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Systematic Literature Review of Health-Related Quality-of-Life Measures for Caregivers of Older Adult Trauma Patients. J Surg Res 2024; 297:47-55. [PMID: 38430862 PMCID: PMC11023761 DOI: 10.1016/j.jss.2024.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/11/2023] [Accepted: 01/03/2024] [Indexed: 03/05/2024]
Abstract
INTRODUCTION As the older adult population increases, hospitals treat more older adults with injuries. After leaving, these patients suffer from decreased mobility and independence, relying on care from others. Family members often assume this responsibility, mostly informally and unpaid. Caregivers of other older adult populations have increased stress and decreased caregiver-related quality of life (CRQoL). Validated CRQoL measures are essential to capture their unique experiences. Our objective was to review existing CRQoL measures and their validity in caregivers of older adult trauma patients. METHODS A professional librarian searched published literature from the inception of databases through August 12, 2022 in MEDLINE (via PubMed), Embase (via Elsevier), and CINAHL Complete (via EBSCO). We identified 1063 unique studies of CRQoL in caregivers for adults with injury and performed a systematic review following COnsensus-based Standards for the selection of health Measurement Instruments guidelines for CRQoL measures. RESULTS From the 66 studies included, we identified 54 health-related quality-of-life measures and 60 domains capturing caregiver-centered concerns. The majority (83%) of measures included six or fewer CRQoL content domains. Six measures were used in caregivers of older adults with single-system injuries. There were no validated CRQoL measures among caregivers of older adult trauma patients with multisystem injuries. CONCLUSIONS While many measures exist to assess healthcare-related quality of life, few, if any, adequately assess concerns among caregivers of older adult trauma patients. We found that CRQoL domains, including mental health, emotional health, social functioning, and relationships, are most commonly assessed among caregivers. Future measures should focus on reliability and validity in this specific population to guide interventions.
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Trends in Paediatric Emergency Medical Presentations. IRISH MEDICAL JOURNAL 2024; 117:913. [PMID: 38446194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
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Development of a prospective biliary dashboard to compare performance and surgical cost. Surg Endosc 2023; 37:8829-8840. [PMID: 37626234 DOI: 10.1007/s00464-023-10376-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/30/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Transparency around surgeon level data may align healthcare delivery with quality care for patients. Biliary surgery includes numerous procedures performed by both general surgeons and subspecialists alike. Cholecystectomy is a common surgical procedure and an optimal cohort to measure quality outcomes within a healthcare system. METHODS Data were collected for 5084 biliary operations performed by 68 surgeons in 11 surgical divisions in a health system including a tertiary academic hospital, two regional community hospitals, and two ambulatory surgery centers. A privacy protected dashboard was developed to compare surgeon performance and cost between July 2018 and June 2022. A sample cohort of patients ≥ 18 years who underwent cholecystectomy were compared by operative time, cost, and 30-day outcomes. RESULTS Over 4 years, 4568 cholecystectomy procedures were performed by 57 surgeons. Operations were done by 57 surgeons in four divisions and included 3846 (84.2%) laparoscopic cholecystectomies, 601 (13.2%) laparoscopic cholecystectomies with cholangiogram, and 121 (2.6%) open cholecystectomies. Patients were admitted from the emergency room in 2179 (47.7%) cases while 2389 (52.3%) cases were performed in the ambulatory setting. Individual surgeons were compared to peers for volume, intraoperative data, cost, and outcomes. Cost was lowest at ambulatory surgery centers, yet only 4.2% of elective procedures were performed at these facilities. Prepackaged kits with indocyanine green were more expensive than cholangiograms that used iodinated contrast. The rate of emergency department visits was lowest when cases were performed at ambulatory surgery centers. CONCLUSION Data generated from clinical dashboards can inform surgeons as to how they compare to peers regarding quality metrics such as cost, time, and complications. In turn, this may guide strategies to standardize care, optimize efficiency, provide cost savings, and improve outcomes for cholecystectomy procedures. Future application of clinical dashboards can assist surgeons and administrators to define value-based care.
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Response to Letter to the Editor. J Med Imaging Radiat Sci 2023; 54:388. [PMID: 37015844 DOI: 10.1016/j.jmir.2023.03.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 03/19/2023] [Indexed: 04/04/2023]
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Optimal Nutrition in the Older Adult: Beneficial Versus Ineffective Supplements. Curr Nutr Rep 2023:10.1007/s13668-023-00459-y. [PMID: 36689099 DOI: 10.1007/s13668-023-00459-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2022] [Indexed: 01/24/2023]
Abstract
PURPOSE OF REVIEW Proper nutrition in older adults is essential, as nutritional deficiencies are common in this population. This review aims to summarize the benefits and risks of nutritional supplementation in the older adult population including the efficacy of various supplements, their risks, and common drug interactions with frequently prescribed medications. RECENT FINDINGS In recent years, a growing percentage of older adults have been found to take multiple daily nutritional supplements. This population has complex nutritional needs due to the physiology of aging and the presence of comorbidities. However, many primary care providers are unaware of the benefits and drawbacks of nutritional supplementation in the elderly. This review summarizes the current literature to provide more clarity to providers on how to support this population's nutritional needs. Nutritional supplementation is essential for elderly populations who may not be able to obtain adequate nutrition from dietary sources. Supplements vary widely in efficacy and safety. As such, supplementation should be individualized and guided by a qualified healthcare provider to ensure patients receive effective, beneficial nutrition.
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POS1497-HPR FEASIBILITY OF A PHYSIOTHERAPIST LED, BEHAVIOUR CHANGE INTERVENTION TO IMPROVE PHYSICAL ACTIVITY IN PEOPLE WITH RHEUMATOID ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundPhysical activity (PA) is an important component in the management of people with rheumatoid arthritis (RA) (1). Interventions incorporating Behaviour Change (BC) theory are needed to target physically inactive people with RA. The study Physiotherapist-led Intervention to Promote Physical Activity in Rheumatoid Arthritis (PIPPRA) was designed using the Behaviour Change Wheel (BCW) and a pilot study of feasibility undertaken (ClinicalTrials.gov Identifier: NCT03644160).ObjectivesTo obtain reliable estimates regarding recruitment rates; participant retention; protocol adherence and possible adverse events, and to producing estimates of the potential effect sizes of the BC intervention on changes in outcomes of physical activity; fatigue; disability and quality of life.MethodsParticipants were recruited at University Hospital (UH) rheumatology clinics and randomly assigned to control group (physical activity information leaflet) or intervention group (four BC physiotherapy sessions in eight weeks). Inclusion criteria were diagnosis of RA (ACR/EULAR 2010 classification criteria), aged 18+ years and classified as insufficiently physically active. Ethical approval was obtained from the UH research ethics committee. Participants were assessed at baseline (T0), 8-weeks (T1), and 24-weeks (T2). Descriptive statistics and t-tests were used to analyse the data with SPSS v22.Results320 participants were identified through chart review with direct contact then with people meeting the inclusion criteria at rheumatology clinics. Of the clinic attendees n=183 (57%) were eligible to participate and n=58 (55%) of those consented to participate. The recruitment rate was 6.4 per month and refusal rate was 59%. Due to impact of COVID-19 on the study n=25 (43%) participants completed the study (n=11 (44%) in intervention and n=14 (56%) in control). Of the 25, n= 23 (92%) were female, mean age was 60 years (sd 11.5). Intervention group participants completed 100% of BC sessions 1 & 2, 88% session 3 and 81% session 4. No serious adverse events were reported. Secondary outcome measures data is Table 1.Table 1.Mean (sd) for secondary outcome measures in PIPPRA feasibility studyOutcomes and instrumentsInterventionControlBaseline Mean (sd)Time 1 Mean (sd)Time 2 Mean (sd)Baseline Mean (sd)Time 1 Mean (sd)Time 2 Mean (sd)Physical Activity – self report (YPAS1)146.27 (193.73)120.88 (70.80)132.00 (70.65)91.75 (85.86)58.03 (50.61)124.31 (69.75)Physical Activity – objective (Step Count)32,616.9132,190.0027,793.3330,476.1542,117.2534,288.77(11,415.85)(9,291.57)(7,426.92)(12,642.97)(21,714.67)(17,677.90)Pain (VAS2)4.184.904.503.715.104.79(2.40)(1.91)(1.90)(2.55)(2.77)(4.50)Disability (HAQDI3)0.850.941.030.710.711.52(0.57)(0.57)(0.65)(0.56)(0.52)(0.69)Fatigue (BRAF MDQ4)18.1814.82 (13.15)18.55 (11.84)15.71 (12.29)13.93 (15.27)20.21 (10.85)(8.98)Psychological Constructs (TPB5)22.0019.91 (7.76)20.27 (8.63)21.79 (5.67)15.50 (11.43)25.36 (6.86)(4.84)Quality of Life (RA QoL6)15.1814.73 (7.23)17.09 (7.33)18.4311.50 (10.02)14.86 (6.47)(6.08)(5.06)Sleep (PSQI7)11.558.509.9110.219.0910.14(3.56)(3.27)(3.62)(3.47)(4.32)(4.42)1YPAS – Yale Physical Activity Scale2VAS – Visual Analogue Scale3HAQDI – Health Assessment Questionnaire Disability Index4BRAF MDQ - Bristol Rheumatoid Arthritis Fatigue Multidimensional Questionnaire5TPB – Theory of Planned Behaviour Questionnaire6RA QoL – Rheumatoid Arthritis Quality of Life Scale7PSQI – Pittsburgh Sleep Quality IndexConclusionThe PIPPRA study designed using the BCW to improve promote physical activity was feasible and safe. This pilot study provides a framework for larger intervention studies and based on these findings a fully powered trial is recommended.References[1]Rausch Osthoff A, Niedermann K, Braun J, et al. (2018) EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis. Annals of the Rheumatic Diseases 77:1251-1260.Disclosure of InterestsNone declared
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POS1511-HPR “I LEARNT SO MUCH ABOUT MY APPROACH TO BEING ACTIVE”: EXPERIENCES OF PEOPLE WITH RHEUMATOID ARTHRITIS ON THE IMPACT OF A PHYSIOTHERAPIST LED INTERVENTION TO PROMOTE PHYSICAL ACTIVITY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundPhysical activity is an important component in the management of people with rheumatoid arthritis (RA) [1]. A Physiotherapist-led Intervention to Promote Physical Activity in people with RA (PIPPRA) was undertaken using the Behaviour Change Wheel, with the aim of examining the feasibility of promoting physical activity in RA. This qualitative study involved participants and health care professionals who participated and were involved in a behaviour change pilot RCT intervention.ObjectivesTo determine, qualitatively, the acceptability of PIPPRA to participants with RA and health care professionals, in order to capture their reality.MethodsA qualitative study design of face-to-face semi-structured interviews was undertaken. The interview schedule explored the following areas: experience of the intervention; unintended consequences; experience and suitability of outcome measures used; views regarding the intervention; perceptions of behaviour change and physical activity. Interviews were transcribed verbatim by a professional transcriber. Thematic analysis was used as an analytical approach [2]. The research team searched for patterns, analysed and coded the data, and generated themes and sub-themes. Themes were reviewed by the research team to check if they worked in relation to the coded extracts and the entire data set. The COREQ checklist provided guidance throughout [3].ResultsFourteen participants [13 female/1 male; mean age of 59 (SD 6.3); mean RA diagnosis of 8.6 (SD 6.8) years; moderate to severe disability (HAQ-DI: 1.4 (SD 0.50)] and 8 healthcare staff [4 female/4 male; mean age of 41 (SD 5.6)] participated. Three main themes were generated from participants:- 1) Positive experience of behaviour change intervention - “I found it very knowledgeable to help you get stronger”; 2) Improvement in self-management - “…….motivate me maybe to go back to doing a little bit more exercise”; 3) Negative impact of COVID-19 on intervention – “I don’t think doing it online again would be really good at all”. Two main themes from health care professionals:- 1) Positive learning experience of behaviour change delivery – “Really made me realise the importance of discussing physical activity with patients”; 2) Positive approach to recruitment – “Very professional team showing the importance of having a study member on site”.ConclusionThe findings demonstrated that participants had a positive experience of being involved in a behaviour change intervention in order to improve their physical activity and found it acceptable as an intervention. However, if given the choice they would prefer the intervention delivery face to face rather than telehealth. Healthcare professionals also had a positive experience and in particular found it beneficial to their own development, in particular the importance of recommending PA to patients.References[1]Rausch Osthoff A, Niedermann K, Braun J, et al. (2018) EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis. Annals of the Rheumatic Diseases 77:1251-1260[2]Clarke, V. and Braun, V., 2014. Thematic analysis. In Encyclopedia of critical psychology (pp. 1947-1952). Springer, New York, NY[3]Tong, A., Sainsbury, P. and Craig, J., 2007. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International journal for quality in health care, 19(6), pp.349-357Disclosure of InterestsNone declared
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A Survey to Determine the Acceptability of an Interactive Recipe Tool to Increase Children’s Exposure and Acceptance to Healthy Foods. J Acad Nutr Diet 2021. [DOI: 10.1016/j.jand.2021.06.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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AB0872-HPR IMPACT OF COVID-19 ON A PHYSICAL ACTIVITY FEASIBILITY PILOT STUDY: THE PIPPRA EXPERIENCE. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:The PIPPRA (Physiotherapist-led Intervention to Promote Physical Activity in Rheumatoid Arthritis) project is a feasibility project examining the impact of a physical activity behaviour change intervention in people who have rheumatoid arthritis (RA). The PIPPRA study recruitment commenced in October 2019, with participant assessment and intervention commencing in November 2019. In the Republic of Ireland people who have RA are categorised as high risk category for Covid-19, due to immunosuppression [1], although this categorisation contrasts with EULAR’s provisional recommendations [2].Objectives:To examine the impact of the Covid-19 pandemic and public health restrictions on a pilot randomised controlled feasibility study in 2020.Methods:Participants (aged 18 years+, diagnosis of RA, independently mobile and low levels of physical activity [3]) were recruited from a rheumatology clinic at an urban hospital. Target recruitment was four participants per month for one year (N=48). Assessments were planned at baseline, eight and twenty-four weeks (N=144). Participants were randomised to intervention group or control group. The intervention group received four 1:1 sixty minute sessions with a physiotherapist (N=96). The intervention was delivered over eight weeks. Intervention and control groups received a physical activity information leaflet.Results:The Covid-19 pandemic and associated public health restrictions forced the study to be formally paused in April 2020 and the study formally resumed in August 2020. N=48 participants were recruited between October 2019 and March 2020 (six months). N=20 participants have commenced in the study, N=16 are awaiting baseline assessment, N=6 withdrew and N=6 were lost to follow-up prior to baseline. Trial protocol planned for the delivery of N=55 assessments and N=36 intervention sessions for participants who had commenced in the study. N=22 assessments and N=26 intervention sessions were delivered between November 2019 and March 2020. N=5 assessments and N=6 intervention sessions were conducted between August and October 2020. No assessment or intervention delivery occurred in November-December 2020 due to participant hesitancy in attending for assessment and/or intervention with increased public health restrictions. The impact of Covid-19 restrictions resulted in N=33 (60%) deviations from assessment protocol and N=10 (27%) deviations from intervention delivery protocol (Figure 1).Figure 1.Deviations from assessment and intervention protocol in the PIPPRA studyConclusion:The Covid-19 pandemic has had a significant impact on the delivery of the PIPPRA study. Feasibility study outcomes, including participant retention rate, and study delivery as per protocol, have been affected due to the Covid-19 pandemic. Participant reluctance to attend face-to-face sessions demonstrates the need to consider alternative methods of delivery, e.g. virtual delivery of interventions, where attending in person is not acceptable to participants [4], in future studies.References:[1]Health Service Executive. (2019). People at higher risk from COVID-19.Accessed 5th Jan 2020 https://www2.hse.ie/conditions/coronavirus/people-at-higher-risk.html.[2]Landewé RB et al (2020). EULAR provisional recommendations for the management of rheumatic and musculoskeletal diseases in the context of SARS-CoV-2. Annals of the Rheumatic Diseases 79:851-858.[3]Godin, G. (2011). The Godin-Shephard leisure-time physical activity questionnaire. The Health & Fitness Journal of Canada, 4(1):18-22.[4]Inan, OT et al. (2020). Digitizing clinical trials. npj Digit. Med. 3:10.Disclosure of Interests:None declared
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Abstract No. 558 Does lung shunt fraction estimation using injection of 99mTc-MAA still vital in 90Y radioembolization dosimetry? A hypothetical study using patient specific information. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Abstract No. 556 Real-time image-guided drainage of postsurgical pericardial effusion is an effective alternative to surgical window. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Gratitude Enhanced Mindfulness (GEM): A pilot study of an internet-delivered programme for self-management of pain and disability in people with arthritis. THE JOURNAL OF POSITIVE PSYCHOLOGY 2020. [DOI: 10.1080/17439760.2019.1627397] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Cardiovascular stress reactions in recent- and long-retired rugby players when watching a game. Physiol Behav 2020; 219:112832. [DOI: 10.1016/j.physbeh.2020.112832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 11/08/2019] [Accepted: 02/05/2020] [Indexed: 11/17/2022]
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P316 THE EFFECTS OF ALLERGEN SUBCUTANEOUS IMMUNOTHERAPY ON SYMPTOMS OF POLLEN FOOD ALLERGY SYNDROME. Ann Allergy Asthma Immunol 2019. [DOI: 10.1016/j.anai.2019.08.323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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EP-1454 Multi-parametric MRI as a biomarker in anal cancer: a prospective trial. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31874-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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EP-1455 Post chemoradiotherapy FDG-PET parameters predict for recurrence in anal cancer: a prospective trial. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31875-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Weight Status in Children with Autism Spectrum Disorder. IRISH MEDICAL JOURNAL 2019; 112:904. [PMID: 31124628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Imaging features and safety and efficacy of endovascular stroke treatment: a meta-analysis of individual patient-level data. Lancet Neurol 2018; 17:895-904. [DOI: 10.1016/s1474-4422(18)30242-4] [Citation(s) in RCA: 213] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 06/11/2018] [Accepted: 06/12/2018] [Indexed: 11/29/2022]
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The free energy principle and autopoiesis: Comment on "Answering Schrödinger's question: A free-energy formulation" by Maxwell James Désormeau Ramstead, Paul Benjamin Badcock, Karl John Friston. Phys Life Rev 2018; 24:24-26. [PMID: 29307787 DOI: 10.1016/j.plrev.2017.12.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 12/29/2017] [Indexed: 10/18/2022]
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Effect of general anaesthesia on functional outcome in patients with anterior circulation ischaemic stroke having endovascular thrombectomy versus standard care: a meta-analysis of individual patient data. Lancet Neurol 2018; 17:47-53. [DOI: 10.1016/s1474-4422(17)30407-6] [Citation(s) in RCA: 129] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 10/05/2017] [Accepted: 10/11/2017] [Indexed: 10/18/2022]
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P1.16-003 Learning Curve for Adoption of Robotic Lobectomy for Early Stage Non-Small Cell Lung Cancer by a Thoracic Surgeon Experienced in Open Lobectomy. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Severe Vitamin B12 Deficiency; an Unusual Cause of Developmental Regression in Infants. IRISH MEDICAL JOURNAL 2016; 109:474. [PMID: 28125188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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AB1102-HPR “if A Joint Is Hot It's Not The Time”: Health Professionals' Views on Developing Physical Activity Interventions for People Who Have Rheumatoid Arthritis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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FRI0633-HPR “It Might Hurt, but Still It's Good”: People with Rheumatoid Arthritis Beliefs and Expectations about Physical Activity Interventions. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
Invasive fungal infections and systemic mycosis, whether from nosocomial infection or immunodeficiency, have been on an upward trend for numerous years. Despite advancements in antifungal medication, treatment in certain patients can still be difficult for reasons such as impaired organ function, limited administration routes or poor safety profiles of the available antifungal medications. The growing number of invasive fungal species becoming resistant to current antifungal medications is of appreciable concern. Triazole compounds containing one or more 1,2,4-triazole rings have been shown to contain some of the most potent antifungal properties. Itracon-azole and fluconazole were some of the first triazoles synthesized, but had limitations associated with their use. Second-generation triazoles such as voriconazole, posa-conazole, albaconazole, efinaconazole, ravuconazole and isavuconazole are all derivatives of either itraconazole or fluconazole, and designed to overcome the deficiencies of their parent drugs. The goal of this manuscript is to review antifungal agents derived from triazole.
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The influence of self-esteem and social support on the relationship between stigma and depressive symptomology in parents caring for children with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2015; 59:948-957. [PMID: 26031805 DOI: 10.1111/jir.12205] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 02/20/2015] [Accepted: 04/22/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND This study explored the synergistic relationship between stigma, self-esteem and social support, as predictors of depressive symptomology in parents of children with disabilities (e.g. Autism and Down syndrome). METHOD One hundred and seventy-three parents (115 parents of children with disabilities and 58 control parents) completed measures of perceived stigma, self-esteem, social support and depressive symptoms. RESULTS Parents of children with disabilities reported more depressive symptomology; additionally, stigma, self-esteem and social support were associated with depressive symptomology. Moreover, the association between stigma and depressive symptomology was mediated by self-esteem, i.e. parents who reported higher stigma were lower on self-esteem and more depressed. Further, this path varied as a function of emotional support. CONCLUSION Results highlight the need for tailored interventions that offer parents effective strategies in dealing with stigma through social support and self-esteem.
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Long-term sensorimotor and therapeutical effects of a mild regime of prism adaptation in spatial neglect. A double-blind RCT essay. Ann Phys Rehabil Med 2015; 58:40-53. [DOI: 10.1016/j.rehab.2014.10.004] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 10/03/2014] [Accepted: 10/10/2014] [Indexed: 11/28/2022]
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Life after the emergency services: an exploratory study of well being and quality of life in emergency service retirees. ACTA ACUST UNITED AC 2014; 16:223-31. [PMID: 25345234 DOI: 10.4172/1522-4821.1000108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Much is known about the negative impact of emergency services work, but no studies, to date, have investigated its long-term consequences. This cross-sectional study assesses the possible long-term effects on quality of life, of trauma exposure and emergency work in a sample of retirees from the Irish emergency services (n = 169) and a comparison group of non-emergency service retirees (n = 140). A multi-questionnaire postal survey was administered to assess quality of life (QoL; WHOQOL-BREF), experiences of trauma, and trauma symptoms (PSS-SR). QoL was significantly better in non-emergency retirees, whilst this group also had significantly fewer trauma symptoms. Incidents involving children were identified by a large proportion of emergency retirees as being particularly difficult to manage. The findings address a significant gap in our knowledge around the possible longer-term effects of emergency services work in an often neglected sub-group. Factors associated with increased QoL and reduced symptoms of PTSD are discussed, as are some possible recommendations for the future.
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FIRST VERSUS SECOND-GENERATION DRUG-ELUTING STENTS IN THE TREATMENT OF IN-STENT RESTENOSIS: FROM THE CAPITAL PCI REGISTRY. Can J Cardiol 2014. [DOI: 10.1016/j.cjca.2014.07.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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OP61 Perceived maternal stress and emotional wellbeing as risk factors for miscarriage. Br J Soc Med 2014. [DOI: 10.1136/jech-2014-204726.64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Assessment of occlusion after placement of stainless steel crowns in children - a pilot study. J Oral Rehabil 2014; 41:730-6. [PMID: 24913609 DOI: 10.1111/joor.12196] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2014] [Indexed: 11/30/2022]
Abstract
Many stainless steel crowns (SSCs) disrupt the occlusion in children, but stabilisation appears to occur within a short period post-placement. The extent and mechanism of these short-term occlusal changes in children are unknown. This study sought to determine whether placement of a SSC changes the maximum intercuspation position (MIP) in children, whether the MIP returns to normal within 4 weeks and whether local anaesthesia had an effect on the child's ability to achieve MIP. The T-Scan(®) III was used for the measurement of occlusal contacts. Reliability and reproducibility of the system was determined using a calibration exercise where MIP recordings were taken of eleven children not undergoing any dental treatment. For the main study, the percentage of total occlusal force on each tooth was recorded in 20 children preoperatively, after local anaesthesia, after SSC placement and 4 weeks postoperatively. There was no significant difference in MIP (P = 0·435) preoperatively and post-administration of local anaesthesia. There was a significant difference between the preoperative force on a tooth and the reading after crown placement (P = 0·0013, Wilcoxon test). By 4 weeks, there was no significant difference overall between post-SSC placement and the preoperative value for the tooth (P = 0·3). Administration of local anaesthesia did not affect the ability of a child to attain MIP. Maximum intercuspation position was disturbed by the placement of a SSC in seven of 20 cases. When MIP was disturbed, in most cases, it returned to preoperative status within 4 weeks of crown placement.
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Happy but unhealthy: The relationship between social ties and health in an emerging network. EUROPEAN JOURNAL OF SOCIAL PSYCHOLOGY 2014. [DOI: 10.1002/ejsp.2030] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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An audit of the management of thyroid disease in children with Down syndrome. IRISH MEDICAL JOURNAL 2014; 107:118-119. [PMID: 24834588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Children with Down syndrome are at a higher risk of thyroid dysfunction than children in the general population. The aim of this audit was to determine thyroid screening practice at University Hospital Limerick and to compare it to the Irish guidelines for the medical management of children with Down syndrome. The thyroid function tests (TFT) of 148 children with Down syndrome were assessed through retrospective database review. Overall compliance with the guidelines was 79/148 (53%), although this varied by age category. The 0-5 years category had a compliance rate of 47/54 (87%), the 6-11 years category was 22/51 (43%), and the 12-17 years category had a compliance rate of 10/43 (23%). The guidelines are effective for monitoring purposes, although performing an annual TFT throughout childhood may be warranted.
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Impact of diabetes mellitus and renal insufficiency on 5-year mortality following coronary artery bypass graft surgery: a cohort study of 4869 UK patients. Eur J Cardiothorac Surg 2014; 45:1075-81. [DOI: 10.1093/ejcts/ezt630] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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Thyroid dysfunction in children with Down syndrome: a literature review. Ir J Med Sci 2013; 183:1-6. [PMID: 23934377 DOI: 10.1007/s11845-013-0994-y] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Accepted: 07/29/2013] [Indexed: 12/23/2022]
Abstract
INTRODUCTION This article is an evidence-based review of thyroid disease in children with Down syndrome, including a comparison between various professional guidelines for the management of thyroid disease in children with Down syndrome. Aspects of thyroid disease which are discussed include: congenital hypothyroidism; autoimmune thyroid disease; subclinical hypothyroidism; and hyperthyroidism. The national professional guidelines of Ireland, the United Kingdom, the United States of America, Australia and Canada are reviewed and compared. MATERIALS AND METHODS A literature search was conducted using Medline and PubMed. Search terms included 'Down syndrome' and 'thyroid disease', 'hypothyroidism', 'hyperthyroidism', 'subclinical hypothyroidism'. RESULTS Eighty-nine articles were retrieved and reviewed for inclusion. The guidelines on the medical management of children with Down syndrome of five expert groups have also been retrieved and reviewed for this discussion. These various guidelines offer largely similar advice regarding frequency of thyroid function tests, with only Ireland and the UK testing less frequently than annually. Only the United Kingdom and Irish Down Syndrome Medical Interest Group guidelines suggest testing for thyroid antibodies at every thyroid screen. None of the guidelines offer suggestions on the optimal course of action to pursue after the discovery of subclinical hypothyroidism. CONCLUSION In conclusion, more evidence is required regarding the optimal course of treatment for subclinical hypothyroidism. Such evidence may be best obtained by conducting a prospective randomized control trial.
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Eptifibatide and abciximab are associated with similar outcomes when used during primary percutaneous coronary intervention for ST-elevation myocardial infarction. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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No difference in mortality between immediate vs delayed staged intervention of non culprit vessel in patients with multivessel disease following primary angioplasty. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p4816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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040 THE EFFECT OF GLYCOPROTEIN IIBIIIA INHIBITORS ON MORTALITY FOLLOWING PCI FOR NSTEMI/UA. BRITISH HEART JOURNAL 2013. [DOI: 10.1136/heartjnl-2013-304019.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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094 CLINICAL USE OF CARDIAC STRESS PERFUSION MRI SCAN TO GUIDE TREATMENT OF NON CULPRIT CORONARY ARTERY DISEASE IN PATIENTS WITH MULTI-VESSEL DISEASE UNDERGOING PPCI FOR STEMI. BRITISH HEART JOURNAL 2013. [DOI: 10.1136/heartjnl-2013-304019.94] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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063 TIMING OF STAGED INTERVENTION FOR NON-CULPRIT DISEASE IN PATIENTS WITH MULTI-VESSEL DISEASE UNDERGOING PPCI FOR STEMI. BRITISH HEART JOURNAL 2013. [DOI: 10.1136/heartjnl-2013-304019.63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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064 LONG-TERM OUTCOME AMONG PATIENTS WITH EARLY, LATE, AND VERY LATE STENT THROMBOSIS FOLLOWING PREVIOUS PCI FOR ST-ELEVATION MYOCARDIAL INFARCTION. BRITISH HEART JOURNAL 2013. [DOI: 10.1136/heartjnl-2013-304019.64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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BHPR: Audit and Clinical Evaluation * 103. Dental Health in Children and Young Adults with Inflammatory Arthritis: Access to Dental Care. Rheumatology (Oxford) 2013. [DOI: 10.1093/rheumatology/ket196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Comparison of cap lamp and laser illumination for detecting visual escape cues in smoke. TRANSACTIONS OF SOCIETY FOR MINING, METALLURGY, AND EXPLORATION, INC 2013; 334:401-409. [PMID: 26259492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The Illuminating Engineering Society of North America reports that an underground mine is the most difficult environment to illuminate (Rea, 2000). Researchers at the U.S. National Institute for Occupational Safety and Health (NIOSH) Office of Mine Safety and Health Research (OMSHR) are conducting ongoing studies designed to explore different lighting technologies for improving mine safety. Underground miners use different visual cues to escape from a smoke-filled environment. Primary and secondary escapeways are marked with reflective ceiling tags of various colors. Miners also look for mine rail tracks. The main objective of this paper is to compare different lighting types and ceiling tag colors to differentiate what works best in a smoke-filled environment. Various cap lamps (LED and incandescent) and lasers (red, blue, green) were compared to see which options resulted in the longest detection distances for red, green and blue reflective markers and a section of mine rail track. All targets advanced toward the human subject inside of a smoke-filled room to simulate the subject walking in a mine environment. Detection distances were recorded and analyzed to find the best cap lamp, laser color and target color in a smoke environment. Results show that cap lamp, laser color and target color do make a difference in detection distances and are perceived differently based on subject age. Cap lamps were superior to lasers in all circumstances of ceiling tag detection, with the exception of the green laser. The incandescent cap lamp worked best in the simulated smoke compared to the LED cap lamps. The green laser was the best color for detecting the tags and track compared to the red and blue lasers. The green tags were the easiest color to detect on the ceiling. On average, the track was easier for the subjects to detect than the ceiling tags.
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Comparison of cap lamp and laser illumination for detecting visual escape cues in smoke. TRANSACTIONS OF SOCIETY FOR MINING, METALLURGY, AND EXPLORATION, INC 2013; 334:401-409. [PMID: 26236146 PMCID: PMC4521996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The Illuminating Engineering Society of North America reports that an underground mine is the most difficult environment to illuminate (Rea, 2000). Researchers at the U.S. National Institute for Occupational Safety and Health (NIOSH) Office of Mine Safety and Health Research (OMSHR) are conducting ongoing studies designed to explore different lighting technologies for improving mine safety. Underground miners use different visual cues to escape from a smoke-filled environment. Primary and secondary escapeways are marked with reflective ceiling tags of various colors. Miners also look for mine rail tracks. The main objective of this paper is to compare different lighting types and ceiling tag colors to differentiate what works best in a smoke-filled environment. Various cap lamps (LED and incandescent) and lasers (red, blue, green) were compared to see which options resulted in the longest detection distances for red, green and blue reflective markers and a section of mine rail track. All targets advanced toward the human subject inside of a smoke-filled room to simulate the subject walking in a mine environment. Detection distances were recorded and analyzed to find the best cap lamp, laser color and target color in a smoke environment. Results show that cap lamp, laser color and target color do make a difference in detection distances and are perceived differently based on subject age. Cap lamps were superior to lasers in all circumstances of ceiling tag detection, with the exception of the green laser. The incandescent cap lamp worked best in the simulated smoke compared to the LED cap lamps. The green laser was the best color for detecting the tags and track compared to the red and blue lasers. The green tags were the easiest color to detect on the ceiling. On average, the track was easier for the subjects to detect than the ceiling tags.
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A visual warning system to reduce struck-by or pinning accidents involving mobile mining equipment. APPLIED ERGONOMICS 2012; 43:1058-1065. [PMID: 22503737 PMCID: PMC4518725 DOI: 10.1016/j.apergo.2012.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Revised: 03/09/2012] [Accepted: 03/19/2012] [Indexed: 05/31/2023]
Abstract
This paper describes an experiment to examine whether a visual warning system can improve detection of moving machine hazards that could result in struck-by or pinning accidents. Thirty-six participants, twelve each in one of three age groups, participated in the study. A visual warning system capable of providing four different modes of warning was installed on a continuous mining machine that is used to mine coal. The speed of detecting various machine movements was recorded with and without the visual warning system. The average speed of detection for forward and reverse machine movements was reduced by 75% when using the flashing mode of the visual warning system. This translated to 0.485 m of machine travel for the fast speed condition of 19.8 m/min, which is significant in the context of the confined spaces of a mine. There were no statistically significant differences among age groups in the ability to detect machine movements for the visual warning modes in this study. The visual warning system shows promise as a safety intervention for reducing struck-by or pinning accidents involving continuous mining machines. The methods and results of this study could be applied to other moving machinery used in mining or other industries where moving machinery poses struck-by or pinning hazards.
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THE IMPACT OF DIFFERENT FORMS OF IPO FIRM LEGITIMACY ON THE CHOICE OF ALLIANCE GOVERNANCE STRUCTURE. JOURNAL OF MANAGEMENT & ORGANIZATION 2012. [DOI: 10.5172/jmo.2012.2300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Consensus statement of the consortium for LESS cholecystectomy. Surg Endosc 2012; 26:2711-6. [PMID: 22936433 DOI: 10.1007/s00464-012-2478-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Accepted: 04/19/2012] [Indexed: 02/03/2023]
Abstract
Many surgeons attempting Laparo-Endoscopic Single Site (LESS) cholecystectomy have found the operation difficult, which is inconsistent with our experience. This article is an attempt to promote a standardized approach that we feel surgeons with laparoscopic skills can perform safely and efficiently. This is a four-trocar approach consistent with the four incisions utilized in conventional laparoscopic cholecystectomy. After administration of general anesthesia, marcaine is injected at the umbilicus and a 12-mm vertical incision is made through the already existing anatomical scar of the umbilicus. A single four-trocar port is inserted. A 5-mm deflectable-tip laparoscope is placed through the trocar at the 8 o'clock position, a bariatric length rigid grasper is inserted through the trocar at the 4 o'clock position (to grasp the fundus), and a rigid bent grasper is placed through the 10-mm port (to grasp the infundibulum). This arrangement of the instruments promotes minimal internal and external instrument clashing with simultaneous optimization of the operative view. This orientation allows retraction of the gallbladder in a cephalad and lateral direction, development of a window between the gallbladder and the liver which promotes the "critical view" of the cystic duct and artery, and provides triangulation with excellent visualization of the operative field. The operation is concluded with diaphragmatic irrigation of marcaine solution to minimize postoperative pain. Standardization of LESS cholecystectomy will speed adoption, reduce intraoperative complications, and improve the efficiency and safety of the approach.
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Protein analysis by SDS-PAGE and detection by Coomassie blue or silver staining. CURRENT PROTOCOLS IN PHARMACOLOGY 2012; Appendix 3:3B. [PMID: 21971792 DOI: 10.1002/0471141755.pha03bs02] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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