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Bajunaid RM, Saeed A, Bostaji M, Farsi NJ. Hand hygiene compliance and improvement interventions in the Eastern Mediterranean Region: a systematic review and meta-analysis. Infect Prev Pract 2024; 6:100363. [PMID: 38601128 PMCID: PMC11004405 DOI: 10.1016/j.infpip.2024.100363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 02/06/2024] [Indexed: 04/12/2024] Open
Abstract
Hand hygiene compliance among healthcare workers is crucial for preventing infections in healthcare settings. This systematic review and meta-analysis aimed to assess the compliance of healthcare workers in the Eastern Mediterranean region with hand hygiene guidelines and synthesize evidence on the success rate of strategies to improve hand hygiene. Five electronic databases (PubMed, CINAHL, Cochrane, Web of Science, and Scopus) were searched up to August 2020. Articles were included if they were conducted in the Eastern Mediterranean Region. A manual search was conducted for reference lists of included papers, and relevant additional references were reviewed. Two reviewers independently screened articles for inclusion, performed data extraction, and assessed quality. A meta-analysis was conducted to synthesize findings and determine the prevalence of hand hygiene compliance interventions. The search yielded 6678 articles. After removing duplicates and applying inclusion/exclusion criteria, 42 articles were included, of which 24 were meta-analyzed. The meta-analysis showed a compliance prevalence of 32% with significant heterogeneity (I2= 99.7% p <0.001). Interventions using the World Health Organization (WHO) guidelines were over two times more likely to improve compliance rates (OR= 2.26, [95% CI:(2.09 - 2.44)], I2= 95%, p<0.001) compared to no intervention. Other interventions were close to two times more likely to improve compliance rates (OR= 1.84, [95% CI:(1.66 - 2.04)], I2= 98% p= 0.001). Approximately two-thirds of healthcare providers in the Eastern Mediterranean region were non-compliant with standard hand hygiene practices, highlighting the need for increased efforts, awareness, observation, and control policies.
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Affiliation(s)
- Rbab M. Bajunaid
- Faculty of Medicine, King Abdulaziz University, P.O.Box 80213, Jeddah 22252, Saudi Arabia
| | | | - Muataz Bostaji
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Nada J. Farsi
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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Papoutsis D, Klazoglou P, Valasoulis G, Tzavara C. The improvement and retention of skills in shoulder dystocia management with the use of high-fidelity simulation: The SAFE (SimulAtion high-FidElity) study. Women Birth 2024; 37:101590. [PMID: 38368201 DOI: 10.1016/j.wombi.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 01/20/2024] [Accepted: 02/12/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND Shoulder dystocia is a relatively uncommon but serious childbirth-related emergency. AIM To explore the improvement and retention of skills in shoulder dystocia management through high-fidelity simulation training. METHODS The SAFE (SimulAtion high-FidElity) study was a prospective cohort study that utilised a high-fidelity birth simulator. Registered midwives and final year midwifery students were invited to participate in a one-day workshop at 6-monthly intervals. There was a 30-minute initial assessment, a 30-minute theoretical and hands-on training, and a 30-minute post-training assessment on shoulder dystocia management. Pre-training and post-training values for the predetermined outcomes were compared. In each workshop we assessed the proportion of successful simulated births, the performance of manoeuvres to manage shoulder dystocia, the head-to-body birth time, the fetal head traction force, the quality of communication, the perception of time-to-birth, and the self-reported confidence levels. FINDINGS The baseline workshop recruited 101 participants that demonstrated a significant increase in the proportion of successful simulated births (8.9% vs 93.1%), and a two-fold to three-fold increase in the score of manoeuvres, communication, and confidence after training. Those with low pre-training levels of competency and confidence improved the most post-training at baseline. There was a retention of manoeuvres, communication skills and confidence at 6 months. There was no reduction in fetal head traction force over time. Those being proficient before initial training retained and performed best at the 6-month follow-up. CONCLUSION The SAFE study found a significant improvement in skills and confidence after the initial high-fidelity simulation training that were retained after 6 months.
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Affiliation(s)
- Dimitrios Papoutsis
- Department of Midwifery, School of Health Sciences, University of Western Macedonia, Kozani 50200, Greece; Department of Obstetrics and Gynaecology, Shrewsbury and Telford Hospitals NHS Trust, Apley Castle, Grainger Drive, Telford TF16TF, United Kingdom.
| | - Paraskevi Klazoglou
- Department of Midwifery, School of Health Sciences, University of Western Macedonia, Kozani 50200, Greece
| | - George Valasoulis
- Department of Midwifery, School of Health Sciences, University of Western Macedonia, Kozani 50200, Greece; Department of Obstetrics and Gynaecology, Medical School, University of Thessaly, Larissa 41500, Greece
| | - Chara Tzavara
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens 115 27, Greece
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He K, Liu Y, Tian L, He W, Cheng Q. Review in anaerobic digestion of food waste. Heliyon 2024; 10:e28200. [PMID: 38560199 PMCID: PMC10979283 DOI: 10.1016/j.heliyon.2024.e28200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 02/27/2024] [Accepted: 03/13/2024] [Indexed: 04/04/2024] Open
Abstract
Due to the special property of food waste (FW), anaerobic digestion of food waste is facing many challenges like foaming, acidification, ammonia nitrogen and (NH4+-N) inhibition which resulted in a low biogas yield. A better understanding on the problems exiting in the FW anaerobic digestion would enhance the bio-energy recovery and increase the stable operation. Meanwhile, to overcome the bottle necks, pretreatment, co-digestion and additives is proposed as well as the solutions to improve biogas yield in FW digestion system. At last, future research directions regarding FW anaerobic digestion were proposed.
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Affiliation(s)
- Kefang He
- School of Management, Wuhan Polytechnic University, China
| | - Ying Liu
- School of Chemical and Environmental Engineering, Wuhan Polytechnic University, China
| | - Longjin Tian
- School of Chemical and Environmental Engineering, Wuhan Polytechnic University, China
| | - Wanyou He
- School of Management, Wuhan Polytechnic University, China
| | - Qunpeng Cheng
- School of Chemical and Environmental Engineering, Wuhan Polytechnic University, China
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Sharma S, Nehra A, Pandey S, Tripathi M, Srivastava A, Padma MV, Garg A, Pandey RM, Chandra S, Tripathi M. Neuropsychological Rehabilitation for Epilepsy in India: Looking Beyond the Basics. Epilepsy Behav 2024; 153:109703. [PMID: 38452517 DOI: 10.1016/j.yebeh.2024.109703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 02/11/2024] [Accepted: 02/15/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Neuropsychological Rehabilitation (NR) helps manage cognitive deficits in epilepsy. As internationally developed programs have limited applicability to resource-limited countries, we developed a program to bridge this gap. This 6-week caregiver-assisted, culturally suitable program has components of (1) psychoeducation, (2) compensatory training, and, (3) cognitive retraining and is called EMPOWER (Indigenized Home Based Attention and Memory Rehabilitation Program for Adult Patients with Drug Refractory Epilepsy). Its efficacy needs to be determined. METHODS We carried out an open-label parallel randomized controlled trial. Adults aged 18-45 years with Drug Refractory Epilepsy (DRE), fluency in Hindi and or English, with impaired attention or memory (n = 28) were randomized to Intervention Group (IG) and Control Group (CG). The primary outcomes were objective memory (Auditory Verbal Learning Test), patient and caregiver reported everyday memory difficulties (Everyday Memory Questionnaire-Revised), number of memory aids in use, depression (Hamilton Depression Rating Scale), anxiety (Hamilton Anxiety Rating Scale) and quality of life (Quality of Life in Epilepsy-31). Intention to treat was carried out for group analysis. In the absence of norms necessary for computing Reliable Change Indices (RCIs), a cut-off of +1.0 Standard Deviation (SD) was utilized to identify clinically meaningful changes in the individual analysis of objective memory. A cut-off of 11.8 points was used for quality of life. Feedback and program evaluation responses were noted. RESULTS The majority of the sample comprised DRE patients with temporal lobe epilepsy who had undergone epilepsy surgery. Group analysis indicated improved learning (p = 0.013), immediate recall (p = 0.001), delayed recall (p < 0.001), long-term retention (p = 0.031), patient-reported everyday memory (p < 0.001), caregiver-reported everyday memory (p < 0.001), anxiety (p = 0.039) and total quality of life (p < 0.001). Individual analysis showed improvement in 50 %, 64 %, 71 %, 57 %, and 64 % of patients on learning, immediate recall, delayed recall, long-term retention, and total quality of life respectively. Despite improvements, themes indicative of a lack of awareness and understanding of cognitive deficits were identified. Overall, the program was rated favorably by patients and caregivers alike. CONCLUSION NR shows promise for patients with DRE, however larger studies are warranted. The role of cognition in epilepsy needs to be introduced at the time of diagnosis to help lay the foundation for education and acceptance.
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Affiliation(s)
- Shivani Sharma
- Neuropsychology, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Ashima Nehra
- Neuropsychology, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India.
| | - Shivam Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Madhavi Tripathi
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Achal Srivastava
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - M V Padma
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Ajay Garg
- Department of Neuroradiology, All India Institute of Medical Sciences, New Delhi, India
| | - R M Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Sarat Chandra
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Manjari Tripathi
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
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Si J, Ding Z, Hu Y, Zhang X, Zhang Y, Cao H, Liu Y. Predictors and prognostic implications of left ventricular ejection fraction trajectory improvement in the spectrum of heart failure with reduced and mildly reduced ejection fraction. J Cardiol 2024; 83:250-257. [PMID: 37802201 DOI: 10.1016/j.jjcc.2023.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 09/11/2023] [Accepted: 09/28/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND The latest guidelines emphasize the significance of evaluating the left ventricular ejection fraction (LVEF) trajectory in patients with heart failure (HF). Because patients with HF with reduced ejection fraction (HFrEF) and HF with mildly reduced ejection fraction (HFmrEF) have reduction in systolic function, they might be in a trajectory of LVEF improvement after medical and device-based therapies. While previous studies have primarily focused on LVEF improvement in HFrEF, there is limited research on LVEF trajectory improvement across the spectrum of HFrEF and HFmrEF. This study aimed to assess the determinants and prognostic implications of LVEF trajectory improvement in HFrEF and HFmrEF patients. METHODS The cohort was classified into the improved group (HFrEF-to-HF with improved ejection fraction (HFimpEF) and HFmrEF-to-HF with preserved ejection fraction (HFpEF)) and the unimproved group (lack of improved group criteria). The primary endpoints were the composite of all-cause mortality or HF hospitalization, all-cause mortality, and HF hospitalization. Predictors of LVEF trajectory improvement were also evaluated. RESULTS A total 1303 patients were included in the study (improved/unimproved group: n = 497/806). Cox regression analysis showed that the improved group experienced lower risks of prespecified end points than the unimproved group. Multivariate logistic regression analysis showed that atrial flutter, use of spironolactone, and treatment with catheter ablation were associated with LVEF trajectory improvement, while myocardial infarction, prior percutaneous catheter intervention or coronary artery bypass graft, E/e', and left ventricular end-diastolic diameter were identified as negative predictors of LVEF trajectory improvement. In the improved subgroup, the prognosis for the HFrEF-to-HFimpEF and HFmrEF-to-HFpEF was comparable. CONCLUSIONS LVEF trajectory improvement patients had improved clinical outcomes and it was associated with important clinical, baseline cardiac structure and function, and treatment factors. Outcomes were similar in both HFrEF-to-HFimpEF and HFmrEF-to-HFpEF subgroups. These results suggest that emphasis should be placed on LVEF trajectory improvement to improve the outcomes of this population.
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Affiliation(s)
- Jinping Si
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
| | - Zijie Ding
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
| | - Yuze Hu
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
| | - Xinxin Zhang
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
| | - Yanli Zhang
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
| | - Huajun Cao
- Clinical Laboratory, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China.
| | - Ying Liu
- Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China.
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Cao S, Zhang H, Liu Y, Sun Y, Chen ZJ. Cytoplasmic genome contributions to domestication and improvement of modern maize. BMC Biol 2024; 22:64. [PMID: 38481288 PMCID: PMC10938767 DOI: 10.1186/s12915-024-01859-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 02/28/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Studies on maize evolution and domestication are largely limited to the nuclear genomes, and the contribution of cytoplasmic genomes to selection and domestication of modern maize remains elusive. Maize cytoplasmic genomes have been classified into fertile (NA and NB) and cytoplasmic-nuclear male-sterility (CMS-S, CMS-C, and CMS-T) groups, but their contributions to modern maize breeding have not been systematically investigated. RESULTS Here we report co-selection and convergent evolution between nuclear and cytoplasmic genomes by analyzing whole genome sequencing data of 630 maize accessions modern maize and its relatives, including 24 fully assembled mitochondrial and chloroplast genomes. We show that the NB cytotype is associated with the expansion of modern maize to North America, gradually replaces the fertile NA cytotype probably through unequal division, and predominates in over 90% of modern elite inbred lines. The mode of cytoplasmic evolution is increased nucleotypic diversity among the genes involved in photosynthesis and energy metabolism, which are driven by selection and domestication. Furthermore, genome-wide association study reveals correlation of cytoplasmic nucleotypic variation with key agronomic and reproductive traits accompanied with the diversification of the nuclear genomes. CONCLUSIONS Our results indicate convergent evolution between cytoplasmic and nuclear genomes during maize domestication and breeding. These new insights into the important roles of mitochondrial and chloroplast genomes in maize domestication and improvement should help select elite inbred lines to improve yield stability and crop resilience of maize hybrids.
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Affiliation(s)
- Shuai Cao
- State Key Laboratory of Crop Genetics and Germplasm Enhancement, Nanjing Agricultural University, 1 Weigang Road, Nanjing, 210095, China
- Temasek Life Sciences Laboratory, 1 Research Link, National University of Singapore, Singapore, 117604, Singapore
| | - Huanhuan Zhang
- Shanxi Key Laboratory of Minor Crops Germplasm Innovation and Molecular Breeding, Shanxi Agricultural University, Shanxi, Taiyuan, 030031, China
| | - Yang Liu
- State Key Laboratory of Crop Genetics and Germplasm Enhancement, Nanjing Agricultural University, 1 Weigang Road, Nanjing, 210095, China
| | - Yi Sun
- Shanxi Key Laboratory of Minor Crops Germplasm Innovation and Molecular Breeding, Shanxi Agricultural University, Shanxi, Taiyuan, 030031, China
| | - Z Jeffrey Chen
- Department of Molecular Biosciences, The University of Texas at Austin, Austin, TX, 78712, USA.
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Lev V, Anbarchian T, Yao H, Bhat A, Britt P, Shieh L. Health care-associated Clostridioides difficile infection: Learning the perspectives of health care workers to build successful strategies. Am J Infect Control 2024; 52:284-292. [PMID: 37579972 DOI: 10.1016/j.ajic.2023.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND Clostridioides difficile (C difficile) is one of the most common health care-associated infections that negatively impact patient care and health care costs. This study takes a unique approach to C difficile infection (CDI) control by investigating key prevention obstacles through the perspectives of Stanford health care (SHC) frontline health care personnel. METHODS An anonymous qualitative survey was distributed at SHC, focusing on knowledge and practice of CDI prevention guidelines, as well as education, communication, and perspectives regarding CDI at SHC. RESULTS 112 survey responses were analyzed. Our findings unveiled gaps in personnel's knowledge of C difficile diagnostic guidelines and revealed a need for targeted communication and guideline-focused education. Health care staff shared preferences and recommendations, with the majority recommending enhanced communication of guidelines and information as a strategy for reducing CDI rates. The findings were then used to design and propose internal recommendations for SHC to mitigate the gaps found. DISCUSSION Many guidelines and improvement strategies are based on strong scientific and medical foundations; however, it is important to ask whether these guidelines are effectively translated into practice. Frontline health care workers hold empirical perspectives that could be key in infection control. CONCLUSIONS Our findings emphasize the importance of including frontline health care personnel in infection prevention decision-making processes and the strategies presented here can be applied to mitigating infections in different health care settings.
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Affiliation(s)
- Vered Lev
- Stanford University School of Medicine, Stanford, CA.
| | | | - Hanqi Yao
- Stanford University School of Medicine, Stanford, CA
| | | | | | - Lisa Shieh
- Stanford University School of Medicine, Stanford, CA
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Fan H, Yao X, Chen Z, Ma R, Bi Y, Wen Y, Li H, Wang J, Sun B. Study on the improvement of complexation efficiency and anti-digestibility of phenolic acids based on electrospun starch fibers. Food Res Int 2024; 177:113921. [PMID: 38225108 DOI: 10.1016/j.foodres.2023.113921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 12/12/2023] [Accepted: 12/21/2023] [Indexed: 01/17/2024]
Abstract
Phenolic acids can be encapsulated by starch electrospun fibers, and the structural and functional properties of the electrospun fiber are affected by the chemical structure of phenolic acid. In this study, five phenolic acids (protocatechuic acid (PA), p-hydroxybenzoic acid (PHBA), p-coumaric acid (PCA), ferulic acid (FA), and caffeic acid (CA)) were chosen to prepare electrospun fibers with high amylose corn starch (HACS) at different voltages. Morphology and complexation efficiency results revealed that the electrospun fibers prepared at 21.0 kV were smooth and continuous with high encapsulation efficiency (EE) and loading efficiency (LE). The chemical structure of phenolic acid played an important role in the structure and properties of electrospun fibers by influencing the complexation of HACS with phenolic acids and the inhibitory effect of amylase. As a result, electrospun fibers containing HACS-CA inclusion complex had higher relative crystallinity (25.47 %), higher thermal degradation temperatures (356.17 °C), and the strongest resistance to digestion (starch digestive ratio = 22.98 %). It is evident that electrospun fibers containing HACS-phenolic acid inclusion complexes not only achieve high phenolic acid complexation efficiency, but also resist the effects of the gastric and small intestinal environment on phenolic acids, thereby improving the bioaccessibility of phenolic acids.
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Affiliation(s)
- Haoran Fan
- Key Laboratory of Geriatric Nutrition and Health (Beijing Technology and Business University), Ministry of Education, Beijing, 100048, China
| | - Xu Yao
- Key Laboratory of Geriatric Nutrition and Health (Beijing Technology and Business University), Ministry of Education, Beijing, 100048, China
| | - Zhijun Chen
- Key Laboratory of Geriatric Nutrition and Health (Beijing Technology and Business University), Ministry of Education, Beijing, 100048, China
| | - Ruolan Ma
- Key Laboratory of Geriatric Nutrition and Health (Beijing Technology and Business University), Ministry of Education, Beijing, 100048, China
| | - Yanhong Bi
- Jiangsu Provincial Key Construction Laboratory of Probiotics Preparation, Huaiyin Institute of Technology, Huaian 223003, P. R. China
| | - Yangyang Wen
- College of Chemistry and Materials Engineering, Beijing Technology and Business University (BTBU), 11 Fucheng Road, Beijing 100048, China
| | - Hongyan Li
- Key Laboratory of Geriatric Nutrition and Health (Beijing Technology and Business University), Ministry of Education, Beijing, 100048, China.
| | - Jing Wang
- Key Laboratory of Geriatric Nutrition and Health (Beijing Technology and Business University), Ministry of Education, Beijing, 100048, China
| | - Baoguo Sun
- Key Laboratory of Geriatric Nutrition and Health (Beijing Technology and Business University), Ministry of Education, Beijing, 100048, China
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Marcińczyk M, Krasucka P, Duan W, Bo P, Oleszczuk P. Effect of chemical aging on phosphate adsorption and ecotoxicological properties of magnesium-modified biochar. Chemosphere 2024; 349:140721. [PMID: 37972863 DOI: 10.1016/j.chemosphere.2023.140721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 10/20/2023] [Accepted: 11/12/2023] [Indexed: 11/19/2023]
Abstract
Using magnesium-biochar composites (Mg-BC) in adsorption allows for the efficient and economically relevant removal of phosphate (PO43-) from water and wastewater. Applying Mg-BC for pollutant removal requires evaluating the adsorption capacity of composites and their ecotoxicological properties. Investigating the composite aging during the application of these composites into the soil is also essential. In the present study, nonaged and aged (at 60 or 90 °C) Mg-BC composites were investigated in the context of pyrolysis temperature (500 or 700 °C). All analyzed biochars were examined by Fourier transform infrared spectroscopy, X-ray powder diffraction, X-ray photoelectron spectroscopy, Raman spectroscopy and surface area. The content of polycyclic aromatic hydrocarbons (PAHs) (bioavailable Cfree and organic solvent-extractable Ctot), heavy metals (HMs), and environmentally persistent free radicals (EPFRs) were determined. Ecotoxicity was evaluated using tests with Folsomia candida and Allivibrio fischeri. The dependence of adsorption on pyrolysis temperature and composite aging time was observed. Changes in physicochemical properties occurring as a result of aging reduced the adsorption of PO43- on Mg-BC composites. It was found that nonaged Mg-BC700 was more effective (9.55 mg g -1) in the adsorption of PO43- than Mg-BC500 (5.75 mg g-1). The adsorption capacities of aged composites were from 21 to 61% lower than those of the nonaged composites. Due to aging, the content of Cfree PAHs increased by 3-5 times depending on the pyrolysis temperature. However, aging reduced the Ctot PAHs in all composites from 24 to 35% depending on the pyrolysis temperature. Ecotoxicological evaluation of Mg-BC composites showed increased toxicity after aging to both organisms. The use of aged BC potentially increases the contaminant content and toxicity of Mg-BC composites.
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Affiliation(s)
- Marta Marcińczyk
- Department of Radiochemistry and Environmental Chemistry, Faculty of Chemistry, Maria Curie-Skłodowska University, 3 Maria Curie-Skłodowska Square, 20-031, Lublin, Poland
| | - Patrycja Krasucka
- Department of Radiochemistry and Environmental Chemistry, Faculty of Chemistry, Maria Curie-Skłodowska University, 3 Maria Curie-Skłodowska Square, 20-031, Lublin, Poland
| | - Wenyan Duan
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, 650500, People's Republic of China
| | - Pan Bo
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, 650500, People's Republic of China
| | - Patryk Oleszczuk
- Department of Radiochemistry and Environmental Chemistry, Faculty of Chemistry, Maria Curie-Skłodowska University, 3 Maria Curie-Skłodowska Square, 20-031, Lublin, Poland.
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10
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Wang H, Zhang X, Wang P, Dai G, Liu L, Xu Y, Wang H, Zhang Y. Study of electronic biofeedback combined with nursing intervention in the treatment of vascular cognitive impairment-no dementia. Acta Neurol Belg 2024:10.1007/s13760-023-02471-z. [PMID: 38285160 DOI: 10.1007/s13760-023-02471-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 12/22/2023] [Indexed: 01/30/2024]
Abstract
OBJECTIVE To investigate the effects of electronic biofeedback combined with nursing intervention and conventional drug treatment on cognitive function in patients with vascular cognitive impairment-no dementia (VCIND). METHODS A total of 102 patients with VCIND treated in the Department of Neurology from January 2021 to May 2022 were enrolled and divided into the routine treatment group and biofeedback group according to different treatment methods. The routine treatment group was given conventional drug therapy and nursing intervention; for the biofeedback group, electronic biofeedback therapy was added, based on the routine treatment group. The Montreal Cognitive Assessment, (MoCA), Alzheimer's Disease Assessment Scale-Cognitive Subscale, (ADAS-cog), and Hamilton Depression Scale (HAMD) were checked before treatment, 2 weeks after treatment, and 3 months after treatment. RESULTS At 3 months of treatment, the scores of the MoCA and ADAS-cog scales in the biofeedback group were better than those in the routine treatment group, while no difference was detected in the HAMD scores before and after treatment and between the two groups. CONCLUSION Electronic biofeedback therapy for VCIND can significantly improve the MoCA score, reduce the ADAS-cog score and improve the cognitive level of patients and can be used as a complementary treatment for VCIND.
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Affiliation(s)
- Hongmin Wang
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, 050031, Hebei, China
| | - Xin Zhang
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, 050031, Hebei, China
| | - Peizhi Wang
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, 050031, Hebei, China
| | - Guining Dai
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, 050031, Hebei, China
| | - Li Liu
- Department of Neurology, The First Hospital of Hebei Medical University, Shijiazhuang, 050031, Hebei, China
| | - Yanfang Xu
- Department of Hepatology, The First Hospital of Hebei Medical University, Shijiazhuang, 050031, Hebei, China
| | - Huijun Wang
- Neurological Function Examination Center, The First Hospital of Hebei Medical University, Shijiazhuang, 050031, Hebei, China
| | - Yongqian Zhang
- Department of Oncology, The First Hospital of Hebei Medical University, No. 89 of Donggang Road, Yuhua District, Shijiazhuang, 050031, Hebei, China.
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Abstract
OBJECTIVE The decline in suicide rates has leveled off in many countries during the last decade, suggesting that new interventions are needed in the work with suicide prevention. Learnings from investigations of suicide should contribute to the development of these new interventions. However, reviews of investigations have indicated that few new lessons have been learned. To be an effective tool, revisions of the current investigation methods are required. This review aimed to describe the problems with the current approaches to investigations of suicide as patient harm and to propose ways to move forward. METHODS Narrative literature review. RESULTS Several weaknesses in the current approaches to investigations were identified. These include failures in embracing patient and system perspectives, not addressing relevant factors, and insufficient competence of the investigation teams. Investigation methods need to encompass the progress of knowledge about suicidal behavior, suicide prevention, and patient safety. CONCLUSIONS There is a need for a paradigm shift in the approaches to investigations of suicide as potential patient harm to enable learning and insights valuable for healthcare improvement. Actions to support this paradigm shift include involvement of patients and families, education for investigators, multidisciplinary analysis teams with competence in and access to relevant parts across organizations, and triage of cases for extensive analyses. A new model for the investigation of suicide that support these actions should facilitate this paradigm shift.HIGHLIGHTSThere are weaknesses in the current approaches to investigations of suicide.A paradigm shift in investigations is needed to contribute to a better understanding of suicide.New knowledge of suicidal behavior, prevention, and patient safety must be applied.
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Ullah A, Granell R, Haider S, Lowe L, Fontanella S, Arshad H, Murray CS, Turner S, Holloway JW, Simpson A, Roberts G, Custovic A. Obstructive and restrictive spirometry from school age to adulthood: three birth cohort studies. EClinicalMedicine 2024; 67:102355. [PMID: 38169936 PMCID: PMC10758747 DOI: 10.1016/j.eclinm.2023.102355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/21/2023] [Accepted: 11/21/2023] [Indexed: 01/05/2024] Open
Abstract
Background Spirometric obstruction and restriction are two patterns of impaired lung function which are predictive of poor health. We investigated the development of these phenotypes and their transitions through childhood to early adulthood. Methods In this study, we analysed pooled data from three UK population-based birth cohorts established between 1989 and 1995. We applied descriptive statistics, regression modelling and data-driven modelling to data from three population-based birth cohorts with at least three spirometry measures from childhood to adulthood (mid-school: 8-10 years, n = 8404; adolescence: 15-18, n = 5764; and early adulthood: 20-26, n = 4680). Participants were assigned to normal, restrictive, and obstructive spirometry based on adjusted regression residuals. We considered two transitions: from 8-10 to 15-18 and from 15-18 to 20-26 years. Findings Obstructive phenotype was observed in ∼10%, and restrictive in ∼9%. A substantial proportion of children with impaired lung function in school age (between one third in obstructive and a half in restricted phenotype) improved and achieved normal and stable lung function to early adulthood. Of those with normal lung function in school-age, <5% declined to adulthood. Underweight restrictive and obese obstructive participants were less likely to transit to normal. Maternal smoking during pregnancy and current asthma diagnosis increased the risk of persistent obstruction and worsening. Significant associate of worsening in restrictive phenotypes was lower BMI at the first lung function assessment. Data-driven methodologies identified similar risk factors for obstructive and restrictive clusters. Interpretation The worsening and improvement in obstructive and restrictive spirometry were observed at all ages. Maintaining optimal weight during childhood and reducing maternal smoking during pregnancy may reduce spirometry obstruction and restriction and improve lung function. Funding MRC Grant MR/S025340/1.
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Affiliation(s)
- Anhar Ullah
- National Heart and Lung Institute, Imperial College London, UK
- NIHR Imperial Biomedical Research Centre, London, UK
| | - Raquel Granell
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Sadia Haider
- National Heart and Lung Institute, Imperial College London, UK
- NIHR Imperial Biomedical Research Centre, London, UK
| | - Lesley Lowe
- Faculty of Biology, Medicine and Health, Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, Manchester Academic Health Science Centre, UK
| | - Sara Fontanella
- National Heart and Lung Institute, Imperial College London, UK
- NIHR Imperial Biomedical Research Centre, London, UK
| | - Hasan Arshad
- Faculty of Medicine, Human Development and Health, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton, UK
- David Hide Asthma and Allergy Research Centre, Isle of Wight, UK
| | - Clare S. Murray
- Faculty of Biology, Medicine and Health, Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, Manchester Academic Health Science Centre, UK
| | - Steve Turner
- Royal Aberdeen Children's Hospital NHS Grampian Aberdeen, AB25 2ZG, UK
- Child Health, University of Aberdeen, Aberdeen, UK
| | - John W. Holloway
- Faculty of Medicine, Human Development and Health, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | - Angela Simpson
- Faculty of Biology, Medicine and Health, Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, Manchester Academic Health Science Centre, UK
| | - Graham Roberts
- Faculty of Medicine, Human Development and Health, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton, UK
- David Hide Asthma and Allergy Research Centre, Isle of Wight, UK
| | - Adnan Custovic
- National Heart and Lung Institute, Imperial College London, UK
- NIHR Imperial Biomedical Research Centre, London, UK
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Wang YH, Sun HY, Liu YQ, Gong XY, Xu Y, Zong QQ, Yu GH, Hu WQ, Zhai CX, Wang LL, Yan ZY, Zhang TY, Cai J, Li M, Chen YF, Wang F, Zou YF. Health-related quality of life in Chinese SLE patients: evidence from 1568 SLE patients and 2610 healthy controls. Qual Life Res 2024; 33:207-218. [PMID: 37824058 DOI: 10.1007/s11136-023-03516-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVE To investigate the effects of systemic lupus erythematosus (SLE) on health-related quality of life (HRQOL), the relationship between disease activity and HRQOL, and potential factors affecting HRQOL in Chinese SLE patients. METHODS This study recruited 1568 patients and 2610 controls to explore the effects of SLE on HRQOL. The association between disease activity and HRQOL, and the influencing factors of HRQOL were determined in 1568 patients. Then, we prospectively followed 1096 patients to explore the association between reduced disease activity and improved HRQOL, and the influencing factors of improved HRQOL. The Short-Form 36 (SF-36) and SLE disease activity index (SLEDAI) were used to evaluate HRQOL and disease activity. RESULTS Chinese SLE patients had lower HRQOL than controls in all domains (P < 0.001), especially in role-physical (RP) and role-emotional (RE). Compared with SLE patients from outside China, the HRQOL of Chinese patients appeared to be higher in mental component summary (MCS) but lower in RP and RE. SLEDAI was negatively correlated with HRQOL, which was validated using the results of a follow-up study, where SLEDAI reduction was positively associated with HRQOL improvements (P < 0.05). Furthermore, personality, life nervous and experiences of adverse life events may influence HRQOL and HRQOL improvements. CONCLUSION SLE significantly affected the HRQOL of Chinese patients, especially in RP and RE. Disease activity was negatively correlated with HRQOL. We also found for the first time some factors affecting HRQOL, which can be regarded as the basis for improving the HRQOL of SLE patients.
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Affiliation(s)
- Yu-Hua Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81, Meishan Road, Shushan District, Hefei, 230032, Anhui, China
- The Key Laboratory of Anhui Medical Autoimmune Diseases, Hefei, 230032, Anhui, China
| | - Hong-Yu Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81, Meishan Road, Shushan District, Hefei, 230032, Anhui, China
- The Key Laboratory of Anhui Medical Autoimmune Diseases, Hefei, 230032, Anhui, China
| | - Yu-Qi Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81, Meishan Road, Shushan District, Hefei, 230032, Anhui, China
- The Key Laboratory of Anhui Medical Autoimmune Diseases, Hefei, 230032, Anhui, China
| | - Xing-Yu Gong
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81, Meishan Road, Shushan District, Hefei, 230032, Anhui, China
- The Key Laboratory of Anhui Medical Autoimmune Diseases, Hefei, 230032, Anhui, China
| | - Ying Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81, Meishan Road, Shushan District, Hefei, 230032, Anhui, China
- The Key Laboratory of Anhui Medical Autoimmune Diseases, Hefei, 230032, Anhui, China
| | - Qi-Qun Zong
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81, Meishan Road, Shushan District, Hefei, 230032, Anhui, China
- The Key Laboratory of Anhui Medical Autoimmune Diseases, Hefei, 230032, Anhui, China
| | - Guang-Hui Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81, Meishan Road, Shushan District, Hefei, 230032, Anhui, China
- The Key Laboratory of Anhui Medical Autoimmune Diseases, Hefei, 230032, Anhui, China
| | - Wan-Qin Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81, Meishan Road, Shushan District, Hefei, 230032, Anhui, China
- The Key Laboratory of Anhui Medical Autoimmune Diseases, Hefei, 230032, Anhui, China
| | - Chun-Xia Zhai
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81, Meishan Road, Shushan District, Hefei, 230032, Anhui, China
- The Key Laboratory of Anhui Medical Autoimmune Diseases, Hefei, 230032, Anhui, China
| | - Lin-Lin Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81, Meishan Road, Shushan District, Hefei, 230032, Anhui, China
- The Key Laboratory of Anhui Medical Autoimmune Diseases, Hefei, 230032, Anhui, China
| | - Zi-Ye Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81, Meishan Road, Shushan District, Hefei, 230032, Anhui, China
- The Key Laboratory of Anhui Medical Autoimmune Diseases, Hefei, 230032, Anhui, China
| | - Ting-Yu Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81, Meishan Road, Shushan District, Hefei, 230032, Anhui, China
- The Key Laboratory of Anhui Medical Autoimmune Diseases, Hefei, 230032, Anhui, China
| | - Jing Cai
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
| | - Mu Li
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
| | - Yang-Fan Chen
- Department of Rheumatology and Immunology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
| | - Fang Wang
- Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Yan-Feng Zou
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81, Meishan Road, Shushan District, Hefei, 230032, Anhui, China.
- The Key Laboratory of Anhui Medical Autoimmune Diseases, Hefei, 230032, Anhui, China.
- Key Laboratory of Dermatology (Anhui Medical University), Ministry of Education, Hefei, 230032, Anhui, China.
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Rogers MJ, Ou Z, Clawson JW, Presson AP, Stockburger CL, Kazmers NH. The Relationship Between Patient-Reported Outcomes and Patient Satisfaction With Ligament Reconstruction Tendon Interposition. J Hand Surg Am 2023; 48:1218-1228. [PMID: 37737802 PMCID: PMC10841050 DOI: 10.1016/j.jhsa.2023.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 08/10/2023] [Accepted: 08/24/2023] [Indexed: 09/23/2023]
Abstract
PURPOSE Achieving the minimal clinically important difference (MCID) on an outcomes instrument and reporting satisfaction with surgical outcomes are not equivalent. We hypothesized that improvement exceeding the QuickDASH and PROMIS UE CAT MCID is associated with a greater likelihood of reporting satisfaction with ligament reconstruction tendon interposition (LRTI) treatment. Our secondary hypothesis was that a subset of patients failing to meet MCID would still be satisfied. METHODS Patients ≥1 year after LRTI at one academic tertiary institution were included. QuickDASH and UE CAT v1.2 scores were obtained before and after surgery. Postoperative satisfaction and levels of improvement in pain and function were also obtained. RESULTS A total of 93 patients completed the QuickDASH, and of those, 90 also completed the UE CAT. At a mean of 2.6 ± 1.0 years after surgery, QuickDASH and UE CAT score improvement exceeded the previously published MCID estimates of 8.8 and 4.8. Although 90% (84/93) of the patients reported satisfaction, only 85% (72/93) and 72% (59/90) achieved MCID on the QuickDASH and UE CAT, respectively. Using the MCID estimate of 8.8, 96% (72/75) of the patients meeting the MCID were satisfied with their treatment. Those failing to achieve MCID reported significantly less physical function and pain improvement; however, most were satisfied nonetheless (68% [13/19] for QuickDASH, 77% [23/30] for UE CAT). CONCLUSIONS Achieving published MCID thresholds on the QuickDASH and PROMIS UE CAT v1.2 was predictive of patients reporting general satisfaction with their LRTI outcome ≥1 year after surgery. Most patients failing to achieve MCID still reported satisfaction with their LRTI. Achieving MCID thresholds alone should not be used as a surrogate for patient satisfaction with their treatment. Patient satisfaction is a complicated construct that is potentially very different from that of high-quality care. TYPE OF STUDY/LEVEL OF EVIDENCE Prognostic IV.
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Affiliation(s)
- Miranda J Rogers
- Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT
| | - Zhining Ou
- Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT
| | - Jordan W Clawson
- Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT
| | - Angela P Presson
- Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT
| | | | - Nikolas H Kazmers
- Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT.
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Zakaria AMZ, Mahamat-Azaki O, Mahamat YK, Ali AA, Nelson NL, Aboubakar AM, Soha AA, Lucien A, Temoua ND, Ibrahim TA. [Management of heart failure at the CHU the National Reference of Ndjamena/Chad]. Ann Cardiol Angeiol (Paris) 2023; 72:101633. [PMID: 37647694 DOI: 10.1016/j.ancard.2023.101633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 05/25/2023] [Accepted: 07/15/2023] [Indexed: 09/01/2023]
Abstract
INTRODUCTION Heart failure (HF) is a syndrome of diverse etiologies, and a real public health problem in both developed and developing countries. The aim of this study was to determine the clinical, etiological, therapeutic and evolutionary aspects of heart failure. MATERIALS AND METHODS This was a descriptive and analytical study carried out in the cardiology department of the national referral university hospital in N'Djamena (Chad). RESULTS Heart failure accounted for 30.84% of cardiovascular pathologies hospitalized in the cardiology department during the study period. The mean age of our patients was 52 ± 34 years, with extremes ranging from 18 to 87 years. Females predominated, accounting for 50.7% of cases, with a M/F sex-ratio of 0.97. Hypertensive heart disease (33.7%), valvular heart disease (16.6%) and ischemic heart disease (15.1%) were the most frequent etiologies. The drugs most frequently used were loop diuretics (97%), ACE inhibitors (96%) and beta-blockers (93.5%). The in-hospital mortality rate was 9% in our series.
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Affiliation(s)
| | - Oumar Mahamat-Azaki
- Service de Cardiologie du CHU de la Référence Nationale. BP : 130 Ndjamena, Tchad.
| | - Yaya Kichiné Mahamat
- Service de Cardiologie du CHU de la Référence Nationale. BP : 130 Ndjamena, Tchad.
| | - Adam Ahamat Ali
- Service de Médecine du CHU de la Renaissance. BP : 2029 Ndjamena, Tchad.
| | | | | | - Alsser Adam Soha
- Service de Cardiologie du CHU de la Référence Nationale. BP : 130 Ndjamena, Tchad.
| | - Allawaye Lucien
- Service de Cardiologie du CHU de la Référence Nationale. BP : 130 Ndjamena, Tchad.
| | - Naibe Dangwe Temoua
- Service de Cardiologie du CHU de la Référence Nationale. BP : 130 Ndjamena, Tchad.
| | - Toure Ali Ibrahim
- Service de Médecine interne et de Cardiologie du CHU de Lamorde. BP : 11146 Niamey, Niger.
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Kakarala K, Mifsud M, Dziegielewski P. Improving Quality and Value in Head and Neck Reconstruction. Otolaryngol Clin North Am 2023; 56:853-858. [PMID: 37380327 DOI: 10.1016/j.otc.2023.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Multiple advances in surgical techniques, technology, and perioperative patient care have revolutionized head and neck reconstruction over the last 40 years. Concurrent with these advances, health systems, patients, and payers have become increasingly focused on value and quality, owing in part to rapidly increasing health care costs. However, there is no consensus on how to define value and quality in the realm of head and neck reconstruction. This review focuses on the past, present, and future of quality improvement efforts in head and neck reconstruction.
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Affiliation(s)
- Kiran Kakarala
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.
| | - Matthew Mifsud
- Department of Otolaryngology-Head and Neck Surgery, University of South Florida School of Medicine, 13330 USF Laurel Drive, Tampa, FL 33612, USA
| | - Peter Dziegielewski
- Department of Otolaryngology-Head and Neck Surgery, University of Florida School of Medicine, 1600 Southwest Archer Road, D1-121, Gainesville, FL 32608, USA
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Azami-Aghdash S, Sayadzadeh M, Ashtari A, Derakhshani N, Sedaei Z, Rezapour R. Improving the hospital waste management at the Farabi hospital in Malekan -Iran: An action research study. Heliyon 2023; 9:e17695. [PMID: 37483697 PMCID: PMC10359768 DOI: 10.1016/j.heliyon.2023.e17695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 06/24/2023] [Accepted: 06/26/2023] [Indexed: 07/25/2023] Open
Abstract
Hospital waste poses numerous concerns for both human health and the environment. Using an action research technique, this study attempts to improve waste management at the Farabi Hospital in Malekan city-Iran. In 2020, integrated (quantitative-qualitative) action research was done. For action research, the Simmons model was employed. First, a list of significant issues was found during the waste management process evaluation using a standard checklist and brainstorming with hospital officials and workers. The identified issues were prioritized using a prioritization matrix. Then, after consulting with hospital officials, 11 interventions were designed and implemented over six months. Finally, waste management performance was re-evaluated. Average knowledge of the participants about hospital waste management (HWM) standards was improved significantly (64 ± 13.8 before the training, 84.6 ± 20.6). General waste production was reduced by 27.7% in terms of garbage bags and 23.4% in terms of waste weight (95.5 kg-73.1 kg), respectively. Infectious waste output was reduced by 22.8% in the number of garbage bags and 32.1% in the weight of waste (57.5 kg-39 kg). The rate of compliance with HWM criteria was improved from 10 to 33 items. Although the interventions in this study improved the HWM to an acceptable level, more interventions and ongoing monitoring are required. The study's findings also show that an action research strategy might address a wide range of issues and weaknesses in hospitals and related facilities.
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Affiliation(s)
- Saber Azami-Aghdash
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahdi Sayadzadeh
- Health and Environment Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Ashtari
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Naser Derakhshani
- Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Sedaei
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ramin Rezapour
- Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Moghadasi J, Keikavoosi-Arani L. Investigating the factors influencing students' academic enthusiasm for a shift of paradigm among education managers shaping academic pedagogy. BMC Med Educ 2023; 23:480. [PMID: 37370044 DOI: 10.1186/s12909-023-04453-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Education managers are among the most important determinants of a university's academic pedagogy and plans to improve the quality of education. To improve the quality of education and academic enthusiasm of students in a medical university, it might be necessary to improve the university's pedagogy paradigm through people who shape this pedagogy. This study aimed to investigate the factors that influence the academic enthusiasm of students in a medical university with the purpose of improving the university's pedagogy paradigm. METHODS This cross-sectional descriptive-correlational study was conducted on the students of Alborz University of Medical Sciences in the academic year 2021-2022 (3180 students). The sample size was calculated to be 343 using Cochran's formula. The participants were recruited by stratified random sampling with respect to the proportion of students in different faculties, disciplines, and education levels. The data collection tool was a researcher-made questionnaire. Data were analyzed by one-sample t-test and confirmatory factor analysis using SMART-PLS and SPSS26. RESULTS The developed model consisted of 3 dimensions (academic, individual and social), 10 components (teaching-learning environment, culture, extracurricular activities, facilities and equipment, attitude, knowledge, skill, classmate, family, relatives and friends) and 64 indicators. CONCLUSION The developed model can help medical universities take a step towards improving the academic productivity and performance of their students and gain a competitive advantage in this respect.
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Affiliation(s)
- Javad Moghadasi
- Department of Higher Education Administration, School of Management and Economics, Science and research branch, Islamic Azad University, Tehran, Iran
| | - Leila Keikavoosi-Arani
- Department of Healthcare Services Management, School of Health, Research Center for Health, Safety and Environment, Alborz University of medical sciences, Karaj, Iran.
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Lennox L, Antonacci G, Harris M, Reed J. Unpacking the 'process of sustaining'-identifying threats to sustainability and the strategies used to address them: a longitudinal multiple case study. Implement Sci Commun 2023; 4:68. [PMID: 37337274 DOI: 10.1186/s43058-023-00445-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 05/25/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Although sustainability remains a recognised challenge for Quality Improvement (QI) initiatives, most available research continues to investigate sustainability at the end of implementation. As a result, the learning and continuous adjustments that shape sustainability outcomes are lost. With little understanding of the actions and processes that influence sustainability within QI initiatives, there is limited practical guidance and direction on how to enhance the sustainability of QI initiatives. This study aims to unpack the 'process of sustaining', by exploring threats to sustainability encountered throughout the implementation of QI Initiatives and identifying strategies used by QI teams to address these threats over time. METHODS A longitudinal multiple case study design was employed to follow 4 QI initiatives over a 3-year period. A standardised sustainability tool was used quarterly to collect perceptions of sustainability threats and actions throughout implementation. Interviews (n=38), observations (32.5 h), documentary analysis, and a focus group (n=10) were conducted to enable a greater understanding of how the process of sustaining is supported in practice. Data were analysed using the Consolidated Framework for Sustainability (CFS) to conduct thematic analysis. RESULTS Analysis identified five common threats to sustainability: workforce stability, improvement timelines, organisational priorities, capacity for improvement, and stakeholder support. Each of these threats impacted multiple sustainability constructs demonstrating the complexity of the issues encountered. In response to threats, 12 strategies to support the process of sustaining were identified under three themes: engagement (five strategies that promoted the development of relationships), integration (three strategies that supported initiatives to become embedded within local systems), and adaptation (four strategies that enhanced understanding of, and response to, emergent conditions and contextual needs). CONCLUSIONS Sustaining improvements from QI initiatives requires continuous investment in relationships, resilience to integrate improvements in local systems, and flexibility to understand emergent conditions. Findings provide practitioners, funders, and researchers with a better understanding of, and preparation for, the threats associated with sustaining improvements from QI initiatives and offer insight into specific actions that can be taken to mitigate these risks. This learning can be used to inform future initiative design and support, to optimise the sustainability of healthcare improvements. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Laura Lennox
- National Institute of Health Research (NIHR) Applied Research Collaboration (ARC) for Northwest London, 369 Fulham Road, London, SW10 9NH, UK.
- Department of Primary Care and Public Health, Imperial College London, Charing Cross Campus, The Reynolds Building, St Dunstan's Road, London, W6 8RP, UK.
| | - Grazia Antonacci
- National Institute of Health Research (NIHR) Applied Research Collaboration (ARC) for Northwest London, 369 Fulham Road, London, SW10 9NH, UK
- Department of Primary Care and Public Health, Imperial College London, Charing Cross Campus, The Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
- Business School, Centre for Health Economics and Policy Innovation (CHEPI), Imperial College London, South Kensington Campus, Exhibition Rd, London, SW7 2AZ, UK
| | - Matthew Harris
- National Institute of Health Research (NIHR) Applied Research Collaboration (ARC) for Northwest London, 369 Fulham Road, London, SW10 9NH, UK
- Department of Primary Care and Public Health, Imperial College London, Charing Cross Campus, The Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
| | - Julie Reed
- Julie Reed Consultancy Ltd, 27 Molasses House, London, UK
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20
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Rolnitsky A, Bell CM. Sustaining Improvement Initiatives: Challenges and Potential Tools. Clin Perinatol 2023; 50:307-320. [PMID: 37201983 DOI: 10.1016/j.clp.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Like many implemented organizational changes, quality improvement (QI) projects demonstrate frequent decline after implementation. Factors associated with successfully sustained change are leadership, change characteristics, system capacity for changes and the resources required, and processes to maintain, evaluate, and communicate results. This review uses lessons from change theory and behavioral sciences to discuss change and sustainment of improvement efforts, to list models to support maintenance, and to provide evidence-based practical suggestions to enable the sustainability of QI interventions.
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Affiliation(s)
- Asaph Rolnitsky
- DAN Women and Babies Program, Newborn and Developmental Paediatrics, University of Toronto, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada.
| | - Chaim M Bell
- University of Toronto, Mount Sinai Hospital Suite 426 600 University Avenue Toronto, ON M5G 1X5, Canada
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Habinshuti I, Nsengumuremyi D, Muhoza B, Ebenezer F, Yinka Aregbe A, Antoine Ndisanze M. Recent and novel processing technologies coupled with enzymatic hydrolysis to enhance the production of antioxidant peptides from food proteins: A review. Food Chem 2023; 423:136313. [PMID: 37182498 DOI: 10.1016/j.foodchem.2023.136313] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 05/01/2023] [Accepted: 05/03/2023] [Indexed: 05/16/2023]
Abstract
Antioxidant peptides obtained through enzymatic hydrolysis of food proteins exhibit a broad range of bioactivities both in vitro and in vivo models. The antioxidant peptides showed the potential to fight against the reactive oxygen species, free radicals and other pro-oxidative substances which are considered the source of various chronic diseases for humans. Both animals and plants have been recognized as natural protein sources and attracted much research interest over the synthetic ones in terms of safety. However, the main challenge remains to increase the antioxidant peptides yield, reduce the enzyme quantity and the reaction time. Consequently, different efficient and innovative food processing technologies such as thermal, ultrasound, microwave, high hydrostatic pressure, pulsed electric field, etc. have been developed and currently used to treat food proteins before (pretreatment) or during the enzymatic hydrolysis (assisted). Those technologies were found to significantly enhance the degree of hydrolysis and the production of substantial antioxidant peptides. These emerging technologies enhance the enzymatic hydrolysis by inducing protein denaturation/unfolding, and the enzymatic activation without altering their functional and nutritional properties. This review discusses the state of the art of thermal, ultrasound, high hydrostatic pressure, microwave, and pulsed electric field techniques, their applications while coupled with enzymatic hydrolysis, their comparison and potential challenges for the production of antioxidant peptides from food proteins.
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Affiliation(s)
- Ildephonse Habinshuti
- INES-Ruhengeri, Institute of Applied Sciences, B.P. 155, Ruhengeri, Rwanda; Organization of African Academic Doctors (OAAD), Off Kamiti Road P.O. Box 25305-00100, Nairobi, Kenya; Thought For Food Foundation, 2101 Highland Ave, Birmingham, Alabama 35205, USA.
| | | | - Bertrand Muhoza
- College of Food Science, Northeast Agricultural University, Harbin, Heilongjiang 150030, China
| | - Falade Ebenezer
- Organization of African Academic Doctors (OAAD), Off Kamiti Road P.O. Box 25305-00100, Nairobi, Kenya
| | - Afusat Yinka Aregbe
- Organization of African Academic Doctors (OAAD), Off Kamiti Road P.O. Box 25305-00100, Nairobi, Kenya
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22
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Yu H, Bhat JA, Li C, Zhao B, Guo T, Feng X. Genome-wide survey identified superior and rare haplotypes for plant height in the north-eastern soybean germplasm of China. Mol Breed 2023; 43:22. [PMID: 37309452 PMCID: PMC10248691 DOI: 10.1007/s11032-023-01363-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 02/18/2023] [Indexed: 06/14/2023]
Abstract
The proper and efficient utilization of natural genetic diversity can significantly impact crop improvements. Plant height is a quantitative trait governing the plant type as well as the yield and quality of soybean. Here, we used a combined approach including a genome-wide association study (GWAS) and haplotype and candidate gene analyses to explore the genetic basis of plant height in diverse natural soybean populations. For the GWAS analysis, we used the whole-genome resequencing data of 196 diverse soybean cultivars collected from different accumulated temperature zones of north-eastern China to detect the significant single-nucleotide polymorphisms (SNPs) associated with plant height across three environments (E1, E2, and E3). A total of 33 SNPs distributed on four chromosomes, viz., Chr.02, Chr.04, Chr.06, and Chr.19, were identified to be significantly associated with plant height across the three environments. Among them, 23 were consistently detected in two or more environments and the remaining 10 were identified in only one environment. Interestingly, all the significant SNPs detected on the respective chromosomes fell within the physical interval of linkage disequilibrium (LD) decay (± 38.9 kb). Hence, these genomic regions were considered to be four quantitative trait loci (QTLs), viz., qPH2, qPH4, qPH6, and qPH19, regulating plant height. Moreover, the genomic region flanking all significant SNPs on four chromosomes exhibited strong LD. These significant SNPs thus formed four haplotype blocks, viz., Hap-2, Hap-4, Hap-6, and Hap-19. The number of haplotype alleles underlying each block varied from four to six, and these alleles regulate the different phenotypes of plant height ranging from dwarf to extra-tall heights. Nine candidate genes were identified within the four haplotype blocks, and these genes were considered putative candidates regulating soybean plant height. Hence, these stable QTLs, superior haplotypes, and candidate genes (after proper validation) can be deployed for the development of soybean cultivars with desirable plant heights. Supplementary Information The online version contains supplementary material available at 10.1007/s11032-023-01363-7.
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Affiliation(s)
- Hui Yu
- Key Laboratory of Soybean Molecular Design Breeding, Northeast Institute of Geography and Agroecology, Chinese Academy of Sciences, Changchun, 130102 China
- Zhejiang Lab, Hangzhou, 310012 China
| | | | - Candong Li
- Jiamusi Branch Academy of Heilongjiang Academy of Agricultural Sciences, Jiamusi, 154007 China
| | - Beifang Zhao
- Key Laboratory of Soybean Molecular Design Breeding, Northeast Institute of Geography and Agroecology, Chinese Academy of Sciences, Changchun, 130102 China
| | - Tai Guo
- Jiamusi Branch Academy of Heilongjiang Academy of Agricultural Sciences, Jiamusi, 154007 China
| | - Xianzhong Feng
- Key Laboratory of Soybean Molecular Design Breeding, Northeast Institute of Geography and Agroecology, Chinese Academy of Sciences, Changchun, 130102 China
- Zhejiang Lab, Hangzhou, 310012 China
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23
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Hsiao CS, Hsiao SH, Chiou FR, Chiou KR. Early predicting improvement of severe systolic heart failure by left atrial volume. Heart Vessels 2023; 38:523-534. [PMID: 36409354 DOI: 10.1007/s00380-022-02199-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 10/26/2022] [Indexed: 11/23/2022]
Abstract
Left atrium (LA) modulates left ventricle (LV) filling and cardiac performance. We aimed to assess the effect of heart failure (HF) therapy on LA and LV function, and the relationship between LA/LV improvement and clinical outcome in acute HF with reduced LV ejection fraction (LVEF). Totally, 224 hospitalized patients with acute HF and LVEF < 35% were enrolled and underwent echocardiography. They all received maximal tolerable doses of evidence-based medications. Patients received echocardiographic measurements at each visit including stroke volume, LVEF, LA minimal/maximal volume (LAVmin/LAVmax), LA expansion index, and tissue Doppler parameters. The threshold of LV functional improvement was LVEF > 45% ever occurred before study end. During the mean follow-up of 6.3 years, 62 cases improved well, mean LVEF 49 ± 5% at study end. The reduction of LV filling pressure occurring as early as 2 weeks later, LV systolic function improvement took longer (> 1 month). The reductions in LAVmin and LAVmax between initial stabilization and 2 weeks after HF treatment (Initial-2 W) and the increase of LA expansion index (Initial-2 W) were associated independently with LVEF improvement (p 0.002, 0.006, and 0.007, respectively). The best predictor of LVEF improvement was LAVmin reduction (Initial-2 W) > 5 ml with 77% sensitivity, 76% specificity. Cox proportional hazard regression analyses for cardiovascular events revealed LVEF improvement reduced 74% of events (hazard ratio 0.264, 95% CI 0.192-0.607, p < 0.0001); and LA expansion index (per 1% increase) reduced 14% of events (hazard ratio 0.862, 95% CI 0.771-0.959, p < 0.0001). The early reduction of LAV (Initial-2 W), especially LAVmin, is a powerful early predictor of LVEF improvement. Its occurrence reduces cardiovascular events significantly. ClinicalTrials.gov number: NCT01307722.
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Affiliation(s)
- Chao-Sheng Hsiao
- Division of Cardiology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.,Department of Internal Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Shih-Hung Hsiao
- Division of Cardiology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Fei-Ran Chiou
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Kuan-Rau Chiou
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan. .,School of Medicine, Taipei Medical University, Taipei, Taiwan.
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Harrison MI, Borsky AE. How alignment between health systems and their embedded research units contributes to system learning. Healthc (Amst) 2023; 11:100688. [PMID: 37003049 DOI: 10.1016/j.hjdsi.2023.100688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 01/04/2023] [Accepted: 02/23/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND There is growing interest in the contributions of embedded, learning health system (LHS), research within healthcare delivery systems. We examined the organization of LHS research units and conditions affecting their contributions to system improvement and learning. METHODS We conducted 12 key-informant and 44 semi-structured interviews in six delivery systems engaged in LHS research. Using rapid qualitative analysis, we identified themes and compared: successful versus challenging projects; LHS units and other research units in the same system; and LHS units in different systems. RESULTS LHS units operate both independently and as subunits within larger research centers. Contributions of LHS units to improvements and learning are influenced by alignment of facilitating factors within units, within the broader system, and between unit and host system. Key alignment factors were availability of internal (system) funding directing researchers' work toward system priorities; researchers' skills and experiences that fit a system's operational needs; LHS unit subculture supporting system improvement and collaboration with clinicians and other internal stakeholders; applications of external funding to system priorities; and executive leadership for system-wide learning. Mutual understanding and collaboration between researchers, clinicians, and leaders was fostered through direct consultation between LHS unit leaders and system executives and engagement of researchers in clinical and operational activities. CONCLUSIONS Embedded researchers face significant challenges to contributing to system improvement and learning. Nevertheless, when appropriately led, organized, and supported by internal funding, they may learn to collaborate effectively with clinicians and system leaders in advancing care delivery toward the learning health system ideal.
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Affiliation(s)
- Michael I Harrison
- Center for Evidence and Practice Improvement, Agency for Healthcare Research and Quality, 5600 Fisher's Lane, Rockville, MD, 20850, USA.
| | - Amanda E Borsky
- Health Services Research and Development, Veterans Health Administration, Washington, DC, USA
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25
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Pronk Y, van der Weegen W, Schreurs BW, Pilot P. Quality of total hip arthroplasty health care based on four years of patient-reported outcomes in the Netherlands. Health Qual Life Outcomes 2023; 21:24. [PMID: 36918879 PMCID: PMC10011788 DOI: 10.1186/s12955-023-02104-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 02/21/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Joint arthroplasty registries have incorporated patient-reported outcomes (PROs) to evaluate outcomes from a patients' perspective to improve total hip arthroplasty (THA). To draw valid conclusions on PROs, a minimum response rate (RR) of 60% is advised. This study investigated (1) if the quality of THA health care based on PROs improved over the years in the Netherlands, (2) if RRs improved over the years, and (3) difference in PROs over the years in hospitals with RR ≥ 60% compared to RR < 60%. METHODS Longitudinal study with publicly available datasets from 2016 to 2019. Primary outcome was increase/decrease in PRO change scores including 95%CI ranges over the years between preoperatively and 3 months postoperatively (pre-3 m), and 12 months postoperatively (pre-12 m). Improved quality of health care was arbitrary defined as when ≥ 3 of 4 included scores or ranges were statistically significant improved. Secondary outcome was increase/decrease in RRs over the years. Subgroups RR ≥ 60% and RR < 60% were compared. RESULTS Hospitals (%) collecting THA PROs increased from 78 to 92%. EQ VAS change score increased over the years, and 95%CI ranges of EQ VAS, EQ-5D descriptive system and NRS pain during activity decreased over the years at pre-3 m (p < 0.05). All THA pre-12 m PRO change scores and 95%CI ranges remained equal (p > 0.05). Pre-3 m RR remained equal (around 43%, p = 0.107) and pre-12 m RR decreased 9% (49% to 40%, p = 0.008). Pre-3 m subgroup RR ≥ 60% was too small to analyse (5%). No difference was found between pre-12 m subgroups (RR ≥ 60% = 16%), p > 0.05). CONCLUSIONS Quality of THA health care based on PROs seems equal in the Netherlands between 2016 and 2019. Although more hospitals participated in PRO collection, low RRs with large IQRs are observed and only 16% of the hospitals achieved the advised RR ≥ 60%. Multiple recommendations are provided to improve PRO collection and use.
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Affiliation(s)
- Yvette Pronk
- Research Department, Kliniek ViaSana, Hoogveldseweg 1, 5451 AA, Mill, The Netherlands
| | - Walter van der Weegen
- Department of Orthopaedic Surgery, Sports & Orthopaedics Research Centre, Sint Anna Ziekenhuis, Bogardeind 2, 5664 EH, Geldrop, The Netherlands.
| | - Berend Willem Schreurs
- Department of Orthopaedic Surgery, Radboudumc, Geert Grooteplein Zuid 10, 6562 GA, Nijmegen, The Netherlands.,Landelijke Registratie Orthopedische Implantaten (LROI), Bruistensingel 230, 5232 AD, 's-Hertogenbosch, The Netherlands
| | - Peter Pilot
- IMUKA, Kanaalstraat 10, 6116 AD, Roosteren, The Netherlands
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Provenzale J. Suggestions for improving the work culture in radiology: Advice from a famous basketball coach. Clin Imaging 2023; 95:7-9. [PMID: 36577317 DOI: 10.1016/j.clinimag.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 12/03/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
This manuscript addresses the issue of the need for improvement of the work culture in Radiology departments. The manuscript uses advice from the famous college basketball coach John Wooden to highlight the issues involved in the work culture environment in Radiology and to provide suggestions for improvement.
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Affiliation(s)
- James Provenzale
- Box 3808, Department of Radiology, Duke University Medical Center, Durham, NC 27710, United States of America.
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27
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Song B, Jiang X, Wang S, Liu Q, Yu T. The promotion and application of green remanufacturing: a case study in a machine tool plant. Environ Sci Pollut Res Int 2023; 30:40870-40885. [PMID: 36622588 DOI: 10.1007/s11356-022-24722-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
Low parts utilization, high resource consumption, and low profit margins have become the main factors hindering the development of machine tool remanufacturing in China. A machine tool manufacturing company was taken as a case to investigate the improvement of the remanufacturing production line. The remanufacturing workshop and production line of the case enterprise have been completely re-planned, adding remaining life assessment, additive manufacturing, quality monitoring, and reassembly quality control. After applying the new production line, the energy consumption and water consumption of each remanufacturing machine tool were reduced by 29.87 kgce and 0.042 m3, respectively, and the pollutants generated were reduced by 4.352 kg. With the increase in remanufactured machine tool capacity, the part reutilization has increased by 26.9%. Despite satisfactory results, machine remanufacturing still faces many difficulties in China. Combined with case enterprises, the current situation of machine tool remanufacturing in China was discussed, and several suggestions for promoting remanufacturing in Chinese manufacturing companies were put forward.
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Affiliation(s)
- Boxue Song
- Shenyang University of Technology, Shenyang, China
| | - Xingyu Jiang
- Shenyang University of Technology, Shenyang, China
| | - Song Wang
- Shenyang Jingxin Remanufacturing Co, Shenyang, China
| | - Qing Liu
- Shenyang Jingxin Remanufacturing Co, Shenyang, China
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28
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Mauri F, Schumacher F, Weber M, Gayet-Ageron A, Martinez de Tejada B. Clinicians' views regarding caesarean section rates in Switzerland: A cross-sectional web-based survey. Eur J Obstet Gynecol Reprod Biol X 2023; 17:100182. [PMID: 36879907 PMCID: PMC9984955 DOI: 10.1016/j.eurox.2023.100182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 02/09/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023] Open
Abstract
Objective The caesarean section (CS) rate in Switzerland is currently 32 %, well above the WHO recommended rate of 15 %. The study aims were three-fold: to explore the perception of this high rate among Swiss obstetrics-gynecology (Ob-Gyn) professionals; to assess the factors associated with a perception of a too high national CS rate; and to describe professionals' opinions on measures to reduce this rate. Study design A cross-sectional study was conducted between 1 May and 30 June 2021 using an online questionnaire sent to Ob/Gyn physicians and midwives at a university hospital and members of the Swiss Conference of Heads of Ob/Gyn Divisions. Survey participation was voluntary. The main outcome was the belief that CS was high. Associations were explored between different factors and the main outcome with logistic regression. Results were presented as odds ratios (OR) with 95 % confidence intervals (CIs). Multivariate logistic regression included adjustments for age, gender, place of work and profession. Results Of 226 health professionals invited, 188 completed the questionnaire (83.2 % participation rate). Among respondents, 50.3 % (n = 94) were Ob/Gyn physicians and 49.7 % were midwives (n = 93); 77.1 % were women (n = 145). Most participants (74.7 % [n = 139]) considered the Swiss CS rate as too high and that it should be reduced (79 % [n = 147]) but, notably, they considered their own CS rate as correct (71.9 % [n = 123]). Improving patient education (57.5 % [n = 108]) and professional training (54.8 % [n = 103]) were considered as strategies to reduce this rate. In multivariate analysis, only length of professional experience was significantly associated with a higher likelihood of considering the CS rate as too high (OR 3.07, 95 % CI 1.01-9.30; p = 0.047). When specialty was added in the model, the length of professional experience disappeared and the perception of having a too high CS rate was associated with being a midwife and obstetrician rather than a gynecologist (OR 3.62, 95 % CI 1.72-7.63; p = 0.001). Conclusions Clinicians, particularly obstetricians, believed that the current rate of CS in Switzerland was too high and that actions were needed to reduce this rate. Improving patient education and professional training were considered as the main strategies to be explored.
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Affiliation(s)
- Fabio Mauri
- Obstetrics Division, Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Fanny Schumacher
- Obstetrics Division, Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Marta Weber
- Clinical Research Center, Geneva University Hospitals, Geneva, Switzerland
| | - Angèle Gayet-Ageron
- Clinical Research Center, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Begoña Martinez de Tejada
- Obstetrics Division, Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland.,Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Gu JY, Yang CJ. Application of improved high-risk sign board for older people inpatients: a retrospective study. Ir J Med Sci 2023:10.1007/s11845-023-03311-y. [PMID: 36821022 DOI: 10.1007/s11845-023-03311-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 02/08/2023] [Indexed: 02/24/2023]
Abstract
AIM To observe the effect of the implementation of improved high-risk sign boards for older people inpatients. METHOD The older people inpatients of the Department of Geriatrics at our hospital were selected as the research subjects and divided into two groups. The control group used the single-strip high-risk sign, and the intervention group used the improved double-layer card slot, push-pull integrated high-risk sign board (national patent). The sign-related nurse operation time, patient/attendant satisfaction, and high-risk-related adverse events were observed and compared between the two groups. RESULTS After the adoption of the improved high-risk sign board, the nurse operation time was reduced from 94.3 ± 16.2 s to 53.9 ± 12.5 s, and patient/attendant satisfaction increased from 6.65 ± 0.38 points to 9.30 ± 0.52 points (P < 0.001). The incidence of high-risk-related adverse events decreased from 6.08 to 1.86%, but the difference was not statistically significant (χ2 = 3.675, P = 0.055). The implementation of the improved high-risk sign board can increase nursing efficiency and enhance the awareness of risk prevention in high-risk patients among nurses, older people inpatients, and attendants. CONCLUSION The application of double-layer card slot and push-pull comprehensive high-risk identification card to older people inpatients can alert nurses, patients, and nursing staff more prominently, which can improve patient satisfaction, reduce installation time and reduce the incidence of adverse events to a certain extent.
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Affiliation(s)
- Jin-Ying Gu
- Department of Medical Care, Tianjin Medical University General Hospital, No. 154 of Anshan Road, Heping District, Tianjin, 300052, China.
| | - Chun-Jun Yang
- Department of Stomatology, Tianjin Medical University General Hospital, Tianjin, 300052, China
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30
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Olsen SL, Nedrebø BS, Strand K, Søreide E, Kvaløy JT, Hansen BS. Reduction in omission events after implementing a Rapid Response System: a mortality review in a department of gastrointestinal surgery. BMC Health Serv Res 2023; 23:179. [PMID: 36810005 PMCID: PMC9945730 DOI: 10.1186/s12913-023-09159-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 02/07/2023] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND Hospitals worldwide have implemented Rapid Response Systems (RRS) to facilitate early recognition and prompt response by trained personnel to deteriorating patients. A key concept of this system is that it should prevent 'events of omission', including failure to monitor patients' vital signs, delayed detection, and treatment of deterioration and delayed transfer to an intensive care unit. Time matters when a patient deteriorates, and several in-hospital challenges may prevent the RRS from functioning adequately. Therefore, we must understand and address barriers for timely and adequate responses in cases of patient deterioration. Thus, this study aimed to investigate whether implementing (2012) and developing (2016) an RRS was associated with an overall temporal improvement and to identify needs for further improvement by studying; patient monitoring, omission event occurrences, documentation of limitation of medical treatment, unexpected death, and in-hospital- and 30-day mortality rates. METHODS We performed an interprofessional mortality review to study the trajectory of the last hospital stay of patients dying in the study wards in three time periods (P1, P2, P3) from 2010 to 2019. We used non-parametric tests to test for differences between the periods. We also studied overall temporal trends in in-hospital- and 30-day mortality rates. RESULTS Fewer patients experienced omission events (P1: 40%, P2: 20%, P3: 11%, P = 0.01). The number of documented complete vital sign sets, median (Q1,Q3) P1: 0 (0,0), P2: 2 (1,2), P3: 4 (3,5), P = 0.01) and intensive care consultations in the wards ( P1: 12%, P2: 30%, P3: 33%, P = 0.007) increased. Limitations of medical treatment were documented earlier (median days from admission were P1: 8, P2: 8, P3: 3, P = 0.01). In-hospital and 30-day mortality rates decreased during this decade (rate ratios 0.95 (95% CI: 0.92-0.98) and 0.97 (95% CI: 0.95-0.99)). CONCLUSION The RRS implementation and development during the last decade was associated with reduced omission events, earlier documentation of limitation of medical treatments, and a temporal reduction in the in-hospital- and 30-day mortality rates in the study wards. The mortality review is a suitable method to evaluate an RRS and provide a foundation for further improvement. TRIAL REGISTRATION Retrospectively registered.
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Affiliation(s)
- Siri Lerstøl Olsen
- Department of Quality and Health Technology, Faculty of Health Sciences, SHARE-Centre for Resilience in Healthcare, University of Stavanger, Kjell Arholms gate 43, 4036, Stavanger, Norway. .,Department of Emergency Medicine, Stavanger University Hospital, Stavanger, Norway.
| | - Bjørn S Nedrebø
- grid.412008.f0000 0000 9753 1393Department of Gastrointestinal Surgery, Haukeland University Hospital, Bergen, Norway
| | - Kristian Strand
- grid.412835.90000 0004 0627 2891Department of Intensive Care, Stavanger University Hospital, Stavanger, Norway
| | - Eldar Søreide
- grid.18883.3a0000 0001 2299 9255Faculty of Health Sciences, University of Stavanger, Stavanger, Norway ,grid.412835.90000 0004 0627 2891Section for Quality and Patient Safety, Stavanger University Hospital, Stavanger, Norway
| | - Jan Terje Kvaløy
- grid.18883.3a0000 0001 2299 9255Department of Mathematics and Physics, Faculty of Science and Technology, University of Stavanger, Stavanger, Norway ,grid.412835.90000 0004 0627 2891Research Department, Stavanger University Hospital, Stavanger, Norway
| | - Britt Sætre Hansen
- grid.18883.3a0000 0001 2299 9255Department of Quality and Health Technology, Faculty of Health Sciences, SHARE—Centre for Resilience in Healthcare, University of Stavanger, Kjell Arholms gate 43, 4036 Stavanger, Norway ,grid.412835.90000 0004 0627 2891The Research Group for Nursing and Health Care Science, Stavanger University Hospital, Stavanger, Norway
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31
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Salse J. Translational research from models to crops: comparative genomics for plant breeding. C R Biol 2023; 345:111-128. [PMID: 36847121 DOI: 10.5802/crbiol.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 12/02/2022] [Indexed: 02/18/2023]
Abstract
The concept of translational research, which originated in the medical field in the 1980s, consists in improving the efficient transfer of research results obtained in a species (which can be considered as a model or pivot) to all the species for which these results are of interest for its improvement in Agriculture. In this context, comparative genomics is an important tool for translational research, effectively identifying genes controlling common functions between species. Editing and phenotyping tools must thus allow the functional validation of the gene conserved within the species for which the knowledge has been extrapolated, that is to say transferred, and the identification of the best alleles and associated genotypes for exploitation in current breeding programs.
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32
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Kalemeera F, Godman B, Stergachis A, Rennie T. Effect of tenofovir containing ART on renal function in patients with moderate/severe reduced creatinine clearance at baseline: A retrospective study at two referral hospitals in Namibia. Pharmacol Res Perspect 2022; 11:e00681. [PMID: 36585791 PMCID: PMC9803902 DOI: 10.1002/prp2.681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 08/28/2020] [Accepted: 08/31/2020] [Indexed: 01/01/2023] Open
Abstract
Prescription of tenofovir disoproxil fumarate (TDF) for patients with baseline creatinine clearances (CrCl) <60 mL/min is said to increase risk of further decline in CrCl. Study objectives were to assess incidence of improvement and predictors thereof; to assess incidence of decline and transition to lower stages of CrCl; and comparison of declines between patients with a baseline CrCl < 60mL/min (group-I) and ≥ 60 mL/min (group-II). The study was retrospective, included patients 16 yrs or older who received TDF-containing ART. Improvement and decline were defined as ≥ 25% increase or decrease in CrCl, respectively. Binary logistic regression was performed to identify predictors of improvement. Groups I and II had 2862 and 7526 patients, respectively. In group-I, improvement in CrCl was observed in 40.1% (n = 1146), and was associated with stage IV of CrCl (adjusted Odds Ratio [aOR]=13.4 [95% CI: 6.7 - 26.9, P < .001]); male gender (aHR = 1.8 [95% CI: 1.5 - 2.2, P < .001]); and a poor HIV-status (aHR = 1.2 [95% CI: 1.0 - 1.4], P = .033). In group-I and group-II, respectively, decline occurred in 2.3% and 13.0%, (P < .001); transition to lower stages occurred in 1.0% and 25.2% (P < .001); and migration to stage IV CrCl occurred in 1.0% and 0.5% (P < .001). Improvement was more likely than decline in group-I patients. Although, group-I patients were more likely to experience new onset severe reduced CrCl than group-II patients, the proportions were extremely low. TDF should not be withheld from HIV-positive patients with a baseline CrCl < 60 mL/min.
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Affiliation(s)
| | - Brian Godman
- Strathclyde UniversityKarolinska InstituteSefako Makgatho University of Health SciencesGa‐RankuwaSouth Africa
| | - Andy Stergachis
- School of PharmacyUniversity of WashingtonSeattleWashingtonUSA
| | - Tim Rennie
- Faculty of Health SciencesUniversity of NamibiaWindhoekNamibia
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Liu Y, Lin L, Yuan C, Shen S, Tang Y, Liu Z, Zhu Y, Zhou L. Recovery from diabetes mellitus in primary aldosteronism patients after adrenalectomy. BMC Endocr Disord 2022; 22:331. [PMID: 36572916 PMCID: PMC9793683 DOI: 10.1186/s12902-022-01254-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 12/16/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The prevalence of diabetes mellitus (DM) was higher in primary aldosteronism (PA) patients. We aimed to evaluate the outcome of DM after adrenalectomy and determine the factors associated with that in PA patients. METHODS PA patients with DM (PA + DM patients) who received adrenalectomy were recruited into the study. The patients were classified into 3 groups based on their DM conditions after treatment, including "remission", "improved" and "unchanged" groups. Univariate and multivariate logistic regression analysis was conducted to uncover the preoperative factors affecting the outcome of DM after adrenalectomy. RESULTS A total of 54 PA + DM patients received adrenalectomy. After adrenalectomy, 16.7%, 33.3% and 50.0% of patients were classified into the "remission", "improved" and "unchanged" groups, respectively. The factors negatively associated with remission or improvement from DM after adrenalectomy were longer duration of hypertension (P = 0.029). Higher concentration of urinary magnesium (P = 0.031) and higher 24 h urinary potassium (P = 0.049) were factors negatively associated with the "remission" from DM after adrenalectomy. CONCLUSIONS Adrenalectomy was beneficial for the remission and improvement from DM in the half of PA patients with DM. Longer duration of hypertension, higher concentration of urinary magnesium and higher 24 h urinary potassium may prevent the remission and improvement from DM after adrenalectomy in PA patients. Examination of urinary electrolyte could be considered in PA patients with DM for predicting the outcome of DM after adrenalectomy.
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Affiliation(s)
- Yu Liu
- 1Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, 610041, Chengdu, Sichuan, P.R. China
| | - Lede Lin
- 1Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, 610041, Chengdu, Sichuan, P.R. China
| | - Chi Yuan
- 1Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, 610041, Chengdu, Sichuan, P.R. China
| | - Sikui Shen
- 1Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, 610041, Chengdu, Sichuan, P.R. China
| | - Yin Tang
- 1Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, 610041, Chengdu, Sichuan, P.R. China
| | - Zhihong Liu
- 1Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, 610041, Chengdu, Sichuan, P.R. China
| | - Yuchun Zhu
- 1Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, 610041, Chengdu, Sichuan, P.R. China.
| | - Liang Zhou
- 1Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, 610041, Chengdu, Sichuan, P.R. China.
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Vindrola-Padros C, Ledger J, Hill M, Tomini S, Spencer J, Fulop NJ. The Special Measures for Quality and Challenged Provider Regimes in the English NHS: A Rapid Evaluation of a National Improvement Initiative for Failing Healthcare Organisations. Int J Health Policy Manag 2022; 11:2917-2926. [PMID: 35490260 PMCID: PMC10105181 DOI: 10.34172/ijhpm.2022.6619] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 04/10/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND There is limited knowledge about interventions used for the improvement of low-performing healthcare organisations and their unintended consequences. Our evaluation sought to understand how healthcare organisations in the National Health Service (NHS) in England responded to a national improvement initiative (the Special Measures for Quality [SMQ] and challenged provider [CP] regimes) and its perceived impact on achieving quality improvements (QIs). METHODS Our evaluation included national-level interviews with key stakeholders involved in the delivery of SMQ (n=6); documentary analysis (n=20); and a qualitative study based on interviews (n=60), observations (n=8) and documentary analysis (n=291) in eight NHS case study sites. The analysis was informed by literature on failure, turnaround and QI in organisations in the public sector. RESULTS At the policy level, SMQ/CP regimes were intended to be "support" programmes, but perceptions of the interventions at hospital level were mixed. The SMQ/CP regimes tended to consider failure at an organisational level and turnaround was visualised as a linear process. There was a negative emotional impact reported by staff, especially in the short-term. Key drivers of change included: engaged senior leadership teams, strong clinical input and supportive external partnerships within local health systems. Trusts focused efforts to improve across multiple domains with particular investment in improving overall staff engagement, developing an open, listening organisational culture and better governance to ensure clinical safety and reporting. CONCLUSION Organisational improvement in healthcare requires substantial time to embed and requires investment in staff to drive change and cultivate QI capabilities at different tiers. The time this takes may be underestimated by external 'turn-around' interventions and performance regimes designed to improve quality in the short-term and which come at an emotional cost for staff. Shifting an improvement focus to the health system or regional level may promote sustainable improvement across multiple organisations over the long-term.
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Affiliation(s)
- Cecilia Vindrola-Padros
- Department of Applied Health Research, University College London, London, UK
- Department of Targeted Intervention, University College London, London, UK
| | - Jean Ledger
- Department of Applied Health Research, University College London, London, UK
| | - Melissa Hill
- NHS North Thames Genomic Laboratory Hub, Great Ormond Street Hospital, London, UK
| | - Sonila Tomini
- Department of Applied Health Research, University College London, London, UK
| | | | - Naomi J. Fulop
- Department of Applied Health Research, University College London, London, UK
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Cerier E, Hu A, Goldring A, Rho M, Kulkarni SA. Ergonomics Workshop Improves Musculoskeletal Symptoms in General Surgery Residents. J Surg Res 2022; 280:567-574. [PMID: 35787315 PMCID: PMC10084513 DOI: 10.1016/j.jss.2022.06.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 06/01/2022] [Accepted: 06/08/2022] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Poor operative ergonomics can lead to muscle fatigue and injury. However, formal ergonomics education is uncommon in surgical residencies. Our study examines the prevalence of musculoskeletal (MSK) symptoms, baseline ergonomics knowledge, and the impact of an ergonomics workshop in general surgery residents. METHODS An anonymous voluntary presurvey and postsurvey was distributed to all general surgery residents at a single academic residency, assessing resident characteristics, MSK symptoms, and ergonomic knowledge before and after an ergonomics workshop. The workshop consisted of a lecture and a personalized posture coaching session with a physiatrist. RESULTS The presurvey received 33/35 (94%) responses. Of respondents, 100% reported some degree of MSK pain. Prevalence of muscle stiffness and fatigue decreased with increasing height. Females reported higher frequencies of MSK pain (P = 0.01) and more muscle fatigue than males (100% versus 73%, P = 0.03). All residents reported little to no ergonomics knowledge with 68% reporting that ergonomics was rarely discussed in the operating room. The postsurvey received 26/35 (74%) responses. Of respondents, 100% reported the workshop was an effective method of ergonomics education. MSK symptom severity improved in 82% of residents. Reports that ergonomics was rarely discussed in the operating room significantly decreased to 22.8% of residents (P < 0.01). CONCLUSIONS Surgical resident ergonomics knowledge is poor and MSK symptoms are common. Resident characteristics are associated with different MSK symptoms. Didactic teaching and personalized posture coaching improve ergonomics knowledge and reduce MSK symptom severity. Surgical residencies should consider implementing similar interventions to improve resident wellbeing.
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Affiliation(s)
- Emily Cerier
- Department of Surgery, Feinberg School of Medicine, Northwestern Memorial Hospital, Chicago, Illinois
| | - Andrew Hu
- Department of Surgery, Feinberg School of Medicine, Northwestern Memorial Hospital, Chicago, Illinois
| | - Annie Goldring
- Department of Physical Medicine and Rehabilitation, Section of Musculoskeletal Disease, Shirley Ryan Ability Lab, Chicago, Illinois
| | - Monica Rho
- Department of Physical Medicine and Rehabilitation, Section of Musculoskeletal Disease, Shirley Ryan Ability Lab, Chicago, Illinois
| | - Swati A Kulkarni
- Department of Surgery, Feinberg School of Medicine, Northwestern Memorial Hospital, Chicago, Illinois.
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Capraro GA. Replacement of Culture with Molecular Testing for Diagnosis Infectious Diseases. Clin Lab Med 2022; 42:547-555. [PMID: 36368781 DOI: 10.1016/j.cll.2022.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Gerald A Capraro
- Clinical Microbiology Laboratory, Carolinas Pathology Group, Atrium Health, 5040 Airport Center Parkway, Building H, Suite A, Charlotte, NC 28208, USA.
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Yousefi M, Mashhadi L, Akbarisari A, Ebrahimi Z. Change Management in Hospitals: A Framework Analysis. Stud Health Technol Inform 2022; 299:262-268. [PMID: 36325873 DOI: 10.3233/shti220995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Hospitals are complex organizations that frequently need changes especially in service delivery processes, organizing, human resource management, monitoring and evaluation and technologies. Maintaining and improving productivity is a key requirement in hospital change management. Therefore, we need to develop and expand an appropriate model for management of changes in hospitals; which is the main purpose of this study. METHOD A qualitative approach was used to conduct semi-structured interviews in 2019-2020 with 12 expert managers at Mashhad University of Medical Sciences, Mashhad, Iran. A pre-structured framework was applied for the data analysis. RESULTS Four main themes and nine sub-themes were identified as the main phases or stages of the framework that can be used to manage changes that aim to improve efficiency in hospitals. The main themes were problem identification and initial support; studying, designing and planning; participation in implementation; considering executive requirements; and implementation, assessment, feedback and stabilization. CONCLUSION Management of changes that aim to improve hospital efficiency requires a practical model that was specifically developed by this study. This model should consider all the key elements that were identified; and should consider the expectations of the key stakeholders and their contribution in implementing the change.
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Affiliation(s)
- Mahdi Yousefi
- Dept. of Health Econ.& Mgmt. Science, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Leila Mashhadi
- Department of Anesthesia, Lung Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Akbarisari
- Department of Health Management and Economics, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Ebrahimi
- Human Resource Mgmt., Islamic Azad University of North Tehran Branch, Tehran, Iran
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Novembre E, Giovannini M, Barni S, Mori F. From the Global Initiative for Asthma report and asthma guidelines to real-life asthma control: is there room for improvement? Ital J Pediatr 2022; 48:110. [PMID: 35790997 PMCID: PMC9258205 DOI: 10.1186/s13052-022-01304-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 06/15/2022] [Indexed: 11/22/2022] Open
Abstract
Available guidelines for asthma management represent an important and suitable tool to make the entire medical process evidence-based, effective, and safe for patients. Their purpose is to help doctors and patients formulate the best decisions in regard to asthma management by choosing the most appropriate strategies in each specific clinical situation. The Global Initiative for Asthma (GINA) document, together with other national and international recommendations, is one of the main documents used for asthma prevention and management in Italy, but several studies reported that these recommendations are often not applied in real-life clinical practice, which consequently results in inadequate asthma control. In this context, a substantial simplification of the GINA document and asthma guidelines may represent a feasible strategy to be pursued to ameliorate the knowledge among GPs, primary care pediatricians, and specialists taking care of children and adults with asthma. On the other hand, another critical factor that may explain unsatisfactory control of asthma is the limited importance that all recommendations place on asthma heterogeneity. In the era of personalized medicine and target therapies, phenotype-driven asthma management may become a desirable approach for optimizing the management of asthmatic patients. In addition, digital health strategies have been investigated in the literature to improve asthma monitoring and may represent a promising tool in the future from this point of view. Relevant stakeholders should continue to investigate how to optimize real-life asthma control to propose novel solutions to translate into clinical practice.
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Affiliation(s)
- Elio Novembre
- Meyer Children's University Hospital, Viale Pieraccini 24, 50139, Florence, Italy
| | - Mattia Giovannini
- Meyer Children's University Hospital, Viale Pieraccini 24, 50139, Florence, Italy.
| | - Simona Barni
- Meyer Children's University Hospital, Viale Pieraccini 24, 50139, Florence, Italy
| | - Francesca Mori
- Meyer Children's University Hospital, Viale Pieraccini 24, 50139, Florence, Italy
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Gauthier-Manuel H, Mauny F, Boilleaut M, Ristori M, Pujol S, Vasbien F, Parmentier AL, Bernard N. Improvement of downscaled ozone concentrations from the transnational scale to the kilometric scale: Need, interest and new insights. Environ Res 2022; 210:112947. [PMID: 35183519 DOI: 10.1016/j.envres.2022.112947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 02/04/2022] [Accepted: 02/09/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Ground-level ozone is a major public health issue worldwide. An accurate assessment of ozone exposure is necessary. Modeling tools have been developed to tackle this issue in large areas. However, these models could present inaccuracies at the local scale. OBJECTIVES The objective of this study was i) to assess whether O3 concentrations estimated by transnational modeling at the kilometric scale (9 km2) could be improved, ii) to propose a potential correction of these downscaled ozone concentrations and iii) to evaluate the efficiency and applicability of such a correction. METHOD The present work was carried out in three phases. First, the performance of a transnational modeling platform (PREV'EST) was assessed at 6 geographic points by comparison with data from 6 air quality monitoring stations. Performance indicators were used for this purpose (MBE (mean bias error), MAE (mean absolute error), RMSE (root mean square error), r (Pearson correlation coefficient), and target plots). Second, several corrections were developed using MARS (multivariate adaptive regression splines) and integrating different sets of variables (mean temperature, relative humidity, rainfall amount, wind speed, elevation, and date). Their performance was evaluated. Third, external validation of the corrections was conducted using the data from six additional air quality monitoring stations. RESULTS The uncorrected PREV'EST model presented a lack of exactitude and precision. These concentrations did not reproduce the interday variability of the measurements, leading to a lack of temporal contrast in exposure data. For the best performance enhancement, the correction applied improved MBE, MAE, RMSE and r from 14.67, 19.23, 23.18 and 0.67 to 0.00, 8.00, 10.19 and 0.91, respectively. External validation confirmed the efficiency of the corrections at the regional scale. CONCLUSIONS We propose a validated and efficient methodology integrating local environmental variables. The methodology is adaptable according to the context, needs and data available.
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Affiliation(s)
- Honorine Gauthier-Manuel
- UMR 6249, Laboratoire Chrono-environnement, Université de Bourgogne Franche-Comté, CNRS, 25000, Besançon, France; Unité de Méthodologie en Recherche Clinique, épidémiologie et Santé Publique (uMETh), Inserm CIC 1431, CHU, 25030, Besançon Cedex, France.
| | - Frédéric Mauny
- UMR 6249, Laboratoire Chrono-environnement, Université de Bourgogne Franche-Comté, CNRS, 25000, Besançon, France; Unité de Méthodologie en Recherche Clinique, épidémiologie et Santé Publique (uMETh), Inserm CIC 1431, CHU, 25030, Besançon Cedex, France
| | | | - Marie Ristori
- ATMO Bourgogne-Franche-Comté, 25000, Besançon, France
| | - Sophie Pujol
- UMR 6249, Laboratoire Chrono-environnement, Université de Bourgogne Franche-Comté, CNRS, 25000, Besançon, France; Unité de Méthodologie en Recherche Clinique, épidémiologie et Santé Publique (uMETh), Inserm CIC 1431, CHU, 25030, Besançon Cedex, France
| | | | - Anne-Laure Parmentier
- UMR 6249, Laboratoire Chrono-environnement, Université de Bourgogne Franche-Comté, CNRS, 25000, Besançon, France; Unité de Méthodologie en Recherche Clinique, épidémiologie et Santé Publique (uMETh), Inserm CIC 1431, CHU, 25030, Besançon Cedex, France
| | - Nadine Bernard
- UMR 6249, Laboratoire Chrono-environnement, Université de Bourgogne Franche-Comté, CNRS, 25000, Besançon, France; Centre National de La Recherche Scientifique, UMR 6049, Laboratoire ThéMA, Université de Bourgogne Franche-Comté, 25000, Besançon, France
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Abstract
Measurement-informed care is a cornerstone of evidence-based practice and shared decision-making. A structured diagnostic interview specific to ADHD provides a globally agreed-on standard of evaluation. These interviews are accessible in the public domain in multiple languages and are helpful to clinicians new to the diagnosis of ADHD. Broad-based rating scales looking at multiple domains of psychopathology are critical to assuring recognition of comorbid diagnoses, which might otherwise be missed, differential diagnoses, and identification of the most prominent or treatable diagnosis. Recent innovations in computerized adaptive testing have improved the efficiency and accuracy of diagnostic screening. Rating scales specific to ADHD and disruptive behavior disorders establish the severity of the disorder and response to intervention. Age- and gender-normed symptom rating scales for ADHD capture clinically salient differences between what is normative in different demographic groups. An evaluation of functional impairment in ADHD has been critical to understanding the patient's perspective of the presenting problem. Best practice care for ADHD treatment goes beyond improvement to well-defined standards for both symptom and functional remission. Studies of executive function, emotional regulation, mind-wandering, and sluggish cognitive tempo have led to a richer understanding of the breadth and depth of associated deficits commonly experienced by ADHD patients. Psychometrically validated tools are available to complement every aspect of ADHD care and provide global standards for research.
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Affiliation(s)
- Margaret Danielle Weiss
- Department of Child Psychiatry, Cambridge Health Alliance, 1493 Cambridge Street, Cambridge, MA 02139, USA.
| | - Mark A Stein
- Departments of Psychiatry and Behavioral Sciences, and Pediatrics, University of Washington School of Medicine, 1959 NE Pacific Street, Box 356560, Seattle, WA 98195-6560, USA
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Vindrola-Padros C, Ledger J, Barbosa EC, Fulop NJ. The Implementation of Improvement Interventions for "Low Performing" and "High Performing" Organisations in Health, Education and Local Government: A Phased Literature Review. Int J Health Policy Manag 2022; 11:874-882. [PMID: 33160292 PMCID: PMC9808185 DOI: 10.34172/ijhpm.2020.197] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 10/04/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND There is limited understanding about whether and how improvement interventions are effective in supporting failing healthcare organisations and improving the quality of care in high-performing organisations. The aim of this review was to examine the underlying concepts guiding the design of interventions aimed at low and high performing healthcare organisations, processes of implementation, unintended consequences, and their impact on costs and quality of care. The review includes articles in the healthcare sector and other sectors such as education and local government. METHODS We carried out a phased rapid systematic review of the literature. Phase one was used to develop a theoretical framework of organisational failure and turnaround, and the types of interventions implemented to improve quality. The framework was used to inform phase 2, which was targeted and focused on organisational failure and turnaround in healthcare, education and local government settings. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement to guide the reporting of the methods and findings and the Mixed Methods Appraisal Tool (MMAT) as a quality assessment tool. The review protocol was registered with PROSPERO (CRD: 42019131024). RESULTS Failure is frequently defined as the inability of organisations to meet pre-established performance standards and turnaround as a linear process. Improvement interventions are designed accordingly and are focused on the organisation, with limited system-level thinking. Successful interventions included restructuring senior leadership teams, inspections, and organisational restructuring by external organisations. Limited attention was paid to the potential negative consequences of the interventions and their costs. CONCLUSION Dominant definitions of success/failure and turnaround have led to the reduced scope of improvement interventions, the linear perception of turnaround, and lack of consideration of organisations within the wider system in which they operate. Future areas of research include an analysis of the costs of delivering these interventions in relation to their impact on quality of care.
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Affiliation(s)
| | - Jean Ledger
- Department of Applied Health Research, University College London, London, UK
| | | | - Naomi J. Fulop
- Department of Applied Health Research, University College London, London, UK
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Torrico M, Casino P, López A, Peiró S, Ríos M, Ríos S, Montes MJ, Guillén C, Nardi-Ricart A, García-Montoya E, Asensio D, Marqués AM, Piqué N. Improvement of Mueller-Kauffman Tetrathionate-Novobiocin (MKTTn) enrichment medium for the detection of Salmonella enterica by the addition of ex situ-generated tetrathionate. J Microbiol Methods 2022; 199:106524. [PMID: 35732231 DOI: 10.1016/j.mimet.2022.106524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/15/2022] [Accepted: 06/15/2022] [Indexed: 12/27/2022]
Abstract
The detection of Salmonella in food is based on the use of a selective enrichment broth such as Muller-Kauffman Tetrathionate-Novobiocin (MKTTn), in which tetrathionate plays a key role by providing Salmonella with a growth advantage. As sodium tetrathionate is unstable, it is generated in situ by the addition of iodine (Lugol's solution) before seeding. This step is cumbersome as the solution is easily spilled, compromising the performance of the medium and hindering the work of technicians. The aim of this study was to optimize MKTTn broth by generating tetrathionate ex situ through an external reaction between iodine and thiosulphate followed by lyophilization. Quality control procedures were performed to compare the modified and original media, testing pure productivity (enrichment with 50-120 CFU of Salmonella Thyphimurim ATCC 14028 and Salmonella Enteritidis ATCC 13076 and plating on Xylose Lysine Deoxycholate agar, XLD), mixed productivity (50-120 CFU of Salmonella strains and Pseudomonas aeruginosa and Escherichia coli at ≥104 CFU and XLD plating) and selectivity (≥104 CFU of P. aeruginosa and Enterococcus faecalis and plating on Tryptone Casein Soy agar, TSA). The modified MKTTn medium (S/L) performed comparably with the original medium in terms of growth of both Salmonella strains (>300 colonies in XLD), alone or with P. aeruginosa and E. coli. Quantitative assays showed no statistically significant differences in the number of colonies grown on XLD after 10-5 dilution (p = 0.7015 with S. Thyphimurim ATCC 14028 and p = 0.2387 with S. enteritidis ATCC 13076; ANOVA test). MKTTn medium (S/L) was also selective against E. coli (≤100 colonies) and E. faecalis (<10 colonies). These results suggest that adding tetrathionate as a lyophilisate (S/L) is a feasible alternative to the use of Lugol's solution for the preparation of MKTTn enrichment broth and does not affect the properties of the medium.
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Affiliation(s)
- M Torrico
- Department of Quality Control, Reactivos para Diagnóstico, S.L. (RPD). Josep Tura, 9H, polígon industrial Mas d'en Cisa, 08181 Sentmenat, Barcelona, Catalonia, Spain
| | - P Casino
- Department of Quality Control, Reactivos para Diagnóstico, S.L. (RPD). Josep Tura, 9H, polígon industrial Mas d'en Cisa, 08181 Sentmenat, Barcelona, Catalonia, Spain
| | - A López
- Department of Quality Control, Reactivos para Diagnóstico, S.L. (RPD). Josep Tura, 9H, polígon industrial Mas d'en Cisa, 08181 Sentmenat, Barcelona, Catalonia, Spain
| | - S Peiró
- Department of Quality Control, Reactivos para Diagnóstico, S.L. (RPD). Josep Tura, 9H, polígon industrial Mas d'en Cisa, 08181 Sentmenat, Barcelona, Catalonia, Spain; Microbiology Section, Department of Biology, Healthcare and Environment, Faculty of Pharmacy and Food Sciences, Universitat de Barcelona (UB), Barcelona, Catalonia, Spain
| | - M Ríos
- Department of Genetics, Microbiology and Statistics, Biology Faculty, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - S Ríos
- Department of Genetics, Microbiology and Statistics, Biology Faculty, Universitat de Barcelona, Barcelona, Catalonia, Spain; Department of Biochemistry and Biotechnology, Human Nutrition Unit, Universitat Rovira i Virgili, Reus, Catalonia, Spain
| | - M J Montes
- Microbiology Section, Department of Biology, Healthcare and Environment, Faculty of Pharmacy and Food Sciences, Universitat de Barcelona (UB), Barcelona, Catalonia, Spain
| | - C Guillén
- Microbiology Section, Department of Biology, Healthcare and Environment, Faculty of Pharmacy and Food Sciences, Universitat de Barcelona (UB), Barcelona, Catalonia, Spain
| | - A Nardi-Ricart
- Department of Pharmacy and Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, Universitat de Barcelona, Catalonia, Spain
| | - E García-Montoya
- Department of Pharmacy and Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, Universitat de Barcelona, Catalonia, Spain; Pharmacotherapy, Pharmacogenetics and Pharmaceutical Technology research group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Catalonia, Spain
| | - D Asensio
- Department of Quality Control, Reactivos para Diagnóstico, S.L. (RPD). Josep Tura, 9H, polígon industrial Mas d'en Cisa, 08181 Sentmenat, Barcelona, Catalonia, Spain
| | - A M Marqués
- Microbiology Section, Department of Biology, Healthcare and Environment, Faculty of Pharmacy and Food Sciences, Universitat de Barcelona (UB), Barcelona, Catalonia, Spain
| | - N Piqué
- Microbiology Section, Department of Biology, Healthcare and Environment, Faculty of Pharmacy and Food Sciences, Universitat de Barcelona (UB), Barcelona, Catalonia, Spain; Institut de Recerca en Nutrició i Seguretat Alimentària de la UB (INSA-UB), Universitat de Barcelona, Barcelona, Catalonia, Spain.
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Vu TTH, Kilian A, Carling J, Lawn RJ. Consensus genetic map and QTLs for morphological and agronomical traits in mungbean using DArT markers. Physiol Mol Biol Plants 2022; 28:1277-1295. [PMID: 35910434 PMCID: PMC9334499 DOI: 10.1007/s12298-022-01201-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 06/02/2022] [Accepted: 06/20/2022] [Indexed: 06/03/2023]
Abstract
Mungbean is an important but understudied food legume compared with other major grain crops. Genetic studies through development of high-through put markers, linkage map construction and QTL analysis can accelerate and improve the efficiency of mining for genes for breeding in this crop. This study used four mungbean F5 recombinant inbred lines (RILs) from crosses of two wild types (ACC 1, ACC 87) and two cultivars (Berken, Kiloga) and DArT markers to construct individual and consensus linkage maps and to identify QTLs associated with 54 traits in mungbean. The number of polymorphic DArT markers identified among the four RIL populations varied from 1062 to 2013. The individual maps covered the lengths of 629.7-883.5 cM, comprising 672-981 DArT markers and 15-19 linkage groups (LG) with average distance between markers of 0.9-1.2 cM. The consensus map had the total length of 795.3 cM, comprising 1539 DArT markers and resolved 11 LGs with an average inter-marker distance of 0.65 cM. Sixty-two QTLs were identified for 39 traits across 10 LGs of the consensus map. Major QTLs were identified for two special traits, late flowering inherited from ACC 1 (6 QTLs, PVE of 11.2-29.9%) and perenniality inherited from ACC 87 (3 QTLs, PVE of 17.4-22.6%) in separate population analysis. Number of congruent QTLs across four mungbean populations and the consensus map was 18 for 13 traits. These results illustrated the high efficiency of DArT marker application in mungbean genetic dissection and suggested the future potential employment of identified QTLs for mungbean improvement.
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Affiliation(s)
- Thi Thuy Hang Vu
- College of Science and Engineering, James Cook University, Townsville, Qld 4811 Australia
- Faculty of Agronomy, Vietnam National University of Agriculture, Hanoi, Vietnam
| | - Adrzeij Kilian
- Diversity Array Technology Pty. Ltd., Monana St., Bruce, ACT, 2617 Australia
| | - Jason Carling
- Diversity Array Technology Pty. Ltd., Monana St., Bruce, ACT, 2617 Australia
| | - Robert John Lawn
- College of Science and Engineering, James Cook University, Townsville, Qld 4811 Australia
- CSIRO Agriculture, ATSIP, James Cook University, Townsville, Qld 4811 Australia
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Ismayilova M, Yaya S. What can be done to improve polycystic ovary syndrome (PCOS) healthcare? Insights from semi-structured interviews with women in Canada. BMC Womens Health 2022; 22:157. [PMID: 35538531 PMCID: PMC9092874 DOI: 10.1186/s12905-022-01734-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 04/25/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a common and perplexing condition affecting metabolic, reproductive, cardiovascular, and psychological health in women. Previous studies point to widespread dissatisfaction and frustration in women with the information and care they receive. Studies have found delays with the diagnosis of PCOS and gaps in knowledge in physicians regarding the diagnosis and management of PCOS. Little has been heard from women on what they think can be improved with PCOS care, especially in Canada. This qualitative study explores women's experiences navigating the healthcare system and their insights on what could be improved based on their lived experiences. METHODS Twenty-five participants were interviewed remotely over the phone by the first author between October and December 2018.Interviews were semi-structured and in-depth. Data were analyzed using thematic analysis and interpretive description methodology. RESULTS Twenty-five in-depth interviews conducted with participants across Canada (ages 18-63) revealed three overall areas in need of improvement. First, women emphasized a need for greater knowledge and awareness of PCOS in primary care physicians (PCPs) as well as the need for the medical community to prioritize women's health. Second, participants advocated for greater PCOS awareness and de-stigmatization in the general community and in women and girls, and any individuals with female reproductive systems. Third, participants brought up several needed resources, such as the need for more PCOS research to be funded and undertaken, more PCOS specialists and experts to be available, credible doctor-provided information (e.g., pamphlets, websites), and age-specific support groups and mental health supports to be available. Participants were generally unaware of existing PCOS organizations and brought up the need for established PCOS organizations to aid in the training and retraining of doctors and local awareness-building in communities. CONCLUSIONS Participants believed that PCPs in Canada needed to be well-versed on how to diagnose and manage PCOS to prevent delays in diagnosis and provide easier access to care. Further, greater awareness and de-stigmatization in the general community are needed so women can identify symptoms early and have access to support from those around them. Overall, PCOS may be an overlooked and under-prioritized condition, both in the Canadian healthcare system and general community.
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Affiliation(s)
- Miya Ismayilova
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Sanni Yaya
- School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa, 120 University Private, Ottawa, ON K1N 6N5 Canada
- The George Institute for Global Health, Imperial College London, London, UK
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A.H SA, Shahen M, Ali EF, Majrashi A, M ES, Khaffagy AE, Ageba MF. Improving integrated management of weed control by determination of weed seed bank in sandy and clay soil. Saudi J Biol Sci 2022; 29:3023-3032. [PMID: 35531212 PMCID: PMC9073137 DOI: 10.1016/j.sjbs.2022.01.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 12/09/2021] [Accepted: 01/13/2022] [Indexed: 12/01/2022] Open
Abstract
Knowledge of soil weed seed bank is important for population dynamics studied, establishment of appropriate weed management programs, a little effort in understanding weed seed bank can give valuable information about what weeds to expect in growing season, weed density, and when most weed germination will take place. In this study, a two - year's, two sites were carried out with the aim of assessing weed seed bank status of the soil throughout 2018 and 2019. A site was worked out in Sakha Agriculture Research farm act as a clay soil, Kafr El-Sheikh Governorate, Agriculture Research Center (ARC). Another site was worked out in El-Ismailia Agr; Res; farm act as sandy soil, El-Ismailia Governorate, ARC. At each site, soil samples were selected from nine different places as like three Zigzag shapes divided into three, six and nine sites, "W" to act the whole soil area (30 faddan in Sakha farm, and 15 faddan in El-Ismailia farm). The soil samples were taken from topsoil 0-10 cm depth with an auger (core) 10 cm diameter the soils without tillage and before sowing the summer crop. The result of present the study in two different stations and soils, revealed that the number of soil samples to estimate weed seed banks should be either six or nine sites; each sample weighted 0.50 Kg soil with zigzag shape act a direct seed extraction technique to able recognize the abundance of weed species into the soil and their seed density. The aim is to improve integrated weed control.
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Affiliation(s)
- Sharshar A. A.H
- The Survey, Ecology and Physiological Weeds Department, Weed Research Central Laboratory (WRCL), Agricultural Research Center (ARC), Giza, Egypt
| | - Mohamed Shahen
- Zoology Department, Faculty of Science, 31527 Tanta University, Egypt
| | - Esmat F. Ali
- Department of Biology, College of Science, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Ali Majrashi
- Department of Biology, College of Science, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| | - Eid S.D. M
- The Survey, Ecology and Physiological Weeds Department, Weed Research Central Laboratory (WRCL), Agricultural Research Center (ARC), Giza, Egypt
| | - Azza E. Khaffagy
- Weed Control in Field Crops Department, (WRCL), ARC, Giza, Egypt
| | - Mohamed F. Ageba
- Zoology Department, Faculty of Science, 31527 Tanta University, Egypt
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Lam AY, Duloy AM, Keswani RN. Quality Indicators for the Detection and Removal of Colorectal Polyps and Interventions to Improve Them. Gastrointest Endosc Clin N Am 2022; 32:329-349. [PMID: 35361339 DOI: 10.1016/j.giec.2021.12.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Modifiable risk factors for postcolonoscopy colorectal cancer include suboptimal lesion detection (missed neoplasms) and inadequate lesion removal (incomplete polypectomy) during colonoscopy. Competent detection and removal of colorectal polyps are thus fundamental to ensuring adequate colonoscopy quality. Several well-researched quality metrics for polyp detection have been implemented into clinical practice, chief among these the adenoma detection rate. Less data are available on quality indicators for polyp removal, which currently include complete resection rates and skills assessment tools. This review summarizes the available literature on quality indicators for the detection and removal of colorectal polyps, as well as interventions to improve them.
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Affiliation(s)
- Angela Y Lam
- Department of Gastroenterology, Kaiser Permanente San Francisco Medical Center, 2350 Geary Boulevard, San Francisco, CA 94115, USA
| | - Anna M Duloy
- Division of Gastroenterology and Hepatology, University of Colorado Anschutz Medical Center, 1635 Aurora Court, Aurora, CO 80045, USA
| | - Rajesh N Keswani
- Division of Gastroenterology and Hepatology, Northwestern University Feinberg School of Medicine, 676 North Street, Clair, Suite 1400, Chicago, IL 60611, USA.
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Wood DP, Robinson CA, Nathan R, McPhillips R. A study of the implementation of patient safety policies in the NHS in England since 2000: what can we learn? J Health Organ Manag 2022; ahead-of-print. [PMID: 35298879 DOI: 10.1108/jhom-02-2021-0073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Despite repeated policy initiatives, progress in improving patient safety in the National Health Service (NHS) in England over the past two decades has been slow. The NHS Patient Safety Strategy (NHS England and NHS Improvement, 2019), which is being implemented currently, aims to address this problem. The purpose of this study is to identify learning from the implementation of past patient safety policies and thereby suggest means of supporting the NHS in delivering the current policy initiative successfully. DESIGN/METHODOLOGY/APPROACH The authors identified key health policies in the domain of patient safety, published since 2000, by searching the United Kingdom (UK) government website. Discussion papers from the research literature concerning these policies were collated and reviewed. The authors then used a thematic analysis approach to identify themes discussed within these papers. These themes represent factors that support the effective delivery of patient safety policy initiatives. FINDINGS Within the discussion papers the authors collated, concerning 11 patient safety policies implemented between 2000 and 2017, five inter-related core themes of capability, culture, systems, candour and leadership were identified. By evaluating these themes and identifying composite sub-themes, a conceptual framework is presented that can be used to support the delivery of patient safety policy initiatives to maximise their impact. ORIGINALITY/VALUE The conceptual framework the authors illustrate, arising from this new contribution to the body of knowledge, can be translated into a novel self-assessment for individual NHS trusts to understand organisational development areas in the domain of patient safety improvement.
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Affiliation(s)
- David Phillip Wood
- The University of Manchester, Manchester, UK.,Cheshire and Wirral Partnership NHS Foundation Trust, Chester, UK
| | | | - Rajan Nathan
- Cheshire and Wirral Partnership NHS Foundation Trust, Chester, UK
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Sun YL, Shang LR, Liu RH, Li XY, Zhang SH, Ren YK, Fu K, Cheng HB, Yahaya BH, Liu YL, Lin JT. Therapeutic effects of menstrual blood-derived endometrial stem cells on mouse models of streptozotocin-induced type 1 diabetes. World J Stem Cells 2022; 14:104-116. [PMID: 35126831 PMCID: PMC8788184 DOI: 10.4252/wjsc.v14.i1.104] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 07/20/2021] [Accepted: 12/25/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Type 1 diabetes (T1D), a chronic metabolic and autoimmune disease, seriously endangers human health. In recent years, mesenchymal stem cell (MSC) transplantation has become an effective treatment for diabetes. Menstrual blood-derived endometrial stem cells (MenSC), a novel MSC type derived from the decidual endometrium during menstruation, are expected to become promising seeding cells for diabetes treatment because of their noninvasive collection procedure, high proliferation rate and high immunomodulation capacity.
AIM To comprehensively compare the effects of MenSC and umbilical cord-derived MSC (UcMSC) transplantation on T1D treatment, to further explore the potential mechanism of MSC-based therapies in T1D, and to provide support for the clinical application of MSC in diabetes treatment.
METHODS A conventional streptozotocin-induced T1D mouse model was established, and the effects of MenSC and UcMSC transplantation on their blood glucose and serum insulin levels were detected. The morphological and functional changes in the pancreas, liver, kidney, and spleen were analyzed by routine histological and immunohistochemical examinations. Changes in the serum cytokine levels in the model mice were assessed by protein arrays. The expression of target proteins related to pancreatic regeneration and apoptosis was examined by western blot.
RESULTS MenSC and UcMSC transplantation significantly improved the blood glucose and serum insulin levels in T1D model mice. Immunofluorescence analysis revealed that the numbers of insulin+ and CD31+ cells in the pancreas were significantly increased in MSC-treated mice compared with control mice. Subsequent western blot analysis also showed that vascular endothelial growth factor (VEGF), Bcl2, Bcl-xL and Proliferating cell nuclear antigen in pancreatic tissue was significantly upregulated in MSC-treated mice compared with control mice. Additionally, protein arrays indicated that MenSC and UcMSC transplantation significantly downregulated the serum levels of interferon γ and tumor necrosis factor α and upregulated the serum levels of interleukin-6 and VEGF in the model mice. Additionally, histological and immunohistochemical analyses revealed that MSC transplantation systematically improved the morphologies and functions of the liver, kidney, and spleen in T1D model mice.
CONCLUSION MenSC transplantation significantly improves the symptoms in T1D model mice and exerts protective effects on their main organs. Moreover, MSC-mediated angiogenesis, antiapoptotic effects and immunomodulation likely contribute to the above improvements. Thus, MenSC are expected to become promising seeding cells for clinical diabetes treatment due to their advantages mentioned above.
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Affiliation(s)
- Yu-Liang Sun
- Stem Cell and Biotherapy Technology Research Center, Xinxiang Medical University, Xinxiang 453000, Henan Province, China
- Regenerative Medicine Cluster, Advanced Medical and Dental Institute (IPPT), Universiti Sains Malaysia, Kepala Batas 13200, Penang, Malaysia
| | - Ling-Rui Shang
- Stem Cell and Biotherapy Technology Research Center, Xinxiang Medical University, Xinxiang 453000, Henan Province, China
| | - Rui-Hong Liu
- College of Biomedical Engineering, Xinxiang Medical University, Xinxiang 453000, Henan Province, China
| | - Xin-Yi Li
- Stem Cell and Biotherapy Technology Research Center, Xinxiang Medical University, Xinxiang 453000, Henan Province, China
| | - Sheng-Hui Zhang
- The Third Affiliated Hospital of Xinxiang Medical University, Xinxiang Medical University, Xinxiang 453000, Henan Province, China
| | - Ya-Kun Ren
- Henan Key Laboratory of Medical Tissue Regeneration, Xinxiang Medical University, Xinxiang 453000, Henan Province, China
| | - Kang Fu
- Department of Technical, Henan Intercell Biotechnology co. LTD, Xinxiang 453000, Henan Province, China
| | - Hong-Bin Cheng
- College of Biomedical Engineering, Xinxiang Medical University, Xinxiang 453000, Henan Province, China
| | - Badrul Hisham Yahaya
- Regenerative Medicine Cluster, Advanced Medical and Dental Institute (IPPT), Universiti Sains Malaysia, Kepala Batas 13200, Penang, Malaysia
| | - Yan-Li Liu
- Stem Cell and Biotherapy Technology Research Center, Xinxiang Medical University, Xinxiang 453000, Henan Province, China
| | - Jun-Tang Lin
- Stem Cell and Biotherapy Technology Research Center, Xinxiang Medical University, Xinxiang 453000, Henan Province, China
- College of Biomedical Engineering, Xinxiang Medical University, Xinxiang 453000, Henan Province, China
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Abstract
Global annual deaths from Trauma are greater than any other single cause in the global working population, and, more than all contagious diseases added together including COVID-19. The number of people injured, either temporarily or permanently, is greater than any other medical condition. This problem affects Low and Middle Income Countries (LMICs) disproportionately. The numbers are so great as to cause "zone out" and present a human rights issue. This is a particular issue as Trauma presently receives less than 1% of global healthcare funding. This article will highlight and discuss many of the issues and raise some uncomfortable arguments showing that improvement is needed, necessary and achievable.
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Affiliation(s)
- Nigel D Rossiter
- Primary Trauma Care Foundation, PO Box 880, Oxford, OX1 9PG, UK.
- The G4 Alliance, Chicago, IL, 60611, USA.
- Hampshire Hospitals, Basingstoke, RG24 7AL, UK.
- The Hampshire Clinic, Old Basing, Basingstoke, RG24 7AL, UK.
- Orthopaedic Trauma Society, Orthopaedic Trauma education AO UK &Ireland, Ireland, UK.
- Orthopaedic Trauma Association, Rosemont, IL, USA.
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Bahat G, Catikkas NM, Yavuz DG, Borman P, Guzel R, Reginster JY. The current situation in the approach to osteoporosis in older adults in Turkey: areas in need of improvement with a model for other populations. Arch Osteoporos 2021; 16:179. [PMID: 34846612 DOI: 10.1007/s11657-021-01038-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 11/08/2021] [Indexed: 02/03/2023]
Abstract
PURPOSE The total number of older adults in Turkey is striking, amounting to around 8 million, and this translates into considerably higher numbers of cases of osteoporosis (OP) and fractures in older adults. In this article, we outlined the current situation of OP in older adults in Turkey and investigated the differences between Turkey and a representative developed European country (Belgium), in terms of the screening, diagnosis, and treatment of OP. Our intention in this regard was to identify areas in need of improvement and subsequently to make a clear call for action to address these issues. METHODS Herein, considering the steps related to the OP approach, we made a complete review of the studies conducted in Turkey and compared with the literature recommendations. RESULTS There is a need for a national osteoporotic fracture registry; measures should be taken to improve the screening and treatment of OP in older males, such as educational activities; technicians involved in dual-energy X-ray absorptiometry (DXA) scanning should undergo routine periodic training; all DXA centers should identify center-specific least significant change values; all older adults should be considered for routine lateral dorsolumbar X-ray imaging for the screening of vertebral fractures while ordering DXA scans; the inclusion of vertebral fracture assessment (VFA) software in DXA assessments should be considered; screening using a fracture risk assessment tool (FRAX) algorithm that is specific to Turkey should be integrated; the fortification of foods with vitamin D is required; the high fracture risk by country-specific FRAX algorithm and the presence of falls/high fall risk should be integrated in reimbursement terms; and finally, more "fracture liaison services" should be established. CONCLUSION We suggest that the practical consideration of our suggestions will provide considerable support to the efforts for combating with the adverse consequences of OP in society. This approach can be subsequently modeled for other populations to improve the management of OP globally.
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