Stimulating appearance comparison dynamics and their effects on psychological dysfunctions: The moderating role of self-compassion

In recent decades, attitudes towards appearance comparison, and self-disapproval have rapidly increased, and these are attitudes strongly associated with psychological disorders. The present study aims to investigate the underlying patterns of depression, appearance-based stress, dietary constraints, and social and celebrity appearance comparison among young adults. It also examines the role of self-compassion in moderating the relationship between psychological dysfunctions and appearance comparison as well as the criteria and influences contributing to appearance comparison. Data on BMI, the measures of depression, appearance-based stress, eating restraints, appearance comparison, self-compassion, and predictors of peers and celebrity appearance comparison were collected from 434 college students (Age: Mean = 22; SD = 2.36; Male = Female = 217) in Sialkot, Pakistan. The data was analyzed by using the Hierarchical Regression Model. The results revealed that respondents who compared their appearances to peers and celebrities had increased depression and appearance-based stress while eating constraints didn't affect the appearance-based comparison, stress, and depression. Moreover, self-compassion significantly moderated the relationship between depression, appearance-based stress, and appearance comparison whereas an insignificant moderation effect is observed between eating restraints and self-compassion. Despite psychological distresses such as depression, appearance-based stress, and eating restraints, appearance comparisons are connected to appearance-based victimization, media appearance pressure, social-cultural appearance pressure, appearance conversation, and self-consciousness.

330 An End to Doctor’s Handwriting in the Digital Age: Evaluating the Legibility of Operation Notes in Otolaryngology

According to GMC Good Medical Practice, clinicians must record their work ‘clearly, accurately and legibly’. Operation notes are no exception and have several key functions. They serve reminder of procedural events, communicate information to the wider team and may be used as evidence when there are complications or complaints.

The aim of this audit was to evaluate the legibility of operation notes within the Otolaryngology department at Peterborough City Hospital.

Handwritten operation notes were audited from 8 dates chosen at random over a 2-month period (n = 27). Multiple surgeons and a variety of operations were included. Parameters such as legibility of the surgeon’s name, patient identification, date, name of procedure, events, findings, closure and post-op instructions were recorded.

Only 11% of the operation notes were legible in all relevant parameters. The surgeon’s name was either absent or not identifiable from the handwriting in 48%. Documentation of the procedure itself and post-op instructions was illegible in 18% and 29% of notes respectively.

Illegibility of operation notes is ultimately a patient safety-issue. Not only does it contribute to confusion about what happened during the surgery but also leaves room for error in terms of post-operative care and follow up. The results of the audit were discussed as part of a departmental meeting to highlight the importance of readable operation notes and help foster a culture of good record keeping.

A switch to computerised operation notes could ensure legibility and thus improve standards of patient care in the hospital.

Improvement in Infection Prevention and Control Measures at The Children Hospital, Lahore. A My Child Matters Collaborative Project

Background: Overcrowding, lack of operational funds, and healthcare associated infections are major challenges at the Children Hospital Lahore, a public healthcare facility in Pakistan with 900 new pediatric cancer admissions annually. In 2014, a collaboration between My Child Matters (MCM), St. Jude Global Infectious Diseases Program (SJ-GID), and our institution was established to address these issues. Aim: To describe the effect of a collaborative improvement strategy on the infection prevention and control (IPC) standards in a pediatric oncology unit in a resource-limited setting. Methods: Our study was a prospective before-and-after study. We compare the WHO Hand Hygiene Self-Assessment Framework (HHSAF) and 4 modules of the St. Jude modified Infection Control Assessment Tool (ICAT) scores. Our strategy included: (1) creating a multidisciplinary team of pediatric hematology-oncology, infectious disease physicians, nurses, microbiologist, and a data manager, (2) engaging on monthly online IPC mentoring sessions with the SJ-GID and MCM mentors, (3) performing daily inpatient healthcare associated (HAI) surveillance rounds, and (4) providing regular hand hygiene training and compliance audits. Results: Our hand hygiene facility level per WHO scores increased from “Inadequate” during the baseline assessment to “Intermediate/Consolidation” by the end of 3-year implementation (122 vs 352 HHSAF scores). The sink: bed and hand sanitizer: bed ratios improved to 1:6 and 1:1 respectively. Six washrooms were added to our unit. ICAT general infection control module increased by 40% (45 vs 78 ICAT score) and hygiene compliance improved by 20% from baseline. Identification of HAI increased from baseline (4.07 vs 8.7 infections per 1000 patient days). A 25% of the isolates were multidrug-resistant microorganisms. Conclusion: Implementing a collaborative improvement strategy improved the IPC standards in our pediatric cancer center. The increase of HAI might be a result of a better surveillance and laboratory identification. Further targeted interventions should be develop to decrease HAI rates and infection-related morbidity and mortality in our population.

Rutin prevents cognitive impairments by ameliorating oxidative stress and neuroinflammation in rat model of sporadic dementia of Alzheimer type

The objective of the present study was to assess the neuroprotective role of rutin (vitamin P) and delineate the mechanism of action. Recent evidence indicates that rutin exhibits antioxidant potential and protects the brain against various oxidative stressors. More precisely, the aim of the present study was to examine the modulating impacts of rutin against cognitive deficits and oxidative damage in intracerebroventricular-streptozotocin (ICV-STZ)-infused rats. Rats were injected bilaterally with ICV-STZ (3 mg/kg), whereas sham rats received the same volume of vehicle. After 2 weeks of streptozotocin (STZ) infusion, rats were tested for cognitive performance using Morris water maze tasks and thereafter euthanized for further biochemical, histopathological, and immunohistochemical studies. Rutin pretreatment (25 mg/kg, orally, once daily for 3 weeks) significantly attenuated thiobarbituric acid reactive substances (TBARS), activity of poly ADP-ribosyl polymerase, and nitrite level and decreased level of reduced glutathione (GSH) and activities of its dependent enzymes (glutathione peroxidase [GPx] and glutathione reductase [GR]) and catalase in the hippocampus of ICV-STZ rats. ICV-STZ rats showed significant cognitive deficits, which was improved significantly by rutin supplementation. The results indicate that rutin attenuates STZ-induced inflammation by reducing the expression of cyclooxygenase-2 (COX-2), glial fibrillary acidic protein (GFAP), interleukin-8 (IL-8), inducible nitric oxide synthase (iNOS), nuclear factor-kB, and preventing the morphological changes in hippocampus. The study thereby suggests the effectiveness of rutin in preventing cognitive deficits and might be beneficial for the treatment of sporadic dementia of Alzheimer type (SDAT).

Long term intubation and successful weaning in two children with Guillain-Barre syndrome

No definite criteria exists in Guillian-Barre syndrome in children regarding prolonged ventilation through an endo-tracheal tube without tracheostomy and successful weaning using a T-piece. Here we report two such cases of Guillian-Barre syndrome requiring prolonged intubation for 56 days and ventilation for 30 days and ultimately successfully weaning them using the T-piece. Both the children eventually made a complete recovery, highlighting the point that in children prolonged intubation and ventilation using the portex tube is equally good, if not, better than tracheostomy with its attendant risks.