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El Bairi K, El Kadmiri N, Fourtassi M. Exploring scientific misconduct in Morocco based on an analysis of plagiarism perception in a cohort of 1,220 researchers and students. Account Res 2024; 31:138-157. [PMID: 35938392 DOI: 10.1080/08989621.2022.2110866] [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] [Indexed: 10/15/2022]
Abstract
Plagiarism is widely regarded as an issue of low- and middle-income countries because of several factors such as the lack of ethics policy and poor research training. In Morocco, plagiarism and its perception by academics has not been investigated on a large scale. In this study, we evaluated different aspects of plagiarism among scholars based on a 23-question cross-sectional survey. Factors associated with plagiarism were explored using contingency tables and logistic regression. The survey results covered all public universities (n=12) and included 1,220 recorded responses. The academic level was significantly associated with plagiarism (p<0.001). Having publication records was statistically associated with a reduced plagiarism (p=0.002). Notably, the ability of participants to correctly define plagiarism was also significantly associated with a reduced plagiarism misconduct (p<0.001). Unintentional plagiarism (p<0.001), time constraint to write an original text (p<0.001), and inability of participants to paraphrase (p<0.001) were associated factors with plagiarism. Moreover, participants that considered plagiarism as a serious issue in academic research had significantly committed less plagiarism (p<0.001). The current study showed that various actionable factors associated with plagiarism can be targeted by educational interventions, and therefore, it provided the rationale to build training programs on research integrity in Morocco.
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Affiliation(s)
- Khalid El Bairi
- Faculty of Medicine and Pharmacy, Mohamed Ist University, Oujda, Morocco
| | - Nadia El Kadmiri
- Molecular Engineering, Biotechnology and Innovation Team, Geo-Bio-Environment Engineering and Innovation Laboratory, Polydisciplinary Faculty of Taroudant, Ibn Zohr University, Taroudannt city, Morocco
| | - Maryam Fourtassi
- Life and Health Sciences Laboratory, Faculty of Medicine and Pharmacy, Abdelmalek Essaâdi University, Tangier, Morocco
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Coughlin MC, Montemayor S, Dolman HS, Nava G, Riddell M, Tarras SL. Desire for Residency-Provided Education and Support for Fertility Concerns: An Institutional Survey. J Surg Res 2024; 299:76-84. [PMID: 38718687 DOI: 10.1016/j.jss.2024.03.024] [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: 02/27/2023] [Revised: 02/23/2024] [Accepted: 03/16/2024] [Indexed: 06/22/2024]
Abstract
INTRODUCTION Medical careers increase infertility risks and pregnancy complications. Residents often postpone pregnancy, contributing to these risks. Limited data exist regarding residents' family planning concerns. This study aims to evaluate fertility concerns and family planning during residency via a survey of residents and attending physicians. METHODS Anonymous online surveys were distributed to all residents (n = 1030) and attending physicians (n = 1111) at a large, urban, single-campus academic hospital center. Data analysis was performed using chi-square analysis with significance at P < 0.05. RESULTS Two hundred nine residents and 111 attendings submitted responses. Most respondents were female (74.7%). Slightly more than one-quarter of respondents were from a surgical specialty (26.6%). Residents compared to attending physicians indicated a higher concern for infertility during (57.4% versus 38.3%, P = 0.006) and after residency (68.9% versus 51.9%, P = 0.011) and a greater concern about pregnancy complications (67.8% versus 38.0%, P < 0.001). Most respondents felt pregnancy could negatively affect their training (67.3%). Surgical respondents were more concerned about the negative effects on colleagues (68.8% versus 51.1%, P = 0.045). Residents considered oocyte preservation more (57.9% versus 20.3%, P < 0.001). Respondents in surgical specialties had more concerns for fertility after residency (72.6% versus 57.9%, P = 0.033). Those in surgical fields trended for consideration of oocyte preservation (53.4% versus 39.7%, P = 0.084). Most respondents reported a need for education on oocyte preservation during residency (94.5%). CONCLUSIONS Residents have increasing concerns about fertility and family planning related to their training. In addition to more institutional and residency program support, residents desire dedicated fertility and family planning education, such as oocyte preservation, as part of their curriculum.
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Affiliation(s)
- Michelle C Coughlin
- The Michael and Marian Ilitch Department of Surgery, Detroit Medical Center, Wayne State University School of Medicine, Detroit, Michigan
| | - Sabrina Montemayor
- The Michael and Marian Ilitch Department of Surgery, Detroit Medical Center, Wayne State University School of Medicine, Detroit, Michigan
| | - Heather S Dolman
- The Michael and Marian Ilitch Department of Surgery, Detroit Medical Center, Wayne State University School of Medicine, Detroit, Michigan
| | - Guillermina Nava
- The Michael and Marian Ilitch Department of Surgery, Detroit Medical Center, Wayne State University School of Medicine, Detroit, Michigan
| | - Madyson Riddell
- The Michael and Marian Ilitch Department of Surgery, Detroit Medical Center, Wayne State University School of Medicine, Detroit, Michigan
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Graafsma J, Klopotowska JE, Derijks HJ, van de Garde EMW, Hoge RHL, Kruip MJHA, Meijer K, Karapinar-Carkit F, van den Bemt PMLA. Adoption of antithrombotic stewardship and utilization of clinical decision support systems-A questionnaire-based survey in Dutch hospitals. PLoS One 2024; 19:e0306033. [PMID: 38905283 PMCID: PMC11192363 DOI: 10.1371/journal.pone.0306033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 06/10/2024] [Indexed: 06/23/2024] Open
Abstract
Antithrombotics require careful monitoring to prevent adverse events. Safe use can be promoted through so-called antithrombotic stewardship. Clinical decision support systems (CDSSs) can be used to monitor safe use of antithrombotics, supporting antithrombotic stewardship efforts. Yet, previous research shows that despite these interventions, antithrombotics continue to cause harm. Insufficient adoption of antithrombotic stewardship and suboptimal use of CDSSs may provide and explanation. However, it is currently unknown to what extent hospitals adopted antithrombotic stewardship and utilize CDSSs to support safe use of antithrombotics. A semi-structured questionnaire-based survey was disseminated to 12 hospital pharmacists from different hospital types and regions in the Netherlands. The primary outcome was the degree of antithrombotic stewardship adoption, expressed as the number of tasks adopted per hospital and the degree of adoption per task. Secondary outcomes included characteristics of CDSS alerts used to monitor safe use of antithrombotics. All 12 hospital pharmacists completed the survey and report to have adopted antithrombotic stewardship in their hospital to a certain degree. The median adoption of tasks was two of five tasks (range 1-3). The tasks with the highest uptake were: drafting and maintenance of protocols (100%) and professional's education (58%), while care transition optimization (25%), medication reviews (8%) and patient counseling (8%) had the lowest uptake. All hospitals used a CDSS to monitor safe use of antithrombotics, mainly via basic alerts and less frequently via advanced alerts. The most frequently employed alerts were: identification of patients using a direct oral anticoagulant (DOAC) or a vitamin K antagonist (VKA) with one or more other antithrombotics (n = 6) and patients using a VKA to evaluate correct use (n = 6), both reflecting basic CDSS. All participating hospitals adopted antithrombotic stewardship, but the adopted tasks vary. CDSS alerts used are mainly basic in their logic.
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Affiliation(s)
- Jetske Graafsma
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Joanna E. Klopotowska
- Department of Medical Informatics Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health Institute, Amsterdam, the Netherlands
| | | | - Ewoudt M. W. van de Garde
- Department of Pharmacy, St. Antonius Hospital, Nieuwegein, Utrecht, the Netherlands
- Division Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Utrecht, the Netherlands
| | - Rien H. L. Hoge
- Department of Pharmacy, Wilhelmina Hospital, Assen, the Netherlands
- Gaston Medical, Eindhoven, the Netherlands
| | - Marieke J. H. A. Kruip
- Department of Hematology, Erasmus MC, Erasmus University medical center, Rotterdam, the Netherlands
| | - Karina Meijer
- Department of Hematology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Fatma Karapinar-Carkit
- Department of Clinical Pharmacy & Toxicology, Maastricht University Medical Center+, Maastricht, the Netherlands
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands
| | - Patricia M. L. A. van den Bemt
- Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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Karumbi J, Gorst S, Gathara D, Young B, Williamson P. Experiences of core outcome set developers on including stakeholders from low- and middle-income countries: An online survey. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003365. [PMID: 38900810 PMCID: PMC11189180 DOI: 10.1371/journal.pgph.0003365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 05/28/2024] [Indexed: 06/22/2024]
Abstract
Core outcome set (COS) development and use enhances comparability of research findings. It may also enhance the translation of research into practice and reduce research waste. However, there is limited involvement of stakeholders from low- and middle-income countries (LMICs) in COS development and use. In this study, we explored the experiences of researchers in COS development projects who included stakeholders from LMICs. Online survey conducted in English of 70 COS developers from HICs who had included LMIC stakeholders in the process of developing a COS, published before the end of 2019. Respondents were identified from the COMET database and sent a link to the survey via a personalised email. Quantitative data were analysed using simple descriptive statistics. Qualitative data analysis was based on qualitative content analysis. There were 37 respondents yielding a 53% overall response rate. Analysis was limited to the responses related to 29 COS developed in the years 2015 to 2019, to reduce the potential for recall bias for earlier COS. Most respondents 20/29 (69%) were researchers. Determining 'what to measure' was reported as the most common stage of inclusion of LMIC stakeholders. Respondents cited (24/29, 83%) their ongoing collaborations with LMIC stakeholders such as clinicians or researchers as their main rationale for including LMICs stakeholders and reported that translation of the Delphi into languages other than English may be useful to enhance wider stakeholder participation. Involvement of LMIC stakeholders only in the later stages of COS development, lack of adequate resources to support their involvement, and lack of networks and contacts were thought to limit fuller participation of stakeholders from LMICs. To improve the involvement of LMIC stakeholders in COS development and use, COS developers need to raise awareness on the utility of COS. The need for and feasibility of translation into multiple languages warrants further discussion.
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Affiliation(s)
- Jamlick Karumbi
- Department of Health Data Science, University of Liverpool, Liverpool, United Kingdom
- Health Systems Research, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Sarah Gorst
- Department of Health Data Science, University of Liverpool, Liverpool, United Kingdom
| | - David Gathara
- Health Systems Research, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- Centre for Maternal, Adolescent, Reproductive & Child Health (MARCH), London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Bridget Young
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, United Kingdom
| | - Paula Williamson
- Department of Health Data Science, University of Liverpool, Liverpool, United Kingdom
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Pioche M, Cunha Neves JA, Pohl H, Lê MQ, Grau R, Dray X, Yzet C, Mochet M, Jacques J, Wallenhorst T, Rivory J, Siret N, Peillet AL, Chevaux JB, Mion F, Chaput U, Jacob P, Grinberg D, Saurin JC, Baddeley R, Rodriguez de Santiago E, Cottinet PJ. The environmental impact of small-bowel capsule endoscopy. Endoscopy 2024. [PMID: 38657660 DOI: 10.1055/a-2313-5142] [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] [Indexed: 04/26/2024]
Abstract
INTRODUCTION The environmental impact of endoscopy, including small-bowel capsule endoscopy (SBCE), is a topic of growing attention and concern. This study aimed to evaluate the greenhouse gas (GHG) emissions (kgCO2) generated by an SBCE procedure. METHODS Life cycle assessment methodology (ISO 14040) was used to evaluate three brands of SBCE device and included emissions generated by patient travel, bowel preparation, capsule examination, and video recording. A survey of 87 physicians and 120 patients was conducted to obtain data on travel, activities undertaken during the procedure, and awareness of environmental impacts. RESULTS The capsule itself (4 g) accounted for < 6 % of the total product weight. Packaging (43-119 g) accounted for 9 %-97 % of total weight, and included deactivation magnets (5 g [4 %-6 %]) and paper instructions (11-50 g [up to 40 %]). A full SBCE procedure generated approximately 20 kgCO2, with 0.04 kgCO2 (0.2 %) attributable to the capsule itself and 18 kgCO2 (94.7 %) generated by patient travel. Capsule retrieval using a dedicated device would add 0.98 kgCO2 to the carbon footprint. Capsule deconstruction revealed materials (e. g. neodymium) that are prohibited from environmental disposal; 76 % of patients were not aware of the illegal nature of capsule disposal via wastewater, and 63 % would have been willing to retrieve it. The carbon impact of data storage and capsule reading was negligible. CONCLUSION The carbon footprint of SBCE is mainly determined by patient travel. The capsule device itself has a relatively low carbon footprint. Given that disposal of capsule components via wastewater is illegal, retrieval of the capsule is necessary but would likely be associated with an increase in device-related emissions.
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Affiliation(s)
- Mathieu Pioche
- Endoscopy and Gastroenterology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Joao A Cunha Neves
- Department of Gastroenterology, Algarve University Hospital Centre, Portimão, Portugal
| | - Heiko Pohl
- Departments of Gastroenterology, VA Medical Center, White River Junction, Vermont; and Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Minh-Quyen Lê
- Material Analysis Laboratory, INSA Lyon, Villeurbanne, France
| | - Raphaelle Grau
- Endoscopy and Gastroenterology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Xavier Dray
- Sorbonne University, Centre for Digestive Endoscopy, Hôpital Saint-Antoine, APHP, Paris, France
| | - Clara Yzet
- Endoscopy and Gastroenterology Unit, University Hospital, Amiens, France
| | - Mikael Mochet
- Endoscopy and Gastroenterology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Jérémie Jacques
- Gastroenterology and Endoscopy Unit, Dupuytren University Hospital, Limoges, France
| | - Timothée Wallenhorst
- Gastroenterology and Endoscopy Unit, University Hospital Pontchaillou, Rennes, France
| | - Jérôme Rivory
- Endoscopy and Gastroenterology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Nadège Siret
- Endoscopy and Gastroenterology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Anne-Laure Peillet
- Endoscopy and Gastroenterology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | | | - François Mion
- Digestive Physiology Department, Hospices Civils de Lyon, Lyon, France
| | - Ulriikka Chaput
- Sorbonne University, Centre for Digestive Endoscopy, Hôpital Saint-Antoine, APHP, Paris, France
| | - Philippe Jacob
- Endoscopy and Gastroenterology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
- Gastroenterology and Endoscopy Unit, Nimes Private Clinic, Nimes, France
| | - Daniel Grinberg
- Material Analysis Laboratory, INSA Lyon, Villeurbanne, France
- Cardiac Surgery, Cardiologic Hospital, Hospices Civils de Lyon, Lyon, France
| | - Jean-Christophe Saurin
- Endoscopy and Gastroenterology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Robin Baddeley
- Wolfson Unit for Endoscopy, St Mark's Hospital and Academic Institute; King's Health Partners Institute for Therapeutic Endoscopy, King's College Hospital; and Imperial College London, London, UK
| | - Enrique Rodriguez de Santiago
- Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBEREHD, Universidad de Alcalá, Madrid, Spain
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Thompson JH, Thompson J, Bailey S. Shared decision-making in advanced physiotherapy and first contact physiotherapy management of adults with musculoskeletal disorders in the United Kingdom: An online cross-sectional survey. J Eval Clin Pract 2024. [PMID: 38881399 DOI: 10.1111/jep.14043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 04/25/2024] [Accepted: 05/25/2024] [Indexed: 06/18/2024]
Abstract
RATIONALE Advanced practice physiotherapy roles (Advanced Physiotherapy Practitioners [APPs] and First Contact Physiotherapists [FCPs]) are pivotal in supporting patients to manage their musculoskeletal (MSK) conditions. Having a greater understanding of how decisions are made by these practitioners will inform competency frameworks and improve the provision of patient-centred care. AIM To evaluate the current knowledge, views and use of shared decision-making in MSK advanced physiotherapy practice in the United Kingdom. METHODS A cross-sectional survey using an online questionnaire was used to collect demographic information, knowledge, views and self-reported use of shared decision-making (SDM) of APPs and FCPs who work with adults with MSK disorders in the United Kingdom. RESULTS Responses from 49 participants (25 APPs and 24 FCPs) were included in the study. In total, 80% of participants had received SDM training and overall high levels of knowledge were shown. Only 12% of participants used a communication model to facilitate SDM. In total, 80% of participants reported making decisions together with the patient either always or most of the time. FCPs favoured a more patient-led approach to decision-making compared to APPs who favoured collaborative decision-making. The most commonly reported barriers to SDM included lack of time, lack of patient education resources, lack of access to patient decision aids and treatment pathway restrictions. CONCLUSIONS The responses in this study showed that overall APPs and FCPs have good knowledge of SDM and report routine use of collaborative and patient-led decision-making approaches.
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Steinhauser S, Haroz R, Jones I, Skelton W, Fuller BM, Roberts MB, Jones CW, Trzeciak S, Roberts BW. Emergency department staff compassion is associated with lower fear of enacted stigma among patients with opioid use disorder. Acad Emerg Med 2024. [PMID: 38881343 DOI: 10.1111/acem.14970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 04/15/2024] [Accepted: 04/21/2024] [Indexed: 06/18/2024]
Abstract
OBJECTIVES Fear of enacted stigma (fear of discrimination or being treated unfairly) is associated with decreased health care-seeking behaviors among patients with opioid use disorder (OUD). We sought to describe the prevalence of fear of enacted stigma among patients presenting to the emergency department (ED) with OUD and to test whether experiencing greater compassion from ED staff is associated with lower fear of enacted stigma. METHODS We conducted a cross-sectional study in the ED of an academic medical center between February and August 2023. We included adult patients with OUD presenting to the ED and assessed patient experience of compassion from ED staff using a previously validated 5-item compassion measure (score range 5-20). The primary outcome measure was fear of enacted stigma in the ED, measured using the validated 9-item subscale of the Substance Abuse Self-Stigma Scale (score range 9-45). RESULTS Of the 116 subjects enrolled, 97% (95% confidence interval [CI] 91%-99%) reported some degree of stigma, with a median (interquartile range) score of 23 (16-31). In a multivariable model adjusting for potential confounders, patient experience of greater ED compassion was independently associated with lower fear of enacted stigma, β = -0.66 (95% CI -1.03 to -0.29), suggesting that every 1-point increase in the 5-item compassion measure score is associated with a 0.66-point decrease in the fear of enacted stigma score. CONCLUSIONS Among ED patients with OUD, fear of enacted stigma is common. Patient experience of compassion from ED staff is associated with lower fear of enacted stigma. Future research is warranted to test if interventions aimed at increasing compassion from ED staff reduce patient fear of enacted stigma among patients with OUD.
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Affiliation(s)
- Savannah Steinhauser
- The Department of Emergency Medicine, Cooper University Health Care (CUHC), Cooper Medical School of Rowan University (CMSRU), Camden, New Jersey, USA
| | - Rachel Haroz
- The Department of Emergency Medicine, Cooper University Health Care (CUHC), Cooper Medical School of Rowan University (CMSRU), Camden, New Jersey, USA
- The Department of Emergency Medicine, Division of Toxicology and Addiction Medicine, CUHC/CMSRU, Camden, New Jersey, USA
- Cooper Center for Healing, CUHC/CMSRU, Camden, New Jersey, USA
| | - Iris Jones
- Cooper Center for Healing, CUHC/CMSRU, Camden, New Jersey, USA
| | - William Skelton
- The Department of Emergency Medicine, Cooper University Health Care (CUHC), Cooper Medical School of Rowan University (CMSRU), Camden, New Jersey, USA
- Department of Behavioral Medicine, CUHC/CMSRU, Camden, New Jersey, USA
| | - Brian M Fuller
- Division of Critical Care Medicine, Departments of Emergency Medicine and Anesthesia, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Michael B Roberts
- Institutional Research and Outcomes Assessment, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, USA
| | - Christopher W Jones
- The Department of Emergency Medicine, Cooper University Health Care (CUHC), Cooper Medical School of Rowan University (CMSRU), Camden, New Jersey, USA
| | | | - Brian W Roberts
- The Department of Emergency Medicine, Cooper University Health Care (CUHC), Cooper Medical School of Rowan University (CMSRU), Camden, New Jersey, USA
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Guenego A, Fahed R, Rouchaud A, Walker G, Faizy TD, Sporns PB, Aggour M, Jabbour P, Alexandre AM, Mosimann PJ, Dmytriw AA, Ligot N, Sadeghi N, Dai C, Hassan AE, Pereira VM, Singer J, Heit JJ, Taccone FS, Chen M, Fiehler J, Lubicz B. Diagnosis and endovascular management of vasospasm after aneurysmal subarachnoid hemorrhage - survey of real-life practices. J Neurointerv Surg 2024; 16:677-683. [PMID: 37500477 DOI: 10.1136/jnis-2023-020544] [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: 05/07/2023] [Accepted: 06/26/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Vasospasm and delayed cerebral ischemia (DCI) are the leading causes of morbidity and mortality after intracranial aneurysmal subarachnoid hemorrhage (aSAH). Vasospasm detection, prevention and management, especially endovascular management varies from center to center and lacks standardization. We aimed to evaluate this variability via an international survey of how neurointerventionalists approach vasospasm diagnosis and endovascular management. METHODS We designed an anonymous online survey with 100 questions to evaluate practice patterns between December 2021 and September 2022. We contacted endovascular neurosurgeons, neuroradiologists and neurologists via email and via two professional societies - the Society of NeuroInterventional Surgery (SNIS) and the European Society of Minimally Invasive Neurological Therapy (ESMINT). We recorded the physicians' responses to the survey questions. RESULTS A total of 201 physicians (25% [50/201] USA and 75% non-USA) completed the survey over 10 months, 42% had >7 years of experience, 92% were male, median age was 40 (IQR 35-46). Both high-volume and low-volume centers were represented. Daily transcranial Doppler was the most common screening method (75%) for vasospasm. In cases of symptomatic vasospasm despite optimal medical management, endovascular treatment was directly considered by 58% of physicians. The most common reason to initiate endovascular treatment was clinical deficits associated with proven vasospasm/DCI in 89%. The choice of endovascular treatment and its efficacy was highly variable. Nimodipine was the most common first-line intra-arterial therapy (40%). Mechanical angioplasty was considered the most effective endovascular treatment by 65% of neurointerventionalists. CONCLUSION Our study highlights the considerable heterogeneity among the neurointerventional community regarding vasospasm diagnosis and endovascular management. Randomized trials and guidelines are needed to improve standard of care, determine optimal management approaches and track outcomes.
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Affiliation(s)
- Adrien Guenego
- Interventional Neuroradiology Department, Hôpital Erasme - Hôpital Universitaire de Bruxelles (HUB) - Université Libre de Bruxelles (ULB), Bruxelles, Belgium
| | - Robert Fahed
- Department of Medicine - Division of Neurology, The Ottawa Hospital - Ottawa Hospital Research Institute and University of Ottawa, Ottawa, Ontario, Canada
| | - Aymeric Rouchaud
- Interventional neuroradiology, Centre Hospitalier Universitaire de Limoges, Limoges, France
- Univsersity of Limoges, CNRS, XLIM, UMR 7252, Limoges, France
| | - Gregory Walker
- Department of Medicine - Division of Neurology, Royal Columbian Hospital, New Westminster, British Columbia, Canada
- Department of Medicine - Division of Neurology, Royal Columbian Hospital, New Westminster, British Columbia, Canada
| | - Tobias D Faizy
- Radiology, Stanford University School of Medicine, Stanford, California, USA
| | - Peter B Sporns
- Department of Neuroradiology, University Hospital Basel, Basel, Switzerland
| | - Mohamed Aggour
- Department of Radiology, The Royal London Hospital, London, UK
| | - Pascal Jabbour
- Neurological surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Andrea M Alexandre
- UOSA Neuroradiologia Interventistica, Fondazione Policlinico Universitario A.Gemelli IRCCS, Roma, Italy
| | - Pascal John Mosimann
- Neuroradiology Division, University Medical Imaging TorontoJoint Department of Medical ImagingUniversity Health Networks and University of TorontoToronto Western Hospital, Toronto, Ontario, Canada
| | - Adam A Dmytriw
- Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Neurovascular Centre, Departments of Medical Imaging & Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Noémie Ligot
- Department of Neurology, Hôpital Erasme - Hôpital Universitaire de Bruxelles (HUB) - Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Niloufar Sadeghi
- Department of Radiology and Neuroradiology, Hôpital Erasme - Hôpital Universitaire de Bruxelles (HUB) - Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Chengbo Dai
- Department of Neurology, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Ameer E Hassan
- Department of Neurology, Valley Baptist Health System Inc, Harlingen, Texas, USA
| | - Vitor M Pereira
- Neurovascular Centre, Departments of Medical Imaging & Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Justin Singer
- Neurosurgery, Spectrum Health Michigan State University College of Human Medicine Internal Medicine Residency Program, Grand Rapids, Michigan, USA
| | - Jeremy J Heit
- Radiology, Neuroadiology and Neurointervention Division, Stanford University, Stanford, California, USA
| | - Fabio Silvio Taccone
- Department of Intensive Care, Hospital Erasme, Hôpital Erasme - Hôpital Universitaire de Bruxelles (HUB) - Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Michael Chen
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Jens Fiehler
- Department of Neuroradiology, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Boris Lubicz
- Interventional Neuroradiology Department, Hôpital Erasme - Hôpital Universitaire de Bruxelles (HUB) - Université Libre de Bruxelles (ULB), Bruxelles, Belgium
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Gaertner J, Boehlke C, Kreye G, Fusi-Schmidhauser T, Mueller E, Roch C. Pharmacological treatment of cancer pain and opioid induced nausea and vomiting: online survey and comparison with current guidelines. Support Care Cancer 2024; 32:436. [PMID: 38879720 PMCID: PMC11180006 DOI: 10.1007/s00520-024-08628-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 06/02/2024] [Indexed: 06/19/2024]
Abstract
PURPOSE We assumed that in Palliative Care, even in common clinical situations, the choice of drugs differs substantially between physicians. Therefore, we assessed the practice of pharmaceutical treatment choices of physicians for cancer pain and opioid-induced nausea and vomiting (OINV) and the rationale for their choices. METHODS An online survey was conducted with physicians covering the following domains: i) Cancer pain therapy: non-opioids in addition to opioids: choice of drug ii) prevention of OINV: choice of drug and mode of application. Current guidelines concerning cancer pain therapy and prevention of OINV were compared. RESULTS Two-hundred-forty European physicians responded to our survey. i) Use of non-opioids in addition to opioids for the treatment of cancer pain: Only 1.3% (n = 3) of respondents never used an additional non-opioid. Others mostly used: dipyrone/metamizole (49.2%, n = 118), paracetamol/acetaminophen (34.2%, n = 82), ibuprofen / other NSAIDs (11.3%, n = 27), specific Cox2-inhibitors (2.1%, n = 5), Aspirin (0.4%, n = 1), no answer (2.9%, n = 7). ii) Antiemetics to prevent OINV: The drugs of choice were metoclopramide (58.3%, n = 140), haloperidol (26.3%, n = 63), 5-HT3 antagonists (9.6%, n = 23), antihistamines (1.3%, n = 3) and other (2.9%, n = 7); no answer (1.7%, n = 4). Most respondents prescribed the substances on-demand (59.6%, n = 143) while others (36.3%, n = 87) provided them as around the clock medication. Over both domains, most physicians answered that their choices were not based on solid evidence from randomized controlled trials (RCTs). Guidelines were inconsistent regarding if and what non-opioid to use for cancer pain and recommend anti-dopaminergic drugs for prevention or treatment of OINV. CONCLUSIONS Physician's practice in palliative care for the treatment of cancer pain and OINV differed substantially. Respondents expressed the lack of high-quality evidence- based information from RCTs. We call for evidence from methodologically high-quality RCTs to be available to inform physicians about the benefits and harms of pharmacological treatments for common symptoms in palliative care.
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Affiliation(s)
- Jan Gaertner
- Palliative Care Center Basel, Basel, Switzerland
- Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Christopher Boehlke
- Palliative Care Center Basel, Basel, Switzerland.
- Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland.
| | - Gudrun Kreye
- Division of Palliative Care, Department of Internal Medicine, Karl Landsteiner University of Health Sciences, Krems, Austria
- Karl Landsteiner University of Health Sciences, University Hospital, Krems, Austria
| | - Tanja Fusi-Schmidhauser
- Palliative and Supportive Care Clinic and Department of Internal Medicine, Ente Ospedaliero Cantonale, Lugano, Switzerland
- Department of Rehabilitation and Geriatrics, University of Geneva, Geneva, Switzerland
| | - Evelyn Mueller
- Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Carmen Roch
- Interdisciplinary Center for Palliative Medicine, University Hospital Wuerzburg, Würzburg, Germany
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Brekelmans M, Hopmans T, van Mourik M, de Greeff S, Swillens J, van Rooden S. Evaluation of a multifaceted implementation strategy for semi-automated surveillance of surgical site infections after total hip or knee arthroplasty: a multicentre pilot study in the Netherlands. Antimicrob Resist Infect Control 2024; 13:63. [PMID: 38872201 PMCID: PMC11170835 DOI: 10.1186/s13756-024-01418-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 06/01/2024] [Indexed: 06/15/2024] Open
Abstract
INTRODUCTION To promote the nation-wide implementation of semi-automated surveillance (AS) of surgical site infection after hip and knee arthroplasty, the Dutch National Institute for Public Health and the Environment (RIVM) deployed a decentralised multifaceted implementation strategy. This strategy consisted of a protocol specifying minimum requirements for an AS system, supported by a user manual, education module, individual guidance for hospitals and user-group meetings. This study describes an effect evaluation and process evaluation of the implementation strategy for AS in five frontrunner hospitals. METHODS To evaluate the effect of the implementation strategy, the achieved phase of implementation was determined in each frontrunner hospital at the end of the study period. The process evaluation consisted of (1) an evaluation of the feasibility of strategy elements, (2) an evaluation of barriers and facilitators for implementation and (3) an evaluation of the workload for implementation. Interviews were performed as a basis for a subsequent survey quantifying the results regarding the feasibility as well as barriers and facilitators. Workload was self-monitored per profession. Qualitative data were analysed using a framework analysis, whereas quantitative data were analysed descriptively. RESULTS One hospital finished the complete implementation process in 240 person-hours. Overall, the elements of the implementation strategy were often used, positively received and overall, the strategy was rated effective and feasible. During the implementation process, participants perceived the relative advantage of AS and had sufficient knowledge about AS. However, barriers regarding complexity of AS data extraction, data-infrastructure, and validation, lack of capacity and motivation at the IT department, and difficulties with assigning roles and responsibilities were experienced. CONCLUSION A decentralised multifaceted implementation strategy is suitable for the implementation of AS in hospitals. Effective local project management, including clear project leadership and ownership, obtaining commitment of higher management levels, active involvement of stakeholders, and appropriate allocation of roles and responsibilities is important for successful implementation and should be facilitated by the implementation strategy. Sufficient knowledge about AS, its requirements and the implementation process should be available among stakeholders by e.g. an education module. Furthermore, exchange of knowledge and experiences between hospitals should be encouraged in user-group meetings.
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Affiliation(s)
- Manon Brekelmans
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.
- Department of Medical Microbiology and Infection Control, University Medical Centre Utrecht, Utrecht, the Netherlands.
| | - Titia Hopmans
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Maaike van Mourik
- Department of Medical Microbiology and Infection Control, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Sabine de Greeff
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Julie Swillens
- Scientific Centre for Quality of Healthcare (IQ Healthcare), Radboud Institute for Health Sciences (RIHS), Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Stephanie van Rooden
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
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11
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Pasqualotto L, Driusso P, Dos Reis FJJ, Rodrigues JC, Catai CC, Riccetto C, Jorge CH, Botelho S. Low-Value Practices for Pelvic Floor Dysfunction-Choosing Wisely Recommendations from the Brazilian Association of Physiotherapy in Women's Health: Observational Study. Int Urogynecol J 2024:10.1007/s00192-024-05828-x. [PMID: 38864858 DOI: 10.1007/s00192-024-05828-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 05/07/2024] [Indexed: 06/13/2024]
Abstract
INTRODUCTION AND HYPOTHESIS The Choosing Wisely campaign is an international initiative that is aimed at promoting a dialog between professionals, helping the population to choose an evidence-based, truly necessary and risk-free care. The aim of the study was to develop the Choosing Wisely Brazil list on Women's Health Physiotherapy in the area of the pelvic floor. METHODS A observational study was carried out between January 2022 and July 2023, proposed by the Brazilian Association of Physiotherapy in Women's Health, and developed by researchers working in the area of the pelvic floor. The development of the list consisted of six stages: a panel of experts, consensus building, national research, a review by the Choosing Wisely Brazil team, preparation of the list, and publication of the recommendations. Descriptive and content analyses were carried out in order to include evidence-based recommendations with over 80% agreement by physiotherapists in Brazil. RESULTS The expert panel was made up of 25 physiotherapists who submitted 63 recommendations. Seven physiotherapists/researchers carried out a critical analysis of the literature and refined the recommendations, resulting in 11 recommendations that were put to a national vote, in which 222 physiotherapists took part. After a review by the Choosing Wisely Brazil team, five recommendations with an average agreement of 88.2% agreement were chosen for publication. CONCLUSIONS The Choosing Wisely Brazil team in Physiotherapy in Women's Health/Pelvic Floor proposed a list of five recommendations that showed a high agreement among Brazilian physiotherapists working in the area.
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Affiliation(s)
- Luísa Pasqualotto
- University of Campinas, School of Medical Sciences, Postgraduate Program in Surgical Science (UNICAMP), Campinas, São Paulo, Brazil
| | - Patricia Driusso
- Women's Health Research Laboratory, Physical Therapy Department (UFSCar), São Carlos, Federal University of São Carlos, São Paulo, Brazil
| | - Felipe José Jandre Dos Reis
- Federal Institute of Rio de Janeiro, Physiotherapy Department (IFRJ), Rio de Janeiro, Brazil
- Department of Physiotherapy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brusselm Pain in Motion Research Group, Brussels, Belgium
| | - Jessica Cordeiro Rodrigues
- Women's Health Research Laboratory, Physical Therapy Department (UFSCar), São Carlos, Federal University of São Carlos, São Paulo, Brazil
| | - Camila Chiazuto Catai
- Department of Health Science, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Cassio Riccetto
- University of Campinas, School of Medical Sciences, Postgraduate Program in Surgical Science (UNICAMP), Campinas, São Paulo, Brazil
- Department of Health Science, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
- Women's Health Research Laboratory, Physical Therapy Department (UFSCar), São Carlos, Federal University of São Carlos, São Paulo, Brazil
- Federal Institute of Rio de Janeiro, Physiotherapy Department (IFRJ), Rio de Janeiro, Brazil
- Department of Physiotherapy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brusselm Pain in Motion Research Group, Brussels, Belgium
- Federal University of Alfenas, Motor Science Institute, Postgraduate Program in Rehabilitation Sciences (UNIFAL/MG), Alfenas, Minas Gerais, Brazil
| | - Cristine Homsi Jorge
- Department of Health Science, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Simone Botelho
- University of Campinas, School of Medical Sciences, Postgraduate Program in Surgical Science (UNICAMP), Campinas, São Paulo, Brazil.
- Federal University of Alfenas, Motor Science Institute, Postgraduate Program in Rehabilitation Sciences (UNIFAL/MG), Alfenas, Minas Gerais, Brazil.
- UroFisioterapia Laboratory of the Postgraduate Program in Rehabilitation Sciences, Federal University of Alfenas, UNIFAL/MG, Av. Jovino Fernandes Sales, 2600 Santa Clara, Building C, Room 101-K, Alfenas, MG, 37130-000, Brazil.
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Hassan AHF, Barry HE, Hughes CM. An exploration of Northern Ireland general practice pharmacists' views on their role in general practice: a cross-sectional survey. BMC PRIMARY CARE 2024; 25:201. [PMID: 38844848 PMCID: PMC11157875 DOI: 10.1186/s12875-024-02457-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 05/31/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND There is limited research examining the views of general practice pharmacists (GPPs) on their role and their impact in general practice. The aim of this study was to explore GPPs' views regarding this role and its potential impact within general practice in Northern Ireland (NI). METHODS A paper-based self-administered questionnaire was mailed to 319 general practices in NI in 2022, directed to the GPP who spent most time at the practice. A variety of closed and open questions were included in six sections. Responses to closed questions were analysed descriptively whilst open question responses were analysed using content analysis. To ascertain associations between variables (e.g. GPP prescribing status, working arrangements and aspects of collaboration with GPPs), Fisher's exact test was employed with an a priori significance level of p < 0.05. RESULTS 155 responses were received equating to a response rate of 48.5%. Most participants (72.3%) were female, independent prescribers (71%), and 64.5% were currently using their independent prescriber qualification. Services that were provided by most GPPs were medication reconciliation (99.4%) and medication reviews (97.4%). The most common method of communication between GPPs and general practitioners (GPs) was face-to-face (89.0%). Telephone was the most common method of communication between GPPs, community pharmacists (97.4%) and patients (98.7%). Most GPPs (> 80%) showed positive attitudes towards collaboration with GPs and those who worked in multiple practices were more likely to agree with the Attitudes Towards Collaboration Instrument for pharmacists (ATCI-P) statements compared to those who worked in a single practice (p < 0.05). Less than 40% (36.8%) of GPPs agreed that patients were aware of the role they provided. The majority of GPPs (80.6%) expressed positive views on their impact on primary care. Analysis of the free-text comments revealed the need for more GPP patient-facing activities, GPP-specific training, and promotion of the GPP role. CONCLUSION The findings indicated that GPPs had largely positive views about their role and their impact on primary care. The results may be helpful for practices and service commissioners. Further research is necessary to explore the perspectives of patients regarding the role of the GPP and to enhance patients' awareness of the GPP.
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Affiliation(s)
- Abrar H F Hassan
- Primary Care Research Group, School of Pharmacy, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, Northern Ireland, UK
- Department of Clinical Pharmacy, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Heather E Barry
- Primary Care Research Group, School of Pharmacy, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, Northern Ireland, UK
| | - Carmel M Hughes
- Primary Care Research Group, School of Pharmacy, Medical Biology Centre, Queen's University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, Northern Ireland, UK.
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13
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Ferrández-Gómez JÉ, Gacto-Sánchez M, Nouni-García R, Gascón-Jaén J, Lozano-Quijada C, Baño-Alcaraz A. Physiotherapists' adherence to Clinical Practice Guidelines in fibromyalgia: a cross-sectional online survey. Rheumatol Int 2024:10.1007/s00296-024-05630-4. [PMID: 38839659 DOI: 10.1007/s00296-024-05630-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 05/28/2024] [Indexed: 06/07/2024]
Abstract
To evaluate the level of knowledge and adherence to Clinical Practice Guidelines on fibromyalgia of physiotherapists in Spain. A cross-sectional study using an ad-hoc online survey was implemented to assess aspects on the assessment, treatment, and decision of the length of the therapeutic approach on fibromyalgia. Based on the results, professionals were classified as adherent, partially adherent, or non-adherent. The level of agreement with several statements on the condition was also evaluated across the professionals surveyed to evaluate the potential consensus. A total of 240 physiotherapists met inclusion criteria, amongst which 68 (28.33%) were adherent. The academic level of studies (Chi-square = 48.601, p-value = 0.001) and having had previous training in fibromyalgia (Chi-square = 151.011, p-value = 0.001) displayed statistically significant differences across adherence-based groups. Consensus was reached for 15 out of 24 statements. Our findings highlight the presence of an acceptable level of knowledge and adherence to clinical practice guidelines in the field of fibromyalgia among physiotherapists in Spain.Practice implicationsOur results also reveal the existence of an evidence-to-practice gap in the field, with potential room for improvement: further efforts on promoting and reinforcing the importance of evidence-based therapies are needed, from university teaching plans to clinical updates for daily practice.
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Affiliation(s)
- José Édgar Ferrández-Gómez
- Physiotherapy Area, Pathology and Surgery Department, School of Medicine, University of Miguel Hernández de Elche, Ctra, Nacional N-332 s/n, 03550, San Juan de Alicante, Spain
- Faculty of Physiotherapy, Occupational Therapy and Podiatry, UCAM Catholic University of Murcia, Murcia, Spain
| | - Mariano Gacto-Sánchez
- Department of Physical Therapy, Campus of Health Sciences, University of Murcia, Av. Buenavista, 32 El Palmar, 30120, Murcia, Spain.
| | - Rauf Nouni-García
- Physiotherapy Area, Pathology and Surgery Department, School of Medicine, University of Miguel Hernández de Elche, Ctra, Nacional N-332 s/n, 03550, San Juan de Alicante, Spain
- Diagnostic Center, Institute of Health and Biomedical Research of Alicante, General University Hospital of Alicante, Fifth Floor, Pintor Baeza Street, 12, 03110, Alicante, Spain
- Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS), 03550, San Juan de Alicante, Spain
| | - Jaime Gascón-Jaén
- Physiotherapy Area, Pathology and Surgery Department, School of Medicine, University of Miguel Hernández de Elche, Ctra, Nacional N-332 s/n, 03550, San Juan de Alicante, Spain
| | - Carlos Lozano-Quijada
- Department of Pathology and Surgery, Faculty of Medicine, Center for Translational Research in Physiotherapy, Miguel Hernandez University, Ctra. Alicante-Valencia Km. 8,7-N 332, 03550, Alicante, Spain
| | - Aitor Baño-Alcaraz
- Department of Physical Therapy, Campus of Health Sciences, University of Murcia, Av. Buenavista, 32 El Palmar, 30120, Murcia, Spain
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Leerling AT, Ueckert DA, Van der Giesen FJ, Vliet-Vlieland T, Winter EM. Role of physical therapy in adult chronic non-bacterial osteitis: patients' and therapists' perspectives. Scand J Rheumatol 2024:1-10. [PMID: 38832471 DOI: 10.1080/03009742.2024.2352965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 05/06/2024] [Indexed: 06/05/2024]
Abstract
OBJECTIVES Chronic nonbacterial osteitis (CNO) is a rare bone disease causing pain and functional impairment. We aimed to explore the application of physical therapy (PT) for adult CNO from the patients' and primary care therapists' perspective. METHOD Cross-sectional study among the Dutch adult CNO cohort (1992-present). A survey on PT-use for axial spondylarthritis was adapted for CNO. Patients using PT in the past 2 years (recent PT-users) were asked about modalities, perceived effects, satisfaction, and preferences for provision. Their current physical therapists were invited to complete a self-developed survey covering therapy details and educational preferences. RESULTS 80/199 invited patients and 14/16 invited therapists completed the survey respectively. 41 (51%) patients used PT for CNO in the preceding 2 years, 14 (18%) used PT >2 years back, and 25 (31%) never used PT. Recent PT-users (n=41) reported diverse treatment modalities, involving massage (61%), joint mobilizations (44%), breathing exercises (49%), muscle strengthening (32%) and counselling through of home-exercises (46%) and pain education (32%). 64% of all patients desired greater emphasis from physicians regarding the role of PT. Most therapists would appreciate referral letters with CNO-specific information (93%), and consultations with specialized therapists (86%). CONCLUSIONS In this study, two-third of adult CNO patients had -ever or recently- used PT, which involved variable therapeutic modalities. Most patients were receptive to a larger role of PT in CNO-management and most therapists preferred CNO-specific information to optimize their care. These findings provide a foundation for the development and systematic evaluation of CNO-specific PT.
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Affiliation(s)
- A T Leerling
- Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
- Center for Bone Quality, Leiden University Medical Center, Leiden, The Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - D A Ueckert
- Department of Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands
| | - F J Van der Giesen
- Department of Rheumatology, Zuyderland Ziekenhuis, Heerlen, The Netherlands
| | - Tpm Vliet-Vlieland
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands
| | - E M Winter
- Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
- Center for Bone Quality, Leiden University Medical Center, Leiden, The Netherlands
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Landry MJ, Ward CP, Koh LM, Gardner CD. The knowledge, attitudes, and perceptions towards a plant-based dietary pattern: a survey of obstetrician-gynecologists. Front Nutr 2024; 11:1381132. [PMID: 38895659 PMCID: PMC11183291 DOI: 10.3389/fnut.2024.1381132] [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: 02/06/2024] [Accepted: 05/15/2024] [Indexed: 06/21/2024] Open
Abstract
Background Obstetricians-gynecologists (OB/GYNs) play a critical role for their pregnant patients during their perinatal period, but research on OB/GYNs knowledge, attitudes, and perceptions regarding plant-based dietary patterns (PBDP) and how this may influence recommendations to patients is lacking. An online cross-sectional survey was conducted to examine OB/GYN's knowledge, attitudes, and perceptions towards a PBDP. Methods Postcards were mailed in June 2023 to a convenience sample of 5,000 OB/GYNs across the US using a mailing list provided by the American College of Obstetricians and Gynecologists. Postcards had a brief study description and a QR code that linked to an online survey asking questions about demographics, behavior (e.g., nutritional habits), and other factors that may influence knowledge, attitudes, and perceptions towards a PBDP for their patients. Results Ninety-six OB/GYNs completed the full questionnaire (~2% response rate). Most (92%) felt that it is within an OB/GYN's role to incorporate nutrition education and counseling within practice. However, 72% felt inadequately trained to discuss nutrition and diet-related issues with patients. Despite a perceived lack of nutrition training, 86% reported that a PBDP was safe and health-promoting, and 81% reported that a well-planned PBDP could adequately meet all nutritional needs of pregnant and lactating patients. Conclusion Findings suggest that OB/GYNs are generally knowledgeable about the components and health benefits of a plant-based diets. However, nutrient adequacy misconceptions and lack of sufficient training to discuss nutrition with patients may result in OB/GYNs not recommending PBDPs to patients. These findings underscore the need to enhance OB/GYN graduate medical education and training by integrating education on PBDPs, therefore improving a clinician's ability to confidently and effectively counsel pregnant persons on this aspect of perinatal care.
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Affiliation(s)
- Matthew J. Landry
- Department of Population Health and Disease Prevention, Program in Public Health, University of California, Irvine, Irvine, CA, United States
| | - Catherine P. Ward
- Stanford Prevention Research Center, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Linda M. Koh
- Stanford Prevention Research Center, School of Medicine, Stanford University, Palo Alto, CA, United States
| | - Christopher D. Gardner
- Stanford Prevention Research Center, School of Medicine, Stanford University, Palo Alto, CA, United States
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Ginzberg SP, Gasior JA, Passman JE, Stein J, Keddem S, Soegaard Ballester JM, Finn CB, Myers JS, Kelz RR, Shea JA, Wachtel H. Surgeon and Surgical Trainee Experiences After Adverse Patient Events. JAMA Netw Open 2024; 7:e2414329. [PMID: 38829617 PMCID: PMC11148685 DOI: 10.1001/jamanetworkopen.2024.14329] [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: 11/06/2023] [Accepted: 04/01/2024] [Indexed: 06/05/2024] Open
Abstract
Importance Adverse patient events are inevitable in surgical practice. Objectives To characterize the impact of adverse patient events on surgeons and trainees, identify coping mechanisms, and assess whether current forms of support are sufficient. Design, Setting, and Participants In this mixed-methods study, a validated survey instrument was adapted and distributed to surgical trainees from 7 programs, and qualitative interviews were conducted with faculty from 4 surgical departments in an urban academic health system. Main Outcomes and Measures The personal impact of adverse patient events, current coping mechanisms, and desired forms of support. Results Of 216 invited trainees, 93 (43.1%) completed the survey (49 [52.7%] male; 60 [64.5%] in third postgraduate year or higher; 23 [24.7%] Asian or Pacific Islander, 6 [6.5%] Black, 51 [54.8%] White, and 8 [8.6%] other race; 13 [14.0%] Hispanic or Latinx ethnicity). Twenty-three of 29 (79.3%) invited faculty completed interviews (13 [56.5%] male; median [IQR] years in practice, 11.0 [7.5-20.0]). Of the trainees, 77 (82.8%) endorsed involvement in at least 1 recent adverse event. Most reported embarrassment (67 of 79 trainees [84.8%]), rumination (64 of 78 trainees [82.1%]), and fear of attempting future procedures (51 of 78 trainees [65.4%]); 28 of 78 trainees (35.9%) had considered quitting. Female trainees and trainees who identified as having a race and/or ethnicity other than non-Hispanic White consistently reported more negative consequences compared with male and White trainees. The most desired form of support was the opportunity to discuss the incident with an attending physician (76 of 78 respondents [97.4%]). Similarly, faculty described feelings of guilt and shame, loss of confidence, and distraction after adverse events. Most described the utility of confiding in peers and senior colleagues, although some expressed unwillingness to reach out. Several suggested designating a departmental point person for event debriefing. Conclusions and Relevance In this mixed-methods study of the personal impact of adverse events on surgeons and trainees, these events were nearly universally experienced and caused significant distress. Providing formal support mechanisms for both surgical trainees and faculty may decrease stigma and restore confidence, particularly for underrepresented groups.
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Affiliation(s)
- Sara P. Ginzberg
- Department of Surgery, University of Pennsylvania Health System, Philadelphia
- Center for Healthcare Improvement and Patient Safety, University of Pennsylvania, Philadelphia
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia
| | - Julia A. Gasior
- Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Jesse E. Passman
- Department of Surgery, University of Pennsylvania Health System, Philadelphia
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia
| | - Jacob Stein
- Sackler School of Medicine New York State/American Program, Tel Aviv University, Tel Aviv, Israel
| | - Shimrit Keddem
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia
- Department of Family Medicine and Community Health, University of Pennsylvania Health System, Philadelphia
| | | | - Caitlin B. Finn
- Department of Surgery, Weill Cornell Medicine, Philadelphia, Pennsylvania
| | - Jennifer S. Myers
- Center for Healthcare Improvement and Patient Safety, University of Pennsylvania, Philadelphia
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia
- Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Department of Medicine, University of Pennsylvania Health System, Philadelphia
| | - Rachel R. Kelz
- Department of Surgery, University of Pennsylvania Health System, Philadelphia
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia
- Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Judy A. Shea
- Leonard Davis Institute for Health Economics, University of Pennsylvania, Philadelphia
- Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Department of Medicine, University of Pennsylvania Health System, Philadelphia
| | - Heather Wachtel
- Department of Surgery, University of Pennsylvania Health System, Philadelphia
- Perelman School of Medicine, University of Pennsylvania, Philadelphia
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Pinto P, Valentin L, Borčinová M, Wiesnerová M, Filip F, Burgetova A, Masek M, Lambert L, Chiappa V, Franchi D, Testa AC, Moro F, Avesani G, Panico C, Alessi S, Pricolo P, Vigorito R, Calareso G, Kocian R, Slama J, Fagotti A, Urbinati AMV, Signorelli M, Bertolina F, Cibula D, Fischerova D. Patient satisfaction with ultrasound, whole-body CT and whole-body diffusion-weighted MRI for pre-operative ovarian cancer staging: a multicenter prospective cross-sectional survey. Int J Gynecol Cancer 2024; 34:871-878. [PMID: 38531539 DOI: 10.1136/ijgc-2023-005264] [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] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND In addition to the diagnostic accuracy of imaging methods, patient-reported satisfaction with imaging methods is important. OBJECTIVE To report a secondary outcome of the prospective international multicenter Imaging Study in Advanced ovArian Cancer (ISAAC Study), detailing patients' experience with abdomino-pelvic ultrasound, whole-body contrast-enhanced computed tomography (CT), and whole-body diffusion-weighted magnetic resonance imaging (WB-DWI/MRI) for pre-operative ovarian cancer work-up. METHODS In total, 144 patients with suspected ovarian cancer at four institutions in two countries (Italy, Czech Republic) underwent ultrasound, CT, and WB-DWI/MRI for pre-operative work-up between January 2020 and November 2022. After having undergone all three examinations, the patients filled in a questionnaire evaluating their overall experience and experience in five domains: preparation before the examination, duration of examination, noise during the procedure, radiation load of CT, and surrounding space. Pain perception, examination-related patient-perceived unexpected, unpleasant, or dangerous events ('adverse events'), and preferred method were also noted. RESULTS Ultrasound was the preferred method by 49% (70/144) of responders, followed by CT (38%, 55/144), and WB-DWI/MRI (13%, 19/144) (p<0.001). The poorest experience in all domains was reported for WB-DWI/MRI, which was also associated with the largest number of patients who reported adverse events (eg, dyspnea). Patients reported higher levels of pain during the ultrasound examination than during CT and WB-DWI/MRI (p<0.001): 78% (112/144) reported no pain or mild pain, 19% (27/144) moderate pain, and 3% (5/144) reported severe pain (pain score >7 of 10) during the ultrasound examination. We did not identify any factors related to patients' preferred method. CONCLUSION Ultrasound was the imaging method preferred by most patients despite being associated with more pain during the examination in comparison with CT and WB-DWI/MRI. TRIAL REGISTRATION NUMBER NCT03808792.
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Affiliation(s)
- Patrícia Pinto
- Department of Gynecology, Portuguese Institute of Oncology of Lisbon Francisco Gentil, Lisboa, Portugal
- First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Lil Valentin
- Department of Obstetrics and Gynaecology, Skane University Hospital, Malmo, Sweden
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Martina Borčinová
- Gynecologic Oncology Centre, Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Markéta Wiesnerová
- Masaryk University Institute of Biostatistics and Analyses, Brno, Czech Republic
| | - Fruhauf Filip
- Gynecologic Oncology Centre, Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Andrea Burgetova
- Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Martin Masek
- Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Lukas Lambert
- Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Valentina Chiappa
- Department of Gynecologic Oncology, Foundation IRCCS National Cancer Institute, Milan, Italy
| | - Dorella Franchi
- Preventive Gynecology Unit, Division of Gynaecology, European Institute of Oncology, Milan, Italy
| | - Antonia Carla Testa
- Dipartimento Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Rome, Italy
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Lazio, Italy
| | - Francesca Moro
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Lazio, Italy
| | - Giacomo Avesani
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Lazio, Italy
| | - Camilla Panico
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Lazio, Italy
| | - Sarah Alessi
- Division of Radiology, Istituto Europeo di Oncologia, Milan, Italy
| | - Paola Pricolo
- Division of Radiology, Istituto Europeo di Oncologia, Milan, Italy
| | - Raffaella Vigorito
- Department of Radiology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Giuseppina Calareso
- Department of Radiology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Roman Kocian
- Gynecologic Oncology Centre, Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Jiri Slama
- Gynecologic Oncology Centre, Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Anna Fagotti
- Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Lazio, Italy
| | | | - Mauro Signorelli
- Department of Gynecologic Oncology, Foundation IRCCS National Cancer Institute, Milan, Italy
| | - Francesca Bertolina
- Department of Gynecologic Oncology, Foundation IRCCS National Cancer Institute, Milan, Italy
| | - David Cibula
- Gynecologic Oncology Centre, Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Daniela Fischerova
- Gynecologic Oncology Centre, Department of Gynecology, Obstetrics and Neonatology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
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Cheng TY, Renaud DL, Proudfoot KL, Pempek JA, Habing GG. Dairy producers' colostrum practices, marketing, and attitudes toward male dairy calves. J Dairy Sci 2024; 107:3885-3898. [PMID: 38216040 DOI: 10.3168/jds.2023-24149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 12/03/2023] [Indexed: 01/14/2024]
Abstract
Optimal early-life care of surplus calves born on dairy farms is critical for health and welfare. This cross-sectional study aimed to describe the marketing practices of male dairy calves, differences in the colostrum management between male and female calves on dairy farms, and the relationship between discrepant colostrum practices and dairy producers' attitudes toward male calf care. United States dairy producers (n = 1,000) in the states of Florida, Michigan, Ohio, Vermont, and Wisconsin were selected using stratified random sampling. A questionnaire containing questions about farm demographics, colostrum management (including quantity and timeliness of colostrum delivery), and producers' attitudes toward male calf care was mailed in February 2021. Attitudes toward male calf care were assessed using 5-point Likert scales for 10 statements regarding perceptions of the value of male calves and barriers in providing optimal care. Producer responses to questions about the quantity and timeliness of colostrum delivery between male and female calves were compared using a nonparametric Wilcoxon rank-sum test. Multivariable logistic regression models were used to investigate the association between differences in colostrum management and producers' attitudes. By May 2021, 953 surveys were delivered and 315 (33.1%) were returned with complete responses. Most producers (>90%) reported feeding equal volumes of colostrum and performing the first postbirth feeding within a similar time frame for male and female calves. However, compared with females, male calves had a longer delay to the first colostrum feeding. Approximately 40% of producers marketed their male calves through auctions, and over half (54.6%) of farms sold the male calves between 3 and 10 d of age. Large farms (≥500 lactating cows) were found to market male calves at a younger age (≤3 d of age). Most producers (>78%) believed their male calves were receiving optimal care and did not consider the workload and financial costs as obstacles to providing good care to male calves. However, those who viewed the workload as an obstacle to good care and produced organic products were marginally more likely to feed a lower volume of colostrum to male calves in the first feeding after birth. These findings suggest that interventions to improve colostrum practices should be more broadly targeted to all calves born on dairy farms, and that age at transport is markedly different between large and small farms.
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Affiliation(s)
- Ting-Yu Cheng
- Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210
| | - David L Renaud
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada N1G 2W1
| | - Kathryn L Proudfoot
- Department of Health Management, Atlantic Veterinary College, University of Prince Edward Island, Prince Edward Island, Canada C1A 4P3
| | - Jessica A Pempek
- Department of Animal Sciences, College of Food, Agricultural, and Environmental Sciences, The Ohio State University, Columbus, OH 43210
| | - Gregory G Habing
- Department of Veterinary Preventive Medicine, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210.
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19
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Fenech M, Miklas M, Hussein A, El-Abed Y, Moudgil D, Abdel-Nabi R, Touma K, Hossami M, Nassar R, Zaib F, Rim SC, Hirmiz R, Hilal O, Paunic M, Cavallo-Medved D, Hamm C. Identifying and addressing a new barrier to community-based patients accessing cancer clinical trials. Contemp Clin Trials Commun 2024; 39:101296. [PMID: 38660007 PMCID: PMC11039343 DOI: 10.1016/j.conctc.2024.101296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 08/21/2023] [Accepted: 03/27/2024] [Indexed: 04/26/2024] Open
Affiliation(s)
- Melissa Fenech
- Schulich School of Medicine & Dentistry, Windsor Regional Cancer Centre, N8W1L9, Windsor, Ontario, Canada
| | - Maegan Miklas
- Schulich School of Medicine & Dentistry, Windsor Regional Cancer Centre, N8W1L9, Windsor, Ontario, Canada
| | - Abdulkadir Hussein
- University of Windsor, Windsor Regional Cancer Centre, N8W1L9, Windsor, Ontario, Canada
| | - Youshaa El-Abed
- University of Windsor, Windsor Regional Cancer Centre, N8W1L9, Windsor, Ontario, Canada
| | - Devinder Moudgil
- Schulich School of Medicine & Dentistry, Windsor Regional Cancer Centre, N8W1L9, Windsor, Ontario, Canada
- WE-Spark Health Institute, N9B3P4, Ontario, Canada
| | - Rhonda Abdel-Nabi
- University of Windsor, Windsor Regional Cancer Centre, N8W1L9, Windsor, Ontario, Canada
- Clinical Trials Navigator, Canada
| | - Kayla Touma
- University of Windsor, Windsor Regional Cancer Centre, N8W1L9, Windsor, Ontario, Canada
- Clinical Trials Navigator, Canada
| | - Mahmoud Hossami
- University of Windsor, Windsor Regional Cancer Centre, N8W1L9, Windsor, Ontario, Canada
- Clinical Trials Navigator, Canada
| | | | - Farwa Zaib
- Schulich School of Medicine & Dentistry, Windsor Regional Cancer Centre, N8W1L9, Windsor, Ontario, Canada
| | - Sanghyuk Claire Rim
- Schulich School of Medicine & Dentistry, Windsor Regional Cancer Centre, N8W1L9, Windsor, Ontario, Canada
| | | | | | - Milica Paunic
- University of Windsor, Windsor Regional Cancer Centre, N8W1L9, Windsor, Ontario, Canada
| | - Dora Cavallo-Medved
- University of Windsor, Windsor Regional Cancer Centre, N8W1L9, Windsor, Ontario, Canada
- WE-Spark Health Institute, N9B3P4, Ontario, Canada
| | - Caroline Hamm
- Schulich School of Medicine & Dentistry, Windsor Regional Cancer Centre, N8W1L9, Windsor, Ontario, Canada
- University of Windsor, Windsor Regional Cancer Centre, N8W1L9, Windsor, Ontario, Canada
- WE-Spark Health Institute, N9B3P4, Ontario, Canada
- Clinical Trials Navigator, Canada
- Schulich School of Medicine & Dentistry, Windsor Regional Hospital, N8W2X3, Windsor, Ontario, Canada
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20
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Vasileva-Slaveva M, Morales-Espinosa D, Puccini A, Meissner M, Milic M, Lamberti G, Altena R. Tackling hurdles in front of young clinical investigators in oncology - Results from an international survey. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024; 50:108031. [PMID: 38552416 DOI: 10.1016/j.ejso.2024.108031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 01/08/2024] [Accepted: 02/14/2024] [Indexed: 05/26/2024]
Abstract
INTRODUCTION Cancer is a leading cause of morbidity and mortality worldwide, and coordinated research efforts are vital to improve global outcomes. Clinical or translational research is usually planned, coordinated and executed by clinical researchers. With this survey we aimed to identify the main hurdles in front of young clinical investigators in oncology. METHODS AND MATERIALS An anonymized survey was distributed using social media between April and November 2022. Target population were health-care professionals in the field of oncology - physicians, nurses and researchers. We divided participants according to working experience (<40 vs. >40 years of age) and country of practice (Europeans vs. non-Europeans). RESULTS We received 121 responses from participants practicing in 36 countries. Eighty-seven (72%) of the participants were under 40 years. Eighty-nine (74%) were from European countries and thirty-two (26%) were from non-European. Experienced and European professionals were more likely to be involved in all different aspects of clinical trials. The main source of funding - independently of geographic location - were industry grants. Investigators out of Europe have less participation in international grants. Over 50% of participants dedicate time for clinical research from their personal time and are not paid for it. Almost 50% of investigators don't have access to an experienced mentor in their institution. CONCLUSION The majority of respondents to our survey are active clinical researchers. Our data indicate that access to education and training as well as possibilities for appropriate networking, and specifically lack of mentorship, are key limiting factors in developing clinical research by healthcare professionals.
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Affiliation(s)
- Mariela Vasileva-Slaveva
- Bulgarian Breast and Other Gynecological Cancers Association, Sofia, Mladost 1, 1750, Block 122, Bulgaria; Shterev Hospital, Sofia, 1330, Hristo Blagoev 25, Bulgaria; Medical University Pleven, Pleven, 5800, Blvd Kliment Ohridski 1, Bulgaria.
| | | | - Alberto Puccini
- IRCCS, Humanitas Research Hospital, Humanitas Cancer Center, Medical Oncology and Hematology Unit Rozzano, Via Alessandro Manzoni, 56, 20089, Rozzano, Milan, Italy
| | - Magdalena Meissner
- Cardiff University - Division of Cancer and Genetics, School of Medicine, Cardiff University, Sir Geraint Evans Building, Heath Park, CF14 4XN, Cardiff, United Kingdom; Velindre NHS Trust, Velindre Cancer Centre, Velindre Road, Cardiff, CF14 2TL, United Kingdom
| | - Marina Milic
- University College London Hospitals NHS Foundation Trust, 250 Euston Road, NW1 2PG, London, United Kingdom
| | - Giuseppe Lamberti
- Department of Medical and Surgical Sciences, University of Bologna, Via Zamboni, 33, 40126, Bologna, Italy
| | - Renske Altena
- Medical Unit Breast, Endocrine Tumors and Sarcoma, Karolinska Comprehensive Cancer Center, Karolinska University Hospital, Eugeniavägen 3, 171 76, Solna, Sweden; Inst. Onk-Pat, Karolinska Institutet, Stockholm, Sweden
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21
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de Wit K, Tran A, Clayton N, Seeburruth D, Lim RK, Archambault PM, Chan TM, Rang LCF, Gray S, Ritchie K, Gérin-Lajoie C, Mercuri M. A Longitudinal Survey on Canadian Emergency Physician Burnout. Ann Emerg Med 2024; 83:576-584. [PMID: 38323951 DOI: 10.1016/j.annemergmed.2024.01.009] [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: 05/10/2023] [Revised: 12/11/2023] [Accepted: 01/04/2024] [Indexed: 02/08/2024]
Abstract
STUDY OBJECTIVE Since Canada eased pandemic restrictions, emergency departments have experienced record levels of patient attendance, wait times, bed blocking, and crowding. The aim of this study was to report Canadian emergency physician burnout rates compared with the same physicians in 2020 and to describe how emergency medicine work has affected emergency physician well-being. METHODS This longitudinal study on Canadian emergency physician wellness enrolled participants in April 2020. In September 2022, participants were invited to a follow-up survey consisting of the Maslach Burnout Inventory and an optional free-text explanation of their experience. The primary outcomes were emotional exhaustion and depersonalization levels, which were compared with the Maslach Burnout Inventory survey conducted at the end of 2020. A thematic analysis identified common stressors, challenges, emotions, and responses among participants. RESULTS The response rate to the 2022 survey was 381 (62%) of 615 between September 28 and October 28, 2022, representing all provinces or territories in Canada (except Yukon). The median participant age was 42 years. In total, 49% were men, and 93% were staff physicians with a median of 12 years of work experience. 59% of respondents reported high emotional exhaustion, and 64% reported high depersonalization. Burnout levels in 2022 were significantly higher compared with 2020. Prevalent themes included a broken health care system, a lack of societal support, and systemic workplace challenges leading to physician distress and loss of physicians from the emergency workforce. CONCLUSION We found very high burnout levels in emergency physician respondents that have increased since 2020.
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Affiliation(s)
- Kerstin de Wit
- Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada; Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
| | - Anna Tran
- School of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Natasha Clayton
- Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada; Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Emergency Department, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Darshana Seeburruth
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Rodrick K Lim
- Department of Pediatrics and Medicine, Western University, London, Ontario, Canada
| | - Patrick M Archambault
- Department of Family and Emergency Medicine, Université Laval, Québec City, Québec, Canada; Centre Intégré en Santé et Services Sociaux de Chaudière-Appalaches, Lévis, Québec, Canada
| | - Teresa M Chan
- Division of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, Ontario, Canada; Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada; McMaster Education Research, Innovation, and Theory (MERIT) program, McMaster University, Hamilton, Ontario, Canada; Dean of the School of Medicine, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Louise C F Rang
- Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada
| | - Sara Gray
- Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Kerri Ritchie
- People Health and Wellness and the Ottawa Hospital Research Institute, the Ottawa Hospital, Ottawa, Ontario, Canada
| | | | - Mathew Mercuri
- Department of Emergency Medicine, Queen's University, Kingston, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Institute for the Future of Knowledge, University of Johannesburg, Auckland Park, South Africa
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Goldsmith S, Smithers-Sheedy H, Almasri N, Andersen GL, Diviney L, Gincota EB, Himmelmann K, Jahan I, Waight E, McIntyre S. Cerebral palsy registers around the world: A survey. Dev Med Child Neurol 2024; 66:765-777. [PMID: 37946559 DOI: 10.1111/dmcn.15798] [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: 07/13/2023] [Revised: 09/28/2023] [Accepted: 10/04/2023] [Indexed: 11/12/2023]
Abstract
AIM To provide a description of cerebral palsy (CP) registers globally, identify which aim to report on CP epidemiology, and report similarities and differences across topics of importance for the sustainability and collaboration between registers. METHOD Representatives of all known CP registers globally (n = 57) were invited to participate. The online survey included 68 questions across aims, methodologies, output/impact, and stakeholder involvement. Responses were analysed using descriptive statistics. RESULTS Forty-five registers participated, including three register networks. Twenty were newly established or under development, including 12 in low- and middle-income countries (LMICs). An epidemiological aim was reported by 91% of registers. Funding is received by 85% of registers, most often from not-for-profit organizations. CP definitions are comparable across registers. While the minimum data set of a register network is used by most registers, only 25% of identified items are collected by all three register networks. Ninety per cent of registers measure research activities/output, and 64% measure research impact. People with lived experience are involved in 62% of registers. INTERPRETATION There has been a recent surge in CP registers globally, particularly in LMICs, which will improve understanding of CP epidemiology. Ongoing efforts to address identified methodological differences are essential to validate comparison of results and support register collaboration. WHAT THIS PAPER ADDS Cerebral palsy (CP) registers represent an increasing number of regions, including low- and middle-income, worldwide. Most registers collect the minimum data set of a CP register network. Research activities/output and impact are measured by most registers. The majority of registers involve people with lived experience in operation or research.
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Affiliation(s)
- Shona Goldsmith
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia
| | - Hayley Smithers-Sheedy
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia
| | - Nihad Almasri
- Department of Physiotherapy, The University of Jordan, Amman, Jordan
| | - Guro L Andersen
- Norwegian Quality and Surveillance Registry for Cerebral Palsy, Vestfold Hospital Trust, Tønsberg, Norway
| | - Leanne Diviney
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia
| | - Ecaterina Bufteac Gincota
- Republican Rehabilitation Center for Children, Chisinau, Moldova
- State Medical and Pharmaceutical University 'N. Testemitanu', Chisinau, Moldova
| | - Kate Himmelmann
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden
| | - Israt Jahan
- CSF Global, Dhaka, Bangladesh
- Asian Institute of Disability and Development (AIDD), University of South Asia, Dhaka, Bangladesh
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
- Central Queensland Public Health Unit, Central Queensland Hospital and Health Service, Rockhampton, Australia
| | - Emma Waight
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia
| | - Sarah McIntyre
- Cerebral Palsy Alliance Research Institute, Specialty of Child & Adolescent Health, Sydney Medical School, Faculty of Medicine & Health, The University of Sydney, Sydney, Australia
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23
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Conroy S, Gallagher PG. Survey research in perinatal medicine. J Perinatol 2024; 44:771-772. [PMID: 38538912 DOI: 10.1038/s41372-024-01940-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/08/2024] [Accepted: 03/12/2024] [Indexed: 06/09/2024]
Affiliation(s)
- Sara Conroy
- The Ohio Perinatal Research Network, Center for Perinatal Research, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
- Center for Biostatistics, The Ohio State University Wexner Medical Center, Columbus, OH, USA
- Biostatistics Resource at Nationwide Children's Hospital, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Patrick G Gallagher
- Center for Biostatistics, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
- Departments of Pediatrics, Physiology and Cell Biology, Ohio State University, Columbus, OH, USA.
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Abstract
OBJECTIVES To identify and geolocate pediatric post-acute care (PAC) facilities in the United States. DESIGN Cross-sectional survey using both online resources and telephone inquiry. SETTING All 50 U.S. states surveyed from June 2022 to May 2023. Care sites identified via state regulatory agencies and the Centers for Medicare & Medicaid Services. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Number, size, and type of facility, scope of practice, and type of care provided. One thousand three hundred fifty-five facilities were surveyed; of these, 18.6% (252/1355) were pediatric-specific units or adult facilities accepting some pediatric patients. There were 109 pediatric-specific facilities identified within 39 U.S. states. Of these, 38 were freestanding with all accepting children with tracheostomies, 97.4% (37/38) accepting those requiring mechanical ventilation via tracheostomy, and 81.6% (31/38) accepting those requiring parenteral nutrition. The remaining 71 facilities were adult facilities with embedded pediatric units or children's hospitals with 88.7% (63/71), 54.9% (39/71), and 54.9% (39/71), accepting tracheostomies, mechanical ventilation via tracheostomy, and parenteral nutrition, respectively. Eleven states lacked any pediatric-specific PAC units or facilities. CONCLUSIONS The distribution of pediatric PAC is sparse and uneven across the United States. We present an interactive map and database describing these facilities. These data offer a starting point for exploring the consequences of pediatric PAC supply.
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Affiliation(s)
- Nadine Straka
- Division of Critical Care, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA
- Harvard Medical School, Harvard University, Boston, MA
| | - Urbano L França
- Division of Critical Care, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA
- Harvard Medical School, Harvard University, Boston, MA
| | - Jennifer D Franks
- Division of Critical Care, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA
| | - Michael L McManus
- Division of Critical Care, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA
- Harvard Medical School, Harvard University, Boston, MA
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25
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Newington L, Ceh D, Sandford F, Parsons V, Madan I. Supporting work participation for adults with hand and upper limb conditions: A survey of the British Association of hand therapists. HAND THERAPY 2024; 29:75-84. [PMID: 38827651 PMCID: PMC11143940 DOI: 10.1177/17589983241238424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 02/18/2024] [Indexed: 06/04/2024]
Abstract
Introduction Musculoskeletal disorders affect over a third of the UK adult population and are a common reason for sick leave from work. The aims of this study were to describe the reported provision of work participation support for adults with hand and upper limb conditions by UK hand therapists, and to identify potential training needs in this area. Methods A previous survey of the Australian Hand Therapy Association was adapted for the UK. The electronic questionnaire was distributed to members of the British Association of Hand Therapists. Eligible individuals were UK-based occupational therapists or physiotherapists whose role included the assessment and/or treatment of patients ≥18 years with hand or upper limb issues. Results There were 123 participants (17% response rate). The most frequently reported work participation interventions were discussing graded return to work and sign-posting patients to speak with their doctor. The Allied Health Professionals Health and Work Report and Fit Note were not regularly used, and respondents reported low levels of confidence in issuing these documents. Barriers to providing work recommendations included a perceived lack of time, skills, knowledge and training. Facilitators included the patient discussing work as a rehabilitation goal. Conclusion Development opportunities for UK hand therapists include increasing patient awareness that they can ask for work-related advice and documentation, promoting existing health and work training, developing hand therapy-specific resources, and ensuring access to electronic Fit Notes. International opportunities include the continuation of this survey with a focus on generating exemplar work participation strategies to inform further research.
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Affiliation(s)
- Lisa Newington
- Barts Bone and Joint Health, Queen Mary University of London, London, UK
- Hand Therapy, Barts Health NHS Trust, London, UK
- London Centre for Work and Health, London, UK
| | - Daniel Ceh
- Hand Therapy, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - Fiona Sandford
- Hand Therapy, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
- School of Biomedical Engineering and Imaging Sciences, School of Life Couse and Population Sciences, King’s College London, London, UK
| | - Vaughan Parsons
- London Centre for Work and Health, London, UK
- Occupational Health, Safety and Wellbeing Service, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
- Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | - Ira Madan
- London Centre for Work and Health, London, UK
- Occupational Health, Safety and Wellbeing Service, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
- Faculty of Life Sciences and Medicine, King’s College London, London, UK
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Leerling AT, Niesters M, Flendrie M, Tel M, Appelman-Dijkstra NM, Dekkers OM, Winter EM. Neuropathic and Nociplastic Pain Profiles are Common in Adult Chronic Nonbacterial Osteitis (CNO). Calcif Tissue Int 2024; 114:603-613. [PMID: 38627292 PMCID: PMC11090977 DOI: 10.1007/s00223-024-01214-3] [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: 01/22/2024] [Accepted: 03/28/2024] [Indexed: 05/14/2024]
Abstract
Chronic nonbacterial osteitis (CNO) is a rare musculoskeletal disease causing chronic bone pain. It is known that chronic musculoskeletal pain may involve other mechanisms than nociceptive pain only. We investigate the prevalence of neuropathic and nociplastic pain in adult CNO and their association with clinical characteristics and treatment outcomes. Survey study among the Dutch adult CNO cohort (n = 84/195 participated), including PAIN-detect for neuropathic pain, and the Central Sensitization Inventory (CSI), Fibromyalgia Rapid Screening Tool (FiRST), and ACTTION-APS Pain Taxonomy (AAPT) for nociplastic pain. Clinical characteristics and CNO-related bone pain scores were compared between patients with exclusive nociceptive pain and those with nociceptive pain plus neuropathic and/or nociplastic pain (mixed pain). 31% (95% CI 21-41) of patients classified as likely having neuropathic pain according to PAIN-detect. 53% (41-64) of patients displayed central sensitization on CSI, 61% (50-72) screened positive for fibromyalgia on FiRST and 14% (7-23) of patients fulfilled the AAPT criteria, all indicative of nociplastic pain. Mixed pain was associated with longer diagnostic delay (mean difference 2.8 years, 95% CI 0.4-5.2, p = 0.023), lower educational level (72% versus 20%, p < 0.001), and opioid use (37% versus 13%, p = 0.036). Despite comparable disease severity and extent, patients with mixed pain reported significantly higher CNO-related bone pain scores. This study demonstrates the high prevalence of mixed pain in adult CNO, in which neuropathic and nociplastic pain exist alongside nociceptive inflammatory bone pain. Disease burden in CNO may extend beyond inflammatory activity, highlighting the need for a multifaceted management approach.
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Affiliation(s)
- Anne T Leerling
- Division of Endocrinology, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
- Center for Bone Quality, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, The Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Marieke Niesters
- Department of Anesthesiology and Pain Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Marcel Flendrie
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - Marije Tel
- Division of Endocrinology, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
- Center for Bone Quality, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, The Netherlands
| | - Natasha M Appelman-Dijkstra
- Division of Endocrinology, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
- Center for Bone Quality, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, The Netherlands
| | - Olaf M Dekkers
- Division of Endocrinology, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Elizabeth M Winter
- Division of Endocrinology, Department of Internal Medicine, Leiden University Medical Center, Leiden, The Netherlands.
- Center for Bone Quality, Leiden University Medical Center, Albinusdreef 2, 2333, ZA, Leiden, The Netherlands.
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O'Brien T, Hospers G, Conroy T, Lenz HJ, Smith JJ, Andrews E, O'Neill B, Leonard G. The role of total neoadjuvant therapy in locally advanced rectal cancer: a survey of specialists attending the All-Ireland Colorectal Cancer Conference 2022 including lead investigators of OPRA, PRODIGE-23 and RAPIDO. Ir J Med Sci 2024; 193:1183-1190. [PMID: 38141097 PMCID: PMC11128399 DOI: 10.1007/s11845-023-03591-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND The treatment of locally advanced rectal cancer (LARC) has evolved following recent landmark trials of total neoadjuvant therapy (TNT)-the delivery of preoperative chemotherapy sequenced with radiation. AIM To assess the preferences of colorectal surgery (CRS), radiation oncology (RO) and medical oncology (MO) specialists attending the All-Ireland Colorectal Cancer Conference (AICCC) 2022 regarding the neoadjuvant management of LARC. METHODS A live electronic survey explored the preferred treatment approach and TNT regimen for early-, intermediate-, bad-, and advanced-risk categories of rectal cancer according to the European Society of Medical Oncology (ESMO) guidelines. The survey was preceded by an update from lead investigators of TNT trials (OPRA, PRODIGE-23 and RAPIDO), who then participated in a multidisciplinary panel discussion. RESULTS Ten CRS, 7 RO and 15 MO (32 of 45 specialists) participated fully in the survey resulting in a response rate of 71%. Ninety-four percent, 76% and 53% of specialists preferred a TNT approach for patients with advanced, bad, and intermediate-risk rectal cancer, respectively. A consolidation TNT regimen of long-course chemoradiotherapy followed by chemotherapy was the most preferred regimen. Upfront surgery was preferred by 77% for early-risk disease. CONCLUSION This survey illustrated the general acceptance of TNT by rectal cancer specialists attending the AICCC as a valuable treatment strategy for higher-risk category LARC. Whilst the treatment of LARC changes, it remains best practice to individualize care, incorporating the selective use of TNT as discussed by an MDT and in keeping with the patient's goals of care.
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Affiliation(s)
- Timothy O'Brien
- Patrick G Johnston Centre for Cancer Research, Queen's University, Belfast, Northern Ireland.
| | - Geke Hospers
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Thierry Conroy
- Medical Oncology Department, Institut de Cancérologie de Lorraine, Vandoeuvre-Lès-Nancy, Nancy, France
- Université de Lorraine, APEMAC, Équipe MICS, Nancy, France
| | - Heinz-Josef Lenz
- Division of Medical Oncology, Keck School of Medicine, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA
| | - Jesse Joshua Smith
- Department of Surgery, Colorectal Service, Memorial Sloan Kettering, New York, NY, USA
| | - Emmet Andrews
- Department of Surgery, Cork University Hospital, University College Cork, Cork, Ireland
| | - Brian O'Neill
- Department of Radiation Oncology, St Luke's Radiation Oncology Network, Dublin, Ireland
| | - Gregory Leonard
- Department of Medical Oncology, University Hospital Galway, Newcastle Road, Galway, Ireland
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Zerbinati P, Mazzoli D, Galletti M, Basini G, Rambelli C, Mascioli F, Bò MC, Delia C, Petroselli L, Vulpiani MC, Prati P, Bemporad J, Merlo A. A survey on the short to medium-term satisfaction of neurological patients treated by functional surgery for the correction of limb deformities. Curr Med Res Opin 2024:1-10. [PMID: 38756086 DOI: 10.1080/03007995.2024.2352855] [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: 01/16/2024] [Accepted: 05/05/2024] [Indexed: 05/18/2024]
Abstract
OBJECTIVES Functional surgery (FS) is often used to correct congenital or acquired deformities in neurological patients. Along with functional results, short- and medium-term patient satisfaction should always be considered a key goal of surgery and rehabilitation. The aim of this study is to assess the short to medium-term satisfaction of patients who underwent FS and its correlation with perceived improvements. METHODS Invitation to an anonymous online survey was sent via e-mail to all neurological adult patients or caregivers of children who underwent lower or upper limb FS over the 2018-2020 period. The survey investigated patients' satisfaction with the surgery and the variation in pain, ADLs, level of independence, body image, self-esteem, social interaction skills, participation in social events, leisure activities and sports, and use of orthoses or walking aids. Descriptive data analysis was performed. Correlations were assessed using Kendall's tau. RESULTS 122 out of 324 adults and 53 out of 163 children's caregivers filled out the questionnaire, with a response rate approaching 40%. Eighty-three percent of adult respondents and 87% of the children's caregivers were satisfied or very satisfied in the short and medium terms and reported their expectations had been met. Satisfaction was significantly correlated (p < 0.01) with improvements in functional abilities, social participation, self-esteem, and pain reduction. Half of the adults and 40% of children stopped using their orthoses or replaced them with lighter ones. Dissatisfaction and worsened conditions were reported by <10% of the respondents. CONCLUSION According to patients and caregivers, FS was satisfactory in the short and medium terms, following improvements in all the ICF domains for most patients.
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Affiliation(s)
- Paolo Zerbinati
- Neuro-Orthopedic Surgery Unit, Sol et Salus Hospital, Torre Pedrera di Rimini, RN, Italy
| | - Davide Mazzoli
- Gait&Motion Analysis Laboratory, Sol et Salus Hospital, Torre Pedrera di Rimini, RN, Italy
| | - Martina Galletti
- Gait&Motion Analysis Laboratory, Sol et Salus Hospital, Torre Pedrera di Rimini, RN, Italy
| | - Giacomo Basini
- Gait&Motion Analysis Laboratory, Sol et Salus Hospital, Torre Pedrera di Rimini, RN, Italy
| | - Chiara Rambelli
- Gait&Motion Analysis Laboratory, Sol et Salus Hospital, Torre Pedrera di Rimini, RN, Italy
| | - Francesca Mascioli
- Gait&Motion Analysis Laboratory, Sol et Salus Hospital, Torre Pedrera di Rimini, RN, Italy
| | - Maria Chiara Bò
- Gait&Motion Analysis Laboratory, Sol et Salus Hospital, Torre Pedrera di Rimini, RN, Italy
| | - Caterina Delia
- Azienda Ospedaliero-Universitaria Sant'Andrea, Roma, Italy
| | | | | | - Paolo Prati
- Gait&Motion Analysis Laboratory, Sol et Salus Hospital, Torre Pedrera di Rimini, RN, Italy
| | - Jonathan Bemporad
- Neurologic Rehabilitation Unit, Sol et Salus Hospital, Torre Pedrera di Rimini, RN, Italy
| | - Andrea Merlo
- Gait&Motion Analysis Laboratory, Sol et Salus Hospital, Torre Pedrera di Rimini, RN, Italy
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Dunne P, Culliney L, O'Mahony L, Byrne M, Murphy AW, O'Reilly S. Exploring health professionals' knowledge, practices and attitudes regarding gestational diabetes: A cross-sectional Irish national survey. Diabet Med 2024:e15373. [PMID: 38820178 DOI: 10.1111/dme.15373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 05/16/2024] [Accepted: 05/17/2024] [Indexed: 06/02/2024]
Abstract
AIM Gestational diabetes confers short- and long-term risk of mother and offspring health complications. Healthcare professionals such as endocrinologists, diabetes nurses, dietitians, midwives and general practitioners provide gestational diabetes care. We sought to explore healthcare professionals' perspectives on gestational diabetes care during pregnancy and postpartum. METHODS Healthcare professionals in the Republic of Ireland, whose role included gestational diabetes care were invited to complete an online 20-item survey between June and September 2022. Social media, professional organisations and personal networks were used for recruitment. Questions included guideline use, postpartum diabetes screening and advice practices. Analyses were performed using SPSS statistical software and free text was coded using NVivo. RESULTS Seventeen healthcare professions across primary and secondary care settings participated (n = 127). No differences were noted between groups (medical, nursing/midwifery, allied health/other); therefore, findings were reported as a single group. Healthcare professionals reported using multiple different guidelines to support gestational diabetes management (n = 14). The most cited were 'Health Service Executive guidelines' (24.5%), 'local guidelines' (13.2%) and National Institute for Clinical Excellence guidelines (11.3%); 12.3% cited uncertainty, and 27.5% reported not to follow any named guidelines. For postpartum follow-up, 39% felt clear guidelines were available to support practice, 37% felt appropriate systems were in place and 29% reported effective communication between primary and secondary care services. Qualitative findings emphasised a desire for improved communication between systems, participants and providers, clear interdisciplinary guidelines, and adequate resourcing for gestational diabetes management and postpartum diabetes prevention, including comprehensive support and follow-up. CONCLUSION System-level challenges and ineffective communication across settings are barriers to optimum postpartum care. Nationally agreed guidelines for best practice gestational diabetes management including postpartum diabetes prevention are needed.
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Affiliation(s)
- Pauline Dunne
- School of Agriculture and Food Science, University College Dublin, Dublin, Ireland
| | | | | | - Molly Byrne
- Health Behaviour Change Research Group, University of Galway, Galway, Ireland
| | - Andrew W Murphy
- Health Research Board Primary Care Clinical Trials Network Ireland, University of Galway, Galway, Ireland
| | - Sharleen O'Reilly
- School of Agriculture and Food Science, University College Dublin, Dublin, Ireland
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Abramson TM, Burner E, Arora S, Wenzel S, Gausche-Hill M. Prehospital Care for Persons Experiencing Homelessness: A Cross-Sectional Survey of the Challenges, Experiences, and Perspectives of Operational EMS Agency Medical Directors. PREHOSP EMERG CARE 2024:1-8. [PMID: 38771734 DOI: 10.1080/10903127.2024.2358146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 05/13/2024] [Indexed: 05/23/2024]
Abstract
OBJECTIVE Persons experiencing homelessness (PEH) are among the most vulnerable populations and experience significant health disparities. Nationally, PEH utilize Emergency Medical Services (EMS) at disproportionately higher rates than their housed peers. Developing optimal strategies to care for PEH has become critically important. However, limited data exists on best practices, challenges, and experiences of providing care to PEH. The objective of this study was to describe the experiences, challenges and perspectives of operational EMS agency medical directors in Los Angeles (LA) County as they confront the homelessness crisis. METHODS We performed a cross-sectional survey of 9-1-1 operational EMS agency medical directors in LA County, which has one of the largest populations of PEH nationally. Twenty-nine 9-1-1 operational EMS agencies operate in LA County. The link to an anonymous, web-based survey examining documentation, training, resources, operational impact, and care challenges was emailed to medical directors with three reminders during the study period (4/19/2023-9/15/2023). RESULTS Three quarters (75.9%; 22/29) of operational EMS agencies responded to the survey, with all questions answered in 69% (20/29) of surveys. Of these, 68.2% (15/22) of agencies document housing status and 75% (15/20) agreed or strongly agreed that homelessness presents operational challenges. No operational EMS agency reported adequate EMS clinician training on homelessness. Operational EMS agencies most commonly utilized domestic violence resources (43%, 9/21), social services (38%, 8/21), and law enforcement (38%, 8/21) services to assist PEH. Referrals were limited by accessibility (86%, 18/21), time (52%, 11/21), lack of awareness (52% 11/21) and lack of mandates (52%, 11/21). All operational EMS agencies agreed or strongly agreed that mental health and substance use disorders are major issues for PEH. The most common daily challenges reported were mental health (55%, 11/20), substance use (55%, 11/20), and patient resistance (35%, 7/20). CONCLUSION In LA County, EMS agencies experience important operational and clinical challenges in caring for PEH, with limited resources, minimal training, and high rates of substance use disorders and mental health comorbidities. Further prehospital research is essential to standardize documentation of housing status, to identify areas for intervention, increase linkage to services, and define best practices.
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Affiliation(s)
- Tiffany M Abramson
- Department of Emergency Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Elizabeth Burner
- Department of Emergency Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Sanjay Arora
- Department of Emergency Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Suzanne Wenzel
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California
| | - Marianne Gausche-Hill
- Los Angeles County EMS Agency, Los Angeles, California
- Harbor-UCLA Medical Center Department of Emergency Medicine and the Lundquist Institute for Biomedical Innovation, Los Angeles, California
- David Geffen School of Medicine at UCLA, Los Angeles, California
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31
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Canela MRM, Brito LGO, Silva-Filho AL, Bahamondes L, Juliato CRT. The personal experience of female obstetricians and gynaecologists with contraceptive use influences the guidance and prescription of contraceptive methods: a web-survey. EUR J CONTRACEP REPR 2024:1-5. [PMID: 38813777 DOI: 10.1080/13625187.2024.2349038] [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: 05/31/2023] [Accepted: 04/22/2024] [Indexed: 05/31/2024]
Abstract
OBJECTIVE To evaluate the influence of the personal experience of female obstetricians and gynaecologists (Obst/Gyns) who utilise contraceptive methods on the provision of these methods. METHODS An anonymous online web-based survey was carried out with female Obst/Gyns. The instrument contained questions about their current and previous contraceptive methods use, factors that influenced the choice and satisfaction with the ongoing method, as well as the occurrence of adverse events. They were also asked whether the experience of any adverse events influenced their decision in prescribing any particular contraceptive method. RESULTS 476/9000 (5.3%) female Obst/Gyns answered the survey. The most common contraceptive in use was the 52-mg levonorgestrel-intrauterine device (52-mg LNG-IUD) (34%), followed by non-Long-Acting Reversible Contraception hormonal methods (21.2%). More than half of the respondents (57.6%) reported having some adverse effects and 18.7% reported that the personal experience of an adverse effect with the use of a contraceptive method influenced the prescription of that method. CONCLUSION Half of female Obst/Gyns encountered adverse events linked to contraceptive usage. Additionally, almost one-fifth believe that their own encounter with adverse effects from a contraceptive method impacts their decision to prescribe the same method.
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Affiliation(s)
- Mariana R M Canela
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Luiz G O Brito
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Agnaldo Lopes Silva-Filho
- Department of Obstetrics and Gynecology, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Luis Bahamondes
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Cássia R T Juliato
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
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Brasil S, Godoy DA, Videtta W, Rubiano AM, Solla D, Taccone FS, Robba C, Rasulo F, Aries M, Smielewski P, Meyfroidt G, Battaglini D, Hirzallah MI, Amorim R, Sampaio G, Moulin F, Deana C, Picetti E, Kolias A, Hutchinson P, Hawryluk GW, Czosnyka M, Panerai RB, Shutter LA, Park S, Rynkowski C, Paranhos J, Silva THS, Malbouisson LMS, Paiva WS. A Comprehensive Perspective on Intracranial Pressure Monitoring and Individualized Management in Neurocritical Care: Results of a Survey with Global Experts. Neurocrit Care 2024:10.1007/s12028-024-02008-z. [PMID: 38811514 DOI: 10.1007/s12028-024-02008-z] [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: 02/23/2024] [Accepted: 05/01/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Numerous trials have addressed intracranial pressure (ICP) management in neurocritical care. However, identifying its harmful thresholds and controlling ICP remain challenging in terms of improving outcomes. Evidence suggests that an individualized approach is necessary for establishing tolerance limits for ICP, incorporating factors such as ICP waveform (ICPW) or pulse morphology along with additional data provided by other invasive (e.g., brain oximetry) and noninvasive monitoring (NIM) methods (e.g., transcranial Doppler, optic nerve sheath diameter ultrasound, and pupillometry). This study aims to assess current ICP monitoring practices among experienced clinicians and explore whether guidelines should incorporate ancillary parameters from NIM and ICPW in future updates. METHODS We conducted a survey among experienced professionals involved in researching and managing patients with severe injury across low-middle-income countries (LMICs) and high-income countries (HICs). We sought their insights on ICP monitoring, particularly focusing on the impact of NIM and ICPW in various clinical scenarios. RESULTS From October to December 2023, 109 professionals from the Americas and Europe participated in the survey, evenly distributed between LMIC and HIC. When ICP ranged from 22 to 25 mm Hg, 62.3% of respondents were open to considering additional information, such as ICPW and other monitoring techniques, before adjusting therapy intensity levels. Moreover, 77% of respondents were inclined to reassess patients with ICP in the 18-22 mm Hg range, potentially escalating therapy intensity levels with the support of ICPW and NIM. Differences emerged between LMIC and HIC participants, with more LMIC respondents preferring arterial blood pressure transducer leveling at the heart and endorsing the use of NIM techniques and ICPW as ancillary information. CONCLUSIONS Experienced clinicians tend to personalize ICP management, emphasizing the importance of considering various monitoring techniques. ICPW and noninvasive techniques, particularly in LMIC settings, warrant further exploration and could potentially enhance individualized patient care. The study suggests updating guidelines to include these additional components for a more personalized approach to ICP management.
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Affiliation(s)
- Sérgio Brasil
- Division of Neurosurgery, Department of Neurology, School of Medicine University of São Paulo, Av. Dr. Eneas de Carvalho Aguiar 255, São Paulo, Brazil.
| | | | - Walter Videtta
- Intensive Care Unit, Hospital Posadas, Buenos Aires, Argentina
| | | | - Davi Solla
- Division of Neurosurgery, Department of Neurology, School of Medicine University of São Paulo, Av. Dr. Eneas de Carvalho Aguiar 255, São Paulo, Brazil
| | - Fabio Silvio Taccone
- Department of Intensive Care, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium
| | - Chiara Robba
- Anesthesia and Intensive Care, Scientific Institute for Research, Hospitalization and Healthcare, Policlínico San Martino, Genoa, Italy
| | - Frank Rasulo
- Neuroanesthesia, Neurocritical and Postoperative Care, Spedali Civili University Affiliated Hospital of Brescia, Brescia, Italy
| | - Marcel Aries
- Department of Intensive Care, Maastricht University Medical Center, Maastricht, The Netherlands
- School of Mental Health and Neurosciences, University Maastricht, Maastricht, The Netherlands
| | - Peter Smielewski
- Department of Clinical Neurosciences, Addenbrookes Hospital, University of Cambridge, Cambridge, UK
| | - Geert Meyfroidt
- Department and Laboratory of Intensive Care Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Denise Battaglini
- Anesthesia and Intensive Care, Scientific Institute for Research, Hospitalization and Healthcare, Policlínico San Martino, Genoa, Italy
| | - Mohammad I Hirzallah
- Departments of Neurology, Neurosurgery, and Center for Space Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Robson Amorim
- Division of Neurosurgery, Department of Neurology, School of Medicine University of São Paulo, Av. Dr. Eneas de Carvalho Aguiar 255, São Paulo, Brazil
| | - Gisele Sampaio
- Neurology Department, São Paulo Federal University Medical School, São Paulo, Brazil
| | - Fabiano Moulin
- Neurology Department, São Paulo Federal University Medical School, São Paulo, Brazil
| | - Cristian Deana
- Department of Anesthesia and Intensive Care, Health Integrated Agency of Friuli Centrale, Udine, Italy
| | - Edoardo Picetti
- Department of Anesthesia and Intensive Care, Parma University Hospital, Parma, Italy
| | | | | | - Gregory W Hawryluk
- Cleveland Clinic Neurological Institute, Akron General Hospital, Fairlawn, OH, USA
- Uniformed Services University, Bethesda, USA
- Brain Trauma Foundation, New York, USA
| | - Marek Czosnyka
- Division of Neurosurgery, Addenbrooke's Hospital, Cambridge, UK
| | - Ronney B Panerai
- Cerebral Haemodynamics in Ageing and Stroke Medicine Group, Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Lori A Shutter
- Departments of Critical Care Medicine, Neurology and Neurosurgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Soojin Park
- Departments of Neurology and Biomedical Informatics, Columbia University Vagelos College of Physicians and Surgeons, New York-Presbyterian Hospital, New York, NY, USA
| | - Carla Rynkowski
- Department of Urgency and Trauma, Medical Faculty, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - Jorge Paranhos
- Intensive Care and Neuroemergency, Santa Casa de Misericórdia, São João del Rei, Brazil
| | - Thiago H S Silva
- Department of Intensive Care, School of Medicine University of São Paulo, São Paulo, Brazil
| | - Luiz M S Malbouisson
- Department of Intensive Care, School of Medicine University of São Paulo, São Paulo, Brazil
| | - Wellingson S Paiva
- Division of Neurosurgery, Department of Neurology, School of Medicine University of São Paulo, Av. Dr. Eneas de Carvalho Aguiar 255, São Paulo, Brazil
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Grant A, Turner S, Shaw SCK, Williams K, Morgan H, Ellis R, Brown A. "I am afraid of being treated badly if I show it": A cross-sectional study of healthcare accessibility and Autism Health Passports among UK Autistic adults. PLoS One 2024; 19:e0303873. [PMID: 38809913 PMCID: PMC11135756 DOI: 10.1371/journal.pone.0303873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 05/01/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Autistic people are more likely to experience stigma, communication barriers and anxiety during healthcare. Autism Health Passports (AHPs) are a communication tool that aim to provide information about healthcare needs in a standardised way. They are recommended in research and policy to improve healthcare quality. AIM To explore views and experiences of AHPs among Autistic people from the UK who have been pregnant. METHODS We developed an online survey using a combination of open and closed questions focused on healthcare impairments and views and experiences of AHPs. Data were anlaysed using descriptive statistics, Kruskal-Wallis tests, and content analysis. FINDINGS Of 193 Autistic respondents (54% diagnosed, 22% undergoing diagnosis and 24% self-identifying), over 80% reported anxiety and masking during healthcare always or most of the time. Some significant differences were identified in healthcare (in)accessibility by diagnostic status. Only 4% of participants knew a lot about AHPs, with 1.5% of participants using one at least half of the time. Almost three quarters of respondents had not previously seen an AHP. Open text responses indicated that the biggest barrier to using an AHP was a belief that health professionals would discriminate against Autistic patients. Additional barriers included staff lack of familiarity with AHPs and respondents expecting a negative response to producing an AHP. CONCLUSIONS Our findings suggest that AHPs are not reducing health inequalities for Autistic adults who have been pregnant. Alternative solutions are needed to reduce health inequalities for Autistic people.
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Affiliation(s)
- Aimee Grant
- School of Health and Social Care, Swansea University, Swansea, United Kingdom
| | - Sarah Turner
- Children’s Hospital Research Institute, University of Manitoba, Winnipeg City, Canada
| | - Sebastian C. K. Shaw
- Department of Medical Education, Brighton and Sussex Medical School, Brighton and Hove, United Kingdom
| | - Kathryn Williams
- Autistic UK CIC, Polegate, United Kingdom
- School of Social Sciences, Cardiff University, Cardiff, United Kingdom
| | - Hayley Morgan
- School of Health and Social Care, Swansea University, Swansea, United Kingdom
| | - Rebecca Ellis
- School of Health and Social Care, Swansea University, Swansea, United Kingdom
| | - Amy Brown
- School of Health and Social Care, Swansea University, Swansea, United Kingdom
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Griffiths S, Shepherd V, Volkmer A. Determining capacity of people with dementia to take part in research: an electronic survey study of researcher confidence, competence and training needs. BMC Med Ethics 2024; 25:65. [PMID: 38802779 PMCID: PMC11131177 DOI: 10.1186/s12910-024-01056-6] [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: 01/25/2024] [Accepted: 05/08/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Researchers are required to determine whether a person has capacity to consent to a research study before they are able to participate. The Mental Capacity Act and accompanying Code of Practice for England and Wales provide some guidance on this process, but researchers have identified that it can be difficult to determine capacity to consent when a person has complex cognitive or communication needs. This study aimed to understand the experiences and opinions of researchers who recruit people with dementia to research projects, to inform the future development of training resources. METHODS A mixed method, cross-sectional, electronic survey was circulated via social media and research networks in England and Wales. The survey remained open for ten weeks and included open and closed questions exploring respondents' confidence in determining capacity in the context of recruiting people with dementia to consent, their views on training and support they have experienced and their suggestions for future training and support needs. RESULTS 60 respondents completed the survey from across England and Wales. Although 75% of respondents had experience of determining capacity to consent with people with dementia to research, only 13% rated themselves as feeling 'very confident' in this. Qualitative content analysis of open responses led to the generation of six themes, explaining researchers' confidence, competence and future training needs in this area: (1) Researcher uncertainties, (2) Lack of time, (3) Balancing information complexity with accessibility, (4) Gatekeepers, (5) Existing enablers and (6) Envisioning future training. CONCLUSIONS Researchers would benefit from specific training in undertaking conversations around consent with people with dementia. People with dementia may have fluctuating capacity, and despite support from caregivers, researchers have little practical guidance on methods of determining a person's ability to understand or appreciate the information they have provided during the consent process. Given the development of large complex trials within dementia research, there is an urgency to develop specific and practical guidance and training for researchers working with people with dementia and their families.
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Affiliation(s)
- Sarah Griffiths
- Centre for Ageing Population Studies, Primary Care and Population Health, University College London, London, UK.
| | | | - Anna Volkmer
- Psychology and Language Sciences, University College London, London, UK
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Newton LE, Predovic M, Wong SL. Systematic Review Assessing Quality of the Survey Literature in Surgery. J Surg Res 2024; 300:133-140. [PMID: 38810526 DOI: 10.1016/j.jss.2024.04.051] [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: 12/04/2023] [Revised: 04/11/2024] [Accepted: 04/22/2024] [Indexed: 05/31/2024]
Abstract
INTRODUCTION The use of survey methodology in surgical research has proliferated in recent years, but the quality of these surveys and of their reporting is understudied. METHODS We conducted a comprehensive review of surgical survey literature (January 2022-July 2023) via PubMed in July 2023. Articles which (1) reported data gleaned from a survey, (2) were published in an English language journal, (3) targeted survey respondents in the United States or Canada, and (4) pertained to general surgery specialties were included. We assessed quality of survey reports using the Checklist for Reporting Of Survey Studies (CROSS) guidelines. Articles were evaluated for concordance with CROSS using a dichotomous (yes or no) scale. RESULTS Initial literature search yielded 481 articles; 57 articles were included in analysis based on the inclusion criteria. The mean response rate was 37% (range 0.62%-98%). The majority of surveys were administered electronically (n = 50, 87.8%). No publications adhered to all 40 CROSS items; on average, publications met 61.2% of items applicable to that study. Articles were most likely to adhere to reporting criteria for title and abstract (mean adherence 99.1%), introduction (99.1%), and discussion (92.4%). Articles were least adherent to items related to methodology (42.6%) and moderately adherent to items related to results (76.6%). Only five articles cited CROSS guidelines or another standardized survey reporting tool (10.5%). CONCLUSIONS Our analysis demonstrates that CROSS reporting guidelines for survey research have not been adopted widely. Surveys reported in surgical literature may be of variable quality. Increased adherence to guidelines could improve development and dissemination of surveys done by surgeons.
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Affiliation(s)
- Laura E Newton
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; Dartmouth Health, Department Of Surgery, Lebanon, New Hampshire; Department of Surgery, White River Junction VA Medical Center, White River Junction, Vermont.
| | - Marina Predovic
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; Dartmouth Health, Department Of Surgery, Lebanon, New Hampshire
| | - Sandra L Wong
- Emory University, School of Medicine, Atlanta, Georgia
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D’Amico F, Peyrin-Biroulet L, Danese S. Benefits of Biosimilars in the Management of Patients with Inflammatory Bowel Disease: An International Survey. J Clin Med 2024; 13:3069. [PMID: 38892780 PMCID: PMC11172954 DOI: 10.3390/jcm13113069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 05/17/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024] Open
Abstract
Background/Objectives: The development of biosimilar drugs has revolutionized the management of patients with inflammatory bowel diseases (IBD), significantly reducing healthcare costs. However, the impact of biosimilar availability on patient care is unknown. We conducted a survey to investigate the benefits of using biosimilars in patients with IBD. Methods: Physicians involved in the IBD care were invited to participate in an anonymous online survey. The questionnaire consisted of 42 questions addressing availability, cost, recommendations, and positioning regarding the use of biosimilars. Results: A total of 233 physicians (88.4% gastroenterologists) from 63 countries worldwide participated in the survey. Most respondents had >10 years of practice (202/233, 85.9%). Biosimilars were available in almost all cases (221, 94.8%), and over two-thirds of respondents had more than one biosimilar of adalimumab or infliximab on hospital formulary. In most cases, adalimumab and infliximab biosimilars had a reduced cost of at least 30% compared to the originators. The savings resulting from the use of biosimilars allowed physicians to improve patient care (3/233, 1.3%) or to improve research (2/233, 0.8%) in only a few cases. Interestingly, for about 50% of respondents, the cost of biologics was a limitation for patient access to therapy. For the majority of participants, the availability of biosimilars did not influence treatment decisions in Crohn's disease (70/165, 42.4%) and ulcerative colitis (83/165, 50.3%). Conclusions: The reduced cost of biosimilars compared to reference products is the main driver of choice in IBD. The impact of biosimilars of ustekinumab and vedolizumab in improving access to therapies and changing the treatment algorithm remains to be defined.
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Affiliation(s)
- Ferdinando D’Amico
- Department of Gastroenterology and Endoscopy, IRCCS San Raffaele Hospital, 20132 Milan, Italy;
| | - Laurent Peyrin-Biroulet
- Department of Gastroenterology, Nancy University Hospital, F-54500 Vandœuvre-lès-Nancy, France;
- Inserm, NGERE, University of Lorraine, F-54000 Nancy, France
- INFINY Institute, Nancy University Hospital, F-54500 Vandœuvre-lès-Nancy, France
- FHU-CURE, Nancy University Hospital, F-54500 Vandœuvre-lès-Nancy, France
- Groupe Hospitalier Privé Ambroise Paré-Hartmann, Paris IBD Center, F-92200 Neuilly sur Seine, France
- Division of Gastroenterology and Hepatology, McGill University Health Centre, Montreal, QC H4A 3J1, Canada
| | - Silvio Danese
- Department of Gastroenterology and Endoscopy, IRCCS San Raffaele Hospital, 20132 Milan, Italy;
- Department of Gastroenterology and Endoscopy, Vita-Salute San Raffaele University, 20132 Milan, Italy
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Lovegrove J, Tobiano G, Chaboyer W, Carlini J, Liang R, Addy K, Gillespie BM. Clinicians' perceptions of "enhanced recovery after surgery" (ERAS) protocols to improve patient safety in surgery: a national survey from Australia. Patient Saf Surg 2024; 18:18. [PMID: 38783341 PMCID: PMC11119013 DOI: 10.1186/s13037-024-00397-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 04/09/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Surgical patients are at risk of postoperative complications, which may lead to increased morbidity, mortality, hospital length-of-stay and healthcare costs. Enhanced Recovery After Surgery (ERAS®) protocols are evidence-based and have demonstrated effectiveness in decreasing complications and associated consequences. However, their adoption in Australia has been limited and the reason for this is unclear. This study aimed to describe clinicians' perceptions of ERAS protocols in Australia. METHODS A national online survey of anaesthetists, surgeons and nurses was undertaken. Invitations to participate were distributed via emails from professional colleges. The 30-item survey captured respondent characteristics, ERAS perceptions, beliefs, education and learning preferences and future planning considerations. The final question was open-ended for elaboration of perceptions of ERAS. Descriptive and inferential statistics were used to describe and compare group differences across disciplines relative to perceptions of ERAS. RESULTS The sample included 178 responses (116 nurses, 65.2%; 36 surgeons, 20.2%; 26 anaesthetists, 14.6%) across six states and two territories. More than half (n = 104; 58.8%) had used ERAS protocols in patient care, and most perceived they were 'very knowledgeable' (n = 24; 13.6%) or 'knowledgeable' (n = 71; 40.3%) of ERAS. However, fewer nurses had cared for a patient using ERAS (p <.01) and nurses reported lower levels of knowledge (p <.001) than their medical counterparts. Most respondents agreed ERAS protocols improved patient care and financial efficiency and were a reasonable time investment (overall Md 3-5), but nurses generally recorded lower levels of agreement (p.013 to < 0.001). Lack of information was the greatest barrier to ERAS knowledge (n = 97; 62.6%), while seminars/lectures from international and national leaders were the preferred learning method (n = 59; 41.3%). Most supported broad implementation of ERAS (n = 130; 87.8%). CONCLUSION There is a need to promote ERAS and provide education, which may be nuanced based on the results, to improve implementation in Australia. Nurses particularly need to be engaged in ERAS protocols given their significant presence throughout the surgical journey. There is also a need to co-design implementation strategies with stakeholders that target identified facilitators and barriers, including lack of support from senior administration, managers and clinicians and resource constraints.
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Affiliation(s)
- Josephine Lovegrove
- NHMRC Centre of Research Excellence in Wiser Wound Care, School of Nursing and Midwifery, Griffith University, Gold Coast Campus, 1 Parklands Dr, 4222, Southport, QLD, Australia
- UQ Centre for Clinical Research, Royal Brisbane and Women?s Hospital, Herston Infectious Diseases Institute, Metro North Health, Level 7, 4029, Herston, Australia
- School of Nursing, Midwifery & Social Work, Faculty of Health & Behavioral Sciences, The University of Queensland, 4072, St Lucia, QLD, Australia
| | - Georgia Tobiano
- NHMRC Centre of Research Excellence in Wiser Wound Care, School of Nursing and Midwifery, Griffith University, Gold Coast Campus, 1 Parklands Dr, 4222, Southport, QLD, Australia
- Gold Coast Hospital & Health Service, Gold Coast University Hospital, 1 Hospital Blvd, 4215, Southport, QLD, Australia
| | - Wendy Chaboyer
- NHMRC Centre of Research Excellence in Wiser Wound Care, School of Nursing and Midwifery, Griffith University, Gold Coast Campus, 1 Parklands Dr, 4222, Southport, QLD, Australia
| | - Joan Carlini
- Department of Marketing, Griffith University, Gold Coast Campus, 1 Parklands Dr, 4222, Southport, QLD, Australia
- Gold Coast Health Consumer Advisory Group, Gold Coast Hospital & Health Service, 1 Hospital Blvd, 4215, Southport, QLD, Australia
| | - Rhea Liang
- Faculty of Health Sciences, Bond University, 14 University Dr, 4226, Robina, QLD, Australia
- Robina Hospital, Gold Coast Hospital & Health Service, 2 Bayberry Ln, 4226, Robina, QLD, Australia
| | - Keith Addy
- Gold Coast Hospital & Health Service, Gold Coast University Hospital, 1 Hospital Blvd, 4215, Southport, QLD, Australia
| | - Brigid M Gillespie
- NHMRC Centre of Research Excellence in Wiser Wound Care, School of Nursing and Midwifery, Griffith University, Gold Coast Campus, 1 Parklands Dr, 4222, Southport, QLD, Australia.
- Gold Coast Hospital & Health Service, Gold Coast University Hospital, 1 Hospital Blvd, 4215, Southport, QLD, Australia.
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Pinardi E, Ornago AM, Bianchetti A, Morandi A, Mantovani S, Marengoni A, Colombo M, Arosio B, Okoye C, Cortellaro F, Bellelli G. Optimizing older patient care in emergency departments: a comprehensive survey of current practices and challenges in Northern Italy. BMC Emerg Med 2024; 24:86. [PMID: 38764046 PMCID: PMC11103964 DOI: 10.1186/s12873-024-01004-y] [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: 02/26/2024] [Accepted: 05/10/2024] [Indexed: 05/21/2024] Open
Abstract
BACKGROUND The progressive aging of the population and the increasing complexity of health issues contribute to a growing number of older individuals seeking emergency care. This study aims to assess the state of the art of care provided to older people in the Emergency Departments of Lombardy, the most populous region in Italy, counting over 2 million people aged 65 years and older. METHODS An online cross-sectional survey was developed and disseminated among emergency medicine physicians and physicians affiliated to the Lombardy section of the Italian Society of Geriatrics and Gerontology (SIGG), during June and July 2023. The questionnaire covered hospital profiles, geriatric consultation practices, risk assessment tools, discharge processes and perspectives on geriatric emergency care. RESULTS In this mixed method research, 219 structured interviews were collected. The majority of physicians were employed in hospitals, with 54.7% being geriatricians. Critical gaps in older patient's care were identified, including the absence of dedicated care pathways, insufficient awareness of screening tools, and a need for enhanced professional training. CONCLUSIONS Tailored protocols and geriatric educational programs are crucial for improving the quality of emergency care provided to older individuals. These measures might also help relieve the burden on the Emergency Departments, thereby potentially enhancing overall efficiency and ensuring better outcomes.
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Affiliation(s)
- Elena Pinardi
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
- Italian Society of Gerontology and Geriatrics (Società Italiana di Gerontologia e Geriatria - SIGG), Firenze, Italy.
| | - Alice Margherita Ornago
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- Italian Society of Gerontology and Geriatrics (Società Italiana di Gerontologia e Geriatria - SIGG), Firenze, Italy
| | - Angelo Bianchetti
- Italian Society of Gerontology and Geriatrics (Società Italiana di Gerontologia e Geriatria - SIGG), Firenze, Italy
- Medicine and Rehabilitation Department, Istituto Clinico S.Anna Hospital, Gruppo San Donato, Brescia, Italy
| | - Alessandro Morandi
- Italian Society of Gerontology and Geriatrics (Società Italiana di Gerontologia e Geriatria - SIGG), Firenze, Italy
- Intermediate Care and Rehabilitation, Azienda Speciale "Cremona Solidale", Cremona, Italy
- Parc Sanitari Pere Virgili, Vall d'Hebrón Institute of Research, Barcelona, Spain
| | - Stefano Mantovani
- Italian Society of Gerontology and Geriatrics (Società Italiana di Gerontologia e Geriatria - SIGG), Firenze, Italy
- RSA Don Giuseppe Cuni, Magenta, Italy
| | - Alessandra Marengoni
- Italian Society of Gerontology and Geriatrics (Società Italiana di Gerontologia e Geriatria - SIGG), Firenze, Italy
- Department of Clinical and Experimental Sciences, Geriatric Unit, University of Brescia, Brescia, Italy
| | - Mauro Colombo
- Italian Society of Gerontology and Geriatrics (Società Italiana di Gerontologia e Geriatria - SIGG), Firenze, Italy
- Golgi Cenci Foundation, Abbiategrasso, Italy
| | - Beatrice Arosio
- Italian Society of Gerontology and Geriatrics (Società Italiana di Gerontologia e Geriatria - SIGG), Firenze, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Chukwuma Okoye
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- Italian Society of Gerontology and Geriatrics (Società Italiana di Gerontologia e Geriatria - SIGG), Firenze, Italy
- Acute Geriatrics Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Francesca Cortellaro
- Integrazione Percorsi di Cura Ospedale Territorio, Urgency Emergency Regional Agency (Agenzia Regionale Emergenza Urgenza - AREU), Milan, Italy
| | - Giuseppe Bellelli
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
- Italian Society of Gerontology and Geriatrics (Società Italiana di Gerontologia e Geriatria - SIGG), Firenze, Italy
- Acute Geriatrics Unit, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
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Ramdin C, Zembrzuska M, Zembrzuski K, Nelson L. Layperson knowledge on naloxone and medications for opioid use disorder in an urban population: a cross sectional survey study. J Addict Dis 2024:1-9. [PMID: 38764149 DOI: 10.1080/10550887.2024.2353431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2024]
Abstract
BACKGROUND AND OBJECTIVES There has been little research in an urban population regarding knowledge of harm reduction measures and treatment options. The objective of our study was to evaluate knowledge and perceptions of harm reduction measures and types of treatment available for opioid use disorder among patients and family in an urban emergency department (ED) waiting room. METHODS We conducted a single center, cross-sectional survey study that occurred between September 2021 and August 2022. A convenience sample of patients and family members that were above 18 and English speaking were recruited by research assistants. Participants were assessed on knowledge and preferences around drug treatment options and harm reduction. Data were summarized using descriptive statistics and compared using the Freeman-Halton/Kruskall-Wallis/Mann-Whitney U tests. p-Values were reported at the 0.05 significance level. RESULTS We collected 200 responses. Of these, 104 people had a connection to someone with a substance use disorder (SUD) and 50 had an SUD. Of those who had a connection to someone with SUD, 63 had heard of naloxone (60.6%, CI: [50.5, 69.9]). Fewer than 60% of respondents in each group had heard of Medications for Opioid Use Disorder (MOUD) (p = 0.46) and fewer than 50% thought that among people who use drugs that they knew would be interested in receiving treatment (p = 0.10). DISCUSSION AND CONCLUSIONS Our study found that among people who came to an urban emergency department, there was a lack of awareness of harm reduction and MOUD. Interventions should be put into place to educate on the importance of MOUD and harm reduction.
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Affiliation(s)
- Christine Ramdin
- Department of Emergency Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA
| | | | - Krzysztof Zembrzuski
- School of Medicine, Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, USA
| | - Lewis Nelson
- Department of Emergency Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA
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Liu C, Zhang H, Yang L, Chen L, Zu C, Wang F, Dai Y, Zhao H. Knowledge and attitude toward postoperative antithrombotic management and prevention in patients with coronary revascularization: a cross-sectional study. Front Cardiovasc Med 2024; 11:1388164. [PMID: 38826816 PMCID: PMC11140389 DOI: 10.3389/fcvm.2024.1388164] [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: 02/29/2024] [Accepted: 05/08/2024] [Indexed: 06/04/2024] Open
Abstract
Background This study aimed to explore the knowledge and attitude (KA) toward postoperative antithrombotic management and prevention among coronary artery disease (CAD) patients who underwent coronary revascularization. Methods This cross-sectional study enrolled CAD outpatients and inpatients between May and December 2023 at Kailuan Medical Group at Tangshan. Basic demographic characteristics and KA scores were collected through a self-made questionnaire. Results This study included 523 valid questionnaires. The mean knowledge and attitude scores were 13.20 ± 6.20 (range: 0-26) and 43.68 ± 6.01 (range: 21-50), respectively, indicating poor knowledge and favorable attitude. Multivariable logistic regression analysis showed that junior high school education (OR = 2.160, P = 0.035), high school or technical school education (OR = 2.356, P = 0.039), and monthly average income >5,000 RMB (OR = 3.407, P = 0.002) were independently associated with knowledge. Knowledge (OR = 1.095, P = 0.002), BMI ≥ 24.0 kg/m2 (OR = 0.372, P = 0.011), junior high school (OR = 3.699, P = 0.002), high school or technical school (OR = 2.903, P = 0.028), high associate degree or above education (OR = 6.068, P = 0.014), monthly average income 3,000-5,000 RMB (OR = 0.296, P = 0.005), monthly average income > 5,000 RMB (OR = 0.225, P = 0.021), with hypertension (OR = 0.333, P = 0.003), blood tests every 2-3 weeks (OR = 10.811, P = 0.011), blood tests every month (OR = 4.221, P = 0.024), and blood tests every 2-3 months (OR = 3.342, P = 0.033) were independently associated with attitude. Conclusion CAD patients who underwent coronary revascularization had poor knowledge but favorable attitudes toward postoperative antithrombotic management and prevention. The study underscores the need for targeted education, especially for individuals with lower education and income levels, ultimately improving patient compliance and cardiovascular outcomes.
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Affiliation(s)
- Chunlu Liu
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Haijun Zhang
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Liming Yang
- Department of Cardiology, Tangshan Gongren Hospital, Tangshan, China
| | - Lihua Chen
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Changhao Zu
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Fangfang Wang
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Yunjia Dai
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Haiyan Zhao
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
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Gagnon PL, Thérasse É, Voizard N, Dubé M, Caty V. Uterine Fibroid Embolization Survey in Canada: Challenges, Opportunities, and Differences in Practices Across the Country. Can Assoc Radiol J 2024:8465371241252307. [PMID: 38755969 DOI: 10.1177/08465371241252307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024] Open
Abstract
Purpose: To assess the current practices surrounding Uterine Fibroid Embolization (UFE) in Canada. Methods: An online survey was sent to Canadian Association for Interventional Radiology (CAIR) members. It included questions on symptoms prompting UFE, patient awareness, investigation, UFE settings, the number of UFE procedures, and post-UFE care. The findings were discussed at CAIR's 2023 annual meeting by an expert panel. Results: Out of 792 surveys sent, 87 were filled (11%). Menorrhagia is the most common indication for UFE (87%). Women's awareness of UFE as a treatment option for fibroids is viewed as poor or average by 94% of our survey respondents. Most respondents see patients in clinics (92%) before the procedure and evaluate fibroids with MRI pre-UFE (76%). There is variability in care post-UFE, with 33% of procedures being performed as day surgery while 67% lead to overnight stay. For pain management, intravenous analgesia (including patient-controlled analgesia) is used in 76% (63/83) of cases while 19% (16/83) of respondents mentioned using epidural analgesia. Finally, there is an even split between embolic agent used; non-spherical polyvinyl alcohol (50%) and spherical particles (50%). Conclusion: Respondents believe patients in Canada still have limited awareness of UFE. Interventional radiologists are increasingly involved in the entire patient care trajectory, overseeing pre-and post-procedure care and hospitalizing patients. For pain management after UFE, it is observed that while epidural analgesia has been demonstrated more effective than alternatives, it is not widely used as the primary method.
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Affiliation(s)
- Pierre-Luc Gagnon
- Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
| | - Éric Thérasse
- Faculté de médecine, Département de radiologie, radio-oncologie et médecine nucléaire, Université de Montréal, Montréal, QC, Canada
- Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Nicolas Voizard
- Faculté de médecine, Département de radiologie, radio-oncologie et médecine nucléaire, Université de Montréal, Montréal, QC, Canada
- Centre intégré universitaire de santé et des services sociaux de l'Est de l'Ile de Montréal-Hôpital Maisonneuve-Rosemont, Montréal, QC, Canada
| | - Michel Dubé
- Faculté de médecine, Département de radiologie, radio-oncologie et médecine nucléaire, Université de Montréal, Montréal, QC, Canada
- Centre intégré universitaire de santé et des services sociaux de l'Est de l'Ile de Montréal-Hôpital Maisonneuve-Rosemont, Montréal, QC, Canada
| | - Véronique Caty
- Faculté de médecine, Département de radiologie, radio-oncologie et médecine nucléaire, Université de Montréal, Montréal, QC, Canada
- Centre intégré universitaire de santé et des services sociaux de l'Est de l'Ile de Montréal-Hôpital Maisonneuve-Rosemont, Montréal, QC, Canada
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Liu E, D'Souza R, Lapinsky SE. Critical Care Services for Pregnant Patients in Ontario: A Province-Wide Survey. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2024; 46:102560. [PMID: 38754626 DOI: 10.1016/j.jogc.2024.102560] [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: 11/17/2023] [Revised: 04/24/2024] [Accepted: 04/26/2024] [Indexed: 05/18/2024]
Abstract
Critically ill pregnant patients require advanced critical care support, but access to these services is variable. We surveyed active Ontario obstetric facilities regarding critical care access. Responses were received from 44 of 80 obstetric units (55%), 13 (30%) being rural. Transport to another facility was required by 59% (majority >1 hour transport time), and differences were noted in the availability of specialty support services such as anesthesia and internal/obstetric medicine, as well as radiology and laboratory facilities, and use of massive transfusion protocols. Training in early supportive care of obstetric complications and optimized facility transport are areas for potential improvement.
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Affiliation(s)
- Emily Liu
- Department of Medicine, Sinai Health System, Toronto, ON
| | - Rohan D'Souza
- Department of Obstetrics and Gynaecology and Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON
| | - Stephen E Lapinsky
- Department of Medicine, Sinai Health System, and Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON.
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Bosch-Donate E, Vico-Moreno E, Fernández-Domínguez JC, González-Trujillo A, Sastre-Munar A, Romero-Franco N. Symptomatology and knowledge regarding pelvic floor dysfunctions and influence of gender stereotypes in female athletes. Sci Rep 2024; 14:11052. [PMID: 38744879 PMCID: PMC11094071 DOI: 10.1038/s41598-024-61464-x] [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: 11/08/2023] [Accepted: 05/06/2024] [Indexed: 05/16/2024] Open
Abstract
Pelvic floor dysfunctions (PFD) are highly prevalent among females who do athletics, a sport requiring jumping, strength, and running. Although educational approaches are useful options, the educational need for this particular population remains unknown. The objective of the present study was to describe the level of knowledge regarding PFD and its relationship with symptomatology and gender stereotypes in female athletes in Spain. A total of 255 female athletes completed an anonymous online survey to explore their knowledge regarding urinary incontinence (UI), pelvic organ prolapse (POP), anal incontinence (AI), and sexual dysfunction (SexD), as well as their PFD symptoms and gender stereotyped beliefs related to sport. Educational level and sports characteristics (training volume, experience, and athletic modality) were also explored. Participants demonstrated a low level of knowledge in terms of POP (52.5%), AI (64.0%), and SexD (40%), but not for UI (70.8%). The proportion of PFD complaints was 63.5% for dyspareunia, 51.8% for urine leakage, 42.4% for pelvic pain, 17.3% for AI, and 9.0% for POP, with no associations with knowledge (p > 0.05). Lower knowledge about UI and SexD was related to greater gender stereotypes (p < 0.05) and rejection of professional healthcare (p = 0.010). As a conclusion, the level of knowledge about PFD was low in female athletes who train and compete in athletics in Spain, mainly with regard to sexual dysfunction. Although 63.5% of athletes had dyspareunia and 51.8% urinary leakages, symptomatology was not associated with level of knowledge. However, a lower level of knowledge was associated with more stereotyped beliefs and rejection of professional healthcare for PFD. These findings confirm the need to design appropriate educational interventions to disseminate information on all the types of PFD, particularly sexual contents. The potential influence of gender stereotypes makes it appropriate to include the gender perspective in these interventions.
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Affiliation(s)
- Elisa Bosch-Donate
- Nursing and Physiotherapy Department, University of the Balearic Islands, Crta de Valldemossa, Km 7.5, 07122, Palma de Mallorca, Spain
| | - Elena Vico-Moreno
- Nursing and Physiotherapy Department, University of the Balearic Islands, Crta de Valldemossa, Km 7.5, 07122, Palma de Mallorca, Spain
| | - Juan Carlos Fernández-Domínguez
- Nursing and Physiotherapy Department, University of the Balearic Islands, Crta de Valldemossa, Km 7.5, 07122, Palma de Mallorca, Spain.
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain.
| | - Antonio González-Trujillo
- Nursing and Physiotherapy Department, University of the Balearic Islands, Crta de Valldemossa, Km 7.5, 07122, Palma de Mallorca, Spain
| | - Andreu Sastre-Munar
- Nursing and Physiotherapy Department, University of the Balearic Islands, Crta de Valldemossa, Km 7.5, 07122, Palma de Mallorca, Spain
| | - Natalia Romero-Franco
- Nursing and Physiotherapy Department, University of the Balearic Islands, Crta de Valldemossa, Km 7.5, 07122, Palma de Mallorca, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
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Quintiens B, Smets T, Chambaere K, Van den Block L, Deliens L, Cohen J. Willingness to support neighbours practically or emotionally: a cross-sectional survey among the general public. Palliat Care Soc Pract 2024; 18:26323524241249196. [PMID: 38737406 PMCID: PMC11085024 DOI: 10.1177/26323524241249196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 04/05/2024] [Indexed: 05/14/2024] Open
Abstract
Background Wider social networks are increasingly recognized for supporting people with care needs. Health-promoting initiatives around the end of life aim to foster these social connections but currently provide little insight into how willing people are to help neighbours facing support needs. Objectives This study describes how willing people are to help neighbours who need support practically or emotionally, whether there is a difference in willingness depending on the type of support needed and what determines this willingness. Design We applied a cross-sectional survey design. Methods We distributed 4400 questionnaires to a random sample of people aged >15 across four municipalities in Flanders, Belgium. These surveys included attitudinal and experiential questions related to serious illness, caregiving and dying. Respondents rated their willingness (scale of 1-5) to provide support to different neighbours in hypothetical scenarios: (1) an older person in need of assistance and (2) a caregiver of a dying partner. Results A total of 2008 questionnaires were returned (45.6%). The average willingness to support neighbours was 3.41 (case 1) and 3.85 (case 2). Helping with groceries scored highest; cooking and keeping company scored lowest. Factors associated with higher willingness included an optimistic outlook about receiving support from others, family caregiving experience and prior volunteering around serious illness or dying. Conclusion People are generally willing to support their neighbours who need help practically or emotionally, especially when they have prior experience with illness, death or dying and when they felt supported by different groups of people. Community-based models that build support around people with care needs could explore to what extent this willingness translates into durable community support. Initiatives promoting social connection and cohesion around serious illness, caregiving and dying may harness this potential through experiential learning.
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Affiliation(s)
- Bert Quintiens
- End-of-Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Laarbeeklaan 103, Brussels 1090, Belgium
| | - Tinne Smets
- End-of-Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels, Belgium
| | - Kenneth Chambaere
- End-of-Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels, Belgium
| | - Lieve Van den Block
- End-of-Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels, Belgium
| | - Luc Deliens
- End-of-Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels, Belgium
| | - Joachim Cohen
- End-of-Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels, Belgium
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Kustra-Mulder A, Liebau M, Grewer G, Rosmalen JGM, Cosci F, Rymaszewska J, Löwe B, Weigel A. Healthcare professionals' views on factors influencing persistent somatic symptoms - ARISE-HCP online survey across countries. J Psychosom Res 2024:111695. [PMID: 38762407 DOI: 10.1016/j.jpsychores.2024.111695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 05/06/2024] [Accepted: 05/06/2024] [Indexed: 05/20/2024]
Abstract
OBJECTIVE The Health Care Online Survey Europe-Healthcare Professionals (ARISE-HCP) cross-sectionally investigated healthcare professionals' (HCPs) views on healthcare factors influencing the symptom course of persistent somatic symptoms (PSS) across four European countries. METHODS An online survey was developed for HCPs experienced in PSS care in Germany, Italy, Poland, and the Netherlands. The study employed a mixed-methods approach. Quantitatively, it assessed HCPs' perspectives on training, tools, and consultation times. Qualitatively, it explored their perceptions of healthcare-related factors influencing the PSS symptom course and systemic barriers encountered in treatment and diagnosis. RESULTS Overall, 258 HCPs participated: 152 from the Netherlands, 46 from Germany, 30 from Italy, and 30 from Poland (67% female, mean age = 47.68 ± 11.64 years). HCPs' views on PSS training, tool adequacy, and consultation time sufficiency differed significantly. Regarding symptom persistence and deterioration, HCPs from Italy and Poland highlighted access-related issues, whereas German and Dutch HCPs focused on care implementation. Across all countries, interdisciplinary collaboration was mentioned as important for symptom improvement. A more holistic approach was advocated, emphasizing the need for comprehensive PSS-focused training and the integration of these practices in care delivery, service coordination, and patient engagement. CONCLUSION Healthcare factors associated with the course of PSS and systemic treatment and diagnosis barriers varied across different countries, highlighting the importance of considering country-specific factors in managing PSS. Taking tailored measures to enhance multidisciplinary collaboration and HCP education is essential for improving patient outcomes, and sharing knowledge about effective healthcare practices across countries can improve patient care. Future research should focus on identifying systemic barriers to optimal care and developing country-specific interventions.
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Affiliation(s)
- Aleksandra Kustra-Mulder
- University Medical Center Hamburg-Eppendorf, Department of Psychosomatic Medicine and Psychotherapy, Hamburg, Germany.
| | - Martin Liebau
- Methoden und Analysen GmbH (USUMA), Unabhängiger Service für Umfragen, Berlin, Germany.
| | - Georg Grewer
- Methoden und Analysen GmbH (USUMA), Unabhängiger Service für Umfragen, Berlin, Germany
| | - Judith G M Rosmalen
- University of Groningen, University Medical Center Groningen, Departments of Psychiatry and Internal Medicine, Groningen, the Netherlands.
| | - Fiammetta Cosci
- University of Florence, Department of Health Sciences, Florence, Italy.
| | - Joanna Rymaszewska
- Wrocław University of Science and Technology, Department of Clinical Neuroscience, Wrocław, Poland.
| | - Bernd Löwe
- University Medical Center Hamburg-Eppendorf, Department of Psychosomatic Medicine and Psychotherapy, Hamburg, Germany.
| | - Angelika Weigel
- University Medical Center Hamburg-Eppendorf, Department of Psychosomatic Medicine and Psychotherapy, Hamburg, Germany.
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46
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Ranjous Y, Al Balkhi A, Alnader I, Rkab M, Ataya J, Abouharb R. Knowledge and misconceptions of choking and first-aid procedures among Syrian adults: A cross-sectional study. SAGE Open Med 2024; 12:20503121241249399. [PMID: 38725922 PMCID: PMC11080803 DOI: 10.1177/20503121241249399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 04/08/2024] [Indexed: 05/12/2024] Open
Abstract
Background Choking is a critical emergency that occurs when foreign objects obstruct the airways. It commonly affects young children, older people, individuals with developmental disabilities, those with acquired or lifelong disability, and those with mental health conditions. Symptoms can vary, ranging from coughing to cyanosis. Aim Our study aims to evaluate Syrian adults' knowledge of choking and their understanding of first-aid procedures. Specifically, we will assess the prevalence of misconceptions in order to train community members and increase their level of knowledge about first aid for choking. Ultimately, our goal is to reduce deaths resulting from this critical condition. Methods This cross-sectional study aims to assess the knowledge and attitudes regarding choking among adults in Syria. The targeted population consists of Syrians aged between 18 and 45 years who reside in Syria. Data were collected through an online survey, disseminated via social media platforms from March to July 2022. Scores were computed to quantify levels of knowledge, with participants achieving a score of 16 or higher classified as having a high level of knowledge. The collected data were analyzed using descriptive statistics, Pearson's correlation coefficient, and chi-square tests. Results A total of 406 responded to the survey, with 246 (60.6%) scoring less than 16 points, indicating a low level of knowledge. Gender and place of residency were not correlated with knowledge level p = 0.249, p = 0.913, respectively). Participants employed in the medical field, those who had received training in first aid, and individuals with higher levels of education exhibited higher levels of knowledge. However, the level of knowledge was below expectations for these groups. Conclusion There should be an increase in the availability of first-aid courses to the public and improvements in hands-on training for physicians and medical trainees.
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Affiliation(s)
- Yahia Ranjous
- Faculty of Medicine, Damascus University, Damascus, Syria
| | | | | | - Majd Rkab
- Faculty of Medicine, Damascus University, Damascus, Syria
| | - Jamal Ataya
- Faculty of Medicine, University of Aleppo, Aleppo, Syria
| | - Raed Abouharb
- Faculty of Medicine, Damascus University, Damascus, Syria
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47
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Hackett L, Zhang MM, Casey M, Miller J, Smith J, Low C, Aldridge E, Owen PJ, Buntine P. N-95/P2 respirator compliance with fit testing recommendations and respirator satisfaction amongst hospital staff. Infect Dis Health 2024:S2468-0451(24)00023-3. [PMID: 38702235 DOI: 10.1016/j.idh.2024.04.001] [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: 12/14/2023] [Revised: 04/02/2024] [Accepted: 04/04/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Filtering Facepiece Respirators (FFRs) are an important and readily scalable infection control measure; however their effectiveness is ultimately determined by compliance. We aimed to examine staff compliance and satisfaction with wearing the N95/P2 FFRs assigned to them via the standardised fit testing protocol implemented in a single large healthcare network in Victoria, Australia. METHODS In this cross-sectional survey, employees from five hospital campuses who participated in the health networks N95/P2 FFR fit testing process were invited in person to participate in the study. Data were analysed descriptively, after which chi-squared analysis was performed to determine differences between respirator types, gender, and age groups. RESULTS Amongst the 258 staff members surveyed, 28% had either never or only sometimes worn an FFR to which they had been successfully fit tested, and 11% had experienced facial changes that potentially rendered their most recent fit test invalid. More than half (53%) of those surveyed had experienced side effects, the most common being skin irritation and pressure sores. A majority (87%) of staff felt that wearing an FFR had some impact on their ability to perform their duties. Pooled mean self-reported satisfaction ratings were highest for three-panel flat-fold and duckbill models. CONCLUSION 28% of HCWs surveyed described not wearing N-95/P2 FFRs for which they had successfully been fit tested. Reasons for non-compliance remain unclear, but rates of side effects and interference with duties were high. Further research is required to determine and address potential causative factors and ascertain ongoing optimal organisation-level fit test strategies.
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Affiliation(s)
- Liam Hackett
- Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia; Eastern Health Emergency Medicine Program, Melbourne, Victoria, Australia.
| | - Melanie Meilun Zhang
- Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia; Department of General Surgery, Eastern Health, Melbourne, Victoria, Australia
| | - Matthew Casey
- OHS, Emergency Management and Wellbeing, Eastern Health, Melbourne, Victoria, Australia
| | - Joseph Miller
- Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia; Eastern Health Emergency Medicine Program, Melbourne, Victoria, Australia
| | - Jesse Smith
- Eastern Health Emergency Medicine Program, Melbourne, Victoria, Australia
| | - Caitlin Low
- Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia; Department of Anaesthesia, Pain and Perioperative Medicine, Eastern Health, Melbourne, Victoria, Australia; Department of Anaesthesia, Austin Health, Melbourne, Victoria, Australia
| | - Emogene Aldridge
- Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia; Eastern Health Emergency Medicine Program, Melbourne, Victoria, Australia
| | - Patrick J Owen
- Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia; Eastern Health Emergency Medicine Program, Melbourne, Victoria, Australia
| | - Paul Buntine
- Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia; Eastern Health Emergency Medicine Program, Melbourne, Victoria, Australia
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El Bairi K, Trapani D, Nidhamalddin SJ, Khan SZ, Chowdhury AR, Lengyel CG, Hussain S, Habeeb BS, Petrillo A, Omar NE, Altuna S, Seid FU, Elfaham E, Seeber A, Roitberg F, Burguete-Torres A, El Kefi S, Hammad N, Mutebi M, Al Jarroudi O, El Kadmiri N, Curigliano G, Afqir S. Global Landscape of the Attack of Predatory Journals in Oncology. JCO Glob Oncol 2024; 10:e2300287. [PMID: 38781549 DOI: 10.1200/go.23.00287] [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: 08/15/2023] [Revised: 01/05/2024] [Accepted: 03/27/2024] [Indexed: 05/25/2024] Open
Abstract
PURPOSE Open-access publishing expanded opportunities to give visibility to research results but was accompanied by the proliferation of predatory journals (PJos) that offer expedited publishing but potentially compromise the integrity of research and peer review. To our knowledge, to date, there is no comprehensive global study on the impact of PJos in the field of oncology. MATERIALS AND METHODS A 29 question-based cross-sectional survey was developed to explore knowledge and practices of predatory publishing and analyzed using descriptive statistics and binary logistic regression. RESULTS Four hundred and twenty-six complete responses to the survey were reported. Almost half of the responders reported feeling pressure to publish from supervisors, institutions, and funding and regulatory agencies. The majority of authors were contacted by PJos through email solicitations (67.8%), with fewer using social networks (31%). In total, 13.4% of the responders confirmed past publications on PJo, convinced by fast editorial decision time, low article-processing charges, limited peer review, and for the promise of academic boost in short time. Over half of the participants were not aware of PJo detection tools. We developed a multivariable model to understand the determinants to publish in PJos, showing a significant correlation of practicing oncology in low- and middle-income countries (LMICs) and predatory publishing (odds ratio [OR], 2.02 [95% CI, 1.01 to 4.03]; P = .04). Having previous experience in academic publishing was not protective (OR, 3.81 [95% CI, 1.06 to 13.62]; P = .03). Suggestions for interventions included educational workshops, increasing awareness through social networks, enhanced research funding in LMICs, surveillance by supervisors, and implementation of institutional actions against responsible parties. CONCLUSION The prevalence of predatory publishing poses an alarming problem in the field of oncology, globally. Our survey identified actionable risk factors that may contribute to vulnerability to PJos and inform guidance to enhance research capacity broadly.
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Affiliation(s)
- Khalid El Bairi
- Department of Medical Oncology, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medical Sciences, University Mohammed VI Polytechnic, Ben Guerir, Morocco
| | - Dario Trapani
- European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hemato-oncology (DIPO), University of Milan, Milan, Italy
| | | | - Shah Zeb Khan
- Department of Clinical Oncology, Binor, Bannu, Pakistan
| | | | | | - Sadaqat Hussain
- Oncology Department, University Hospital of Leicester, Leicester, United Kingdom
| | | | | | - Nabil Elhadi Omar
- Pharmacy Department, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
- Clinical and Population Health Research, College of Pharmacy, Qatar University, Doha, Qatar
| | - Sara Altuna
- Medical Oncology, Oncomédica Clinic, Caracas, Venezuela
| | - Fahmi Usman Seid
- Department of Oncology, Hawassa University College of Medicine and Health Sciences, Hawassa, Ethiopia
| | - Essam Elfaham
- Hemato-Oncology Department Kuwait Cancer Control Center, Kuwait, Kuwait
| | - Andreas Seeber
- Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Alan Burguete-Torres
- Gastrointestinal Tumors Unit, University of Nuevo Leon Cancer Center, Monterrey, México
| | - Safa El Kefi
- Stevens Institute of Technology, School of Systems and Enterprises, Hoboken, NJ
| | - Nazik Hammad
- Department of Oncology, Queen's University, Kingston, Canada
| | - Miriam Mutebi
- Department of Surgery, Aga Khan University, Nairobi, Kenya
| | - Ouissam Al Jarroudi
- Department of Medical Oncology, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine and Pharmacy, Mohammed Ist University, Oujda, Morocco
| | - Nadia El Kadmiri
- Molecular Engineering, Biotechnology and Innovation Team, Geo-Bio-Environment Engineering and Innovation Laboratory, Polydisciplinary Faculty of Taroudant, IBN ZOHR University, Taroudannt, Morocco
| | - Giuseppe Curigliano
- European Institute of Oncology, IRCCS, Milan, Italy
- Department of Oncology and Hemato-oncology (DIPO), University of Milan, Milan, Italy
| | - Said Afqir
- Department of Medical Oncology, Mohammed VI University Hospital, Oujda, Morocco
- Faculty of Medicine and Pharmacy, Mohammed I University, Oujda, Morocco
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Ronde E, van de Lücht VA, Lachkar N, Ubbink DT, Breugem CC. Stakeholders' Views on Information Needed in a Patient Decision Aid for Microtia Reconstruction. Cleft Palate Craniofac J 2024; 61:854-869. [PMID: 36604964 PMCID: PMC10981206 DOI: 10.1177/10556656221146584] [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] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE To assess which information about microtia and the possible reconstructive options health care providers (HCPs), patients and parents believe should be included in a patient decision aid (PtDA). DESIGN A mixed-methods study comprised of an online survey of HCPs and focus group discussions with patients and parents. PARTICIPANTS Survey respondents were members of the International Society for Auricular Reconstruction (ISAR). Focus group participants were patients with microtia and their parents, recruited through the microtia outpatient clinic at Amsterdam UMC, and through a Dutch patient organization for cleft and craniofacial conditions. METHODS An online, investigator-made survey was sent to ISAR members in December 2021. Semi-structured focus group discussions were held in February 2022. Quantitative results were summarized, and qualitative results were thematically grouped. RESULTS Thirty-two HCPs responded to the survey (response rate 41%). Most respondents (n = 24) were plastic surgeons, who had a median of 15 years of experience (IQR: 7-23 years). Two focus groups were held with a total of five patients and two parents. HCPs, patients and parents generally agreed on the information needed in a PtDA, emphasizing the importance of realistic expectation management. Patients and parents also considered psychosocial and functional outcomes, patient experiences, as well as patients' involvement in decision-making important. CONCLUSIONS A PtDA for microtia reconstruction should target all patients with microtia, and include information on at least technique-related information, expected esthetic results, possible adverse effects, psychosocial and functional outcomes and patient experiences. Preference eliciting questions should be developed for both pediatric patients and their parents.
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Affiliation(s)
- E.M. Ronde
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Reproduction and Development, Amsterdam, the Netherlands
| | - Veronique A.P. van de Lücht
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
| | - N. Lachkar
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
| | - Dirk T. Ubbink
- Department of Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Personalized Medicine, Amsterdam Public Health, Amsterdam, the Netherlands
| | - Corstiaan C. Breugem
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Reproduction and Development, Amsterdam, the Netherlands
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Saldanha IJ, Hughes KL, Dodd S, Lasserson T, Kirkham JJ, Wu Y, Lucas SW, Williamson PR. Study found increasing use of core outcome sets in Cochrane systematic reviews and identified facilitators and barriers. J Clin Epidemiol 2024; 169:111277. [PMID: 38428540 DOI: 10.1016/j.jclinepi.2024.111277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/25/2024] [Accepted: 02/04/2024] [Indexed: 03/03/2024]
Abstract
OBJECTIVES In 2019, only 7% of Cochrane systematic reviews (SRs) cited a core outcome set (COS) in relation to choosing outcomes, even though a relevant COS existed but was not mentioned (or cited) for a further 29% of SRs. Our objectives for the current work were to (1) examine the extent to which authors are currently considering COS to inform outcome choice in Cochrane protocols and completed SRs, and (2) understand author facilitators and barriers to using COS. STUDY DESIGN AND SETTING We examined all completed Cochrane SRs published in the last 3 months of 2022 and all Cochrane protocols published in 2022 for the extent to which they: (a) cited a COS, (b) searched for COS, (c) used outcomes from existing COS, and (d) reported outcome inconsistency among included studies and/or noted the need for COS. One investigator extracted information; a second extractor verified all information, discussing discrepancies to achieve consensus. We then conducted an online survey of authors of the included SRs to assess awareness of COS and identify facilitators and barriers to using COS to inform outcome choice. RESULTS Objective 1: We included 294 SRs of interventions (84 completed SRs and 210 published SR protocols), of which 13% cited specific COS and 5% did not cite but mentioned searching for COS. A median of 83% of core outcomes from cited COS (interquartile range [IQR] 57%-100%) were included in the corresponding SR. We identified a relevant COS for 39% of SRs that did not cite a COS. A median of 50% of core outcomes from noncited COS (IQR 35%-72%) were included in the corresponding SR. Objective 2: Authors of 236 (80%) of the 294 eligible SRs completed our survey. Seventy-seven percent of authors noted being aware of COS before the survey. Fifty-five percent of authors who did not cite COS but were aware of them reported searching for a COS. The most reported facilitators of using COS were author awareness of the existence of COS (59%), author positive perceptions of COS (52%), and recommendation in the Cochrane Handbook regarding COS use (48%). The most reported barriers related to matching of the scope of the COS and the SR: the COS target population was too narrow/broad relative to the SR population (29%) or the COS target intervention was too narrow/broad relative to the SR intervention (21%). Most authors (87%) mentioned that they would consider incorporating missing core outcomes in the SR/update. CONCLUSION Since 2019, there is increasing consideration and awareness of COS when choosing outcomes for Cochrane SRs of interventions, but uptake remains low and can be improved further. Use of COS in SRs is important to improve outcome standardization, reduce research waste, and improve evidence syntheses of the relevant effects of interventions across health research.
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Affiliation(s)
- Ian J Saldanha
- Department of Epidemiology, Center for Clinical Trials and Evidence Synthesis, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Karen L Hughes
- Department of Health Data Science, MRC-NIHR Trials Methodology Research Partnership, University of Liverpool, Liverpool, UK
| | - Susanna Dodd
- Department of Health Data Science, MRC-NIHR Trials Methodology Research Partnership, University of Liverpool, Liverpool, UK
| | - Toby Lasserson
- Central Executive, The Cochrane Collaboration, London, UK
| | - Jamie J Kirkham
- Centre for Biostatistics, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Yuhui Wu
- Department of Epidemiology, Center for Clinical Trials and Evidence Synthesis, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Samuel W Lucas
- Department of Health Data Science, MRC-NIHR Trials Methodology Research Partnership, University of Liverpool, Liverpool, UK
| | - Paula R Williamson
- Department of Health Data Science, MRC-NIHR Trials Methodology Research Partnership, University of Liverpool, Liverpool, UK
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