51
|
Arab W, Lukanović D, Matjašič M, Blaganje M, Deval B. Determinants of Dissatisfaction After Laparoscopic Cure of Vaginal and/or Rectal Prolapse using Mesh: a Comprehensive Retrospective Cohort Study. Int Urogynecol J 2024; 35:457-465. [PMID: 38206336 DOI: 10.1007/s00192-023-05701-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 11/15/2023] [Indexed: 01/12/2024]
Abstract
INTRODUCTION AND HYPOTHESIS The primary objective is to identify determinants of dissatisfaction after surgical treatment of vaginal prolapse ± rectal prolapse, using laparoscopic mesh sacrohysteropexy (LSH) or sacrocolpopexy (LSC) ± ventral mesh rectopexy (VMR). The secondary objective is the evaluation of complications and objective/subjective recurrence rates. METHODS The study performed was a single-surgeon retrospective review of prospectively collected data. LSH/LSC ± VMR were performed between July 2005 and September 2022. Primary investigated outcome was patients' satisfaction, assessed using the Patient Global Impression of Improvement (PGI-I) score and the bother visual analog scale (VAS) obtained postoperatively (at a 1-month interval and on a 6-month/yearly basis thereafter). We looked for a correlation between the level of satisfaction (as reflected by the VAS) and potential determinants. RESULTS There were 355 patients with a mean age of 62 ±12 years. Nearly all the patients (94.3%) had a stage 3 or 4 prolapse according to the POP-Q classification. The mean postoperative bother VAS was 1.8, with only 12.7% of patients reporting a bother VAS score ≥ 3/10, indicating a dissatisfaction. PGI-I showed improvement in the vast majority of patients (96.4% scoring 1 to 3). Patients with anal incontinence preoperatively scored higher on the bother VAS postoperatively (r=0.175, p < 0.05). The use of a posterior arm mesh (for posterior vaginal prolapse) correlated with better satisfaction overall (r= -0.178, p = 0.001), whereas the performance of VMR was associated with a bothering sensation (r = 0.232, p < 0.001). A regression analysis confirmed the impact of posterior mesh and VMR on satisfaction levels, with odds of dissatisfaction being 2.18 higher when VMR was combined with LSH/LSC. CONCLUSIONS Posterior mesh use improves patient satisfaction when the posterior compartment is affected. In patients with concomitant vaginal and rectal prolapse, combining VMR with anterior LSC/LSH appears to negatively impact patients' satisfaction. Preoperative anal incontinence was demonstrated to be a risk factor for postoperative dissatisfaction.
Collapse
Affiliation(s)
- Wissam Arab
- Department of Functional Pelvic Surgery & Oncology, Geoffroy Saint-Hilaire, Ramsay, Générale de Santé, Paris, France
| | - David Lukanović
- Department of Functional Pelvic Surgery & Oncology, Geoffroy Saint-Hilaire, Ramsay, Générale de Santé, Paris, France
- Department of Gynecology, Division of Gynecology and Obstetrics, Ljubljana University Medical Center, Ljubljana, Slovenia
- Department of Gynecology and Obstetrics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Miha Matjašič
- Department of Education Studies, Faculty of Education, University of Ljubljana, Ljubljana, Slovenia
| | - Mija Blaganje
- Department of Functional Pelvic Surgery & Oncology, Geoffroy Saint-Hilaire, Ramsay, Générale de Santé, Paris, France
- Department of Gynecology, Division of Gynecology and Obstetrics, Ljubljana University Medical Center, Ljubljana, Slovenia
- Department of Gynecology and Obstetrics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Bruno Deval
- Department of Functional Pelvic Surgery & Oncology, Geoffroy Saint-Hilaire, Ramsay, Générale de Santé, Paris, France.
| |
Collapse
|
52
|
Meyer JA, Alton S, Seung H, Pahlavan A, Trilling AR, Coghlan M, Goetzinger KR, Cojocaru L. Enhanced recovery after cesarean from the patient perspective: a prospective study of the ERAC Questionnaire (ERAC-Q). J Perinat Med 2024; 52:14-21. [PMID: 37609844 DOI: 10.1515/jpm-2023-0234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 07/26/2023] [Indexed: 08/24/2023]
Abstract
OBJECTIVES To evaluate the impact of an Enhanced Recovery After Cesarean (ERAC) protocol on the post-cesarean recovery experience using a validated ten-item questionnaire (ERAC-Q). METHODS This is a prospective cohort study of patients completing ERAC quality-of-life questionnaires (ERAC-Q) during inpatient recovery after cesarean delivery (CD) between October 2019 and September 2020, before and after the implementation of our ERAC protocol. Patients with non-Pfannenstiel incision, ICU admission, massive transfusion, bowel injury, existing chronic pain disorders, acute postpartum depression, or neonatal demise were excluded. The ERAC-Q was administered on postoperative day one and day of discharge to the pre- and post-ERAC implementation cohorts, rating aspects of their recovery experience on a scale of 0 (best) to 10 (worst). The primary outcome was ERAC-Q scores. Statistical analysis was performed with SAS software. RESULTS There were 196 and 112 patients in the pre- and post-ERAC cohorts, respectively. The post-ERAC group reported significantly lower total ERAC-Q scores compared to the pre-ERAC group, reflecting fewer adverse symptoms and greater perceived recovery on postoperative day one (1.6 [0.7, 2.8] vs. 2.7 [1.6, 4.3]) and day of discharge (0.8 [0.3, 1.5] vs. 1.4 [0.7, 2.2]) (p<0.001). ERAC-Q responses did not predict the time to achieve objective postoperative milestones. However, worse ERAC-Q pain and total scores were associated with higher inpatient opiate use. CONCLUSIONS ERAC implementation positively impacts patient recovery experience. The administration of ERAC-Q can provide real-time feedback on patient-perceived recovery quality and how healthcare protocol changes may impact their experience.
Collapse
Affiliation(s)
- Jessica A Meyer
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, NYU Grossman School of Medicine, New York, NY, USA
| | - Suzanne Alton
- Department of Obstetrics, Gynecology & Reproductive Science, University of Maryland Medical Center, Baltimore, MD, USA
| | - Hyunuk Seung
- Department of Pharmacy Practice & Sciences, University of Maryland School of Pharmacy, Baltimore, MD, USA
| | - Autusa Pahlavan
- Department of Gynecology & Obstetrics, Johns Hopkins University, Baltimore, MD, USA
| | - Ariel R Trilling
- Department of Obstetrics, Gynecology & Reproductive Science, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Martha Coghlan
- Department of Obstetrics, Gynecology & Reproductive Science, University of Maryland Medical Center, Baltimore, MD, USA
| | - Katherine R Goetzinger
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology & Reproductive Science, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Liviu Cojocaru
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology & Reproductive Science, University of Maryland School of Medicine, Baltimore, MD, USA
- Division of Anesthesia Critical Care, Department of Anesthesiology, Perioperative Care, & Pain Medicine, NYU Grossman School of Medicine, New York, NY, USA
- Division of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, Staten Island University Hospital of Northwell Health, New York, NY, USA
| |
Collapse
|
53
|
Mogawer RM, Fawzy MM, Mourad A, Ahmed H, Nasr M, Nour ZA, Hafez V. Topical sodium valproate-loaded nanospanlastics versus conventional topical steroid therapy in alopecia areata: a randomized controlled study. Arch Dermatol Res 2024; 316:64. [PMID: 38170256 PMCID: PMC10764371 DOI: 10.1007/s00403-023-02785-1] [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: 07/22/2023] [Revised: 10/17/2023] [Accepted: 11/20/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND A myriad of therapeutic modalities for alopecia areata are available; however, none is of high level of evidence, creating an immense need for the evaluation of other treatment modalities, of which topical sodium valproate is of potential role via proposed decrease in beta-catenin breakdown, despite its well-known side effect of hair fall as an oral therapy. OBJECTIVE Evaluating the efficacy and the safety of sodium valproate (SV)-loaded nanospanlastics, in comparison to topical corticosteroids, this is the currently available gold standard topical treatment for patchy AA. METHODOLOGY A total of 66 patients with patchy AA were randomly assigned to receive either topical mometasone furoate lotion or topical SV applied twice daily to all patches except a control patch, which was left untreated. Clinical, trichoscopic and biochemical assessments of beta-catenin tissue levels and Axin-2 gene expression were carried out at baseline and after 3 months. RESULTS Both therapeutic modalities were comparable. Potential efficacy was highlighted by significant improvement in the representative patch, the largest treated patch, to the control patch, the smallest untreated patch in both steroid and valproate groups (p = 0.027, 0.003 respectively). Both beta-catenin levels and Axin-2 gene expression were reduced after treatment, pointing to the inhibitory effect of dominating uncontrolled inflammatory milieu. Baseline beta-catenin was found to significantly negatively correlate with improvement in the representative patch in patients with baseline level above 0.42 ng/ml (p = - 0.042). CONCLUSION Both topical SV and steroids are of comparable modest efficacy. Thus, further evaluation of SV is due in combination with intralesional steroids and other anti-inflammatory treatment modalities, together with developing individualized approaches based on baseline beta-catenin level. CLINICALTRIALS GOV IDENTIFIER NCT05017454, https://clinicaltrials.gov/ct2/show/NCT05017454 .
Collapse
Affiliation(s)
- Rania M Mogawer
- Dermatology Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt.
| | - Marwa Mohamed Fawzy
- Dermatology Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Mourad
- Dermatology Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Heba Ahmed
- Dermatology Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Maha Nasr
- Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
| | - Zeinab Ahmed Nour
- Biochemistry Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Vanessa Hafez
- Dermatology Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| |
Collapse
|
54
|
D'hondt J, Briers B. The visual analogue scale as a child-friendly measure of the unhealthy = tasty intuition. Appetite 2024; 192:107098. [PMID: 37939730 DOI: 10.1016/j.appet.2023.107098] [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: 04/11/2023] [Revised: 08/11/2023] [Accepted: 10/23/2023] [Indexed: 11/10/2023]
Abstract
Worldwide, obesity is a growing concern. The implicit belief that healthiness and tastiness in food are inversely related (the Unhealthy = Tasty Intuition or UTI) decreases healthy food consumption and increases the risk of obesity. Since also childhood obesity has increased at an alarming rate and a large component of adult obesity is established during childhood, questions about children's own food beliefs and preferences are important. However, methods currently used to assess the UTI are either unvalidated Likert scales or implicit measures that are time intensive and too complex to be used for children. Two studies presented here offer an alternative measurement - the simple visual analogue scale. The findings show that this measure is more effective in predicting dietary quality in adults and the frequency of healthy food consumption in children compared to more traditional measures. This simple and effective tool could be used by academics and health practitioners alike to better understand children's food beliefs at an early age, which is a critical step when addressing the increasing obesity problem.
Collapse
Affiliation(s)
- Jonathan D'hondt
- Department of Work, Organisation and Society, Ghent University, Henri Dunantlaan 2, 9000, Ghent, Belgium; Area Marketing, Vlerick Business School, Reep 1, 9000, Ghent, Belgium.
| | - Barbara Briers
- Department of Work, Organisation and Society, Ghent University, Henri Dunantlaan 2, 9000, Ghent, Belgium; Department of Marketing, Faculty of Business and Economics, Prinsstraat 13, B2000, Antwerp, Belgium.
| |
Collapse
|
55
|
Chen CY, Zhou YH, Fang JR, Luo CE, Tan LL, Wang HB. The Auricular Injection Technique: A New Treatment for Lying Ear. Plast Reconstr Surg 2024; 153:74e-78e. [PMID: 36988631 DOI: 10.1097/prs.0000000000010484] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
SUMMARY Lying-ear deformity refers to an auricle that bends backward excessively, is excessively folded against the head, and has a very prominent antihelix. It usually requires experienced surgeons to perform surgical treatment and a prolonged postoperative recovery process. This article proposes a simple and effective hyaluronic acid injection technique that significantly improves the shape of the outer ear and enhances perceived facial aesthetics. Twenty patients underwent treatment with multiple injections. Measure-related parameters were used to evaluate the postoperative effect, and the results were graded using a visual analog scale. Interrater reliability among graders was evaluated using intraclass correlation coefficients. After treatment, no serious complications, such as infection or embolism, occurred. Six months after the procedure, the average auriculocephalic angle increased from 25.11 ± 9.46 to 32.72 ± 8.29 degrees, the average conchoscaphal angle increased from 87.69 ± 9.06 to 95.94 ± 7.11 degrees, and patients' average visual analog scale score increased from 4.40 ± 1.14 to 8.57 ± 0.68. Interrater reliability was fair to good for visual analog scale before injection and 6 months after injection (intraclass correlation coefficients, 0.49 and 0.45, respectively; both P < 0.001). The patients were satisfied with the injection process and results. This injection protocol improved the shape of the outer ear, resulting in excellent postoperative outcomes.
Collapse
Affiliation(s)
- Chao-Yang Chen
- From the Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital
| | - Yu-Hao Zhou
- From the Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital
| | - Jun-Ren Fang
- From the Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital
| | - Cheng-En Luo
- From the Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital
| | | | - Hai-Bin Wang
- From the Department of Plastic and Reconstructive Surgery, Guangdong Second Provincial General Hospital
| |
Collapse
|
56
|
Lo S, Rose A, Fowers S, Darko K, Britto A, Spina T, Ankrah L, Godonu A, Ntreh D, Lalwani R, Graham C, Tittsworth D, McIntyre A, O'Dowd C, Watson S, Maguire R, Hoak A, Ampomah O, Cutler B. Ghana 3D Telemedicine International MDT: A proof-of-concept study. J Plast Reconstr Aesthet Surg 2024; 88:425-435. [PMID: 38091684 DOI: 10.1016/j.bjps.2023.10.130] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 10/23/2023] [Accepted: 10/23/2023] [Indexed: 01/02/2024]
Abstract
A real-time 3D Telemedicine system - leveraging Microsoft's Holoportation™ communication technology - enabled an international multidisciplinary team meeting (MDT) to consult with complex reconstructive patients before, during, and after an overseas surgical collaboration. METHODS A proof-of-concept international 3D MDT clinic took place in November 2022, between the Canniesburn Plastic Surgery Unit, UK, and the National Reconstructive Plastic Surgery and Burns Centre, Korle Bu Teaching Hospital, Ghana. The 3D system was utilised 1) previsit to assess patients and enable logistical planning, 2) on-site in Ghana to further allow patients to see themselves and proposed operations in 3D, and 3) post visit to debrief the team and patients. RESULTS Four Ghana patients were followed through their patient journey (mandibular ameloblastoma, sarcoma thigh, maxillary tumour, sarcoma back). Thirteen participants (four patients, four Ghana clinicians, and five UK clinicians) completed feedback on the 3D MDT. Outcome measures were rated highly with satisfaction 84.31/100, perceived benefit 4.54/5, overall quality 127.3/147 (Telehealth Usability Questionnaire), and usability 83.2/100 (System Usability Scale). These data show close alignment with that previously published on high-income countries. CONCLUSIONS This novel technology has the potential to enhance the delivery of overseas surgical visits to low-to-middle-income countries, by improving planning, informed discussion with patients, expert consensus on complex cases, and fostering engagement with professionals who may be thousands of miles away. This is the first demonstration that real-time 3D Telemedicine can both work, and enhance care within an international MDT clinic, and may thus enable change in the approach to overseas surgical collaborations.
Collapse
Affiliation(s)
- Steven Lo
- Canniesburn Regional Plastic Surgery Unit, Glasgow G4 0SF, UK; School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK.
| | - Anna Rose
- Canniesburn Regional Plastic Surgery Unit, Glasgow G4 0SF, UK; School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | | | - Kwame Darko
- National Reconstructive Plastic Surgery and Burns Centre, Korle Bu Teaching Hospital, Accra, Ghana
| | | | | | - Levi Ankrah
- National Reconstructive Plastic Surgery and Burns Centre, Korle Bu Teaching Hospital, Accra, Ghana
| | - Arnold Godonu
- National Reconstructive Plastic Surgery and Burns Centre, Korle Bu Teaching Hospital, Accra, Ghana
| | - Daniel Ntreh
- National Reconstructive Plastic Surgery and Burns Centre, Korle Bu Teaching Hospital, Accra, Ghana
| | - Ruchi Lalwani
- West of Scotland NHS Innovation Hub, Queen Elizabeth University Hospital Campus, Govan Road, Glasgow G51 4TF, UK
| | - Catriona Graham
- Canniesburn Regional Plastic Surgery Unit, Glasgow G4 0SF, UK
| | | | - Aileen McIntyre
- West of Scotland NHS Innovation Hub, Queen Elizabeth University Hospital Campus, Govan Road, Glasgow G51 4TF, UK
| | | | - Stuart Watson
- Canniesburn Regional Plastic Surgery Unit, Glasgow G4 0SF, UK
| | - Roma Maguire
- Computer and Information Sciences, Livingstone Tower, University of Strathclyde, Glasgow G1 1XH, UK
| | | | - Opoku Ampomah
- National Reconstructive Plastic Surgery and Burns Centre, Korle Bu Teaching Hospital, Accra, Ghana
| | | |
Collapse
|
57
|
Savic N, Petry H, de Bruin ED, Lehmann R, Eggenberger P, Adcock M, Hirschmann R, Knols RH. Feasibility of an exergaming training program in type 2 diabetes mellitus: A mixed method study. Digit Health 2024; 10:20552076241285090. [PMID: 39430701 PMCID: PMC11489935 DOI: 10.1177/20552076241285090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 09/03/2024] [Indexed: 10/22/2024] Open
Abstract
Introduction Individuals with Type 2 Diabetes Mellitus may benefit from exergaming training. Exergaming, technology-driven physical activities requiring participants to be physically active or exercise to play the game, allows combining cognitive with motor training. This trial aimed to primarily evaluate the feasibility of an exergame-based training protocol. Secondarily, possible effects on physical, functional, and patient-reported outcomes were explored. Methods Type 2 diabetic individuals performed an exergaming protocol on a pressure sensitive platform. After a 6-week control period, training was administered 2-3 times weekly for another six weeks for 30-60 minutes per session. Outcome variables were assessed during baseline (T0), pre-intervention (T1) and twice at postintervention (T1 and T2). An interview after completion ended the study program. Feasibility was determined by recruitment, adherence, compliance, attrition rates, motivation, satisfaction, and technology acceptance. Results Eleven of 13 participants completed the study protocol. The feasibility criteria adherence-mandatory (86.4%), adherence-voluntary (70.2%), compliance (99.7%), attrition (15.4%) rate, motivation (82%), satisfaction (80%), and technology acceptance (62.5%) were all deemed acceptable, except for the recruitment rate (13.7%). There were inconsistent effects on functional outcomes, appraisal of diabetes, and health-related quality of life. Qualitative patient-reported experience was overall positive, which is in line with the quantitative results. Conclusion The exergame-based training program is feasible and safe and type 2 diabetic participants' acceptance of this approach was high, although the recruitment procedure needs minor changes. Furthermore, results were obtained that might be useful in selecting appropriate assessments and sample sizes in future trials.
Collapse
Affiliation(s)
- Nikola Savic
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Directorate of Research and Education, Physiotherapy and Occupational Therapy Research Center, University Hospital Zurich, Zurich, Switzerland
| | - Heidi Petry
- Center for Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
| | - Eling D. de Bruin
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
- Department of Health, OST-Eastern Swiss University of Applied Sciences, St Gallen, Switzerland
| | - Roger Lehmann
- Department of Endocrinology and Diabetology, University Hospital Zurich, Zurich, Switzerland
| | - Patrick Eggenberger
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Department of Endocrinology and Diabetology, University Hospital Zurich, Zurich, Switzerland
| | - Manuela Adcock
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Ruth Hirschmann
- Department of Endocrinology and Diabetology, University Hospital Zurich, Zurich, Switzerland
| | - Ruud H. Knols
- Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Directorate of Research and Education, Physiotherapy and Occupational Therapy Research Center, University Hospital Zurich, Zurich, Switzerland
| |
Collapse
|
58
|
Oguslu U, Gümüş B, Yalçin M, Sahin OZ, Yilmaz G. Comparison of supraclavicular brachiocephalic and femoral vein approaches for tunneled dialysis catheter placement in patients with thrombosed internal jugular veins. Hemodial Int 2024; 28:24-31. [PMID: 37798865 DOI: 10.1111/hdi.13117] [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: 04/26/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/07/2023]
Abstract
INTRODUCTION There is still debate on the best access route in case of bilateral internal jugular vein thrombosis. We aimed to compare the safety, effectiveness, and outcomes of tunneled dialysis catheter placement via supraclavicular brachiocephalic and femoral vein approaches in patients with bilateral internal jugular vein thrombosis. METHODS Between January 2018 and December 2021, data of the patients in whom tunneled dialysis catheters were placed via the supraclavicular brachiocephalic vein (n = 42) and femoral vein (n = 57) approaches were extracted. Patient demographics, technical and clinical success rates, complications, and outcomes were noted. The Likert scale was used to assess patient satisfaction. FINDINGS Forty two (42.4%) patients were men, and the mean age was 61.9 (range, 12-93) years. The technical and clinical success rate was 100% for both groups. No major complication was encountered. The mean follow-up period was 497.5 (range, 32-1698) catheter days. Thirty-day patency was similar for the brachiocephalic vein and femoral vein group (40 [95.2%] vs. 55 [96.5%], p = 0.754). Also, primary and cumulative patency rates were comparable (p = 0.158; p = 0.660). The infection rate was 2.6 and 4.1 per 1000 catheter days for the brachiocephalic vein and femoral vein group. The infection-free survival was significantly higher in the brachiocephalic vein group (71.9% vs. 35.3% at 12 months, p < 0.001). Patient satisfaction was higher in the brachiocephalic vein group (median satisfaction, 5 vs. 4, p < 0.001). DISCUSSION Both supraclavicular brachiocephalic vein and femoral vein approaches have high technical and clinical success with comparable patency rates. However, low infection rate and high patient satisfaction make the supraclavicular brachiocephalic vein approach a reasonable alternative before proceeding to the femoral vein access.
Collapse
Affiliation(s)
- Umut Oguslu
- Department of Radiology, Biruni University Faculty of Medicine, Istanbul, Turkey
| | - Burçak Gümüş
- Department of Radiology, Medicana Health Group, Istanbul, Turkey
| | - Murat Yalçin
- Department of Cardiology, Medicana Health Group, Istanbul, Turkey
| | | | - Gökalp Yilmaz
- Department of Radiology, Bahçelievler Public Hospital, Istanbul, Turkey
| |
Collapse
|
59
|
Reid C, Jones L, Janda M, Langbecker D, Stone L, Laing B, McCarthy A. Development and testing of a patient-reported experience measure for cancer: A cross-sectional survey. J Adv Nurs 2024; 80:312-327. [PMID: 37432759 DOI: 10.1111/jan.15767] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 03/14/2023] [Accepted: 06/21/2023] [Indexed: 07/12/2023]
Abstract
AIM To develop and psychometrically test the Patient-reported Experience Measure-Cancer (PREM-C), reflecting patients' perceptions of cancer care experiences according to the Institute of Medicine domains. DESIGN A three-phase cross-sectional survey was conducted. METHODS Development, reliability and validity testing of the PREM-C measure was undertaken. Data collection included three phases: firstly (development) between October and November, 2015; secondly (psychometric testing), May 2016-June, 2017, and finally, (revision and psychometric testing) May 2019-March 2020. RESULTS The final PREM-C structure, created using the Institute of Medicine domains, was psychometrically sound with five factors identified in the Exploratory Factor Analysis, demonstrating internal reliability ranging from 0.8 to 0.9. Confirmatory Factor Analysis indicated the hypothesized model fitted well (Root mean square error of approximation = 0.076). External convergent and divergent validity was established with the PREM-C found to be moderately correlated with the Picker Patient Experience Questionnaire but weakly correlated with the WHOQoL-BREF. CONCLUSION The development and testing of the PREM-C demonstrated good fit as a clinically relevant measure of ambulatory cancer patients' experiences of care. To make meaningful changes to nursing practice and health services, patient experience measures such as the PREM-C might support staff to identify areas for service improvement. IMPACT Few reliable measures and less validated measures collect patients' perceptions of the quality of their healthcare provision. Rigorous psychometric testing of the newly developed PREM-C demonstrated good internal consistency, test-retest reliability, and external convergent and divergent validity. The PREM-C is a potentially relevant measure of cancer patients' experiences of care. It might be used to assess patient-centred care and guide safety and quality improvements in clinical settings. PREM-C use might inform service providers of experiences of care in their institution and inform policy and practice development. This measure is sufficiently generic, allowing potential use in other chronic disease populations. PATIENT OR PUBLIC CONTRIBUTION This conduct of this study was supported by the participating patients of the hospital Cancer Outpatients Service.
Collapse
Affiliation(s)
- Carol Reid
- University of the Sunshine Coast, Sippy Downs, Queensland, Australia
- Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Lee Jones
- Queensland University of Technology, Brisbane City, Queensland, Australia
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Monica Janda
- The University of Queensland, St Lucia, Queensland, Australia
| | | | - Leanne Stone
- Princess Alexandra Hospital, Brisbane, Queensland, Australia
- Queensland University of Technology, Brisbane City, Queensland, Australia
| | - Bobbi Laing
- University of Auckland, Auckland, New Zealand
- Menzies Health Institute, Southport, Queensland, Australia
| | - Alexandra McCarthy
- Princess Alexandra Hospital, Brisbane, Queensland, Australia
- The University of Queensland, St Lucia, Queensland, Australia
- Mater Research Institute, South Brisbane, Queensland, Australia
| |
Collapse
|
60
|
Mondahl J, Hellesø R, Thomsen TG, Homøe P, Frederiksen K. A support nurse may strengthen the participation of patients with low socio-economic status in treatment pathways of head and neck cancer: A theory-based evaluation. J Adv Nurs 2023; 79:4850-4862. [PMID: 37534733 DOI: 10.1111/jan.15816] [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: 01/26/2023] [Revised: 07/07/2023] [Accepted: 07/20/2023] [Indexed: 08/04/2023]
Abstract
AIM To test and evaluate a support nurse intervention within the head and neck cancer (HNC) pathway. BACKGROUND Even though interventions aiming to support patients with a low socio-economic status have been a focus for development and implementation in several countries, research still shows that these patients often have unmet needs and encounter challenges in communicating with health professionals during their treatment pathways. Furthermore, support interventions are few in Denmark and none of the existing interventions target patients with HNC receiving radiation therapy of whom the majority have a low socio-economic status and therefore potentially carry a high risk of being challenged during their treatment pathways. DESIGN A theory-based evaluation was used as framework. A support nurse intervention was designed to offer patients with a low socio-economic status help and support in the initial part of the HNC pathway. Eleven patients were included in the trial period. METHODS The evaluation of the intervention was based on interviews, a questionnaire survey and field notes. RESULTS The expected outputs were achieved, thus: (1) the patients felt supported and assisted, (2) the support nurse was capable of supporting, helping and accompanying the patients, (3) the patients were informed as relevant and understood the information provided. Unexpected outputs were that the support nurse was capable of co-ordinating the pathway in line with the patient's needs and that she facilitated the interaction between patients and health professionals. CONCLUSIONS Support for patients with a low socio-economic status improves their ability to engage in their cancer treatment pathway. This, in turn, increases their preparedness for participation and, hence, strengthens their choice of treatment. REPORTING METHOD This study is reported using consolidated guideline for reporting interventions Template for intervention description and replication (TIDieR checklist). We used theory-based evaluation as described by Peter Dahler-Larsen. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
Collapse
Affiliation(s)
- Julie Mondahl
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Koege, Denmark
| | - Ragnhild Hellesø
- Department of Nursing Science, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Thora Grothe Thomsen
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Koege, Denmark
| | - Preben Homøe
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Koege, Denmark
| | - Kirsten Frederiksen
- Section for Nursing, Department of Public Health, Aarhus University, Aarhus, Denmark
| |
Collapse
|
61
|
Lo S, Fowers S, Darko K, Spina T, Graham C, Britto A, Rose A, Tittsworth D, McIntyre A, O'Dowd C, Maguire R, Chang W, Young D, Hoak A, Young R, Dunlop M, Ankrah L, Messow M, Ampomah O, Cutler B, Armstrong R, Lalwani R, Davison R, Bagnall S, Hudson W, Shepperd M, Johnson J. Participatory development of a 3D telemedicine system during COVID: The future of remote consultations. J Plast Reconstr Aesthet Surg 2023; 87:479-490. [PMID: 36890078 DOI: 10.1016/j.bjps.2022.10.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 10/04/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND The COVID pandemic brought the need for more realistic remote consultations into focus. 2D Telemedicine solutions fail to replicate the fluency or authenticity of in-person consultations. This research reports on an international collaboration on the participatory development and first validated clinical use of a novel, real-time 360-degree 3D Telemedicine system worldwide. The development of the system - leveraging Microsoft's Holoportation™ communication technology - commenced at the Canniesburn Plastic Surgery Unit, Glasgow, in March 2020. METHODS The research followed the VR CORE guidelines on the development of digital health trials, placing patients at the heart of the development process. This consisted of three separate studies - a clinician feedback study (23 clinicians, Nov-Dec 2020), a patient feedback study (26 patients, Jul-Oct 2021), and a cohort study focusing on safety and reliability (40 patients, Oct 2021-Mar 2022). "Lose, Keep, and Change" feedback prompts were used to engage patients in the development process and guide incremental improvements. RESULTS Participatory testing demonstrated improved patient metrics with 3D in comparison to 2D Telemedicine, including validated measures of satisfaction (p<0.0001), realism or 'presence' (Single Item Presence scale, p<0.0001), and quality (Telehealth Usability Questionnaire, p = 0.0002). The safety and clinical concordance (95%) of 3D Telemedicine with a face-to-face consultation were equivalent or exceeded estimates for 2D Telemedicine. CONCLUSIONS One of the ultimate goals of telemedicine is for the quality of remote consultations to get closer to the experience of face-to-face consultations. These data provide the first evidence that Holoportation™ communication technology brings 3D Telemedicine closer to this goal than a 2D equivalent.
Collapse
Affiliation(s)
- Steven Lo
- School of Medicine, Dentistry and Nursing, University of Glasgow, UK; Canniesburn Regional Plastic Surgery Unit, Glasgow G4 0SF, UK.
| | | | - Kwame Darko
- National Reconstructive Plastic Surgery and Burns Centre, Korle Bu Teaching Hospital, Accra, Ghana
| | | | - Catriona Graham
- Canniesburn Regional Plastic Surgery Unit, Glasgow G4 0SF, UK
| | | | - Anna Rose
- Canniesburn Regional Plastic Surgery Unit, Glasgow G4 0SF, UK
| | | | - Aileen McIntyre
- West of Scotland NHS Innovation Hub, Queen Elizabeth University Hospital Campus, Govan Road, Glasgow G51 4TF, UK
| | | | - Roma Maguire
- Computer and Information Sciences, Livingstone Tower, University of Strathclyde, Glasgow G1 1XH, UK
| | | | - David Young
- Mathematics and Statistics, Livingstone Tower, University of Strathclyde, Glasgow G1 1XH, UK
| | | | - Robin Young
- Robertson Centre for Biostatistics, University of Glasgow, Boyd Orr Building, G12 8QQ, UK
| | - Mark Dunlop
- Computer and Information Sciences, Livingstone Tower, University of Strathclyde, Glasgow G1 1XH, UK
| | - Levi Ankrah
- National Reconstructive Plastic Surgery and Burns Centre, Korle Bu Teaching Hospital, Accra, Ghana
| | - Martina Messow
- Robertson Centre for Biostatistics, University of Glasgow, Boyd Orr Building, G12 8QQ, UK
| | - Opoku Ampomah
- National Reconstructive Plastic Surgery and Burns Centre, Korle Bu Teaching Hospital, Accra, Ghana
| | | | - Roma Armstrong
- West of Scotland NHS Innovation Hub, Queen Elizabeth University Hospital Campus, Govan Road, Glasgow G51 4TF, UK
| | - Ruchi Lalwani
- West of Scotland NHS Innovation Hub, Queen Elizabeth University Hospital Campus, Govan Road, Glasgow G51 4TF, UK
| | - Ruairidh Davison
- West of Scotland NHS Innovation Hub, Queen Elizabeth University Hospital Campus, Govan Road, Glasgow G51 4TF, UK
| | - Sophie Bagnall
- West of Scotland NHS Innovation Hub, Queen Elizabeth University Hospital Campus, Govan Road, Glasgow G51 4TF, UK
| | | | | | | |
Collapse
|
62
|
Pierson SR, Lam R, Ngoue M, Rajagopalan D, Ring D, Ramtin S. Clinician Interruptions and Patient-Rated Clinician Empathy in Specialty Visits. J Am Acad Orthop Surg 2023; 31:1129-1135. [PMID: 37467397 DOI: 10.5435/jaaos-d-23-00071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 06/09/2023] [Indexed: 07/21/2023] Open
Abstract
INTRODUCTION Clinicians tend to interrupt patients when they are describing their problem, which may contribute to feeling unheard or misunderstood. Using transcripts of audio and video recordings from musculoskeletal (MSK) specialty visits, we asked what factors are associated with (1) Perceived clinician empathy, including the time a patient spends describing the problem and time to the first interruption, (2) duration of patient symptom description, and (3) duration between the end of greeting and first nonactive listening interruption. METHODS We analyzed transcripts of 194 adult patients seeking MSK specialty care with a median age (Interquartile range [IQR]) of 47 (33 to 59) years. Participants completed postvisit measures of perceived clinician empathy, symptoms of depression, accommodation of pain, and health anxiety. A nonactive listening interruption was defined as the clinician unilaterally redirecting the topic of conversation. Factors associated with patient-rated clinician empathy, patient problem description duration, and time until the first nonactive listening interruption were sought in bivariate and multivariable analyses. RESULTS The patient's narrative was interrupted at least one time in 144 visits (74%). The duration of each visit was a median of 12 minutes (IQR 9 to 16 minutes). The median time patients spent describing their symptoms was 139 seconds before the first interruption (IQR 84 to 225 seconds). The median duration between the end of the initial greeting and the first interruption was 60 seconds (IQR 30 to 103 seconds). Clinician interruption was associated with shorter duration of symptom description. Greater perceived clinician empathy was associated with greater accommodation of pain (regression coefficient [95% confidence interval] = 0.015 [0.0005-0.30]; P = 0.04). DISCUSSION Clinician interruption was associated with shorter symptom presentation, but not with diminished perception of clinician empathy. Although active listening and avoidance of interruption are important communication tactics, other aspects of the patient-clinician relationship may have more effect on patient experience.
Collapse
Affiliation(s)
- S Ryan Pierson
- From the Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas, Austin, TX
| | | | | | | | | | | |
Collapse
|
63
|
Claudic Y, Letissier H, Perruisseau-Carrier A, Hu W, Le Nen D, Andro C. WALANT for hand wound exploration in isolated conditions: Feasibility study. Orthop Traumatol Surg Res 2023; 109:103551. [PMID: 36649788 DOI: 10.1016/j.otsr.2023.103551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 11/24/2022] [Accepted: 12/13/2022] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Military doctors usually deal with hand wound management. Their practice sometimes takes them far from any specialized surgical center. The WALANT could be a powerful tool for doctors operating in nuclear submarines or as part of special forces. This is a comparative, prospective and multicenter study. The hypothesis was that the management of hand wounds by military doctors specifically trained in WALANT and in the surgical exploration of hand wounds allowed a diagnosis as effective as in the FESUM center. PATIENTS AND METHODS Military doctors, usually operating in isolated conditions, were trained at WALANT. Then, this method was used for the exploration of hand wounds in the emergency room, in a center outside FESUM. At the end, two different questionnaires were completed respectively by the patient and the operator. They aimed to assess various criteria such as the overall satisfaction of the patient and the operator, the level of pain felt or the ability of the operator to establish a precise lesion assessment. The results were compared with those obtained under the same conditions by hand surgeons in the FESUM centre. RESULTS No significant difference was found between the two centers in terms of diagnostic capacity, satisfaction, comfort and perceived pain intensity. DISCUSSION Under cover of prior training, the WALANT is effective for the exploration of hand wounds by submariner doctors and members of the special forces. Its use makes it possible to establish a precise injury report and this in material and human conditions approaching as closely as possible those of the armed forces on mission. The comfort of the patient remains preserved. CONCLUSION The WALANT represents an effective tool for the exploration and lesion assessment of hand wounds outside the FESUM centre. Since emergency conditions are similar to those encountered in operational conditions, its use is also possible in situations specific to military doctors: nuclear submarines, special forces on mission. LEVEL OF EVIDENCE III; comparative study, retrospective, multicentre.
Collapse
Affiliation(s)
- Yannis Claudic
- Service de Chirurgie Plastique, reconstructrice et esthétique, Hôpital de la Cavale Blanche, 29200 Brest, France
| | - Hoel Letissier
- Service de Chirurgie orthopédique et traumatologique, Hôpital de la Cavale Blanche, 29200 Brest, France; LaTIM, Inserm, UMR 1101, SFR IBSAM, 29200 Brest, France.
| | - Anne Perruisseau-Carrier
- Service de Chirurgie Plastique, reconstructrice et esthétique, Hôpital de la Cavale Blanche, 29200 Brest, France
| | - Weiguo Hu
- Service de Chirurgie Plastique, reconstructrice et esthétique, Hôpital de la Cavale Blanche, 29200 Brest, France
| | - Dominique Le Nen
- Service de Chirurgie orthopédique et traumatologique, Hôpital de la Cavale Blanche, 29200 Brest, France
| | - Christophe Andro
- LaTIM, Inserm, UMR 1101, SFR IBSAM, 29200 Brest, France; Service de Chirurgie orthopédique et traumatologique, HIA Clermont-Tonnerre, 29200 Brest, France
| |
Collapse
|
64
|
Oguslu U, Gümüş B, Danışan G. Ultrasound-Guided Popliteal Sciatic Nerve Block: A Minimally Invasive Method for Pain Control During Endovascular Treatment of Critical Limb Ischemia. J Vasc Interv Radiol 2023; 34:1690-1696. [PMID: 37391073 DOI: 10.1016/j.jvir.2023.06.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 06/15/2023] [Accepted: 06/23/2023] [Indexed: 07/02/2023] Open
Abstract
PURPOSE To evaluate the safety and effectiveness of ultrasound-guided popliteal sciatic nerve block (PSNB) for pain control in endovascular treatment of critical limb ischemia (CLI). MATERIALS AND METHODS This retrospective study included 252 patients who underwent endovascular treatment for CLI between January 2020 and August 2022. Of these, 69 patients underwent PSNB, whereas moderate procedural sedation and analgesia was delivered in 183 patients. Pain scores were assessed using the visual analog scale (VAS) before and during the intervention. Technical and clinical success of PSNB, duration of the procedure, time to onset of nerve block, time for block resolution, and adverse events were recorded. Patient and operator satisfaction were assessed using the Likert scale. RESULTS All PSNB procedures were technically and clinically successful, and the mean procedural duration of PSNB was 5.0 minutes ± 0.8 (range, 4-7 minutes). Prolonged effect of PSNB was observed in 3 patients, which resolved within 24 hours. No adverse events were encountered. Median VAS score was significantly lower in the PSNB group than in the moderate procedural sedation and analgesia group during endovascular treatment (0 [range, 0-2] vs 3 [range, 0-7]; P < .001). Patient satisfaction was comparable ("very satisfied" in 66 [95.7%] vs 161 [88.0%]; P = .069). However, operator satisfaction was significantly higher in the PSNB group ("very satisfied" in 69 [100%] vs 161 [88.0%]; P = .003). CONCLUSIONS PSNB is safe and effective for pain control during endovascular treatment of CLI. Low adverse event rates with high patient and operator satisfaction make PSNB a reasonable alternative for high-risk patients.
Collapse
Affiliation(s)
- Umut Oguslu
- Department of Radiology, Biruni University Faculty of Medicine, Istanbul, Turkey.
| | - Burçak Gümüş
- Department of Radiology, Medicana Health Group, Istanbul, Turkey
| | - Gürkan Danışan
- Department of Radiology, Sakarya University Faculty of Medicine, Sakarya, Turkey
| |
Collapse
|
65
|
Chin WC, Huang YS, Tang I, Lee PY, Wang CH, Chao KY. Impact of Taiwan's 2021 COVID-19 lockdown on the symptom severity and quality of life of patients with narcolepsy. Sleep Biol Rhythms 2023; 21:419–429. [PMID: 37363640 PMCID: PMC10113120 DOI: 10.1007/s41105-023-00458-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 04/05/2023] [Indexed: 06/28/2023]
Abstract
COVID-19 lockdowns can influence the sleep quality and daytime condition of patients with narcolepsy. Using data from our cohort study, we investigated changes in the quality of life and the symptom severity of patients with narcolepsy during Taiwan's 2021 lockdown and investigated differences by narcolepsy subtype, sex, and age. Patients with type 1 and type 2 narcolepsy (NT1 and NT2, respectively) aged 6-40 years were retrospectively recruited from our narcolepsy cohort study. These patients were regularly evaluated using the Short Form 36 Health Survey questionnaire (SF-36), the Epworth Sleepiness Scale (ESS), the visual analog scale (VAS) for hypersomnolence, the VAS for cataplexy and sleep diary. We compared the differences between the lockdown and the prelockdown periods by narcolepsy subtype, sex, and age. We used a paired t test analysis to compare differences in the SF-36, ESS, VAS scores and data of sleep diary between the prelockdown and lockdown periods (p1), and an independent t test analysis was used to compare the changes in different subgroups between the prelockdown and lockdown periods (p2). A total of 120 patients with narcolepsy were recruited (mean age 24.22 ± 6.87 years; 58% male); 80 of the patients had NT1 (mean age 25.25 ± 6.79 years; 60% male) and 40 had NT2 (mean age 22.16 ± 6.64, 53% male). During the lockdown period, the ESS score of total patients was decreased (p = 0.039) and body mass index was increased (p = 0.02). The NT1 group decreased significantly (p1 = 0.017), especially in men (p1 = 0.016) and adults (p1 = 0.04); scores for the VT domain of the SF-36 increased significantly in male and adult patients with NT2 (p1 = 0.048 and 0.012). Additionally, male patients with NT2 exhibited significantly decreased scores in the physical and emotional role functioning domains (p1 = 0.028, 0.024). The children and adolescents with NT1 had significantly decreased scores in the general health domain of the SF-36, but no significant change was noted in that of adults (p1 = 0.027, p2 = 0.012). We observed both negative and positive impacts of Taiwan's 2021 lockdown on patients with narcolepsy. A more flexible but structured daily routine with adequate sleep time should be considered for this population during lockdown and nonlockdown periods.
Collapse
Affiliation(s)
- Wei-Chih Chin
- Division of Psychiatry and Sleep Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Shu Huang
- Division of Psychiatry and Sleep Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - I. Tang
- Division of Psychiatry and Sleep Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Pin-Yi Lee
- Department of Clinical Psychology, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Chih-Huan Wang
- Department of Psychology, Zhejiang Normal University, Jinhua, China
| | - Kuo-Yu Chao
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| |
Collapse
|
66
|
Wang D, Chen W, Zhang L, Wang Z, Qian Y, Li T, Sun J. Dexamethasone as additive of local infiltration analgesia reduces opioids consumption after simultaneous bilateral total hip or knee arthroplasty: a randomized controlled double-blind trial. J Orthop Surg Res 2023; 18:715. [PMID: 37736729 PMCID: PMC10514997 DOI: 10.1186/s13018-023-04164-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 09/04/2023] [Indexed: 09/23/2023] Open
Abstract
PURPOSE A randomized controlled double-blind trial was conducted to evaluate the effects of adding dexamethasone to the local infiltration analgesia (LIA) mixture on frequency of patient controlled analgesia (PCA) and opioids consumption after simultaneous bilateral total hip or knee arthroplasty (THA or TKA). METHODS 108 patients who received simultaneous bilateral THA or TKA were randomly divided into dexamethasone group and normal saline (NS) group. The main difference between two groups was whether or not dexamethasone was added to the LIA mixture. The main outcome was the cumulative consumption of opioids within 24 h. The secondary outcome were the total cumulative consumption of opioids during postoperative hospitalization, consumption of opioids drug for rescue analgesia, frequency of PCA, postoperative Visual Analogue Scale (VAS), and complications. RESULTS Cumulative consumption of opioids in the 24 h was similar between two groups (P = 0.17). Total cumulative consumption of opioids in the dexamethasone group during postoperative hospitalization was significantly lower (P = 0.03). No significant difference in the consumption of opioids drug for rescue analgesia between two groups within 24 h, while the frequency of PCA was significantly different (P = 0.04). VAS of dexamethasone group and NS group were similar during postoperative hospitalization, while the incidence of postoperative nausea and vomiting (PONV) in dexamethasone group was lower than that in NS group. CONCLUSIONS Adding dexamethasone to LIA in the simultaneous bilateral THA or TKA can effectively reduce the total cumulative consumption of opioids and the frequency of PCA, as well as reduce the incidence of PONV. Trial Registration The trial has been registered in the Chinese Clinical Trial Registry (Registration Number: ChiCTR2100042551, Date: 23/01/2021).
Collapse
Affiliation(s)
- Dasai Wang
- Orthopedic Center, Nanjing Jiangbei Hospital, Nanjing, 210043, Jiangsu, People's Republic of China
- Department of Orthopedics Surgery, The First Affiliated Hospital of Wannan Medical College, Wuhu, 241000, Anhui, People's Republic of China
| | - Wang Chen
- Department of Orthopedics Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150000, Heilongjiang, People's Republic of China
| | - Leshu Zhang
- Department of Orthopedics Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150000, Heilongjiang, People's Republic of China
| | - Zhigang Wang
- Orthopedic Center, Nanjing Jiangbei Hospital, Nanjing, 210043, Jiangsu, People's Republic of China
| | - Yu Qian
- Department of Orthopedics Surgery, Nanjing Drum Tower Hospital Group Suqian Hospital, Suqian, 223800, Jiangsu, People's Republic of China
| | - Tao Li
- Orthopedic Center, Nanjing Jiangbei Hospital, Nanjing, 210043, Jiangsu, People's Republic of China.
| | - Jianning Sun
- Department of Orthopedics Surgery, Nanjing Drum Tower Hospital Group Suqian Hospital, Suqian, 223800, Jiangsu, People's Republic of China.
- Department of Orthopedics Surgery, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, 221000, Jiangsu, People's Republic of China.
| |
Collapse
|
67
|
Pierson SR, Ngoue M, Lam R, Rajagopalan D, Ring D, Ramtin S. When Musculoskeletal Clinicians Respond to Empathetic Opportunities, do Patients Perceive Greater Empathy? Clin Orthop Relat Res 2023; 481:1771-1780. [PMID: 36853843 PMCID: PMC10427050 DOI: 10.1097/corr.0000000000002614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/05/2023] [Accepted: 02/06/2023] [Indexed: 03/01/2023]
Abstract
BACKGROUND Patient use of verbal and nonverbal communication to signal what is most important to them can be considered empathetic opportunities. Orthopaedic surgeons may have mixed feelings toward empathetic opportunities, on one hand wanting the patient to know that they care, and on the other hand fearing offense, prolonged visit duration, or discussions for which they feel ill prepared. Evidence that action about empathetic opportunities does not harm the patient's experience or appreciably prolong the visit could increase the use of these communication tactics with potential for improved experience and outcomes of care. QUESTIONS/PURPOSES Using transcripts from musculoskeletal specialty care visits in prior studies, we asked: (1) Are there factors, including clinician attentiveness to empathetic opportunities, associated with patient perception of clinician empathy? (2) Are there factors associated with the number of patient-initiated empathetic opportunities? (3) Are there factors associated with clinician acknowledgment of empathetic opportunities? (4) Are there factors associated with the frequency with which clinicians elicited empathetic opportunities? METHODS This study was a retrospective, secondary analysis of transcripts from prior studies of audio and video recordings of patient visits with musculoskeletal specialists. Three trained observers identified empathetic opportunities in 80% (209 of 261) of transcripts of adult patient musculoskeletal specialty care visits, with any uncertainties or disagreements resolved by discussion and a final decision by the senior author. Patient statements considered consistent with empathetic opportunities included relation of emotion, expression of worries or concerns, description of loss of valued activities or loss of important roles or identities, relation of a troubling psychologic or social event, and elaboration on daily life. Clinician-initiated empathetic opportunities were considered clinician inquiries about these factors. Clinician acknowledgment of empathetic opportunities included encouragement, affirmation or reassurance, or supportive statements. Participants completed post-visit surveys of perceived clinician empathy, symptoms of depression, and health anxiety. Factors associated with perceived clinician empathy, number of empathetic opportunities, clinician responses to these opportunities, and the frequency with which clinicians elicited empathetic opportunities were sought in bivariate and multivariable analyses. RESULTS After controlling for potentially confounding variables such as working status and pain self-efficacy scores in the multivariable analysis, no factors were associated with patient perception of clinician empathy, including attentiveness to empathetic opportunities. Patient-initiated empathetic opportunities were modestly associated with longer visit duration (correlation coefficient 0.037 [95% confidence interval 0.023 to 0.050]; p < 0.001). Clinician acknowledgment of empathetic opportunities was modestly associated with longer visit duration (correlation coefficient 0.06 [95% CI 0.03 to 0.09]; p < 0.001). Clinician-initiated empathetic opportunities were modestly associated with younger patient age (correlation coefficient -0.025 [95% CI -0.037 to -0.014]; p < 0.001) and strongly associated with one specific interviewing clinician as well as other clinicians (correlation coefficient -1.3 [95% CI -2.2 to -0.42]; p = 0.004 and -0.53 [95% CI -0.95 to -0.12]; p = 0.01). CONCLUSION Musculoskeletal specialists can respond to empathic opportunities without harming efficiency, throughput, or patient experience. CLINICAL RELEVANCE Given the evidence that patients prioritize feeling heard and understood, and evidence that a trusting patient-clinician relationship is protective and healthful, the results of this study can motivate specialists to train and practice effective communication tactics.
Collapse
Affiliation(s)
- S. Ryan Pierson
- The University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Marielle Ngoue
- The University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Ryan Lam
- The University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Dayal Rajagopalan
- The University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - David Ring
- The University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Sina Ramtin
- The University of Texas at Austin Dell Medical School, Austin, TX, USA
| |
Collapse
|
68
|
Shankar DS, Avila A, DeClouette B, Vasavada KD, Jazrawi IB, Alaia MJ, Gonzalez-Lomas G, Strauss EJ, Campbell KA. Home ownership, full-time employment, and other markers of higher socioeconomic status are predictive of shorter time to initial evaluation, shorter time to surgery, and superior postoperative outcomes among lateral patellar instability patients undergoing medial patellofemoral ligament reconstruction. Knee Surg Relat Res 2023; 35:20. [PMID: 37461119 DOI: 10.1186/s43019-023-00193-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 06/29/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND The purpose of this study was to identify socioeconomic predictors of time to initial evaluation, time to surgery, and postoperative outcomes among lateral patellar instability patients undergoing medial patellofemoral ligament reconstruction (MPFLR). METHODS We conducted a retrospective review of patients at our institution who underwent primary MPFLR with allograft from 2011 to 2019 and had minimum 12-month follow-up. Patients were administered an email survey in January 2022 to assess symptom history, socioeconomic status, and postoperative outcomes including VAS satisfaction and Kujala score. Predictors of time to initial evaluation, time to surgery, and postoperative outcomes were identified using multivariable linear and logistic regression with stepwise selection. RESULTS Seventy patients were included in the cohort (mean age 24.8 years, 72.9% female, mean follow-up time 45.7 months). Mean time to evaluation was 6.4 months (range 0-221) and mean time to surgery was 73.6 months (range 0-444). Having a general health check-up in the year prior to surgery was predictive of shorter time to initial evaluation (β = - 100.5 [- 174.5, - 26.5], p = 0.008). Home ownership was predictive of shorter time to surgery (β = - 56.5 [- 104.7, 8.3], p = 0.02). Full-time employment was predictive of higher VAS satisfaction (β = 14.1 [4.3, 23.9], p = 0.006) and higher Kujala score (β = 8.7 [0.9, 16.5], p = 0.03). CONCLUSION Markers of higher socioeconomic status including having a general check-up in the year prior to surgery, home ownership, and full-time employment were predictive of shorter time to initial evaluation, shorter time to surgery, and superior postoperative outcomes. LEVEL OF EVIDENCE IV, retrospective case series.
Collapse
Affiliation(s)
- Dhruv S Shankar
- Department of Orthopedic Surgery, New York University Langone Health, 333 East 38Th St, 4Th Floor, New York, NY, 10016, USA.
| | - Amanda Avila
- Department of Orthopedic Surgery, New York University Langone Health, 333 East 38Th St, 4Th Floor, New York, NY, 10016, USA
| | - Brittany DeClouette
- Department of Orthopedic Surgery, New York University Langone Health, 333 East 38Th St, 4Th Floor, New York, NY, 10016, USA
| | - Kinjal D Vasavada
- Department of Orthopedic Surgery, New York University Langone Health, 333 East 38Th St, 4Th Floor, New York, NY, 10016, USA
| | - Isabella B Jazrawi
- Department of Orthopedic Surgery, New York University Langone Health, 333 East 38Th St, 4Th Floor, New York, NY, 10016, USA
| | - Michael J Alaia
- Department of Orthopedic Surgery, New York University Langone Health, 333 East 38Th St, 4Th Floor, New York, NY, 10016, USA
| | - Guillem Gonzalez-Lomas
- Department of Orthopedic Surgery, New York University Langone Health, 333 East 38Th St, 4Th Floor, New York, NY, 10016, USA
| | - Eric J Strauss
- Department of Orthopedic Surgery, New York University Langone Health, 333 East 38Th St, 4Th Floor, New York, NY, 10016, USA
| | - Kirk A Campbell
- Department of Orthopedic Surgery, New York University Langone Health, 333 East 38Th St, 4Th Floor, New York, NY, 10016, USA
| |
Collapse
|
69
|
Oscar GE, Irene S, Raul M. Visual satisfaction with progressive addition lenses prescribed with novel foveal fixation axis measurements. Sci Rep 2023; 13:11262. [PMID: 37438410 DOI: 10.1038/s41598-023-38446-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 07/08/2023] [Indexed: 07/14/2023] Open
Abstract
Progressive addition lens (PAL) prescription is usually conducted using the pupillary centre as a reference, which in general does not coincide with the visual axis (kappa distance), and this difference could induce undesired prismatic effects in far and near vision distances and adaptation problems. This study aimed to assess the impact on subjects' visual satisfaction with PALs prescribed based on foveal fixation axis (FFA) measurements. Two different PALs (LifeStyle 3i, Hoya Lens Iberia) were randomly prescribed [one with a customized inset (the difference between the FFA measurements (Ergofocus®, Lentitech, Spain) at far and near distances and the second with a standard inset (2.5 mm)] to be used by 71 healthy presbyopic volunteers in a prospective double-masked crossover clinical study involving one month of use of each PAL. Patients were self-classified into four groups according to their previous experience with PALs: neophyte, PAL users, PAL drop-out, and uncomfortable PAL users. Visual function and overall satisfaction with each PAL were collected and compared. Ninety-seven percent (95% CI 93-100%) of participants successfully adapted to PALs prescribed with FFA without significant differences (P = 0.26) among the study groups (100% neophyte and uncomfortable PAL users (95% CI 100% in both groups), 89% (95% CI 67-100%) PAL users and 94% (95% CI 82-100%) PAL drop-out group). There were no statistically significant differences in visual function (P > 0.05) between customized and standard inset PALs. Customized and standard inset lenses showed similar satisfaction (P > 0.42) that increased significantly (P < 0.01 without any carry-over effect) after 30 days of wear. PALs prescribed with FFA measurements showed high visual satisfaction, suggesting that these measurements are suitable for prescribing PAL adaptation processes. Additional research is necessary to assess differences in PAL users' performance with different prescription methods and lens designs.
Collapse
Affiliation(s)
- Garcia-Espinilla Oscar
- Optometry Research Group, IOBA Eye Institute, School of Optometry, University of Valladolid, 47011, Valladolid, Spain
- Departamento de Física Teórica, Atómica y Óptica, Universidad de Valladolid, Paseo de Belén, 7 - Campus Miguel Delibes, 47011, Valladolid, Spain
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Paseo de Belén, 17 - Campus Miguel Delibes, 47011, Valladolid, Spain
| | - Sanchez Irene
- Optometry Research Group, IOBA Eye Institute, School of Optometry, University of Valladolid, 47011, Valladolid, Spain.
- Departamento de Física Teórica, Atómica y Óptica, Universidad de Valladolid, Paseo de Belén, 7 - Campus Miguel Delibes, 47011, Valladolid, Spain.
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Paseo de Belén, 17 - Campus Miguel Delibes, 47011, Valladolid, Spain.
| | - Martin Raul
- Optometry Research Group, IOBA Eye Institute, School of Optometry, University of Valladolid, 47011, Valladolid, Spain
- Departamento de Física Teórica, Atómica y Óptica, Universidad de Valladolid, Paseo de Belén, 7 - Campus Miguel Delibes, 47011, Valladolid, Spain
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Paseo de Belén, 17 - Campus Miguel Delibes, 47011, Valladolid, Spain
| |
Collapse
|
70
|
Boyle T, Zaragoza R, Li J, Cvetanovski V, Weaver P, Hoyle P, Venkatesha V, Fernando SL. A retrospective review of immunology patients with primary and/or secondary immunodeficiency, demonstrating the benefits of the rapid transitioning from intravenous immunoglobulin to subcutaneous immunoglobulin at the onset of the COVID-19 pandemic. Intern Med J 2023; 53:1256-1260. [PMID: 37092797 DOI: 10.1111/imj.16104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 04/08/2023] [Indexed: 04/25/2023]
Abstract
Forty-four of 50 immunology patients with primary or secondary immunodeficiency receiving intravenous immunoglobulin at a hospital in New South Wales, Australia, were rapidly enrolled in the subcutaneous immunoglobulin (SCIg) programme at the onset of the 2020 COVID-19 pandemic. Health and economic outcomes demonstrated that SCIg provides clinical efficacy as evidenced by the number of infections and maintenance of IgG levels, and also facilitates cost reduction in immunoglobulin maintenance programmes.
Collapse
Affiliation(s)
- Therese Boyle
- Clinical Immunology Department, Level 3, ASB, Royal North Shore Hospital, Sydney, New South Wales, Australia
- Immunology Laboratory, Level 5, ASB, Royal North Shore Hospital, Sydney, New South Wales, Australia
- School of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Reina Zaragoza
- Clinical Immunology Department, Level 3, ASB, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Jamma Li
- Clinical Immunology Department, Level 3, ASB, Royal North Shore Hospital, Sydney, New South Wales, Australia
- Immunology Laboratory, Level 5, ASB, Royal North Shore Hospital, Sydney, New South Wales, Australia
- School of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Vera Cvetanovski
- Clinical Immunology Department, Level 3, ASB, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Phillippa Weaver
- Patient Safety and Quality Unit, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Philip Hoyle
- School of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Department of Medical Services, ASB, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | | | - Suran L Fernando
- Clinical Immunology Department, Level 3, ASB, Royal North Shore Hospital, Sydney, New South Wales, Australia
- Immunology Laboratory, Level 5, ASB, Royal North Shore Hospital, Sydney, New South Wales, Australia
- School of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
71
|
Klinger M, Vinci V, Romeo MA, Battistini A, Klinger F, Bandi V, Maione L, Vinciguerra P, Di Maria A. Surgical Tips for Aesthetic Lower Lid Blepharoplasty: Prevention of Round Eye. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5092. [PMID: 37404781 PMCID: PMC10317483 DOI: 10.1097/gox.0000000000005092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 05/05/2023] [Indexed: 07/06/2023]
Abstract
In the present study, we highlight surgical tips based on our experience in lower eyelid blepharoplasty. These have been shown to be crucial in the prevention of several complications, specifically lateral lower-lid displacement. Methods A series of bilateral lower-lid blepharoplasties were performed on 280 patients at Humanitas-Research-Hospital (Milan, Italy) between January 2016 and January 2020. Patients with a history of lower-lid blepharoplasty and patients requiring canthopexy/canthoplasty were excluded. Needing to singularly evaluate and correct several lower-eyelid structures to obtain a harmonic result, we preoperatively assessed the amount of skin excess, the eyelid margin malposition relative to the globe, and the presence/absence of herniated fat-pads. Pre- and postoperative standard photographs were collected. Patients were evaluated by measuring scleral show, snap-back test, and distraction test. Blinded-fashioned photograph analysis was performed by independent plastic and oculoplastic surgeons who did not execute the procedures. A visual analogue scale was administered to all patients to assess satisfaction. Results In total, 280 patients underwent successful lower blepharoplasty, with satisfactory results of scleral show, snap-back test, and distraction test. Of the 280 patients, four presented postoperative complications. At 10-month follow-up visit, we achieved a mean patient visual analogue scale satisfaction score of 8.4. Postoperative surgeon's photographs mean score was 4.5. Conclusions Without the use of muscle flaps, our technique averts tarsal ligament misposition, preserves orbicularis-muscle innervation, and limits thermal spread, assuring excellent stability of results and high patient and surgeon satisfaction. Cosmetic outcome in terms of symmetry, appearance, and lower lid line definition revealed high satisfaction with the result over time, with a remarkably low complication rate.
Collapse
Affiliation(s)
- Marco Klinger
- From the Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Humanitas Clinical and Research Hospital, Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Milan, Italy
| | - Valeriano Vinci
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Department of Aesthetic Plastic and Reconstructive Surgery, Humanitas Clinical and Research Center-IRCCS, Milan, Italy
| | | | - Andrea Battistini
- From the Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Humanitas Clinical and Research Hospital, Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Milan, Italy
| | - Francesco Klinger
- University of Milan, Department of Health Sciences, Ospedale San Paolo, Milan, Italy
| | - Valeria Bandi
- From the Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Humanitas Clinical and Research Hospital, Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Milan, Italy
| | - Luca Maione
- From the Plastic Surgery Unit, Department of Medical Biotechnology and Translational Medicine BIOMETRA, Humanitas Clinical and Research Hospital, Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Milan, Italy
| | - Paolo Vinciguerra
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Department of Ophthalmology, Humanitas Clinical and Research Center-IRCCS, Milan, Italy
| | - Alessandra Di Maria
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Department of Ophthalmology, Humanitas Clinical and Research Center-IRCCS, Milan, Italy
| |
Collapse
|
72
|
Schelfhout S, Derous E. Presenting the direct intercultural effectiveness simulation: an implicit trait policy on intercultural competence. Front Psychol 2023; 14:1137871. [PMID: 37457081 PMCID: PMC10342204 DOI: 10.3389/fpsyg.2023.1137871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 06/06/2023] [Indexed: 07/18/2023] Open
Abstract
Background An implicit trait policy (ITP) represents the interaction between a personal disposition and general domain knowledge on how to effectively handle a specific (intercultural) situation. Such an ITP is a proven construct to create instruments that can predict future effective behavior. Moreover, such a simulation can provide valuable proxies for actual (future) behavior, as measures of (future) real life intercultural interactions are not always available. Methods In a series of three studies (N1 = 224, N2 = 291, N3 = 478), the present research introduces a "Direct Intercultural Effectiveness Simulation" or DIES, an instrument that simulates intercultural effectiveness by directly tapping into an ITP on intercultural competence. Results First and foremost, the present research demonstrates that the DIES instrument generates reliable and construct-valid measures of intercultural effectiveness. Second, the DIES instrument also shows expected converging and diverging patterns when correlated with a nomological network on intercultural effectiveness. And third, the DIES measure is further validated by integration into an ITP framework of intercultural effectiveness based on theoretical and empirical accounts from literature. Conclusion The DIES instrument generates a reliable and valid measure of intercultural effectiveness by tapping into an ITP on intercultural competence. Theoretically, the present research integrates the instrument into literature by empirically verifying an ITP framework of intercultural effectiveness. In practice, the DIES instrument can be used as an awareness or training proxy for actual behavior to tackle important problems like ethnic prejudice and discrimination.
Collapse
Affiliation(s)
- Stijn Schelfhout
- Vocational and Personnel Psychology Lab, Department of Work, Organisation and Society, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
- Department of Experimental Psychology, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Eva Derous
- Vocational and Personnel Psychology Lab, Department of Work, Organisation and Society, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| |
Collapse
|
73
|
Franck H, Dempfle A, Reischig K, Baastrup J, Meinzer A, Kossakowski M, Krebs TF, Bergholz R. Mobile Dressing Trolleys Improve Satisfaction and Logistics on Pediatric Surgery Wards. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1089. [PMID: 37508586 PMCID: PMC10378491 DOI: 10.3390/children10071089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 06/13/2023] [Accepted: 06/15/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Evidence-based data on the effect of dressing trolleys on children's postoperative recovery are not available. The aim of this study was to evaluate a specific pediatric surgical dressing trolley on patient and caregiver satisfaction, as well as temporal and logistical aspects of the dressing change procedures. METHODS In a prospective observational non-randomized study, a total of 100 dressing changes were observed before (group 1) and after (group 2) the introduction of a pediatric surgical dressing trolley and the satisfaction, time and logistical factors were recorded on site. RESULTS The median preparation time, the duration of the dressing change and the total time decreased significantly from group 1 to group 2 by 1:11 min (p < 0.001); 1:56 min (p = 0.05) and 5:09 min (p = 0.001), respectively. The patient's room was left significantly less often in group 2 to retrieve missing bandages. The median satisfaction of the medical staff increased by 12% in group 2 (p < 0.001). The satisfaction of the parents increased by 2.5% in group 2 (p = 0.042), and that of the nursing staff increased by 9.25% in group 2 (p = 0.015). CONCLUSIONS Our results demonstrate the positive effects of a dressing trolley for pediatric surgical dressing changes by minimizing postoperative handling and manipulation of the child. It improves time and logistical factors as well as the satisfaction of those involved, which may lead to a faster recovery.
Collapse
Affiliation(s)
- Hannes Franck
- Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, UKSH University Hospital of Schleswig-Holstein Kiel Campus, Arnold-Heller-Strasse 3, 24105 Kiel, Germany
| | - Astrid Dempfle
- Institute of Medical Informatics and Statistics, UKSH University Hospital of Schleswig-Holstein Kiel Campus, Arnold-Heller-Strasse 3, 24105 Kiel, Germany
| | - Katja Reischig
- Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, UKSH University Hospital of Schleswig-Holstein Kiel Campus, Arnold-Heller-Strasse 3, 24105 Kiel, Germany
| | - Jonas Baastrup
- Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, UKSH University Hospital of Schleswig-Holstein Kiel Campus, Arnold-Heller-Strasse 3, 24105 Kiel, Germany
| | - Andreas Meinzer
- Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, UKSH University Hospital of Schleswig-Holstein Kiel Campus, Arnold-Heller-Strasse 3, 24105 Kiel, Germany
| | - Meike Kossakowski
- Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, UKSH University Hospital of Schleswig-Holstein Kiel Campus, Arnold-Heller-Strasse 3, 24105 Kiel, Germany
| | - Thomas Franz Krebs
- Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, UKSH University Hospital of Schleswig-Holstein Kiel Campus, Arnold-Heller-Strasse 3, 24105 Kiel, Germany
- Department of Pediatric Surgery, Children's Hospital of Eastern Switzerland, Claudiusstrasse 6, 9006 St. Gallen, Switzerland
| | - Robert Bergholz
- Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, UKSH University Hospital of Schleswig-Holstein Kiel Campus, Arnold-Heller-Strasse 3, 24105 Kiel, Germany
| |
Collapse
|
74
|
Tsao H, Tang C, Trembath M, Jones P, Snelling PJ. Ultrasound-guided supraclavicular block versus Bier block for emergency reduction of upper limb injuries: a protocol for an open-label, non-inferiority, randomised controlled trial. Trials 2023; 24:366. [PMID: 37254224 PMCID: PMC10230709 DOI: 10.1186/s13063-023-07403-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/22/2023] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND Closed reduction of upper limb fractures and/or dislocations are common in the emergency department (ED), which involves physically re-aligning the injured part prior to immobilisation. As this is painful, numerous techniques are available to provide regional anaesthesia to ensure patient tolerance. A Bier block (BB) is typically performed as part of routine care. An alternative technique gaining interest in the ED is ultrasound-guided supraclavicular block (UGSCB), which involves injecting local anaesthetic around the brachial plexus at the supraclavicular fossa under ultrasound guidance. It is unclear whether UGSCB is effective and safe when performed in the ED. METHODS SUPERB (SUPraclavicular block for Emergency Reduction versus Bier block) is a prospective open-label, non-inferiority randomised controlled trial that compares the effectiveness of UGSCB versus BB for closed reduction of upper limb fractures and/or dislocations. Adult patients presenting with an upper limb fracture and/or dislocation that requires emergent closed reduction in the ED will be eligible. After screening, participants will be randomised to either UGSCB or BB. Once regional anaesthesia is obtained, closed reduction of the injured part will be performed and appropriately immobilised. The primary outcome is maximal pain experienced during closed reduction measured via a visual analogue scale (VAS). Secondary outcomes include baseline and post-reduction pain, patient satisfaction, total opioid requirement in ED, ED length of stay, adverse events and regional anaesthesia failure. DISCUSSION Existing evidence suggests UGSCB is effective when performed in the operating theatre by trained anaesthetists. SUPERB will be the first randomised controlled trial to elucidate the effectiveness and safety of UGSCB in the ED. The findings have the potential to provide an alternative safe and effective option for the management of upper extremity emergencies in the ED. TRIAL REGISTRATION This trial has been registered on 21 October 2022 with Australia and New Zealand Clinical Trials Registry (ACTRN12622001356752).
Collapse
Affiliation(s)
- Henry Tsao
- Emergency Department, Redland Hospital, Cleveland, QLD, Australia.
- School of Medicine, The University of Queensland, Herston, QLD, Australia.
| | - Christopher Tang
- Emergency Department, Redland Hospital, Cleveland, QLD, Australia
- School of Medicine, The University of Queensland, Herston, QLD, Australia
| | - Mark Trembath
- School of Medicine, The University of Queensland, Herston, QLD, Australia
- Department of Anaesthetics, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Philip Jones
- Department of Emergency Medicine, Gold Coast University Hospital, Southport, QLD, Australia
| | - Peter J Snelling
- School of Medicine, The University of Queensland, Herston, QLD, Australia
- Department of Emergency Medicine, Gold Coast University Hospital, Southport, QLD, Australia
- School of Medicine and Dentistry, Griffith University, Southport, QLD, Australia
- Sonography Innovation and Research Group (Sonar Group), Southport, QLD, Australia
| |
Collapse
|
75
|
Woo SJ, Jung JH, Choi JH, Kim Y, Kwon ST, Kim BJ. The Effect of Epiphysiodesis on the Longitudinal Bone Growth of Hands or Feet in Children With Macrodactyly Based on Long-term Quantitative Analysis. J Pediatr Orthop 2023; 43:e363-e369. [PMID: 36914261 DOI: 10.1097/bpo.0000000000002387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
BACKGROUND Treatment protocols for macrodactyly have not been elucidated due to its rarity and variety of clinical manifestations. This study aims to share our long-term clinical results of epiphysiodesis in children with macrodactyly. METHODS A retrospective chart review was performed for 17 patients with isolated macrodactyly treated with epiphysiodesis over 20 years. Length and width of each phalanx in both the affected finger and the corresponding unaffected finger in the contralateral hand were measured. Results were presented in ratios of the affected to unaffected side for each phalanx. Measuring of length and width of phalanx was performed preoperatively and postoperatively at 6, 12, and 24 months, and the last follow-up session. Postoperative satisfaction scoring was done with visual analogue scale. RESULTS The mean follow-up period was 7 years and 2 months. In the proximal phalanx, length ratio significantly decreased compared with preoperative state at after more than 24 months, in the middle phalanx after 6 months, in the distal phalanx after 12 months. When classified by the growth patterns, the progressive type showed significant decrease in length ratio at after 6 months, and the static type after 12 months. Patients were overall satisfied with the results. CONCLUSION Epiphysiodesis effectively regulated longitudinal growth with different degree of control for different phalanges in the long-term follow-up.
Collapse
Affiliation(s)
- Soo Jin Woo
- Department of Plastic and Reconstructive Surgery, Seoul National University Hospital, Seoul National University College of Medicine
| | | | - Jun Ho Choi
- 345 Plastic Surgery Clinic, Seoul, Republic of Korea
| | - Yumin Kim
- Department of Plastic and Reconstructive Surgery, Seoul National University Hospital, Seoul National University College of Medicine
| | - Sung Tack Kwon
- Department of Plastic and Reconstructive Surgery, Seoul National University Hospital, Seoul National University College of Medicine
| | - Byung Jun Kim
- Department of Plastic and Reconstructive Surgery, Seoul National University Hospital, Seoul National University College of Medicine
| |
Collapse
|
76
|
Popova ES, J Hahn B, Morris H, Loomis K, Shy E, Andrews J, Iacullo M, Peters A. Exploring Well-Being: Resilience, Stress, and Self-Care in Occupational Therapy Practitioners and Students. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2023; 43:159-169. [PMID: 35481402 DOI: 10.1177/15394492221091271] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Burnout is increasingly documented in occupational therapy (OT); however, practitioner and student well-being have not been examined to date. The research aim was to explore the relationship between well-being, resilience, stress, and self-care in OT. For this purpose, a cross-sectional survey of practitioners and students was done, including a background survey, World Health Organization-5 Well-Being Index (WHO-5), Brief Resilience Scale (BRS), Perceived Stress Scale (PSS), and Mindful Self-Care Scale (MSCS). Open-ended questions and Visual Analog Scales were used to gather satisfaction and service access. Practitioners (n = 235) and students (n = 200) reported well-being "less than half of the time" on the WHO-5, "moderate" stress on the PSS, and "normal" resilience on the BRS. The BRS, PSS, and MSCS explained a significant proportion of variance on the WHO-5 for practitioners and students. Most participants used at least one self-care strategy and desired additional organizational services. The findings of elevated stress and decreased well-being underscore the importance of reimagining wellness initiatives in OT.
Collapse
Affiliation(s)
| | | | | | | | - Erin Shy
- Rush University Medical Center, Chicago, IL, USA
| | | | | | | |
Collapse
|
77
|
Miró JI, Bensi AG, Rodríguez GLG, Clembosky G. Minimally Invasive Fixation with Dorsal Suspension Button and Volar Plate in Distal Radius Fractures with Dorsal Die Punch Fragments: A Preliminary Study. J Wrist Surg 2023; 12:161-169. [PMID: 36926206 PMCID: PMC10010901 DOI: 10.1055/s-0042-1749161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 03/08/2022] [Indexed: 10/17/2022]
Abstract
Objective The objective of the study is to analyze the clinical and radiological results obtained using a minimally invasive fixation technique with a volar locking plate and a suspension system with a dorsal button in distal articular radius fractures with dorsal comminution. Materials and Methods Six patients with distal radius fractures, between 19 and 68 years of age, were included in the study. Mean follow-up was of 15 weeks. Range of motion (ROM) in flexion, extension, radial deviation, ulnar deviation, pronation, supination, the strength in kilograms, and values on the Visual Analog Scale (VAS), Disabilities of Arm, Shoulder and Hand (DASH), and Mayo Wrist Score (MWS) scales were evaluated at 4, 8, and 12 weeks postoperative. Correction of anteroposterior diameter of the radius and concordance between postoperative anteroposterior diameter and the contralateral wrist diameter were evaluated radiologically. Results The following mean values were obtained at 12 weeks postoperative: ROM in flexion: 40.5°, ROM in extension: 49.5°, ROM in radial deviation: 24.5°, ROM in ulnar deviation: 15°, ROM in pronation: 87°, ROM in supination: 89°, strength: 37.5 kg, pain in VAS scale: 2 points, DASH: 54.5 points, and MWS: 67.5 points. At 12 weeks postoperative, the mean correction of anteroposterior diameter was 0.49 mm. The anteroposterior diameter and that of the contralateral wrist were strongly correlated. Conclusion Fixation with the volar locking plate and dorsal suspension button could be considered an alternative to dorsal plate fixation for treatment of distal radius fractures with comminution or associated dorsal die punch fragments.
Collapse
Affiliation(s)
- José Ignacio Miró
- Department of Orthopedic Surgery and Traumatology, Santa Ana Hospital of Motril, Granada, Spain
| | | | | | | |
Collapse
|
78
|
Versluijs Y, Fatehi A, Gonzalez AI, Reichel L, Laverty D, Ring D. Factors Associated With Patient Satisfaction Measured Using an Iterative Scale. Qual Manag Health Care 2023; 32:69-74. [PMID: 35714285 DOI: 10.1097/qmh.0000000000000352] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVES Patient experience measures tend to have notable ceiling effects that make it difficult to learn from gradations of satisfaction to improve care. This study tested 2 different iterative satisfaction measures after a musculoskeletal specialty care visit in the hope that they might have less ceiling effect. We measured floor effects, ceilings effects, skewness, and kurtosis of both questionnaires. We also assessed patient factors independently associated with the questionnaires and the top 2 possible scores. METHODS In this cross-sectional study, 186 patients completed questionnaires while seeing 1 of 11 participating orthopedic surgeons in July and August 2019; the questionnaire measured: (1) demographics, (2) symptoms of depression, (3) catastrophic thinking in response to nociception, (4) heightened illness concerns, and (5) satisfaction with the visit on 2 iterative satisfaction scales. Bivariate and multivariable analyses sought associations of the explanatory variable with the satisfaction scales. RESULTS There is a small correlation between the 2 scales ( r = 0.27; P < .001). Neither scale had a floor effect and both had a ceiling effect of 45%. There is a very small correlation between greater health anxiety and lower satisfaction measured with one of the scales ( r = -0.16; P = .05). CONCLUSION An iterative satisfaction questionnaire created some spread in patient experience data, but could not limit ceiling effects. Additional strategies are needed to remove ceiling effects from satisfaction measures.
Collapse
Affiliation(s)
- Yvonne Versluijs
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin (Drs Versluijs, Fatehi, Gonzalez, Reichel, Laverty, and Ring); and Department of Trauma Surgery, Leiden University Medical Center, Leiden, the Netherlands (Dr Versluijs)
| | | | | | | | | | | |
Collapse
|
79
|
Aslan M. The Influence of Health Behavior on Immediate Loading Implant Success and Patient Satisfaction In The Complete Edentulous Treatment. Am J Health Behav 2023; 47:75-86. [PMID: 36945102 DOI: 10.5993/ajhb.47.1.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
Objective: The cases of edentulous treatment are increasing in Turkey. The patients are less satisfied with the health care facilities of the public sector health institutes. The government of Turkey is facing critical challenges for medical reforms in the public sector to improve the living standards of the public. The objective of current research is to determine the influence of health behavior on immediate loading implant success and patient satisfaction in complete edentulous treatment. Method: A Likert scale questionnaire is employed and the response rate of this research is 71%. The population of this research is the patients visiting different clinics for edentulous treatment and loading implant success. Results: The research findings demonstrate the satisfaction of the patients and implant success is influenced by the health behavior of patients. Conclusion: The model of this research is enrichment in the knowledge of the edentulous treatment of the patients. The practical implications of this research are outstanding to influence the satisfaction of the edentulous treatment patients who are getting the treatment of loading implant success. The research has certain limitations that are straightforwardly presented with future directions to enrich the knowledge of edentulous treatment by the research work of scholars in health care.
Collapse
Affiliation(s)
- Muzaffer Aslan
- Istanbul Health and Technology University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Türkiye;,
| |
Collapse
|
80
|
Hu P, Lei L, Wang Y, Tang J, Liu L. Effect of anterior vaginal wall prolapse repair by modified transvaginal mesh surgery: a retrospective cohort study. Arch Gynecol Obstet 2023; 307:1513-1520. [PMID: 36773045 DOI: 10.1007/s00404-023-06945-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 01/24/2023] [Indexed: 02/12/2023]
Abstract
OBJECTIVE To explore clinical outcomes and complications of modified Transvaginal mesh (M-TVM) for advanced anterior vaginal wall prolapse in 1 year follow-up. METHODS 574 patients underwent TVM surgeries from 2019 to 2020 were collected and divided into TVM group and M-TVM group, all preoperative and postoperative data was obtained and compared between the two groups. RESULTS 285 women were involved eventually, including 181 in TVM group and 104 in M-TVM group. No significant difference of general conditions was found between these two groups. After long-term follow-up, patients in TVM group were more likely to suffer from pelvic pain than M-TVM group (P = 0.046). Meshes seemed much wider in M-TVM group (4.5 ± 0.69 cm) than in TVM group (3.0 ± 0.91 cm). No matter TVM or M-TVM, surgeries can significantly change point Aa and Ba when compared to preoperative data. Compared to TVM group, point C and D were significant changed in patients in M-TVM group after surgery (P < 0.001) CONCLUSION: M-TVM is a commendable procedure that can significant correct anterior prolapse with mesh extended wider, and also supply stable apical support at the same time.
Collapse
Affiliation(s)
- Pan Hu
- Obstetrics and Gynecology, Chongqing Health Center for Women and Children, No.120, Longshan Road, Yubei District, Chongqing, 410013, China.,Obstetrics and Gynecology, Women and Children's Hospital, Chongqing Medical University, Chongqing, China
| | - Li Lei
- Obstetrics and Gynecology, Chongqing Health Center for Women and Children, No.120, Longshan Road, Yubei District, Chongqing, 410013, China.,Obstetrics and Gynecology, Women and Children's Hospital, Chongqing Medical University, Chongqing, China
| | - Ying Wang
- Obstetrics and Gynecology, Chongqing Health Center for Women and Children, No.120, Longshan Road, Yubei District, Chongqing, 410013, China.,Obstetrics and Gynecology, Women and Children's Hospital, Chongqing Medical University, Chongqing, China
| | - Jing Tang
- Ultrasound, Chongqing Health Center for Women and Children, Chongqing, China.,Ultrasound, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Lubin Liu
- Obstetrics and Gynecology, Chongqing Health Center for Women and Children, No.120, Longshan Road, Yubei District, Chongqing, 410013, China. .,Obstetrics and Gynecology, Women and Children's Hospital, Chongqing Medical University, Chongqing, China.
| |
Collapse
|
81
|
Lo SJ, Chapman P, Young D, Drake D, Devlin M, Russell C. The Cleft Lip Education with Augmented Reality (CLEAR) VR Phase 2 Trial: A Pilot Randomized Crossover Trial of a Novel Patient Information Leaflet. Cleft Palate Craniofac J 2023; 60:179-188. [PMID: 34982018 PMCID: PMC9850392 DOI: 10.1177/10556656211059709] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The Cleft Lip Education with Augmented Reality (CLEAR) project centers around the use of augmented reality (AR) in patient leaflets, as a visual means to overcome the "health literacy" gap. This trial followed Virtual Reality (VR CORE) guidelines for VR Phase 2 (Pilot) trials. METHODS Participants included families of children treated for Cleft Lip and Palate at the Royal Hospital for Children, Glasgow. Interventions were AR leaflet or Traditional Leaflet. Objectives were to calculate sample sizes, assess outcome instruments, trial design, and acceptability to patients. Primary outcome measure was Mental Effort Rating Scale, and secondary outcomes were Patient Satisfaction (Visual Analogue Scale), Usefulness Scale for Patient Information Material (USE) scale, and Instructional Materials Motivation Survey (IMMS). Randomization was by block randomization. The trial was single blinded with assessors blinded to group assignment. RESULTS 12 Participants were randomized, with crossover design permitting analysis of 12 per group. Primary outcome with Mental Effort Rating Scale indicated higher mental effort with Traditional compared to AR Leaflet (4.75 vs 2.00, P = .0003). Secondary outcomes for Satisfaction were Traditional 54.50 versus AR 93.50 (P = .0001); USE scale 49.42 versus 74.08 (P = .0011); and IMMS 112.50 versus 161.75 (P = .0003). Subjective interviews noted overwhelmingly positive patient comments regarding the AR leaflet. Outcome instruments and trial design were acceptable to participants. No harms were recorded. CONCLUSIONS The CLEAR pilot trial provides early evidence of clinical efficacy of AR leaflets in patient education. It is hoped that this will provide a future paradigm shift in the way patient education is delivered.
Collapse
Affiliation(s)
- Steven John Lo
- Canniesburn Regional Plastic Surgery and Burns Unit, Glasgow, UK
- Steven John Lo, Canniesburn Regional Plastic Surgery and Burns Unit, Glasgow Royal Infirmary, Glasgow G4 0SF, UK.
| | | | | | - David Drake
- National Cleft Service, The Royal Hospital for Children, Glasgow, UK
| | - Mark Devlin
- National Cleft Service, The Royal Hospital for Children, Glasgow, UK
| | - Craig Russell
- National Cleft Service, The Royal Hospital for Children, Glasgow, UK
| |
Collapse
|
82
|
Caronni A, Ramella M, Arcuri P, Salatino C, Pigini L, Saruggia M, Folini C, Scarano S, Converti RM. The Rasch Analysis Shows Poor Construct Validity and Low Reliability of the Quebec User Evaluation of Satisfaction with Assistive Technology 2.0 (QUEST 2.0) Questionnaire. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1036. [PMID: 36673791 PMCID: PMC9859407 DOI: 10.3390/ijerph20021036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/02/2023] [Accepted: 01/03/2023] [Indexed: 06/17/2023]
Abstract
This study aims to test the construct validity and reliability of the Quebec User Evaluation of Satisfaction with assistive Technology 2.0 (QUEST)-device, an eight-item questionnaire for measuring satisfaction with assistive devices. We collected 250 questionnaires from 79 patients and 32 caregivers. One QUEST was completed for each assistive device. Five assistive device types were included. QUEST was tested with the Rasch analysis (Many-Facet Rating Scale Model: persons, items, and device type). Most patients were affected by neurological disabilities, and most questionnaires were about mobility devices. All items fitted the Rasch model (InfitMS range: 0.88-1.1; OutfitMS: 0.84-1.28). However, the ceiling effect of the questionnaire was large (15/111 participants totalled the maximum score), its targeting poor (respondents mean measure: 1.90 logits), and its reliability was 0.71. The device classes had different calibrations (range: -1.18 to 1.26 logits), and item 3 functioned differently in patients and caregivers. QUEST satisfaction measures have low reliability and weak construct validity. Lacking invariance, the QUEST total score is unsuitable for comparing the satisfaction levels of users of different device types. The differential item functioning suggests that the QUEST could also be problematic for comparing satisfaction in patients and caregivers.
Collapse
Affiliation(s)
- Antonio Caronni
- IRCCS Istituto Auxologico Italiano, Department of Neurorehabilitation Sciences, Ospedale San Luca, 20122 Milan, Italy
| | - Marina Ramella
- IRCCS Fondazione Don Carlo Gnocchi Onlus, 20148 Milan, Italy
| | - Pietro Arcuri
- IRCCS Fondazione Don Carlo Gnocchi Onlus, 20148 Milan, Italy
| | | | - Lucia Pigini
- IRCCS Fondazione Don Carlo Gnocchi Onlus, 20148 Milan, Italy
| | | | - Chiara Folini
- IRCCS Fondazione Don Carlo Gnocchi Onlus, 20148 Milan, Italy
| | - Stefano Scarano
- IRCCS Istituto Auxologico Italiano, Department of Neurorehabilitation Sciences, Ospedale San Luca, 20122 Milan, Italy
- Department of Biomedical Sciences for Health, Università Degli Studi di Milano, 20129 Milan, Italy
| | | |
Collapse
|
83
|
Intra-articular Injection of Bone Marrow Concentrate for Treatment of Patellofemoral Osteoarthritis: Preliminary Results Utilizing an Ultrasound-Guided Marrow Harvesting Technique. J Vasc Interv Radiol 2023; 34:71-78.e1. [PMID: 36244631 DOI: 10.1016/j.jvir.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 09/01/2022] [Accepted: 10/04/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To assess the effectiveness of intra-articular injection of bone marrow concentrate (BMC) under ultrasound (US) guidance in the treatment of patellofemoral osteoarthritis (OA), with clinical and volumetric magnetic resonance (MR) imaging follow-up. METHODS This retrospective study included 96 consecutive patients referred for US-guided intra-articular injection of BMC for symptomatic patellofemoral OA for which conservative treatment had failed. A control group of 21 patients with symptomatic patellofemoral OA was included for comparison. Data on International Knee Documentation Committee (IKDC), Visual Analog Scale (VAS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores as well as volumetric MR imaging (using T2 mapping sequence) were collected before and 12 months after injection, and the results were compared. RESULTS No technical adverse events were noted during bone marrow aspiration, BMC preparation, or intra-articular injection of BMC. No clinical adverse events were reported during long-term follow-up. All mean scores improved between baseline and 12 months after intra-articular injection of BMC (VAS 5.5 to 3.6, P < .0001; WOMAC 36.8 to 22.2, P < .0001; and IKDC 41.8 to 58.2, P < .0001). MR imaging at 1 year of follow-up after BMC treatment showed no statistically significant difference in hyaline cartilage volume compared with that at the baseline (P = .690), suggesting stabilization of the cartilage degradation process. In contrast, the group of untreated patients showed a significant decrease in the cartilage volume (P = .001), corresponding to a cartilage loss of 6.9%. CONCLUSIONS The results suggest that intra-articular injection of BMC under US guidance could be a promising option for the treatment of symptomatic patellofemoral OA and could promote the preservation of healthy residual cartilage volume.
Collapse
|
84
|
Routh J, Paramasivam SJ, Cockcroft P, Wood S, Remnant J, Westermann C, Reid A, Pawson P, Warman S, Nadarajah VD, Jeevaratnam K. Rating and ranking preparedness characteristics important for veterinary workplace clinical training: a novel application of pairwise comparisons and the Elo algorithm. Front Med (Lausanne) 2023; 10:1128058. [PMID: 37153090 PMCID: PMC10160665 DOI: 10.3389/fmed.2023.1128058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 03/30/2023] [Indexed: 05/09/2023] Open
Abstract
Quantitatively eliciting perspectives about a large number of similar entities (such as a list of competences) is a challenge for researchers in health professions education (HPE). Traditional survey methods may include using Likert items. However, a Likert item approach that generates absolute ratings of the entities may suffer from the "ceiling effect," as ratings cluster at one end of the scale. This impacts on researchers' ability to detect differences in ratings between the entities themselves and between respondent groups. This paper describes the use of pairwise comparison (this or that?) questions and a novel application of the Elo algorithm to generate relative ratings and rankings of a large number of entities, on a unidimensional scale. A study assessing the relative importance of 91 student "preparedness characteristics" for veterinary workplace clinical training (WCT) is presented as an example of this method in action. The Elo algorithm uses pairwise comparison responses to generate an importance rating for each preparedness characteristic on a scale from zero to one. This is continuous data with measurement variability which, by definition, spans an entire spectrum and is not susceptible to the ceiling effect. The output should allow for the detection of differences in perspectives between groups of survey respondents (such as students and workplace supervisors) which Likert ratings may be insensitive to. Additional advantages of the pairwise comparisons are their low susceptibility to systematic bias and measurement error, they can be quicker and arguably more engaging to complete than Likert items, and they should carry a low cognitive load for respondents. Methods for evaluating the validity and reliability of this survey design are also described. This paper presents a method that holds great potential for a diverse range of applications in HPE research. In the pursuit quantifying perspectives on survey items which are measured on a relative basis and a unidimensional scale (e.g., importance, priority, probability), this method is likely to be a valuable option.
Collapse
Affiliation(s)
- Jennifer Routh
- School of Veterinary Medicine, University of Surrey, Guildford, United Kingdom
| | | | - Peter Cockcroft
- School of Veterinary Medicine, University of Surrey, Guildford, United Kingdom
| | - Sarah Wood
- Bristol Veterinary School, University of Bristol, Langford, United Kingdom
| | - John Remnant
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington, United Kingdom
| | | | - Alison Reid
- School of Veterinary Science, University of Liverpool, Neston, United Kingdom
| | - Patricia Pawson
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Sheena Warman
- Bristol Veterinary School, University of Bristol, Langford, United Kingdom
| | - Vishna Devi Nadarajah
- Division of Human Biology, School of Medicine and IMU Centre for Education, International Medical University, Kuala Lumpur, Malaysia
| | - Kamalan Jeevaratnam
- School of Veterinary Medicine, University of Surrey, Guildford, United Kingdom
- *Correspondence: Kamalan Jeevaratnam,
| |
Collapse
|
85
|
Hernández-Alfaro F, Vivas-Castillo J, Belle de Oliveira R, Hass-Junior O, Giralt-Hernando M, Valls-Ontañón A. Barcelona line. A multicentre validation study of a facial projection reference in orthognathic surgery. Br J Oral Maxillofac Surg 2023; 61:3-11. [PMID: 36609073 DOI: 10.1016/j.bjoms.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/03/2022] [Accepted: 10/10/2022] [Indexed: 01/06/2023]
Abstract
The purpose of this study was to validate an already published facial anteroposterior reference: upper incisor (UI) to soft tissue plane or so-called Barcelona line (BL) to trace the most aesthetic sagittal position of the maxilla. A cross-sectional multicentre evaluation of Caucasian patients from Spain and Brazil with different anteroposterior maxillary positions was designed. Sagittal images in natural head orientation of grouped patients according to the horizontal distance from the UI to BL were ranked by healthcare professionals and non-professional Caucasian raters according to the aesthetic perception of each profile, using a digital survey. Seventy-four raters (50 laypeople, 12 orthodontists, and 12 maxillofacial surgeons) rated 40 profiles. The best-rated profile corresponded to group 3 (0-4 mm UI-BL) with 61.8% of positive evaluations, followed by group 4 (≥ 4 mm UI-BL): with 61.1%. On the other hand, group 1 (≤-4 mm UI-BL) was the worst-ranked profile with 71.8% of negative evaluations, followed by group 2 (-4-0 mm UI-BL): with 59.6% of negative evaluations. The correlation between the mean assessment score and UI-BL showed a moderately-strong association (r = 0.68, p < 0.001). The inter-rater reliability of assessment (74 evaluators) was moderate (k = 0.49, 95% CI: 0.39 to 0.59). The results suggest that protrusive middle-third facial profiles are preferable. The BL is proposed as a simple, individualised, and reproducible tool to trace an aesthetic sagittal position of the maxilla in orthognathic surgery.
Collapse
Affiliation(s)
- Federico Hernández-Alfaro
- Maxillofacial Institute - Teknon Medical Center, Barcelona, Spain; Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya (UIC), Sant Cugat del Vallès, Barcelona, Spain.
| | - Jocelyn Vivas-Castillo
- Maxillofacial Institute - Teknon Medical Center, Barcelona, Spain; Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya (UIC), Sant Cugat del Vallès, Barcelona, Spain; University of Washington, Seattle, USA.
| | | | - Orion Hass-Junior
- Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.
| | - Mária Giralt-Hernando
- Maxillofacial Institute - Teknon Medical Center, Barcelona, Spain; Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya (UIC), Sant Cugat del Vallès, Barcelona, Spain.
| | - Adaia Valls-Ontañón
- Maxillofacial Institute - Teknon Medical Center, Barcelona, Spain; Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya (UIC), Sant Cugat del Vallès, Barcelona, Spain.
| |
Collapse
|
86
|
Albano G, Salerno L, Cardi V, Brockmeyer T, Ambwani S, Treasure J, Lo Coco G. Patient and mentor language style matching as a predictor of working alliance, engagement with treatment as usual, and eating disorders symptoms over the course of an online guided self-help intervention for anorexia nervosa. EUROPEAN EATING DISORDERS REVIEW 2023; 31:135-146. [PMID: 35983983 PMCID: PMC10087304 DOI: 10.1002/erv.2948] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 06/29/2022] [Accepted: 08/07/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The aim of this study was to examine the processes involved in a guided self-help (GSH) pre-treatment intervention (RecoveryMANTRA) for patients with anorexia nervosa (AN), by measuring the levels of patient/mentor Language Style Matching (LSM). RecoveryMANTRA was supported by student mentors or peer mentors (recovered individuals) over six weekly chat-based sessions. We examined whether LSM during RecoveryMANTRA predicted patients'working alliance with the clinic therapist, motivation, eating disorder (ED) and general psychopathology. A further aim was to examine differences in LSM between student mentors and peer mentors. METHOD 87 AN adults received RecoveryMANTRA plus treatment as usual. The LSM algorithm was used to calculate verbal attunement between patient and mentor. Participants were assessed at baseline and at the end of the intervention. RESULTS Both early (1st session) and late (6th session) LSM predicted higher working alliance with the clinic therapist. Moreover, late LSM predicted lower EDs symptoms at the end of the RecoveryMANTRA intervention. Patient/peer mentor dyads showed higher late verbal attunement than patient/student mentor dyads. CONCLUSIONS These findings suggests that in the early phase of treatment relational aspects can impact on engagement with treatment. Verbal attunement in a GSH for AN is associated with working alliance and better clinical outcome.
Collapse
Affiliation(s)
- Gaia Albano
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Laura Salerno
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Valentina Cardi
- Department of Psychological Medicine, King's College London, London, UK.,Department of General Psychology, University of Padova, Padova, Italy
| | - Timo Brockmeyer
- Department of Psychosomatic Medicine and Psychotherapy, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
| | - Suman Ambwani
- Department of Psychology, Dickinson College, Carlisle, Pennsylvania, USA
| | - Janet Treasure
- Department of Psychological Medicine, King's College London, London, UK
| | - Gianluca Lo Coco
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| |
Collapse
|
87
|
Discrepancy of the subjective perception of the nasal appearance between independent individuals and patients undergoing functional rhinoplasty (fRPL). Eur Arch Otorhinolaryngol 2023; 280:191-197. [PMID: 35763081 PMCID: PMC9813204 DOI: 10.1007/s00405-022-07504-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 06/09/2022] [Indexed: 01/09/2023]
Abstract
PURPOSE Satisfaction with the nasal appearance is a crucial outcome parameter in functional rhinoplasty (fRPL). The visual analogue scale is a suitable instrument not only for the preoperative patient assessment, but also as a patient-reported outcome measure in fRPL. In this study, we analyzed whether a high discrepancy in the preoperative subjective perception of the nasal appearance between patients and other individuals predicts a lower level of satisfaction with the postoperative result and hence a worse outcome of fRPL. METHODS Standardized facial pictures of patients (n = 80) who underwent fRPL were taken preoperatively, 3 and 12 months postoperatively. In addition, patients were asked to complete the German version of the Utrecht Outcome Assessment Questionnaire in Aesthetic Rhinoplasty (D-OAR). The standardized facial pictures of the patients were presented to surgeons as well as to examiners without a medical background, and they were asked to evaluate the patients' nasal appearance using the visual analogue scale. RESULTS The external evaluation of patient's nasal appearance was 1.7 points higher in median than the patient's subjective perception (range -5.7-7.00). A large discrepancy between self- and external estimation significantly correlates with higher D-OAR values (r = 0.539, p < 0.001). Patients with high scores in the D-OAR trick questions, indicating a body dysmorphic disorder, show a significant larger discrepancy between the external- and the self-assessment (2.8 ± 0.5 vs. 1.4 ± 0.3, mean ± SEM, p = 0.017). CONCLUSIONS Large discrepancies between the self and external assessment of the nasal appearance are associated with a high-perceived influence of the appearance of the nose on the quality of life in patients undergoing functional rhinoplasty. That might be an indicator for unrealistic expectations concerning the postoperative outcome. Knowledge about this factor helps to identify the need for intensive discussion about possibilities and limitations of the planned procedure to avoid postoperative dissatisfaction.
Collapse
|
88
|
Sun DJ, You YX, He XJ, Li HT, Zeng XP, Li DZ, Wang W. Effects of light music played by piano intervention on satisfaction, anxiety, and pain in patients undergoing colonoscopy: A randomized controlled trial. Medicine (Baltimore) 2022; 101:e32339. [PMID: 36595974 PMCID: PMC9803447 DOI: 10.1097/md.0000000000032339] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Colonoscopy is the main kind of way to detect and treat diseases about large intestine, but during the examination and preparation, these 2 processes are able to lead abdominal pain, abdominal distention and other discomfort feel, which will cause patients to refuse the examination and become anxious. Painless and sedative endoscopy may reduce discomfort of patients, but there is a risk of adverse effects. Many studies have shown that playing music during colonoscopy can reduce discomfort and increase acceptance of colonoscopy, but the conclusion remains controversial. The 3 approaches of random, single-blind, controlled method were used to investigate the interventions effects of piano light music on satisfaction, anxiety and pain in patients undergoing colonoscopy. METHODS A total of 216 patients were randomly divided into piano music group (n = 112, piano music played during colonoscopy) and control group (n = 104, no music during colonoscopy) to compare patients satisfaction, anxiety score, pain score, vital signs, endoscopic difficulty score, and willingness to undergo colonoscopy again. RESULTS There were no significant differences in vital signs, pre-colonoscopic state anxiety score, and trait anxiety score before and after colonoscopy, and willingness to undergo colonoscopy again between the 2 groups (P > .05). The difficulty of colonoscopy operation and the score of state anxiety after colonoscopy in the piano group were lower than those in the control group (P < .05), and the satisfaction of colonoscopy process, pain management and overall service satisfaction were better than those of the control group (P < .05), and they were more likely to listen to music in the next examination (P < .001). CONCLUSION The light music played by piano can relieve patients' anxiety, improve the satisfaction of colonoscopy process, pain management and service satisfaction, reduce the difficulty of colonoscopy, which have no obvious adverse reactions. Therefore, it is worthy of promotion.
Collapse
Affiliation(s)
- Dong-Jie Sun
- Department of Digestive Diseases, Fuzong Teaching Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Department of Digestive Diseases, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Digestive Diseases, 900th Hospital of PLA, Fuzhou, China
- Department of Digestive Diseases, Oriental Hospital Affiliated to Xiamen University, Fuzhou, China
| | - Yi-Xiang You
- Department of Digestive Diseases, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Xiao-Jian He
- Department of Digestive Diseases, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Digestive Diseases, 900th Hospital of PLA, Fuzhou, China
- Department of Digestive Diseases, Oriental Hospital Affiliated to Xiamen University, Fuzhou, China
| | - Hai-Tao Li
- Department of Digestive Diseases, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Digestive Diseases, 900th Hospital of PLA, Fuzhou, China
- Department of Digestive Diseases, Oriental Hospital Affiliated to Xiamen University, Fuzhou, China
| | - Xiang-Peng Zeng
- Department of Digestive Diseases, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Digestive Diseases, 900th Hospital of PLA, Fuzhou, China
- Department of Digestive Diseases, Oriental Hospital Affiliated to Xiamen University, Fuzhou, China
| | - Da-Zhou Li
- Department of Digestive Diseases, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Digestive Diseases, 900th Hospital of PLA, Fuzhou, China
- Department of Digestive Diseases, Oriental Hospital Affiliated to Xiamen University, Fuzhou, China
| | - Wen Wang
- Department of Digestive Diseases, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Digestive Diseases, 900th Hospital of PLA, Fuzhou, China
- Department of Digestive Diseases, Oriental Hospital Affiliated to Xiamen University, Fuzhou, China
- * Correspondence: Wen Wang, Department of Digestive Diseases, The Fuzong Clinical Medical College, Fujian Medical University, 156 North Road of West No.2 Ring, Fuzhou 350025, China (e-mails: )
| |
Collapse
|
89
|
Agreement between the visual analogue scale (VAS) and the dysfunctional voiding scoring system (DVSS) in the post-treatment evaluation of electrical nerve stimulation in children and adolescents with overactive bladder. J Pediatr Urol 2022; 18:740.e1-740.e8. [PMID: 36123285 DOI: 10.1016/j.jpurol.2022.07.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 06/22/2022] [Accepted: 07/27/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Electrical nerve stimulation is one of the most commonly used and well-tolerated treatments for overactive bladder (OAB); however, different studies have used different instruments to assess patients' response to treatment. OBJECTIVE To analyze agreement between use of the visual analogue scale (VAS) and the Dysfunctional Voiding Scoring System (DVSS) for assessing improvement in urinary symptoms following electrical nerve stimulation treatment in children and adolescents with OAB. STUDY DESIGN A cross-sectional analytical study including children and adolescents of 4-17 years of age diagnosed with OAB who underwent 20 sessions of transcutaneous (TENS) or percutaneous (PENS) electrical nerve stimulation. The DVSS and the VAS were used to assess daytime urinary symptoms before and following treatment. While the DVSS was always applied by a physician, the VAS was applied separately by a physiotherapist and then by a physician. Treatment was considered successful when the DVSS score was zero and the VAS score was ≥90%. Correlations between post-treatment VAS and DVSS scores were evaluated using the kappa coefficient. The VAS scores evaluated by the different professionals were compared for agreement using intraclass correlation and the Bland-Altman plot. RESULTS Data from 49 cases were available for analysis. Of these, 27 (55.1%) were girls. Mean age was 7.1 ± 2.6 years. There was agreement between the two instruments used, the DVSS and the VAS, in 36/49 patients (73.5%), with a moderate Kappa of 0.44. There was moderate agreement between the VAS scores applied by the two different professionals. DISCUSSION imitations of the present study include the small sample size and the fact that the inter-observer evaluation was conducted following a single sequence, i.e. all the patients were first evaluated by the physiotherapist and then by the physician, which may have biased answers and the post-treatment VAS scores. Furthermore, although the child participated actively in completing the questionnaires, in cases of divergent answers, the questions were redirected to the responsible adult, and the final answer may not fully represent the patient's true situation. CONCLUSION The present study found moderate agreement between the DVSS and the VAS, and moderate agreement between VAS scores when the instrument was applied by two different professionals. Although both tools appear to be important, and possibly complementary, a DVSS score of zero precludes the need to apply the VAS.
Collapse
|
90
|
Melchiorri G, Triossi T, Viero V, Marroni S, D’Arcangelo G, Tancredi V. A Study about a New Standardized Method of Home-Based Exercise in Elderly People Aged 65 and Older to Improve Motor Abilities and Well-Being: Feasibility, Functional Abilities and Strength Improvements. Geriatrics (Basel) 2022; 7:geriatrics7060134. [PMID: 36547270 PMCID: PMC9777551 DOI: 10.3390/geriatrics7060134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 11/04/2022] [Accepted: 11/18/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND To verify the effects in terms of feasibility, strength and functional abilities of a standardized exercise training method that is partially supported (home training), with the aim of improving motor abilities and well-being. METHODS A total of 67 participants underwent two sessions per week for 12 weeks for the program, based on 8 sequences with specific body part targets, with each sequence made up of 9 exercises. OUTCOME MEASURES Recording of training session data, Chair Test, Hand Grip Test, Timed Up-and-Go Test, Stork Balance Test, Sit-and-Reach Test, VAS, Perceived Physical Exertion. RESULTS In total, 97% of the sample were "adherent" (more than 70% of the prescribed treatments performed). The rate of adverse events was infrequent (only 8). Chair Test +31%, Hand Grip Test +6%, Timed Up-and-Go Test -17%, Stork Balance Test +65%, Sit-and-Reach Test +55%, VAS -34%, Perceived Physical Exertion -69%. CONCLUSIONS Home training has good feasibility (adherence, tolerability, safety) and cost-effectiveness ratio and improves both strength and functional abilities, which, in turns, helps to improve motor abilities and well-being.
Collapse
Affiliation(s)
- Giovanni Melchiorri
- School of Sport and Exercise Sciences, Department of Systems Medicine, Faculty of Medicine and Surgery, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
- Don Gnocchi Foundation IRCCS, Piazzale Rodolfo Morandi 6, 20121 Milan, Italy
| | - Tamara Triossi
- School of Sport and Exercise Sciences, Faculty of Medicine and Surgery, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Valerio Viero
- School of Sport and Exercise Sciences, Faculty of Medicine and Surgery, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
- Correspondence: ; Tel.: +39-338-4723601
| | - Silvia Marroni
- School of Sport and Exercise Sciences, Faculty of Medicine and Surgery, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Giovanna D’Arcangelo
- Department of Systems Medicine and Centre of Space BioMedicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Virginia Tancredi
- Department of Systems Medicine and Centre of Space BioMedicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| |
Collapse
|
91
|
Lombardo G, Signoriello A, Marincola M, Liboni P, Faccioni P, Zangani A, D’Agostino A, Nocini PF. Short and Ultra-Short Implants, in Association with Simultaneous Internal Sinus Lift in the Atrophic Posterior Maxilla: A Five-Year Retrospective Study. MATERIALS (BASEL, SWITZERLAND) 2022; 15:ma15227995. [PMID: 36431480 PMCID: PMC9695726 DOI: 10.3390/ma15227995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 11/04/2022] [Accepted: 11/08/2022] [Indexed: 05/31/2023]
Abstract
Recent short-term studies suggested the use of short and ultra-short implants in association with a modified osteotome sinus floor elevation (internal sinus lift) technique for the treatment of edentulous resorbed posterior maxilla. The aim of this retrospective study was to investigate this hypothesis in locking-taper implants with a mid-term follow-up of 5 years. Overall, 155 implants (32, 100, and 23 of, respectively, 5.0 mm, 6.0 mm, and 8.0 mm length) were positioned in the atrophic upper maxilla of 79 patients, and 151 implants were loaded with single crowns. Overall implant survival after 5 years was 94.84%. Implant survival for each length group was 93.75%, 94%, and 100% for 5.0, 6.0, and 8.0 mm length, respectively. Preoperative residual crestal bone height of 4.45 (1.3) mm increased to 9.25 (2.13) mm after implant placement and settled at 6.35 (1.73) mm after loading and at 5.25 (1.68) mm at follow-up. Elevation of the Schneiderian membrane was 4.8 (2.46) mm after implant placement, 3.06 (1.3) mm after loading, and 1.46 (1.06) mm at follow-up. Mean variations of peri-implant crestal bone loss and first bone-to-implant contact point were, respectively, -0.36 (1.3) mm and -0.62 (1.15) mm. It can be confirmed that internal sinus lift procedure revealed stable bone gain and negligible resorption at mid-term follow-up for atrophic upper crests with reduced height.
Collapse
Affiliation(s)
- Giorgio Lombardo
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Annarita Signoriello
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Mauro Marincola
- Dental Implant Unit, Research Department, Faculty of Dentistry, University of Cartagena, Cartagena 130001, Colombia
| | - Pietro Liboni
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Paolo Faccioni
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Alessandro Zangani
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Antonio D’Agostino
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Pier Francesco Nocini
- Dentistry and Maxillo-Facial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| |
Collapse
|
92
|
Danila MI, Sun D, Jackson LE, Cutter G, Jackson EA, Ford EW, DeLaney E, Mudano A, Foster PJ, Rosas G, Melnick JA, Curtis JR, Saag KG. Satisfaction with modes of telemedicine delivery during COVID-19: A randomized, single-blind, parallel group, noninferiority trial. Am J Med Sci 2022; 364:538-546. [PMID: 35793732 PMCID: PMC9446840 DOI: 10.1016/j.amjms.2022.06.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 05/09/2022] [Accepted: 06/28/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Little is known about satisfaction with different modes of telemedicine delivery. The objective of this study was to determine whether patient satisfaction with phone-only was noninferior to video visits. METHODS We conducted a parallel group, randomized (1:1), single-blind, noninferiority trial in multispecialty clinics at a tertiary academic medical center. Adults age ≥ 60 years or with Medicare/Medicaid insurance were eligible. Primary outcome was visit satisfaction rate (9 or 10 on a 0-10 satisfaction scale). Noninferiority was determined if satisfaction with phone-only (intervention) versus video visits (comparator) was no worse by a -15% prespecified noninferiority margin. We performed modified intent-to-treat (mITT) and per protocol analyses, after adjusting for age and insurance. RESULTS 200 participants, 43% Black, 68% women completed surveys. Visit satisfaction rates were high. In the mITT analysis, phone-only visits were noninferior by an adjusted difference of 3.2% (95% CI, -7.6% to 14%). In the per protocol analysis, phone-only were noninferior by an adjusted difference of -4.1% (95% CI, -14.8% to 6.6%). The proportion of participants who indicated they preferred the same type of telemedicine visit as their next clinic visit were similar (30.2% vs 27.9% video vs phone-only, p = 0.78) and a majority said their medical concerns were addressed and would recommend a telemedicine visit. CONCLUSIONS Among a group of diverse, established older or underserved patients, the satisfaction rate for phone-only was noninferior to video visits. These findings could impact practice and policies governing telemedicine.
Collapse
Affiliation(s)
- Maria I Danila
- Department of Medicine, Division of Clinical Immunology and Rheumatology University of Alabama at Birmingham, Birmingham, AL, USA; Birmingham VA Medical Center, Birmingham, AL, USA.
| | - Dongmei Sun
- Department of Medicine, Division of Clinical Immunology and Rheumatology University of Alabama at Birmingham, Birmingham, AL, USA
| | - Lesley E Jackson
- Department of Medicine, Division of Clinical Immunology and Rheumatology University of Alabama at Birmingham, Birmingham, AL, USA
| | - Gary Cutter
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Elizabeth A Jackson
- Department of Medicine, Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Eric W Ford
- Department of Healthcare Organization and Policy, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Erin DeLaney
- Department of Family and Community Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Amy Mudano
- Department of Medicine, Division of Clinical Immunology and Rheumatology University of Alabama at Birmingham, Birmingham, AL, USA
| | - Phillip J Foster
- Department of Medicine, Division of Clinical Immunology and Rheumatology University of Alabama at Birmingham, Birmingham, AL, USA
| | - Giovanna Rosas
- Department of Medicine, Division of Clinical Immunology and Rheumatology University of Alabama at Birmingham, Birmingham, AL, USA
| | - Joshua A Melnick
- Department of Medicine, Division of Clinical Immunology and Rheumatology University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jeffrey R Curtis
- Department of Medicine, Division of Clinical Immunology and Rheumatology University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kenneth G Saag
- Department of Medicine, Division of Clinical Immunology and Rheumatology University of Alabama at Birmingham, Birmingham, AL, USA
| |
Collapse
|
93
|
Kim JA, Park MJ, Song E, Roh E, Park SY, Lee DY, Kim J, Yu JH, Seo JA, Choi KM, Baik SH, Yoo HJ, Kim NH. Comparison of Laser and Conventional Lancing Devices for Blood Glucose Measurement Conformance and Patient Satisfaction in Diabetes Mellitus. Diabetes Metab J 2022; 46:936-940. [PMID: 35350088 PMCID: PMC9723205 DOI: 10.4093/dmj.2021.0293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 01/28/2022] [Indexed: 12/29/2022] Open
Abstract
Self-monitoring of capillary blood glucose is important for controlling diabetes. Recently, a laser lancing device (LMT-1000) that can collect capillary blood without skin puncture was developed. We enrolled 150 patients with type 1 or 2 diabetes mellitus. Blood sampling was performed on the same finger on each hand using the LMT-1000 or a conventional lancet. The primary outcome was correlation between glucose values using the LMT-1000 and that using a lancet. And we compared the pain and satisfaction of the procedures. The capillary blood sampling success rates with the LMT-1000 and lancet were 99.3% and 100%, respectively. There was a positive correlation (r=0.974, P<0.001) between mean blood glucose levels in the LMT-1000 (175.8±63.0 mg/dL) and conventional lancet samples (172.5±63.6 mg/dL). LMT-1000 reduced puncture pain by 75.0% and increased satisfaction by 80.0% compared to a lancet. We demonstrated considerable consistency in blood glucose measurements between samples from the LMT-1000 and a lancet, but improved satisfaction and clinically significant pain reduction were observed with the LMT-1000 compared to those with a lancet.
Collapse
Affiliation(s)
- Jung A Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Daejin Medical Center, Bundang Jesaeng Hospital, Seongnam, Korea
| | - Min Jeong Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Eyun Song
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Eun Roh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - So Young Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Da Young Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jaeyoung Kim
- Research Institute for Skin Imaging, Korea University College of Medicine, Seoul, Korea
| | - Ji Hee Yu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ji A Seo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Kyung Mook Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sei Hyun Baik
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hye Jin Yoo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- Corresponding authors: Hye Jin Yoo Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul 08308, Korea E-mail:
| | - Nan Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- BK21 FOUR R&E Center for Learning Health Systems, Korea University, Seoul, Korea
- Nan Hee Kim Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, 123 Jeokgeum-ro, Danwon-gu, Ansan 15355, Korea E-mail:
| |
Collapse
|
94
|
Measuring the processes of interdisciplinary team collaboration: Creating valid measures using a many-facet Rasch model approach. J Clin Transl Sci 2022; 6:e134. [PMID: 36590349 PMCID: PMC9794954 DOI: 10.1017/cts.2022.472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 08/10/2022] [Accepted: 09/23/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction The science of team science (SciTS) is an emerging research area that studies the processes and outcomes of team-based research. A well-established conceptual framework and appropriate methodology for examining the effectiveness of team science are critically important for promoting and advancing collaborative and interdisciplinary research. Although many instruments have been developed and used in the SciTS field, psychometric evidence has not been routinely assessed or reported for these scales. In addition, commonly used psychometric methods were mainly limited to internal consistency and factor analysis. To fill the gaps, this study introduces a framework based on Rasch measurement theory for creating and evaluating measures for team sciences. Methods We illustrate the application of Rasch measurement theory through the creation of valid measures to evaluate the processes of interdisciplinary scientific teams. Data were collected from 16 interdisciplinary teams through a university-wide initiative for promoting interdisciplinary team collaboration. Psychometric evidence based on a many-facet Rasch model was obtained for assessing the quality of the measures. Results The interdisciplinary teams differed in their clarity measures. Significant differences were also found between gender groups, racial groups, and academic ranks. We reported the reliability of measures and identified items that do not fit the model and may present potential threat to validity and fairness of SciTS measures. Conclusion This study shows the great potential of using Rasch measurement theory for developing and evaluating SciTS measures. Applying Rasch measurement theory produces objective measures that are comparable across individuals, interdisciplinary teams, institutions, time, and various demographic groups.
Collapse
|
95
|
Graetz DE, Rivas SE, Fuentes AL, Caceres-Serrano A, Antillon-Klussmann F, Rodriguez-Galindo C, Mack JW. Development and Adaptation of a Patient-Centered Communication Survey for Parents of Children With Cancer in Guatemala. JCO Glob Oncol 2022; 8:e2200124. [PMID: 36179269 PMCID: PMC9812448 DOI: 10.1200/go.22.00124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
PURPOSE Surveys to assess patient and family experiences of pediatric cancer care have been primarily developed and validated in high-income Western settings with English-speaking participants. However, 90% of children with cancer live in low- and middle-income countries. We sought to develop a survey focused on pediatric cancer communication for use in a low-literacy population in Guatemala, including adaptation of many previously validated items. METHODS A multidisciplinary team developed a quantitative survey on the basis of a theoretical model of important components and influences on pediatric cancer communication. The original survey included established items previously used in high-income settings and novel questions designed for this study. The survey was translated into Spanish and pilot tested with parents of children receiving treatment at Unidad Nacional de Oncologia Pediatrica in Guatemala City, Guatemala, from April-June 2019. Cognitive interviews were used during pilot testing, and the survey was iteratively revised throughout this process. RESULTS Early in testing, Guatemalan parents tended to choose answers at the extreme ends of response categories and socially desirable responses. Ultimately, a visual aid was developed to accompany three-item Likert scale response options. This allowed for successful administration of the survey instrument, resulting in moderate variation of response options and similar proportions to those generated when the original five-item responses were used in parent populations from the United States. CONCLUSION Appropriately adapted surveys are necessary to understand patient-centered communication among pediatric oncology populations in low- and middle-income countries. Eventual validation of such tools will enable cross-cultural studies and comparative analysis of results.
Collapse
Affiliation(s)
- Dylan E. Graetz
- St Jude Children's Research Hospital, Memphis, TN,Dylan E. Graetz, MD, MPH, St Jude Children's Research Hospital, 262 Danny Thomas Place, Mailstop 721, Memphis, TN 38105-3678; Twitter: @DylanGraetzMD; e-mail:
| | | | | | | | - Federico Antillon-Klussmann
- Unidad Nacional de Oncología Pediátrica, Guatemala City, Guatemala,Francisco Marroquin University School of Medicine, Guatemala City, Guatemala
| | | | - Jennifer W. Mack
- Dana Farber Cancer Institute/Boston Children's Hospital, Boston, MA
| |
Collapse
|
96
|
Luo M, Hu FR, Wang PD, Yao L, Hu SJ, Bai FH. EncephalApp stroop test versus electronic number connection test-A for screening minimal hepatic encephalopathy in patients with liver cirrhosis: a comparative study. Scand J Gastroenterol 2022; 57:1066-1069. [PMID: 35348416 DOI: 10.1080/00365521.2022.2055975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Minimal hepatic encephalopathy (MHE) is a common neuropsychiatric complication of liver cirrhosis. Both EncephalApp Stroop test (EncephalApp) and electronic number connection test-A (eNCT-A) are novel computerised psychometric tests for MHE screening. We aimed to compare the efficiency, convenience, accessibility, and acceptability of EncephalApp with that of eNCT-A for MHE screening in cirrhotic patients. METHODS Ninety-five patients with hepatitis B-induced liver cirrhosis were included and respectively tested by the psychometric hepatic encephalopathy score (PHES), EncephalApp, and eNCT-A. Using PHES as the gold standard for MHE diagnosis, the efficiency of EncephalApp and eNCT-A for MHE screening were respectively analysed by the receiver operating characteristic (ROC) curve, and the areas under the ROC curve (AUROC) were compared. The convenience, accessibility, and acceptability of PHES, EncephalApp and eNCT-A were respectively evaluated by the 5-point Likert scale. RESULTS Fifty-two (55%) of included cirrhotic patients were diagnosed with MHE. The EncephalApp had a sensitivity of 84.6%, a specificity of 74.4%, and an AUROC of 0.836. Meanwhile, the eNCT-A had a sensitivity of 78.8%, a specificity of 83.7%, and an AUROC of 0.845. No significant difference in AUROC was detected between the EncephalApp and eNCT-A (p = .453). Compared with the EncephalApp, the eNCT-A presented better convenience and higher acceptability in cirrhotic patients undergoing MHE screening (p = .019 and p < .001, respectively). CONCLUSIONS As with the EncephalApp, the eNCT-A will be a potential home monitoring and point-of-care tool for cirrhotic patients at high risk of MHE.
Collapse
Affiliation(s)
- Ming Luo
- Department of Gastroenterology, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, PR China
| | - Fang-Rui Hu
- Department of Gastroenterology, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, PR China
| | - Peng-Da Wang
- Department of Gastroenterology, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, PR China
| | - Li Yao
- Department of Gastroenterology, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, PR China
| | - Sheng-Juan Hu
- Department of Gastroenterology, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, PR China
| | - Fei-Hu Bai
- Department of Gastroenterology, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, PR China
| |
Collapse
|
97
|
Urban S, Horożaniecka P, Włodarczak S, Błaziak M, Jura M, Zymliński R, Biegus J, Siennicka A. Tablet-Based Assessment of Cognitive Function Among Heart Failure Patients. Crit Pathw Cardiol 2022; 21:147-152. [PMID: 35880943 DOI: 10.1097/hpc.0000000000000291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cognitive impairment accompanying heart failure (HF) is an additional HF comorbidity, which may potentially affect the patient's self-care and compliance. We aimed to assess cognitive function (CF) using an application with games created as a cognitive training tool for children and adults, applied using a tablet, and to compare the results obtained by HF patients with the results obtained by healthy age-matched controls. METHODS A total of 69 individuals (49 HF patients and 10 healthy controls) were assessed using 4 games dedicated to measuring cognitive skills as well as questionnaires regarding their socioeconomic status. Additionally, HF patients were asked about their quality of life and anxiety and depression. RESULTS HF patients demonstrated worse results in each game assessing their cognitive functions as compared to the healthy age-matched controls, which is consistent with the previous studies on CF in HF. We have also noticed interesting patterns of relations between CF and sleep and education. CONCLUSIONS We have demonstrated that information and communication technology devices can be successfully applied as feasible tools for cognitive assessment in the HF population. This is important as tablet-based CF assessment can be done on a large population without the involvement of trained personnel.
Collapse
Affiliation(s)
- Szymon Urban
- From the Institute of Heart Diseases, Wroclaw Medical University Borowska, Wroclaw, Poland
| | - Paulina Horożaniecka
- Student Scientific Organization, Institute of Heart Diseases, Wroclaw Medical University Borowska, Wroclaw, Poland
| | - Szymon Włodarczak
- Student Scientific Organization, Institute of Heart Diseases, Wroclaw Medical University Borowska, Wroclaw, Poland
| | - Mikołaj Błaziak
- From the Institute of Heart Diseases, Wroclaw Medical University Borowska, Wroclaw, Poland
| | - Maksym Jura
- Student Scientific Organization, Institute of Heart Diseases, Wroclaw Medical University Borowska, Wroclaw, Poland
- Department of Physiology and Pathophysiology, Wroclaw Medical University, Wrocław, Poland
| | - Robert Zymliński
- From the Institute of Heart Diseases, Wroclaw Medical University Borowska, Wroclaw, Poland
| | - Jan Biegus
- From the Institute of Heart Diseases, Wroclaw Medical University Borowska, Wroclaw, Poland
| | - Agnieszka Siennicka
- Department of Physiology and Pathophysiology, Wroclaw Medical University, Wrocław, Poland
| |
Collapse
|
98
|
Temporiti F, Ruspi A, De Leo D, Ugolini A, Grappiolo G, Avanzini P, Rizzolatti G, Gatti R. Action Observation and Motor Imagery administered the day before surgery enhance functional recovery in patients after total hip arthroplasty: A randomized controlled trial. Clin Rehabil 2022; 36:1613-1622. [PMID: 35892135 DOI: 10.1177/02692155221116820] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To investigate the effects of Action Observation and Motor Imagery administered the day before surgery on functional recovery in patients after total hip arthroplasty. DESIGN Randomised controlled trial. SETTING Humanitas Clinical and Research Center, Milan, Italy. PARTICIPANTS Eighty inpatients with end-stage hip osteoarthritis undergoing total hip arthroplasty. INTERVENTIONS All patients followed a standardized postoperative rehabilitation program. Experimental group (AO + MI) performed two 12-minute Action Observation and Motor Imagery sessions on the preoperative day, whereas control group underwent usual care consisting of education without any additional preoperative activity. OUTCOME MEASURES A blinded physiotherapist assessed participants for functional mobility (Timed Up and Go - TUG) (primary outcome), maximum walking speed (10-Meter Walk Test - 10MWT), pain (Numeric Pain Rating Scale - NPRS) and fear of movement (Tampa Scale of Kinesiophobia - TSK) the day before and at four days after surgery. RESULTS No between-group differences were found at baseline. Although TUG and 10MWT worsened in both groups (p < 0.001), better TUG was found for AO + MI group at four days (mean difference -5.8 s, 95% confidence interval from -11.3 to -0.3 s, p = 0.039). NPRS (p < 0.001) and TSK (p = 0.036 for AO + MI group, p = 0.003 for control group) improved after surgery without between-group differences. CONCLUSIONS Patients undergoing Action Observation and Motor Imagery on the day before surgery showed less functional decline than control group in the first days after total hip arthroplasty. This intervention may contribute to a safer discharge with higher functional abilities in patients hospitalized for total hip arthroplasty.
Collapse
Affiliation(s)
- Federico Temporiti
- Physiotherapy Unit, 9268Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy.,Department of Biomedical Sciences, 437807Humanitas University, Pieve Emanuele, Milan, Italy
| | - Alessandra Ruspi
- Physiotherapy Unit, 9268Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
| | - Davide De Leo
- Physiotherapy Unit, 9268Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
| | - Alberto Ugolini
- Physiotherapy Unit, 9268Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
| | - Guido Grappiolo
- Hip and Knee Orthopedic Surgery Department, 9268Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy
| | - Pietro Avanzini
- Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, Parma, Italy
| | - Giacomo Rizzolatti
- Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, Parma, Italy
| | - Roberto Gatti
- Physiotherapy Unit, 9268Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy.,Department of Biomedical Sciences, 437807Humanitas University, Pieve Emanuele, Milan, Italy
| |
Collapse
|
99
|
Qualitative Methodology for Planning and Executing In-Person and Virtual Neurosurgery Educational Opportunities for Medical Students: Lessons Learned from Five Years of Medical Student Neurosurgery Training Center Initiatives. World Neurosurg 2022; 163:164-170. [PMID: 35729817 DOI: 10.1016/j.wneu.2022.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 02/28/2022] [Accepted: 03/01/2022] [Indexed: 11/23/2022]
Abstract
INTRODUCTION There is a growing need for collaborative and broad-scale medical student neurosurgery educational initiatives. Here, we propose a comprehensive methodology and structure for hosting both in-person and virtual learning opportunities for early trainees interested in clinical neurosciences. METHODS We conducted an internal review of educational courses hosted by Medical Student Neurosurgery Training Center from 2017 to 2022. Inspired by the lessons learned from these activities, we examine the elements vital to the planning, production, funding, and execution of future programs. RESULTS Six domains were deemed important for carrying out medical student neurosurgery educational opportunities: directorship, curriculum, logistics, faculty and instructor outreach, funding, and marketing. Each of these elements is discussed in detail for both in-person and web-based programs, as well as an examination of the advantages and disadvantages of various implementation strategies. CONCLUSIONS Based on the Medical Student Neurosurgery Training Center experience, successful production and hosting of both in-person and virtual educational endeavors seems to be contingent on a collaborative effort by medical students, resident physicians, and neurosurgery faculty. Including medical students throughout the planning phase adds to the overall educational value of each experience and promotes program longevity and consumer engagement. Curricula should be guided by clear learning objectives and a variety of teaching modalities available to the organization. Finally, methods for assessing course outcomes are important, including institutional review board-approved data curation and analysis. Further investigation of neurosurgical learning outcome measurement is needed and has the potential to shape the future of medical student education and neurosurgery career preparation.
Collapse
|
100
|
Ascanelli S, Bombardini C, Chimisso L, Carcoforo P, Turroni S, D’Amico F, Caniati ML, Baldi E, Tugnoli V, Morotti C, Valpiani G, Bazzocchi G. Trans-anal irrigation in patients with multiple sclerosis: Efficacy in treating disease-related bowel dysfunctions and impact on the gut microbiota: A monocentric prospective study. Mult Scler J Exp Transl Clin 2022; 8:20552173221109771. [PMID: 35832690 PMCID: PMC9272186 DOI: 10.1177/20552173221109771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 06/10/2022] [Indexed: 11/17/2022] Open
Abstract
Background Constipation and faecal incontinence are not so uncommon in patients with multiple sclerosis, impairing quality of life. The gut microbiota is altered in multiple sclerosis patients and likely contributes to disease pathogenesis. Trans-anal irrigation has been proven to allow treatment of neurogenic bowel dysfunction and may affect gut microbiota. Objectives The primary outcome was trans-anal irrigation effectiveness on constipation and faecal incontinence. The secondary outcome was gut microbiota profiling compared to healthy subjects and during trans-anal irrigation adoption. Methods We conducted a prospective cohort study on multiple sclerosis patients, screened with Patient Assessment of Constipation Quality of Life questionnaire before undergoing constipation and faecal incontinence scoring, abdomen X-ray for intestinal transit time, compilation of food and evacuation diaries and faecal sample collection for gut microbiota analysis before and after 4 weeks of trans-anal irrigation. Results and Conclusions Eighty patients were screened of which nearly half had intestinal symptoms. The included population (n = 37) was predominantly composed of women with significantly longer disease duration, higher mean age and disability than the excluded one ( p < 0.05). Twelve patients completed the trans-anal irrigation phase, which led to significant improvement of bowel dysfunction symptom-related quality of life, increase in gut microbiota diversity and reduction of the proportions of pro-inflammatory taxa ( p < 0.05). Trans-anal irrigation was safe, satisfactory and could help counteract multiple sclerosis-related dysbiosis.
Collapse
Affiliation(s)
| | | | | | - Paolo Carcoforo
- Department of Morphology, Surgery and Experimental Medicine, Colorectal Unit, Section General Surgery, University Hospital of Ferrara, Ferrara, Italy
| | - Silvia Turroni
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Federica D’Amico
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | | | | | - Valeria Tugnoli
- Department of Neuroscience Rehabilitation, Multiple Sclerosis Center, Unit of Neurology, University Hospital of Ferrara, Ferrara, Italy
| | | | - Giorgia Valpiani
- Accreditation Office Quality Research Innovation, University Hospital of Ferrara, Ferrara, Italy
| | - Gabriele Bazzocchi
- Montecatone Rehabilitation Institute, University of Bologna, Imola, Italy
| |
Collapse
|