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Moore JD, Nguyen USDT, Ojha RP, Griner SB, Thompson EL. Physician-level determinants of HCV screening during pregnancy in a U.S. sample. Arch Gynecol Obstet 2024; 309:2491-2498. [PMID: 37454352 DOI: 10.1007/s00404-023-07146-x] [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: 04/20/2023] [Accepted: 07/07/2023] [Indexed: 07/18/2023]
Abstract
PURPOSE The purpose of this study was to assess the association between select determinants and HCV screening guideline adherence among physicians who provide prenatal care. RESEARCH QUESTION What factors may act as determinants of guideline adherence to HCV screening among physicians who provide prenatal care? METHODS We surveyed a national sample of physicians who provided prenatal care in 2021. The survey included questions from the Clinician Guideline Determinant (CGD) questionnaire, demographic characteristics, and medical practice characteristics. We estimated odds ratios and 95% confidence intervals (CIs) using semi-Bayesian logistic regression for the association between determinants and guideline adherence. RESULTS Participants included 224 physicians in the United States who reported providing prenatal care. Most physicians practiced in private practice (65%) and the majority were members of the American College of Obstetricians and Gynecologists (ACOG; 91%). Less than half (43%; 95% CI: 36%-49%) of physicians reported regular use of the HCV screening guideline. Physicians who reported general knowledge about HCV (OR = 9.0, 95% CI 3.1-30) or endorsed agreement with ease of implementation (OR = 8.0, 95% CI 2.7-25) had higher odds of adherence to the HCV screening guideline. CONCLUSION Our study suggests that less than half of practicing prenatal care physicians adhere to HCV screening guidelines for pregnant patients. Our results may be useful as a preliminary screening of select determinants of guideline use for further investigation.
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Affiliation(s)
- Jonathan D Moore
- School of Public Health, Department of Epidemiology and Biostatistics, University of North Texas Health Science Center, Fort Worth, USA.
| | - Uyen-Sa D T Nguyen
- School of Public Health, Department of Epidemiology and Biostatistics, University of North Texas Health Science Center, Fort Worth, USA
| | - Rohit P Ojha
- School of Public Health, Department of Epidemiology and Biostatistics, University of North Texas Health Science Center, Fort Worth, USA
- Center for Epidemiology and Healthcare Delivery Research, JPS Health Network, Fort Worth, USA
| | - Stacey B Griner
- School of Public Health, Department of Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, USA
| | - Erika L Thompson
- School of Public Health, Department of Epidemiology and Biostatistics, University of North Texas Health Science Center, Fort Worth, USA
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Uprety S, Ngo I, Maggos M, Dangol B, Sherchan SP, Shisler JL, Amarasiri M, Sano D, Nguyen TH. Multiple pathogen contamination of water, hands, and fomites in rural Nepal and the effect of WaSH interventions. Int J Hyg Environ Health 2024; 257:114341. [PMID: 38442666 DOI: 10.1016/j.ijheh.2024.114341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/23/2024] [Accepted: 02/16/2024] [Indexed: 03/07/2024]
Abstract
Water, Sanitation, and Hygiene (WaSH) interventions are the most effective in reducing diarrheal disease severity and prevalence. However, very few studies have investigated the effectiveness of WaSH intervention in reducing pathogen presence and concentration. In this study, we employed a microfluidic PCR approach to quantify twenty bacterial pathogens in water (n = 360), hands (n = 180), and fomite (n = 540) samples collected in rural households of Nepal to assess the pathogen exposures and the effect of WaSH intervention on contamination and exposure rates. The pathogen load and the exposure pathways for each pathogen in intervention and control villages were compared to understand the effects of WaSH intervention. Pathogens were detected in higher frequency and concentration from fomites samples, toilet handle (21.42%; 5.4,0 95%CI: mean log10 of 4.69, 5.96), utensils (23.5%; 5.47, 95%CI: mean log10 of 4.77, 6.77), and water vessels (22.42%; 5.53, 95%CI: mean log10 of 4.79, 6.60) as compared to cleaning water (14.36%; 5.05, 95%CI: mean log10 of 4.36, 5.89), drinking water (14.26%; 4.37, 85%CI: mean log10 of 4.37, 5.87), and hand rinse samples (16.92%; 5.49, 95%CI: mean log10 of 4.77, 6.39). There was no clear evidence that WaSH intervention reduced overall pathogen contamination in any tested pathway. However, we observed a significant reduction (p < 0.05) in the prevalence, but not concentration, of some target pathogens, including Enterococcus spp. in the intervention village compared to the control village for water and hands rinse samples. Conversely, no significant reduction in target pathogen concentration was observed for water and hand rinse samples. In swab samples, there was a reduction mostly in pathogen concentration rather than pathogen prevalence, highlighting that a reduction in pathogen prevalence was not always accompanied by a reduction in pathogen concentration. This study provides an understanding of WaSH intervention on microbe concentrations. Such data could help with better planning of intervention activities in the future.
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Affiliation(s)
- Sital Uprety
- Department of Civil and Environmental Engineering, University of Illinois at Urbana Champaign, Urbana, IL, USA; Department of Sanitation, Water and Solid Waste for Development (Sandec), Swiss Federal Institute of Aquatic Science and Technology (Eawag), Dübendorf, Zurich, Switzerland; Department of Civil and Environmental Engineering, Tohoku University Sendai, Japan.
| | - Isaac Ngo
- Department of Microbiology, University of Illinois at Urbana Champaign, Urbana, IL, USA
| | - Marika Maggos
- Department of Microbiology, University of Illinois at Urbana Champaign, Urbana, IL, USA
| | - Bipin Dangol
- Environment and Public Health Organization (ENPHO), Kathmandu, Nepal
| | - Samendra P Sherchan
- Environment and Public Health Organization (ENPHO), Kathmandu, Nepal; Department of Environmental Health Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA; BioEnvironmental Science Program Morgan State University, Baltimore, MD, 21251, USA
| | - Joanna L Shisler
- Department of Microbiology, University of Illinois at Urbana Champaign, Urbana, IL, USA; Institute of Genomic Biology, University of Illinois at Urbana Champaign, Urbana, IL, USA
| | - Mohan Amarasiri
- School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
| | - Daisuke Sano
- Department of Frontier Sciences for Advanced Environment, Tohoku University, Sendai, Japan; Department of Civil and Environmental Engineering, Tohoku University Sendai, Japan
| | - Thanh H Nguyen
- Department of Civil and Environmental Engineering, University of Illinois at Urbana Champaign, Urbana, IL, USA; Institute of Genomic Biology, University of Illinois at Urbana Champaign, Urbana, IL, USA
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Khedr EM, Mahmoud DM, Hussein HB, Malky IEL, Mostafa SS, Gamea A. Treatment satisfaction with disease-modifying therapy is the only predictor of Adherence among multiple sclerosis patients from Upper Egypt. Sci Rep 2024; 14:7027. [PMID: 38528018 DOI: 10.1038/s41598-024-57116-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 03/14/2024] [Indexed: 03/27/2024] Open
Abstract
Despite the proven efficacy of the disease-modifying therapy (DMT) for multiple sclerosis (MS), the rates of non-adherence are frequently high. We aimed to evaluate the rate of non-adherence to the first DMT in Upper Egypt and identify different contributing factors. Out of 310 patients, ninety-seven adult patients with RRMS were recruited from three MS units located in Upper Egypt and were subjected to the following: complete clinical history, expanded disability status score (EDSS), Eight-item Morisky Medication Adherence Scale (MMAS-8), abbreviated Treatment Satisfaction Questionnaire for Medication-9 (TSQM-9), Hamilton depression scale, Fatigue Severity Scale (FSS) and the Pittsburgh Sleep Quality Index (PSQI). According to MMAS-8 scores, 63 (64.9%) of patients were non-adherent to their first DMT. Non-adherent patients are more likely to have longer disease duration (p = 0.002), longer duration on first DMT (p = 0.030), first DMT-start date before 2019 (p = 0.040), and lower treatment satisfaction scores (p = 0.016). However, there was no significant relation with physical disability, depression, fatigue, or sleep quality. On the regression analysis model, a lower treatment satisfaction score was the only predictor of DMT non-adherence (p = 0.012). Despite expanding DMT options, non-adherence among MS patients in Upper Egypt is high. Treatment satisfaction with DMT is the only predictor of adherence among MS patients of Upper Egypt. Adherence and satisfaction with the prescribed DMT should be assessed carefully to maximize DMT benefits.
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Affiliation(s)
- Eman M Khedr
- Department of Neuropsychiatry, Faculty of Medicine, Assiut University Hospital, Asyût, Egypt.
- Neuropsychiatric Department, Faculty of Medicine, Aswan University Hospital, Aswân, Egypt.
| | - Doaa M Mahmoud
- Department of Neuropsychiatry, Faculty of Medicine, Assiut University Hospital, Asyût, Egypt
| | - Hussein B Hussein
- Neuropsychiatric Department, Faculty of Medicine, South Valley University, Qena University Hospital, Qena, Egypt
| | - Islam E L Malky
- Neuropsychiatric Department, Faculty of Medicine, South Valley University, Qena University Hospital, Qena, Egypt
| | - Sarah S Mostafa
- Department of Neuropsychiatry, Faculty of Medicine, Assiut University Hospital, Asyût, Egypt
| | - Ayman Gamea
- Neuropsychiatric Department, Faculty of Medicine, South Valley University, Qena University Hospital, Qena, Egypt
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Xu P, Broniatowski DA, Dredze M. Twitter social mobility data reveal demographic variations in social distancing practices during the COVID-19 pandemic. Sci Rep 2024; 14:1165. [PMID: 38216716 PMCID: PMC10786940 DOI: 10.1038/s41598-024-51555-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 01/06/2024] [Indexed: 01/14/2024] Open
Abstract
The COVID-19 pandemic demonstrated the importance of social distancing practices to stem the spread of the virus. However, compliance with public health guidelines was mixed. Understanding what factors are associated with differences in compliance can improve public health messaging since messages could be targeted and tailored to different population segments. We utilize Twitter data on social mobility during COVID-19 to reveal which populations practiced social distancing and what factors correlated with this practice. We analyze correlations between demographic and political affiliation with reductions in physical mobility measured by public geolocation tweets. We find significant differences in mobility reduction between these groups in the United States. We observe that males, Asian and Latinx individuals, older individuals, Democrats, and people from higher population density states exhibited larger reductions in movement. Furthermore, our study also unveils meaningful insights into the interactions between different groups. We hope these findings will provide evidence to support public health policy-making.
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Affiliation(s)
- Paiheng Xu
- Department of Computer Science, University of Maryland, College Park, MD, 20742, USA
| | - David A Broniatowski
- Department of Engineering Management and Systems Engineering, The George Washington University, Washington, DC, 20052, USA
| | - Mark Dredze
- Department of Computer Science, Johns Hopkins University, Baltimore, MD, 21218, USA.
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Kenis I, Van Hecke A, Foulon V. The cocreation of care pathways for patients treated with oral anticancer drugs: From assessment data to an actual care pathway. J Eval Clin Pract 2023; 29:1354-1362. [PMID: 36949720 DOI: 10.1111/jep.13840] [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: 01/06/2023] [Revised: 02/23/2023] [Accepted: 03/09/2023] [Indexed: 03/24/2023]
Abstract
RATIONALE Due to the emergence of oral anticancer therapies, existing care processes in oncology - that are mainly focused on in-hospital treatments - must be rethought. The development of a care pathway is a well-known methodology to reorganise and standardise care for a specific patient group. However, care pathway development might be complex and burdensome for healthcare teams, requiring a well-thought-out methodology that provides guidance to the teams. AIMS AND OBJECTIVES In 10 Belgian oncology departments, multidisciplinary teams developed a tailored care pathway, aimed to offer high-quality patient-centred care. Each department followed a cocreation methodology, consisting of a current practice assessment, a priority setting, and the actual development of the care pathway. The aim of this study was to investigate how and to which extent underperformed evidence-based key elements (KEs), identified in the current practice assessment, guided the development of the care pathway, and how compliant the final care pathways are with the list of evidence-based KEs. METHODS A qualitative content analysis was conducted to describe and compare the results of each phase of the cocreation methodology. RESULTS This study shows that much of the evidence and feedback on current practice that was used as a starting point, got lost throughout the cocreation process. Only a limited proportion of the (seriously) underperformed KEs were prioritised by the multidisciplinary teams. Furthermore, several prioritised KEs could not be retrieved in the care pathway documents. Also, the final care pathways were not fully compliant with existing evidence. CONCLUSION Based on the findings, a more rigorous cocreation methodology seems needed, offering very concrete support for multidisciplinary teams to integrate the prioritised KEs in the care process (e.g., by using a model care pathway). Next to the selfreported performance data from healthcare professionals and patients, more objective data (e.g., walkthrough, medical records) and more extensive patient involvement should be considered in the priority setting.
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Affiliation(s)
- Ilyse Kenis
- Department of Pharmaceutical and Pharmacological Sciences, Clinical Pharmacology and Pharmacotherapy, KU Leuven, Leuven, Belgium
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium
| | - Ann Van Hecke
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium
- Nursing Department, Ghent University Hospital, Ghent, Belgium
| | - Veerle Foulon
- Department of Pharmaceutical and Pharmacological Sciences, Clinical Pharmacology and Pharmacotherapy, KU Leuven, Leuven, Belgium
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Sharpe E, Perovic A. A survey of speech and language therapists' opinions of bilingualism and the advice they give to bilingual families of children with speech, language and communication needs - a comparative study between the UK and Singapore. CLINICAL LINGUISTICS & PHONETICS 2023:1-33. [PMID: 37921589 DOI: 10.1080/02699206.2023.2268260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 10/03/2023] [Indexed: 11/04/2023]
Abstract
There is emerging evidence that bilingualism is advantageous to children with speech, language and communication needs (SLCN), reflected in recommendations to promote maintenance of the home language. However, little is known about Speech and Language Therapists (SLTs)' opinions on bilingualism and practices with bilingual families. To survey the opinions and practices of SLTs on this topic, a questionnaire was developed and delivered as an anonymous web-based survey. We recruited SLTs from Singapore, where bilingualism is the norm amongst the general population and enshrined in government policies, and the UK, where bilingualism is less prevalent and not embedded in government policy. Questions probed SLTs' opinions, advice given to parents/carers, personal and professional experience of bilingualism, and knowledge of and opinions on official guidelines from the Royal College of Speech and Language Therapy (RCSLT). The survey revealed variability in opinions and practices of SLTs working with bilingual families. Amongst the UK-based respondents, the RCSLT bilingualism guidance was generally perceived positively, however, many were unfamiliar with its content, or found barriers to its implementation. Most SLTs reported recommending bilingualism to families of children with SLCN and suggesting that parents/carers speak in all languages they are proficient in, but a minority reported views and practice based on outdated assumptions: practitioners who believed bilingualism can cause or contribute to SLCN were less likely to recommend that parents/carers speak languages they are proficient in. These findings can help identify areas to target within training and continuing professional development to increase evidence-based advice given to bilingual families.
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Affiliation(s)
- Eleanor Sharpe
- Oxford Centre for Enablement, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Alexandra Perovic
- Division of Psychology and Language Sciences, University College London, London, UK
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Te Paske R, Vervloet M, Linn AJ, Brabers AEM, van Boven JFM, van Dijk L. The impact of trust in healthcare and medication, and beliefs about medication on medication adherence in a Dutch medication-using population. J Psychosom Res 2023; 174:111472. [PMID: 37741115 DOI: 10.1016/j.jpsychores.2023.111472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 08/17/2023] [Accepted: 08/19/2023] [Indexed: 09/25/2023]
Abstract
INTRODUCTION Trust in healthcare and medication, defined as feelings of reassurance and confidence in the healthcare system or medication, may be a key prerequisite before engaging in the use of medication. However, earlier studies have focussed on beliefs about medication rather than trust as predictors of medication adherence. This study therefore aims to simultaneously explore the relationship of trust in healthcare, medication and beliefs about medication, with medication adherence. METHODS In a cross-sectional study, an online questionnaire was sent out to 1500 members of the Dutch Health Care Consumer Panel of Nivel in November 2018. Respondents were asked to grade their level of trust in healthcare and medication (scale 1-10). The Beliefs About Medicines Questionnaire (BMQ) for general and specific medication beliefs was used to address beliefs, the Medication Adherence Report Scale (MARS-5) to measure medication adherence. Data were analysed using structural equation modelling (SEM) with a backward stepwise approach. Out of 753 people that completed the questionnaire, 407 people used prescription medication and were included in the analyses. RESULTS A positive association between trust in medication and medication adherence was found (0.044, p < 0.05). BMQ subscales Overuse (-0.083, p < 0.05), Necessity (0.075, p < 0.05) and Concerns (-0.134, p < 0.01) related with medication adherence. BMQ subscale Harm did not relate to medication adherence. CONCLUSION Trust in medication and beliefs about medication were both individually associated with medication adherence. Healthcare providers should therefore not only focus on patients' medication beliefs, but also on strengthening patients' trust in medication to improve medication adherence.
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Affiliation(s)
- Roland Te Paske
- Nivel, Netherlands Institute for Health Services Research, Utrecht, the Netherlands; University of Groningen, Groningen Research Institute of Pharmacy, Unit of PharmacoTherapy, - Epidemiology & -Economics, University of Groningen, Groningen, the Netherlands.
| | - Marcia Vervloet
- Nivel, Netherlands Institute for Health Services Research, Utrecht, the Netherlands
| | - Annemiek J Linn
- University of Amsterdam/Amsterdam School of Communication Research, Amsterdam, the Netherlands
| | - Anne E M Brabers
- Nivel, Netherlands Institute for Health Services Research, Utrecht, the Netherlands
| | - Job F M van Boven
- University of Groningen, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Department of Clinical Pharmacy & Pharmacology, Groningen, the Netherlands
| | - Liset van Dijk
- Nivel, Netherlands Institute for Health Services Research, Utrecht, the Netherlands; University of Groningen, Groningen Research Institute of Pharmacy, Unit of PharmacoTherapy, - Epidemiology & -Economics, University of Groningen, Groningen, the Netherlands
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8
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Zhao S, Du H, Lin D, Wu Q, Li Q, Chi P. Role of self-esteem in the association between mindset of socioeconomic status and well-being: A cross-lagged panel analysis. Appl Psychol Health Well Being 2023; 15:1336-1351. [PMID: 36882890 DOI: 10.1111/aphw.12439] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 02/16/2023] [Indexed: 03/09/2023]
Abstract
People who believe that their socioeconomic status (SES) can be changed-with growth mindset or incremental implicit theory of SES-tend to have better psychological well-being. Nevertheless, it remains unclear on why growth mindset of SES benefits well-being. The present research aims to answer this question by investigating the longitudinal associations between mindset of SES and well-being (i.e. depression and anxiety) and a potential mechanism (i.e. self-esteem). We recruited 600 adults in Guangzhou, China, as participants in this study. Participants completed a list of questionnaires containing measures of mindset of SES, self-esteem, depression, and anxiety at three time points over the course of 18 months. The cross-lagged panel model showed that individuals holding a growth mindset of SES reported significantly lower depression and anxiety 1 year later, but the effect was not sustained later. More importantly, self-esteem accounted for the associations of mindset of SES with both depression and anxiety, such that individuals with growth mindset of SES had higher self-esteem, and in turn, demonstrated lower depression and anxiety over 18 months. These findings deepen the understanding of the salutary effects of implicit theories of SES on psychological well-being. Implications for future research and mindset-related interventions are discussed.
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Affiliation(s)
- Shan Zhao
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Hongfei Du
- Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University, Zhuhai, China
| | - Danhua Lin
- Institute of Developmental Psychology, Beijing Normal University, Beijing, China
| | - Qinglu Wu
- Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University, Zhuhai, China
| | - Qianfeng Li
- School of Educational Science, Guangdong Polytechnic Normal University, Guangzhou, China
| | - Peilian Chi
- Department of Psychology, University of Macau, Macau SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macau SAR, China
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Galvin J, Howes A, Richards G. Longitudinal Associations Between Autistic Traits, Self-compassion, Anxiety and Depression in Autistic and Non-autistic Adults Without Intellectual Disability. J Autism Dev Disord 2023:10.1007/s10803-023-06157-6. [PMID: 37874475 DOI: 10.1007/s10803-023-06157-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2023] [Indexed: 10/25/2023]
Abstract
PURPOSE Previous cross-sectional research suggests self-compassion may mediate associations between autistic traits and mental health in autistic and non-autistic adults. However, no research to date has examined these relationships longitudinally. In this study, we used a cross-lagged panel analysis to examine correlations over time between autistic traits, self-compassion, and anxiety/depression. METHODS Participants were from the UK and included autistic (n = 228 at T1, n = 156 at T2, and n = 165 at T3) and non-autistic adults (n = 228 at T1, n = 122 at T2, and n = 124 at T3) without intellectual disability. Participants were recruited through an online participation platform and completed demographics, the Autism Spectrum Quotient (AQ), the Self-Compassion Scale (SCS), and the Hospital Anxiety and Depression Scale (HADS) at baseline (T1), 6 months (T2), and 12 months (T3). RESULTS In the autistic sample, negative correlations were observed between self-compassion and subsequent anxiety/depression across all models and timepoints, and these relationships were not reciprocal (i.e., earlier depression and anxiety did not predict future self-compassion). In the non-autistic sample, the findings generally suggested bi-directional relationships between self-compassion and anxiety/depression. In both groups, an indirect pathway between T1 autistic traits and T3 anxiety/depression via T2 self-compassion was confirmed. CONCLUSION Considering the high prevalence of anxiety and depression among autistic people, and that self-compassion can be cultivated through practice, these findings suggest that self-compassion could be a useful therapeutic target to promote mental health in the autistic population.
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Affiliation(s)
- John Galvin
- Department of Psychology, University of Warwick, Coventry, UK.
| | - Abby Howes
- Norwich Medical School, University of East Anglia, East Of England, UK
| | - Gareth Richards
- School of Psychology, Newcastle University, Newcastle upon Tyne, UK
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Gosrani R, Hang MK. How Physicians Tackle Internet-Misinformed Patients: Going Beyond Traditional Patient-Centered Communication - A Study Protocol [Letter]. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2023; 14:1103-1104. [PMID: 37814689 PMCID: PMC10560462 DOI: 10.2147/amep.s441807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 09/30/2023] [Indexed: 10/11/2023]
Affiliation(s)
- Riya Gosrani
- UCL Medical School, University College London, London, UK
- School of Anthropology and Museum Ethnography, University of Oxford, Oxford, UK
| | - Man Kien Hang
- UCL Medical School, University College London, London, UK
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Exterkate SH, Jongebloed-Westra M, Ten Klooster PM, Koffijberg H, Bode C, van Gemert-Pijnen JEWC, van Baal JG, van Netten JJ. Objectively assessed long-term wearing patterns and predictors of wearing orthopaedic footwear in people with diabetes at moderate-to-high risk of foot ulceration: a 12 months observational study. J Foot Ankle Res 2023; 16:60. [PMID: 37705016 PMCID: PMC10500813 DOI: 10.1186/s13047-023-00656-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/20/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Orthopaedic footwear can only be effective in preventing diabetic foot ulcers if worn by the patient. Robust data on long-term wearing time of orthopaedic footwear are not available, and needed to gain more insights into wearing patterns and associated factors (i.e. participants' demographic, disease-related characteristics, and footwear usability). We aimed to objectively assess long-term wearing patterns and identify factors associated with wearing orthopaedic footwear in people with diabetes at moderate-to-high risk of ulceration. METHODS People diagnosed with diabetes mellitus type 1 and 2 with loss of protective sensation and/or peripheral artery disease and prescribed with orthopaedic footwear were included and followed for 12 months. The primary outcome was mean daily wearing time, continuously measured using a temperature sensor inside the footwear (Orthotimer®). Adherence to wearing orthopaedic footwear was calculated as percentage of wearing time of a total assumed 16 h out-of-bed daytime, where adherence < 60% was a pre-determined non-adherent threshold. Wearing time patterns were assessed by calculating participants' wearing (in)consistency. One-way analyses of variance tested for wearing time differences between subgroups, weekdays, and weekend days. Factors potentially associated with wearing time were collected by questionnaires and medical files. Univariately associated factors were included in multivariate linear regression analysis. RESULTS Sixty one participants were included (mean (SD) age: 68.0 (7.4) years; females: n = 17; type 2 diabetes mellitus: n = 54). Mean (SD) overall daily wearing time was 8.3 (6.1) hours/day. A total of 40 (66%) participants were non-adherent. Participants with a consistent wearing pattern showed higher daily wearing times than participants with an inconsistent pattern. Mean (SD) wearing times were 12.7 (4.3) vs 3.6 (4.8) hours/day, respectively (P < 0.001). Mean (SD) wearing time was significantly higher (P < 0.010) during weekdays (8.7 (6.0) hours/day) compared to Saturday (8.0 (6.1) hours/day) and Sunday (6.9 (6.2) hours/day). In the multivariate model (R2 = 0.28), "satisfaction with my wear of orthopaedic footwear" was positively associated (P < 0.001) with wearing time. The other seven multivariate model factors (four demographic variables and three footwear usability variables) were not associated with wearing time. CONCLUSIONS Only one out of three people at moderate to high risk of foot ulceration were sufficiently adherent to wearing their orthopaedic footwear. Changing people's wearing behaviour to a more stable pattern seems a potential avenue to improve long-term adherence to wearing orthopaedic footwear. Investigated factors are not associated with daily wearing time. Based on these factors the daily wearing time cannot be estimated in daily practice. TRIAL REGISTRATION Netherlands Trial Register NL7710. Registered: 6 May 2019.
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Affiliation(s)
- Stein H Exterkate
- Research & Development, Voetencentrum Wender, Hengelo, 7555 SK, The Netherlands.
| | - Manon Jongebloed-Westra
- Department of Psychology, Health and Technology, Centre for eHealth Research and Wellbeing, University of Twente, Enschede, 7500 AE, The Netherlands
| | - Peter M Ten Klooster
- Department of Psychology, Health and Technology, Centre for eHealth Research and Wellbeing, University of Twente, Enschede, 7500 AE, The Netherlands
| | - Hendrik Koffijberg
- Department of Health Technology and Services Research, Tech Med Centre, University of Twente, Enschede, 7500 AE, The Netherlands
| | - Christina Bode
- Department of Psychology, Health and Technology, Centre for eHealth Research and Wellbeing, University of Twente, Enschede, 7500 AE, The Netherlands
| | - Julia E W C van Gemert-Pijnen
- Department of Psychology, Health and Technology, Centre for eHealth Research and Wellbeing, University of Twente, Enschede, 7500 AE, The Netherlands
| | - Josephus G van Baal
- Research & Development, Voetencentrum Wender, Hengelo, 7555 SK, The Netherlands
- Ziekenhuisgroep Twente (ZGT), ZGT Academy, Hengelo, 7555 DL, The Netherlands
- University of Cardiff, Cardiff, CF10 3AT, UK
| | - Jaap J van Netten
- Department of Rehabilitation Medicine, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, 1105 AZ, the Netherlands
- Rehabilitation & Development, Amsterdam Movement Sciences, Amsterdam, The Netherlands
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Roson N, Antolín A, Torregrosa A, Pedraza Gutiérrez S, Lopez Cano M, Badia JM. How do we diagnose acute diverticulitis? Results of a national survey about the role of imaging techniques. RADIOLOGIA 2023; 65:315-326. [PMID: 37516485 DOI: 10.1016/j.rxeng.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 02/21/2022] [Indexed: 07/31/2023]
Abstract
INTRODUCTION The choice of imaging techniques in the diagnosis of acute diverticulitis is controversial. This study aimed to determine radiologists' preferences for different imaging techniques in the management of acute diverticulitis and the extent to which they use the different radiologic techniques for this purpose. METHODS An online survey was disseminated through the Spanish Society of Abdominal Imaging (Sociedad Española de Diagnóstico por Imagen del Abdomen (SEDIA)) and Twitter. The survey included questions about respondents' working environments, protocolization, personal preferences, and actual practice in the radiological management of acute diverticulitis. RESULTS A total of 186 responses were obtained, 72% from radiologists working in departments organized by organ/systems. Protocols for managing acute diverticulitis were in force in 48% of departments. Ultrasonography was the initial imaging technique in 47.5%, and 73% of the respondents considered that ultrasonography should be the first-choice technique; however, in practice, ultrasonography was the initial imaging technique in only 24% of departments. Computed tomography was the first imaging technique in 32.8% of departments, and its use was significantly more common outside normal working hours. The most frequently employed classification was the Hinchey classification (75%). Nearly all (96%) respondents expressed a desire for a consensus within the specialty about using the same classification. Hospitals with >500 beds and those organized by organ/systems had higher rates of protocolization, use of classifications, and belief that ultrasonography is the best first-line imaging technique. CONCLUSIONS The radiologic management of acute diverticulitis varies widely, with differences in the protocols used, radiologists' opinions, and actual clinical practice.
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Affiliation(s)
- N Roson
- Servicio de Diagnóstico por la Imagen, Hospital Universitari Vall d'Hebron, Institut de Diagnòstic per la Imatge (IDI), Barcelona, Spain.
| | - A Antolín
- Servicio de Diagnóstico por la Imagen, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - A Torregrosa
- Área Clínica de Imagen Médica, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - S Pedraza Gutiérrez
- Servicio de Diagnóstico por la Imagen, Hospital Universitari Josep Trueta, Institut de Diagnòstic per la Imatge (IDI), IDIBGI, Girona, Spain
| | - M Lopez Cano
- Servicio de Cirugía General y Aparato Digestivo, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - J M Badia
- Servicio de Cirugía General y Aparato Digestivo, Hospital General de Granollers, Granollers, Barcelona, Spain; Universitat Internacional de Catalunya, Barcelona, Spain
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Al‐Shehab U, Zia H, Goodwin B, Lo DF. Association of serum sodium levels and diabetes: A critical analysis. J Diabetes 2023; 15:275-276. [PMID: 36734160 PMCID: PMC10036252 DOI: 10.1111/1753-0407.13366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 01/16/2023] [Indexed: 02/04/2023] Open
Affiliation(s)
- Usmaan Al‐Shehab
- Department of MedicineRowan University School of Osteopathic MedicineStratfordNew JerseyUSA
| | - Hasan Zia
- American Preventive Screening & Education Association (APSEA)StratfordNew JerseyUSA
- Department of Biology, RutgersThe State University of New JerseyNew BrunswickNew JerseyUSA
| | - Brandon Goodwin
- Department of MedicineRowan University School of Osteopathic MedicineStratfordNew JerseyUSA
| | - David F. Lo
- Department of MedicineRowan University School of Osteopathic MedicineStratfordNew JerseyUSA
- American Preventive Screening & Education Association (APSEA)StratfordNew JerseyUSA
- Department of Biology, RutgersThe State University of New JerseyNew BrunswickNew JerseyUSA
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Shrubsole K, Power E, Hallé MC. Communication partner training with familiar partners of people with aphasia: A systematic review and synthesis of barriers and facilitators to implementation. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023; 58:601-628. [PMID: 36417196 DOI: 10.1111/1460-6984.12805] [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: 07/08/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Factors influencing the implementation of communication partner training (CPT) with familiar partners of people with aphasia (PWA) have previously been documented using disparate approaches. To date there has been no synthesis of these factors using a common theoretical framework. Investigating CPT implementation factors using a common theoretical framework may further our understanding of universal barriers and guide future development of tailored, theoretically informed implementation strategies. AIMS (1) To determine the perceived and/or observed barriers and facilitators to implementing CPT with familiar partners of adults with aphasia; (2) to map extracted barriers and facilitators to a common theoretical framework; (3) to synthesize extracted barriers and facilitators; and (4) to identify potential implementation strategies to address the most frequently identified barriers and facilitators. METHODS & PROCEDURES A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Four electronic databases (MEDLINE, EMBASE, CINAHL, Web of Science) were systematically searched in April 2021. Empirical qualitative and/or quantitative research studies reporting barriers/facilitators to speech-language therapists (SLTs) implementing CPT with familiar partners of adults with aphasia were included. The search was limited to English or French articles with no date limit applied. Methodological quality of included studies was assessed using the Mixed-Methods Appraisal Tool (MMAT). A framework and content analysis was then conducted to extract and synthesize the implementation factors in alignment with the Theoretical Domains Framework (TDF), followed by a theoretically informed mapping exercise to identify potential implementation strategies. RESULTS & MAIN CONTRIBUTION The database searches yielded 2115 studies. Following screening, 17 studies were included in the review. Overall, the included studies had good methodological quality. Extracted implementation factors were classified as barriers, facilitators or mixed (i.e., both) and aligned with 13 of the 14 TDF domains, plus two additional domains: 'carer perspectives on the CPT intervention' and 'patient/carer characteristics'. Synthesized data revealed eight key theoretical domains: Environmental context and resources; Social influences; Beliefs about consequences; Skills; Memory, attention and decision-making; Knowledge; Beliefs about capabilities; and Reinforcement. Within each domain, the research team identified common categories and developed illustrative examples of theoretically informed implementation strategies. CONCLUSIONS & IMPLICATIONS This systematic review and theory-informed synthesis of previously reported CPT implementation factors enabled the identification of key barriers to SLTs delivering this best practice. This led to proposed implementation strategies that should be validated, refined and evaluated in future research involving stakeholders who have contextual understanding of implementing CPT. WHAT THIS PAPER ADDS What is already known on the subject CPT of familiar partners of PWA is an effective intervention that is inconsistently used in clinical settings. Factors influencing CPT implementation have previously been identified, but using disparate approaches and frameworks. A synthesis of these factors articulated around a common framework is currently not available. What this paper adds to existing knowledge This paper provides a theory-informed synthesis of previously reported barriers and facilitators to SLTs implementing CPT with familiar partners of PWA. It highlights key factors influencing the uptake of this best practice and includes suggestion of implementation strategies to address them. What are the potential or actual clinical implications of this work? The key influencing factors and proposed implementation strategies reported in this paper may support stakeholders in the future design of tailored and theoretically informed implementation strategies aiming to improve the delivery of familiar CPT in their setting.
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Affiliation(s)
- Kirstine Shrubsole
- The Queensland Aphasia Research Centre, Brisbane, QLD, Australia
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia
- Faculty of Health, Southern Cross University, Gold Coast, QLD, Australia
- Centre for Research Excellence in Aphasia Recovery and Rehabilitation, Bundoora, Victoria, Australia
| | - Emma Power
- Centre for Research Excellence in Aphasia Recovery and Rehabilitation, Bundoora, Victoria, Australia
- Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Marie-Christine Hallé
- Speech and Language Pathology Department, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada
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Bass GA, Kaplan LJ, Ryan ÉJ, Cao Y, Lane-Fall M, Duffy CC, Vail EA, Mohseni S. The snapshot audit methodology: design, implementation and analysis of prospective observational cohort studies in surgery. Eur J Trauma Emerg Surg 2023; 49:5-15. [PMID: 35840703 PMCID: PMC10606835 DOI: 10.1007/s00068-022-02045-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 06/30/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE For some surgical conditionns and scientific questions, the "real world" effectiveness of surgical patient care may be better explored using a multi-institutional time-bound observational cohort assessment approach (termed a "snapshot audit") than by retrospective review of administrative datasets or by prospective randomized control trials. We discuss when this might be the case, and present the key features of developing, deploying, and assessing snapshot audit outcomes data. METHODS A narrative review of snapshot audit methodology was generated using the Scale for the Assessment of Narrative Review Articles (SANRA) guideline. Manuscripts were selected from domains including: audit design and deployment, statistical analysis, surgical therapy and technique, surgical outcomes, diagnostic testing, critical care management, concomitant non-surgical disease, implementation science, and guideline compliance. RESULTS Snapshot audits all conform to a similar structure: being time-bound, non-interventional, and multi-institutional. A successful diverse steering committee will leverage expertise that includes clinical care and data science, coupled with librarian services. Pre-published protocols (with specified aims and analyses) greatly helps site recruitment. Mentored trainee involvement at collaborating sites should be encouraged through manuscript contributorship. Current funding principally flows from medical professional organizations. CONCLUSION The snapshot audit approach to assessing current care provides insights into care delivery, outcomes, and guideline compliance while generating testable hypotheses.
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Affiliation(s)
- Gary A Bass
- Division of Trauma, Surgical Critical Care, and Emergency Surgery, Perelman School of Medicine, University of Pennsylvania, 51 N. 39th Street, MOB 1, Suite 120, Philadelphia, PA, 19104, USA.
- Division of Trauma and Emergency Surgery, Orebro University Hospital and Faculty of School of Medical Sciences, Orebro University, 702 81, Orebro, Sweden.
- Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISC-LDI), University of Pennsylvania, Philadelphia, PA, USA.
- Center for Perioperative Outcomes Research and Transformation (CPORT), University of Pennsylvania, 3400 Spruce St, 5 Dulles, Philadelphia, PA, 19104, USA.
| | - Lewis J Kaplan
- Division of Trauma, Surgical Critical Care, and Emergency Surgery, Perelman School of Medicine, University of Pennsylvania, 51 N. 39th Street, MOB 1, Suite 120, Philadelphia, PA, 19104, USA
- Corporal Michael J. Crescenz Veterans Affairs Medical Center, 3900 Woodland Avenue, Philadelphia, PA, 19104, USA
| | - Éanna J Ryan
- Division of Trauma and Emergency Surgery, Orebro University Hospital and Faculty of School of Medical Sciences, Orebro University, 702 81, Orebro, Sweden
- Department of Surgery, Tallaght University Hospital, Dublin, Ireland
| | - Yang Cao
- Department of Clinical Epidemiology and Biostatistics, Orebro University, Orebro, Sweden
| | - Meghan Lane-Fall
- Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISC-LDI), University of Pennsylvania, Philadelphia, PA, USA
- Center for Perioperative Outcomes Research and Transformation (CPORT), University of Pennsylvania, 3400 Spruce St, 5 Dulles, Philadelphia, PA, 19104, USA
- Department of Anesthesia and Critical Care, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Drive, 309 Blockley Hall, Philadelphia, PA, 19104, USA
| | - Caoimhe C Duffy
- Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISC-LDI), University of Pennsylvania, Philadelphia, PA, USA
- Center for Perioperative Outcomes Research and Transformation (CPORT), University of Pennsylvania, 3400 Spruce St, 5 Dulles, Philadelphia, PA, 19104, USA
- Department of Anesthesia and Critical Care, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Drive, 309 Blockley Hall, Philadelphia, PA, 19104, USA
| | - Emily A Vail
- Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISC-LDI), University of Pennsylvania, Philadelphia, PA, USA
- Center for Perioperative Outcomes Research and Transformation (CPORT), University of Pennsylvania, 3400 Spruce St, 5 Dulles, Philadelphia, PA, 19104, USA
- Department of Anesthesia and Critical Care, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Drive, 309 Blockley Hall, Philadelphia, PA, 19104, USA
| | - Shahin Mohseni
- Division of Trauma and Emergency Surgery, Orebro University Hospital and Faculty of School of Medical Sciences, Orebro University, 702 81, Orebro, Sweden
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Holder E, Xiong C. Dispersion vs Disparity: Hiding Variability Can Encourage Stereotyping When Visualizing Social Outcomes. IEEE TRANSACTIONS ON VISUALIZATION AND COMPUTER GRAPHICS 2023; 29:624-634. [PMID: 36201416 DOI: 10.1109/tvcg.2022.3209377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Visualization research often focuses on perceptual accuracy or helping readers interpret key messages. However, we know very little about how chart designs might influence readers' perceptions of the people behind the data. Specifically, could designs interact with readers' social cognitive biases in ways that perpetuate harmful stereotypes? For example, when analyzing social inequality, bar charts are a popular choice to present outcome disparities between race, gender, or other groups. But bar charts may encourage deficit thinking, the perception that outcome disparities are caused by groups' personal strengths or deficiencies, rather than external factors. These faulty personal attributions can then reinforce stereotypes about the groups being visualized. We conducted four experiments examining design choices that influence attribution biases (and therefore deficit thinking). Crowdworkers viewed visualizations depicting social outcomes that either mask variability in data, such as bar charts or dot plots, or emphasize variability in data, such as jitter plots or prediction intervals. They reported their agreement with both personal and external explanations for the visualized disparities. Overall, when participants saw visualizations that hide within-group variability, they agreed more with personal explanations. When they saw visualizations that emphasize within-group variability, they agreed less with personal explanations. These results demonstrate that data visualizations about social inequity can be misinterpreted in harmful ways and lead to stereotyping. Design choices can influence these biases: Hiding variability tends to increase stereotyping while emphasizing variability reduces it.
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Henriksen BT, Krogseth M, Nguyen CT, Mathiesen L, Davies MN, Andersen RD, Andersson Y. Medication management for patients with hip fracture at a regional hospital and associated primary care units in Norway: a descriptive study based on a survey of clinicians' experience and a review of patient records. BMJ Open 2022; 12:e064868. [PMID: 36379642 PMCID: PMC9668037 DOI: 10.1136/bmjopen-2022-064868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Patients with hip fracture are at high risk of medication errors due to a combination of high age, comorbidities, polypharmacy and several care transitions after fracture. The aim was to study medication management tasks concerning patient safety: medication reconciliation, medication review and communication of key medication information in care transitions. DESIGN Descriptive study comprising a self-administered clinician survey (MedHipPro-Q) and a retrospective review of hospital medical records of patients with hip fracture. SETTING Regional hospital and the associated primary care units (South-Eastern Norway). PARTICIPANTS The survey received responses from 253 clinicians, 61 medical doctors and 192 nurses, involved in the medication management of patients with hip fracture, from acute admittance to the regional hospital, through an in-hospital fast track, primary care rehabilitation and back to permanent residence. Respondents' representativeness was unknown, introducing a risk of selection and non-response bias, and extrapolating findings should be done with caution. The patient records review included a random sample of records of patients with hip fracture (n=50). OUTCOME MEASURES Medication reconciliation, medication review and communication of medication information from two perspectives: the clinicians' (ie, experiences with medication management) and the practice (ie, documentation of completed medication management). RESULTS In the survey, most clinicians stated they performed medication reconciliation (79%) and experienced that patients often arrived without a medication list after care transition (37%). Doctors agreed that more patients would benefit from medication reviews (86%). In the hospital patient records, completed medication reconciliation was documented in most patients (76%). Medication review was documented in 2 of 50 patients (4%). Discharge summary guidelines were followed fully for 3 of 50 patients (6%). CONCLUSION Our study revealed a need for improved medication management for patients with hip fracture. Patients were at risk of medication information not being transferred correctly between care settings, and medication reviews seemed to be underused in clinical practice.
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Affiliation(s)
- Ben Tore Henriksen
- Tonsberg Hospital Pharmacy, Hospital Pharmacies Enterprise, South Eastern Norway, Tonsberg, Norway
- Division of Surgery, Vestfold Hospital Trust, Tonsberg, Norway
- Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Maria Krogseth
- Old Age Psychiatry Research Network, Telemark Vestfold, Vestfold Hospital Trust, Tonsberg, Norway
- Department of Nursing and Health Science, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
- Department of Internal Medicine, Telemark Hospital Trust, Skien, Norway
| | - Caroline Thy Nguyen
- Tonsberg Hospital Pharmacy, Hospital Pharmacies Enterprise, South Eastern Norway, Tonsberg, Norway
- Department of Pharmacy, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromso, Norway
| | - Liv Mathiesen
- Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Maren Nordsveen Davies
- Tonsberg Hospital Pharmacy, Hospital Pharmacies Enterprise, South Eastern Norway, Tonsberg, Norway
| | - Randi Dovland Andersen
- Department of Research, Telemark Hospital Trust, Skien, Norway
- Research Centre for Habilitation and Rehabilitation Models & Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Yvonne Andersson
- Department of Research, Hospital Pharmacies Enterprise, South Eastern Norway, Oslo, Norway
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Saher T, Al-Worafi YM, Iqbal MN, Wahid A, Iqbal Q, Khan A, Atif M, Ahmad N. Doctors' adherence to guidelines recommendations and glycaemic control in diabetic patients in Quetta, Pakistan: Findings from an observational study. Front Med (Lausanne) 2022; 9:978345. [PMID: 36388939 PMCID: PMC9661729 DOI: 10.3389/fmed.2022.978345] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 10/12/2022] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Poor control of diabetes mellitus (DM) is partly attributed to doctors' poor adherence to guidelines. OBJECTIVE To evaluate doctors' adherence to pharmacotherapeutic recommendations of DM management guidelines and factors associated with guidelines adherence and glycaemic control. METHODS This prospective observational study included 30 doctors who were treating DM patients in their private clinics in Quetta, Pakistan. On visit 1, a total of 600 prescriptions written by 30 enrolled doctors (20 patients per doctor) were noted along with patients' sociodemographic and clinical characteristics. American Diabetes Association guidelines was used as a reference. The prescriptions noted were judged for guidelines compliance. Of 600 enrolled patients, 450 patients (15 patients per doctor) were followed for one more visit and included in final analysis. Glycated hemoglobin (HbA1c) level noted one visit 2 was related with the respective prescription on visit 1. Data were analyzed by SPSS (version 23). A p-value <0.05 was considered statistically significant. RESULTS Patients received a median of two antidiabetic drugs (range: 1-5). A total of 73.1% patients were on polytherapy. Metformin was the most frequently prescribed (88.4%) antidiabetic followed by gliptins (46.2%). A total of 41.6% prescriptions were judged guidelines compliant. In multivariate binary logistic regressions (MVBLR) analysis, chronic kidney disease (CKD) (OR = 0.422) and polytherapy (OR = 0.367) had statistically significant negative associations (p-value <0.05) with guidelines' compliant prescriptions. The group of doctors comprised of specialists and consultants wrote significantly (p-value = 0.004) high number of guidelines adherent prescriptions (mean rank = 20.25) than the group comprised of medical officers (mean rank = 11.34). On visit 2, only 39.5% patients were on goal glycemic levels. In MVBLR analysis, suffering from dyslipidemia (OR = 0.134) and CKD (OR = 0.111), receiving sulfonylurea (OR = 0.156) and guidelines' compliant prescription (OR = 4.195) were significantly (p-value <0 .05) associated with glycemic control. CONCLUSION Although guidelines compliant prescriptions produced better glycemic control, but doctors' adherence to guidelines and glycemic control were poor. Polytherapy and CKD emerged as risk factors for guidelines divergent prescriptions. Dyslipidemia, CKD and reception of sulfonylureas had negative association with glycemic control.
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Affiliation(s)
- Tabassum Saher
- Department of Pharmacy Practice, Faculty of Pharmacy and Health Sciences, University of Baluchistan, Quetta, Pakistan
| | - Yaser Mohammed Al-Worafi
- Department of Clinical Sciences, College of Pharmacy, University of Science and Technology of Fujairah, Fujairah, United Arab Emirates
| | | | - Abdul Wahid
- Department of Pharmacy Practice, Faculty of Pharmacy and Health Sciences, University of Baluchistan, Quetta, Pakistan
| | - Qaiser Iqbal
- Department of Pharmaceutics, Faculty of Pharmacy and Health Sciences, University of Baluchistan, Quetta, Pakistan
| | - Asad Khan
- Department of Pharmacy Practice, Faculty of Pharmacy and Health Sciences, University of Baluchistan, Quetta, Pakistan
| | - Muhammad Atif
- Department of Pharmacy Practice, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, Pakistan
| | - Nafees Ahmad
- Department of Pharmacy Practice, Faculty of Pharmacy and Health Sciences, University of Baluchistan, Quetta, Pakistan
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Tucker S, McNett M, O'Leary C, Rosselet R, Mu J, Thomas B, Gallagher‐Ford L, Melnyk BM. EBP education and skills building for leaders: An RCT to promote EBP infrastructure, process and implementation in a comprehensive cancer center. Worldviews Evid Based Nurs 2022; 19:359-371. [PMID: 35923135 PMCID: PMC9804542 DOI: 10.1111/wvn.12600] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 04/22/2022] [Accepted: 05/25/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Implementation of evidence-based practice (EBP) in healthcare remains challenging. The influence of leadership has been recognized. However, few randomized trials have tested effects of an educational and skills building intervention for leaders in clinical settings. AIMS Test effects of an EBP leadership immersion intervention on EBP attributes over time among two cohorts of leaders at a national comprehensive cancer center. METHODS A stratified, randomized, wait-list group, controlled design was conducted. Participants received the evidence-based intervention one year apart (2020, n = 36; 2021, n = 30) with EBP knowledge, beliefs, competencies, implementation self-efficacy, implementation behaviors, and organizational readiness measured at pre- and post-intervention, and one- and two-year follow-ups. Participants applied learnings to a specific clinical or organization priority topic. RESULTS Baseline outcomes variables and demographics did not differ between cohorts except for age and years of experience. Both cohorts demonstrated significant changes in EBP attributes (except organizational readiness) post-intervention. Mixed linear modeling revealed group by time effects at 3-months for all EBP attributes except implementation behaviors and organizational readiness after the first intervention, favoring cohort 2020, with retained effects for EBP beliefs and competencies at one year. Following Cohort 2021 intervention, at 12-weeks post-intervention, implementation behaviors were significantly higher for cohort 2021. LINKING EVIDENCE TO ACTION An intensive EBP intervention can increase healthcare leaders' EBP knowledge and competencies. Aligning EBP projects with organizational priorities is strategic. Follow-up with participants to retain motivation, knowledge and competencies is essential. Future research must demonstrate effects on clinical outcomes.
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Affiliation(s)
- Sharon Tucker
- Helene Fuld Health Trust National Institute for EBPColumbusOhioUSA
| | - Molly McNett
- Implementation/Translation Science Core, Helene Fuld Health Trust National Institute for EBPColumbusOhioUSA
| | - Colleen O'Leary
- Evidence‐Based Practice James Cancer Hospital Department of Research and Evidence‐Based PracticeColumbusOhioUSA
| | | | - Jinjian Mu
- The Ohio State UniversityColumbusOhioUSA
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van den Berg M, Kaal SEJ, Schuurman TN, Braat DDM, Mandigers CMPW, Tol J, Tromp JM, van der Vorst MJDL, Beerendonk CCM, Hermens RPMG. Quality of integrated female oncofertility care is suboptimal: A patient-reported measurement. Cancer Med 2022; 12:2691-2701. [PMID: 36031940 PMCID: PMC9939180 DOI: 10.1002/cam4.5149] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 07/28/2022] [Accepted: 08/08/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Clinical practice guidelines recommend to inform female cancer patients about their infertility risks due to cancer treatment. Unfortunately, it seems that guideline adherence is suboptimal. In order to improve quality of integrated female oncofertility care, a systematic assessment of current practice is necessary. METHODS A multicenter cross-sectional survey study in which a set of systematically developed quality indicators was processed, was conducted among female cancer patients (diagnosed in 2016/2017). These indicators represented all domains in oncofertility care; risk communication, referral, counseling, and decision-making. Indicator scores were calculated, and determinants were assessed by multilevel multivariate analyses. RESULTS One hundred twenty-one out of 344 female cancer patients participated. Eight out of 11 indicators scored below 90% adherence. Of all patients, 72.7% was informed about their infertility, 51.2% was offered a referral, with 18.8% all aspects were discussed in counseling, and 35.5% received written and/or digital information. Patient's age, strength of wish to conceive, time before cancer treatment, and type of healthcare provider significantly influenced the scores of three indicators. CONCLUSIONS Current quality of female oncofertility care is far from optimal. Therefore, improvement is needed. To achieve this, improvement strategies that are tailored to the identified determinants and to guideline-specific barriers should be developed.
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Affiliation(s)
- Michelle van den Berg
- Department of Obstetrics and GynecologyRadboud University Medical CenterNijmegenthe Netherlands
| | - Suzanne E. J. Kaal
- Department of Medical OncologyRadboud University Medical CenterNijmegenthe Netherlands,Dutch AYA ‘Young and Cancer’ Care NetworkIKNLUtrechtthe Netherlands
| | - Teska N. Schuurman
- Center for Gynecologic Oncology AmsterdamThe Netherlands Cancer Institute‐Antoni van Leeuwenhoek HospitalAmsterdamThe Netherlands
| | - Didi D. M. Braat
- Department of Obstetrics and GynecologyRadboud University Medical CenterNijmegenthe Netherlands
| | | | - Jolien Tol
- Department of Medical Oncology, Jeroen Bosch HospitalDen BoschThe Netherlands
| | - Jacqueline M. Tromp
- Dutch AYA ‘Young and Cancer’ Care NetworkIKNLUtrechtthe Netherlands,Department of Medical OncologyAmsterdam University Medical CenterAmsterdamThe Netherlands
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Hagley SP, Kruppert A, Leal RO, Pizarro del Valle JC, Iannucci C, Hennink I, Boiron L, Hoehne SN. Self-Reported Clinical Practice of Small Animal Cardiopulmonary Resuscitation and Compliance With RECOVER Guidelines Among Veterinarians in Eight Western European Regions. Front Vet Sci 2022; 9:919206. [PMID: 35937302 PMCID: PMC9352391 DOI: 10.3389/fvets.2022.919206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 06/15/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionThe objective of this study was to assess whether small animal veterinarians across Western Europe are compliant with the 2012 cardiopulmonary resuscitation (CPR) guidelines by the Reassessment Campaign on Veterinary Resuscitation (RECOVER).MethodsA previously published online questionnaire from Switzerland was adapted and translated into 7 languages, corresponding to national languages in Austria, France, Germany, Ireland, Italy, Liechtenstein, Netherlands, Portugal, Spain, and the United Kingdom. The survey was distributed via respective national veterinary organizations and social media outlets. A subset of questions was analyzed to evaluate respondent demographics, RECOVER guideline awareness, and to allocate composite compliance scores for CPR preparedness, basic life support (BLS) and advanced life support (ALS). Percentages of group total (95% confidence interval) were calculated. Multivariable logistic regression was used to evaluate the effects of region of practice, gender, age, specialty training, and guideline awareness on compliance. Odds ratios (95% confidence interval) were generated and significance set at P < 0.05.ResultsNine-hundred and thirty respondents were included in analysis. Awareness of and compliance with RECOVER guidelines varied widely across regions. Compliance with all assessed RECOVER guideline recommendations was highest in Germany/Austria [14% (7- 27%)] and lowest in France and Portugal [0% (0–3%)]. CPR preparedness compliance was higher in participants aware of RECOVER guidelines [OR 10.1 (5.2-19.5)], those practicing in Germany/Austria [OR 4.1 (1.9–8.8)] or UK/Ireland [OR 2.2 (1.3–3.7)], and lower in those practicing in Portugal [OR 0.2 (0.1–0.9)]. Specialty training [OR 1.8 (1.1–2.9)], guideline awareness [OR 5.2 (3.2–8.6)], and practice in Germany/Austria [OR 3.1 (1.5–6.5)], UK/Ireland [OR 2.6 (1.7–4.1)], or the Netherlands [OR 5.3 (2.0–14.2)] were associated with increased BLS compliance. ALS compliance was higher in participants with guideline awareness [OR 7.0 (2.9–17.0)], specialty training [OR 6.8 (3.8–12.1)], those practicing in Germany/Austria [OR 3.5 (1.3–9.6)], UK/Ireland [OR 4.0 (1.9–8.3)], or Spain [OR 3.2 (1.2–8.3)] and in younger survey participants [OR 0.9 (0.9–1.0)].ConclusionsAwareness and compliance with RECOVER guidelines varied widely among countries surveyed, however overall compliance scores in all countries were considered low. Further research may highlight factors surrounding poor guideline awareness and compliance so targeted efforts can be made to improve veterinary CPR in Europe.
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Affiliation(s)
- Simon P. Hagley
- Emergency and Critical Care Department, Vets Now Referrals, Manchester, United Kingdom
| | - Anne Kruppert
- Division of Anaesthesia and Analgesia, Department of Clinical Veterinary Science, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Rodolfo Oliveira Leal
- CIISA Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal; Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS)
| | - José Carlos Pizarro del Valle
- , Small Animal Hospital, School of Veterinary Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Claudia Iannucci
- Division of Small Animal Emergency and Critical Care, Department of Clinical Veterinary Science, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Imke Hennink
- Division of Small Animal Emergency and Critical Care, Department of Clinical Veterinary Science, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Ludivine Boiron
- Department of Emergency and Critical Care, Clinique Vétérinaire Languedocia, Montpellier, France
| | - Sabrina N. Hoehne
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA, United States
- *Correspondence: Sabrina N. Hoehne
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22
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Overby MS, Mazeika S, DiFazio M, Ioli J, Birch K, Devorace L. Clinicians' Perspectives of Treatment for Lateralization Errors: A Quantitative and Qualitative Study. Lang Speech Hear Serv Sch 2022; 53:749-767. [PMID: 35679621 DOI: 10.1044/2022_lshss-21-00109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE This mixed-methods study aimed to obtain information regarding speech-language pathologists' (SLPs) perspectives about treatment of lateralization errors (LEs), challenges to implementing evidence-based LE treatment practice, and the sources SLPs' use to find evidence to treat LEs. This information can assist our understanding of ways to facilitate the uptake of evidence-based practice into the everyday treatment of clients with this disorder. METHOD A convergent parallel mixed-methods design was used to collect data from SLPs (N = 214) using 24 questions from an online survey distributed through electronic mailing lists and Speech and Hearing State Associations. Quantitative data were analyzed using frequencies and averages; themes and subthemes of qualitative data were analyzed using a content analysis approach with no a priori codes. Quantitative and qualitative results were compared and integrated. RESULTS Participants believed that LEs required individualized treatment before the age of 5 years, were largely caused by structural and neuromuscular factors, and required an understanding of orofacial and dental structure and function. Challenges to implementing LE treatment included a lack of skills and knowledge specific to LEs, competing demands on clinicians' time and resources, and a research-practice gap. Sources of evidence frequently used to obtain information about LE treatment were colleagues, trainings, workshops, and American Speech-Language-Hearing Association journals. CONCLUSIONS Clinicians believe that LE treatment is challenging and requires skill training. Future research in LEs will need to consider the real-world decisions clinicians must make when treating this disorder as well as clinicians' everyday constraints and challenges.
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Affiliation(s)
- Megan S Overby
- Department of Speech-Language Pathology, Duquesne University, Pittsburgh, PA
| | - Sarah Mazeika
- Department of Speech-Language Pathology, Duquesne University, Pittsburgh, PA
| | - Magdalena DiFazio
- Department of Speech-Language Pathology, Duquesne University, Pittsburgh, PA
| | - Julianna Ioli
- Department of Speech-Language Pathology, Duquesne University, Pittsburgh, PA
| | - Katherine Birch
- Department of Speech-Language Pathology, Duquesne University, Pittsburgh, PA
| | - Lauren Devorace
- Department of Speech-Language Pathology, Duquesne University, Pittsburgh, PA
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23
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Badia JM, Amillo Zaragüeta M, Rubio-Pérez I, Espin-Basany E, González Sánchez C, Balibrea JM. What have we learned from the surveys of the AEC, AECP and the Observatory of Infection in Surgery? Compliance with postoperative infection prevention measures and comparison with the AEC recommendations. Cir Esp 2022; 100:392-403. [PMID: 35283055 DOI: 10.1016/j.cireng.2022.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 10/12/2021] [Indexed: 06/14/2023]
Abstract
Before planning improvement strategies, it is crucial to know the degree of implementation of preventative measures for postoperative infection. The aggregated results of 3 surveys carried out by the Observatory of Infection in Surgery to members of 11 associations of surgeons and perioperative nurses are presented. The questions were aimed to determine the knowledge of the scientific evidence, personal beliefs and the actual use of the main measures. Of 2295 respondents, 45.1% did not receive feedback on the infection rate of their unit. Insufficient knowledge of some of the main prevention recommendations and some disturbing rates of use were observed. The preferred strategies to improve compliance with preventive guidelines and their degree of implementation were investigated. A gap between scientific evidence and clinical practice in the prevention of infection in different surgical specialties was confirmed.
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Affiliation(s)
- Josep M Badia
- Servicio de Cirugía General, Hospital General de Granollers, Universitat Internacional de Catalunya, Granollers, Spain.
| | - Mireia Amillo Zaragüeta
- Servicio de Cirugía General, Hospital General de Granollers, Universitat Internacional de Catalunya, Granollers, Spain
| | - Inés Rubio-Pérez
- Servicio de Cirugía General, Hospital Universitario la Paz, Madrid, Spain
| | - Eloy Espin-Basany
- Servicio de Cirugía General, Hospital Universitari Vall d'Hebrón, Barcelona, Spain
| | | | - José M Balibrea
- Servicio de Cirugía General, Hospital Clínic de Barcelona, Barcelona, Spain
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24
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The effectiveness of PROMISE minimal smoking cessation intervention strategy to improve the adherence to smoking cessation counselling during pregnancy: A stepped-wedge cluster randomized controlled trial. Midwifery 2022; 111:103364. [DOI: 10.1016/j.midw.2022.103364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 03/08/2022] [Accepted: 05/09/2022] [Indexed: 11/22/2022]
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25
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Roson N, Antolín A, Torregrosa A, Pedraza Gutiérrez S, Lopez Cano M, Badia J. ¿Cómo diagnosticamos la diverticulitis aguda? Resultados de una encuesta nacional sobre el papel de las técnicas de imagen. RADIOLOGIA 2022. [DOI: 10.1016/j.rx.2022.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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26
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Duration, frequency, and time distortion: Which is the best predictor of problematic smartphone use in adolescents? A trace data study. PLoS One 2022; 17:e0263815. [PMID: 35180248 PMCID: PMC8856513 DOI: 10.1371/journal.pone.0263815] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 01/27/2022] [Indexed: 12/05/2022] Open
Abstract
Problematic smartphone use (PSU) during adolescence has been associated with negative short- and long-term consequences for personal well-being and development. Valid and reliable predictors and indicators of PSU are urgently needed, and digital trace data can add valuable information beyond self-report data. The present study aimed to investigate whether trace data (duration and frequency of smartphone use), recorded via an app installed on participants’ smartphone, are correlated with self-report data on smartphone use. Additionally, the present study aimed to explore which usage indicators, i.e., duration, frequency, and time distortion of smartphone use, better predict PSU levels cross-sectionally and longitudinally, one year later. Results from a sample of 84 adolescents showed that adolescents tend to rely on the frequency of smartphone use when reporting on the time they spent with the smartphone. Traced duration of smartphone use as well as time distortion, i.e., over-estimation, are significant predictors of PSU. Methodological issues and theoretical implications related to predictors and indicators of PSU are discussed.
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Badia JM, Amillo Zaragüeta M, Rubio-Pérez I, Espin-Basany E, González Sánchez C, Balibrea JM. ¿Qué hemos aprendido de las encuestas de la AEC, AECP y del Observatorio de Infección en Cirugía? Cumplimiento de las medidas de prevención de infección postoperatoria y comparación con las recomendaciones de la AEC. Cir Esp 2021. [DOI: 10.1016/j.ciresp.2021.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Monteiro NRO, Pegorari MS, Ohara DG, Ferreira VTK, Matos AP. The basis of information to guide clinical decision-making in knee osteoarthritis management: A survey with Brazilian physical therapists. J Eval Clin Pract 2021; 27:1216-1222. [PMID: 33386671 DOI: 10.1111/jep.13532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 12/11/2020] [Accepted: 12/14/2020] [Indexed: 11/28/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES Several health information sources are available to assist physical therapists in the clinical decision-making process, with a notable increase in the importance of using evidence-based practice (EBP). The aim of this study is to investigate the health information sources most used by Brazilian physical therapists to guide their clinical decision making for knee osteoarthritis (OA) management, use of Physiotherapy Evidence Database (PEDro), knowledge about the existence of clinical practice guidelines (CPGs), and associated factors. METHODS A cross-sectional study using an electronic survey was conducted. Physical therapists registered in a Regional Physical Therapy Council in Brazil were invited to participate. Sociodemographic data, professional training, health information sources, frequency of use of PEDro, and knowledge about CPGs were collected. Descriptive analysis of the data was performed, and the chi square test and multinomial and binary logistic regression were used to verify association between the variables. RESULTS The survey was completed by 370 professionals. The three health information sources most used by Brazilian physical therapists were clinical experience, courses, and books. Among these professionals, only 12.1% use PEDro frequently, and 60.5% know that CPGs for knee OA management exist. Level of education was associated with PEDro use and knowledge about the existence of CPGs (P < .05). CONCLUSIONS The study results indicated a significant deficiency in engagement with research evidence by Brazilian physical therapists to guide their clinical decision making for knee OA. Further investigations on educational needs and the development of new strategies to narrow the gap between research evidence and clinical practice should be performed.
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Affiliation(s)
- Nívea Renata Oliveira Monteiro
- Ribeirão Preto Clinical Hospital, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.,Department of Biological and Health Sciences, Physiotherapy Course, Federal University of Amapá, Macapá, Brazil
| | - Maycon Sousa Pegorari
- Department of Biological and Health Sciences, Physiotherapy Course, Federal University of Amapá, Macapá, Brazil
| | - Daniela Gonçalves Ohara
- Department of Biological and Health Sciences, Physiotherapy Course, Federal University of Amapá, Macapá, Brazil
| | - Vânia Tiê Koga Ferreira
- Department of Biological and Health Sciences, Physiotherapy Course, Federal University of Amapá, Macapá, Brazil
| | - Areolino Pena Matos
- Department of Biological and Health Sciences, Physiotherapy Course, Federal University of Amapá, Macapá, Brazil
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Booth S, Meller S, Packer RM, Farquhar R, Maddison JE, Volk HA. Owner compliance in canine epilepsy. Vet Rec 2021; 188:e16. [PMID: 34651709 DOI: 10.1002/vetr.16] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/15/2020] [Accepted: 10/30/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Poor medication compliance by human epilepsy patients is one of the leading causes of treatment failure and increased seizure frequency. The aim of this cross-sectional study was to analyse owner compliance in pharmacological treatment of canine idiopathic epilepsy and to identify factors associated with poor compliance. METHODS The number of antiseizure drug tablets was recorded to determine if the patient received sufficient tablets to cover the time period between prescriptions and to assess compliant prescription cycles. Additionally, compliance was assessed by an online survey of owners. RESULTS For the prescription monitoring data from 94 cases from three small animal practices in the United Kingdom revealed an overall median compliance of 56%. Thirt-three per cent of owners were >80% compliant, while 21% were 100% compliant. During a non-compliant prescription cycle, a patient missed a median of 6 days (0.11-519 days) of treatment. Patients on polytherapy had higher compliance rates than on monotherapy (p = 0.031). The survey (229 respondents from online canine epilepsy groups) showed that low daily dosing was associated with better compliance (p = 0.049). CONCLUSION Owner compliance was subpar in this study and could represent a significant issue in epilepsy management, which needs to be considered by veterinary surgeons when treating canine epilepsy.
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Affiliation(s)
- Samantha Booth
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK
| | - Sebastian Meller
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Rowena Ma Packer
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK
| | | | - Jill E Maddison
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK
| | - Holger A Volk
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK.,Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
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Young PJ, Frei D. Oxygen therapy for critically Ill and post-operative patients. J Anesth 2021; 35:928-938. [PMID: 34490494 PMCID: PMC8420843 DOI: 10.1007/s00540-021-02996-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 08/28/2021] [Indexed: 11/02/2022]
Abstract
Nearly all patients receiving treatment in a peri-operative or intensive care setting receive supplemental oxygen therapy. It is biologically plausible that the dose of oxygen used might affect important patient outcomes. Most peri-operative research has focussed on oxygen regimens that target higher than normal blood oxygen levels. Whereas, intensive care research has mostly focussed on conservative oxygen regimens which assiduously avoid exposure to higher than normal blood oxygen levels. While such conservative oxygen therapy is preferred for spontaneously breathing patients with chronic obstructive pulmonary disease, the optimal oxygen regimen in other patient groups is not clear. Some data suggest that conservative oxygen therapy might be preferred for patients with hypoxic ischaemic encephalopathy. However, unless oxygen supplies are constrained, routinely aggressively down-titrating oxygen in either the peri-operative or intensive care setting is not necessary based on available data. Targeting higher than normal levels of oxygen might reduce surgical site infections in the perioperative setting and/or improve outcomes for intensive care patients with sepsis but further research is required and available data are not sufficiently strong to warrant routine implementation of such oxygen strategies.
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Affiliation(s)
- Paul J Young
- Medical Research Institute of New Zealand, Private Bag 7902, Wellington, 6242, New Zealand. .,Intensive Care Unit, Wellington Regional Hospital, Wellington, New Zealand. .,Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia. .,Department of Critical Care, University of Melbourne, Parkville, VIC, Australia.
| | - Daniel Frei
- Medical Research Institute of New Zealand, Private Bag 7902, Wellington, 6242, New Zealand.,Department of Anaesthesia, Wellington Regional Hospital, Wellington, New Zealand
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Wu W, Lyu H, Luo J. Characterizing Discourse about COVID-19 Vaccines: A Reddit Version of the Pandemic Story. HEALTH DATA SCIENCE 2021; 2021:9837856. [PMID: 36405359 PMCID: PMC9629685 DOI: 10.34133/2021/9837856] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 06/28/2021] [Indexed: 12/18/2022]
Abstract
It has been one year since the outbreak of the COVID-19 pandemic. The good news is that vaccines developed by several manufacturers are being actively distributed worldwide. However, as more and more vaccines become available to the public, various concerns related to vaccines become the primary barriers that may hinder the public from getting vaccinated. Considering the complexities of these concerns and their potential hazards, this study is aimed at offering a clear understanding about different population groups' underlying concerns when they talk about COVID-19 vaccines-particularly those active on Reddit. The goal is achieved by applying LDA and LIWC to characterize the pertaining discourse with insights generated through a combination of quantitative and qualitative comparisons. Findings include the following: (1) during the pandemic, the proportion of Reddit comments predominated by conspiracy theories outweighed that of any other topics; (2) each subreddit has its own user bases, so information posted in one subreddit may not reach that from other subreddits; and (3) since users' concerns vary across time and subreddits, communication strategies must be adjusted according to specific needs. The results of this study manifest challenges as well as opportunities in the process of designing effective communication and immunization programs.
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Affiliation(s)
- Wei Wu
- Goergen Institute for Data Science, University of Rochester, Rochester, USA
| | - Hanjia Lyu
- Goergen Institute for Data Science, University of Rochester, Rochester, USA
| | - Jiebo Luo
- Department of Computer Science, University of Rochester, Rochester, USA
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32
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Eschen R, Mbaabu PR, Ramamonjisoa BS, Robledo-Abad C. Factors enhancing the level of utilisation of research knowledge on ecosystems. PLoS One 2021; 16:e0254752. [PMID: 34293005 PMCID: PMC8297782 DOI: 10.1371/journal.pone.0254752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 07/04/2021] [Indexed: 11/18/2022] Open
Abstract
The significant resource investment in research on ecosystems for development of the Global South does not necessarily result in high levels of research knowledge utilisation (RKU). Understanding the factors associated with various levels of RKU can inform funding agencies and researchers developing new projects. We applied a combination of a questionnaire survey and follow up interviews with members of research teams of multiple, broadly comparable projects to make an assessment of achieved RKU levels using a combination of quantitative statistical hypothesis testing and narrative description of survey responses. Research knowledge dissemination by members of the project team who work for non-academic institutions or champions, e.g. particularly motivated people that promote and facilitate implementation or adoption of the project results, and via television was associated with higher research knowledge utilization. By contrast, dissemination by members of the project team working for academic institutions and via peer-reviewed journals was associated with lower RKU. The achieved level of RKU was consistently lower than the targeted level of RKU across spatial scales. The discrepancy between the perceived level of RKU and the evidence provided by survey respondents indicates the need for better monitoring the utilisation of research knowledge in development pathways. Our results further suggest that three years project duration is too short to achieve high levels of RKU in socio-ecological systems. We recommend involvement of non-academic members of the project team in project design, leadership and dissemination for increasing RKU.
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Affiliation(s)
| | - Purity Rima Mbaabu
- Kenya Forestry Research Institute (KEFRI), Marigat, Kenya
- Institute for Climate Change and Adaptation (ICCA), University of Nairobi, Nairobi, Kenya
- Faculty of Humanities and Social Sciences, Chuka University, Chuka, Kenya
| | - Bruno Salomon Ramamonjisoa
- Département des Eaux et Forêts de l’Ecole Supérieure des Sciences Agronomiques, Université d’Antananarivo, Antananarivo, Madagascar
| | - Carmenza Robledo-Abad
- Transdisciplinarity Laboratory (D-USYS TdLab), Institute for Environmental Decisions, ETH Zurich, Zurich, Switzerland
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Apornpong T, Grinsztejn B, Hughes M, Ritz J, Kerr SJ, Fletcher CV, Ruxrungtham K, Godfrey C, Gross R, Hogg E, Wallis CL, Badal-Faesen S, Hosseinipour MC, Mngqbisa R, Santos BR, Shah S, Hovind LJ, Mawlana S, Van Schalkwyk M, Chotirosniramit N, Kanyama C, Kumarasamy N, Salata R, Collier AC, Gandhi M. Antiretroviral hair levels, self-reported adherence, and virologic failure in second-line regimen patients in resource-limited settings. AIDS 2021; 35:1439-1449. [PMID: 33831905 PMCID: PMC8243835 DOI: 10.1097/qad.0000000000002901] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate associations between hair antiretroviral hair concentrations as an objective, cumulative adherence metric, with self-reported adherence and virologic outcomes. DESIGN Analysis of cohort A of the ACTG-A5288 study. These patients in resource-limited settings were failing second-line protease inhibitor-based antiretroviral therapy (ART) but were susceptible to at least one nucleoside reverse transcriptase inhibitor (NRTI) and their protease inhibitor, and continued taking their protease inhibitor-based regimen. METHODS Antiretroviral hair concentrations in participants taking two NRTIs with boosted atazanavir (n = 69) or lopinavir (n = 112) were analyzed at weeks 12, 24, 36 and 48 using liquid-chromatography--tandem-mass-spectrometry assays. Participants' self-reported percentage of doses taken in the previous month; virologic failure was confirmed HIV-1 RNA at least 1000 copies/ml at week 24 or 48. RESULTS From 181 participants with hair samples (61% women, median age: 39 years; CD4+ cell count: 167 cells/μl; HIV-1 RNA: 18 648 copies/ml), 91 (50%) experienced virologic failure at either visit. At 24 weeks, median hair concentrations were 2.95 [interquartile range (IQR) 0.49-4.60] ng/mg for atazanavir, 2.64 (IQR 0.73--7.16) for lopinavir, and 0.44 (IQR 0.11--0.76) for ritonavir. Plasma HIV-1 RNA demonstrated inverse correlations with hair levels (rs -0.46 to -0.74) at weeks 24 and 48. Weaker associations were seen with self-reported adherence (rs -0.03 to -0.24). Decreasing hair concentrations were significantly associated with virologic failure, the hazard ratio (95% CI) for ATV, LPV, and RTV were 0.69 (0.56-0.86), 0.77 (0.68-0.87), and 0.12 (0.06-0.27), respectively. CONCLUSION Protease inhibitor hair concentrations showed stronger associations with subsequent virologic outcomes than self-reported adherence in this cohort. Hair adherence measures could identify individuals at risk of second-line treatment failure in need of interventions.
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Affiliation(s)
| | - Beatriz Grinsztejn
- Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, Brazil
| | - Michael Hughes
- Harvard T.H. Chan School of Public Health, Boston, Maryland, USA
| | - Justin Ritz
- Harvard T.H. Chan School of Public Health, Boston, Maryland, USA
| | - Stephen J Kerr
- HIV-NAT, TRCARC, Bangkok, Thailand
- Biostatistics Excellence Centre, Bangkok, Thailand
- The Kirby Institute, UNSW, Sydney, Australia
| | | | - Kiat Ruxrungtham
- HIV-NAT, TRCARC, Bangkok, Thailand
- Chulalongkorn University, Bangkok, Thailand
| | | | | | - Evelyn Hogg
- Social & Scientific Systems, Silver Spring, Maryland, USA
| | | | - Sharlaa Badal-Faesen
- Clinical HIV Research Unit, Helen Joseph Hospital, University of the Witwatersrand, Johannesburg, South Africa
| | | | | | - Breno R Santos
- Hospital Nossa Senhora da Conceicao CRS, Rio Grande do Sul, Brazil
| | | | - Laura J Hovind
- Frontier Science & Technology Research Foundation, Inc., Amherst, Massachusetts, USA
| | - Sajeeda Mawlana
- Hospital Nossa Senhora da Conceicao CRS, Rio Grande do Sul, Brazil
| | - Marije Van Schalkwyk
- Family Centre for Research with Ubuntu (FAMCRU), Stellenbosch University, Cape Town, South Africa
| | | | | | | | | | | | - Monica Gandhi
- University of California, San Francisco, California, USA
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StrokeWatch: An Instrument for Objective Standardized Real-Time Measurement of Door-to-Needle Times in Acute Ischemic Stroke Treatment. J Stroke Cerebrovasc Dis 2021; 30:105962. [PMID: 34265596 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/12/2021] [Accepted: 06/17/2021] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES Monitoring critical time intervals in acute ischemic stroke treatment delivers metrics for quality of performance - the door-to-needle time being well-established. To resolve the conflict of self-reporting bias a "StrokeWatch" was designed - an instrument for objective standardized real-time measurement of procedural times. MATERIALS AND METHODS An observational, monocentric analysis of patients receiving intravenous thrombolysis for acute ischemic stroke between January 2018 and September 2019 was performed based on an ongoing investigator-initiated, prospective, and blinded endpoint registry. Patient data and treatment intervals before and after introduction of "StrokeWatch" were compared. RESULTS "StrokeWatch" was designed as a mobile board equipped with three digital stopwatches tracking door-to-needle, door-to-groin, and door-to-recanalization intervals as well as a form for standardized documentation. 118 patients before introduction of "StrokeWatch" (subgroup A) and 53 patients after introduction of "StrokeWatch" (subgroup B) were compared. There were no significant differences in baseline characteristics, procedural times, or clinical outcome. A non-significant increase in patients with door-to-needle intervals of 60 min or faster (93.2 vs 98.1%, p = 0.243) and good functional outcome (mRS d90 ≤ 2, 47.5 vs 58.5%, p = 0.218) as well as a significant increase in reports of delayed arrival of intra-hospital patient transport service (0.8 vs 13.2%, p = 0.001) were observed in subgroup B. CONCLUSIONS The implementation of StrokeWatch for objective standardized real-time measurement of door-to-needle times is feasible in a real-life setting without negative impact on procedural times or outcome. It helped to reassure a high-quality treatment standard and reveal factors associated with procedural delays.
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Bahns C, Happe L, Thiel C, Kopkow C. Physical therapy for patients with low back pain in Germany: a survey of current practice. BMC Musculoskelet Disord 2021; 22:563. [PMID: 34147077 PMCID: PMC8214788 DOI: 10.1186/s12891-021-04422-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 06/01/2021] [Indexed: 11/25/2022] Open
Abstract
Background Low back pain (LBP) is one of the most common musculoskeletal disorders worldwide. The National Disease Management Guideline (NVL) “Non-specific LBP” is a practical decision-making aid for both physicians and non-medical professionals in Germany to improve quality of health care. Although LBP is the most frequent diagnosis resulting in physical therapy treatment, information on the current management of patients with LBP and guideline adherence is limited. The objective of this study was to evaluate the current physical therapy management of patients with LBP in Germany, and to explore guideline adherence to the NVL “Non-specific LBP” recommendations. Methods An online survey among physical therapists working in Germany was conducted based on the recommendations given in the NVL “Non-specific LBP”. Participants were recruited using a snowball sampling approach and invited to complete the questionnaire. Guideline adherence was evaluated by comparing the survey findings with the recommendations of the NVL. Results In total, 1361 physical therapists (41 years of age (SD 11); 839 female, 514 male; 16 years of clinical experience (SD 10)) completed the survey. Fifty percent (n = 675) of our respondents adhered to the recommendations of the NVL on the therapeutic diagnostic process, and 72% (n = 973) to the recommendations concerning treatment. The guideline adherence across the entire management process (i.e., both diagnosis and treatment) of LBP was 38% (n = 513). German physical therapists predominantly provide active interventions, e.g., exercise therapy, but also use interventions with low or conflicting evidence, respectively. Massage and Kinesio Taping were frequently used despite being not recommended. Less than one third of study participants (n = 400, 29%) answered to know the NVL or had dealt with its recommendations. Conclusions In the management of LBP, overall guideline adherence among German physical therapists was 38% with higher adherence in the treatment section than in the physical therapeutic diagnostic process. Widespread employment of implementation strategies and removal of existing barriers against the application of evidence-based guidelines could facilitate the transfer of scientific evidence into clinical practice and contribute to optimize the quality of health care. Trial registration German Clinical Trials Register (DRKS00012607). Registered 04 October 2017. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-021-04422-2.
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Affiliation(s)
- Carolin Bahns
- Department of Therapy Science I, Brandenburg Technical University Cottbus - Senftenberg, Universitätsplatz 1, 01968, Senftenberg, Germany. .,Department of Applied Health Sciences, Division of Physiotherapy, University of Applied Sciences, Bochum, Germany.
| | - Lisa Happe
- Department of Applied Health Sciences, Division of Physiotherapy, University of Applied Sciences, Bochum, Germany.,Department for Health Services Research, Assistance Systems and Medical Devices, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Christian Thiel
- Department of Applied Health Sciences, Division of Physiotherapy, University of Applied Sciences, Bochum, Germany.,Faculty of Sports Science, Training and Exercise Science, Ruhr-University Bochum, Bochum, Germany
| | - Christian Kopkow
- Department of Therapy Science I, Brandenburg Technical University Cottbus - Senftenberg, Universitätsplatz 1, 01968, Senftenberg, Germany.,Department of Applied Health Sciences, Division of Physiotherapy, University of Applied Sciences, Bochum, Germany
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Exploration of Clinician Adherence and Competency as Predictors of Treatment Outcomes in a School-Based Homework and Organization Intervention for Students with ADHD. SCHOOL MENTAL HEALTH 2021. [DOI: 10.1007/s12310-021-09430-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Datar M, Ramakrishnan S, Montgomery E, Coca SG, Vassalotti JA, Goss T. A qualitative study documenting unmet needs in the management of diabetic kidney disease (DKD) in the primary care setting. BMC Public Health 2021; 21:930. [PMID: 34001084 PMCID: PMC8127260 DOI: 10.1186/s12889-021-10959-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 04/27/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND A majority of diabetic kidney disease (DKD) patients receive medical care in the primary care setting, making it an important opportunity to improve patient management. There is limited evidence evaluating whether primary care physicians (PCPs) are equipped to effectively manage these patients in routine clinical practice. The present study was undertaken to identify gaps in primary care and unmet needs in the diagnosis and monitoring of DKD in type 2 diabetes (T2D) patients among PCPs. METHODS This was a qualitative analysis based on 30-45-min interviews with PCPs treating T2D patients. PCPs were recruited via email and were board-certified, in practice for more than 3 years, spent most of their time in direct clinical care, and provided care for more than three T2D patients in a week. Descriptive data analysis was conducted to identify and examine themes that were generated by interviews. Two reviewers evaluated interview data to identify themes and developed consensus on the priority themes identified. RESULTS A total of 16 PCPs satisfying the inclusion criteria were recruited for qualitative interviews. Although the PCPs recognized kidney disease as an important comorbidity in T2D patients, testing for kidney disease was not consistently top of mind, with 56% reportedly performing kidney function testing in their T2D patients. PCPs most frequently reported using estimated glomerular filtration rate (eGFR) alone to monitor and stage DKD; only 25% PCPs reported testing for albuminuria. Most PCPs incorrectly believed that a majority of DKD patients are diagnosed in early stages. Also, early stages of DKD emerged as ambiguous areas of decision-making, wherein treatments prescribed greatly varied among PCPs. Lastly, early and accurate risk stratification of DKD patients emerged as the most important unmet need; which, if it could be overcome, was consistently identified by PCPs as a key to monitoring, appropriate nephrologist referrals, and intervening to improve outcomes in patients with DKD. CONCLUSIONS Our study highlights important unmet needs in T2D DKD testing, staging, and stratification in the PCP setting that limit effective patient care. Health systems and insurers in the U.S. should prioritize the review and approval of new strategies that can improve DKD staging and risk stratification.
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Affiliation(s)
| | | | | | - Steven G Coca
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joseph A Vassalotti
- National Kidney Foundation, Inc., New York, NY, USA
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Thomas Goss
- Boston Healthcare Associates, Boston, MA, USA.
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Guglielmo D, Murphy LB, Theis KA, Helmick CG, Omura JD, Odom EL, Croft JB. Physical Activity Assessment and Recommendation for Adults With Arthritis by Primary Care Providers-DocStyles, 2018. Am J Health Promot 2021; 35:559-570. [PMID: 33356415 PMCID: PMC10479947 DOI: 10.1177/0890117120981371] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE To examine primary care providers' (PCPs) physical activity assessment and recommendation behaviors for adults with arthritis. DESIGN Cross-sectional. SETTING 2018 DocStyles online national market research survey of US physicians and nurse practitioners. SAMPLE 1,389 PCPs seeing adults with arthritis. MEASURES 2 independent behaviors (assessment and recommendation) as 3 non-mutually exclusive groups: "always assesses," "always recommends," and "both" ("always assesses and recommends"). ANALYSIS Calculated percentages of each group (overall and by PCP characteristics), and multivariable-adjusted prevalence ratios (PRs) using binary logistic regression. RESULTS Among PCPs, 49.2% always assessed and 57.7% always recommended physical activity; 39.7% did both. Across all 3 groups, percentages were highest for seeing ≥20 adults with arthritis weekly ("both": 56.4%; "always assesses": 66.7%; "always recommends": 71.3%) and lowest among obstetrician/gynecologists ("both": 26.9%; "always assesses": 36.8%; "always recommends": 40.7%). Multivariable-adjusted associations were strongest for seeing ≥20 adults with arthritis weekly (referent: 1-9 adults) and each of "always assesses" (PR = 1.5 [95% confidence interval (CI): 1.3-1.8] and "both" (PR = 1.6 [95% CI: 1.4-1.9]). CONCLUSIONS Approximately 40% of PCPs sampled always engaged in both behaviors (assessing and recommending physical activity) with adults with arthritis; seeing a high volume of adults with arthritis was consistently related to engaging in each behavior. Evidence-based approaches to support PCP counseling include offering provider education and training, raising awareness of available resources, and using health system supports.
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Affiliation(s)
- Dana Guglielmo
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | - Louise B. Murphy
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kristina A. Theis
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Charles G. Helmick
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - John D. Omura
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Erica L. Odom
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Janet B. Croft
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Hussein R, Killeen R, He Z, Grindrod K. Assessing pharmacists' knowledge and compliance with narcotic inventory management using a computer-based educational platform. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2021; 29:265-270. [PMID: 33890668 DOI: 10.1093/ijpp/riab013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 03/25/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Pharmacy professionals are required to take all necessary steps to protect commonly misused drugs such as opioids at their pharmacies to minimize the risk of diversion. The aim of this study is to assess Canadian pharmacy professionals' knowledge and compliance with federal and provincial regulations using the computer-based educational platform Pharmacy5in5. METHODS A Narcotic Inventory module was created and reviewed by experts representing provincial and federal regulators. Descriptive statistics were used to analyze users' performance in quizzes. Binomial regression and logistic regression models were used to investigate the effect of demographic factors on users' performance. P-values less than 0.05 were considered statistically significant. KEY FINDINGS The analysis included data collected over a period of three months. A total of 792 users accessed the Narcotic Inventory module on the Pharmacy5in5 website between July 2019 and November 2019. Most of the users were licenced pharmacists (64%), female (72%), received their training in Canada (68%), and were practising in Ontario (80%). Users performed best on the quiz addressing the steps for reconciliation of inventory (93%), and worst on the quiz reviewing how to prepare for a Health Canada visit (66%). CONCLUSIONS Overall, pharmacy professionals showed adequate knowledge of the CDSA and provincial/territorial regulations regarding opioids inventory management. Conversely, the study highlighted poor compliance with the reporting of losses and theft of controlled substances by pharmacy professionals. Innovative approaches are needed to influence pharmacy professionals' behaviours to improve their compliance with best practices concerning inventory management to reduce drug diversion.
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Affiliation(s)
- Rand Hussein
- School of Pharmacy, University of Waterloo, Waterloo, ON, Canada
| | - Rosemary Killeen
- School of Pharmacy, University of Waterloo, Waterloo, ON, Canada
| | - Zhoushanyue He
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON, Canada
| | - Kelly Grindrod
- School of Pharmacy, University of Waterloo, Waterloo, ON, Canada
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Babaier RS, Basudan SO. Do dentists practice what they know? A cross-sectional study on the agreement between dentists' knowledge and practice in restoring endodontically treated teeth. BMC Oral Health 2021; 21:110. [PMID: 33691705 PMCID: PMC7945671 DOI: 10.1186/s12903-021-01479-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 03/03/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND There are very few studies comparing dentists' knowledge in relation to their clinical approach despite the existence of a possible gap between what they know and what they do. AIM To measure the agreement between knowledge and practice methods related to a selected clinical scenario involving the placement of an indirect post in endodontically treated teeth (ETT) among different types of practitioners. METHODS An electronic questionnaire was emailed to members of the Saudi Dental Society. The questionnaire presented a clinical scenario of restoring a posterior ETT with an indirect post, core unit, and crown, followed by specific questions regarding knowledge and practice related to ten different treatment aspects such as who prepares the post space, technique, isolation, time, gap between gutta-percha, and time to cementation of the crown. Each question was presented twice for each aspect, once asking about their practice method and then what they thought was the correct practice (knowledge). The relationship between the participants' responses and their specialty and the agreement between the responses of knowledge and practice for each participant were analyzed by Pearson's chi-square test and Kappa. RESULTS 203 completed questionnaires were analyzed. Most participants were 30 years old or younger (62.6%), and general dental practitioners (59%). When comparing the knowledge to the practice methods of each participant, nine out of ten aspects were of a "weak" level agreement or below (kappa < 0.59, p < 0.001). Only one aspect demonstrated a "strong" level of agreement (Kappa = 0.804), which was related to the duration of time between obturation and post space preparation in the presence of a periapical lesion. However, this strong agreement in the responses was not aligned with current evidence. There was also a significant difference among the responses of endodontists, restorative dentists and general practitioners in most of the aspects. CONCLUSION Overall, there was a weak agreement between what practitioners know and do in most aspects of a selected clinical scenario involving the placement of an indirect post in posterior ETT. Moreover, the participant's specialty influenced their responses regarding both knowledge and clinical practice.
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Affiliation(s)
- Rua S Babaier
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, 12372, Saudi Arabia. .,Division of Dentistry, Faculty of Biology, Medicine, and Health, School of Medical Sciences, University of Manchester, Manchester, UK.
| | - Sumaya O Basudan
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Hussein R, Lin ECJ, Grindrod K. Effects of computer-based education on health professionals' knowledge, skills, and behavior: A scoping review. J Am Pharm Assoc (2003) 2021; 61:e44-e68. [PMID: 33648894 DOI: 10.1016/j.japh.2021.01.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 01/21/2021] [Accepted: 01/26/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Computer-based platforms are rapidly growing as a promising way to deliver education to health professionals (HPs). However, evidence to support the use of computer-based education to change professional behavior and clinical practice and to guide the selection of design features of computer-based educational platforms is lacking in the existing literature. OBJECTIVES To address the current gaps in knowledge, a scoping review approach was used to explore the effects of computer-based education on HP knowledge, skills, and behavior as the primary objective. A secondary aim was to determine the design features of computer-based educational platforms that enhanced user satisfaction. METHODS The scoping review was conducted using the Arksey and O'Malley framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Relevant studies were first identified through searches in 7 scientific databases. Studies were then selected through independent screening by 2 reviewers. Finally, the data of selected studies were extracted and charted using Excel (Microsoft Corporation). RESULTS Seventeen studies were selected for inclusion. The included studies were conducted on a wide range of HPs and used computer-based educational platforms with varying features, duration, clinical content, and offerings of accreditation. All studies reported at least 1 of the following outcomes: HPs' acceptance, attitude, and satisfaction; knowledge and skills; and behavior; however, none of the studies evaluated the degrees of change in patient outcomes. Only 2 studies used theoretical frameworks to develop their platform, with mixed impact on effectiveness and consistent effect on satisfaction. In addition, the platforms employed newer features such as tailored feedback and instant messaging. CONCLUSION Computer-based education can enhance HP knowledge, skills, and behavior. Future studies should explicitly outline the features that further improve learning outcomes and construct their interventions around well-grounded theory to improve the effectiveness of computer-based education on changing HP behavior.
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Abstract
Objective To evaluate whether Clostridioides (formerly Clostridium) difficile–contaminated stethoscope diaphragms remained aseptic by the placement of an aseptic diaphragm barrier. Methods On November 1, 2019, fresh cultures of C difficile were diluted to 107 colony-forming units (CFU)/mL and used to inoculate 16 stethoscope diaphragms; 8 had an aseptic diaphragm barrier applied and 8 served as nonbarrier controls. Contaminated stethoscopes were anaerobically incubated, then swabbed at 15 and 30 minutes, 2 and 4 hours, and 1, 2, 3, and 7 days after inoculation and subsequently plated onto blood, chocolate, and cycloserine-cefoxitin fructose agar. Plates were incubated for 48 hours and on November 9, 2019, the resulting colonies were manually counted. Statistical analyses (RStudio, version 1.0.153) used analysis of variance with post hoc Tukey honestly significant difference. Results Overall, mean colony count was 33 CFU on stethoscopes without barriers vs zero on those with barriers (P≤.05). Growth was greatest at 48 hours, with colony counts as high as 160 CFU. The presence of the barrier resulted in no growth in 100% of stethoscope diaphragms for up to 1 week. Conclusion We found that stethoscope diaphragm barriers provide an aseptic patient contact point, thus reducing the potential for transmission of C difficile during the physical examination. In critical care environments, in which many hospitals use acoustically inferior disposable stethoscopes, the option of a disposable aseptic stethoscope barrier may allow high-quality auscultation while reducing the potential for pathogen transmission.
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van Zelm R, Coeckelberghs E, Sermeus W, Wolthuis A, Bruyneel L, Panella M, Vanhaecht K. A mixed methods multiple case study to evaluate the implementation of a care pathway for colorectal cancer surgery using extended normalization process theory. BMC Health Serv Res 2021; 21:11. [PMID: 33397382 PMCID: PMC7784254 DOI: 10.1186/s12913-020-06011-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 12/10/2020] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Specific factors that facilitate or prevent the implementation of enhanced recovery protocols for colorectal cancer surgery have been described in previous qualitative studies. This study aims to perform a concurrent qualitative and quantitative evaluation of factors associated with successful implementation of a care pathway (CP) for patients undergoing surgery for colorectal cancer. METHODS This comparative mixed methods multiple case study was based on a sample of 10 hospitals in 4 European countries that implemented a specific CP and performed pre- and post-implementation measurements. In-depth post-implementation interviews were conducted with healthcare professionals who were directly involved. Primary outcomes included protocol adherence and improvement rate. Secondary outcomes included length of stay (LOS) and self-rated protocol adherence. The hospitals were ranked based on these quantitative findings, and those with the highest and lowest scores were included in this study. Qualitative data were summarized on a per-case basis using extended Normalization Process Theory (eNPT) as theoretical framework. The data were then combined and analyzed using joint display methodology. RESULTS Data from 381 patients and 30 healthcare professionals were included. Mean protocol adherence rate increased from 56 to 62% and mean LOS decreased by 2.1 days. Both measures varied greatly between hospitals. The two highest-ranking hospitals and the three lowest-ranking hospitals were included as cases. Factors which could explain the differences in pre- and post-implementation performance included the degree to which the CP was integrated into daily practice, the level of experience and support for CP methodology provided to the improvement team, the intrinsic motivation of the team, shared goals and the degree of management support, alignment of CP development and hospital strategy, and participation of relevant disciplines, most notably, physicians. CONCLUSIONS Overall improvement was achieved but was highly variable among the 5 hospitals evaluated. Specific factors involved in the implementation process that may be contributing to these differences were conceptualized using eNPT. Multidisciplinary teams intending to implement a CP should invest in shared goals and teamwork and focus on integration of the CP into daily processes. Support from hospital management directed specifically at quality improvement including audit may likewise facilitate the implementation process. TRIAL REGISTRATION NCT02965794 . US National Library of Medicine, ClinicalTrials.gov . Registered 4 August 2014.
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Affiliation(s)
- R van Zelm
- Leuven Institute for Healthcare Policy, Katholieke Universiteit Leuven, Leuven, Belgium.
| | - E Coeckelberghs
- Leuven Institute for Healthcare Policy, Katholieke Universiteit Leuven, Leuven, Belgium
| | - W Sermeus
- Depertment of Abdominal Surgery, University Hospital Leuven, Leuven, Belgium
| | - A Wolthuis
- Depertment of Abdominal Surgery, University Hospital Leuven, Leuven, Belgium
| | - L Bruyneel
- Leuven Institute for Healthcare Policy, Katholieke Universiteit Leuven, Leuven, Belgium
| | - M Panella
- Department of Translational Medicine, University of Eastern Piemonte (UPO), Novarra, Italy
| | - K Vanhaecht
- Leuven Institute for Healthcare Policy, Katholieke Universiteit Leuven, Leuven, Belgium.,Department of Quality, Academic Policy Advisor, University Hospital Leuven, Leuven, Belgium
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Xu P, Dredze M, Broniatowski DA. The Twitter Social Mobility Index: Measuring Social Distancing Practices With Geolocated Tweets. J Med Internet Res 2020; 22:e21499. [PMID: 33048823 PMCID: PMC7717895 DOI: 10.2196/21499] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/04/2020] [Accepted: 10/11/2020] [Indexed: 11/21/2022] Open
Abstract
Background Social distancing is an important component of the response to the COVID-19 pandemic. Minimizing social interactions and travel reduces the rate at which the infection spreads and “flattens the curve” so that the medical system is better equipped to treat infected individuals. However, it remains unclear how the public will respond to these policies as the pandemic continues. Objective The aim of this study is to present the Twitter Social Mobility Index, a measure of social distancing and travel derived from Twitter data. We used public geolocated Twitter data to measure how much users travel in a given week. Methods We collected 469,669,925 tweets geotagged in the United States from January 1, 2019, to April 27, 2020. We analyzed the aggregated mobility variance of a total of 3,768,959 Twitter users at the city and state level from the start of the COVID-19 pandemic. Results We found a large reduction (61.83%) in travel in the United States after the implementation of social distancing policies. However, the variance by state was high, ranging from 38.54% to 76.80%. The eight states that had not issued statewide social distancing orders as of the start of April ranked poorly in terms of travel reduction: Arkansas (45), Iowa (37), Nebraska (35), North Dakota (22), South Carolina (38), South Dakota (46), Oklahoma (50), Utah (14), and Wyoming (53). We are presenting our findings on the internet and will continue to update our analysis during the pandemic. Conclusions We observed larger travel reductions in states that were early adopters of social distancing policies and smaller changes in states without such policies. The results were also consistent with those based on other mobility data to a certain extent. Therefore, geolocated tweets are an effective way to track social distancing practices using a public resource, and this tracking may be useful as part of ongoing pandemic response planning.
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Affiliation(s)
- Paiheng Xu
- Malone Center for Engineering in Healthcare, Center for Language and Speech Processing, Department of Computer Science, Johns Hopkins University, Baltimore, MD, United States
| | - Mark Dredze
- Malone Center for Engineering in Healthcare, Center for Language and Speech Processing, Department of Computer Science, Johns Hopkins University, Baltimore, MD, United States
| | - David A Broniatowski
- Department of Engineering Management and Systems Engineering, The George Washington University, Washington, DC, United States
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Chung J, Buchanan B. A Self‐Report Survey: Australian Clinicians’ Attitudes Towards Progress Monitoring Measures. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12352] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - Ben Buchanan
- School of Psychological Sciences, Monash University
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Sandelowsky H, Krakau I, Modin S, Ställberg B, Johansson SE, Nager A. Patient outcomes following GPs' educations about COPD: a cluster randomized controlled trial. NPJ Prim Care Respir Med 2020; 30:44. [PMID: 33060615 PMCID: PMC7566632 DOI: 10.1038/s41533-020-00204-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 09/23/2020] [Indexed: 11/24/2022] Open
Abstract
This study aimed to compare patient outcomes following case method learning and traditional lectures as methods for continuing medical education (CME) about chronic obstructive pulmonary disease (COPD) for general practitioners (GPs) in Sweden. In a pragmatic cluster randomized controlled trial, COPD patients (n = 425; case method group n = 209, traditional lectures group n = 216) from 24 primary health care centers replied to questionnaires prior to and 18 months after a 2 × 2-h CME was given to GPs (n = 255). We measured changes in the scores of the Clinical COPD Questionnaire (CCQ), symptoms, needs for disease information, exacerbations, smoking, and use of pulmonary rehabilitation. The changes over time were similar for both CME methods. Patients who had used pulmonary rehabilitation increased from 13.2 to 17.8% (P = 0.04), and prevalence of smoking decreased from 28.9 to 25.1% (P = 0.003). In conclusion, neither of the used CME methods was superior than the other regarding patient outcomes. CME's primary value may lay in improving GPs' adherence to guidelines, which should lead to long-term positive changes in patient health.
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Affiliation(s)
- Hanna Sandelowsky
- Karolinska Institutet, Department of Medicine, Division of Clinical Epidemiology, SE-171 76, Stockholm, Sweden.
- Academic Primary Health Care Centre, Stockholm County Council, Box 45436, SE-104 31, Stockholm, Sweden.
- Karolinska Institutet, NVS, Section for Family Medicine and Primary Care, Alfred Nobels Allé 23, Huddinge, SE-141 83, Stockholm, Sweden.
| | - Ingvar Krakau
- Karolinska Institutet, Department of Medicine, Division of Clinical Epidemiology, SE-171 76, Stockholm, Sweden
| | - Sonja Modin
- Karolinska Institutet, NVS, Section for Family Medicine and Primary Care, Alfred Nobels Allé 23, Huddinge, SE-141 83, Stockholm, Sweden
| | - Björn Ställberg
- Uppsala University, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Box 564, SE-751 22, Uppsala, Sweden
| | - Sven-Erik Johansson
- Lund University, Center for Primary Health Care Research, Department of Clinical Sciences, SE-205 02, Malmö, Sweden
| | - Anna Nager
- Karolinska Institutet, NVS, Section for Family Medicine and Primary Care, Alfred Nobels Allé 23, Huddinge, SE-141 83, Stockholm, Sweden
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47
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Vasudevan RS, Horiuchi Y, Torriani FJ, Cotter B, Maisel SM, Dadwal SS, Gaynes R, Maisel AS. Persistent Value of the Stethoscope in the Age of COVID-19. Am J Med 2020; 133:1143-1150. [PMID: 32569591 PMCID: PMC7303610 DOI: 10.1016/j.amjmed.2020.05.018] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 05/04/2020] [Indexed: 12/25/2022]
Abstract
The stethoscope has long been at the center of patient care, as well as a symbol of the physician-patient relationship. While advancements in other diagnostic modalities have allowed for more efficient and accurate diagnosis, the stethoscope has evolved in parallel to address the needs of the modern era of medicine. These advancements include sound visualization, ambient noise reduction/cancellation, Bluetooth (Bluetooth SIG Inc, Kirkland, Wash) transmission, and computer algorithm diagnostic support. However, despite these advancements, the ever-changing climate of infection prevention, especially in the wake of the COVID-19 pandemic, has led many to question the stethoscope as a vector for infectious diseases. Stethoscopes have been reported to harbor bacteria with contamination levels comparable with a physician's hand. Although disinfection is recommended, stethoscope hygiene compliance remains low. In addition, disinfectants may not be completely effective in eliminating microorganisms. Despite these risks, the growing technological integration with the stethoscope continues to make it a highly valuable tool. Rather than casting our valuable tool and symbol of medicine aside, we must create and implement an effective method of stethoscope hygiene to keep patients safe.
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Affiliation(s)
- Rajiv S Vasudevan
- Department of Medicine, University of California San Diego, La Jolla.
| | - Yu Horiuchi
- Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan
| | - Francesca J Torriani
- Department of Medicine, University of California San Diego, La Jolla; Division of Infectious Diseases
| | - Bruno Cotter
- Department of Medicine, University of California San Diego, La Jolla; Division of Cardiovascular Medicine, University of California San Diego, La Jolla
| | | | - Sanjeet S Dadwal
- Division of Infectious Diseases, City of Hope National Medical Center, Duarte, Calif
| | - Robert Gaynes
- Division of Infectious Diseases, Emory University, Atlanta, Ga
| | - Alan S Maisel
- Department of Medicine, University of California San Diego, La Jolla; Division of Cardiovascular Medicine, University of California San Diego, La Jolla
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48
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Donaldson L, Stevenson MA, Fletcher DJ, Gillespie Í, Kellett-Gregory L, Boller M. Differences in the clinical practice of small animal CPR before and after the release of the RECOVER guidelines: Results from two electronic surveys (2008 and 2017) in the United States and Canada. J Vet Emerg Crit Care (San Antonio) 2020; 30:615-631. [PMID: 32975359 DOI: 10.1111/vec.13010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 02/24/2019] [Accepted: 03/29/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess whether the clinical approach to CPR has changed following the publication of the Reassessment Campaign on Veterinary Resuscitation (RECOVER) guidelines in 2012. DESIGN Internet-based survey. SETTING Academia and referral practice. SUBJECTS Four hundred and ninety-one small animal veterinarians in clinical practice in the United States and Canada. INTERVENTIONS An internet-based survey assessing the clinical approach to small animal CPR was circulated with the assistance of veterinary professional organizations on 2 separate occasions: prior to (2008) and following (2017) publication of the 2012 (RECOVER) guidelines. Survey questions identical to both surveys solicited details of clinician approaches to CPR preparedness, basic life support (BLS), and advanced life support (ALS). Respondents were grouped into level of expertise (board-certified specialists [BCS, n = 202] and general practitioners in emergency clinics [GPE, n = 289]), and year of response to the survey (2008, n = 171; 2017, n = 320). MEASUREMENTS AND MAIN RESULTS Compliance with the RECOVER guidelines pertaining to CPR preparedness (P < 0.01), BLS (P < 0.01), and ALS P < 0.01) was consistently higher in respondents to the 2017 survey compared to those of the 2008 survey. Being a BCS was associated with significantly higher compliance with the RECOVER recommendations than GPE in the domains of preparedness (P = 0.02), BLS (P < 0.01), and ALS (P < 0.01). Increases in age of the respondent had a negative effect on compliance with the BLS guidelines (P < 0.01), while gender had no effect. CONCLUSIONS Compared to 2008, current practices in small animal CPR in the North American emergency and critical care community shifted toward those recommended in the RECOVER guidelines across all CPR domains. This supports the notion that uptake of the RECOVER guidelines among veterinary emergency or critical care clinicians was sufficient to lead to a change in the practice of CPR.
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Affiliation(s)
- Liam Donaldson
- Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Melbourne, Australia
| | - Mark A Stevenson
- Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Melbourne, Australia
| | - Daniel J Fletcher
- College of Veterinary Medicine, Department of Clinical Sciences, Cornell University, Ithaca, New York
| | - Íde Gillespie
- Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Melbourne, Australia
| | | | - Manuel Boller
- Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Melbourne, Australia.,Translational Research and Clinical Trials (TRACTs), Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Melbourne, Australia
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49
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Park J, Park S, Kim K, Hwang W, Yoo S, Yi GS, Lee D. An interactive retrieval system for clinical trial studies with context-dependent protocol elements. PLoS One 2020; 15:e0238290. [PMID: 32946464 PMCID: PMC7500653 DOI: 10.1371/journal.pone.0238290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 08/14/2020] [Indexed: 11/19/2022] Open
Abstract
A well-defined protocol for a clinical trial guarantees a successful outcome report. When designing the protocol, most researchers refer to electronic databases and extract protocol elements using a keyword search. However, state-of-the-art database systems only offer text-based searches for user-entered keywords. In this study, we present a database system with a context-dependent and protocol-element-selection function for successfully designing a clinical trial protocol. To do this, we first introduce a database for a protocol retrieval system constructed from individual protocol data extracted from 184,634 clinical trials and 13,210 frame structures of clinical trial protocols. The database contains a variety of semantic information that allows the filtering of protocols during the search operation. Based on the database, we developed a web application called the clinical trial protocol database system (CLIPS; available at https://corus.kaist.edu/clips). This system enables an interactive search by utilizing protocol elements. To enable an interactive search for combinations of protocol elements, CLIPS provides optional next element selection according to the previous element in the form of a connected tree. The validation results show that our method achieves better performance than that of existing databases in predicting phenotypic features.
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Affiliation(s)
- Junseok Park
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
- Bio-Synergy Research Center, KAIST, Daejeon, Republic of Korea
| | - Seongkuk Park
- Information & Electronics Research Institute, Daejeon, Republic of Korea
| | - Kwangmin Kim
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
- Bio-Synergy Research Center, KAIST, Daejeon, Republic of Korea
| | - Woochang Hwang
- The Milner Institute, University of Cambridge, Cambridge, United Kingdom
| | - Sunyong Yoo
- School of Electronics and Computer Engineering, Chonnam National University, Gwangju, Republic of Korea
| | - Gwan-su Yi
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
- Bio-Synergy Research Center, KAIST, Daejeon, Republic of Korea
| | - Doheon Lee
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
- Bio-Synergy Research Center, KAIST, Daejeon, Republic of Korea
- * E-mail:
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50
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Badia JM, Rubio-Pérez I, López-Menéndez J, Diez C, Al-Raies Bolaños B, Ocaña-Guaita J, Meijome XM, Chamorro-Pons M, Calderón-Nájera R, Ortega-Pérez G, Paredes-Esteban R, Sánchez-Viguera C, Vilallonga R, Picardo AL, Bravo-Brañas E, Espin E, Balibrea JM. The persistent breach between evidence and practice in the prevention of surgical site infection. Qualitative study. Int J Surg 2020; 82:231-239. [PMID: 32877754 DOI: 10.1016/j.ijsu.2020.08.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/20/2020] [Accepted: 08/11/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND Despite the dissemination of guidelines for surgical site infection (SSI) prevention, a gap between the theoretical measures and their compliance persists. Accurate estimates of the implementation of preventative measures is crucial before planning dissemination strategies. METHODS A web-based survey was distributed to members of 11 Associations of operative nurses and surgeons. Questions aimed to determine their awareness of evidence, personal beliefs and actual use of the main preventative measures. RESULTS Of 1105 responders, 50.5% receive no feed-back of their SSI rate. Responders show a moderate rate of awareness of the recommendations about not removing hair, hair clipping, skin antisepsis with alcoholic solutions, and normothermia. Antibiotic prophylaxis is given for more than 24 h by 18.8% of respondents. Screening for S. aureus is performed by 27.6%. Hair removal by shaving is used by 16.6% of responders. The most common antiseptic solutions are alcoholic chlorhexidine (57.2%) and aqueous povidone (23.3%). 62.8% of surgeons allow the solution to air dry before applying surgical drapes. Adhesive drapes in the surgical field are used routinely in 33.4% of cases. Perioperative normothermia, glucose control and hyperoxia are used in 84.3%, 65.9% and 23.3% of cases. Antimicrobial sutures and negative pressure therapy are used by 20.2% and 43.5% of teams, respectively. Prior to closing the incision, 83.9% replace surgical instruments always or selectively. Wound irrigation before closing is used in 78.1% of cases, mostly with saline. Check-lists, standardized orders, surveillance, feed-back and educational programs were rated most highly by respondents as a means to improve compliance with preventative guidelines, but few of these strategies were in place at their institutions. CONCLUSION Gaps in the translation of evidence into practice remain in the prevention of SSI among different surgical specialities. Several areas for improvement have been identified, as some core prevention measures are not in common use.
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Affiliation(s)
- Josep M Badia
- Department of Surgery, Hospital General de Granollers, Avinguda Francesc Ribas 1, 08402, Spain; Universitat Internacional de Catalunya, Barcelona, Spain.
| | - Inés Rubio-Pérez
- Department of Surgery, Hospital Universitario La Paz, Paseo de La Castellana, 261, 28046, Madrid, Spain.
| | - José López-Menéndez
- Department of Cardiac Surgery, Hospital Universitario Ramón y Cajal, Ctra. de Colmenar Viejo Km. 9, 100, 28034, Madrid, Spain.
| | - Cecilia Diez
- Surgical Area, Hospital Universitari Sant Pau, Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain.
| | - Bader Al-Raies Bolaños
- Department of Vascular Surgery, Hospital de Manises, Av. de La Generalitat Valenciana, 50, 46940, Manises, Valencia, Spain.
| | - Julia Ocaña-Guaita
- Department of Vascular Surgery, Hospital Ramón y Cajal, Ctra. de Colmenar Viejo Km. 9, 100, 28034, Madrid, Spain.
| | - Xose M Meijome
- Gerencia de Asistencia Sanitaria Del Bierzo, León, Gerencia de Asistencia Sanitaria Del Bierzo, Nursing and Healthcare Research Unit, C/ El Medio, 1, 24400, Ponferrada, León, Spain.
| | - Manuel Chamorro-Pons
- Department of Oral and Maxillofacial Surgery, Hospital Ruber Juan Bravo, Calle de Juan Bravo, 49, 28006, Madrid, Spain.
| | - Ramón Calderón-Nájera
- Department of Aesthetic, Plastic and Reconstructive Surgery, Hospital Ruber Internacional, Calle de La Masó, 38 28034, Madrid, Spain.
| | - Gloria Ortega-Pérez
- Department of Surgical Oncology, MD Anderson Cancer Center, Calle de Arturo Soria, 270, 28033, Madrid, Spain.
| | - Rosa Paredes-Esteban
- Unidad de Cirugía Pediátrica, Hospital Universitario Reina Sofía, Av. Menendez Pidal, S/n, 14004, Córdoba, Spain.
| | - Cristina Sánchez-Viguera
- Servicio de Neurocirugía, Hospital Regional Universitario de Málaga, Av. de Carlos Haya, 84, 29010, Málaga, Spain.
| | - Ramon Vilallonga
- Endocrine-Metabolic and Bariatric Surgery Unit, Hospital Universitari Vall D'Hebrón, Passeig de La Vall D'Hebron, 119, 08035, Barcelona, Spain.
| | - Antonio L Picardo
- Endocrine-Metabolic and Bariatric Surgery Unit, HM Montepríncipe, Avenida de Montepríncipe Nº 25, 28660, Boadilla Del Monte, Madrid, Spain.
| | - Elena Bravo-Brañas
- Department of Aesthetic, Plastic and Reconstructive Surgery, Hospital Universitario La Paz, Paseo de La Castellana, 261, 28046, Madrid, Spain.
| | - Eloy Espin
- Department of Surgery, Hospital Universitari Vall D'Hebrón, Passeig de La Vall D'Hebron, 119, 08035, Barcelona, Spain.
| | - José M Balibrea
- Department of Surgery, Hospital Clínic de Barcelona, Carrer de Villarroel, 170, 08036, Barcelona, Spain; Universitat de Barcelona, Barcelona, Spain.
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