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Javier-González M, Boulahssass R, Lago LD, González-Senac NM, Nair S, Vetter M. Survey on current clinical practice in geriatric oncology: the individual experience in five European Cancer Centers. Eur Geriatr Med 2024:10.1007/s41999-024-01041-7. [PMID: 39441518 DOI: 10.1007/s41999-024-01041-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 08/12/2024] [Indexed: 10/25/2024]
Abstract
PURPOSE To gather information from clinicians on how geriatric oncology models of care have emerged in different European countries and describe current practice in this clinical area. METHODS A semi-structured online interview was performed, exploring aspects related to implementation, perceived quality of care, and professional satisfaction. RESULTS The centers participating in this interview showed significant differences in terms of resource allocation, team members, components of the comprehensive geriatric assessment (CGA), and CGA-driven interventions. High levels of professional satisfaction were expressed by all participants. This was deemed a consequence of a perception of increased quality in the provision of care and enhanced educational and academic opportunities. CONCLUSION Interdisciplinary models of care in geriatric oncology, regardless of implementation details, seem to provide grounds for increased professional satisfaction and perception of better provision of quality of care. These characteristics could support promoting and further developing similar collaborations on a wider scale.
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Affiliation(s)
- M Javier-González
- Department of Oncology and Hematology, Kantonsspital Baselland Liestal, Liestal, Switzerland.
| | - R Boulahssass
- Geriatric Coordination Unit for Geriatric Oncology (UCOG), Centre Hospitalier Universitaire de Nice, University of Côte d'Azur, FHU OncoAge, Nice, France
| | - L Dal Lago
- Comprehensive Cancer Center, Delta Hospital, Chirec Hospital Group, Brussels, Belgium
| | - N M González-Senac
- Geriatrics Department, Biopathology of Aging Group, Hospital General Universitario Gregorio Marañón, Health Research Institute Gregorio Marañón (IiSGM), Madrid, Spain
| | - S Nair
- Department of Elderly Medicine, Leeds Teaching Hospital Trust, Leeds, UK
| | - M Vetter
- Department of Oncology and Hematology, Kantonsspital Baselland Liestal, Liestal, Switzerland
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2
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Ilan Y. Using the Constrained Disorder Principle to Navigate Uncertainties in Biology and Medicine: Refining Fuzzy Algorithms. BIOLOGY 2024; 13:830. [PMID: 39452139 PMCID: PMC11505099 DOI: 10.3390/biology13100830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2024] [Revised: 09/17/2024] [Accepted: 10/15/2024] [Indexed: 10/26/2024]
Abstract
Uncertainty in biology refers to situations in which information is imperfect or unknown. Variability, on the other hand, is measured by the frequency distribution of observed data. Biological variability adds to the uncertainty. The Constrained Disorder Principle (CDP) defines all systems in the universe by their inherent variability. According to the CDP, systems exhibit a degree of variability necessary for their proper function, allowing them to adapt to changes in their environments. Per the CDP, while variability differs from uncertainty, it can be viewed as a regulated mechanism for efficient functionality rather than uncertainty. This paper explores the various aspects of un-certainties in biology. It focuses on using CDP-based platforms for refining fuzzy algorithms to address some of the challenges associated with biological and medical uncertainties. Developing a fuzzy decision tree that considers the natural variability of systems can help minimize uncertainty. This method can reveal previously unidentified classes, reduce the number of unknowns, improve the accuracy of modeling results, and generate algorithm outputs that are more biologically and clinically relevant.
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Affiliation(s)
- Yaron Ilan
- Department of Medicine, Hadassah Medical Center, Faculty of Medicine, Hebrew University, Jerusalem 9112001, Israel
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3
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Masood M, Guitar NA, Connelly DM, Nguyen A. Nurses' Descriptions of Interdisciplinary Interactions in Stroke and Geriatric Rehabilitation Units: A Case Example of the Registered Practical Nurse. J Adv Nurs 2024. [PMID: 39355993 DOI: 10.1111/jan.16501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 08/13/2024] [Accepted: 09/14/2024] [Indexed: 10/03/2024]
Abstract
AIM To analyse how nurses describe their interactions with other interdisciplinary team members within stroke and geriatric rehabilitation. DESIGN A secondary analysis of cross-sectional ethnographic interview data was conducted using Elo and Kyngäs' (2008) deductive content analysis. METHODS Between April 12 and July 25, 2022, semi-structured interviews were conducted with 31 registered practical nurses recruited through convenience sampling from three tertiary hospital sites in Southwestern Ontario. Interview transcripts were reviewed to identify described interactions between nurses and interdisciplinary team members and were coded for: who were the interdisciplinary team member(s) involved; what content was addressed; and where, when, and why the interaction occurred. RESULTS Categories representing how nurses describe their interactions with interdisciplinary team members were as follows: (1) arising from the unique roles owned by either the nurse or interdisciplinary team member(s); (2) requiring open communication to achieve patient goals and improve patient care; (3) occurring within what is perceived to be either the therapists' or nurses' physical space; and (4) contributing to supportive team environments that are mutually beneficial. CONCLUSIONS While nurses view other interdisciplinary team members as 'owning' certain roles and physical spaces within rehabilitation, they also recognised their 'owned' spaces and roles. Unique contributions of all team members were valued as necessary to provide holistic, person-centred patient care and positive team-based support. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Nurses' descriptions of their interactions with interdisciplinary team members demonstrated their essential contributions to team-based patient care and acknowledged nurse contributions to the rehabilitation process for patients. IMPACT Findings elucidate the nature of interprofessional interactions and 'ownership' within the rehabilitation process. Results are beneficial for policymakers, educators, and healthcare organisations aiming to optimise the nursing role within rehabilitation spaces. REPORTING METHOD The Consolidated Criteria for Reporting Qualitative Research Checklist (COREQ). PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Mehvish Masood
- School of Physical Therapy, Western University, London, Ontario, Canada
| | - Nicole A Guitar
- School of Physical Therapy, Western University, London, Ontario, Canada
| | - Denise M Connelly
- School of Physical Therapy, Western University, London, Ontario, Canada
| | - Angela Nguyen
- School of Physical Therapy, Western University, London, Ontario, Canada
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4
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Awad MG, Hanafy NAN, Ali RA, Abd El-Monem DD, El-Shafiey SH, El-Magd MA. Exploring the therapeutic applications of nano-therapy of encapsulated cisplatin and anthocyanin-loaded multiwalled carbon nanotubes coated with chitosan-conjugated folic acid in targeting breast and liver cancers. Int J Biol Macromol 2024; 280:135854. [PMID: 39307483 DOI: 10.1016/j.ijbiomac.2024.135854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2024] [Revised: 09/14/2024] [Accepted: 09/19/2024] [Indexed: 09/26/2024]
Abstract
This study aimed to assess the targeted nano-therapy of encapsulated cisplatin (Cis) and anthocyanin (Ant)-loaded multiwalled carbon nanotubes (CNT) coated with chitosan conjugated folic acid on breast MCF7 and liver HepG2 cancer cells. Zeta potential, UV-spectroscopy, FTIR, TEM, and SEM were used to evaluate CNT, its modified form (CNT Mod), CNT-loaded Cis NPs, CNT-loaded Ant NPs, and CNT- Cis + Ant NPs. All treatments induced apoptosis-dependent cytotoxicity in both cell lines as revealed functionally by the MTT assay, morphologically (DNA degradation) by acridine orange/ethidium bromide (AO/EB) double staining, and molecularly (Bax upregulation and Bcl2 downregulation) by real-time PCR, with best effect for the combined treatment (CNT- Cis + Ant NPs). This combined treatment also significantly reduced inflammation (low TNFα), migration (low MMP9 and high TIMP1), and angiogenesis (low VEGF), while significantly increasing antioxidant status (high Nrf2 and OH-1) in MCF7 and HepG2 cells compared to other treatments. Interestingly, cells treated with CNT Mod exhibited higher cytotoxic, apoptotic, anti-migratory, and anti-angiogenic potentials relative to CNT-treated cells. In conclusion, targeted nano-therapy of encapsulated cisplatin and anthocyanin-loaded carbon nanotubes coated with chitosan conjugated folic acid can efficiently combat breast and liver cancers by sustained release, in addition to its apoptotic, antioxidant, anti-inflammatory, anti-metastatic, and anti-angiogenic effects.
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Affiliation(s)
- Mai G Awad
- Zoology Department, Faculty of Women for Arts Science and Education, Ain Shams University, 11757 Cairo, Egypt
| | - Nemany A N Hanafy
- Group of Bionanotechnology and Molecular Cell Biology, Institute of Nanoscience and Nanotechnology, Kafrelsheikh University, 33516 Kafrelsheikh, Egypt
| | - Ramadan A Ali
- Zoology Department, Faculty of Women for Arts Science and Education, Ain Shams University, 11757 Cairo, Egypt
| | - Dalia D Abd El-Monem
- Zoology Department, Faculty of Women for Arts Science and Education, Ain Shams University, 11757 Cairo, Egypt
| | - Sara H El-Shafiey
- Zoology Department, Faculty of Women for Arts Science and Education, Ain Shams University, 11757 Cairo, Egypt
| | - Mohammed A El-Magd
- Department of Anatomy, Faculty of Veterinary Medicine, Kafrelsheikh University, Kafrelsheikh 33516, Egypt.
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Prabakar AD. The Power of Thought: The Role of Psychological Attentiveness and Emotional Support in Patient Trajectories. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2024; 97:335-347. [PMID: 39351320 PMCID: PMC11426302 DOI: 10.59249/cptg1770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/04/2024]
Abstract
In modern healthcare, the influence of a patient's mindset on health outcomes is an often neglected yet vital component of holistic care. This review explores the significant impact of positive and negative mindsets on disease progression and recovery, emphasizing the need to integrate mental wellness practices into conventional medical care. Drawing from a wide array of studies, it demonstrates how fostering a positive mindset can enhance patient trajectories across various medical specialties. The article advocates for training healthcare providers to adopt a more empathetic and patient-centered approach, bridging the gap between mind and body. By presenting compelling evidence on the correlation between patient mindset and health outcomes, this review highlights the potential benefits of incorporating psychological support and holistic strategies into standard care protocols. Practical strategies for implementing mindset-focused interventions are also proposed, including training programs for healthcare professionals and the development of interdisciplinary treatment plans. Ultimately, this article underscores the need for a paradigm shift in medical practice, advocating for a comprehensive approach that recognizes the power of thought in promoting patient wellness.
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Guerra-Paiva S, Mira JJ, Strametz R, Fernandes J, Klemm V, Madarasova Geckova A, Knezevic B, Potura E, Buttigieg S, Carrillo I, Sousa P. Application and Evaluation of a Multimodal Training on the Second Victim Phenomenon at the European Researchers' Network Working on Second Victims Training School: Mixed Methods Study. JMIR Form Res 2024; 8:e58727. [PMID: 39213524 PMCID: PMC11418314 DOI: 10.2196/58727] [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: 03/23/2024] [Revised: 05/14/2024] [Accepted: 06/24/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Health care workers (HCWs) are often impacted by distressing situations during patient care and can experience the second victim phenomenon (SVP). Addressing an adequate response, training, and increasing awareness of the SVP can increase HCWs' well-being and ultimately improve the quality of care and patient safety. OBJECTIVE This study aims to describe and evaluate a multimodal training organized by the European Researchers' Network Working on Second Victims to increase knowledge and overall awareness of SVP and second victim programs. METHODS We implemented a multimodal training program, following an iterative approach based on a continuous quality improvement process, to enhance the methodology and materials of the training program over the duration of 2 years. We conducted web-based surveys and group interviews to evaluate the scope and design of the training, self-directed learning materials, and face-to-face activities. RESULTS Out of 42 accepted candidates, 38 (90%) participants attended the 2 editions of the Training School program. In the second edition, the level of participants' satisfaction increased, particularly when adjusting the allocated time for the case studies' discussion (P<.001). After the multimodal training, participants stated that they had a better awareness and understanding of the SVP, support interventions, and its impact on health care. The main strengths of this Training School were the interdisciplinary approach as well as the contact with multiple cultures, the diversity of learning materials, and the commitment of the trainers and organizing team. CONCLUSIONS This multimodal training is suitable for different stakeholders of the health care community, including HCWs, clinical managers, patient safety and quality-of-care teams, academicians, researchers, and postgraduate students, regardless of their prior experience with SVP. Furthermore, this study represents a pioneering effort in elucidating the materials and methodology essential for extending this training approach to similar contexts.
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Affiliation(s)
- Sofia Guerra-Paiva
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, NOVA University Lisbon, Lisbon, Portugal
| | - José Joaquín Mira
- Alicante-Sant Joan Health District, Alicante, Spain
- Department of Health Psychology, Miguel Hernandez University, Elche, Spain
| | - Reinhard Strametz
- Wiesbaden Institute for Healthcare Economics and Patient Safety, RheinMain University of Applied Sciences, Wiesbaden, Germany
| | - Joana Fernandes
- NOVA National School of Public Health, NOVA University Lisbon, Lisbon, Portugal
| | - Victoria Klemm
- Wiesbaden Institute for Healthcare Economics and Patient Safety, RheinMain University of Applied Sciences, Wiesbaden, Germany
| | - Andrea Madarasova Geckova
- Department of Health Psychology and Research Methodology, Faculty of Medicine, University of Pavol Jozef Šafárik, Košice, Slovakia
- Institute of Applied Psychology, Faculty of Social and Economic Sciences, Comenius University, Bratislava, Slovakia
| | - Bojana Knezevic
- Department for Quality Assurance and Improvement in Health Care, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Eva Potura
- Gesundheit Österreich GmbH, Bundesinstitut für Qualität im Gesundheitswesen, Vienna, Austria
| | - Sandra Buttigieg
- Department of Health Systems Management and Leadership, Faculty of Health Sciences,University of Malta, Malta, Malta
| | - Irene Carrillo
- Department of Health Psychology, Miguel Hernandez University, Elche, Spain
| | - Paulo Sousa
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, NOVA University Lisbon, Lisbon, Portugal
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Mukhalalati B, Aly A, Yakti O, Elshami S, Daud A, Awaisu A, Sethi A, El-Awaisi A, Stewart D, Abu-Hijleh MF, Austin Z. Examining the perception of undergraduate health professional students of their learning environment, learning experience and professional identity development: a mixed-methods study. BMC MEDICAL EDUCATION 2024; 24:886. [PMID: 39152424 PMCID: PMC11330008 DOI: 10.1186/s12909-024-05875-4] [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: 07/03/2024] [Accepted: 08/08/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND The quality of the learning environment significantly impacts student engagement and professional identity formation in health professions education. Despite global recognition of its importance, research on student perceptions of learning environments across different health education programs is scarce. This study aimed to explore how health professional students perceive their learning environment and its influence on their professional identity development. METHODS An explanatory mixed-methods approach was employed. In the quantitative phase, the Dundee Ready Education Environment Measure [Minimum-Maximum possible scores = 0-200] and Macleod Clark Professional Identity Scale [Minimum-Maximum possible scores = 1-45] were administered to Qatar University-Health students (N = 908), with a minimum required sample size of 271 students. Data were analyzed using SPSS, including descriptive statistics and inferential analysis. In the qualitative phase, seven focus groups (FGs) were conducted online via Microsoft Teams. FGs were guided by a topic guide developed from the quantitative results and the framework proposed by Gruppen et al. (Acad Med 94:969-74, 2019), transcribed verbatim, and thematically analyzed using NVIVO®. RESULTS The questionnaire response rate was 57.8% (525 responses out of 908), with a usability rate of 74.3% (390 responses out of 525) after excluding students who only completed the demographic section. The study indicated a "more positive than negative" perception of the learning environment (Median [IQR] = 132 [116-174], Minimum-Maximum obtained scores = 43-185), and a "good" perception of their professional identity (Median [IQR] = 24 [22-27], Minimum-Maximum obtained scores = 3-36). Qualitative data confirmed that the learning environment was supportive in developing competence, interpersonal skills, and professional identity, though opinions on emotional support adequacy were mixed. Key attributes of an ideal learning environment included mentorship programs, a reward system, and measures to address fatigue and boredom. CONCLUSIONS The learning environment at QU-Health was effective in developing competence and interpersonal skills. Students' perceptions of their learning environment positively correlated with their professional identity. Ideal environments should include mentorship programs, a reward system, and strategies to address fatigue and boredom, emphasizing the need for ongoing improvements in learning environments to enhance student satisfaction, professional identity development, and high-quality patient care.
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Affiliation(s)
- Banan Mukhalalati
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar.
| | - Aaliah Aly
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Ola Yakti
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Sara Elshami
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Alaa Daud
- College of Dental Medicine, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Ahmed Awaisu
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Ahsan Sethi
- College of Health Sciences, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Alla El-Awaisi
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Derek Stewart
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | | | - Zubin Austin
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
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Manca LCM, Fontes ARM, Guimarães MRN, Sigahi TFAC, Saltorato P, Rodrigues DDS, Vieira MHP, Tessarini Júnior G, Kawasaki BC. Caring for those who care: key challenges and improvement opportunities for health professionals working with children with disabilities. ERGONOMICS 2024:1-14. [PMID: 39093599 DOI: 10.1080/00140139.2024.2384639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 07/20/2024] [Indexed: 08/04/2024]
Abstract
This paper investigates the challenges faced by health professionals working with children with disabilities, with the aim of identifying areas for improvement. Employing a focus group method, the study involved knowledge levelling, discussions, problematization, cause formulation, and validation. A diverse team of ten professionals participated, including physiotherapists, speech therapists, occupational therapists, psychologists, nursing technicians, and social workers. Findings reveal organisational inflexibility in appointment scheduling, lack of deadlines affecting case monitoring, and the mental strain of immediate clinical responses. Effective communication and multidisciplinary care emerge as beneficial. Proposed improvements include flexible space utilisation, enhanced room design, structured collaboration training, role clarification, parent partnerships, flexible scheduling, and continuous professional development. This study unveils unique challenges and rewards in the healthcare environment, offering insights into causative factors and practical strategies for enhancing the work of health professionals working with children with disabilities.
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Affiliation(s)
| | | | | | - Tiago F A C Sigahi
- Department of Production Engineering, Federal University of São Carlos, Sorocaba, Brazil
- School of Mechanical Engineering, State University of Campinas, Campinas, Brazil
| | - Patrícia Saltorato
- Department of Production Engineering, Federal University of São Carlos, Sorocaba, Brazil
| | | | | | - Geraldo Tessarini Júnior
- School of Economics, Business Administration, and Accounting, University of São Paulo, São Paulo, Brazil
| | - Bruno Cesar Kawasaki
- Department of Production Engineering, Polytechnic School, University of São Paulo, São Paulo, Brazil
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Pawar YB, Thool AR. Ophthalmologic Implications of Connective Tissue Diseases: A Comprehensive Review of Current Knowledge and Innovations. Cureus 2024; 16:e67078. [PMID: 39286691 PMCID: PMC11405085 DOI: 10.7759/cureus.67078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Accepted: 08/17/2024] [Indexed: 09/19/2024] Open
Abstract
Connective tissue diseases (CTDs), including rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), Sjögren's syndrome, and systemic sclerosis (SSc), represent a diverse group of disorders characterized by abnormalities in the proteins that support tissues and organs. These diseases can affect multiple organ systems and are often associated with significant morbidity and mortality. The eyes are frequently affected among the various organ systems involved, with ocular manifestations ranging from benign conditions such as dry eye syndrome to severe, sight-threatening complications like scleritis, retinal vasculitis, and optic neuritis. Recognizing and managing these ophthalmologic implications is crucial for preventing severe complications, providing diagnostic clues, and improving patients' quality of life. This comprehensive review aims to elucidate the current knowledge and innovations related to the ophthalmologic implications of CTDs. It details the ocular manifestations associated with major CTDs, explores diagnostic approaches to identifying and differentiating these conditions, and discusses management strategies, including pharmacological and surgical interventions. Additionally, the review highlights recent advancements and emerging therapies in diagnosing and treating CTD-related ophthalmologic conditions. The review also addresses this field's challenges and future directions, emphasizing the importance of interdisciplinary collaboration and continuous research. By synthesizing the latest research and clinical insights, this review seeks to enhance the understanding of healthcare professionals regarding the interplay between CTDs and ocular health, ultimately contributing to improved patient care and outcomes.
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Affiliation(s)
- Yuga B Pawar
- Department of Ophthalmology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Archana R Thool
- Department of Ophthalmology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Gruescu ACS, Popoiu C, Levai MC, Barata PI, Streian CG. Evaluating Family Coping Mechanisms in Pediatric Seizure Disorders: From Emergency Room to Long-Term Follow-Up. Pediatr Rep 2024; 16:657-668. [PMID: 39189289 PMCID: PMC11348255 DOI: 10.3390/pediatric16030055] [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: 06/06/2024] [Revised: 07/21/2024] [Accepted: 07/29/2024] [Indexed: 08/28/2024] Open
Abstract
Pediatric seizure disorders profoundly impact family dynamics, often escalating stress and impairing coping mechanisms. This study aimed to longitudinally assess the impact of pediatric seizures on family stress and coping, evaluating the efficacy of multidisciplinary follow-up care in enhancing psychological resilience and adaptation. A longitudinal study design was implemented, enrolling children aged 1-18 who presented with a first seizure and received a neurologist's diagnosis at the Emergency Clinical Hospital for Children "Louis Turcanu," Timisoara, Romania. Validated questionnaires, including the Parenting Stress Index (PSI), Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale (PSS-10), and Parental Concerns Questionnaire (PCQ), were employed at baseline, 6, and 12 months. Statistical analysis utilized ANOVA and t-tests to evaluate changes in stress and coping outcomes. The study involved 68 families, with significant reductions in stress and anxiety reported over the follow-up period. Initial PSI scores showed high stress levels across various domains: Emotional Stress (59.47) decreased to 50.63 at one year; Parent-Child Communication Difficulties started at 66.03 ± 20.15 and reduced to 56.92 ± 18.74; and Total Family Stress decreased from 65.55 to 55.97. The HADS scores indicated initial anxiety and depression at 8.2 ± 3.1 and 7.1 ± 2.8, respectively, with reductions to 6.8 and 5.9 by the end of the year. The overall HADS score showed a decrease from 15.4 to 12.8. PCQ results mirrored these findings, with Total Score dropping from 9.7 to 7.7. PSS-10 scores declined from 13.5 to 11.3, with a significant reduction in the positive sub-score. The proactive, multidisciplinary care approach significantly reduced stress and enhanced coping mechanisms in families dealing with pediatric seizures. The decreases in stress, anxiety, and depression scores highlight the potential for integrated care models to improve long-term outcomes in these families. These findings support the continued development of targeted interventions to aid in the management of chronic pediatric conditions.
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Affiliation(s)
- Ada Claudia Silvana Gruescu
- Department of Pediatrics, Victor Babes University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (A.C.S.G.); (C.P.)
- Doctoral School, Victor Babes University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
| | - Calin Popoiu
- Department of Pediatrics, Victor Babes University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (A.C.S.G.); (C.P.)
| | - Mihaela Codrina Levai
- Research Center for Medical Communication, Victor Babes University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania;
| | - Paula Irina Barata
- Center for Research and Innovation in Precision Medicine of Respiratory Diseases, University of Medicine and Pharmacy Victor Babes Timisoara, 300041 Timisoara, Romania
- Department of Physiology, Faculty of Medicine, “Vasile Goldis” Western University of Arad, 310025 Arad, Romania
| | - Caius Glad Streian
- Department of Cardiac Surgery, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu sq, 300041 Timisoara, Romania;
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Gillman A, Hayes M, Walsh I, Walshe M, Reynolds JV, Regan J. Long-term impact of aerodigestive symptoms on adults with oesophageal cancer: A qualitative study. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024:1-12. [PMID: 39028205 DOI: 10.1080/17549507.2024.2360065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2024]
Abstract
PURPOSE The impact of long-term aerodigestive symptoms following oesophageal cancer surgery is still not well understood. This study aimed to qualitatively understand the long-term impact of aerodigestive symptoms on quality of life in adults post-oesophagectomy. METHOD Participants who received curative transhiatal/transthoracic surgery for oesophageal cancer in Ireland's National Oesophageal Cancer Centre were invited to attend semi-structured interviews. Surgery had to be completed at least 12 months prior. Reflexive thematic analysis was conducted. RESULT Forty participants were interviewed individually face-to-face. Four key themes were identified: (a) isolation, reflecting the reported solitude experienced by oesophageal cancer survivors when attempting to manage their ongoing aerodigestive symptoms; (b) fear, including fear of choking and fear that dysphagia symptoms may indicate recurrence of oesophageal cancer; (c) altered work capacity, caused by ongoing aerodigestive symptoms; and (d) avoidance of social situations involving food, due to the pain, discomfort, and embarrassment caused by these symptoms. CONCLUSION Oesophageal cancer treatment can be lifesaving, however, such medical interventions can result in distressing physiological aerodigestive symptoms throughout survivorship, which can significantly impact quality of life. Our findings indicate a need for greater community support to manage aerodigestive symptoms and reduce the impact these have on quality of life.
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Affiliation(s)
- Anna Gillman
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin 2, Ireland
| | - Michelle Hayes
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin 2, Ireland
| | - Irene Walsh
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin 2, Ireland
| | - Margaret Walshe
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin 2, Ireland
| | - John V Reynolds
- Department of Surgery, St James' Hospital, Dublin 8, Ireland
- Department of Surgery, Trinity Translational Medicine Institute, Trinity College Dublin, Dublin 2, Ireland
| | - Julie Regan
- Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin 2, Ireland
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12
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Rachakonda VS, Addanki S, Nasef H, Rajput V. Comparing and Contrasting Professional Identity Formation Among Health Professional Students. Cureus 2024; 16:e65577. [PMID: 39192941 PMCID: PMC11349241 DOI: 10.7759/cureus.65577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2024] [Accepted: 07/27/2024] [Indexed: 08/29/2024] Open
Abstract
This project aims to review and compare the professional identity formation (PIF) of medical, dental, nursing, and pharmacy students while analyzing the role of interprofessional education (IPE) in this journey. Our medical research librarian conducted a literature review. Papers were selected based on the inclusion criteria developed by authors for PIF and IPE topics, which were then stratified for each health program of interest: medicine, dentistry, nursing, and pharmacy. The IPE core competencies were analyzed to understand the effect of IPE on each respective group of health professional students. Among all four major health professions, trust, collaboration, responsibility, accountability, communication, and empathy are key values within PIF. Trust, collaboration, and empathy were also regarded as core values in developing professionalism. Medical and dental students placed greater emphasis on responsibility and accountability regarding PIF. IPE played a crucial role in PIF for all students as values, teamwork, roles, and responsibilities were emphasized among each healthcare discipline of interest. This review provides significant information regarding which characteristics are emphasized for professional development across healthcare training programs. Future research to explore how certain characteristics and values influence healthcare as a whole is crucial. Investigating various influences on PIF outcomes is warranted for enhancing professional training programs and promoting interprofessional collaboration for better healthcare delivery.
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Affiliation(s)
- Varun S Rachakonda
- Medical Education, Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, USA
| | - Sunaina Addanki
- Medical Education, Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, USA
| | - Hazem Nasef
- Medical Education, Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, USA
| | - Vijay Rajput
- Medical Education, Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, USA
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13
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Wong B, Ismail Z, Watt J, Holroyd-Leduc J, Goodarzi Z. Barriers and facilitators to care for agitation and/or aggression among persons living with dementia in long-term care. BMC Geriatr 2024; 24:330. [PMID: 38600482 PMCID: PMC11008022 DOI: 10.1186/s12877-024-04919-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/25/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Agitation and/or aggression affect up to 60% of persons living with dementia in long-term care (LTC). It can be treated via non-pharmacological and pharmacological interventions, but the former are underused in clinical practice. In the literature, there is currently a lack of understanding of the challenges to caring for agitation and/or aggression among persons living with dementia in LTC. This study assesses what barriers and facilitators across the spectrum of care exist for agitation and/or aggression among people with dementia in LTC across stakeholder groups. METHODS This was a qualitative study that used semi-structured interviews among persons involved in the care and/or planning of care for people with dementia in LTC. Participants were recruited via purposive and snowball sampling, with the assistance of four owner-operator models. Interviews were guided by the Theoretical Domains Framework and transcribed and analyzed using Framework Analysis. RESULTS Eighteen interviews were conducted across 5 stakeholder groups. Key identified barriers were a lack of agitation and/or aggression diagnostic measures, limited training for managing agitation and/or aggression in LTC, an overuse of physical and chemical restraints, and an underuse of non-pharmacological interventions. Facilitators included using an interdisciplinary team to deliver care and having competent and trained healthcare providers to administer non-pharmacological interventions. CONCLUSIONS This study advances care for persons living with dementia in LTC by drawing attention to unique and systemic barriers present across local and national Canadian LTC facilities. Findings will support future implementation research endeavours to eliminate these identified barriers across the spectrum of care, thus improving care outcomes among people with dementia in LTC.
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Affiliation(s)
- Britney Wong
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Zahinoor Ismail
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Jennifer Watt
- Division of Geriatric Medicine, University of Toronto, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jayna Holroyd-Leduc
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Department of Medicine, University of Calgary and Alberta Health Services, Calgary, AB, Canada
| | - Zahra Goodarzi
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada.
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.
- Department of Medicine, University of Calgary and Alberta Health Services, Calgary, AB, Canada.
- O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada.
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14
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Qian L, Yan S, Ting ST, Han ZM, Qi T. Complications and psychological impact of pressure ulcers on patients and caregivers. Int Wound J 2024; 21:e14836. [PMID: 38531386 DOI: 10.1111/iwj.14836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 02/18/2024] [Accepted: 03/01/2024] [Indexed: 03/28/2024] Open
Abstract
Pressure ulcers are persistent skin lesions that have substantial detrimental effects on the physical well-being of patients. Moreover, their psychological ramifications for both patients and their caregivers are becoming more widely acknowledged. This research was conducted to examine the psychological ramifications of pressure ulcers and ascertain efficacious approaches to mitigate these effects and improve overall well-being. A cross-sectional study was conducted from March 2022 to December 2023 across tertiary care centres located in Beijing. The cohort consisted of 431 participants, which included primary caregivers and patients who were diagnosed with pressure ulcers. The data were gathered through the utilization of structured questionnaires and semi-structured interviews. These methods encompassed demographic details, clinical characteristics and validated scales that assessed psychological parameters, including quality of life, anxiety, stress and depression. The research exposed substantial psychological toll on both individuals receiving care and those providing care, with caregivers enduring diminished quality of life and elevated levels of anxiety, depression and stress (p < 0.05). A significant positive correlation was identified between the degree of psychological distress and severity of pressure ulcers (p < 0.05). Both location of the ulcer and duration of care were substantial contributors to the psychological burden (p < 0.05). In spite of the apparent necessity, a significant proportion of the participants refrained from obtaining psychological counselling. The results underscored the significant psychological ramifications of pressure ulcers for both individuals receiving care and the caregivers. As a result, comprehensive care strategies that incorporate psychological assistance into the prescribed treatment plan are imperative. This research highlighted the criticality of implementing all-encompassing, interdisciplinary approaches to tackle the complex issues presented by pressure ulcers in an effort to enhance the general welfare of those influences.
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Affiliation(s)
- Li Qian
- Geriatric Nurseing, Beijing Shijingshan Hospital, Shijingshan, China
| | - Song Yan
- Geriatric Nurseing, Beijing Shijingshan Hospital, Shijingshan, China
| | - Shen Ting Ting
- Geriatric Nurseing, Beijing Shijingshan Hospital, Shijingshan, China
| | - Zhang Meng Han
- Geriatric Nurseing, Beijing Shijingshan Hospital, Shijingshan, China
| | - Tian Qi
- Nursing, Chinese PLA General Hospital, Beijing, China
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15
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Saragih ID, Suarilah I, Hsiao CT, Fann WC, Lee BO. Interdisciplinary simulation-based teaching and learning for healthcare professionals: A systematic review and meta-analysis of randomized controlled trials. Nurse Educ Pract 2024; 76:103920. [PMID: 38382335 DOI: 10.1016/j.nepr.2024.103920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 02/01/2024] [Accepted: 02/09/2024] [Indexed: 02/23/2024]
Abstract
AIM This study aimed to investigate the effects of interdisciplinary simulation-based teaching and learning on the interprofessional knowledge of healthcare professionals. BACKGROUND Interdisciplinary simulation-based teaching and learning have been employed to prepare learners to collaborate in clinical settings. This strategy could help healthcare professionals to better understand each other, develop interdisciplinary shared values and promote mutual respect between professions, while reducing errors and adverse events in hospital. A meta-analysis was performed to investigate the effects of interdisciplinary simulation-based teaching and learning on healthcare professionals. DESIGN A systematic review and meta-analysis. METHODS A systematic search was conducted of databases including Academic Search Complete, CINAHL Plus with full text, Cochrane Library, Embase, Medline Complete, PubMed and Web of Science from their inception to September 5, 2023. The study included randomized controlled trials that provided interdisciplinary simulation-based education to healthcare professionals. Protocol trials or studies that did not include median or mean and standard deviation were excluded. The pooled standardized mean differences of outcomes were analyzed using a DerSimonian-Laird random-effects model. Heterogeneity was assessed using I2. Egger's regression test was used to examine publication bias indicated in forest plots. RESULTS Ten randomized control trials with a total of 766 participants were included in the pooled analyses. Interdisciplinary simulation-based teaching and learning positively enhanced the interprofessional knowledge of healthcare professionals (pooled SMD = 0.30; 95% CI = 0.10-0.50; p < 0.001). Egger's regression test results were non-significant, indicating that publication bias had little impact on the pooled SMDs. CONCLUSION Interdisciplinary simulation-based teaching and learning for health professionals appear to be significantly beneficial for increasing their interprofessional knowledge. This strategy highlights the importance of providing a well-developed scenario with relevant properties, which applies valid and rigorous instruments, to measure behavioral changes induced by interdisciplinary simulation-based teaching and learning.
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Affiliation(s)
| | - Ira Suarilah
- Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Cheng-Ting Hsiao
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan, ROC; School of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
| | - Wen-Chih Fann
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan, ROC
| | - Bih-O Lee
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC; Center for Innovative Research on Aging Society (CIRAS), National Chung Cheng University, Taiwan, ROC.
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16
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Weismantel I, Zhang N, Burston A. Exploring intensive care nurses' perception of simulation-based learning: A systematic review and meta-synthesis. J Clin Nurs 2024; 33:1195-1208. [PMID: 38258507 DOI: 10.1111/jocn.17016] [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: 10/25/2023] [Revised: 12/13/2023] [Accepted: 01/10/2024] [Indexed: 01/24/2024]
Abstract
AIM(S) To explore intensive care nurses' (ICN) perceptions of simulation-based learning (SBL). DESIGN A systematic review and meta-synthesis. METHODS The review followed the PRISMA guidelines for reporting a systematic review. A systematic search strategy was developed using a modified PICo framework. A comprehensive search was conducted in July 2023 in CINAHL, OVID Embase, Medline complete, Web of Science, ERIC and Scopus databases for articles published in English between 2013 and 2023. Data were extracted using the Joanna Briggs Institute QARI Data Extraction, with data synthesis guided by Braun and Clark's thematic analysis approach. Quality appraisal was assessed using the CASP tool. RESULTS Eleven studies providing qualitative data were included for analysis. Analysis and meta-synthesis led to the construction of two themes: The learning experience and professional growth through collaboration. CONCLUSION The review highlights the balance needed in finding the appropriate simulation approach, with the right level of fidelity, conducted at appropriately regular intervals, incorporating the correct makeup of professional team members, conducted in the right environment and facilitated by a skilled facilitator, to ensure best outcomes and return on investment for ICN's education. IMPLICATIONS FOR PRACTICE These findings are a valuable resource for educators and organisations considering simulation-based learning initiatives in the intensive care setting. NO PATIENT OR PUBLIC CONTRIBUTION This review involved analysis of existing literature and as such no unique patient or public involvement occurred. REPORTING METHOD The systematic review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) reporting guidelines.
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Affiliation(s)
- Isabella Weismantel
- School of Nursing, Midwifery and Paramedicine (Melbourne), Faculty of Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia
| | - Nancy Zhang
- School of Nursing, Midwifery and Paramedicine (Melbourne), Faculty of Health Sciences, Australian Catholic University, Fitzroy, Victoria, Australia
| | - Adam Burston
- Nursing Research and Practice Development Centre, The Prince Charles Hospital, Chermside, Queensland, Australia
- School of Nursing, Midwifery and Paramedicine (Brisbane), Faculty of Health Sciences, Australian Catholic University, Brisbane, Queensland, Australia
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17
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Aydogdu ALF. Interpersonal relationships of the nursing team in the work environment according to nursing students: A qualitative study. Nurse Educ Pract 2024; 74:103861. [PMID: 38070419 DOI: 10.1016/j.nepr.2023.103861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/27/2023] [Accepted: 11/24/2023] [Indexed: 01/17/2024]
Abstract
AIM To explore the perceptions of nursing students from Brazilian universities about the interpersonal relationship of the nursing team in the work environment. BACKGROUND Healthcare institutions are complex entities where diverse professionals from different educational backgrounds work together to provide high-quality care to the population. The effective coordination of services within these institutions is closely linked to the interpersonal relationships among these different healthcare professionals. Nurses play a crucial role as members of the multidisciplinary healthcare team, acting as fundamental links between other professionals and patients. DESIGN This is a descriptive study with a qualitative approach. METHODS An online, open-ended questionnaire was used. A total of 30 nursing students participated in the study. RESULTS Data were organized in two themes: (1) Interpersonal relationships of the nursing team and (2) Improving interpersonal relationships of the nursing team. Also, eight sub-themes were identified: Conflict dynamics within the nursing team, Hierarchical issues, Lack of communication, Impact of workplace interpersonal relationships on nursing students, Valuing the profession, Understanding role boundaries, Training in effective communication and conflict management, and Curricular reform. CONCLUSIONS Blurred boundaries between professional roles, lack of respect, ineffective communication, hierarchical issues, and conflicts, were identified. Of particular concern was the limited interaction observed between the nursing team and multidisciplinary/support teams. Inadequate interpersonal relationships between members of the health team reflect negatively on nursing students during their clinical placements. These findings underscore the urgent need for interventions aimed at improving interpersonal relationships within nursing teams.
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Affiliation(s)
- Ana Luiza Ferreira Aydogdu
- Istanbul Health and Technology University, Faculty of Health Sciences, Department of Nursing, Sütlüce Mah., İmrahor Cd. No: 82, Beyoglu, Istanbul 34275, Turkey.
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18
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Daniels CJ, Cupler ZA, Napuli JG, Walsh RW, Ziegler AML, Meyer KW, Knieper MJ, Walters SA, Salsbury SA, Trager RJ, Gliedt JA, Young MD, Anderson KR, Kirk EJ, Mooring SA, Battaglia PJ, Paris DJ, Brown AG, Goehl JM, Hawk C. Development of Preliminary Integrated Health Care Clinical Competencies for United States Doctor of Chiropractic Programs: A Modified Delphi Consensus Process. GLOBAL ADVANCES IN INTEGRATIVE MEDICINE AND HEALTH 2024; 13:27536130241275944. [PMID: 39157778 PMCID: PMC11329915 DOI: 10.1177/27536130241275944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 07/23/2024] [Accepted: 07/29/2024] [Indexed: 08/20/2024]
Abstract
Background There has been rapid growth of chiropractors pursuing career opportunities in both public and private hospitals and other integrated care settings. Chiropractors that prosper in integrated care settings deliver patient-centered care, focus on the institutional mission, understand and adhere to organizational rules, and are proficient in navigating complex systems. The Council on Chiropractic Education Accreditation Standards do not outline specific meta-competencies for integrated care clinical training. Objective The purpose of this study was to develop preliminary integrated health care competencies for DC programs to guide the advancement of clinical chiropractic education. Methods A systematic literature search was performed. Articles were screened for eligibility and extracted in duplicate. Domains and seed statements were generated from this literature, piloted at a conference workshop, and evaluated via a modified Delphi consensus process. Of 42 invited, 36 chiropractors participated as panelists. Public comment period yielded 20 comments, none resulting in substantive changes to the competencies. Results Of 1718 citations, 23 articles met eligibility criteria. After 2 modified Delphi rounds, consensus was reached on all competency statements. A total of 78 competency statements were agreed upon, which encompassed 4 domains and 11 subdomains. The 4 domains were: 1) Collaboration, (2) Clinical Excellence, (3) Communication, and (4) Systems Administration. Conclusion We identified 78 preliminary competencies appropriate for preparing DC students and early career chiropractors for clinical practice in integrated healthcare settings. Educational programs may consider these competencies for curricular design and reform to strengthen DC program graduates for integrated practice, advanced training, and employment.
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Affiliation(s)
- Clinton J Daniels
- Rehabilitation Care Services, VA Puget Sound Health Care System, Tacoma, WA, USA
- Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Zachary A Cupler
- Physical Medicine and Rehabilitation Services, Butler VA Health Care, Butler PA, USA
- Institute of Clinical Research Education, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jason G Napuli
- Primary Care Services-Whole Health, VA St. Louis Health Care System, St. Louis, MO, USA
- College of Chiropractic, Logan University, Chesterfield, MO, USA
| | - Robert W Walsh
- Integrated Primary Care Service, VA Palo Alto Health Care System, Palo Alto, CA, USA
- Palmer College of Chiropractic, Palmer West College of Chiropractic, San Jose, CA, USA
| | - Anna-Marie L Ziegler
- Primary Care Services-Whole Health, VA St. Louis Health Care System, St. Louis, MO, USA
- College of Chiropractic, Logan University, Chesterfield, MO, USA
| | - Kevin W Meyer
- Rehabilitation Care Services, VA Puget Sound Health Care System, Tacoma, WA, USA
| | - Matthew J Knieper
- Primary Care Services-Whole Health, VA St. Louis Health Care System, St. Louis, MO, USA
- College of Chiropractic, Logan University, Chesterfield, MO, USA
| | | | - Stacie A Salsbury
- Palmer Center for Chiropractic Research, Palmer College of Chiropractic, Davenport, IA, USA
| | - Robert J Trager
- Connor Whole Health, University Hospitals, Cleveland, OH, USA
- Department of Family Medicine & Community Health, Case Western Reserve University, Cleveland, OH, USA
| | - Jordan A Gliedt
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Morgan D Young
- Washington State Department of Labor and Industries, Olympia, WA, USA
| | | | - Eric J Kirk
- Aurora Health Care, Milwaukee, WI, USA
- Southern California University of Health Sciences, Whittier, CA, USA
| | - Scott A Mooring
- Northwestern University Health Sciences, Bloomington, MN, USA
- Athletic Medicine Department, University of Minnesota, Minneapolis, MN, USA
| | - Patrick J Battaglia
- Community-Based Clinical Education, University of Western States, Portland, OR, USA
| | - David J Paris
- Physical Medicine and Rehabilitation, VA Northern California Health Care, Redding, CA, USA
- Mercy Medical Center Mt. Shasta, Mount Shasta, CA, USA
| | - Amanda G Brown
- Center for Integrative Medicine, Henry Ford Health, Detroit, MI, USA
| | - Justin M Goehl
- Family Medicine, Dartmouth Health, Dartmouth, Lebanon, NH, USA
- Community and Family Medicine, Geisel School of Medicine, Dartmouth, Lebanon, NH, USA
| | - Cheryl Hawk
- Texas Chiropractic College, Pasadena, TX, USA
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Rehman A, Choudhari J, Shehryar A, Affaf M, Ata H, Batool W, Khan B, Mehra I, Gasim RW, Masood QF, Anika NN, Rehman S. Harmonizing Medicine and Surgery in the Pursuit of Boolean Remission: A Rheumatological Magnum Opus. Cureus 2023; 15:e48205. [PMID: 38054151 PMCID: PMC10694394 DOI: 10.7759/cureus.48205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2023] [Indexed: 12/07/2023] Open
Abstract
Rheumatic diseases encompass a diverse group of musculoskeletal conditions that often lead to inflammation, pain, and significant limitations in patients' lives. While traditional treatment approaches have primarily centered on medications to control symptoms, recent developments have introduced the concept of Boolean remission. Boolean remission offers a comprehensive evaluation of disease activity by considering clinical, biochemical, and patient-reported outcomes. This narrative review explores the multifaceted landscape of Boolean remission in the context of rheumatic diseases, with a focus on rheumatoid arthritis (RA), as it remains a substantial clinical challenge. The review outlines the definition, criteria, historical context, and development of Boolean remission, shedding light on its emergence as a more patient-centered and stringent treatment goal. The role of pharmacological interventions, including immunomodulators and biologics, in achieving Boolean remission is discussed, emphasizing the significance of treatment protocols that encompass regular monitoring, medication adjustment, shared decision-making, and patient education. Surgical interventions, such as joint replacements and synovectomies, complement medication-based strategies when joint damage becomes severe, with adherence to surgical protocols ensuring sustained Boolean remission. The integration of medicine and surgery through integrated care models and interdisciplinary teams is examined as a critical aspect of optimizing patient outcomes. Boolean remission's broader impact on healthcare policies and clinical trial endpoints is explored, underscoring its growing significance in rheumatic disease management. The review concludes by looking toward the future, where emerging technologies, biomarkers, and personalized medicine approaches hold promise in refining Boolean remission criteria and making it a more attainable and impactful treatment goal. Policy implications suggest the integration of Boolean remission into healthcare quality metrics, incentivizing healthcare providers to prioritize this rigorous standard of care. Boolean remission represents a pivotal shift in the holistic and patient-centered management of rheumatic diseases, offering hope for improved patient outcomes and enhanced quality of life in this challenging clinical landscape.
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Affiliation(s)
| | - Jinal Choudhari
- Division of Research & Academic Affairs, Larkin Community Hospital, Miami, USA
| | | | - Maryam Affaf
- Internal Medicine, Women's Medical & Dental College, Abbotabad, PAK
| | - Hareem Ata
- Internal Medicine, National University of Science and Technology, Rawalpindi, PAK
| | - Wajiha Batool
- Internal Medicine, Army Medical College, Rawalpindi, PAK
| | - Bilal Khan
- General Surgery, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Iti Mehra
- Internal Medicine, Emilio Aguinaldo College, Manila, PHL
| | - Rayan W Gasim
- Internal Medicine, University of Khartoum, Khartoum, SDN
| | | | - Nabila N Anika
- Surgery, Holy Family Red Crescent Medical College and Hospital, Dhaka, BGD
| | - Shehryar Rehman
- Internal Medicine, Al-Assad University Hospital, Damascus, SYR
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Javvaji CK, Vagha JD, Meshram RJ, Taksande A. Assessment Scales in Cerebral Palsy: A Comprehensive Review of Tools and Applications. Cureus 2023; 15:e47939. [PMID: 38034189 PMCID: PMC10685081 DOI: 10.7759/cureus.47939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 10/28/2023] [Indexed: 12/02/2023] Open
Abstract
Cerebral palsy (CP) is a complex neurological condition characterized by motor dysfunction affecting millions worldwide. This comprehensive review delves into the critical role of assessment in managing CP. Beginning with exploring its definition and background, we elucidate the diverse objectives of CP assessment, ranging from diagnosis and goal setting to research and epidemiology. We examine standard assessment scales and tools, discuss the challenges inherent in CP assessment, and highlight emerging trends, including integrating technology, personalized medicine, and neuroimaging. The applications of CP assessment in clinical diagnosis, treatment planning, research, and education are underscored. Recommendations for the future encompass standardization, interdisciplinary collaboration, research priorities, and professional training. In conclusion, we emphasize the importance of assessment as a compass guiding the care of individuals with CP, issuing a call to action for improved assessment practices to shape a brighter future for those affected by this condition.
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Affiliation(s)
- Chaitanya Kumar Javvaji
- Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Jayant D Vagha
- Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Revat J Meshram
- Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Amar Taksande
- Pediatrics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Bhati D, Deogade MS, Kanyal D. Improving Patient Outcomes Through Effective Hospital Administration: A Comprehensive Review. Cureus 2023; 15:e47731. [PMID: 38021686 PMCID: PMC10676194 DOI: 10.7759/cureus.47731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 10/26/2023] [Indexed: 12/01/2023] Open
Abstract
This comprehensive review delves into the critical role of effective hospital administration in shaping patient outcomes within the healthcare ecosystem. Exploration of key components, strategies, measurement methodologies, and future trends elucidates the multifaceted nature of hospital administration. Key findings underscore the profound impact of administrative decisions and practices on patient safety, satisfaction, and overall well-being. The review highlights the importance of patient-centred care and interdisciplinary collaboration for enhancing patient outcomes. It emphasises the significance of data-driven measurement and benchmarking, which are instrumental in assessing hospital performance and fostering continuous improvement. Looking ahead, emerging technologies, evolving healthcare policies, and persistent challenges are drivers of change in healthcare administration. However, amidst these transformations, the overarching message remains consistent: effective hospital administration is integral to improving patient outcomes. The conclusion calls for a collective commitment from healthcare leaders and policymakers to prioritise the development of capable administrators, invest in technology, promote value-based care, and address healthcare disparities. This collaborative effort ensures that the pursuit of better patient outcomes remains at the forefront of healthcare administration, ultimately shaping the future of healthcare for generations to come.
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Affiliation(s)
- Deepak Bhati
- Hospital Administration, School of Allied Health Sciences, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
| | - Meena S Deogade
- Ayurveda Pharmacology, All India Institute of Ayurveda, New Delhi, IND
| | - Deepika Kanyal
- Hospital Administration, School of Allied Health Sciences, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education & Research, Wardha, IND
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