implementation and evaluation of professional role substitution models of care. Clinicians answered 25 questions which consisted of demographic and targeted questions regarding performance evaluation across six domains of healthcare quality (effectiveness, safety, appropriateness, access & equity, continuity of care, and cost, efficiency, productivity & sustainability). RESULTS A total of 102 clinicians accessed the survey, with 72 providing complete survey data. Eleven allied-health professions were represented, working across twelve specialities in thirteen hospital and health services. Whilst most allied-health clinicians (93-100%) supported measuring performance in each of the six healthcare quality domains, only 26-58% were measuring these domains in practice. Allied-health leadership support (62.5%), clinician drive (62.5%), consumer engagement (50%) and medical support (46%) were enablers whilst a lack of resources (human, time, financial (47%)), healthcare performance frameworks and/or policies (40%) were identified as barriers. Given the opportunity, clinicians would invest the most financial resources in digital solutions as a core strategy to improve performance evaluation. CONCLUSIONS Allied-health professionals expressed strong support for principles of performance evaluation, however in practice, performance evaluation is still in its infancy in professional role substitution models of care. Organisations can implement strategies that maximise the enablers whilst addressing barriers identified to improve performance evaluation in these models of care.
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Affiliation(s)
- Rumbidzai N Mutsekwa
- Gold Coast Hospital and Health Service, Nutrition and Food Services, 1 Hospital Boulevard Southport, Southport, Queensland, 4215, Australia.
- Gold Coast Hospital and Health Service, Allied Health Research Team, 1 Hospital Boulevard Southport, Southport, Queensland, 4215, Australia.
- Centre for Applied Health Economics, School of Medicine, Sir Samuel Griffith Centre, Griffith University, Nathan, Queensland, 4111, Australia.
| | - Katrina L Campbell
- Centre for Applied Health Economics, School of Medicine, Sir Samuel Griffith Centre, Griffith University, Nathan, Queensland, 4111, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Southport, Queensland, 4215, Australia
- Metro North Hospital and Health Service, Healthcare Excellence and Innovation, 153 Campbell Street, Bowen Hills, Queensland, 4029, Australia
| | - Russell Canavan
- Gastroenterology Department, Gold Coast Hospital and Health Service, 1 Hospital Boulevard Southport, Southport, Queensland, 4215, Australia
| | - Rebecca L Angus
- Gold Coast Hospital and Health Service, Nutrition and Food Services, 1 Hospital Boulevard Southport, Southport, Queensland, 4215, Australia
- Gold Coast Hospital and Health Service, Allied Health Research Team, 1 Hospital Boulevard Southport, Southport, Queensland, 4215, Australia
- School of Allied-health Sciences and Social Work, Griffith University, Gold Coast Campus, Southport, Queensland, 4215, Australia
| | - Liza-Jane McBride
- Department of Health, Clinical Excellence 15 Butterfield Street, Herston, Queensland, 4006, Australia
| | - Joshua M Byrnes
- Centre for Applied Health Economics, School of Medicine, Sir Samuel Griffith Centre, Griffith University, Nathan, Queensland, 4111, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Southport, Queensland, 4215, Australia
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228
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Foudhaili A, Vitiello D, Chousterman BG. Early mobilization of patients with subarachnoid haemorrhage: a national survey of french intensive care units. J Rehabil Med 2024; 56:jrm17734. [PMID: 38192161 PMCID: PMC10875754 DOI: 10.2340/jrm.v56.17734] [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: 07/11/2023] [Accepted: 11/06/2023] [Indexed: 01/10/2024] Open
Abstract
OBJECTIVE To describe French intensive care unit practices regarding the mobilization of patients with subarachnoid haemorrhage. DESIGN A cross-sectional nationwide survey study. SUBJECTS Intensivists and physiotherapists or nurses from French intensive care units managing patients with subarachnoid haemorrhage. METHODS An online questionnaire survey was distributed through the Neurocritical Care and Neuro Anesthesiology French Speaking Society. RESULTS The response rate was 89%. Of these, 90% did not have a mobilization protocol for patients with subarachnoid haemorrhage. Sixteen percent of departments prohibited all forms of motor physiotherapy for a predefined period. Nineteen percent systematically prohibited out-of-bed mobilization, regardless of the severity of subarachnoid haemorrhage and in the absence of any complication, for a predefined period. The main factors that would delay or interrupt physiotherapy prescription were intracranial hypertension (79%), currently treated vasospasm (59%), and suspicion of vasospasm (44%). Ninety-one percent of the centres identified at least one complication that could be associated with standing upright. These mainly included decreased cerebral perfusion (71%), dislodged external ventricular or lumbar derivations (68%), and haemodynamic instability (65%). CONCLUSION Mobilization of patients with subarachnoid haemorrhage is heterogeneous among French neuro-intensive care units and several barriers preclude improvement of mobilization practices. Interventional studies assessing mobilization practices, as well as education and training of staff, are crucial to ensure the proper management of patients with subarachnoid haemorrhage and to improve outcomes.
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Affiliation(s)
- Adéla Foudhaili
- Department of Physical Medicine and Rehabilitation, CHU Lariboisière, AP-HP, Paris, France; Université Paris Cité, Inserm, MASCOT; Université Paris Cité, Institut des Sciences du Sport-Santé de Paris.
| | - Damien Vitiello
- Université Paris Cité, Institut des Sciences du Sport-Santé de Paris, Paris, France
| | - Benjamin Glenn Chousterman
- Université Paris Cité, Inserm, MASCOT, Paris, France; Department of Anesthesiology and Critical Care, CHU Lariboisière, AP-HP, Paris, France
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Sick-Samuels AC, Koontz DW, Xie A, Kelly D, Woods-Hill CZ, Aneja A, Xiao S, Colantuoni EA, Marsteller J, Milstone AM. A Survey of PICU Clinician Practices and Perceptions regarding Respiratory Cultures in the Evaluation of Ventilator-Associated Infections in the BrighT STAR Collaborative. Pediatr Crit Care Med 2024; 25:e20-e30. [PMID: 37812030 PMCID: PMC10756695 DOI: 10.1097/pcc.0000000000003379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
OBJECTIVES To characterize respiratory culture practices for mechanically ventilated patients, and to identify drivers of culture use and potential barriers to changing practices across PICUs. DESIGN Cross-sectional survey conducted May 2021-January 2022. SETTING Sixteen academic pediatric hospitals across the United States participating in the BrighT STAR Collaborative. SUBJECTS Pediatric critical care medicine physicians, advanced practice providers, respiratory therapists, and nurses. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS We summarized the proportion of positive responses for each question within a hospital and calculated the median proportion and IQR across hospitals. We correlated responses with culture rates and compared responses by role. Sixteen invited institutions participated (100%). Five hundred sixty-eight of 1,301 (44%) e-mailed individuals completed the survey (median hospital response rate 60%). Saline lavage was common, but no PICUs had a standardized approach. There was the highest variability in perceived likelihood (median, IQR) to obtain cultures for isolated fever (49%, 38-61%), isolated laboratory changes (49%, 38-57%), fever and laboratory changes without respiratory symptoms (68%, 54-79%), isolated change in secretion characteristics (67%, 54-78%), and isolated increased secretions (55%, 40-65%). Respiratory cultures were likely to be obtained as a "pan culture" (75%, 70-86%). There was a significant correlation between higher culture rates and likelihood to obtain cultures for isolated fever, persistent fever, isolated hypotension, fever, and laboratory changes without respiratory symptoms, and "pan cultures." Respondents across hospitals would find clinical decision support (CDS) helpful (79%) and thought that CDS would help align ICU and/or consulting teams (82%). Anticipated barriers to change included reluctance to change (70%), opinion of consultants (64%), and concern for missing a diagnosis of ventilator-associated infections (62%). CONCLUSIONS Respiratory culture collection and ordering practices were inconsistent, revealing opportunities for diagnostic stewardship. CDS would be generally well received; however, anticipated conceptual and psychologic barriers to change must be considered.
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Affiliation(s)
- Anna C Sick-Samuels
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD
- Department of Hospital Epidemiology and Infection Control, Johns Hopkins Hospital, Baltimore, MD
| | - Danielle W Koontz
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD
| | - Anping Xie
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
- Armstrong Institute of Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Daniel Kelly
- Division of Medical Critical Care, Department of Pediatrics, Boston Children's Hospital, Boston, MA
- Department of Pediatrics, Harvard Medical School, Boston, MA
| | - Charlotte Z Woods-Hill
- Division of Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
- The Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
| | - Anushree Aneja
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD
| | - Shaoming Xiao
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD
| | - Elizabeth A Colantuoni
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Jill Marsteller
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
- Armstrong Institute of Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, MD
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Aaron M Milstone
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD
- Department of Hospital Epidemiology and Infection Control, Johns Hopkins Hospital, Baltimore, MD
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Fernández-Castillo RJ, González-Caro MD, Arroyo-Muñoz FJ, Garnacho-Montero J. National survey on changes in visitation, communication and end-of-life care policies in intensive care units through the different COVID-19 pandemic's waves (COVIFAUCI study). ENFERMERIA INTENSIVA 2024; 35:35-44. [PMID: 37558544 DOI: 10.1016/j.enfie.2023.07.004] [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: 11/29/2022] [Revised: 04/06/2023] [Accepted: 04/11/2023] [Indexed: 08/11/2023]
Abstract
INTRODUCTION The pandemic derived from the SARS-CoV-2 infection led to changes in care for both relatives and intensive care patients during the different waves of incidence of the virus. The line of humanization followed by the majority of the hospitals was seriously affected by the restrictions applied. As an objective, we propose to know the modifications suffered during the different waves of the SARS-CoV-2 pandemic in Spain regarding the policy of visits to patients in the ICU, monitoring at the end of life, and the use of new technologies. of communication between family members, patients and professionals. METHODS Multicenter cross-sectional descriptive study through a survey of Spanish ICUs from February to April 2022. Statistical analysis methods were performed on the results as appropriate. The study was endorsed by the Spanish Society of Intensive Nursing and Coronary Units. RESULTS 29% of the units contacted responded. The daily visiting minutes of relatives dropped drastically from 135 (87.5-255) to 45 (25-60) in the 21.2% of units that allowed their access, improving slightly with the passing of the waves. In the case of bereavement, the permissiveness was greater, increasing the use of new technologies for patient-family communication in the case of 96.5% of the units. CONCLUSIONS The family of patients admitted to the ICU during the different waves of the COVID-19 pandemic have suffered restrictions on visits and a change from face-to-face to virtual communication techniques. Access times were reduced to minimum levels during the first wave, recovering with the advance of the pandemic but never reaching initial levels. Despite the implemented solutions and virtual communication, efforts should be directed towards improving the protocols for the humanization of healthcare that allow caring for families and patients whatever the healthcare context.
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Affiliation(s)
- R-J Fernández-Castillo
- Unidad Clínica de Cuidados Intensivos, Hospital Universitario Virgen Macarena, Sevilla, Spain; Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, Spain
| | - M-D González-Caro
- Unidad Clínica de Cuidados Intensivos, Hospital Universitario Virgen Macarena, Sevilla, Spain.
| | - F-J Arroyo-Muñoz
- Unidad Clínica de Cuidados Intensivos, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - J Garnacho-Montero
- Unidad Clínica de Cuidados Intensivos, Hospital Universitario Virgen Macarena, Sevilla, Spain
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231
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Taule T, Hellem I, Smith Eide I, Gjelvik K, Hinderaker LE, Kjeken I, Rolfsnes-Flock B, Hustoft M. A survey of research involvement and priorities among occupational therapists in Norway. Scand J Occup Ther 2024; 31:2273271. [PMID: 37874688 DOI: 10.1080/11038128.2023.2273271] [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: 06/26/2023] [Accepted: 10/17/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND Involvement in research and shared priorities among occupational therapists (OTs) can enhance the quality of occupational therapy practice. AIMS To explore the research involvement and research priorities of OTs in Norway. MATERIALS AND METHODS An online survey comprising 14 open-ended and closed questions was made available to participants at the Seventh Norwegian Congress in Occupational Therapy to fill out. RESULTS Out of 633 congress participants, 307 (49%) OTs completed the survey. Among the respondents, ∼40% were involved in research. The most commonly reported area of research was rehabilitation. Research involvement was associated with employment in education or specialist healthcare services and with greater work experience and post-bachelor's degree education. The most frequently prioritized research question addressed the effect of occupational therapy. Unmet needs and factors conducive to increasing OT's involvement in research were identified. CONCLUSIONS AND SIGNIFICANCE The survey revealed that a considerable, but uneven, distribution of OTs were involved in research. To encourage greater participation in research, researchers, decision-makers, and employee associations should take steps to make research more appealing to OTs. The research priorities highlighted by Norwegian OTs align with those stated by OTs in other countries.
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Affiliation(s)
- Tina Taule
- Bachelor in Occupational Therapy, Faculty of Health and Function, Western Norway University of Applied Sciences, Bergen, Norway
| | - Inger Hellem
- Bachelor in Occupational Therapy, Faculty of Health Studies, VID Specialised University, Stavanger, Norway
| | - Irmelin Smith Eide
- Department of Rehabilitation Services, Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Kristin Gjelvik
- Physio- and Occupational Therapy Services for Children, Sandnes, Norway
| | - Liv Elisabeth Hinderaker
- Bachelor in Occupational Therapy, Faculty of Health Studies, VID Specialised University, Stavanger, Norway
| | - Ingvild Kjeken
- Diakonhjemmet Hospital, Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Oslo, Norway
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
| | | | - Merethe Hustoft
- Bachelor in Occupational Therapy, Faculty of Health and Function, Western Norway University of Applied Sciences, Bergen, Norway
- Regional Center for Habilitation and Rehabilitation in Western Norway, Bergen, Norway
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232
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Newman-Sanders A, Kirkman-Brown JC, Gallagher MT. Gym lifestyle factors and male reproductive health: a study into young adult usage and perceptions. Reprod Biomed Online 2024; 48:103623. [PMID: 38029492 DOI: 10.1016/j.rbmo.2023.103623] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 10/04/2023] [Accepted: 10/10/2023] [Indexed: 12/01/2023]
Abstract
RESEARCH QUESTION What level of awareness do young adults have regarding the potential impacts of gym lifestyle factors and supplementation on male infertility? DESIGN Between February and March 2023 a questionnaire (n = 153) was employed to gauge attitudes to and awareness of the effects of male reproductive health and gym lifestyles on male fertility. Two semi-structured focus groups (n = 10 total), stratified by sex assigned at birth, were conducted using a set of discussion topics. RESULTS The survey revealed a statistically significant difference between male and female awareness of the potential impacts of some forms of high-intensity exercise and protein supplementation on male reproductive health (P = 0.045). Many men do not think about fertility unprompted; the survey revealed that fewer men have thought about their fertility compared with those who are curious about their fertility (P = 4.7 × 10-5) and those who believe their personal fertility is important to them (P = 8.1 × 10-6). Men were more likely to make a change in their behaviour if it had a long-term compared with a short-term effect on their fertility (P < 10-5). Five focus group themes surrounding awareness of male reproductive health were extracted. CONCLUSIONS This work has shown that there is a significant lack of awareness and information surrounding the effects of gym lifestyles on male infertility in a young adult UK population. Crucially, levels of awareness differ significantly between men and women. Men have a potentially alarming lack of concern over their own fertility and how factors such as gym supplements can have negative long-term impacts.
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Affiliation(s)
- Alice Newman-Sanders
- Centre for Human Reproductive Science, Institute of Metabolism and Systems Research University of Birmingham and Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Jackson C Kirkman-Brown
- Centre for Human Reproductive Science, Institute of Metabolism and Systems Research University of Birmingham and Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Meurig T Gallagher
- Centre for Human Reproductive Science, Institute of Metabolism and Systems Research University of Birmingham and Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK.; Centre for Systems Modelling and Quantitative Biomedicine, University of Birmingham, Birmingham, UK..
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Oelhafen S. Digital health in perinatal care: Exploring usage, attitudes, and needs among Swiss women in urban and rural settings. Digit Health 2024; 10:20552076241277671. [PMID: 39233895 PMCID: PMC11372771 DOI: 10.1177/20552076241277671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 08/08/2024] [Indexed: 09/06/2024] Open
Abstract
Background Switzerland's healthcare system is known for its quality but faces challenges such as slow digitalization and fragmentation, especially in perinatal care. This study investigates Swiss women's use, needs, and attitudes in respect of digital health tools during pregnancy and postpartum, focusing on any differences between rural and urban populations. Methods A web-based cross-sectional survey targeted pregnant women and those who had given birth in the last 12 months. Participants were recruited through social media, and the data were analyzed using principal component analysis and multivariable regressions to explore factors affecting the use of digital tools and attitudes toward eHealth. Results A total of 1160 participants completed the survey. Healthcare professionals (92%) and private networks (77%) were the primary sources of information. Women expressed a strong preference for app features such as data access (73%), prescription management (73%), and scheduling appointments with healthcare professionals (71%). However, they also raised concerns about the impersonal nature of digital healthcare interactions (71%). Overall, rural women had more negative attitudes toward online health information seeking, which can be attributed to differences in education levels. Conclusion The findings indicate that while Swiss women in the perinatal period do utilize digital tools, they focus more on nonmedical topics such as tracking physiological development. The study underscores the importance of adapting digital health solutions to the specific needs of women in the perinatal period. Emphasis should be placed on developing applications that are not only informative but also empower women on their healthcare journey while ensuring data privacy and supporting personal interactions with healthcare providers.
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Affiliation(s)
- Stephan Oelhafen
- School of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
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234
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Carsuzaa F, Fieux M, Bartier S, Fath L, Alexandru M, Legré M, Favier V. Perception of environmental issues in the head-and-neck surgery room: A preliminary study. Eur Ann Otorhinolaryngol Head Neck Dis 2024; 141:13-19. [PMID: 37414619 DOI: 10.1016/j.anorl.2023.06.003] [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: 07/08/2023]
Abstract
OBJECTIVES To assess the perception of environmental issues in head-and-neck surgery rooms and to compare the perception of priority environmental issues according to health professionals' age-group, initial training and role in the operating room. METHODS A multicenter descriptive observational study was conducted in January 2023, contacting health professionals working in the operating rooms of 5 French centers. An anonymous online questionnaire explored the perception of environmental issues according to age, initial training and role in the operating room. RESULTS Sixty-nine percent of the 387 persons contacted (267/387) completed the entire questionnaire. Ninety-six percent of respondents (256/267) said that they felt concerned about climate change issues and 85% (226/267) felt well-informed. Ninety-three percent (251/267) were willing to make environmental efforts in the operating room. Priorities were to improve waste recycling and reduce the amount of waste for 95% (251/267) and 97% (259/267) of respondents respectively. Those under 40 years of age tended to feel better informed about climate issues (76% [75/99] versus 60% [100/168]; P=0.010). CONCLUSION Our study showed that the vast majority of health professionals working in head-and-neck surgery rooms in France felt concerned about climate issues and were ready to make an effort. Nevertheless, it seems important to carry out information campaigns dedicated to these environmental issues.
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Affiliation(s)
- F Carsuzaa
- Service ORL, chirurgie cervico-maxillo-faciale et audiophonologie, centre hospitalier universitaire de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France; Groupe Yo-Ifos for Sustainable Development, France.
| | - M Fieux
- Hospices civils de Lyon, centre hospitalier Lyon-Sud, service d'ORL, d'otoneurochirurgie et de chirurgie cervico-faciale, Pierre-Bénite, France
| | - S Bartier
- Service d'ORL, de chirurgie cervico-faciale, hôpital Henri-Mondor, Assistance publique des Hôpitaux de Paris, Créteil, France
| | - L Fath
- Service d'ORL, de chirurgie cervico-faciale, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, avenue Molière, Strasbourg, France
| | - M Alexandru
- Service d'ORL et chirurgie cervico-faciale, Hôpital Bicêtre, Assistance publique-Hôpitaux de Paris (AP-HP), université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - M Legré
- Service d'ORL et chirurgie cervico-faciale, institut Arthur-Vernes, Paris, France
| | - V Favier
- Groupe Yo-Ifos for Sustainable Development, France; Département d'ORL, chirurgie cervico-faciale et maxillo-faciale, hôpital Gui-de-Chauliac, CHU de Montpellier, Montpellier, France
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Papadopoulou SL, Kitsanou E, Brahimi E, Papathanakos G, Andrianopoulos I, Theodorou SJ, Koulouras V, Ziavra N. Evaluation and Treatment of Dysphagia in Public and Private Intensive Care Units (ICUs) in Greece. Int Arch Otorhinolaryngol 2024; 28:e30-e41. [PMID: 38322439 PMCID: PMC10843924 DOI: 10.1055/s-0043-1767676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 12/05/2022] [Indexed: 02/08/2024] Open
Abstract
Introduction Dysphagia is a significant but underrecognized clinical issue in the intensive care unit (ICU), and it is associated with various complications. Despite its clinical importance, there is limited research and no Greek ICU-specific guidelines for managing dysphagic patients. Additionally, only a few ICUs in Greece have dysphagia specialists, specifically speech-language pathologists (SLPs) providing their expertise. Objective Τo identify the current practices for dysphagia management (screening, assessment, treatment) and gain insight into ICU directors' awareness/perceptions of the prevalence, complications, and risk of dysphagia. Materials and Methods We identified 138 Greek ICUs. Data were collected from ICU (including pediatric and neonatal) directors, working in public and private hospitals, via a 24-item, anonymous online questionnaire, within a 4-month period. Results Our survey was completed by 45 ICU directors. Most participants (84.4%) reported that dysphagia is a relevant clinical problem in their ICU, and 51.1% estimated a frequency rate < 20%. Non-instrumental approaches are mainly utilized to screen and diagnose dysphagia, whereas enteral nutrition and diet modifications are used to manage dysphagia. Additionally, 64.4% of ICU directors agreed that SLPs are essential for the management of dysphagic patients, and 66.7%, that awareness of dysphagia in their ICU could be increased. Conclusion The current study documented the methods and approaches used to manage dysphagic patients in Greek ICUs. The ICU directors seem to recognize the clinical significance of dysphagia and its complications. According to our findings, the employment of SLPs could result in a more comprehensive and intensive approach and improve the quality of care for these patients.
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Affiliation(s)
- Soultana L. Papadopoulou
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Evangelia Kitsanou
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Ermioni Brahimi
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | | | | | | | | | - Nafsica Ziavra
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
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Buttolph LP, Villanueva J, Parman N, Wooliscroft L, Yeh GY, Bradley R, Zwickey H. Key Components of Qigong for People With Multiple Sclerosis: A Survey of Clinicians, Researchers, and Instructors. GLOBAL ADVANCES IN INTEGRATIVE MEDICINE AND HEALTH 2024; 13:27536130241280721. [PMID: 39224562 PMCID: PMC11367588 DOI: 10.1177/27536130241280721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 08/01/2024] [Accepted: 08/19/2024] [Indexed: 09/04/2024]
Abstract
Background Preliminary evidence suggests that Qigong (QG), a mind-body therapy, may help address symptoms of multiple sclerosis (MS), but the heterogeneity of QG content and delivery may affect its feasibility, acceptability, and efficacy. Objective To survey researchers, clinicians, and QG instructors with experience working with people with MS to identify key components of MS-specific QG guidelines and protocols. Methods We conducted an online survey to identify QG forms and movements considered helpful for MS, reasons for selection, characteristics of effective learning environments, and recommended dosage and frequency of practice. Quantitative data were analyzed using summary statistics. Qualitative data were analyzed using reflexive thematic analysis. Results Forty-seven experts, including QG instructors, clinicians, and QG and MS researchers, completed the survey. Respondents had a mean (SD) of 20 (11) years of QG teaching experience, 26 (12) years of clinical practice, 24 (9) years of QG research experience, 13 (5) years of MS research experience, and worked with at least 3 (2) people with MS. Approximately 125 QG forms/movements were recommended. Some forms were specifically recommended to address MS symptoms (e.g., emotional regulation, balance and coordination, muscle strength and flexibility, immune regulation, and circulation). Some respondents felt that any QG form could be beneficial if basic principles were met (e.g., intentional movement, posture, focused awareness, rhythmic breathing/movement, and a relaxed mind and body). Instructor qualities included the ability to convey information clearly, being caring and compassionate, proficient in QG, and having basic knowledge of MS. To promote confidence in learning QG, recommendations included having simple, easy-to-learn movements with modifications based on physical ability. We provide a sample protocol based on these recommendations. Conclusions This study provides expert guidance for developing a QG protocol for an MS population, including content and delivery recommendations.
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Affiliation(s)
- Lita P. Buttolph
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR, USA
| | | | - Natasha Parman
- School of Nursing, University of Washington, Seattle, WA, USA
| | - Lindsey Wooliscroft
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA
- MS Center of Excellence, VA Portland Health Care System, Portland, OR, USA
| | - Gloria Y. Yeh
- Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston, MA, USA
- Division of General Medicine, Beth Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Ryan Bradley
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR, USA
- Herbert Wertheim School of Public Health and Human Longevity Sciences, University of California, San Diego, La Jolla, CA, USA
| | - Heather Zwickey
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR, USA
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Cheong KY, Syed Mahmud SMB, Chng NW, Kwek GJ, Yan CC, Yeung MT. Cross-sectional survey of health literacy among health science students in Singapore. THE JOURNAL OF MEDICINE ACCESS 2024; 8:27550834231222382. [PMID: 38306366 PMCID: PMC10822080 DOI: 10.1177/27550834231222382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 12/07/2023] [Indexed: 02/04/2024]
Abstract
Background Health literacy proficiency is essential for health care professionals to provide quality patient care. There is limited research exploring health literacy proficiency among undergraduate health science students. Objectives To determine health literacy among health science students in Singapore using the electronic Health Literacy Questionnaire (HLQ). Design A cross-sectional survey using purposive sampling was conducted among undergraduate health science students. Methodology This study hypothesises that health literacy is influenced by gender, and it increases with the level of health science education, attributed to the increased exposure to the health care system and health care education as undergraduates progress through the years of study. Eligible students from the 4-year entry-level programmes of diagnostic radiography, dietetics, occupational therapy, physiotherapy, radiation therapy and speech and language therapy, aged from 21 to 50, were invited. Exclusion criteria were students who were no longer studying due to dropping out or having immediately graduated from these programmes and students in the accelerated programmes whose studies would be completed in less than 4 years. Results In total, 111 respondents (72 females and 37 males) completed surveys (response rate, 7.7%) returned from physiotherapy (n = 69), occupational therapy (n = 25), diagnostic radiography (n = 12) and dietetics (n = 5), with nil from radiation therapy and speech and language therapy. All participants were English literate. Female participants demonstrated higher HLQ with a mean total score of 30.67 (standard deviation (SD) = 0.61) versus male participants 29.83 (SD = 0.53). Year 2, 3 and 4 students generally scored higher than Year 1 across all nine HLQ scales. Overall, dietetics students had the highest total score on the HLQ, while the diagnostic radiography students had the lowest scores for all the nine HLQ scales. Conclusion This study established the health literacy level of health science students in Singapore. Gender and years of study influenced health literacy levels, supporting the hypothesis.
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Affiliation(s)
- Kenrick Y Cheong
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
- Department of Physiotherapy, Singhealth Polyclinics, Singapore
| | | | - Nicole W Chng
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
| | - Geralyn J Kwek
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
| | - Clement C Yan
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
- Department of Physiotherapy, Sengkang General Hospital, Singapore
| | - Meredith T Yeung
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore
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Charyk Stewart T, Lakha N, Milton L, Bérubé M. Current trauma team activation processes at Canadian trauma centres: A national survey. Injury 2024; 55:111220. [PMID: 38012901 DOI: 10.1016/j.injury.2023.111220] [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: 08/15/2023] [Revised: 10/20/2023] [Accepted: 11/15/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Trauma team activation (TTA) allows the provision of specialized and timely care to improve outcomes for severely injured patients. Limited information is available on the current state of TTA in Canadian trauma centres (TC). Study objectives were to describe TTA processes, data and reports, along with the challenges and successes from a national perspective. METHODS A mixed-methods, cross-sectional survey was undertaken with Canadian trauma leadership, utilizing a total population sampling strategy. The questionnaire, containing 108-items, was administered online between February-April 2022, utilizing a modified Dillman technique. Descriptive statistics and thematic analyses were performed. RESULTS Trauma leaders from 9 out of 10 provinces responded for a response rate of 68% (32/47). Two-thirds (67%) of respondents worked in adult TC; 63% in a level I center. A higher proportion of pediatric TC had a two-tiered TT response (60% pediatric; 35% adult). The most common criteria were neurologic compromise (100% one-level TTA) and hypotension (pediatric: 100% one-level, 100% tier 1; adult: 92% one-level, 86% tier 1). All one-level TTA included penetrating trauma criteria. One-third of respondents reported using TTA subgroup criteria for pediatric, pregnant, and/or geriatric patients. There was variability with disciplines responding to TTA, with largest, most comprehensive teams for tier 1. Two-thirds of TC review activation compliance (under/overtriage), while 55% focus on non-compliance and reasons for missed TTA. The most frequent challenges related to TTA practices were reliable data collection (60%) while successes included were the establishment of TTA guidelines to improve team compliance (33%) and RN initiated TTA. CONCLUSIONS Some TTA practices were similar among Canadian TC, while others showed variability. Findings provide opportunities for improvement, including a two-tier system, geriatric-specific criteria, and RN initiated TTA, and could help establish national standards and best practices. Compliance with standards has the potential to improve Canadian TTA practices and patient outcomes.
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Affiliation(s)
- Tanya Charyk Stewart
- London Health Sciences Centre, London, ON, Canada; Department of Paediatrics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada; Department of Pathology and Laboratory Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada.
| | - Nasira Lakha
- Vancouver General Hospital, Vancouver, BC, Canada
| | | | - Mélanie Bérubé
- CHU de Québec-Université Laval Research Centre, Population Health and Optimal Practices Research Unit Research Unit (Trauma - Emergency - Critical Care Medicine), Québec City, QC, Canada; Faculty of Nursing, Université Laval, Québec City, QC, Canada
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Taylor SL, Elwy AR, Bokhour BG, Coggeshall SS, Cohen A, Der-Martirosian C, Haderlein T, Haun J, Kligler B, Kloehn AT, Lorenz KA, Lott B, Shin MH, Schult T, Toyama J, Whitehead AM, Zhang X, Zeliadt SB. Measuring Patient-Reported Use and Outcomes From Complementary and Integrative Health Therapies: Development of the Complementary and Integrative Health Therapy Patient Experience Survey. GLOBAL ADVANCES IN INTEGRATIVE MEDICINE AND HEALTH 2024; 13:27536130241241259. [PMID: 38585239 PMCID: PMC10998493 DOI: 10.1177/27536130241241259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 02/06/2024] [Accepted: 03/04/2024] [Indexed: 04/09/2024]
Abstract
Background Assessing the use and effectiveness of complementary and integrative health (CIH) therapies via survey can be complicated given CIH therapies are used in various locations and formats, the dosing required to have an effect is unclear, the potential health and well-being outcomes are many, and describing CIH therapies can be challenging. Few surveys assessing CIH therapy use and effectiveness exist, and none sufficiently reflect these complexities. Objective In a large-scale Veterans Health Administration (VA) quality improvement effort, we developed the "Complementary and Integrative Health Therapy Patient Experience Survey", a longitudinal, electronic patient self-administered survey to comprehensively assess CIH therapy use and outcomes. Methods We obtained guidance from the literature, subject matter experts, and Veteran patients who used CIH therapies in designing the survey. As a validity check, we completed cognitive testing and interviews with those patients. We conducted the survey (March 2021-April 2023), inviting 15,608 Veterans with chronic musculoskeletal pain with a recent CIH appointment or referral identified in VA electronic medical records (EMR) to participate. As a second validity check, we compared VA EMR data and patient self-reports of CIH therapy utilization a month after survey initiation and again at survey conclusion. Results The 64-item, electronic survey assesses CIH dosing (amount and timing), delivery format and location, provider location, and payor. It also assesses 7 patient-reported outcomes (pain, global mental health, global physical health, depression, quality of life, stress, and meaning/purpose in life), and 3 potential mediators (perceived health competency, healthcare engagement, and self-efficacy for managing diseases). The survey took 17 minutes on average to complete and had a baseline response rate of 45.3%. We found high degrees of concordance between self-reported and EMR data for all therapies except meditation. Conclusions Validly assessing patient-reported CIH therapy use and outcomes is complex, but possible.
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Affiliation(s)
- Stephanie L Taylor
- Center for the Study of Healthcare Innovation, Implementation and Policy, Greater Los Angeles VA Healthcare System, Los Angeles, CA, USA
- Department of Medicine and Department of Health Policy and Management, UCLA, Los Angeles, CA, USA
| | - A Rani Elwy
- Center for Healthcare Organization and Implementation Research, VA Bedford, Bedford, MA, USA and VA Boston Healthcare Systems, Boston, MA, USA
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Barbara G Bokhour
- Center for Healthcare Organization and Implementation Research, VA Bedford, Bedford, MA, USA and VA Boston Healthcare Systems, Boston, MA, USA
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Scott S Coggeshall
- Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Healthcare System, Seattle, WA, USA
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA
| | - Amy Cohen
- Division of Education, American Psychiatric Association, Washington, DC, USA
| | - Claudia Der-Martirosian
- Center for the Study of Healthcare Innovation, Implementation and Policy, Greater Los Angeles VA Healthcare System, Los Angeles, CA, USA
- Veterans Emergency Management Evaluation Center, Office of Patient Care Services, North Hills, CA, USA
| | - Taona Haderlein
- Center for the Study of Healthcare Innovation, Implementation and Policy, Greater Los Angeles VA Healthcare System, Los Angeles, CA, USA
- Veterans Emergency Management Evaluation Center, Office of Patient Care Services, North Hills, CA, USA
| | - Jolie Haun
- James A. Haley Veterans Hospital, Tampa, FL, USA
- College of Public Health at University of South Florida, Tampa, FL, USA
| | - Benjamin Kligler
- Office of Patient Centered Care and Cultural Transformation, Veterans Health Administration, Washington, DC, USA
| | - Alex T Kloehn
- Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Healthcare System, Seattle, WA, USA
| | - Karl A Lorenz
- Center for Innovation to Implementation, VA Palo Alto Healthcare System, Palo Alto, CA, USA
- Division of Primary Care and Population Health, Stanford School of Medicine, Stanford, CA, USA
| | - Briana Lott
- Center for the Study of Healthcare Innovation, Implementation and Policy, Greater Los Angeles VA Healthcare System, Los Angeles, CA, USA
| | - Marlena H Shin
- Center for Healthcare Organization and Implementation Research, VA Bedford, Bedford, MA, USA and VA Boston Healthcare Systems, Boston, MA, USA
| | - Tammy Schult
- Office of Patient Centered Care and Cultural Transformation, Veterans Health Administration, Washington, DC, USA
| | - Joy Toyama
- Center for the Study of Healthcare Innovation, Implementation and Policy, Greater Los Angeles VA Healthcare System, Los Angeles, CA, USA
| | - Alison M Whitehead
- Office of Patient Centered Care and Cultural Transformation, Veterans Health Administration, Washington, DC, USA
| | - Xiaoyi Zhang
- Department of Biomedical Informatics and Medical Education, School of Medicine, University of Washington, Seattle, WA, USA
| | - Steven B Zeliadt
- Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Healthcare System, Seattle, WA, USA
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA
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Sawan M, Clough A, Mirzaei A, Widjaja GJ, Schneider C, Jeon YH, Chen T, Hilmer SN, Gnjidic D. The Carer Assessment of MedicaTion Management GuidanCe for People With Dementia at Hospital Discharge (CATCH) Tool: Exploratory Factor Analysis. Alzheimer Dis Assoc Disord 2024; 38:59-64. [PMID: 38300882 DOI: 10.1097/wad.0000000000000602] [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: 10/12/2023] [Accepted: 12/16/2023] [Indexed: 02/03/2024]
Abstract
PURPOSE The Carer Assessment of medicaTion management guidanCe for people with dementia at Hospital discharge (CATCH) tool was developed to examine the carer's experiences of medication management guidance delivery at discharge. This study explored its factor structure, characterized carers' experiences at discharge, and identified predictors of carer preparedness to manage medications at discharge. METHODS A cross-sectional survey of carers across Australia was distributed. Survey responses were analyzed descriptively, and exploratory factor and regression analyses were performed. RESULTS A total of 185 survey responses were completed. Exploratory factor analysis revealed 2 factors in the CATCH tool: (1) shared and supported decision-making in medication management (16 items loading 0.47 to 0.93); 2) provision of medication management guidance that is easy to understand (4 items loading (0.48 to 0.82). Internal consistency was acceptable (Cronbach alpha >0.8). Almost 18% of participants stated that they were not included in decisions about medications for people with dementia. The carer reported that the measure of how guidance is provided was positively related to their confidence in the management of medications postdischarge and satisfaction ( P < 0.05 for both). CONCLUSIONS The CATCH tool can give the patient and carer an opportunity to provide feedback on key elements of medication management guidance delivered at discharge.
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Affiliation(s)
| | | | | | | | | | - Yun-Hee Jeon
- Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | | | - Sarah N Hilmer
- Departments of Clinical Pharmacology and Aged Care, Faculty of Medicine and Health, The University of Sydney, Kolling Institute, Royal North Shore Hospital, Sydney, NSW, Australia
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Laskay NMB, Boudreau HS, Estevez-Ordonez D, George JA, Atchley TJ, Bentley JN, Rozzelle CJ. Applicant Perceptions of Postinterview Communication During the 2022 to 2023 Neurosurgery Recruitment Cycle: A Cross-Sectional Survey Study. World Neurosurg 2024; 181:e597-e606. [PMID: 37914078 DOI: 10.1016/j.wneu.2023.10.098] [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: 06/27/2023] [Revised: 10/19/2023] [Accepted: 10/21/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVES To evaluate and describe neurosurgery applicant perceptions of the postinterview communication (PIC) process during the US residency match. METHODS A voluntary and anonymous postmatch web-based survey was developed and sent to 209 candidates who applied to 1 academic neurosurgery practice during the 2022-2023 recruitment cycle, approximately 1 week following match day. Survey questions focused on their perceptions of and participation behaviors with PIC and how this impacted their final rank list. RESULTS Seventy-eight (37.3%) of the 209 candidates responded to the survey. Sixty-four (84.2%) respondents reported submitting a letter of intent (LOI) to their number 1 ranked program. Sixty-one (82%) felt pressured to send a LOI to improve their rank status, fearing that it may harm them if they did not. Fifty-four (73.0%) respondents felt pressured to send an early LOI despite not seeing the program in person to communicate interest before programs certified their rank lists. Fourteen (18.9%) respondents agreed that a second look experience impacted their rank list enough to where they regretted an early LOI. Fifty-five (76.4%) respondents disagreed that second-look attendance had no impact on their rank status with a program. Fifty (71.4%) respondents agreed that PIC causes undue stress during the match process. Sixty-one (84.7%) respondents agreed that aspects of PIC require universal guidelines. CONCLUSIONS This is the first study to describe the perceptions of PIC and behaviors of neurosurgery applicants during the US residency match process. Standardized PIC practices may help to ensure transparency and relieve stress for applicants during the match process.
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Affiliation(s)
- Nicholas M B Laskay
- Department of Neurological Surgery, University of Alabama at Birmingham Birmingham, Alabama, USA.
| | - Hunter S Boudreau
- Department of Neurological Surgery, University of Alabama at Birmingham Birmingham, Alabama, USA
| | | | - Jordan A George
- Department of Neurological Surgery, University of Alabama at Birmingham Birmingham, Alabama, USA
| | - Travis J Atchley
- Department of Neurological Surgery, University of Alabama at Birmingham Birmingham, Alabama, USA
| | - J Nicole Bentley
- Department of Neurological Surgery, University of Alabama at Birmingham Birmingham, Alabama, USA
| | - Curtis J Rozzelle
- Department of Neurological Surgery, University of Alabama at Birmingham Birmingham, Alabama, USA
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242
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Mikhail JN. Demystifying Reporting Guidelines. J Trauma Nurs 2024; 31:3-6. [PMID: 38193484 DOI: 10.1097/jtn.0000000000000760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Affiliation(s)
- Judy N Mikhail
- Michigan Trauma Quality Improvement Program, Department of Surgery, University of Michigan, Ann Arbor
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243
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Dickens GL, Avantaggiato-Quinn M, Long SJ, Schoultz M, Clibbens N. Mental Health Nurses' and Allied Health Professionals' Individual Research Capacity and Organizational Research Culture: A Comparative Study. SAGE Open Nurs 2024; 10:23779608241250207. [PMID: 38746076 PMCID: PMC11092560 DOI: 10.1177/23779608241250207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 03/20/2024] [Accepted: 04/10/2024] [Indexed: 05/16/2024] Open
Abstract
Introduction Healthcare professionals have development needs related to their consumption, use, and practice of clinical research. Little is known about these issues in mental health services specifically. Objectives A survey of healthcare staff working in an NHS Mental Health and Disability Trust in England was conducted to describe research capacity and culture compared with previously reported samples, and to examine subgroup differences. Methods An online questionnaire was utilized. The main measure was the Research Capacity and Culture tool comprising measures of individual's perceived research skills and of team and organizational research culture. Previous studies using the same measure were systematically identified, and pooled results, weighted by sample size, were calculated. Analyses were descriptive (current sample versus previous results) and inferential (comparisons between demographic and professional groups within the current sample). Results N = 293 people completed the survey. The median item scores were poorer than those of pooled samples from studies reporting median item scores on 39/51 (76.5%) occasions and poorer than those pooled samples of studies reporting mean item scores on 51/51 (100.0%) occasions. Individual capability for research was in the 'less than adequate' range more than in previous samples (71.4% vs. 42.9%). For team culture items, the proportions were 84.2% vs. 78.9%, while most responses about organizational culture were in the 'adequate' range (55.6% vs. 66.7%). Staff >20 years employment had poorer perceptions of team and organizational culture. Conclusion Perceptions of individual research capacity and team and organizational culture were poor compared with previous studies, most of which were conducted in non-mental health settings. There is need for development of research capacity and culture in mental health services including opportunities to develop basic research skills through to strategic developments to promote clinical academic careers. There is considerable room for improvement in the way organizations support research and signpost opportunities.
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Affiliation(s)
- Geoffrey L. Dickens
- Department of Nursing Midwifery and Health, Northumbria University, Newcastle Upon Tyne, UK
- Cumbria Northumberland Tyne & Wear NHS Trust, Newcastle Upon Tyne, UK
| | | | - Sara-Jaye Long
- Cumbria Northumberland Tyne & Wear NHS Trust, Newcastle Upon Tyne, UK
| | - Mariyana Schoultz
- Department of Nursing Midwifery and Health, Northumbria University, Newcastle Upon Tyne, UK
| | - Nicola Clibbens
- Department of Nursing Midwifery and Health, Northumbria University, Newcastle Upon Tyne, UK
- Cumbria Northumberland Tyne & Wear NHS Trust, Newcastle Upon Tyne, UK
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244
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Napoli N, Kauffmann EF, Ginesini M, Gianfaldoni C, Fiaschetti P, Lombardi I, Cardillo M, Vistoli F, Boggi U. Safety and safety protocols for living donor nephrectomy in Italy. Updates Surg 2024; 76:209-218. [PMID: 37940801 PMCID: PMC10805880 DOI: 10.1007/s13304-023-01678-2] [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: 03/26/2023] [Accepted: 10/22/2023] [Indexed: 11/10/2023]
Abstract
Living donor kidney transplantation (LDKTx) is recommended by all scientific societies. Living donor nephrectomy (LDN) is probably one of the safest surgical procedures, but it carries some risk for healthy donors. The aim of this study is to provide a snapshot of LDKTx activities in Italy and ask about safety measures implemented in LDN. Data on LDKTx were extracted from the national database. Safety measures were examined through a specific survey. Between 2001 and 2022 40,663 kidney transplants (31.4 per million population-pmp) were performed, including 4731 LDKTx (3.7 pmp). There was no postoperative death of the donor. After a median follow-up of 52.2 months [IQR:17.9-99.5], the 10-year donor survival rate was 93.38% (CI:97.52-98.94). There was evidence of renal disease in 65 donors (1.8%), including 42 (1.1%) with stage III end-stage renal disease. Twenty-nine out of 35 transplant centers (TC) involved in LDKTx responded to the survey (82.9%). Six TCs (21.4%) had a total experience of 20 or fewer LDN. Minimally invasive LDN was the first choice at 24 TC (82.8%). At 10 TC (37.0%) only one surgeon performed LDN. Nineteen TCs (65.5%) had a surgical safety checklist for LDN and 14 had a postoperative surveillance protocol. The renal artery was occluded in 3 TCs (10.3%) mainly by non-transfixion methods (including clips). Redundancy of key safety systems in the operating room was available in 22 of 29 centers (75.8%). In summary, LDKTx should be further implemented in Italy. Donor safety should be improved through the implementation of a national procedural protocol.
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Affiliation(s)
- Niccolò Napoli
- Division of General and Transplant Surgery, University of Pisa, Pisa, Italy
| | | | - Michael Ginesini
- Division of General and Transplant Surgery, University of Pisa, Pisa, Italy
| | - Cesare Gianfaldoni
- Division of General and Transplant Surgery, University of Pisa, Pisa, Italy
| | - Pamela Fiaschetti
- Centro Nazionale Trapianti - Italian National Transplant Centre (ISS-CNT), National Institute of Health, Rome, Italy
| | - Ilaria Lombardi
- Centro Nazionale Trapianti - Italian National Transplant Centre (ISS-CNT), National Institute of Health, Rome, Italy
| | - Massimo Cardillo
- Centro Nazionale Trapianti - Italian National Transplant Centre (ISS-CNT), National Institute of Health, Rome, Italy
| | - Fabio Vistoli
- Division of General and Transplant Surgery, University of Pisa, Pisa, Italy
| | - Ugo Boggi
- Division of General and Transplant Surgery, University of Pisa, Pisa, Italy.
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Walsh L, Chapman B, Carey J, Loycano K, Carreiro S. Opioid Overdose Recognition: A Survey of Perceived Preparedness and Desire for Curricular Integration Among Current US Medical Students. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2024; 11:23821205231225923. [PMID: 38223503 PMCID: PMC10785711 DOI: 10.1177/23821205231225923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 12/23/2023] [Indexed: 01/16/2024]
Abstract
OBJECTIVES Opioid overdose deaths remain a major health issue in the United States (US). As future physicians, medical students must receive comprehensive training to recognize and manage opioid overdoses. This study aimed to highlight training gaps at the medical student level and understand students' attitudes toward patients with opioid use disorder (OUD). METHODS We assessed baseline knowledge of and attitudes toward the management of opioid overdoses and naloxone administration among medical students in the US. Two validated survey tools (Opioid Overdose Knowledge Scale and Opioid Overdose Attitude Scale) were administered to medical students training at accredited institutions along with supplemental questions measuring knowledge and attitudes towards opioid overdose management, naloxone administration, and prior training. RESULTS The final sample had N = 73 participants from US medical schools with a mean age of 25.3 (range of 22-37): 72.6% of respondents were female. Although most respondents reported personal/professional experience with OUD before medical school, they expressed interest in additional training. Knowledge surrounding opioid overdoses increased insignificantly over the 4 years of medical school. However, there was a significant increase in both perceived competence in overdose recognition/management and in concerns about intervening from the first to fourth year of medical school. Female respondents had significantly lower perceived competence and readiness to intervene sub-scores than male counterparts; however, there was no significant difference in overall attitude and knowledge scores when stratified by sex. Incorporating opioid overdose prevention training (OOPT) into early medical education was favorable among respondents, who expressed an overwhelming interest in learning and supporting patients with OUD. CONCLUSIONS Given the ongoing opioid crisis, medical students are ideally placed to identify and manage opioid overdoses. Medical students are ready to receive this training, thus strengthening the argument for OOPT integration into early medical student curricula.
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Affiliation(s)
- Lindsay Walsh
- Division of Medical Toxicology, Department of Emergency Medicine, University of Massachusetts T.H. Chan School of Medicine, Worcester, MA, USA
- Harvard Affiliated Emergency Medicine Residency at Mass General Brigham, Boston, MA, USA
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Brittany Chapman
- Division of Medical Toxicology, Department of Emergency Medicine, University of Massachusetts T.H. Chan School of Medicine, Worcester, MA, USA
| | - Jennifer Carey
- Division of Medical Toxicology, Department of Emergency Medicine, University of Massachusetts T.H. Chan School of Medicine, Worcester, MA, USA
| | - Kayla Loycano
- Division of Medical Toxicology, Department of Emergency Medicine, University of Massachusetts T.H. Chan School of Medicine, Worcester, MA, USA
| | - Stephanie Carreiro
- Division of Medical Toxicology, Department of Emergency Medicine, University of Massachusetts T.H. Chan School of Medicine, Worcester, MA, USA
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Patikorn C, Kategeaw W, Perdrizet J, Li X, Chaiyakunapruk N. Implementation challenges and real-world impacts of switching pediatric vaccines: A global systematic literature review. Hum Vaccin Immunother 2023; 19:2177459. [PMID: 36880656 PMCID: PMC10026932 DOI: 10.1080/21645515.2023.2177459] [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: 03/08/2023] Open
Abstract
Switching a vaccine for another on a pediatric national immunization program is often done for the betterment of society. However, if poorly implemented, switching vaccines could result in suboptimal transitions with negative effects. A systematic review was conducted to evaluate the existing knowledge from identifiable documents on implementation challenges of pediatric vaccine switches and the real-world impact of those challenges. Thirty-three studies met the inclusion criteria. We synthesized three themes: vaccine availability, vaccination program deployment, and vaccine acceptability. Switching pediatric vaccines can pose unforeseen challenges to health-care systems worldwide and additional resources are often required to overcome those challenges. Yet, the magnitude of the impact, especially economic and societal, was frequently under-researched with variability in reporting. Therefore, an efficient vaccine switch requires a thorough consideration of the added benefits of replacing the existing vaccine, preparation, planning, additional resource allocation, implementation timing, public-private partnerships, outreach campaigns, and surveillance for program evaluation.
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Affiliation(s)
- Chanthawat Patikorn
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, USA
- Department of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Warittakorn Kategeaw
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, USA
| | - Johnna Perdrizet
- Global Health Economics and Outcomes Research, Pfizer Inc, New York, NY, USA
| | - Xiuyan Li
- Global Health Economics and Outcomes Research, Pfizer Inc, New York, NY, USA
| | - Nathorn Chaiyakunapruk
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, USA
- IDEAS Center, Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, UT, USA
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Jesser J, Nguyen T, Dmytriw AA, Yamagami H, Miao Z, Sommer LJ, Stockero A, Pfaff JAR, Ospel J, Goyal M, Patel AB, Pereira VM, Hanning U, Meyer L, van Zwam WH, Bendszus M, Wiesmann M, Möhlenbruch M, Weyland CS. Treatment practice of vasospasm during endovascular thrombectomy: an international survey. Stroke Vasc Neurol 2023:svn-2023-002788. [PMID: 38164618 DOI: 10.1136/svn-2023-002788] [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: 08/17/2023] [Accepted: 11/14/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND AND AIM The clinical importance and management of vasospasm as a complication during endovascular stroke treatment (EVT) has not been well studied. We sought to investigate current expert opinions in neurointervention and therapeutic strategies of iatrogenic vasospasm during EVT. METHODS We conducted an anonymous international online survey (4 April 2023 to 15 May 2023) addressing treatment standards of neurointerventionalists (NIs) practising EVT. Several illustrative cases of patients with vasospasm during EVT were shown. Two study groups were compared according to the NI's opinion regarding the potential influence of vasospasm on patient outcome after EVT using descriptive analysis. RESULTS In total, 534 NI from 56 countries responded, of whom 51.5% had performed >200 EVT. Vasospasm was considered a complication potentially influencing the patient's outcome by 52.6% (group 1) whereas 47.4% did not (group 2). Physicians in group 1 more often added vasodilators to their catheter flushes during EVT routinely (43.7% vs 33.9%, p=0.033) and more often treated severe large-vessel vasospasm with vasodilators (75.3% vs 55.9%; p<0.001), as well as extracranial vasospasm (61.4% vs 36.5%, p<0.001) and intracranial medium-vessel vasospasm (27.1% vs 11.2%, p<0.001), compared with group 2. In case of a large-vessel vasospasm and residual and amenable medium-vessel occlusion during EVT, the study groups showed different treatment strategies. Group 2 continued the EVT immediately more often, without initiating therapy to treat the vasospasm first (9.6% vs 21.1%, p<0.001). CONCLUSION There is disagreement among NIs about the clinical relevance of vasospasm during EVT and its management. There was a higher likelihood of use of preventive and active vasodilator treatment in the group that perceived vasospasm as a relevant complication as well as differing interventional strategies for continuing an EVT in the presence of a large-vessel vasospasm.
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Affiliation(s)
- Jessica Jesser
- Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Thanh Nguyen
- Neurology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Adam A Dmytriw
- St. Michael's Hospital, Departments of Medical Imaging and Neurosurgery, Neurovascular Center, University of Toronto, Toronto, Ontario, Canada
- Neuroendovascular Program, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Hiroshi Yamagami
- Stroke Neurology, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Zhongrong Miao
- Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Beijing, China
| | | | | | - Johannes Alex Rolf Pfaff
- University Insitute for Neuroradiology at PMU, Uniklinikum Salzburg-Christian-Doppler-Klinik, Salzburg, Austria
| | - Johanna Ospel
- Departments of Diagnostic Imaging and Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Mayank Goyal
- Departments of Diagnostic Imaging and Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Aman B Patel
- Neuroendovascular Program, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Uta Hanning
- Universitatsklinikum Hamburg Eppendorf Klinik und Poliklinik fur Neuroradiologische Diagnostik und Intervention, Hamburg, Germany
| | - Lukas Meyer
- Diagnostic and Interventional Neuroradiology, Universitatsklinikum Hamburg Eppendorf Klinik und Poliklinik fur Neuroradiologische Diagnostik und Intervention, Hamburg, Germany
| | - Wim H van Zwam
- Radiology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Martin Bendszus
- Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany
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Coe D, Bigirumurame T, Burgess M, Rouse J, Wroe C. Enablers and barriers to engaging under-served groups in research: Survey of the United Kingdom research professional's views. NIHR OPEN RESEARCH 2023; 3:37. [PMID: 39139271 PMCID: PMC11319909 DOI: 10.3310/nihropenres.13434.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/29/2023] [Indexed: 08/15/2024]
Abstract
Background There is a known lack of diversity in research participant populations. This impacts on the generalisability of findings and affects clinician prescribing. In the United Kingdom the research community defines those who are underrepresented as under-served. They are commonly those affected by health inequality and disparity. The notion of under-served is complex, with numerous papers identifying multiple factors that contribute to being under-served and in turn suggesting many strategies to improve engagement. Methods Research professionals in the UK were invited to complete an online survey. The broad aim was to explore their views on under-served groups. The findings were analysed using statistical and qualitative methods to identify enablers and barriers to engaging the under-served. Descriptive statistics were utilised with associations compared univariately by chi-square test and logistic regression for multivariable analysis. Results A total of 945 completed responses were received. Those identified as under-served in this study reflected the previous body of works with a broader descriptor of ethnic and cultural minorities and the addition of adolescents and young adults. Language and literacy skills had the most impact on being under-served. Only 13% of respondents said they felt equipped to meet the needs of the under-served. The main strategy to increase diversity was community engagement and movement of research delivery into the community. The barriers were funding and time. Training needs identified were linked to community engagement, cultural competence and consent processes. Conclusions The UK findings from research professionals reflected the previous literature. Adolescents and young people were added to those identified as under-served. Enablers included community outreach and improvement to communication. Barriers were time, funding, organisational processes and lack of focus. Issues were identified with translation and interpretation services. Training requirements focus on methodologies and methods to engage and the consent processes of those from under-served groups.
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Affiliation(s)
- Dorothy Coe
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, England, UK
| | - Theophile Bigirumurame
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, England, UK
| | - Meera Burgess
- Clinical Research Network Coordinating Centre, National Institute for Health and Care Research, NIHR, UK
| | - John Rouse
- Clinical Research Network North East and North Cumbria, National Institute for Health and Care Research, Regent Point, Newcastle, UK
| | - Caroline Wroe
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, England, UK
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van der Braak K, Heus P, Orelio C, Netterström-Wedin F, Robinson KA, Lund H, Hooft L. Perspectives on systematic review protocol registration: a survey amongst stakeholders in the clinical research publication process. Syst Rev 2023; 12:234. [PMID: 38098085 PMCID: PMC10720136 DOI: 10.1186/s13643-023-02405-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/30/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND As systematic reviews (SRs) inform healthcare decisions, it is key that they address relevant questions and use rigorous methodology. Registration of SR protocols helps researchers identify relevant topics for future reviews and aims to prevent bias and duplication of effort. However, most SRs protocols are currently not registered, despite its significance. To guide future recommendations to enhance preregistration of SRs, it is important to gain a comprehensive understanding of the perspectives within the research community. Therefore, this study aims to examine the experiences with and factors of influence (barriers and facilitators) on prospective SR registration amongst researchers, peer reviewers and journal editors. METHODS Two different surveys were distributed to two groups: researchers and journal editors both identified from an existing sample of SRs. Researchers who indicated to have peer reviewed a SR were surveyed on their perspectives as peer reviewers as well. Survey design and analysis were informed by the Consolidated Framework for Implementation Research (CFIR). Shared and unique subthemes from the perspectives of researchers, peer reviewers and journal editors were identified and linked to the SR registration process (Innovation), to team, organisation (Inner setting) and (inter)national research community (Outer setting), and to characteristics of researchers, peer reviewers or journal editors (Individuals). RESULTS The survey's response rates were 65/727 (9%) for researchers, of which 37 were peer reviewers, and 22/308 (7%) for journal editors. Most respondents (n = 76, 94%) were familiar with SR protocol registration and 81% of researchers had registered minimally one SR protocol. Shared SR registration process subthemes were the importance and advantages of SR protocol registration, as well as barriers such as a high administrative burden. Shared subthemes regarding the inner and outer setting centred on journal processes, external standards and time. Shared individual factors were knowledge, skills and awareness. CONCLUSIONS The majority of the respondents were familiar with SR protocol registration and had a positive attitude towards it. This study identified suboptimal registration process, administrative burden and lack of mandatory SR protocol registration as barriers. By overcoming these barriers, SR protocol registration could contribute more effectively to the goals of open science. SYSTEMATIC REVIEW REGISTRATION osf.io/gmv6z.
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Affiliation(s)
- Kim van der Braak
- Cochrane Netherlands, Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands.
| | - Pauline Heus
- Cochrane Netherlands, Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Claudia Orelio
- Cochrane Netherlands, Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
- Research Support, Diakonessenhuis Utrecht, Bosboomstraat 1, Utrecht, 3582 KE, The Netherlands
| | - Fredh Netterström-Wedin
- School of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Karen A Robinson
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Section for Evidence-Based Practice, Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
| | - Hans Lund
- Section for Evidence-Based Practice, Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
| | - Lotty Hooft
- Cochrane Netherlands, Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
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250
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Nagy R, Ocskay K, Sipos Z, Szentesi A, Vincze Á, Czakó L, Izbéki F, Shirinskaya NV, Poluektov VL, Zolotov AN, Zhu Y, Xia L, He W, Sutton R, Szatmary P, Mukherjee R, Burridge IS, Wauchope E, Francisco E, Aparicio D, Pinto B, Gomes A, Nunes V, Tantau VM, Sagau ED, Tantau AI, Suceveanu AI, Tocia C, Dumitru A, Pando E, Alberti P, Cirera A, Molero X, Lee HS, Jung MK, Kim EJ, Lee S, Rebollo MLR, Nistal RB, Santervas SI, Lesko D, Soltes M, Radonak J, Zatorski H, Małecka-Panas E, Fabisiak A, Yaroslav MS, Mykhailo VM, Olekcandr AT, Barauskas G, Simanaitis V, Ignatavicius P, Jinga M, Balaban VD, Patoni C, Gong L, Song K, Li Y, Gonçalves TC, Freitas M, Macedo V, Vornhuelz M, Klauss S, Beyer G, Koksal AS, Tozlu M, Eminler AT, Monclús NT, Comas EP, Oballe JAR, Nawacki Ł, Głuszek S, Rama-Fernández A, Galego M, de la Iglesia D, Aykut UE, Duman DG, Aslan R, Gherbon A, Deng L, Huang W, Xia Q, Poropat G, Radovan A, Vranić L, Ricci C, Ingaldi C, Casadei R, Negoi I, Ciubotaru C, Iordache FM, Constantinescu G, Sandru V, Altintas E, Balci HR, Constantino J, Aveiro D, Pereira J, Gunay S, Misirlioglu Sucan S, Dronov O, Kovalska I, Bush N, Rana SS, Chooklin S, Chuklin S, Saizu IA, Gheorghe C, Göltl P, Hirth M, Mateescu RB, Papuc G, Minkov GA, Enchev ET, Mastrangelo L, Jovine E, Chen W, Zhu Q, Gąsiorowska A, Fabisiak N, Bezmarevic M, Litvin A, Mottes MC, Choi EK, Bánovčin P, Nosáková L, Kovacheva-Slavova MD, Kchaou A, Tlili A, Marino MV, Kusnierz K, Mickevicius A, Hollenbach M, Molcan P, Ioannidis O, Tokarev MV, Ince AT, Semenenko IA, Galeev S, Ramírez-Maldonado E, Sallinen V, Pencik P, Bajor J, Sarlós P, Hágendorn R, Gódi S, Szabó I, Czimmer J, Pár G, Illés A, Faluhelyi N, Kanizsai P, Nagy T, Mikó A, Németh B, Hamvas J, Bod B, Varga M, Török I, Novák J, Patai Á, Sümegi J, Góg C, Papp M, Erőss B, Váncsa S, Teutsch B, Márta K, Hegyi PJ, Tornai T, Lázár B, Hussein T, Tarján D, Lipp M, Kovács B, Urbán O, Fürst E, Tari E, Kocsis I, Maurovich-Horvát P, Tihanyi B, Eperjesi O, Kormos Z, Deák PÁ, Párniczky A, Hegyi P. Discharge protocol in acute pancreatitis: an international survey and cohort analysis. Sci Rep 2023; 13:22109. [PMID: 38092809 PMCID: PMC10719286 DOI: 10.1038/s41598-023-48480-z] [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: 04/04/2023] [Accepted: 11/27/2023] [Indexed: 12/17/2023] Open
Abstract
There are several overlapping clinical practice guidelines in acute pancreatitis (AP), however, none of them contains suggestions on patient discharge. The Hungarian Pancreatic Study Group (HPSG) has recently developed a laboratory data and symptom-based discharge protocol which needs to be validated. (1) A survey was conducted involving all members of the International Association of Pancreatology (IAP) to understand the characteristics of international discharge protocols. (2) We investigated the safety and effectiveness of the HPSG-discharge protocol. According to our international survey, 87.5% (49/56) of the centres had no discharge protocol. Patients discharged based on protocols have a significantly shorter median length of hospitalization (LOH) (7 (5;10) days vs. 8 (5;12) days) p < 0.001), and a lower rate of readmission due to recurrent AP episodes (p = 0.005). There was no difference in median discharge CRP level among the international cohorts (p = 0.586). HPSG-protocol resulted in the shortest LOH (6 (5;9) days) and highest median CRP (35.40 (13.78; 68.40) mg/l). Safety was confirmed by the low rate of readmittance (n = 35; 5%). Discharge protocol is necessary in AP. The discharge protocol used in this study is the first clinically proven protocol. Developing and testifying further protocols are needed to better standardize patients' care.
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Affiliation(s)
- Rita Nagy
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Heim Pál National Pediatric Institute, Budapest, Hungary
| | | | - Zoltán Sipos
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Andrea Szentesi
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Áron Vincze
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - László Czakó
- Department of Medicine, University of Szeged, Szeged, Hungary
| | - Ferenc Izbéki
- Szent György University Teaching Hospital of Fejér County, Székesfehérvár, Hungary
| | - Natalia V Shirinskaya
- Omsk State Medical Information-Analytical Centre, Omsk State Medical University, Omsk, Russia
| | | | - Alexandr N Zolotov
- Department of Pathophysiology, Clinical Pathophysiology, Omsk State Medical University, Omsk, Russia
| | - Yin Zhu
- Department of Gastroenterology, First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Liang Xia
- Department of Gastroenterology, First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Wenhua He
- Department of Gastroenterology, First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Robert Sutton
- University of Liverpool, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Peter Szatmary
- University of Liverpool, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Rajarshi Mukherjee
- University of Liverpool, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | | | - Emma Wauchope
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Elsa Francisco
- Surgery Department, Hospital Prof. Ferndo Fonseca, Amadora, Portugal
| | - David Aparicio
- Surgery Department, Hospital Prof. Ferndo Fonseca, Amadora, Portugal
| | - Bruno Pinto
- Surgery Department, Hospital Prof. Ferndo Fonseca, Amadora, Portugal
| | - António Gomes
- Surgery Department, Hospital Prof. Ferndo Fonseca, Amadora, Portugal
| | - Vitor Nunes
- Surgery Department, Hospital Prof. Ferndo Fonseca, Amadora, Portugal
| | - Vasile Marcel Tantau
- "Octavin Fodor" Institute of Gastroenterology and Hepartology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - Emanuela Denisa Sagau
- "Octavin Fodor" Institute of Gastroenterology and Hepartology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - Alina Ioana Tantau
- Gastroenterology Department, 4th Medical Clinic, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj Napoca, Romania
| | | | - Cristina Tocia
- Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania
| | - Andrei Dumitru
- Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania
| | - Elizabeth Pando
- Department of Hepato-Pancreato-Biliary and Transplant Surgery, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Piero Alberti
- Department of Hepato-Pancreato-Biliary and Transplant Surgery, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Arturo Cirera
- Department of Hepato-Pancreato-Biliary and Transplant Surgery, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Xavier Molero
- Exocrine Pancreas Research Unit, Hospital Universitari Vall d'Hebron, Institut de Recerca, Universitat Autònoma de Barcelona, CIBEREHD, Barcelona, Spain
| | - Hong Sik Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Min Kyu Jung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Eui Joo Kim
- Division of Gastroenterology, Department of Internal Medicine, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Sanghyub Lee
- Department of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | | | - Reyes Busta Nistal
- Servicio de Aparato Digestivo Hospital Clínico Universitario Valladolid, Valladolid, Spain
| | | | - Dusan Lesko
- 1st Department of Surgery, University Hospital of L. Pasteur, Kosice, Slovak Republic
| | - Marek Soltes
- 1st Department of Surgery, University Hospital of L. Pasteur, Kosice, Slovak Republic
| | - Jozef Radonak
- 1st Department of Surgery, University Hospital of L. Pasteur, Kosice, Slovak Republic
| | - Hubert Zatorski
- Department of Digestive Tract Diseases, Medical University of Lodz, Lodz, Poland
| | - Ewa Małecka-Panas
- Department of Digestive Tract Diseases, Medical University of Lodz, Lodz, Poland
| | - Adam Fabisiak
- Department of Digestive Tract Diseases, Medical University of Lodz, Lodz, Poland
| | - M Susak Yaroslav
- Department of Surgery With a Course of Emergency and Vascular Surgery, Bogomolet National Medical University, Kiev, Ukraine
| | - V Maksymenko Mykhailo
- Department of Surgery With a Course of Emergency and Vascular Surgery, Bogomolet National Medical University, Kiev, Ukraine
| | | | - Giedrius Barauskas
- Department of Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Vytautas Simanaitis
- Department of Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | - Mariana Jinga
- Department of Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | - Cristina Patoni
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Liang Gong
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Kai Song
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Yunlong Li
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - T Cúrdia Gonçalves
- Gastroenterology Department, Hospital da Senhora da Oliveira, Guimarães, Portugal
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga/Guimarães, Portugal
- ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Marta Freitas
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Vítor Macedo
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Gastroenterology Department, Hospital da Senhora da Oliveira, Guimarães, Portugal
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga/Guimarães, Portugal
| | | | - Sarah Klauss
- LMU University Hospital, LMU Munich, Munich, Germany
| | - Georg Beyer
- LMU University Hospital, LMU Munich, Munich, Germany
| | - Aydin Seref Koksal
- Department of Gastroenterology, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Mukaddes Tozlu
- Department of Gastroenterology, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Ahmet Tarik Eminler
- Department of Gastroenterology, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Nuria Torres Monclús
- University Hospital Arnau de Vilanova, Hospital University Santa Maria, Lleida, Spain
| | - Eva Pijoan Comas
- University Hospital Arnau de Vilanova, Hospital University Santa Maria, Lleida, Spain
| | | | - Łukasz Nawacki
- Collegium Medicum, The Jan Kochanowski University in Kielce, Kielce, Poland
| | - Stanisław Głuszek
- Collegium Medicum, The Jan Kochanowski University in Kielce, Kielce, Poland
| | - Alberto Rama-Fernández
- Gastroenterology Department, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Marco Galego
- Gastroenterology Department, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Daniel de la Iglesia
- Gastroenterology Department, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Umut Emre Aykut
- Marmara University Education and Training Hospital, Istanbul, Turkey
| | - Deniz Güney Duman
- Marmara University Education and Training Hospital, Istanbul, Turkey
| | - Rahmi Aslan
- Marmara University Education and Training Hospital, Istanbul, Turkey
| | - Adriana Gherbon
- Discipline of Internal Medicine: Diabetes, Nutrition, Metabolic Diseases and Systemic Rheumatology, Victor Babeş University of Medicine and Pharmacy Timisoara, Timisoara, Romania
| | - Lihui Deng
- Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Center and West China-Liverpool Biomedical Research Center, West China Hospital, Sichuan University, Chengdu, China
| | - Wei Huang
- Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Center and West China-Liverpool Biomedical Research Center, West China Hospital, Sichuan University, Chengdu, China
| | - Qing Xia
- Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Center and West China-Liverpool Biomedical Research Center, West China Hospital, Sichuan University, Chengdu, China
| | - Goran Poropat
- Department of Gastroenterology, Clinical Hospital Center Rijeka, University of Rijeka, Rijeka, Croatia
| | - Anja Radovan
- Department of Gastroenterology, Clinical Hospital Center Rijeka, University of Rijeka, Rijeka, Croatia
| | - Luka Vranić
- Department of Gastroenterology, Clinical Hospital Center Rijeka, University of Rijeka, Rijeka, Croatia
| | - Claudio Ricci
- Division of Pancreatic Surgery, IRCCS, Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
- Department of Internal Medicine and Surgery (DIMEC), Alma Mater Studiorum, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Carlo Ingaldi
- Division of Pancreatic Surgery, IRCCS, Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
- Department of Internal Medicine and Surgery (DIMEC), Alma Mater Studiorum, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Riccardo Casadei
- Division of Pancreatic Surgery, IRCCS, Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
- Department of Internal Medicine and Surgery (DIMEC), Alma Mater Studiorum, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | - Ionut Negoi
- Emergency Hospital of Bucharest, Carol Davila University of Medicine and Pharmacy Bucharest, Bucharest, Romania
| | - Cezar Ciubotaru
- Emergency Hospital of Bucharest, Carol Davila University of Medicine and Pharmacy Bucharest, Bucharest, Romania
| | - Florin Mihail Iordache
- Emergency Hospital of Bucharest, Carol Davila University of Medicine and Pharmacy Bucharest, Bucharest, Romania
| | - Gabriel Constantinescu
- Emergency Hospital of Bucharest, Carol Davila University of Medicine and Pharmacy Bucharest, Bucharest, Romania
| | - Vasile Sandru
- Emergency Hospital of Bucharest, Carol Davila University of Medicine and Pharmacy Bucharest, Bucharest, Romania
| | - Engin Altintas
- Gastroenterology Department, Faculty of Medicine, Mersin University, Yenisehir/Mersin, Turkey
| | - Hatice Rizaoglu Balci
- Gastroenterology Department, Faculty of Medicine, Mersin University, Yenisehir/Mersin, Turkey
| | - Júlio Constantino
- Unidade HBP, Serviço de Cirurgia Geral, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - Débora Aveiro
- Unidade HBP, Serviço de Cirurgia Geral, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - Jorge Pereira
- Unidade HBP, Serviço de Cirurgia Geral, Centro Hospitalar Tondela-Viseu, Viseu, Portugal
| | - Suleyman Gunay
- İzmir Katip Çelebi University Atatürk Training and Research Hospital, Karabaglar/Izmir, Turkey
| | - Seda Misirlioglu Sucan
- İzmir Katip Çelebi University Atatürk Training and Research Hospital, Karabaglar/Izmir, Turkey
| | - Oleksiy Dronov
- General Surgery #1, Bogomolets National Medical University, Kiev, Ukraine
| | - Inna Kovalska
- General Surgery #1, Bogomolets National Medical University, Kiev, Ukraine
| | - Nikhil Bush
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Surinder Singh Rana
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | | | | | | | - Cristian Gheorghe
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- Clinical Institute Fundeni, Bucharest, Romania
| | - Philipp Göltl
- Department of Medicine II, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Michael Hirth
- Department of Medicine II, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Radu Bogdan Mateescu
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
- Gastroenterology Department, Colentina Clinical Hospital Bucharest, Bucharest, Romania
| | - Geanina Papuc
- Gastroenterology Department, Colentina Clinical Hospital Bucharest, Bucharest, Romania
| | | | | | - Laura Mastrangelo
- Department of Surgery, AOU Sant'Orsola Malpighi, IRCCS Azienda Ospedaliera Universitaria, Bologna, Italy
| | - Elio Jovine
- Department of Surgery, AOU Sant'Orsola Malpighi, IRCCS Azienda Ospedaliera Universitaria, Bologna, Italy
| | - Weiwei Chen
- Department of Gastroenterology, Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu, China
| | - Quping Zhu
- Department of Gastroenterology, Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu, China
| | - Anita Gąsiorowska
- Department of Gastroenterology Medical, University of Lodz, Lodz, Poland
| | - Natalia Fabisiak
- Department of Gastroenterology Medical, University of Lodz, Lodz, Poland
| | - Mihailo Bezmarevic
- Department for Hepatobiliary and Pancreatic Surgery, Clinic for General Surgery, Military Medical Academy, University of Defense, Belgrade, Serbia
| | | | - Martina Cattani Mottes
- Department of Medicine, Gastroenterology, The Pancreas Institute, G.B. Rossi University Hospital, Verona, Italy
| | - Eun Kwang Choi
- Department of Internal Medicine, Jeju National University College of Medicine, Jeju, South Korea
| | - Peter Bánovčin
- Clinic of Internal Medicine - Gastroenterology, JFM CU, Jessenius Faculty of Medicine in Martin (JFM CU), Comenius University in Bratislava, Bratislava, Slovakia
| | - Lenka Nosáková
- Clinic of Internal Medicine - Gastroenterology, JFM CU, Jessenius Faculty of Medicine in Martin (JFM CU), Comenius University in Bratislava, Bratislava, Slovakia
| | | | - Ali Kchaou
- Habib Bourguiba University Hospital, Sfax, Tunisia
| | | | - Marco V Marino
- General Surgery Department, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy
| | | | | | - Marcus Hollenbach
- Division of Gastroenterology, University of Leipzig Medical Center, Leipzig, Germany
| | - Pavol Molcan
- Hepatology and Gastroenterology Department of Roosevelt Hospital, Banska Bystrica, Slovakia
| | - Orestis Ioannidis
- 4th Department of Surgery, Medical School, Aristotle University of Thessaloniki, General Hospital "George Papanikolaou", Thessaloniki, Greece
| | - Mark Valerievich Tokarev
- Sklifosovsky Institute for Clinical Medicine, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Ali Tüzün Ince
- Hospital of Bezmialem Vakif University, School of Medicine, Istanbul, Turkey
| | | | - Shamil Galeev
- Saint Luke Clinical Hospital, St. Petersburg, Russia
| | | | - Ville Sallinen
- Department of Transplantation and Liver Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Petr Pencik
- Centrum péče o zažívací trakt, Vítkovická Nemocnice a.s., Ostrava, Czech Republic
| | - Judit Bajor
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Patricia Sarlós
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Roland Hágendorn
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Szilárd Gódi
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Imre Szabó
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - József Czimmer
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Gabriella Pár
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Anita Illés
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Nándor Faluhelyi
- Department of Medical Imaging, Medical School, University of Pécs, Pécs, Hungary
| | - Péter Kanizsai
- Department of Emergency Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Tamás Nagy
- Department of Laboratory Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Alexandra Mikó
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Balázs Németh
- Department of Medicine, University of Szeged, Szeged, Hungary
| | | | | | - Márta Varga
- Department of Gastroenterology, BMKK Dr Rethy Pal Hospital, Békéscsaba, Hungary
| | - Imola Török
- County Emergency Clinical Hospital of Târgu Mures - Gastroenterology Clinic and University of Medicine, Pharmacy, Sciences and Technology "George Emil Palade", Targu Mures, Romania
| | - János Novák
- Pándy Kálmán Hospital of Békés County, Gyula, Hungary
| | - Árpád Patai
- Markusovszky University Teaching Hospital, Szombathely, Hungary
| | - János Sümegi
- Borsod-Abaúj-Zemplén County Hospital and University Teaching Hospital, Miskolc, Hungary
| | - Csaba Góg
- Healthcare Center of County Csongrád, Makó, Hungary
| | - Mária Papp
- Department of Gastroenterology, Institute of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Bálint Erőss
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Szilárd Váncsa
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
- Department of Laboratory Medicine, Semmelweis University, Budapest, Hungary
| | - Brigitta Teutsch
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Department of Laboratory Medicine, Semmelweis University, Budapest, Hungary
| | - Katalin Márta
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Péter Jenő Hegyi
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Tamás Tornai
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Balázs Lázár
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Tamás Hussein
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Dorottya Tarján
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Mónika Lipp
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Beáta Kovács
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Orsolya Urbán
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Emese Fürst
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Edina Tari
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Ibolya Kocsis
- Department of Laboratory Medicine, Semmelweis University, Budapest, Hungary
| | - Pál Maurovich-Horvát
- MTA-SE Cardiovascular Imaging Research Group, Medical Imaging Centre, Semmelweis University, Budapest, Hungary
| | - Balázs Tihanyi
- Department for Surgery, Hungarian Defence Forces - Medical Centre, Budapest, Hungary
| | - Orsolya Eperjesi
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Zita Kormos
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Pál Ákos Deák
- Medical Imaging Centre, Department of Radiology, Semmelweis University, Budapest, Hungary
| | - Andrea Párniczky
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Heim Pál National Pediatric Institute, Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary.
- Translational Pancreatology Research Group, Interdisciplinary Centre of Excellence for Research Development and Innovation, University of Szeged, Szeged, Hungary.
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