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Guerra E, Denti FC, Di Pasquale C, Caroppo F, Angileri L, Cioni M, Parodi A, Fortina AB, Ferrucci S, Burlando M. Peristomal Skin Complications: Detailed Analysis of a Web-Based Survey and Predictive Risk Factors. Healthcare (Basel) 2023; 11:1823. [PMID: 37444657 DOI: 10.3390/healthcare11131823] [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: 04/04/2023] [Revised: 05/27/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
Patients with a stoma are at risk of developing peristomal skin complications (PSCs) that can negatively impact their quality of life. This study aims to identify potential risk factors for dermatitis, pruritis/xerosis, infections, and ulcerations among patients with a stoma and evaluate preventive measures. This cross-sectional study involved data regarding 232 Italian patients with a stoma. A questionnaire was used to collect patient characteristics, comorbidities, and stoma management data. The most frequent PSCs observed were dermatitis and pruritis/xerosis in approximately 60% of patients. Psoriasis was strongly correlated with dermatitis, while being overweight or obese increased the risk of pruritis/xerosis. Class 2 obesity and atopic dermatitis were associated with an increased risk of infections. Being underweight, completely nonautonomous, and having inflammatory bowel disease were associated with a higher risk of ulcerations, while radiotherapy was a strong risk factor for ulceration. Preventive measures such as using hydrocolloid barriers, TNT gauze cleansing, and low pH detergent were effective in preventing dermatitis. Appropriate stoma care and maintenance, including the use of protective film and careful monitoring of weight and comorbidities, are crucial in minimizing the risk of complications associated with a stoma.
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Affiliation(s)
- Eliana Guerra
- Ambulatorio Riabilitazione Enterostomale, ASST Spedali Civili Brescia, 25123 Brescia, Italy
| | | | - Cristina Di Pasquale
- Stomal Therapy Outpatient Service, European Institute of Oncology IRCCS, 20141 Milan, Italy
| | - Francesca Caroppo
- Unit of Dermatology, Department of Medicine DIMED, University of Padua, 35128 Padua, Italy
| | - Luisa Angileri
- Unit of Dermatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Margherita Cioni
- St Mary's Hospital, Imperial College NHS Trust, London W2 1NY, UK
| | - Aurora Parodi
- Di.S.Sal. Section of Dermatology, IRCCS San Martino Polyclinic Hospital, Largo Rosanna Benzi 10, 16100 Genoa, Italy
| | - Anna Belloni Fortina
- Unit of Dermatology, Department of Medicine DIMED, University of Padua, 35128 Padua, Italy
| | - Silvia Ferrucci
- Unit of Dermatology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Martina Burlando
- Di.S.Sal. Section of Dermatology, IRCCS San Martino Polyclinic Hospital, Largo Rosanna Benzi 10, 16100 Genoa, Italy
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352
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Vermeulen J, Fobelets M, Fleming V, Luyben A, Stas L, Buyl R. How Do Midwives View Their Professional Autonomy, Now and in Future? Healthcare (Basel) 2023; 11:1800. [PMID: 37372919 DOI: 10.3390/healthcare11121800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 06/09/2023] [Accepted: 06/18/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Internationally, midwives' professional autonomy is being challenged, resulting in their inability to practice to their full scope of practice. This situation contrasts with the increasing international calls for strengthening the midwifery profession. The aim of this study therefore is to explore Belgian midwives' views on their current and future autonomy. METHODS An online survey among Belgian midwives was performed. Data were collected and analyzed using a quantitative approach, while quotes from respondents were used to contextualize the quantitative data. RESULTS Three hundred and twelve midwives from different regions and professional settings in Belgium completed the questionnaire. Eighty-five percentage of respondents believe that they are mostly or completely autonomous. Brussels' midwives feel the most autonomous, while those in Wallonia feel the least. Primary care midwives feel more autonomous than hospital-based midwives. Older midwives and primary care midwives feel less recognized and respected by other professionals in maternity care. The majority of our respondents believe that in future midwives should be able to work more autonomously in constructive collaboration with other professionals. CONCLUSION While Belgian midwives generally rated their own professional autonomy as high, a significant majority of respondents desire more autonomy in future. In addition, our respondents want to be recognized and respected by society and other health professionals in maternity care. It is recommended to prioritize efforts in enhancing midwives' autonomy, while also addressing the need for increased recognition and respect from society and other maternity care professionals.
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Affiliation(s)
- Joeri Vermeulen
- Department Health Care, Brussels Centre for Healthcare Innovation, Erasmus Brussels University of Applied Sciences and Arts, 1090 Brussels, Belgium
- Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium
| | - Maaike Fobelets
- Department Health Care, Brussels Centre for Healthcare Innovation, Erasmus Brussels University of Applied Sciences and Arts, 1090 Brussels, Belgium
- Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium
- Department of Teacher Education, Vrije Universiteit Brussel (VUB), 1040 Brussels, Belgium
| | - Valerie Fleming
- Faculty of Health, Liverpool John Moores University, Liverpool L3 5UX, UK
| | - Ans Luyben
- Centre for Midwifery, Maternal & Perinatal Health, Bournemouth University, Bournemouth BH1 3LH, UK
- Frauenzentrum (Centre for Women's Health), Lindenhofgruppe, 3012 Bern, Switzerland
| | - Lara Stas
- Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium
- Support for Quantitative and Qualitative Research (SQUARE), Core Facility of the Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium
| | - Ronald Buyl
- Department of Public Health, Biostatistics and Medical Informatics Research Group, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium
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Annick-Mélanie M, Daniel GM, Laure MM, Ghislaine M, Christian E, Eric-Lamou GB, Callixte KT. Beliefs and attitudes of traditional healers regarding epilepsy in Cameroon. Epilepsy Behav 2023; 145:109300. [PMID: 37336130 DOI: 10.1016/j.yebeh.2023.109300] [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: 03/10/2023] [Revised: 05/24/2023] [Accepted: 06/02/2023] [Indexed: 06/21/2023]
Abstract
INTRODUCTION People living with epilepsy suffer from stigmatization, overprotection, or exclusion, thus, part of these population in developing countries uses traditional medicine as a first resort. METHODS We prospectively conducted a study to determine the knowledge, attitudes, and practices (KAP) of traditional healers (THs) concerning epilepsy. Over a 9-month period, we included 208 THs practicing in the Littoral, Center and West regions of Cameroon who agreed to participate in the study. The THs were interviewed using a standardized questionnaire. Data were analyzed using Epi Info version 7.2 software. RESULTS Two-hundred and eight THs were recruited, with a mean age ± standard deviation (SD) of 49.9 ± 11.4 years, and 169 (81.2%) were male. Primary 77(37.0%) and secondary 67(32.2%) levels of education were the most represented, and most of the THs had more than 10 years of professional experience. One hundred and forty-one TH (68,7%) had poor knowledge about epilepsy. The independent factors associated with poor knowledge were female sex, Muslim religion, and marital status of cohabitation. One hundred and eighty-four THs (88.4%) had a good attitude and practices toward people with seizures. Factors independently associated with poor practices and attitude were rural residence, Muslim religion, and education level. CONCLUSION Our result confirmed that THs had poor knowledge about epilepsy but good attitudes and practices about epilepsy. THs were in favor of future collaboration with modern medicine in the care of people living with epilepsy.
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Affiliation(s)
- Magnerou Annick-Mélanie
- Department of Neurology, Laquintinie Hospital of Douala, Cameroon; Faculty of Medicine and Pharmaceutical Sciences, The University of Douala, Cameroon
| | | | | | - Meyo Ghislaine
- Higher Institute of Medical Technology, Nkolondom, Yaoundé, Cameroon
| | - Eyoum Christian
- Department of Neurology, Laquintinie Hospital of Douala, Cameroon; Faculty of Medicine and Pharmaceutical Sciences, The University of Douala, Cameroon
| | | | - Kuate-Tegueu Callixte
- Department of Neurology, Laquintinie Hospital of Douala, Cameroon; Faculty of Medicine and Biomedical Sciences, The University of Yaoundé 1, Cameroon
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354
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Farver-Vestergaard I, Hjorth P, Pisinger C, Larsen PV, Løkke A. A survey exploring the practices of smoking cessation support among hospital-based healthcare providers. BMC Health Serv Res 2023; 23:645. [PMID: 37328757 DOI: 10.1186/s12913-023-09657-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 06/06/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Hospital visits constitute a 'window of opportunity' for initiating smoking cessation attempts, and healthcare providers (HCPs) play an important role in supporting patients to stop smoking. Yet, the current practices of supporting smoking cessation in the hospital setting are largely unexplored. The aim of this study was to explore practices of smoking cessation support among hospital-based HCPs. METHODS HCPs working in a large hospital in the secondary care sector completed an online, cross-sectional survey, including sociodemographic and work-related factors as well as 21 questions assessing practices of smoking cessation support based on the "five As" framework. Descriptive statistics were computed, and predictors of HCPs giving patients advice to stop smoking were explored using logistic regression analysis. RESULTS All employees (N = 3998) in the hospital received a survey link; 1645 (41.1%) HCPs with daily patient contact completed the survey. Smoking cessation support in the hospital setting was limited with regard to assessment of smoking; providing information and advice; planning and referral for further support; and follow-up on smoking cessation attempts. Almost half (44.8%) of participating HCPs with daily patient contact never or rarely advise their patients to stop smoking. Physicians were more likely than nurses to advice patients to stop smoking, and HCPs in outpatient clinics were more likely to give advice than inpatient clinic HCPs. CONCLUSION Smoking cessation support is very limited in the hospital-based healthcare setting. This is problematic, as hospital visits can be windows of opportunity to help patients change their health behaviour. An intensified focus on the implementation of hospital-based smoking cessation support is needed.
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Affiliation(s)
- Ingeborg Farver-Vestergaard
- Department of Medicine, Lillebaelt Hospital, Beriderbakken 4, Vejle, 7100, Denmark.
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
| | - Peter Hjorth
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Psychiatric Hospital, Region of Southern Denmark, Vejle, Denmark
| | - Charlotta Pisinger
- Center for Clinical Research and Prevention, Capital Region of Denmark, Bispebjerg-Frederiksberg University Hospital, Copenhagen, Denmark
- Danish Heart Foundation, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Pia Veldt Larsen
- Mental Health Services, Region of Southern Denmark, Vejle, Denmark
| | - Anders Løkke
- Department of Medicine, Lillebaelt Hospital, Beriderbakken 4, Vejle, 7100, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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355
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Alnasser A, Alomran N. The motivations and practices of vegetarian and vegan Saudis. Sci Rep 2023; 13:9742. [PMID: 37328535 PMCID: PMC10275927 DOI: 10.1038/s41598-023-36980-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 06/13/2023] [Indexed: 06/18/2023] Open
Abstract
In the Middle East, particularly in Saudi Arabia, the offering of a meat dish to guests is a deeply embedded cultural tradition, and a meat-based diet is the standard in Saudi Arabia. Thus, the rise of veganism and vegetarianism within Saudi Arabia is surprising and worthy of attention, as is understanding the perceptions and motivations behind this phenomenon, particularly as they relate to food and sustainability. This research was designed to investigate this emerging phenomenon and to identify key differences in dietarian identity between Saudi vegetarians and vegans using Rosenfeld and Burrow's Dietarian Identity Questionnaire. Among other results, the vegan group scored significantly higher on the prosocial motivation construct, suggesting the desire to help society as a whole is a stronger motivating factor for vegans. As well, the vegan cohort scored higher in the personal motivation category. From an environmental and public health perspective, understanding the key factors motivating individuals to adopt a vegetarian or vegan diet in a meat-based culture like Saudi Arabia can be used to encourage others to pursue more healthy and sustainable food behaviors.
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Affiliation(s)
- Aroub Alnasser
- Food Science and Nutrition Department, College of Food and Agriculture Sciences, King Saud University, 11495, Riyadh, Saudi Arabia.
| | - Norah Alomran
- Food Science and Nutrition Department, College of Food and Agriculture Sciences, King Saud University, 11495, Riyadh, Saudi Arabia
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356
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Le T, Le TTB, Van Truong L, Luu MN, Tran Minh Duc N, Makram AM, Van Dat T, Huy NT. Knowledge, attitude, and perception regarding COVID-19-related prevention practice among residents in Vietnam: a cross-sectional study. Front Public Health 2023; 11:1100335. [PMID: 37397719 PMCID: PMC10309564 DOI: 10.3389/fpubh.2023.1100335] [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: 11/16/2022] [Accepted: 05/22/2023] [Indexed: 07/04/2023] Open
Abstract
Background Vietnam was one of the countries pursuing the goal of "Zero-COVID" and had effectively achieved it in the first three waves of the pandemic. However, the spread of the Delta variant was outbreak first in Vietnam in late April 2021, in which Ho Chi Minh City was the worst affected. This study surveyed the public's knowledge, attitude, perception, and practice (KAPP) toward COVID-19 during the rapid rise course of the outbreak in Ho Chi Minh City. Methods This cross-sectional survey was conducted from 30th September to 16th November 2021, involving 963 residents across the city. We asked residents a series of 21 questions. The response rate was 76.6%. We set a priori level of significance at α = 0.05 for all statistical tests. Results The residents' KAPP scores were 68.67% ± 17.16, 77.33% ± 18.71, 74.7% ± 26.25, and 72.31% ± 31, respectively. KAPP scores of the medical staff were higher than the non-medical group. Our study showed positive, medium-strong Pearson correlations between knowledge and practice (r = 0.337), attitude and practice (r = 0.405), and perception and practice (r = 0.671; p < 0.05). We found 16 rules to estimate the conditional probabilities among KAPP scores via the association rule mining method. Mainly, 94% confident probability of participants had {Knowledge=Good, Attitude=Good, Perception=Good}, as well as {Practice=Good} (in rule 9 with support of 17.6%). In opposition to around 86% to 90% of the times, participants had levels of {Perception=Fair, Practice=Poor} given with either {Attitude=Fair} or {Knowledge=Fair} (according to rules 1, 2, and rules 15, 16 with a support of 7-8%). Conclusion In addition to the government's directives and policies, citizens' knowledge, attitude, perception, and practice are considered one of the critical preventive measures during the COVID-19 pandemic. The results affirmed the good internal relationship among K, A, P, and P scores creating a hierarchy of healthcare educational goals and health behavior among residents.
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Affiliation(s)
- Thoa Le
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Trang T. B. Le
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Le Van Truong
- Traditional Medicine Hospital of Ministry of Public Security, Hanoi, Vietnam
| | - Mai Ngoc Luu
- Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Nguyen Tran Minh Duc
- Faculty of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | | | - Truong Van Dat
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Nguyen Tien Huy
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
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357
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Kumma WP, Chaka FG, Daga WB, Alemayehu MA, Meskele M, Wolka E. Prevalence of teenage pregnancy and associated factors among preparatory and high school students in Wolaita Sodo town, southern Ethiopia: an institution-based cross-sectional study. BMJ Open 2023; 13:e070505. [PMID: 37295830 PMCID: PMC10277080 DOI: 10.1136/bmjopen-2022-070505] [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] [Received: 11/29/2022] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
OBJECTIVE To assess the prevalence of teenage pregnancy and associated factors among teenage schoolgirls aged 15-19 years in Wolaita Sodo town, southern Ethiopia. DESIGN Cross-sectional survey. SETTING This study was conducted among teenage girls from preparatory and high schools in Wolaita Sodo town, southern Ethiopia, between 1 April and 30 May 2019. PARTICIPANTS 588 (97.8%) of 601 randomly selected teenage schoolgirls aged 15-19 years (selected via a multistage random sampling technique) participated in the study. OUTCOME MEASURES Teenage pregnancy and associated factors. RESULTS The prevalence of teenage pregnancy among schoolgirls in Wolaita Sodo town was 14.6% (95% CI 11.9% to 17.7%). The current pregnancy rate was 33.7% (95% CI 23.9% to 44.7%). Having a family history of teenage pregnancy (AOR 3.3; 95% CI 1.3 to 8.4) and access to mass media (AOR 2.5; 95% CI 1.1 to 6.2) were positively associated with teenage pregnancy, while condom use (AOR 0.1; 95% CI 0.03 to 0.5) and knowledge of where to get modern contraceptives (AOR 0.4; 95% CI 0.2 to 0.9) were negatively associated. CONCLUSIONS The prevalence of teenage pregnancy among schoolgirls in Wolaita Sodo was high. Having a family history of teenage pregnancy and access to mass media were positively associated with teenage pregnancy, whereas reported condom use and knowledge of where to get modern contraceptives were negatively associated with teenage pregnancy among schoolgirls.
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Affiliation(s)
- Wondimagegn Paulos Kumma
- Center for International Health, University of Bergen, Bergen, Norway
- School of Public Health, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Feben Girma Chaka
- School of Public Health, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Wakgari Binu Daga
- School of Public Health, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | | | - Mengistu Meskele
- School of Public Health, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Eskinder Wolka
- School of Public Health, Wolaita Sodo University, Wolaita Sodo, Ethiopia
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358
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Al-Ghraiybah T, Sim J, Fernandez R, Lago L. Managing missing and erroneous data in nurse staffing surveys. Nurse Res 2023; 31:19-27. [PMID: 36994632 DOI: 10.7748/nr.2023.e1878] [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] [Accepted: 12/05/2022] [Indexed: 03/31/2023]
Abstract
BACKGROUND Analysis can be problematic in research when data are missing or erroneous. Various methods are available for managing missing and erroneous data, but little is known about which are the best to use when conducting cross-sectional surveys of nurse staffing. AIM To explore how missing and erroneous data were managed in a study that involved a cross-sectional survey of nurse staffing. DISCUSSION The article describes a study that used a cross-sectional survey to estimate the ratio of registered nurses to patients, using self-reported data by nurses. It details the techniques used in the study to manage missing and erroneous data and presents the results of the survey before and after the treatment of missing data. CONCLUSION Managing missing data effectively and reporting procedures transparently reduces the possibility of bias in a study's results and increases its reproducibility. Nurse researchers need to understand the methods available to handle missing and erroneous data. Surveys must contain unambiguous questions, as every participant should have the same understanding of a question's meaning. IMPLICATION FOR PRACTICE Researchers should pilot surveys - even when using validated tools - to ensure participants interpret the questions as intended.
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Affiliation(s)
- Tamer Al-Ghraiybah
- School of Nursing Midwifery and Indigenous Health, University of Wollongong, Wollongong, NSW, Australia
| | - Jenny Sim
- School of Nursing and Midwifery, University of Newcastle, Gosford, NSW, Australia
| | - Ritin Fernandez
- School of Nursing, University of Wollongong, Wollongong, NSW, Australia
| | - Luise Lago
- Centre for Health Research Illawarra Shoalhaven Population, University of Wollongong, Wollongong, NSW, Australia
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Antonelli M, Donelli D, Maggini V, Gallo E, Mascherini V, Firenzuoli F, Gavazzi G, Zabini F, Venturelli E, Margheritini G, Bassi I, Iseppi L, Meneguzzo F. Demographic, Psychosocial, and Lifestyle-Related Characteristics of Forest Therapy Participants in Italy: A Multicenter Cross-Sectional Survey. Healthcare (Basel) 2023; 11:healthcare11111627. [PMID: 37297767 DOI: 10.3390/healthcare11111627] [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: 05/17/2023] [Revised: 05/28/2023] [Accepted: 06/01/2023] [Indexed: 06/12/2023] Open
Abstract
This research aims to provide a comprehensive overview of the key demographic, psychosocial, and lifestyle-related characteristics of forest therapy participants in Italy. A survey was conducted among 1070 adults who had engaged in standardized forest therapy experiences between June 2021 and October 2022. The findings indicate that most forest therapy participants in Italy share certain distinctive traits. They are primarily female, aged between 45 and 54 years, employed, and unmarried. Moreover, they possess a high level of education, predominantly reside in urban areas, demonstrate a strong environmental awareness, maintain a nature-oriented attitude, and typically exhibit moderate levels of trait anxiety. Additionally, they tend to be nonsmokers, possess a healthy BMI within the normal range, and consume an adequate quantity of fruits and vegetables on a daily basis. However, it should be noted that their male counterparts tend to be overweight and exhibit poorer dietary habits. Irrespective of gender, approximately 40% of forest therapy participants in Italy live with a chronic disease that requires daily medicinal treatment. Subsequent research should investigate whether these characteristics hold true in different countries. Furthermore, exploring the potential effectiveness of health-promoting interventions integrated with forest therapy sessions could prove beneficial in addressing these specific issues among forest therapy participants. By doing so, such interventions have the potential to contribute significantly to public health promotion and overall community well-being.
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Affiliation(s)
- Michele Antonelli
- Department of Public Health, AUSL-IRCCS di Reggio Emilia, Via Amendola 2, 42122 Reggio Emilia, Italy
| | - Davide Donelli
- Division of Cardiology, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci 14, 43126 Parma, Italy
| | - Valentina Maggini
- CERFIT, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, Italy
| | - Eugenia Gallo
- CERFIT, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, Italy
| | - Vittorio Mascherini
- CERFIT, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, Italy
| | - Fabio Firenzuoli
- CERFIT, Careggi University Hospital, Largo Brambilla 3, 50134 Florence, Italy
| | - Gioele Gavazzi
- Section of Psychology, Department of Neuroscience, Psychology, Drug Research and Child's Health (NEUROFARBA), University of Florence, Via di San Salvi 12, 50135 Firenze, Italy
| | - Federica Zabini
- Institute of Bioeconomy, National Research Council, Via Madonna del Piano 10, 50019 Sesto Fiorentino, Italy
| | - Emanuela Venturelli
- Psychologist Group, Central Medical Commission, Italian Alpine Club, Via E. Petrella 19, 20124 Milano, Italy
| | - Giovanni Margheritini
- Psychologist Group, Central Medical Commission, Italian Alpine Club, Via E. Petrella 19, 20124 Milano, Italy
| | - Ivana Bassi
- Department of Agricultural, Food, Environmental and Animal Sciences, University of Udine, Via delle Scienze 206, 33100 Udine, Italy
| | - Luca Iseppi
- Department of Agricultural, Food, Environmental and Animal Sciences, University of Udine, Via delle Scienze 206, 33100 Udine, Italy
| | - Francesco Meneguzzo
- Institute of Bioeconomy, National Research Council, Via Madonna del Piano 10, 50019 Sesto Fiorentino, Italy
- Psychologist Group, Central Medical Commission, Italian Alpine Club, Via E. Petrella 19, 20124 Milano, Italy
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Novelli E, Molinari L, Consolo S, Mingrone L. Palpatory tests in manual therapies: an international survey on osteopathic clinical practice. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2023; 20:431-437. [PMID: 36351325 DOI: 10.1515/jcim-2022-0180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES The primary aim of the study is to explore the knowledge and use of palpatory tests in detecting somatic dysfunction, the second is to assess the knowledge about the inhibitory tests among osteopathic practitioners in Italy, England, and France. METHODS A quantitative survey was conducted, between March and May 2021, through the administration of a semi-structured questionnaire. The participants had to answer 8 questions. RESULTS A total of 2,223 e-mails were sent: 423 manual therapy professionals participated in the survey. Subsequently, only the responses of the 385 osteopaths (280 Italian, 23 French and 82 British) were included in the data processing; the 38 excluded were physiotherapists and chiropractors. The most significative outcomes for the total sample were found to: years of working experience and knowledge of a palpatory test that allows to discriminate two dysfunctional anatomical structures was significant with a χ2=12.509 (p-value <0.006); 68.5% answered in the affirmative to this last question. It was found that less work experience is associated with knowledge of a palpatory test to discriminate two dysfunctional structures. The correlation between years of work experience and knowledge of the inhibitory test was explored with the result being statistically significant (p-value <0.001). 64.4% know and use the inhibitory test. 39.1% base the inhibitory test on tissue change. CONCLUSIONS The clinical practice of Italian and French professionals, makes possible to establish the hierarchy between two somatic dysfunctions with respect to English sample. The osteopaths reported a wider use of the tissue change parameters rather than pain reported by the patient. Furthermore, more than half of the sample-based their discriminatory test on the musculoskeletal and fascial systems. There is a vast knowledge of the inhibition test among osteopaths.
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Affiliation(s)
- Emanuele Novelli
- Centre pour l'Etude, la Recherche et la Diffusion Osteopatiques, Department of research, Rome, Italy
| | - Livio Molinari
- Centre pour l'Etude, la Recherche et la Diffusion Osteopatiques, Department of research, Rome, Italy
| | - Stefano Consolo
- Centre pour l'Etude, la Recherche et la Diffusion Osteopatiques, Department of research, Rome, Italy
| | - Luca Mingrone
- Centre pour l'Etude, la Recherche et la Diffusion Osteopatiques, Department of research, Rome, Italy
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361
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Kandi LA, Hammond JB, Nadone H, Kosiorek HE, Rebecca AM, Casey WJ, Reece EM, Cronin PA, Pockaj BA. Patient Perspectives and Quality of Life after Breast Reconstruction and the Impact of Subsequent Revisions. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e4885. [PMID: 37313481 PMCID: PMC10259630 DOI: 10.1097/gox.0000000000004885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 01/23/2023] [Indexed: 06/15/2023]
Abstract
There is limited research on the impact of revisional surgery after breast reconstruction on patient experience and postoperative quality of life (QoL). Methods Patients undergoing mastectomy with immediate implant-based or autologous free-flap breast reconstruction from 2008 to 2020 were reviewed. These patients were categorized by revisions (0-1, 2-3, and 4+) and surveyed on QoL metrics using BREAST-Q and Was It Worth It? (WIWI) questionnaires. BREAST-Q QoL, satisfaction, and WIWI metrics between revision groups were evaluated. Results Among 252 patients, a total of 150 patients (60%) underwent zero to one revisions, 72 patients (28%) underwent two to three revisions, and 30 patients (12%) underwent four or more revisions. Median follow-up was 6 years (range, 1-11 years). BREAST-Q satisfaction among patients with four or more revisions was significantly lower (P = 0.03), while core QoL domains (chest physical, psychosocial, and sexual well-being) did not significantly differ. Analysis of unplanned reoperations due to complications and breast satisfaction showed no significant difference in QoL scores between groups (P = 0.08). Regarding WIWI QoL metrics, four or more revisions were associated with a higher rate of worse QoL (P = 0.035) and worse overall experience (P = 0.001). Most patients in all revision groups felt it was worthwhile to undergo breast reconstruction (86%), would choose breast reconstruction again (83%), and would recommend breast reconstruction to others (79%). Conclusions Overall, a majority of patients undergoing revisions after breast reconstruction still have a worthwhile experience. Although reoperations after breast reconstruction do not significantly impact long-term BREAST-Q QoL domains, patients undergoing four or more revisions have significantly lower breast satisfaction, worse QoL, and a postoperative experience worse than expected.
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Affiliation(s)
- Lyndsay A. Kandi
- From the Division of Plastic and Reconstructive Surgery, Mayo Clinic, Phoenix, Ariz
| | | | - Haley Nadone
- Department of Surgery, Mayo Clinic, Phoenix, Ariz
| | - Heidi E. Kosiorek
- Department of Research, Section of Biostatistics, Mayo Clinic, Scottsdale, Ariz
| | - Alanna M. Rebecca
- From the Division of Plastic and Reconstructive Surgery, Mayo Clinic, Phoenix, Ariz
| | - William J. Casey
- From the Division of Plastic and Reconstructive Surgery, Mayo Clinic, Phoenix, Ariz
| | - Edward M. Reece
- From the Division of Plastic and Reconstructive Surgery, Mayo Clinic, Phoenix, Ariz
| | - Patricia A. Cronin
- Division of Surgical Oncology and Endocrine Surgery, Mayo Clinic, Phoenix, Ariz
| | - Barbara A. Pockaj
- Division of Surgical Oncology and Endocrine Surgery, Mayo Clinic, Phoenix, Ariz
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362
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Uhlich R, Hu P, Yazer M, Jansen JO, Patrician P, Marques MB, Reynolds L, Fifolt M, Stephens SW, Gelbard RB, Kerby J, Holcomb JB. The females have spoken: A patient-centered national survey on the administration of emergent transfusions with the potential for future fetal harm. J Trauma Acute Care Surg 2023; 94:791-797. [PMID: 36808128 DOI: 10.1097/ta.0000000000003914] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
BACKGROUND Traumatic hemorrhage is the leading cause of preventable death. Early in the resuscitation, only RhD-positive red blood cells are likely to be available, which poses a small risk of causing harm to a future fetus if transfused to an RhD-negative females of childbearing age (CBA), that is, 15 to 49 years old. We sought to characterize how the population, in particular females of CBA, felt about emergency blood administration vis-a-vis potential future fetal harm. METHODS A national survey was performed using Facebook advertisements in three waves from January 2021 to January 2022. The advertisements directed users to the survey site with seven demographic questions and four questions on accepting transfusion with differing probabilities for future fetal harm (none/any/1:100/1:10,000). Acceptance of transfusion questions were scored on 3-point Likert scale (likely/neutral/unlikely). Only completed responses by females were analyzed. RESULTS Advertisements were viewed 16,600,430 times by 2,169,805 people with 15,396 advertisement clicks and 2,873 surveys initiated. Most (2,256 of 2,873 [79%]) were fully completed. Majority (2,049 of 2,256 [90%]) of respondents were female. Eighty percent of females (1,645 of 2,049) were of CBA. Most females responded "likely" or "neutral" when asked whether they would accept a lifesaving transfusion if the following risk of fetal harm were present: no risk (99%), any risk (83%), 1:100 risk (85%), and 1:10,000 risk (92%). There were no differences between females of CBA versus non-CBA with respect to the likelihood of accepting lifesaving transfusion with any potential for future fetal harm ( p = 0.24). CONCLUSION This national survey suggests that most females would accept lifesaving transfusion even with the potential low risk of future fetal harm. LEVEL OF EVIDENCE Prognostic and Epidemiological; Level IV.
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Affiliation(s)
- Rindi Uhlich
- From the Center for Injury Science and Division of Trauma and Acute Care Surgery, Department of Surgery (R.U., P.H., J.O.J., S.W.S., R.B.G., J.K., J.B.H.), University of Alabama at Birmingham, Birmingham, Alabama; Department of Pathology (M.Y.), University of Pittsburgh, Pittsburgh, Pennsylvania; and School of Nursing (P.P.), Department of Pathology (M.B.M.), and School of Public Health (L.R., M.F.), University of Alabama at Birmingham, Birmingham, Alabama
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363
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Kearney PM, Stamenic D, Gajewska K, O'Sullivan MB, Doyle S, O'Reilly O, Buckley CM. Cross-sectional survey of compliance behaviour, knowledge and attitudes among cases and close contacts during COVID-19 pandemic. PUBLIC HEALTH IN PRACTICE 2023; 5:100370. [PMID: 36817733 PMCID: PMC9930406 DOI: 10.1016/j.puhip.2023.100370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 02/17/2023] Open
Abstract
Objectives A key public health intervention is self-isolation for cases and restriction of movement for contacts. This study aimed to identify predictors of compliance behaviour and describe knowledge and attitudes among cases and contacts identified by the national Contact Management Programme to inform the global public health response. Study design Secondary data analysis of anonymised cross-sectional survey data on national sample of cases and close contacts. Methods A sample of 1000 cases and 1000 contacts was calculated to estimate compliance within a margin of error of 3% with 95% confidence. A telephone survey administered by trained interviewers collected information on socio-demographics, compliance behaviours, knowledge, and attitudes to COVID-19 from cases and close contacts. Data analysis included chi-squared statistics and multivariable logistic regression. Results Most cases and contacts complied with public health guidance with similar characteristics in those who did and did not comply. Reasons for non-compliance included exercise, medical appointment, shopping, and work. Cases and contacts reported high levels of understanding about symptoms of COVID-19 and satisfaction with available information. Conclusion Achieving high compliance with public health guidance is feasible and requires political leadership, policy changes and practical solutions.
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Affiliation(s)
- Patricia M. Kearney
- School of Public Health, University College Cork, Ireland,Corresponding author
| | - Danko Stamenic
- School of Public Health, University College Cork, Ireland
| | | | | | - Sarah Doyle
- Department of Public Health, Health Services Executive, HSE South, Ireland
| | - Orlaith O'Reilly
- Clinical Design and Innovation, Health Services Executive, Ireland
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Bahns C, Kopkow C. Physiotherapy for patients with hip and knee osteoarthritis in Germany: a survey of current practice. BMC Musculoskelet Disord 2023; 24:424. [PMID: 37312080 PMCID: PMC10262543 DOI: 10.1186/s12891-023-06464-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/26/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Osteoarthritis (OA) of the hip and the knee is common and leads to pain, stiffness and disability. Clinical practice guidelines (CPG) provide recommendations to assist healthcare professionals in clinical decision-making. Although evidence-based physiotherapy has been shown to be effective in the management OA, a gap between clinical practice and guideline recommendations exists. Little is known about OA management provided by physiotherapists in Germany and whether treatment aligns with CPGs. The objectives of this study were (1) to investigate the current physiotherapy practice in patients with hip and/or knee OA in Germany, (2) to evaluate physiotherapists' adherence to guideline recommendations and (3) to explore barriers and facilitators to guideline use. METHODS A cross-sectional online survey was conducted among physiotherapists. The questionnaire collected information on demographic characteristics, physiotherapists' management of hip and knee OA and the use of CPGs in clinical practice. Guideline adherence was evaluated by comparing the survey findings with guideline recommendations. Full adherence was assumed if all recommended treatment options were chosen. RESULTS In total, 447 (74.9%) of 597 eligible physiotherapists completed the survey. Data from 442 participants (mean age 41.2 ± 12.8 years; 288 female (65.1%)) were included in the analysis. The most common treatment choices for both hip and knee OA were exercise therapy (hip OA: 424/442, 95.9%; knee OA: 426/442, 96.4%), self-management advice (hip OA: 413/442, 93.2%; knee OA: 395/442, 89.4%) and education (hip OA: 325/442, 73.5%; knee OA: 331/442, 74.9%), followed by manual therapy (hip OA: 311/442, 70.4%; knee OA: 311/442, 70.4%) and joint traction (hip OA: 208/442, 47.1%; knee OA: 199/442, 45.0%). Full guideline adherence was found in 17.2% (76/442) of physiotherapists for hip OA management and in 8.6% (38/442) for knee OA. Less than half of the respondents (212/430, 49.3%) were aware of an OA guideline. CONCLUSIONS In accordance with current guideline recommendations, most physiotherapists provide exercise therapy and education for patients with hip and/or knee OA. Interventions with low or conflicting evidence were also frequently provided. The limited awareness of existing OA guidelines and the low guideline adherence indicate an insufficient implementation of CPGs in German physiotherapy practice. TRIAL REGISTRATION German Clinical Trials Register (DRKS00026702). Registered 14 October 2021.
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Affiliation(s)
- Carolin Bahns
- Department of Therapy Science I, Brandenburg University of Technology Cottbus-Senftenberg, Universitätsplatz 1, 01968, Senftenberg, Germany.
| | - Christian Kopkow
- Department of Therapy Science I, Brandenburg University of Technology Cottbus-Senftenberg, Universitätsplatz 1, 01968, Senftenberg, Germany
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González-de la Torre H, Hernández-Rodríguez MI, Moreno-Canino AM, Portela-Lomba AM, Berenguer-Pérez M, Verdú-Soriano J. Cross-Cultural Adaptation and Validation of the Perceptions of Empowerment in Midwifery Scale in the Spanish Context (PEMS-e). Healthcare (Basel) 2023; 11:healthcare11101464. [PMID: 37239750 DOI: 10.3390/healthcare11101464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 05/13/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
Midwifery empowerment is an important topic. The most widely used instrument to measure the perceived empowerment of midwives is the Perceptions of Empowerment in Midwifery Scale (PEMS), which has not been validated in Spain. The aim of this study was to translate and adapt the PEMS to the Spanish context. This research was carried out in two phases; Phase 1: Methodological study; translation, backtranslation and cross-cultural adaptation of the PEMS and pilot study on the target population (10 midwives) for evaluation of face validity. Phase 2: Cross-sectional observational study to obtain a sample for construct validation by Exploratory Factor Analysis and measurement of PEMS-e reliability. Additionally, an inferential analysis was carried out to study the possible association between several collected variables and PEMS-e subscale-scores. A total of 410 midwives from 18 Spanish regions participated in the study through an online questionnaire. An initial Spanish version of the PEMS scale was produced, demonstrating adequate face validity. A final model was produced for the PEMS-e, which included 17 items classified into two subscales ("Organizational support" and "Own skills and teamwork") with fit indexes RMSEA = 0.062 (95%CI: 0.048-0.065) and AGFI = 0.985 (95%CI: 0.983-0.989) and Cronbach's alpha 0.922 for the total scale. Results showed that one in four midwives had considered abandoning the profession in the last 6 months (p ≤ 0.001). This research suggests that Spanish midwives perceive their empowerment level as low. The PEMS-e is a valid tool with solid psychometric properties that can be used in future research to identify factors that contribute to increased empowerment among Spanish midwives and inform strategies to improve job satisfaction and retention in the profession.
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Affiliation(s)
- Héctor González-de la Torre
- Research Support Unit of Insular Maternal and Child University Hospital Complex of Gran Canaria, Canary Health Service, Avda Marítima del Sur S/N, 35016 Las Palmas de Gran Canaria-Canary Islands, Spain
- Department of Nursing, University of Las Palmas de Gran Canaria, Edificio Ciencias de la Salud, C/Blas Cabrera Felipe s/n, 35016 Las Palmas de Gran Canaria-Canary Islands, Spain
| | - María-Isabel Hernández-Rodríguez
- Department of Obstetrics and Gynaecology, Insular Maternal and Child University Hospital Complex of Gran Canaria, Canary Health Service, Avda Marítima del Sur S/N, 35016 Las Palmas de Gran Canaria-Canary Islands, Spain
| | - Alba-María Moreno-Canino
- Department of Obstetrics and Gynaecology, Insular Maternal and Child University Hospital Complex of Gran Canaria, Canary Health Service, Avda Marítima del Sur S/N, 35016 Las Palmas de Gran Canaria-Canary Islands, Spain
| | - Ana-María Portela-Lomba
- Department of Obstetrics and Gynaecology, Insular Maternal and Child University Hospital Complex of Gran Canaria, Canary Health Service, Avda Marítima del Sur S/N, 35016 Las Palmas de Gran Canaria-Canary Islands, Spain
| | - Miriam Berenguer-Pérez
- Department of Community Nursing, Preventive Medicine, Public Health and History of Science, Faculty of Health Sciences, University of Alicante (UA), 03690 Alicante, Spain
| | - José Verdú-Soriano
- Department of Community Nursing, Preventive Medicine, Public Health and History of Science, Faculty of Health Sciences, University of Alicante (UA), 03690 Alicante, Spain
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366
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Ooi KS, Abdul Jalal MI, Wong JY, Choo MY, Kamruldzaman NA, Lye CW, Lum LCS. The Prevalence and Determinants of Child Hunger and Its Associations with Early Childhood Nutritional Status among Urban Poverty Households during COVID-19 Pandemic in Petaling District, Malaysia: An Exploratory Cross-Sectional Survey. Nutrients 2023; 15:nu15102356. [PMID: 37242239 DOI: 10.3390/nu15102356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/24/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
Child hunger was prevalent during the COVID-19 pandemic, but the extent, determinants, and impact on pre-school children aged 6 months to 7 years old from Malaysian urban poor households are still unknown. This exploratory cross-sectional study was performed between July 2020 and January 2021 at the Lembah Subang People Housing Project, Petaling. The households' food security status was assessed using the previously validated Radimer/Cornell questionnaire, and the children's anthropometric measurements were taken. Food diversity score was assessed using the World Health Organization Infant and Young Children Feeding (under-2 children) or Food and Agriculture Organization Women's Dietary Diversity (2-year-old-and-above children) systems. Overall, 106 households were recruited. The prevalence of child hunger is 58.4% (95% CI: 50.0, 67.4). Significant differences were found in breastfeeding and sugar-sweetened beverage consumption between under-2 and ≥2-year-old children. There were no significant differences between child hunger and other food-insecure groups in weight-for-age, height-for-age, and weight-for-height z-scores. Only a higher dietary diversity score was significantly protective against child hunger after adjusting for maternal age, paternal employment status, and the number of household children (ORadjusted: 0.637 (95% CI: 0.443, 0.916), p = 0.015)). Proactive strategies are warranted to reduce child hunger during the COVID-19 pandemic by improving childhood dietary diversity.
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Affiliation(s)
- Kai Shen Ooi
- Department of Paediatrics, University Malaya Medical Centre, Kuala Lumpur 59100, Malaysia
| | - Muhammad Irfan Abdul Jalal
- UKM Medical Molecular Biology Institute (UMBI), UKM Medical Centre, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia
| | - Jing Yuan Wong
- Department of Paediatrics, University Malaya Medical Centre, Kuala Lumpur 59100, Malaysia
| | - Minn Yin Choo
- Department of Paediatrics, University Malaya Medical Centre, Kuala Lumpur 59100, Malaysia
| | | | - Chuan Way Lye
- Department of Public Health, University Malaya Medical Centre, Kuala Lumpur 59100, Malaysia
| | - Lucy Chai See Lum
- Department of Paediatrics, University Malaya Medical Centre, Kuala Lumpur 59100, Malaysia
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367
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Sousa-Leite M, Costa R, Figueiredo B, Gameiro S. Discussing the possibility of fertility treatment being unsuccessful as part of routine care offered at clinics: patients' experiences, willingness, and preferences. Hum Reprod 2023:7169439. [PMID: 37196325 DOI: 10.1093/humrep/dead096] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 03/28/2023] [Indexed: 05/19/2023] Open
Abstract
STUDY QUESTION Are patients willing to discuss the possibility of treatment being unsuccessful as part of routine care offered at clinics, and what are the factors associated with this willingness? SUMMARY ANSWER Nine in every 10 patients are willing to discuss this possibility as part of routine care, with willingness being associated with higher perceived benefits, lower barriers, and stronger positive attitudes towards it. WHAT IS KNOWN ALREADY Fifty-eight percent of patients who complete up to three cycles of IVF/ICSI in the UK do not achieve a live birth. Offering psychosocial care for unsuccessful fertility treatment (PCUFT), defined as assistance and guidance on the implications of treatment being unsuccessful, could reduce the psychosocial distress patients experience when it happens, and promote positive adjustment to this loss. Research shows 56% of patients are willing to plan for an unsuccessful cycle, but little is known about their willingness and preferences towards discussing the possibility of definitive unsuccessful treatment. STUDY DESIGN, SIZE, DURATION The study was of cross-sectional design, comprising a theoretically driven and patient-centred bilingual (English, Portuguese) mixed-methods online survey. The survey was disseminated via social media (April 2021-January 2022). Eligibility criteria included being aged 18 or older, waiting to or undergoing an IVF/ICSI cycle, or having completed a cycle within the previous 6 months without achieving a pregnancy. Out of 651 people accessing the survey, 451 (69.3%) consented to participate. From these, 100 did not complete 50% of the survey questions, nine did not report on the primary outcome variable (willingness), and 342 completed the survey (completion rate 75.8%, 338 women). PARTICIPANTS/MATERIALS, SETTING, METHODS The survey was informed by the Health Belief Model (HBM) and Theory of Planned Behaviour (TPB). Quantitative questions covered sociodemographic characteristics and treatment history. Quantitative and qualitative questions gathered data on past experiences, willingness, and preferences (with whom, what, how and when) to receive PCUFT, as well as theory-informed factors hypothesized to be associated with patients' willingness to receive it. Descriptive and inferential statistics were used on quantitative data about PCUFT experiences, willingness, and preferences, and thematic analysis was applied to textual data. Two logistic regressions were used to investigate the factors associated with patients' willingness. MAIN RESULTS AND THE ROLE OF CHANCE Participants were, on average, 36 years old and most resided in Portugal (59.9%) and the UK (38.0%). The majority (97.1%) were in a relationship for around 10 years, and 86.3% were childless. Participants were undergoing treatment for, on average, 2 years [SD = 2.11, range: 0-12 years], with most (71.8%) having completed at least one IVF/ICSI cycle in the past, almost all (93.5%) without success. Around one-third (34.9%) reported having received PCUFT. Thematic analysis showed participants received it mainly from their consultant. The main topic discussed was patients' low prognosis, with the emphasis being put on achieving a positive outcome. Almost all participants (93.3%) would like to receive PCUFT. Reported preferences indicated that 78.6% wanted to receive it from a psychologist/psychiatrist/counsellor, mostly in case of a bad prognosis (79.4%), emotional distress (73.5%), or difficulties in accepting the possibility of treatment being unsuccessful (71.2%). The preferred time to receive PCUFT was before initiating the first cycle (73.3%), while the preferred format was in an individual (mean = 6.37, SD = 1.17; in 1-7 scale) or couple (mean = 6.34, SD = 1.24; in 1-7 scale) session. Thematic analysis showed participants would like PCUFT to provide an overview of treatment and all possible outcomes tailored to each patient's circumstances and to encompass psychosocial support, mainly focused on coping strategies to process loss and sustain hope towards the future. Willingness to receive PCUFT was associated with higher perceived benefit of building psychosocial resources and coping strategies (odds ratios (ORs) 3.40, 95% CI 1.23-9.38), lower perceived barrier of triggering negative emotions (OR 0.49, 95% CI 0.24-0.98), and stronger positive attitudes about PCUFT being beneficial and useful (OR 3.32, 95% CI 2.12-5.20). LIMITATIONS, REASONS FOR CAUTION Self-selected sample, mainly composed of female patients who had not yet achieved their parenthood goals. The small number of participants unwilling to receive PCUFT reduced statistical power. The primary outcome variable was intentions, and research shows a moderate association between intentions and actual behaviour. WIDER IMPLICATIONS OF THE FINDINGS Fertility clinics should provide patients with early opportunities to discuss the possibility of their treatment being unsuccessful as part of routine care. PCUFT should focus on minimizing suffering associated with grief and loss by reassuring patients they can cope with any treatment outcome, promoting coping resources, and signposting to additional support. STUDY FUNDING/COMPETING INTEREST(S) M.S.-L. holds a doctoral fellowship from the Portuguese Foundation for Science and Technology, I.P. [Fundação para a Ciência e a Tecnologia] (FCT; SFRH/BD/144429/2019). R.C. holds a post-doctoral fellowship supported by the European Social Fund (ESF) and FCT (SFRH/BPD/117597/2016). The EPIUnit, ITR and CIPsi (PSI/01662) are also financed by FCT through the Portuguese State Budget, in the scope of the projects UIDB/04750/2020, LA/P/0064/2020 and UIDB/PSI/01662/2020, respectively. Dr Gameiro reports consultancy fees from TMRW Life Sciences and Ferring Pharmaceuticals A/S, speaker fees from Access Fertility, SONA-Pharm LLC, Meridiano Congress International and Gedeon Richter, grants from Merck Serono Ltd, an affiliate of Merck KgaA, Darmstadt, Germany. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- M Sousa-Leite
- School of Psychology, Cardiff University, Cardiff, UK
- Epidemiology Research Unit (EPIUnit), Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - R Costa
- Epidemiology Research Unit (EPIUnit), Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - B Figueiredo
- Psychology Research Centre (CIPsi), School of Psychology, University of Minho, Braga, Portugal
| | - S Gameiro
- School of Psychology, Cardiff University, Cardiff, UK
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368
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Pathak H, Goyal M, Das P, Santhanam S, Khan AK, Malaviya S, Pandey A, Patil P, Pandey BD, Rath P, Pandey S, Jain N, Jain S, Dua A, Goel A, Potikuri D, Kedia AK, Ravindran V. Awareness, perspectives and satisfaction levels among patients with psoriatic arthritis: a multicentric cross-sectional survey. Rheumatol Int 2023:10.1007/s00296-023-05339-w. [PMID: 37173547 DOI: 10.1007/s00296-023-05339-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023]
Abstract
Perception of the disease and its management impacts patients with Psoriatic arthritis (PsA) to a great degree. Studies examining patients' viewpoints and perception of their disease and its management are scarce. This multicentric cross-sectional survey was undertaken to understand the perspectives of patients with PsA. A survey questionnaire with items on demographics, awareness about their disease, treatment, physical therapy, quality of life and satisfaction with the care received was designed. After internal and external validation, a pilot survey was conducted, and the questionnaire was finalized. The final survey (with translations in local languages) was carried out at 17 centres across India. There were 262 respondents (56% males) with mean age of 45.14 ± 12.89 years. In 40%, the time lag between onset of symptoms and medical assessment for it was more than a year. In most of the patients, the diagnosis of PsA was made by a rheumatologist. Over 83% of patients were consulting their rheumatologist periodically as advised and fully compliant with the treatment. Lack of time and cost of therapy were the most common reasons for non-adherence to therapy. Eighty-eight patients (34%) were not fully satisfied with their current treatment. Over two-third of patients had never seen a physiotherapist due to barriers including a lack of time, pain, and fatigue. The daily activities and employment status were affected in nearly 50% of patients with PsA. The current survey has identified a gap in patients' awareness levels and helps healthcare providers in understanding the varied perceptions of patients with PsA. Addressing these issues in a systematic manner would potentially improve the treatment approaches, outcomes, and patient satisfaction levels.
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Affiliation(s)
- Himanshu Pathak
- Tricolour Hospitals, Vadiwadi, Sarabhai Complex, Vadodara, Gujarat, 390007, India.
| | - Mohit Goyal
- Care Pain and Arthritis Centre, Udaipur, India
| | | | | | | | - Sourabh Malaviya
- Ojas Centre for Arthritis and Autoimmune Diseases, Indore, India
| | | | | | | | | | | | | | | | - Amit Dua
- Dua's Rheumatology and Arthritis Care, Bilaspur, India
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Becking-Verhaar FL, Verweij RPH, de Vries M, Vermeulen H, van Goor H, Huisman-de Waal GJ. Continuous Vital Signs Monitoring with a Wireless Device on a General Ward: A Survey to Explore Nurses' Experiences in a Post-Implementation Period. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105794. [PMID: 37239523 DOI: 10.3390/ijerph20105794] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/10/2023] [Accepted: 04/20/2023] [Indexed: 05/28/2023]
Abstract
BACKGROUND Nurse engagement, perceived need and usefulness affect healthcare technology use, acceptance and improvements in quality, safety and accessibility of healthcare. Nurses' opinions regarding continuous monitoring appear to be positive. However, facilitators and barriers were little studied. This study explored nurses' post-implementation experiences of the facilitators and barriers to continuously monitoring patients' vital signs using a wireless device on general hospital wards. METHODS This study employed a cross-sectional survey. Vocational and registered nurses from three general wards in a Dutch tertiary university hospital participated in a survey comprising open and closed questions. The data were analysed using thematic analysis and descriptive statistics. RESULTS Fifty-eight nurses (51.3%) completed the survey. Barriers and facilitators were identified under four key themes: (1) timely signalling and early action, (2) time savings and time consumption, (3) patient comfort and satisfaction and (4) preconditions. CONCLUSIONS According to nurses, early detection and intervention for deteriorating patients facilitate the use and acceptance of continuously monitoring vital signs. Barriers primarily concern difficulties connecting patients correctly to the devices and system.
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Affiliation(s)
- Femke L Becking-Verhaar
- Department of Surgery, Radboud University Medical Centre, Huispost 751, Postbus 9101, 6500 HB Nijmegen, The Netherlands
| | - Robin P H Verweij
- Department of Surgery, Radboud University Medical Centre, Huispost 751, Postbus 9101, 6500 HB Nijmegen, The Netherlands
| | - Marjan de Vries
- Department of Surgery, Radboud University Medical Centre, Huispost 751, Postbus 9101, 6500 HB Nijmegen, The Netherlands
| | - Hester Vermeulen
- Scientific Institute for Quality of Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Centre, Huispost 160, Postbus 9101, 6500 HB Nijmegen, The Netherlands
| | - Harry van Goor
- Department of Surgery, Radboud University Medical Centre, Huispost 751, Postbus 9101, 6500 HB Nijmegen, The Netherlands
| | - Getty J Huisman-de Waal
- Department of Surgery, Radboud University Medical Centre, Huispost 751, Postbus 9101, 6500 HB Nijmegen, The Netherlands
- Scientific Institute for Quality of Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Centre, Huispost 160, Postbus 9101, 6500 HB Nijmegen, The Netherlands
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Prasad M, Batthish M, Beattie K, Berard R. A survey of Canadian adult rheumatologists' knowledge, comfort level, and barriers in assessing psychosocial needs of young adults with rheumatic diseases. Rheumatol Int 2023:10.1007/s00296-023-05337-y. [PMID: 37162528 PMCID: PMC10171159 DOI: 10.1007/s00296-023-05337-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 04/22/2023] [Indexed: 05/11/2023]
Abstract
To assess adult rheumatologists' comfort level, current practices, and barriers to provision of optimal care in supporting young adults with pediatric-onset rheumatic conditions in Canada. Survey questions were informed by literature review, a needs assessment, and using milestones listed by the Royal College of Physicians and Surgeons of Canada for the entrustable professional activities (EPAs) applicable to care for rheumatology patients transitioning to adult practice. The electronic survey was distributed to adult rheumatology members of the Canadian Rheumatology Association over 4 months. Four hundred and fifty-one rheumatologists received the survey, with a response rate of 15.2%. Most respondents were from Ontario and had been in practice ≥ 10 years. Three quarters reported a lack of training in transition care although the same proportion were interested in learning more about the same. Approximately 40% felt comfortable discussing psychosocial concerns such as gender identity, sexuality, contraception, drug and alcohol use, vaping, and mental health. Despite this, 45-50% reported not discussing vaping or gender identity at all. The most frequently reported barriers to providing transition care were lack of primary care providers, allied health support, and training in caring for this age group. Most adult rheumatologists lack formal training in transition care and view it as a barrier to providing care for this unique patient population. Future educational initiatives for adult rheumatology trainees should include issues pertaining to adolescents and young adults. More research is needed to assess the effectiveness of resources such as transition navigators in ensuring a successful transition process.
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Affiliation(s)
- Madhavi Prasad
- Department of Pediatrics, Western University, London, ON, Canada.
| | - Michelle Batthish
- Division of Rheumatology, Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Karen Beattie
- Division of Rheumatology, Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Roberta Berard
- Division of Rheumatology, Department of Pediatrics, Western University, London, ON, Canada
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371
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Naye F, Légaré F, Paquette JS, Tousignant-Laflamme Y, LeBlanc A, Gaboury I, Poitras ME, Toupin-April K, Li LC, Hoens A, Poirier MD, Décary S. Decisional needs assessment for patient-centred pain care in Canada: the DECIDE-PAIN study protocol. BMJ Open 2023; 13:e066189. [PMID: 37156591 PMCID: PMC10173373 DOI: 10.1136/bmjopen-2022-066189] [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: 05/10/2023] Open
Abstract
INTRODUCTION The 2021 Action Plan for Pain from the Canadian Pain Task Force advocates for patient-centred pain care at all levels of healthcare across provinces. Shared decision-making is the crux of patient-centred care. Implementing the action plan will require innovative shared decision-making interventions, specifically following the disruption of chronic pain care during the COVID-19 pandemic. The first step in this endeavour is to assess current decisional needs (ie, decisions most important to them) of Canadians with chronic pain across their care pathways. METHODS AND ANALYSIS DesignGrounded in patient-oriented research approaches, we will perform an online population-based survey across the ten Canadian provinces. We will report methods and data following the CROSS reporting guidelines.SamplingThe Léger Marketing company will administer the online population-based survey to its representative panel of 500 000 Canadians to recruit 1646 adults (age ≥18 years old) with chronic pain according to the definition by the International Association for the Study of Pain (eg, pain ≥12 weeks). ContentBased on the Ottawa Decision Support Framework, the self-administered survey has been codesigned with patients and contain six core domains: (1) healthcare services, consultation and postpandemic needs, (2) difficult decisions experienced, (3) decisional conflict, (4) decisional regret, (5) decisional needs and (6) sociodemographic characteristics. We will use several strategies such as random sampling to improve survey quality. AnalysisWe will perform descriptive statistical analysis. We will identify factors associated with clinically significant decisional conflict and decision regret using multivariate analyses. ETHICS AND DISSEMINATION Ethics was approved by the Research Ethics Board at the Research Centre of the Centre Hospitalier Universitaire de Sherbrooke (project #2022-4645). We will codesign knowledge mobilisation products with research patient partners (eg, graphical summaries and videos). Results will be disseminated via peer-reviewed journals and national and international conferences to inform the development of innovative shared decision-making interventions for Canadians with chronic pain.
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Affiliation(s)
- Florian Naye
- Faculty of Medicine and Health Sciences, School of Rehabilitation, Research Centre of the CHUS, CIUSSS de l'Estrie-CHUS, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - France Légaré
- Faculty of Medicine, Department of Family and Emergency Medicine, Universite Laval, Quebec, Quebec, Canada
- VITAM Research Center on Sustainable Health, Quebec Integrated University Health and Social Services Center, Quebec, Quebec, Canada
- Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Québec, Québec, Canada
| | - Jean-Sébastien Paquette
- Faculty of Medicine, Department of Family and Emergency Medicine, Universite Laval, Quebec, Quebec, Canada
- VITAM Research Center on Sustainable Health, Quebec Integrated University Health and Social Services Center, Quebec, Quebec, Canada
| | - Yannick Tousignant-Laflamme
- Faculty of Medicine and Health Sciences, School of Rehabilitation, Research Centre of the CHUS, CIUSSS de l'Estrie-CHUS, University of Sherbrooke, Sherbrooke, Quebec, Canada
| | - Annie LeBlanc
- Faculty of Medicine, Department of Family and Emergency Medicine, Universite Laval, Quebec, Quebec, Canada
- VITAM Research Center on Sustainable Health, Quebec Integrated University Health and Social Services Center, Quebec, Quebec, Canada
| | - Isabelle Gaboury
- Faculty of Medicine and Health Sciences, Department of Family Medecine and Emergency Medicine, Research Centre of the CIUSSS de l'Estrie-CHUS, Universite de Sherbrooke Faculte de medecine et des sciences de la sante, Longueuil, Quebec, Canada
| | - Marie-Eve Poitras
- Faculty of Medicine and Health Sciences, Department of Family Medicine, Research Centre of the CIUSS du Saguenay-Lac-Saint-Jean, Université de Sherbrooke, Chicoutimi, Quebec, Canada
- Centre de santé et de services sociaux de Chicoutimi, Quebec, Quebec, Canada
| | - Karine Toupin-April
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
- Institut du Savoir Montfort, Ottawa, Ontario, Canada
| | - Linda C Li
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- Arthritis Research Canada, Richmond, British Columbia, Canada
| | - Alison Hoens
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Marie-Dominique Poirier
- Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean du Québec, Chicoutimi, Quebec, Canada
| | - Simon Décary
- Faculty of Medicine and Health Sciences, School of Rehabilitation, Research Centre of the CHUS, CIUSSS de l'Estrie-CHUS, University of Sherbrooke, Sherbrooke, Quebec, Canada
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Heeren P, Lombaert L, Janssens P, Islam F, Flamaing J, Sabbe M, Milisen K. A survey on the availability of geriatric-friendly protocols, equipment and physical environment across emergency departments in Flanders, Belgium. BMC Geriatr 2023; 23:264. [PMID: 37138245 PMCID: PMC10155353 DOI: 10.1186/s12877-023-03994-z] [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: 09/09/2022] [Accepted: 04/24/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND The acquisition of geriatric-friendly resources is an important part of adapting emergency department (ED) care to the needs of vulnerable older patients. The aim of this study was to explore the availability of geriatric-friendly protocols, equipment and physical environment criteria in EDs and to identify related improvement opportunities. METHODS The head nurse of 63 EDs in Flanders and Brussels Capital Region was invited to complete a survey in collaboration with the chief physician of the ED. The questionnaire was inspired by the American College of Emergency Physicians Geriatric ED Accreditation Program and explored the availability, relevance and feasibility of geriatric-friendly protocols, equipment and physical environment. Descriptive analyses were performed. A region-wide improvement opportunity was defined as a resource that was never to occasionally (0-50%) available on Flemish EDs and was scored (rather or very) relevant by at least 75% of respondents. RESULTS A total of 32 questionnaires were analysed. The response rate was 50.8%. All surveyed resources were available in at least one ED. Eighteen out of 52 resources (34.6%) were available in more than half of EDs. Ten region-wide improvement opportunities were identified. These comprised seven protocols and three physical environment characteristics: 1) a geriatric approach initiated from physical triage, 2) elder abuse, 3) discharge to residential facility, 4) frequent geriatric pathologies, 5) access to geriatric specific follow-up clinics, 6) medication reconciliation, 7) minimising 'nihil per os' designation, 8) a large-face, analogue clock in each patient room, 9) raised toilet seats and 10) non-slip floors. CONCLUSIONS Currently available resources supporting optimal ED care for older patients in Flanders are very heterogeneous. Researchers, clinicians and policy makers need to define which geriatric-friendly protocols, equipment and physical environment criteria should become region-wide minimum operational standards. Findings of this study are relevant to facilitate the development process of this endeavour.
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Affiliation(s)
- Pieter Heeren
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Kapucijnenvoer 35/4, 3000, Leuven, Belgium
- Department of Geriatric Medicine, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
- Research Foundation Flanders, Egmontstraat 5, 1000, Brussels, Belgium
| | - Lotte Lombaert
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Kapucijnenvoer 35/4, 3000, Leuven, Belgium
| | - Petra Janssens
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Kapucijnenvoer 35/4, 3000, Leuven, Belgium
| | - Farah Islam
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Kapucijnenvoer 35/4, 3000, Leuven, Belgium
| | - Johan Flamaing
- Department of Geriatric Medicine, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
- Department of Public Health and Primary Care, Gerontology and Geriatrics, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Marc Sabbe
- Department of Emergency Medicine, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
- Department of Public Health and Primary Care, Emergency Medicine, KU Leuven, Kapucijnenvoer 35/4, 3000, Leuven, Belgium
| | - Koen Milisen
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Kapucijnenvoer 35/4, 3000, Leuven, Belgium.
- Department of Geriatric Medicine, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.
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Krysa JA, Buell M, Pohar Manhas K, Kovacs Burns K, Santana MJ, Horlick S, Russell K, Papathanassoglou E, Ho C. Understanding the Experience of Long COVID Symptoms in Hospitalized and Non-Hospitalized Individuals: A Random, Cross-Sectional Survey Study. Healthcare (Basel) 2023; 11:healthcare11091309. [PMID: 37174851 PMCID: PMC10178853 DOI: 10.3390/healthcare11091309] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/21/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
The relationship between initial COVID-19 infection and the development of long COVID remains unclear. The purpose of this study was to compare the experience of long COVID in previously hospitalized and non-hospitalized adults in a community-based, cross-sectional telephone survey. Participants included persons with positive COVID-19 test results between 21 March 2021 and 21 October 2021 in Alberta, Canada. The survey included 330 respondents (29.1% response rate), which included 165 previously hospitalized and 165 non-hospitalized individuals. Significantly more previously hospitalized respondents self-reported long COVID symptoms (81 (49.1%)) compared to non-hospitalized respondents (42 (25.5%), p < 0.0001). Most respondents in both groups experienced these symptoms for more than 6 months (hospitalized: 66 (81.5%); non-hospitalized: 25 (59.5), p = 0.06). Hospitalized respondents with long COVID symptoms reported greater limitations on everyday activities from their symptoms compared to non-hospitalized respondents (p < 0.0001) and tended to experience a greater impact on returning to work (unable to return to work-hospitalized: 20 (19.1%); non-hospitalized: 6 (4.5%), p < 0.0001). No significant differences in self-reported long COVID symptoms were found between male and female respondents in both groups (p > 0.05). This study provides novel data to further support that individuals who were hospitalized for COVID-19 appear more likely to experience long COVID symptoms.
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Affiliation(s)
- Jacqueline A Krysa
- Neurosciences, Rehabilitation and Vision, Strategic Clinical Network, Alberta Health Services, Edmonton, AB T5J 3E4, Canada
- Division of Physical Medicine and Rehabilitation, University of Alberta, Edmonton, AB T6G 2E1, Canada
| | - Mikayla Buell
- Neurosciences, Rehabilitation and Vision, Strategic Clinical Network, Alberta Health Services, Edmonton, AB T5J 3E4, Canada
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Kiran Pohar Manhas
- Neurosciences, Rehabilitation and Vision, Strategic Clinical Network, Alberta Health Services, Edmonton, AB T5J 3E4, Canada
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Katharina Kovacs Burns
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada
- Department of Clinical Quality Metrics, Alberta Health Services, Edmonton, AB T5J 3E4, Canada
| | - Maria J Santana
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Sidney Horlick
- Neurosciences, Rehabilitation and Vision, Strategic Clinical Network, Alberta Health Services, Edmonton, AB T5J 3E4, Canada
- Faculty of Nursing, University of Alberta, Edmonton AB T6G 1C9, Canada
| | - Kristine Russell
- Neurosciences, Rehabilitation and Vision, Strategic Clinical Network, Alberta Health Services, Edmonton, AB T5J 3E4, Canada
| | - Elizabeth Papathanassoglou
- Neurosciences, Rehabilitation and Vision, Strategic Clinical Network, Alberta Health Services, Edmonton, AB T5J 3E4, Canada
- Faculty of Nursing, University of Alberta, Edmonton AB T6G 1C9, Canada
| | - Chester Ho
- Neurosciences, Rehabilitation and Vision, Strategic Clinical Network, Alberta Health Services, Edmonton, AB T5J 3E4, Canada
- Division of Physical Medicine and Rehabilitation, University of Alberta, Edmonton, AB T6G 2E1, Canada
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374
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Moore-Clingenpeel M, Greenhawt M, Shaker M. Reporting guidelines for allergy and immunology survey research. Ann Allergy Asthma Immunol 2023; 130:674-680.e1. [PMID: 36804464 DOI: 10.1016/j.anai.2023.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/05/2023] [Accepted: 02/09/2023] [Indexed: 02/18/2023]
Abstract
Although survey reports are common, fewer than 10% of medical journals provide clear guidelines to investigators for survey research. In this special article, we provide guidance on minimum recommendations in the form of a CHecklist for Allergy and Immunology Reporting of Survey research (CHAIRS). Key components to consider include providing background information, such as a clear statement of the research hypothesis and question, and rationale for the study. When considering sample selection, a clear understanding of the relationship between the target population, sampling frame, sample scheme, representativeness, and sample size is needed. Review of the survey tool by content experts and assessment of threats to survey validity should occur early in questionnaire development with consideration of cognitive interviews and pretesting to facilitate accurate measurement. Last, a transparent description of data collection and qualitative and quantitative characteristics of response rate is needed to ensure that appropriate inferences and conclusions can be drawn from the survey research.
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Affiliation(s)
| | - Matthew Greenhawt
- Section of Allergy and Clinical Immunology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado
| | - Marcus Shaker
- Section of Allergy and Immunology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire; Dartmouth Geisel School of Medicine, Hanover, New Hampshire.
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375
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Esposito AC, Coppersmith NA, White EM, Papageorge MV, DiSiena M, Hess D, LaFemina J, Larkin AC, Miner TJ, Nepomnayshy D, Palesty J, Rosenkranz KM, Seymour NE, Trevisani G, Whiting J, Oliveira KD, Longo WE, Yoo PS. Update on the Financial Well-Being of Surgical Residents in New England. J Am Coll Surg 2023; 236:953-960. [PMID: 36622076 DOI: 10.1097/xcs.0000000000000544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Poor personal financial health has been linked to key components of health including burnout, substance abuse, and worsening personal relationships. Understanding the state of resident financial health is key to improving their overall well-being. STUDY DESIGN A secondary analysis of a survey of New England general surgery residents was performed to understand their financial well-being. Questions from the National Financial Capability Study were used to compare to an age-matched and regionally matched cohort. RESULTS Overall, 44% (250 of 570) of surveyed residents responded. Residents more frequently reported spending less than their income each year compared to the control cohort (54% vs 34%, p < 0.01). However, 17% (39 of 234) of residents reported spending more than their income each year. A total of 65% of residents (152 of 234), found it "not at all difficult" to pay monthly bills vs 17% (76 of 445) of the control cohort (p < 0.01). However, 32% (75 of 234) of residents reported it was "somewhat" or "very" difficult to pay monthly bills. Residents more frequently reported they "certainly" or "probably" could "come up with" $2,000 in a month compared to the control cohort (85% vs 62% p < 0.01), but 16% (37 of 234) of residents reported they could not. In this survey, 21% (50 of 234) of residents reported having a personal life insurance policy, 25% (59 of 234) had disability insurance, 6% (15 of 234) had a will, and 27% (63 of 234) had >$300,000 worth of student loans. CONCLUSIONS Surgical residents have better financial well-being than an age-matched and regionally matched cohort, but there is still a large proportion who suffer from financial difficulties.
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Affiliation(s)
- Andrew C Esposito
- From the Yale School of Medicine, Department of Surgery, New Haven, CT (Esposito, Coppersmith, White, Papageorge, Oliveira, Longo, Yoo)
| | - Nathan A Coppersmith
- From the Yale School of Medicine, Department of Surgery, New Haven, CT (Esposito, Coppersmith, White, Papageorge, Oliveira, Longo, Yoo)
| | - Erin M White
- From the Yale School of Medicine, Department of Surgery, New Haven, CT (Esposito, Coppersmith, White, Papageorge, Oliveira, Longo, Yoo)
| | - Marianna V Papageorge
- From the Yale School of Medicine, Department of Surgery, New Haven, CT (Esposito, Coppersmith, White, Papageorge, Oliveira, Longo, Yoo)
| | - Michael DiSiena
- Berkshire Medical Center, Department of Surgery, Pittsfield, MA (DiSiena)
| | - Donald Hess
- Boston Medical Center, Department of Surgery, Boston, MA (Hess)
| | - Jennifer LaFemina
- the University of Massachusetts Chan Medical School, Department of Surgery, Worcester, MA (LaFemina, Larkin)
| | - Anne C Larkin
- the University of Massachusetts Chan Medical School, Department of Surgery, Worcester, MA (LaFemina, Larkin)
| | - Thomas J Miner
- Rhode Island Hospital, Warren Alpert Medical School, Department of Surgery, Providence, RI (Miner)
| | - Dmitry Nepomnayshy
- Lahey Hospital and Medical Center, Department of Surgery, Burlington, MA (Nepomnayshy)
| | - John Palesty
- Saint Mary's Hospital, Department of Surgery, Waterbury, CT (Palesty)
| | - Kari M Rosenkranz
- Dartmouth-Hitchcock Medical Center, Department of Surgery, Lebanon, NH (Rosenkranz)
| | - Neal E Seymour
- Baystate Health, Department of Surgery, Springfield, MA (Seymour)
| | - Gino Trevisani
- the University of Vermont Medical Center, Department of Surgery, Burlington, VT (Trevisani)
| | - James Whiting
- Maine Medical Center, Department of Surgery, Portland, ME (Whiting)
| | - Kristin D Oliveira
- From the Yale School of Medicine, Department of Surgery, New Haven, CT (Esposito, Coppersmith, White, Papageorge, Oliveira, Longo, Yoo)
| | - Walter E Longo
- From the Yale School of Medicine, Department of Surgery, New Haven, CT (Esposito, Coppersmith, White, Papageorge, Oliveira, Longo, Yoo)
| | - Peter S Yoo
- From the Yale School of Medicine, Department of Surgery, New Haven, CT (Esposito, Coppersmith, White, Papageorge, Oliveira, Longo, Yoo)
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Denman D, Cordier R, Munro N, Kim JH, Speyer R. Standardized Measures Used Regularly by Speech-Language Pathologists when Assessing the Language Abilities of School-Aged Children: A Survey. Folia Phoniatr Logop 2023; 75:334-349. [PMID: 37094559 PMCID: PMC10614266 DOI: 10.1159/000530718] [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: 06/23/2022] [Accepted: 04/05/2023] [Indexed: 04/26/2023] Open
Abstract
INTRODUCTION This study examined speech-language pathologist (SLP)'s use of standardized language measures when assessing school-aged children. METHOD A total of 335 SLPs provided information in a web-based survey regarding the standardized language measures they use for school-aged children. SLPs were asked to identify the domains targeted, purposes of use, and reasons for which regularly used standardized measures were chosen for use. RESULTS Findings indicated that SLPs collectively use many standardized measures, although only a small number are used regularly. SLPs reported using standardized measures to assess domains that measures are not ideally designed for and for purposes that the measures are not ideally suited to assessing. SLPs reported selecting diagnostic measures based on psychometric properties but not for screening measures. Reasons for choice varied depending on the particular measure. CONCLUSION Overall, findings indicated that SLPs need to place greater focus on evidence-based practice recommendations when selecting standardized measures for use with school-aged children. Implications for clinical practice and future directions are discussed.
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Affiliation(s)
- Deborah Denman
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
- Department of Linguistics, Macquarie University, Sydney, NSW, Australia
| | - Reinie Cordier
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle-upon-Tyne, UK
- Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Natalie Munro
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Camperdown, NSW, Australia
| | - Jae-Hyun Kim
- Department of Linguistics, Macquarie University, Sydney, NSW, Australia
| | - Renée Speyer
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
- Department of Special Needs Education, University of Oslo, Oslo, Norway
- Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Centre, Leiden, The Netherlands
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Yeung M, Hagel BE, Bobrovitz N, Stelfox TH, Elliot A, MacPherson A, McBeth P, Schuurmann N, Yanchar NL. Between paradigms: Comparing experiences for adolescents treated at pediatric and adult trauma centres. Injury 2023:S0020-1383(23)00363-7. [PMID: 37147145 DOI: 10.1016/j.injury.2023.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 03/31/2023] [Accepted: 04/12/2023] [Indexed: 05/07/2023]
Abstract
INTRODUCTION Injured adolescents may be treated at pediatric trauma centres (PTCs) or adult trauma centres (ATCs). Patient and parent experiences are an integral component of high-quality health care and can influence patient clinical trajectory. Despite this knowledge, there is little research on differences between PTCs and ATCs with respect to patient and caregiver-reported experience. We sought to identify differences in patient and parent-reported experiences between the regional PTC and ATC using a recently developed Patient and Parent-Reported Experience Measure. METHODS We prospectively enrolled patients (caregivers) aged 15-17 (inclusive), admitted to the local PTC and ATC for injury management (01/01/2020 - 31/05/2021) We provided a survey 8-weeks post-discharge to query acute care and follow-up experience. Patient and parent experiences were compared between the PTC and ATC using descriptive statistics, chi-square tests for categorical and independent t-tests for continuous variables. RESULTS We identified 90 patients for inclusion (51 PTC, and 39 ATC). From this population, we had 77 surveys (32 patient and 35 caregiver) completed at the PTC, and 41 (20 patient and 21 caregiver) at the ATC. ATC patients tended to be more severely injured. We identified few differences in reported experience on the patient measure but identified lower ratings from caregivers of adolescents treated in ATCs for the domains of information and communication, follow-up care, and overall hospital scores. Patients and parents reported poorer family accommodation at the ATC. CONCLUSION Patient experiences were similar between centres. However, caregivers report poorer experiences at the ATC in several domains. These differences are multifaceted, and may reflect differing patient volumes, effects of COVID-19, and healthcare paradigms. However, further work should target information and communication improvement in adult paradigms given its impact on other domains of care.
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Affiliation(s)
- Matthew Yeung
- Cumming School of Medicine, University of Calgary; Health Sciences Centre, Foothills campus, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N 4N1, Canada
| | - Brent E Hagel
- Alberta Children's Hospital Research Institute, University of Calgary, Room 293, Heritage Medical Research Building, 3330 Hospital Dr. NW, Calgary, AB T2N 4N1, Canada
| | - Niklas Bobrovitz
- Temerty Faculty of Medicine, University of Toronto, Temerty Faculty of Medicine, 1 King's College Circle Medical Sciences Building, Room 2109, Toronto, ON M5S 1A8, Canada
| | - Thomas H Stelfox
- Department of Critical Care, University of Calgary, Foothills Medical Centre, 1403 29St NW, Calgary, AB T2N 2T9, Canada
| | - April Elliot
- Department of Pediatrics, Alberta Children's Hospital, 29 Oki Drive, Calgary, AB T2B 6A8, Canada
| | - Alison MacPherson
- Faculty of Health, York University, 337 Norman Bethune College, 170 Campus Walk, North York, ON M3J 1P3, Canada
| | - Paul McBeth
- Department of Surgery, University of Calgary, North Tower, Foothills Medical Centre, 1403 29St NW, Calgary, AB T2N 2T9, Canada
| | - Nadine Schuurmann
- Department of Geography, RCB 6119/7134, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
| | - Natalie L Yanchar
- Natalie L Yanchar: Department of Surgery, University of Calgary, Alberta Children's Hospital, 28 Oki Drive NW, Calgary, AB T3B 6A8, Canada.
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Li Z, Cao H, Yu N, Qin F, Li Y, Li Z, Wang L, Long X, Wang HC. What factors will influence patients when choosing plastic surgeons? A behaviour analysis of Chinese patients. J Plast Reconstr Aesthet Surg 2023; 83:57-68. [PMID: 37270996 DOI: 10.1016/j.bjps.2023.04.070] [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: 08/06/2022] [Revised: 04/18/2023] [Accepted: 04/19/2023] [Indexed: 06/06/2023]
Abstract
PURPOSE To analyze the factors that patients consider when choosing plastic surgeons and investigate patients' attitudes toward physicians' aesthetic ability and their adherence toward same-gender physicians. METHODS A cross-sectional study was conducted. All patients who presented for evaluation and management between January and April 2022 were eligible for study enrolment. Data collected include demographical information and specific questions related to choosing plastic surgeons, including physician's education, surgical ability, research, title, appearance, dress, age, aesthetics, the patient's preference for physicians' gender, and the way of learning about physicians. RESULTS 1006 valid respondents participated, and the average age was 46.44 ± 15.51 years old (participation rate 99.60%). 72.5% were female. Plastic surgery history (OR 3.242, 95%CI: 1.664-6.317, p = 0.001), education (OR 1.895, 95%CI: 1.064-3.375, p = 0.030), income (OR 1.340, 95%CI: 1.026-1.750, p = 0.032), sexual orientation (OR 1.662, 95%CI: 1.066-2.589, p = 0.025), and concern for the physicians' appearance (OR 1.564, 95%CI: 1.160-2.107, p = 0.003) were significantly associated with patients' tendency to value physicians' aesthetic ability. Marital status (OR 0.766, 95% CI: 0.616-0.951, p = 0.016), income (OR 0.896,95% CI: 0.811-0.990, p = 0.031), the attention to physicians' age (OR 1.191,95% CI: 1.031-1.375, p = 0.017), and the attention to physicians' aesthetic ability (OR 0.775,95% CI: 0.666-0.901, p = 0.001) were significantly associated with the respondents' same-gender adherence degree. CONCLUSION These findings suggest that patients with plastic surgery history, higher income, higher education background, and more diverse sexual orientation paid more attention to physicians' aesthetic ability. Marriage and income would affect the same-gender adherence degree, which would further influence patients' attention to the doctor's age and aesthetic ability.
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Affiliation(s)
- Ziming Li
- Department of Plastic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
| | - Hairu Cao
- Department of Plastic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
| | - Nanze Yu
- Department of Plastic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
| | - Feng Qin
- Department of Plastic Surgery, Zhong Shan Hospital, Fudan University, Shanghai, China.
| | - Yunzhu Li
- Department of Plastic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
| | - Zhujun Li
- Department of Plastic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
| | - Liquan Wang
- Department of Plastic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
| | - Xiao Long
- Department of Plastic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
| | - Hayson Chenyu Wang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
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379
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Tohidi M, Mann SM, Groome PA. Total hip arthroplasty for displaced femoral neck fracture: Survey of orthopaedic surgeons in Ontario, Canada. Injury 2023:S0020-1383(23)00376-5. [PMID: 37105778 DOI: 10.1016/j.injury.2023.04.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 03/16/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023]
Abstract
BACKGROUND Total hip arthroplasty (THA) for displaced femoral neck fractures in older patients remains a controversial topic. This study describes patient and surgeon factors that are associated with surgeons' recommendation of THA for this patient population. Furthermore, this study explores surgeon perceptions on why most patients are treated with hemiarthroplasty over THA. METHODS In October 2019, a cross-sectional survey was mailed to practicing orthopaedic surgeons in Ontario, Canada. The questionnaire included paper patient cases to capture surgical practice variation using a full factorial, vignette-based experimental design. Multilevel linear regression and multivariable linear regression were used to determine patient and surgeon factors that are associated with treatment recommendations. RESULTS Of a target population of 494 practicing surgeons, 302 (61.1%) responded. Sixty percent of respondents worked in the community, and most respondents (89.4%) had fellowship training. Surgeon-level predictors of treatment with THA included higher volume of THA for fracture in the last 12 months, having an elective THA practice, and increasing years in practice. Pre-existing hip arthritis increased likelihood to recommend THA, while increasing patient age and comorbidity burden decreased likelihood to recommend THA. There are medical, institutional, financial, and historic reasons why most patients are treated with hemiarthroplasty over THA. INTERPRETATION This survey identified several patient and surgeon-level factors that were associated with treatment recommendation for THA. Hemiarthroplasty remains the more common treatment for this patient population for multiple reasons. There is potential for differential access to care when the factors driving treatment decisions are unrelated to the patient.
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Affiliation(s)
- Mina Tohidi
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada, K7L 3N6; Department of Surgery, Queen's University, Kingston, Ontario, Canada, K7L 2V7.
| | - Stephen M Mann
- Department of Surgery, Queen's University, Kingston, Ontario, Canada, K7L 2V7
| | - Patti A Groome
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada, K7L 3N6; Division of Cancer Care and Epidemiology, Cancer Research Institute at Queen's University, 10 Stuart Street, 2nd level, Kingston, Ontario, Canada, K7L 3N6
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380
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Haro-Ramos AY, Rodriguez HP, Aguilera A. Effectiveness and implementation of a text messaging intervention to reduce depression and anxiety symptoms among Latinx and Non-Latinx white users during the COVID-19 pandemic. Behav Res Ther 2023; 165:104318. [PMID: 37146444 PMCID: PMC10105646 DOI: 10.1016/j.brat.2023.104318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 03/24/2023] [Accepted: 04/13/2023] [Indexed: 05/07/2023]
Abstract
Text messaging interventions are increasingly used to help people manage depression and anxiety. However, little is known about the effectiveness and implementation of these interventions among U.S. Latinxs, who often face barriers to using mental health tools. The StayWell at Home (StayWell) intervention, a 60-day text messaging program based on cognitive behavioral therapy (CBT), was developed to help adults cope with depressive and anxiety symptoms during the COVID-19 pandemic. StayWell users (n = 398) received daily mood inquiries and automated skills-based text messages delivering CBT-informed coping strategies from an investigator-generated message bank. We conduct a Hybrid Type 1 mixed-methods study to compare the effectiveness and implementation of StayWell for Latinx and Non-Latinx White (NLW) adults using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Effectiveness was measured using the PHQ-8 depression and GAD-7 anxiety scales, assessed before starting and after completing StayWell. Guided by RE-AIM, we conducted a thematic text analysis of responses to an open-ended question about user experiences to help contextualize quantitative findings. Approximately 65.8% (n = 262) of StayWell users completed pre-and-post surveys. On average, depressive (-1.48, p = 0.001) and anxiety (-1.38, p = 0.001) symptoms decreased from pre-to-post StayWell. Compared to NLW users (n = 192), Latinx users (n = 70) reported an additional -1.45 point (p < 0.05) decline in depressive symptoms, adjusting for demographics. Although Latinxs reported StayWell as relatively less useable (76.8 vs. 83.9, p = 0.001) than NLWs, they were more interested in continuing the program (7.5 vs. 6.2 out of 10, p = 0.001) and recommending it to a family member/friend (7.8 vs. 7.0 out of 10, p = 0.01). Based on the thematic analysis, both Latinx and NLW users enjoyed responding to mood inquiries and sought bi-directional, personalized text messages and texts with links to more information to resources. Only NLW users stated that StayWell provided no new information than they already knew from therapy or other sources. In contrast, Latinx users suggested that engagement with a behavioral provider through text or support groups would be beneficial, highlighting this group's unmet need for behavioral health care. mHealth interventions like StayWell are well-positioned to address population-level disparities by serving those with the greatest unmet needs if they are culturally adapted and actively disseminated to marginalized groups. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04473599.
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Affiliation(s)
- Alein Y Haro-Ramos
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Hector P Rodriguez
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Adrian Aguilera
- Digital Health Equity and Access Lab, School of Social Welfare, University of California, Berkeley, Berkeley, CA, USA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA.
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381
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Lavin LE, Maki LC. Antimicrobial use in the surgical treatment of canine pyometra: A questionnaire survey of Arizona-licensed veterinarians. Vet Med Sci 2023; 9:1124-1133. [PMID: 37051761 DOI: 10.1002/vms3.1130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 02/06/2023] [Accepted: 03/03/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Recent studies and consensus statements in veterinary and human medicine recommend more judicious use of antimicrobials. While guidelines have been provided for some veterinary diseases, others have poorly elucidated guidelines. Postoperative treatment of canine pyometra is a condition with minimal guidelines regarding antimicrobial use. OBJECTIVE To identify and investigate patterns of antimicrobial use following surgically treated canine pyometra. METHODS A 23-question survey, sent to 863 small and mixed animal practitioners, investigated demographics, patterns of antibiotic use, rate of culture submission and participant's recollection of outcomes of surgically treated pyometra cases. Responses were analysed for relationships between demographics, patterns of antibiotic use and culture results to better understand reasoning for antibiotic protocols. RESULTS One hundred and fifty-two responses were received. Overall, 76% of veterinarians stated they always use preoperative and perioperative antibiotics, and 74% stated they always use postoperative antibiotics. A total of 16 different antibiotics were reported. Twelve per cent of respondents regularly submitted a culture. Culture submission was impacted by cost, prior experience, poor owner compliance, result turnaround time and anticipated results. CONCLUSIONS Most respondents always used antibiotics and rarely or never submitted a culture. To optimise patient care, future clinical studies are needed to determine specific guidelines for the use of culture and antibiotics in the treatment of canine pyometra following ovariohysterectomy.
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Affiliation(s)
- Lindsey E Lavin
- Department of Small Animal Surgery, Ocean State Veterinary Specialists, East Greenwich, Rhode Island
| | - Lynn C Maki
- Department of Small Animal Surgery, VetMED Emergency and Specialty Veterinary Hospital, Phoenix, Arizona, United States
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382
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Østberg N, Jacobsen BG, Lauridsen MM, Ladegaard Grønkjær L. Mental Health, Quality of Life, and Stigmatization in Danish Patients with Liver Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085497. [PMID: 37107779 PMCID: PMC10139198 DOI: 10.3390/ijerph20085497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/05/2023] [Accepted: 04/08/2023] [Indexed: 05/11/2023]
Abstract
The mental health of patients with liver diseases is often overlooked when assessing their overall health and planning care and treatment. The aim of this study was to assess anxiety, depression, hopelessness, quality of life, and the perception of stigmatization in a large cohort of patients with chronic liver disease of different aetiology and severity, as well as to identify predictors associated with mental health disorders. A total of 340 patients completed a survey assessing mental health using the Beck Anxiety Inventory, the Beck Hopelessness Scale, and the Major Depression Inventory. Quality of life was measured with the Chronic Liver Disease Questionnaire and the European Quality-of-Life visual analogue scale. To assess stigmatization, validated questions from the Danish Nationwide Survey of Patient Experiences were used. Predictors associated with anxiety, hopelessness, and depression were analysed using univariable and multivariable logistic regression analyses. Overall, 15% of the patients had moderate or severe anxiety, 3% had moderate or pronounced hopelessness, and 8% had moderate or severe depression. The prevalence of all three was highest in patients with cirrhosis and was associated with a low quality of life. More patients with cirrhosis had perceived stigmatization compared to patients with liver disease without cirrhosis, which affected their self-perception, and more than one-third of the patients refrained from telling others about their liver disease. The results emphasize the need for increased focus on mental health problems and awareness on preventing the discrimination of patients with liver disease.
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383
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Thomas AS, Belli A, Salceda J, López-Ben S, Lee SY, Kwon W, Pawlik TM, Kluger MD. Contemporary practice and perception of autologous blood salvage in hepato-pancreatico-biliary operations: an international survey. HPB (Oxford) 2023:S1365-182X(23)00122-3. [PMID: 37117066 DOI: 10.1016/j.hpb.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 04/04/2023] [Accepted: 04/11/2023] [Indexed: 04/30/2023]
Abstract
BACKGROUND This study aimed to assess contemporary knowledge, attitudes and behaviors around transfusion of intraoperative salvaged blood (sRBCt) during hepato-pancreatico-biliary (HPB) operations. Findings are meant to inform the design of future studies that address provider concerns to change behaviors and improve patient outcomes. METHODS A survey was designed and assessed for relevance, readability and content, and distributed to an international audience of surgeons performing HPB operations. RESULTS The 237 respondents were predominantly distributed across North America (37.55%), Europe (27.43%) and Asia (19.83%). Roughly one-half (52.74%) of respondents had used sRBCt in HPB surgery before. Transplantation surgeons were more likely than HPB surgeons to have previously used sRBCt [odds ratio = 5.18 (95% CI 1.89-14.20)]. More respondents believed sRBCt was safe for non-cancer versus cancer operations (68.57% vs. 24.17%, p < 0.0001). Less than half (45.71%) of respondents believed that sRBCt was safe in clean-contaminated fields. Most did not utilize preoperative strategies to avoid donor transfusion. CONCLUSION Practices related to sRBCt in HPB operations vary widely and there is no consensus on its use. Concerns seem primarily related to cancer-specific and infectious outcomes. While further studies are pursued, surgeons may increase their utilization of preoperative strategies to boost hemoglobin levels for at risk patients.
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Affiliation(s)
- Alexander S Thomas
- Division of Gastrointestinal and Endocrine Surgery, Department of Surgery, Columbia University Irving Medical Center, Herbert Irving Pavilion, 8th Floor, 161 Fort Washington Avenue, New York, NY, 10032, USA.
| | - Andrea Belli
- Hepatobiliary Surgical Oncology Division, "Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Napoli, Italia", Via Mariano Semmola, 53, 80131, Napoli, NA, Italy
| | - Juan Salceda
- Department of Surgery, Ramon Santamarina Hospital, Gral. Paz 1406, B7000, Tandil, Provincia de Buenos Aires, Argentina
| | - Santiago López-Ben
- General Surgery Department, Hospital Universitari de Girona Dr Josep Trueta, Avinguda de França, S/N, 17007, 168753, Girona, Spain
| | - Ser Y Lee
- Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, 31 Third Hospital Ave, Singapore
| | - Wooil Kwon
- Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 101, Daehak-ro Jongno-gu, Seoul, 03080, Republic of Korea
| | - Timothy M Pawlik
- Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, 395 W 12th Ave #670, Columbus, OH, 43210, USA
| | - Michael D Kluger
- Division of Gastrointestinal and Endocrine Surgery, Department of Surgery, Columbia University Irving Medical Center, Herbert Irving Pavilion, 8th Floor, 161 Fort Washington Avenue, New York, NY, 10032, USA
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384
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Spronk I, Van Wijck SFM, Van Lieshout EMM, Verhofstad MHJ, Prins JTH, Wijffels MME, Polinder S. Rib Fixation for Multiple Rib Fractures: Healthcare Professionals Perceived Barriers and Facilitators to Clinical Implementation. World J Surg 2023; 47:1692-1703. [PMID: 37014429 DOI: 10.1007/s00268-023-06973-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND Surgical stabilization of rib fractures (SSRF) is associated with improved respiratory symptoms and shorter intensive care admission in patients with flail chest. For multiple rib fractures, the benefit of SSRF remains a topic of debate. This study investigated barriers and facilitators of healthcare professionals to SSRF as treatment for multiple traumatic rib fractures. METHODS Dutch healthcare professionals were asked to complete an adapted version of the Measurement Instrument for Determinants of Innovations questionnaire to identify barriers and facilitators of SSRF. If ≥ 20% of participants responded negatively, the item was considered a barrier, and if ≥ 80% responded positively, the item was considered a facilitator. RESULTS Sixty-one healthcare professionals participated; 32 surgeons, 19 non-surgical physicians, and 10 residents. The median experience was 10 years (P25-P75 4-12). Sixteen barriers and two facilitators for SSRF in multiple rib fractures were identified. Barriers included lack of knowledge, experience, evidence on (cost-)effectiveness, and the implication of more operations and higher medical costs. Facilitators were the assumption that SSRF alleviates respiratory problems and the feeling that surgeons are supported by colleagues for SSRF. Non-surgeons and residents reported more and several different barriers than surgeons (surgeons: 14; non-surgical physicians: 20; residents: 21; p < 0.001). CONCLUSION For adequate implementation of SSRF in patients with multiple rib fractures, implementation strategies should address the identified barriers. Especially, improved clinical experience and scientific knowledge of healthcare professionals, and high-level evidence on the (cost-) effectiveness of SSRF potentially increase its use and acceptance.
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Affiliation(s)
- Inge Spronk
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, P.O. Box 2040, 3015 GD, Rotterdam, The Netherlands.
| | - Suzanne F M Van Wijck
- Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Esther M M Van Lieshout
- Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Michael H J Verhofstad
- Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Jonne T H Prins
- Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Mathieu M E Wijffels
- Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Suzanne Polinder
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Doctor Molewaterplein 40, P.O. Box 2040, 3015 GD, Rotterdam, The Netherlands
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385
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Soares D, Yamamoto K, Liebertz D. The Future of Visual Documentation? Assessing the Use of Videography in Facial Plastic Surgery. Facial Plast Surg 2023; 39:118-124. [PMID: 35545121 DOI: 10.1055/a-1849-3233] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Recent technological advancements in the field of portable electronics have facilitated the use of videography as a form of visual documentation in facial plastic surgery. Currently, the degree of video adoption and perceptions relating to its use in plastic surgery are not known. This study aimed to evaluate the current use, perceptions, and barriers regarding the adoption of video in the clinical practice of facial plastic surgery. A cross-sectional study of all American Academy of Facial Plastic and Reconstructive Surgery members was conducted through an e-mail-disseminated 24-item online survey. A total of 164 surgeons responded to the survey. Nearly all surgeons reported routinely employing photography for the documentation and marketing of surgical results. Fewer than 25% of respondents acknowledged using video to document surgical outcomes. Younger surgeons (<10 years in practice) and those in academic practices were significantly more likely to adopt videography (32 vs. 17%, p = 0.042 and 38 vs. 18%, p = 0.027, respectively). Most surgeons regarded video as the superior visual documentation format for dynamic facial expression and as being more difficult to deceptively manipulate. Most frequently cited barriers to adoption included time-consuming capture, file editing/storage requirements, and lack of clear standards. Videography holds favorable potential as the future format of visual documentation in facial plastic surgery due to its ability to capture the full range of dynamic facial expression. Establishing standards and setup guidelines for video capture will be essential in increasing its adoption.
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Affiliation(s)
- Danny Soares
- Department of Otolaryngology, Head and Neck Surgery, University of Central Florida, College of Medicine, Orlando, Florida
- American Foundation for Aesthetic Medicine (AFFAM), Fruitland Park, Florida
| | - Kyle Yamamoto
- University of Nevada, Reno School of Medicine, Reno, Nevada
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386
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Subramanian I, McDaniels B, Farahnik J, Mischley LK. Childhood Trauma and Parkinson Disease: Associations of Adverse Childhood Experiences, Disease Severity, and Quality of Life. Neurol Clin Pract 2023; 13:e200124. [PMID: 36891464 PMCID: PMC9987208 DOI: 10.1212/cpj.0000000000200124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 11/04/2022] [Indexed: 02/22/2023]
Abstract
Background and Objectives Childhood trauma has been shown to be associated with adverse health outcomes that can last a lifetime. The effects of trauma have not been evaluated in a Parkinson disease (PD) population. The goal of this study was to survey individuals with PD to evaluate whether the intensity of childhood trauma is associated with individual symptoms, overall disease severity, or quality of life. Methods An Internet-based observational survey was designed to evaluate modifiable variables associated with PD progression. In this cross-sectional analysis, adverse childhood experiences (ACEs) were used as a measure of childhood trauma, patient-reported outcomes in PD for the primary measure of PD severity, and Patient-Reported Outcomes Measurement Information System (PROMIS) Global for quality of life (QoL). Results Seven hundred twelve of 900 participants (79%) responded to the questions related to childhood trauma. Among respondents, QoL decreased as incidence of childhood trauma increased. Individuals with ACE scores 4 or higher reported greater symptom severity for 45% of the variables tested, including apathy, muscle pain, daytime sleepiness, restless leg syndrome, depression, fatigue, comprehension, and anxiety (p < 0.05) compared with individuals with trauma scores of zero. Discussion These data suggest childhood trauma is associated with a mild increase in overall patient-reported PD severity, specifically mood and other nonmotor and motor symptoms. While the associations were statistically significant, the impact of trauma was less robust than previously described predictors of severity, such as diet, exercise, and social connection. Future research should attempt to include more diverse populations, attempt to improve the response rate of these sensitive questions, and, most importantly, determine whether the adverse outcomes associated with childhood trauma can be mitigated with lifestyle modification, psychosocial support, and intervention in adulthood.
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Affiliation(s)
- Indu Subramanian
- David Geffen School of Medicine (IS), UCLA, Department of Neurology, Los Angeles, CA; SW PADRECC (IS), West Los Angeles, Veterans Administration, CA; Department of Rehabilitation and Health Services (BM), University of North Texas, Denton; Bastyr University Research Institute (JF, LKM); and Department of Radiology (LKM), University of Washington
| | - Bradley McDaniels
- David Geffen School of Medicine (IS), UCLA, Department of Neurology, Los Angeles, CA; SW PADRECC (IS), West Los Angeles, Veterans Administration, CA; Department of Rehabilitation and Health Services (BM), University of North Texas, Denton; Bastyr University Research Institute (JF, LKM); and Department of Radiology (LKM), University of Washington
| | - Joshua Farahnik
- David Geffen School of Medicine (IS), UCLA, Department of Neurology, Los Angeles, CA; SW PADRECC (IS), West Los Angeles, Veterans Administration, CA; Department of Rehabilitation and Health Services (BM), University of North Texas, Denton; Bastyr University Research Institute (JF, LKM); and Department of Radiology (LKM), University of Washington
| | - Laurie K Mischley
- David Geffen School of Medicine (IS), UCLA, Department of Neurology, Los Angeles, CA; SW PADRECC (IS), West Los Angeles, Veterans Administration, CA; Department of Rehabilitation and Health Services (BM), University of North Texas, Denton; Bastyr University Research Institute (JF, LKM); and Department of Radiology (LKM), University of Washington
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387
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Esposito AC, Coppersmith NA, Flom EA, Chung M, Reddy V, Leeds I, Longo W, Pantel H, Yoo PS, Mongiu A. So You Want to be a Program Director? Career Paths of Colon and Rectal Surgery Residency Program Directors. JOURNAL OF SURGICAL EDUCATION 2023; 80:588-596. [PMID: 36658062 DOI: 10.1016/j.jsurg.2022.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 11/11/2022] [Accepted: 12/26/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The trajectory of colon and rectal surgery residency program director (PD) career paths has not been well described, leaving those who aspire for the position with minimal guidance. The goal of this study is to characterize their career paths in the United States. By understanding their experiences, the path to train and educate the next generation of colon and rectal surgeons as a PD will be better illuminated. STUDY DESIGN This study was an anonymous, cross-sectional survey of all junior and senior colon and rectal surgery residency PDs in the United States during April and May of 2022. PDs were divided into junior and senior PDs. Results were compared using 2-sided independent t-tests and Kruskall-Wallis tests. RESULTS Of 65 colon and rectal surgery PDs, 48% (31/65) completed the survey which encompassed demographics, leadership, education, research, and time utilization. Participants were primarily white and male, although increased female representation was identified among the junior PDs (50%). Junior PDs were also more likely to hold associate or assistant professor positions at time of appointment (p = 0.01) and a majority of all PDs (64%) previously or currently held a leadership position in a national or regional surgical association. When appointed, senior PDs reported increased teaching time. CONCLUSIONS This multi-institutional analysis of colon and rectal surgery residency PDs identified a trend towards equal gender representation and diversity amongst upcoming junior PDs. All respondents were appointed to PD from within the institution. Other key experiences included previous leadership roles and associate or assistant professor positions at time of appointment. While it is impossible to create a single recommended template for every aspiring colon and rectal surgery educator to advance to a PD position, this study provides guideposts along that career path.
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Affiliation(s)
- Andrew C Esposito
- Department of Surgery, Yale School of Medicine, New Haven, Connecticut.
| | | | - Emily A Flom
- Department of Surgery, Yale School of Medicine, New Haven, Connecticut
| | | | - Vikram Reddy
- Division of Colon and Rectal Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut; Yale School of Management, Yale University, New Haven, Connecticut
| | - Ira Leeds
- Division of Colon and Rectal Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut
| | - Walter Longo
- Division of Colon and Rectal Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut
| | - Haddon Pantel
- Division of Colon and Rectal Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut
| | - Peter S Yoo
- Division of Transplant Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut
| | - Anne Mongiu
- Division of Colon and Rectal Surgery, Department of Surgery, Yale School of Medicine, New Haven, Connecticut
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388
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Haut ER, Kirby JP, Bailey JA, Phuong J, Gavitt B, Remick KN, Staudenmayer K, Cannon JW, Price MA, Bulger EM. Developing a National Trauma Research Action Plan: Results from the trauma systems and informatics panel Delphi survey. J Trauma Acute Care Surg 2023; 94:584-591. [PMID: 36623269 DOI: 10.1097/ta.0000000000003867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND The National Academies of Sciences, Engineering, and Medicine 2016 report on the trauma care system recommended establishing a National Trauma Research Action Plan to strengthen and guide future trauma research. To address this recommendation, the Department of Defense funded a study to generate a comprehensive research agenda spanning the trauma and burn care continuum. Panels were created to conduct a gap analysis and identify high-priority research questions. The National Trauma Research Action Plan panel reported here addressed trauma systems and informatics. METHODS Experts were recruited to identify current gaps in trauma systems research, generate research questions, and establish the priorities using an iterative Delphi survey approach from November 2019 through August 2020. Panelists were identified to ensure heterogeneity and generalizability, including military and civilian representation. Panelists were encouraged to use a PICO format to generate research questions: patient/population, intervention, compare/control, and outcome. In subsequent surveys, panelists prioritized each research question on a 9-point Likert scale, categorized as low-, medium-, and high-priority items. Consensus was defined as ≥60% agreement. RESULTS Twenty-seven subject matter experts generated 570 research questions, of which 427 (75%) achieved the consensus threshold. Of the consensus reaching questions, 209 (49%) were rated high priority, 213 (50%) medium priority, and 5 (1%) low priority. Gaps in understanding the broad array of interventions were identified, including those related to health care infrastructure, technology products, education/training, resuscitation, and operative intervention. The prehospital phase of care was highlighted as an area needing focused research. CONCLUSION This Delphi gap analysis of trauma systems and informatics research identified high-priority research questions that will help guide investigators and funding agencies in setting research priorities to continue to work toward Zero Preventable Deaths after trauma. LEVEL OF EVIDENCE Therapeutic/Care Management; Level IV.
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Affiliation(s)
- Elliott R Haut
- From the Division of Acute Care Surgery, Department of Surgery (E.R.H.), Department of Anesthesiology and Critical Care Medicine (E.R.H.), and Department of Emergency Medicine (E.R.H.), The Johns Hopkins University School of Medicine; The Armstrong Institute for Patient Safety and Quality (E.R.H.), Johns Hopkins Medicine; Department of Health Policy and Management (E.R.H.), The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland Acute and Critical Care Surgery (J.P.K.) and Department of Surgery (J.A.B.), Washington University in St. Louis, St. Louis, Missouri Harborview Injury Prevention and Research Center (J.P.), University of Washington, Seattle, Washington Trauma Surgery and Surgical Critical Care (B.G.), University of Cincinnati Medical Center, Cincinnati, Ohio Department of Surgery (K.N.R.), Uniformed Services University School of Medicine, Bethesda, Maryland Department of General Surgery (K.S.), Stanford University, Stanford, California Division of Traumatology, Surgical Critical Care and Emergency Surgery (J.W.C.), University of Pennsylvania, Philadelphia, Pennsylvania The Coalition for National Trauma Research (M.A.P.), San Antonio, Texas Department of Surgery (E.M.B.), University of Washington, Seattle, Washington Coalition for National Trauma Research (NRAP Trauma Systems and Informatics Panel), San Antonio, Texas
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Garcia-Zamora S, Iomini PA, Pulido L, Miranda-Arboleda AF, Lopez-Santi P, Burgos LM, Perez GE, Priotti M, García DE, Antoniolli M, Musso G, Zaidel EJ, Sosa-Liprandi Á, Del-Sueldo MA, Lopez-Santi R, Vazquez G, Baranchuk A. Comparison of violence and aggressions suffered by health personnel during the COVID-19 pandemic in Argentina and the rest of Latin America. Rev Peru Med Exp Salud Publica 2023; 40:179-188. [PMID: 38232264 PMCID: PMC10953667 DOI: 10.17843/rpmesp.2023.402.12646] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/14/2023] [Indexed: 01/19/2024] Open
Abstract
OBJECTIVES. Motivation for the study. The COVID-19 pandemic has caused profound repercussions at different socio-environmental levels. Its impact on violence against healthcare team workers in Argentina has not been well documented. Main findings. The present study evidenced high rates of aggression, particularly verbal aggression. In addition, almost half of the participants reported having suffered these events on a weekly basis. All participants who experienced violence reported having experienced post-event symptoms, and up to one-third reported having considered changing their profession after these acts. Implications. It is imperative to take action to prevent acts of violence against health personnel, or to mitigate its impact on the victims. . To explore the frequency and impact of violence against healthcare workers in Argentina and to compare it with the rest of their Latin American peers during the COVID-19 pandemic. MATERIALS AND METHODS. A cross-sectional study was conducted by applying an electronic survey on Latin American medical and non-medical personnel who carried out health care tasks since March 2020. We used Poisson regression to estimate crude (PR) and adjusted (aPR) Prevalence Ratios with their respective 95% confidence intervals. RESULTS. A total of 3544 participants from 19 countries answered the survey; 1992 (56.0%) resided in Argentina. Of these, 62.9% experienced at least one act of violence; 97.7% reported verbal violence and 11.8% physical violence. Of those who were assaulted, 41.5% experienced violence at least once a week. Health personnel from Argentina experienced violence more frequently than those from other countries (62.9% vs. 54.6%, p<0.001), and these events were more frequent and stressful (p<0.05). In addition, Argentinean health personnel reported having considered changing their healthcare tasks and/or desired to leave their profession more frequently (p<0.001). In the Poisson regression, we found that participants from Argentina had a higher prevalence of violence than health workers from the region (14.6%; p<0.001). CONCLUSIONS. There was a high prevalence of violence against health personnel in Argentina during the COVID-19 pandemic. These events had a strong negative impact on those who suffered them. Our data suggest that violence against health personnel may have been more frequent in Argentina than in other regions of the continent.
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Affiliation(s)
- Sebastián Garcia-Zamora
- Servicio de Cardiología, Sanatorio Delta, Rosario, Argentina.Servicio de CardiologíaSanatorio DeltaRosarioArgentina
| | - Pablo A. Iomini
- Facultad de Medicina, Universidad de Buenos Aires (UBA) - UDH Hospital Dr. Prof. Alejandro Posadas, Buenos Aires, Argentina.Universidad de Buenos AiresFacultad de MedicinaUniversidad de Buenos Aires (UBA)UDH Hospital Dr. Prof. Alejandro PosadasBuenos AiresArgentina
| | - Laura Pulido
- Pneumonology Service, Sanatorio Centro, Rosario, Argentina.Pneumonology ServiceSanatorio CentroRosarioArgentina
| | - Andrés F. Miranda-Arboleda
- Cardiology Division, Queen’s University, Kingston, Ontario, Canada.Cardiology DivisionQueen’s UniversityKingstonOntarioCanada
| | - Pilar Lopez-Santi
- Cardiology Division, Hospital Italiano de La Plata, La Plata, Argentina.Cardiology DivisionHospital Italiano de La PlataLa PlataArgentina
| | - Lucrecia M. Burgos
- Instituto Cardiovascular de Buenos Aires, Argentina.Instituto Cardiovascular de Buenos AiresArgentina
| | - Gonzalo E. Perez
- Cardiology Division, Clínica Olivos, Buenos Aires, Argentina.Cardiology DivisionClínica OlivosBuenos AiresArgentina
| | - Mauricio Priotti
- Servicio de Cardiología, Sanatorio Delta, Rosario, Argentina.Servicio de CardiologíaSanatorio DeltaRosarioArgentina
| | - Darío E. García
- Latin American Federation of Emergency Medicine, Ciudad de Mexico, Mexico.Latin American Federation of Emergency MedicineCiudad de MexicoMexico
| | - Melisa Antoniolli
- Cardiology Service, Sanatorio Finochietto, Buenos Aires, Argentina.Cardiology ServiceSanatorio FinochiettoBuenos AiresArgentina
| | - Gabriel Musso
- Intensive Care Service, Sanatorio Parque, Rosario, Argentina.Intensive Care ServiceSanatorio ParqueRosarioArgentina
| | - Ezequiel J. Zaidel
- Cardiology Department, Sanatorio Güemes, CABA, Argentina. Cardiology DepartmentSanatorio GüemesCABAArgentina
| | - Álvaro Sosa-Liprandi
- Cardiology Department, Sanatorio Güemes, CABA, Argentina. Cardiology DepartmentSanatorio GüemesCABAArgentina
| | - Mildren A. Del-Sueldo
- Certus-Clínica de Especialidades Foundation, Cordoba, Argentina.Certus-Clínica de Especialidades FoundationCordobaArgentina
| | - Ricardo Lopez-Santi
- Cardiology Division, Hospital Italiano de La Plata, La Plata, Argentina.Cardiology DivisionHospital Italiano de La PlataLa PlataArgentina
| | - Gustavo Vazquez
- Department of Psychiatry, Queen’s University, Kingston, Ontario, Canada.Department of PsychiatryQueen’s UniversityKingstonOntarioCanada
| | - Adrián Baranchuk
- Cardiology Division, Queen’s University, Kingston, Ontario, Canada.Cardiology DivisionQueen’s UniversityKingstonOntarioCanada
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390
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Rowland S, Mills C, Walshe M. Perspectives on speech and language pathology practices and service provision in adult critical care settings in Ireland and international settings: A cross-sectional survey. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 25:219-230. [PMID: 35167432 DOI: 10.1080/17549507.2022.2032346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
PURPOSE Patients admitted to critical care (CC) are at risk of impaired swallowing and communication function. Speech-language pathologists (SLPs) play an important role in this context. In Ireland and internationally speech-language pathology CC guidelines are lacking, with possible variations in practice. To compare clinical practices in dysphagia, communication and tracheostomy management among SLPs working in adult CC units in Ireland and internationally, and explore their perspectives on training, skills and resources. METHOD Participants were SLPs working in CC. An international online survey sought information on (i) SLP workforce demographics and staffing levels, (ii) current dysphagia and communication assessment and management practices, (iii) practices and perspectives on training, skills and resources. RESULT 366 responses were received across 29 countries. 18.03% (66/366) of these respondents worked in Ireland. Findings showed similarities and differences in practices. Total CC SLP whole-time equivalent (WTE) at each staff grade was lower (mean difference: -0.21 to -0.65 WTE p <.001) than desired for optimal service delivery. Negative effects of under-staffing were reported. Recommendations that all tracheostomised patients receive SLP input was unmet in 66% (220/334) of services. CONCLUSION SLP input in CC is limited in terms of dedicated posts, multidisciplinary team (MDT) involvement, consistent management approaches and training opportunities internationally. Implications of findings are discussed.
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Affiliation(s)
- Sarah Rowland
- Department of Speech and Language Therapy, Tallaght University Hospital, Dublin, Ireland
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland
| | - Claire Mills
- Leeds Institute for Health Sciences, University of Leeds, Leeds, UK
| | - Margaret Walshe
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland
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391
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Otón T, Carmona L, Andreu JL. What do patients on methotrexate need and expect at the clinic? An online patient survey. Rheumatol Int 2023; 43:735-741. [PMID: 36436083 DOI: 10.1007/s00296-022-05249-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/14/2022] [Indexed: 11/28/2022]
Abstract
To verify, via a survey, the experience and needs of patients receiving methotrexate (MTX), their general management and the quality of the information provided by the rheumatologist. We conducted a 51-item online survey between May and July 2020 addressed to persons diagnosed with an immune-mediated disease and treated with MTX (regardless of the route of administration). Recruitment was done via Twitter. We obtained 294 responses, of which 283 were complete and could be analysed. Almost 82% of the respondents were women, 80% resided in Spain, 75% were between 31 and 60 years old, and 57% were active workers. Diseases included psoriasis (41%), lupus, Sjögren's or vasculitides (33%), and rheumatoid arthritis (16%), among others. Eighty per cent had read the leaflet inserted in the package, of whom 62% found it helpful. Only 15% of the respondents reported having been offered additional written material, which was considered barely functional (33 out of 100). Most patients (88%) responded that they had not received advice on any reliable sources to consult on the internet, and those who received it considered it unhelpful (24 out of 100). Patients receiving MTX due to an autoimmune disease demand more and better-quality written or web-based information than what is currently offered at their clinics.
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Affiliation(s)
- Teresa Otón
- Instituto de Salud Musculoesquelética (InMusc), Ofelia Nieto, 10, 28039, Madrid, Spain.
| | - Loreto Carmona
- Instituto de Salud Musculoesquelética (InMusc), Ofelia Nieto, 10, 28039, Madrid, Spain
| | - Jose Luis Andreu
- Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
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392
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Gauthier ML, Unverzagt CA, Mendonça LDM, Seitz AL. Missing The Forest For The Trees: A Lack Of Upper Extremity Physical Performance Testing In Sports Physical Therapy. Int J Sports Phys Ther 2023; 18:419-430. [PMID: 37020447 PMCID: PMC10069373 DOI: 10.26603/001c.73791] [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: 11/08/2022] [Accepted: 02/14/2023] [Indexed: 04/03/2023] Open
Abstract
Background Despite shoulder and elbow injuries being common in athletics, return to sport and reinjury rates are less than ideal. These outcomes may be driven by the absence of evidence-informed testing to determine an athlete's readiness for sport. Purpose The purpose of this study was to explore the reported frequency of physical performance testing for return to sport readiness by physical therapists treating athletes with upper extremity injuries and to identify potential barriers that may limit use of these tests. A secondary aim was to compare practice patterns of clinicians with sports physical therapy specialty certification to clinicians without. Study Design International, cross-sectional survey using purposive sampling. Methods A survey instrument was created to assess the frequency of use of physical performance tests by physical therapists treating athletes with upper extremity injuries, as well as the barriers limiting the use of these tests. The 19-question online survey was distributed via email and Twitter among sports physical therapists. Independent t-tests and Chi Square analyses were conducted to determine differences in practice patterns between physical therapists with and without specialization and the frequency of potential barriers that may limit the use of these tests. Results Four hundred ninety-eight participants met study eligibility and completed the survey. Fewer than half of participants reported using any physical performance test in making return to sport decisions for athletes with upper extremity injuries. The greatest barriers to the use of physical performance tests were a lack of equipment followed by lack of understanding of the literature, lack of time, and lack of supporting literature. Sports specialist clinicians were significantly more likely (p<0.001) to use physical performance tests than non-specialist clinicians (71.6% versus 36.3%). Conclusion In this survey of physical therapists (n=498), the majority admit to not using physical performance tests when making return to sport decisions for athletes with upper extremity injuries regardless of specialization.Physical therapists have an opportunity to improve the utilization physical performance testing in the upper extremity athlete in hopes of reducing injury recurrence and enhance return to sport rates. Level of Evidence Level 3b.
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Affiliation(s)
| | | | | | - Amee L Seitz
- Department of Physical Therapy and Human Movement Sciences Northwestern University
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393
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Ardon A, Bojaxhi E, Clendenen S, McClain R, Gillespie N, Robards C, Greengrass R. A Change in the Educational Landscape of Regional Anesthesia: A National Survey of Anesthesiology Residency Programs to Assess the Correlation Between the Frequency of Teaching a Block Technique and Clinical Importance. Cureus 2023; 15:e37869. [PMID: 37223208 PMCID: PMC10202666 DOI: 10.7759/cureus.37869] [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] [Accepted: 04/20/2023] [Indexed: 05/25/2023] Open
Abstract
Introduction Variability regarding which blocks are performed most often can be quite high among anesthesiology residency training programs. Which techniques are viewed by residency programs as "critical" for their graduates to know can also be inconsistent. We administered a national survey to investigate correlations between the cited importance of techniques and the relative frequency with which they are being taught. Materials and methods A three-round modified Delphi method was used to develop the survey. The final survey was sent to 143 training programs across the United States. The surveys collected information on the frequency with which thoracic epidural blocks, truncal blocks, and peripheral blocks were taught. The respondents were also asked to rate how critical each technique is to learn during residency. A correlation between the relative frequency of block teaching and cited importance to education was calculated using Kendall's Tau statistic. Results Among truncal procedures, transversus abdominis plane (TAP) block and thoracic epidural blocks were frequently viewed as "indispensable for daily practice." Among peripheral nerve blocks, interscalene, supraclavicular, adductor, and popliteal blocks were frequently viewed as indispensable. All truncal blocks showed a strong correlation between the relative frequency of block teaching and cited importance to education. However, the frequency of teaching interscalene, supraclavicular, femoral, and popliteal blocks failed to correlate with their reported importance ranking. Conclusions Perceived importance was significantly associated with the reported frequency of block teaching for all truncal and peripheral blocks except for interscalene, supraclavicular, femoral, and popliteal. The lack of correlation between the frequency of teaching and perceived importance is reflective of a changing educational landscape.
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Affiliation(s)
| | | | - Steven Clendenen
- Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, USA
| | | | - Nigel Gillespie
- Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, USA
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O'Hearn K, Cayouette F, Cameron S, Martin DA, Tsampalieros A, Menon K. Assent in Pediatric Critical Care Research: A Cross-Sectional Stakeholder Survey of Canadian Research Ethics Boards, Research Coordinators, Pediatric Critical Care Researchers, and Nurses. Pediatr Crit Care Med 2023; 24:e179-e189. [PMID: 36511694 DOI: 10.1097/pcc.0000000000003135] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Survey of four stakeholder groups involved in defining and obtaining assent for research in Canadian PICUs to better understand their perspectives and perceived barriers to assent. DESIGN Cross-sectional survey. SETTING Fourteen tertiary-care pediatric hospitals in Canada. PARTICIPANTS Research Ethics Board Chairs, pediatric critical care nurses, research coordinators, and researchers. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS A total of 193 participants responded. Thirty-seven percent (59/159) thought it was "Never/Almost Never" (59/159, 37%) feasible to obtain assent during the first 48 hours of PICU admission, and 112 of 170 (66%) indicated there are unique barriers to assent at the time of enrollment in PICU studies. Asking children for assent was most frequently rated as Important/Very Important for interviews/focus groups with the child (138/180, 77%), blood sample collection with a needle poke for research (137/178, 77%), and studies involving genetic testing with results communicated to the child/legal guardian (134/180, 74%). In two scenarios where a child and legal guardian disagreed about study participation, most respondents indicated that whether the child should still be enrolled would depend on the patient's age (34-36%), and/or the risk of the study (24-28%). There was a lack of consensus over how the assent process should be operationalized, and when and for how long children should be followed to seek assent for ongoing study participation. Most stakeholders (117/158, 74%) thought that children should have the opportunity to decide if their samples could stay in a biobank once they are old enough to do so. CONCLUSIONS There was an overall lack of consensus on the feasibility of, and challenges associated with, obtaining assent at the time of study enrollment and on how key aspects of the assent process should be operationalized in the PICU. This highlights the need for guidelines to clarify the assent process in pediatric critical care research.
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Affiliation(s)
- Katie O'Hearn
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Florence Cayouette
- Paediatric Intensive Care Unit, Great Ormond Street Hospital NHS Trust, London, United Kingdom
| | - Saoirse Cameron
- Children's Hospital - London Health Sciences Centre, London, ON, Canada
| | - Dori-Ann Martin
- Section of Critical Care Medicine, Department of Pediatrics, Alberta Children's Hospital, Calgary, AB, Canada
| | - Anne Tsampalieros
- Children's Hospital of Eastern Ontario, Clinical Research Unit, Ottawa, ON, Canada
| | - Kusum Menon
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Children's Hospital of Eastern Ontario, Department of Pediatrics, Division of Critical Care, Ottawa, ON, Canada
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395
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Robinson Y, Ragazzoni L, Della Corte F, von Schreeb J. Teaching extent and military service improve undergraduate self-assessed knowledge in disaster medicine: An online survey study among Swedish medical and nursing students. Front Public Health 2023; 11:1161114. [PMID: 37064676 PMCID: PMC10102457 DOI: 10.3389/fpubh.2023.1161114] [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: 02/07/2023] [Accepted: 03/13/2023] [Indexed: 04/03/2023] Open
Abstract
BackgroundThe purpose of this study was to identify the possible needs for undergraduate disaster medicine education in Sweden and to make informed recommendations for the implementation of disaster medicine content in medical and nursing schools in Sweden.MethodsAn online survey was distributed to undergraduate medical and nursing students through the directors of all medical and nursing programs at Swedish universities. The survey contained demographic questions, as well as questions about the amount of disaster medical education and previous experience with rescue, police, or military services. The final survey page contained self-assessments of disaster medical knowledge. Comparative statistics were applied between nursing and medical students, those with previous military service, and those without, as well as between universities.ResultsA total of 500 medical and 408 nursing students participated in this study. A median of 2 h of disaster medicine education was provided to senior medical students and 4 h was provided to senior nursing students. Senior medical students scored their disaster medical knowledge lower than nursing students (t-test, p < 0.001). A proportion of 1% had served in rescue services or police, and 7% of the participants had a history of military service, of which 67% served in a medical role. Those who had served in rescue services, police, or the armed forces had a higher self-assessed disaster medical knowledge base than those who had not (p < 0.007 and p < 0.001, respectively).ConclusionMost medical and nursing students in this study rated their disaster medical knowledge as insufficient. The correlation between the amount of disaster medical education and self-assessed disaster medical knowledge should influence and help direct Swedish educational policies.
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Affiliation(s)
- Yohan Robinson
- Institute for Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
- *Correspondence: Yohan Robinson,
| | - Luca Ragazzoni
- CRIMEDIM—Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, Novara, Italy
| | - Francesco Della Corte
- CRIMEDIM—Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health, Università del Piemonte Orientale, Novara, Italy
| | - Johan von Schreeb
- Department of Global Public Health, Center for Research on Health Care in Disasters, Karolinska Institute, Stockholm, Sweden
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Fuschlberger M, Putz P. Vitamin B12 supplementation and health behavior of Austrian vegans: a cross-sectional online survey. Sci Rep 2023; 13:3983. [PMID: 36949098 PMCID: PMC10033911 DOI: 10.1038/s41598-023-30843-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 03/02/2023] [Indexed: 03/24/2023] Open
Abstract
The number of vegans is increasing and was estimated at 2.0% of the Austrian population. Austrian vegans were found to have lower intakes and levels of vitamin B12 compared to vegetarians and omnivores. Vegans are advised to consume reliable sources of vitamin B12, e.g., in the form of dietary supplements or fortified foods. This study aimed to investigate health and supplementation behavior, with special emphasis on the supplementation of vitamin B12, and to demographically characterize the community of Austrian adult vegans. A nonrandom, voluntary sample of adult vegans with a principal residence in Austria was recruited with an online cross-sectional survey via social media and messenger platforms. Associations between respondent characteristics (gender, education, nutritional advice by a dietitian or nutritionist) and health/supplementation behaviors were examined by cross-tabulation. The questionnaire was completed by 1565 vegans (completion rate 88%), of whom 86% were female, the median age was 29 years, 6% were obese, and 49% had completed an academic education. Ninety-two percent consumed vitamin B12 through supplements and/or fortified foods, and 76% had their vitamin B12 status checked. The prevalence of vitamin B12 intake through supplements and/or fortified foods was slightly (not statistically significant) higher among women vs. men (93% vs. 89%), those who were academically educated vs. those who were not (93% vs. 91%), and those who had taken nutritional advice vs. those who had not (97% vs. 92%). Professional nutritional advice had been taken by only 9.5% of female and 8.4% of male respondents. Those who had taken advice reported a lower smoking prevalence (p = 0.05, φ = 0.05), higher prevalence of checking vitamin B12 status (p < 0.01, φ = 0.10), vit B12 intake through supplements and/or fortified foods (p = 0.03, φ = 0.05), and taking supplements of omega-3 (p < 0.01, φ = 0.14), selenium (p = 0.02, φ = 0.06), and iodine (p = 0.02, φ = 0.06). Austrian vegans can be characterized as predominantly young, female, urban, highly educated, and nonobese. The rate of vitamin B12 intake through supplements and/or fortified foods is fairly high (92%), but should be further improved e.g., by increasing the share of vegans who follow professional nutritional advice (requiring a diploma in dietetics, nutritional science, or medicine in Austria).
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Affiliation(s)
- Michelle Fuschlberger
- FH Campus Wien University of Applied Sciences, Favoritenstrasse 226, 1100, Vienna, Austria
| | - Peter Putz
- FH Campus Wien University of Applied Sciences, Favoritenstrasse 226, 1100, Vienna, Austria.
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397
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Dufour L, Carrouel F, Dussart C. Human Papillomaviruses in Adolescents: Knowledge, Attitudes, and Practices of Pharmacists Regarding Virus and Vaccination in France. Viruses 2023; 15:v15030778. [PMID: 36992485 PMCID: PMC10058809 DOI: 10.3390/v15030778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 03/13/2023] [Accepted: 03/16/2023] [Indexed: 03/31/2023] Open
Abstract
Human papillomaviruses (HPVs) are responsible for one of the most common sexually transmitted diseases in the world, and their oncogenic role has been well demonstrated in genital, anal, and oropharyngeal areas. However, a certain distrust and a lack of knowledge about this vaccine are perceptible among French adolescents and their parents. Thus, health professionals and, more particularly, pharmacists appear to be key persons to promote HPV vaccination and restore confidence in the target population. The present study aims to assess the knowledge, attitudes, and practices regarding HPV vaccination among pharmacists, particularly in boys, following the 2019 recommendation to vaccinate them. The present study was designed as a cross-sectional, quantitative, and descriptive survey that was conducted from March to September 2021 among pharmacists in France. 215 complete questionnaires were collected. Gaps in knowledge were found, only 21.4% and 8.4% obtained a high level of knowledge related to, respectively, HPV and vaccination. Pharmacists were confident in the HPV vaccine (94.4%), found it safe and useful, and felt that the promotion of the vaccine was part of their role (94.0%). However, only a few have already advised it, which they justify due to a lack of opportunity and forgetfulness. Faced with this, training, computerized reminders, or supportive materials could be implemented to improve the advice and thus the vaccination coverage. Finally, 64.2% were in favor of a pharmacy-based vaccination program. In conclusion, pharmacists are interested in this vaccination and the role of promoter. However, they need the means to facilitate this mission: training, computer alerts, supportive materials such as flyers, and the implementation of vaccination in pharmacies.
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Affiliation(s)
- Lucas Dufour
- Laboratory "Health, Systemic, Process" (P2S), UR4129, University Claude Bernard Lyon 1, University of Lyon, 69008 Lyon, France
| | - Florence Carrouel
- Laboratory "Health, Systemic, Process" (P2S), UR4129, University Claude Bernard Lyon 1, University of Lyon, 69008 Lyon, France
| | - Claude Dussart
- Laboratory "Health, Systemic, Process" (P2S), UR4129, University Claude Bernard Lyon 1, University of Lyon, 69008 Lyon, France
- Hospices Civils of Lyon, 69003 Lyon, France
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398
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Variations in Emergency Service Utilization among Cancer Survivors: Results from the Pan-Canadian Experiences of Cancer Patients in Transition Study Survey. JOURNAL OF ONCOLOGY 2023; 2023:5056408. [PMID: 36968642 PMCID: PMC10036192 DOI: 10.1155/2023/5056408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/04/2023] [Accepted: 03/07/2023] [Indexed: 03/18/2023]
Abstract
Purpose. The objective of this study was to examine variations in emergency service utilization (ESU) among cancer survivors during the first year after completing primary cancer treatment. Methods. In 2016, the Canadian Partnership Against Cancer collected survey responses from cancer survivors across Canada about self-reported ESU after completing primary cancer treatment. We included survey respondents diagnosed with nonmetastatic breast, hematologic, colorectal, melanoma, or prostate cancer. Multivariable, multinomial logistic regression analysis was used to examine factors associated with cancer survivors’ ESU. Results. Of the 5,774 cancer survivors included in our analysis, 22% reported ESU during the first year after completing their primary cancer treatment, 16% reported ESU one to three times, and 6% reported ESU more than three times. Factors significantly associated with frequent ESU included younger age, colorectal and hematologic cancers, more frequent primary care provider and oncology specialist visits, single or retired status, lower income, and self-reported lower quality of life. Conclusion. Our study identified factors associated with more frequent ESU among cancer survivors in the first year after completing primary cancer treatment. These factors highlight differences in cancer survivors’ demographics, their ability to access and need for healthcare services, and the complexity of using ESU as a metric for quality improvement in survivorship care. These variations must be considered in quality improvement initiatives.
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Kaufman EJ, Khatri U, Hall EC, Alur R, Song J, Beard JH, Jacoby SF. Law enforcement in the trauma bay: a survey of members of the American Academy for the Surgery of Trauma. Trauma Surg Acute Care Open 2023; 8:e001022. [PMID: 36937171 PMCID: PMC10016311 DOI: 10.1136/tsaco-2022-001022] [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: 09/29/2022] [Accepted: 02/20/2023] [Indexed: 03/14/2023] Open
Abstract
Background Trauma patients frequently come into contact with law enforcement officers (LEOs) during the course of their medical care, but little is known about how LEO presence affects processes of care. We surveyed members of the American Association for the Surgery of Trauma (AAST) to assess their perspectives on frequency, circumstances, and implications of LEO presence in trauma bays nationwide. Methods Survey items addressed respondents' experience with the frequency and context of LEO presence and their perspectives on the impact of LEO presence for patients, clinical care, and public safety. Respondent demographics, professional characteristics, and practice setting were collected. The survey was distributed electronically to AAST members in September and October of 2020. Responses were compared by participant age, gender, race, ethnicity, urban versus rural location using χ2 tests. Results Of 234 respondents, 189 (80.7%) were attending surgeons, 169 (72.2%) identified as white, and 144 (61.5%) as male. 187 respondents (79.9%) observed LEO presence at least weekly. Respondents found LEO presence was most helpful for public safety, followed by clinical care, and then for patients. Older respondents rated LEO presence as helpful more often than younger respondents regarding the impact on patients, clinical care, and public safety (p<0.001 across all domains). When determining LEO access, respondents assessed severity of the patient's condition, the safety of emergency department staff, the safety of LEOs, and a patient's potential role as a threat to public safety. Conclusions Respondents described a wide range of perspectives on the impact and consequence of LEO in the trauma bay, with little policy to guide interactions. The overlap of law enforcement and healthcare in the trauma bay deserves attention from institutional and professional policymakers to preserve patient safety and autonomy and patient-centered care. Level of evidence IV, survey study.
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Affiliation(s)
- Elinore J Kaufman
- Traumatology, Surgical Critical Care, and Emergency Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Utsha Khatri
- Department of Emergency Medicine, Mount Sinai School of Medicine, New York, New York, USA
| | - Erin C Hall
- Department of Surgery, MedStar Washington Hospital Center, Washington, District of Columbia, USA
| | - Rucha Alur
- Traumatology, Surgical Critical Care, and Emergency Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Jamie Song
- Traumatology, Surgical Critical Care, and Emergency Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Jessica H Beard
- Division of Trauma Surgery and Surgical Critical Care, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania, USA
| | - Sara F Jacoby
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Vaccination status and attitudes towards COVID-19 vaccination in patients undergoing active cancer treatment in a referral center in Mexico: a survey study. Support Care Cancer 2023; 31:209. [PMID: 36913048 PMCID: PMC10009352 DOI: 10.1007/s00520-023-07667-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 03/03/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND COVID-19 vaccination refusal/hesitancy among patients with cancer has been reported to be high. This study aimed to assess vaccination status and attitudes towards COVID-19 vaccines in patients with cancer undergoing active treatment in a single center in Mexico. METHODS A cross-sectional, 26-item survey evaluating vaccination status and attitudes towards COVID-19 vaccination was conducted among patients undergoing active cancer treatment. Descriptive statistics were used to analyze the sociodemographic characteristics, vaccination status, and attitudes. X2 tests and multivariate analysis were used to evaluate associations between characteristics and attitudes with adequate vaccination status. RESULTS Of 201 respondents, 95% had received at least one dose, and 67% had adequate COVID-19 vaccination status (≥ 3 doses). Thirty-six percent of patients had at least one reason for doubting/rejecting vaccination, and the main reason was being afraid of side effects. On multivariate analysis, age ≥ 60 years (odds ratio (OR) 3.77), mass media as main source of information on COVID-19 (OR 2.55), agreeing vaccination against COVID-19 is safe in patients with cancer (OR 3.11), and not being afraid of the composition of the COVID-19 vaccines (OR 5.10) statistically increased the likelihood of adequate vaccination status. CONCLUSIONS Our study shows high vaccination rates and positive attitudes towards COVID-19 vaccines, with a significant proportion of patients undergoing active cancer treatment with adequate vaccination status (≥ 3 doses). Older age, use of mass media as main source of COVID-19 information, and positive attitudes towards COVID-19 vaccines were significantly associated with a higher likelihood of adequate COVID-19 vaccination status among patients with cancer.
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