Tag: nevin manimala

Ann R Coll Surg Engl. 2024 Sep 3. doi: 10.1308/rcsann.2024.0035. Online ahead of print.

ABSTRACT

BACKGROUND: Best practice pathways for common surgical procedures, including total knee arthroplasty (TKA), have the potential to improve patient outcomes and reduce carbon emissions. We aimed to estimate the reduction in carbon emissions due to changing trends in the care of patients undergoing TKA in England.

METHODS: This was a retrospective analysis of Hospital Episode Statistics data from 1 April 2013 to 31 March 2022 on adults undergoing elective primary TKA in England. The carbon footprint for each patient was calculated using carbon factors for multiple steps in the pathway, including ipsilateral knee arthroscopies in the year preceding the TKA, outpatient attendances, the index TKA, revisions of the TKA performed within 180 days of the index procedure, length of hospital stay and emergency readmissions.

RESULTS: A total of 648,861 TKA operations were identified. Over the study period, the median length of stay reduced from four to three days, the proportion of patients undergoing ipsilateral knee arthroscopies performed within a year before TKA surgery fell from 5.9% to 0.5% and the number of early revisions and emergency readmissions also fell. The per-patient carbon footprint reduced from 378.8kgCO₂e to 295.2kgCO₂e over this time. If all the study patients had the same carbon footprint as the average patient in 2021/2022, 32.4kilotons CO₂e would have been saved, enough to power 29,509 UK homes for one year.

CONCLUSIONS: Practices that were introduced primarily to improve patient outcomes can contribute to a reduction in the carbon footprint.

PMID:39224965 | DOI:10.1308/rcsann.2024.0035

Ann R Coll Surg Engl. 2024 Sep 3. doi: 10.1308/rcsann.2024.0059. Online ahead of print.

ABSTRACT

INTRODUCTION: The aim of this study was to explore whether there were any differences in consultant colorectal surgeon training and adjusted 90-day postoperative colorectal cancer mortality rates (AMR).

METHODS: We undertook a retrospective analysis of outcomes data published on the Association of Coloproctology of Great Britain and Ireland (ACPGBI) website. A total of 51,562 procedures for patients in England diagnosed with large bowel cancer between 2010 and 2015, registered under 551 consultants were included. Consultants were split into two cohorts. The first group were the pre-Calman Trained Consultants (pre-CTr), who completed their training before 1998. The second group-the post-Calman Trained Consultants (post-CTr)-included those who received their Certificate of Completion of Training (CCT) under the Calman Training Principles (CTC, 1998-2007) and the Modernising Medical Careers Curriculum (MMC, 2008 and onwards). The outcome measure was an AMR.

RESULTS: The pre-CTr cohort (n=84) consisted of 3.6% female colorectal consultants (n=3/84), whereas the post-CTr cohort (n=467) consisted of 14.3% female colorectal consultants (n=67/467) (p=0.006). In this cross-sectional analysis over 5 years, the average pre-CTr undertook a greater number of colorectal resections than their post-CTr peers: median procedures (interquartile range, IQR): 104 (59) vs 89 (57) respectively, p=0.008. The median AMR was significantly greater among pre-CTrs compared with post-CTrs, median AMR (IQR): 2.7% (2.0) vs 2.1% (2.9), p=0.022.

CONCLUSIONS: These data indicate that the implementation of the MMC and Calman training principles for colorectal training is associated with a statistically lower AMR compared with other historical training periods. This merits further exploration.

PMID:39224964 | DOI:10.1308/rcsann.2024.0059

Health Informatics J. 2024 Jul-Sep;30(3):14604582241279720. doi: 10.1177/14604582241279720.

ABSTRACT

The analysis of large sets of spatio-temporal data is a fundamental challenge in epidemiological research. As the quantity and the complexity of such kind of data increases, automatic analysis approaches, such as statistics, data mining, machine learning, etc., can be used to extract useful information. While these approaches have proven effective, they require a priori knowledge of the information being sought, and some interesting insights into the data may be missed. To bridge this gap, information visualization offers a set of techniques for not only presenting known information, but also exploring data without having a hypothesis formulated beforehand. In this paper, we introduce Epid Data Explorer (EDE), a visualization tool that enables exploration of spatio-temporal epidemiological data. EDE allows easy comparisons of indicators and trends across different geographical areas and times. It facilitates this exploration through ready-to-use pre-loaded datasets as well as user-chosen datasets. The tool also provides a secure architecture for easily importing new datasets while ensuring confidentiality. In two use cases using data associated with the COVID-19 epidemic, we demonstrate the substantial impact of implemented lockdown measures on mobility and how EDE allows assessing correlations between the spread of COVID-19 and weather conditions.

PMID:39224960 | DOI:10.1177/14604582241279720

Nurs Open. 2024 Sep;11(9):e70027. doi: 10.1002/nop2.70027.

ABSTRACT

AIM: To investigate the current state and influencing factors of core competence of oncology specialist nurses as well as the relationship between core competence and perceived professional benefits.

DESIGN: A cross-sectional correlational survey.

METHODS: This questionnaire survey was conducted with oncology specialist nurses working in a Grade III A (tertiary) Public Cancer Hospital in Jinan, China in March 2021. Based on informed consent, a convenience sampling of 350 nurses participated in the study, with 322 valid questionnaires collected. Using IBM SPSS21.0, the data were analysed to perform descriptive statistics, analysis of variance (ANOVA), multiple stepwise regression analysis and Pearson’s correlation analysis.

RESULTS: The overall average score of nurses’ core competence was 224.28 ± 7.95, a medium level and the overall average score of their perceived professional benefits was 132.99 ± 5.05. Nurses’ core competence was positively correlated with perceived professional benefits. The differences in professional title, education, working years and perceived professional benefits were statistically significant.

CONCLUSION: The findings indicated that nurses’ perceived professional benefit is an important factor affecting core competence. Nursing managers who take main responsibility for the quality of care should adopt measures to increase perceived professional benefits, which not only promote nurses’ job satisfaction and happiness, but also enhance the development of their core competence and the quality of cancer care as well.

PATIENT OR PUBLIC CONTRIBUTION: All participants contributed to the conducting of this study by completing self-reported questionnaires.

PMID:39224950 | DOI:10.1002/nop2.70027

Turk J Pharm Sci. 2024 Sep 2;21(4):367-375. doi: 10.4274/tjps.galenos.2023.98572.

ABSTRACT

OBJECTIVES: This study aimed to investigate the anticancer taxane profiles of edible and non-edible parts of seven Turkish hazelnut (Corylus avellana L.) genotypes. Hazelnut is one of the healthy foods rich in nutrients and antioxidants. Its regular consumption is associated with a reduced risk of coronary heart disease and cancer. Hazelnut has been described as a plant source that produces taxanes which are widely used in many cancers. Türkiye is a homeland of hazelnut culture and has its own cultivars. Investigation of anticancer taxane profiles in different parts of Turkish hazelnut genotypes is important to show the potential and value of this plant from the perspective of the pharmaceutical and food industries.

MATERIALS AND METHODS: In this study, green leafy covers (GLCs) and hard shells (HSs) (non-edible parts), skinless kernels (SKs), brown-skins (BSs), and brown-skinned kernels (BSKs) (edible parts) of Çakıldak, Sivri, Tombul, Palaz, and Kalınkara as standard and Ham and Sivri Yağlı as local genotypes were used. The five parts of each genotype were ground to powder and eliminated to a size of less than 80 mesh. Each part was extracted using hexane and methanol for 10-deacetylbaccatin III (10-DAB III), baccatin III (BAC III), cephalomannine, and paclitaxel analyses in three replicates. Samples and standards were analyzed by acetonitrile: water gradient method on NOVA Spher 100 Phenyl-Hexyl C18 column inhigh-performance liquid chromatography reverse phase system with 228 nm ultraviolet detector and 1.0 mL/min flow rate. Microsoft Office Excel, 2016, and analysis of variance Jamovi Version 2.3 were used for statistical and data analysis, consecutively.

RESULTS: Hazelnut parts differed to a very high degree from each other in terms of the highest amount of 10- DAB III (Ham HSs, 9,15 μg/g), BAC III (Kalınkara BSs, 7.24 μg/g), cephalomannine (Sivri Yağlı BSs, 6.37 μg/g), and paclitaxel (Ham BSKs, 4.36 μg/g) they contained. While HSs, BSKs, and BSs were rich in taxanes in all of the analyzed genotypes, SKs, and GLCs remain limited for anticancer taxanes.

CONCLUSION: This is the first report that revealed the differences in taxane contents of Turkish hazelnuts including previously untested standard and local genotypes and their parts. Significant differences between genotype and hazelnut parts are expected to highlight the health benefits of consuming raw Turkish hazelnut with BSs and their possible use as a functional food. These results add more information to elucidate the bioactive potential of Turkish hazelnuts and their by-products and provide a promising resource for the food and pharmaceutical industry with an anticancer perspective.

PMID:39224934 | DOI:10.4274/tjps.galenos.2023.98572

JBI Evid Synth. 2024 Sep 3. doi: 10.11124/JBIES-24-00025. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective of this methodological scoping review was to investigate ways in which qualitative review teams are addressing equity, diversity, and inclusion (EDI) in the process of conducting and reporting qualitative systematic reviews that use JBI guidelines.

INTRODUCTION: To promote health equity, there is a need for evidence synthesis processes and practices to develop approaches that incorporate EDI. Some guidance is available to guide equity-focused review methods and reporting, but this is primarily oriented to quantitative systematic reviews. There is currently limited knowledge about how review teams are addressing EDI within qualitative evidence syntheses.

INCLUSION CRITERIA: This review included English-language qualitative systematic reviews, published in 2022, that used all the steps outlined in JBI guidance for qualitative reviews.

METHODS: A 1-year sample of published reviews was identified from a search undertaken on March 17, 2023, of 2 health care databases: MEDLINE (Ovid) and CINAHL (EBSCOhost). Data extraction followed a framework approach, using an adapted preexisting equity template. This included attention to i) the reporting of a range of characteristics associated with EDI, ii) search approaches, and iii) analytical approaches (including reflexivity, intersectionality, and knowledge user engagement). Data were analyzed using descriptive statistics and narrative summary.

RESULTS: Forty-three reviews met the inclusion criteria. The majority of reviews (n=30) framed their questions and aims in a generic/universal (rather than EDI-focused) way. Six reviews justified their population focus in terms of an EDI-related issue. Only one review included a knowledge user. The sociodemographic and other key characteristics of the samples in underpinning studies were poorly reported, making it hard to discern EDI-related issues or to undertake EDI-related analyses. Thirteen of the reviews included non-English-language evidence sources, and 31 reviews included gray literature sources. Ten reviews demonstrated an element of intersectional or otherwise critical approaches within their analyses of categories and synthesized findings (whereby issues of power and/or representation were explicitly considered). Only 8 reviews included discussions of review team composition and reflexivity within the review process.

CONCLUSIONS: This EDI-focused methodological enquiry has highlighted some limitations within current qualitative evidence synthesis practice. Without closer attention to EDI, there is a danger that systematic reviews may simply serve to amplify, rather than illuminate, existing gaps, silences, and inequitable knowledge claims based on dominant representations. This review sets out a range of suggestions to help qualitative evidence synthesis teams to more systematically embed EDI within their methods and practices.

REVIEW REGISTRATION: Open Science Framework https://osf.io/wy5kv/.

PMID:39224923 | DOI:10.11124/JBIES-24-00025

SAGE Open Med. 2024 Aug 31;12:20503121241275230. doi: 10.1177/20503121241275230. eCollection 2024.

ABSTRACT

INTRODUCTION: Contact with pets within healthcare settings is considered worldwide an added value to assistance both in the case of animal-assisted interventions and also when pets are visiting hospitalized owners, due to the special emotional relationship between them and their pets. The goal of this work was to analyze local experiences on access of pets to healthcare facilities using a survey sent to doctors, veterinarians, and students in the region of Sardinia (Italy).

METHODS: The online survey consisted of 17 questions, with the objective to evaluate knowledge and interest of study participants on some aspects of human-animal interaction with particular reference to potential access of pets to hospitals facilities and nursing homes and to promote an initial social judgment in the medical and healthcare environment. A total of 2484 subjects were invited to participate to the survey through an email explaining the purpose of the study. Statistical analysis on the survey results was conducted by comparing the characteristics of respondents with their answers to animal-assisted-intervention-related questions.

RESULTS: Results showed that over 70% of the participants owned an animal; almost 80% of responses showed that survey participants were in favor of animal presence in hospitals; furthermore, the responses showed how the concept of One Health seems not only scarcely established, but also barely known. The large majority of respondents (over 80%) positively responded on questions around the role of animals as co-therapists.

CONCLUSIONS: On the one hand, this study showed lack of knowledge on the concept of One Health, whose essence is too often unknown and, on the other hand, it confirmed that women may be more inclined to show empathy and sensitivity toward animals. Regarding the profession, students seem more concerned about the introduction of animals into hospitals than healthcare workers.

PMID:39224895 | PMC:PMC11367599 | DOI:10.1177/20503121241275230

Eur Heart J Imaging Methods Pract. 2024 Jul 12;2(2):qyae067. doi: 10.1093/ehjimp/qyae067. eCollection 2024 Apr.

ABSTRACT

AIMS: Rheumatic mitral stenosis (MS) frequently leads to impaired left atrial (LA) function because of pressure overload, highlighting the underlying atrial pathology. Two-dimensional speckle tracking echocardiography (2D-STE) offers early detection of LA dysfunction, potentially improving risk assessment in patients with MS. This study aims to evaluate the predictive value of LA function assessed by 2D-STE for clinical outcomes in patients with MS.

METHODS AND RESULTS: Between 2011 and 2021, patients with MS underwent LA function assessment using 2D-STE, with focus on the reservoir phase (LASr). Atrial fibrillation (AF) development constituted the primary outcome, with death or valve replacement as the secondary outcome. Conditional inference trees were employed for analysis, validated through sample splitting. The study included 493 patients with MS (mean valve area 1.1 ± 0.4 cm², 84% female). At baseline, 166 patients (34%) had AF, with 62 patients (19%) developing AF during follow-up. LASr emerged as the primary predictor for new-onset AF, with a threshold of 17.9%. Over a mean 3.8-year follow-up, 125 patients (25%) underwent mitral valve replacement, and 32 patients (6.5%) died. A decision tree analysis identified key predictors such as age, LASr, severity of tricuspid regurgitation (TR), net atrioventricular compliance (C _n), and early percutaneous mitral valvuloplasty, especially in patients aged ≤49 years, where LASr, with a threshold of 12.8%, significantly predicted adverse outcomes.

CONCLUSION: LASr emerged as a significant predictor of cardiovascular events in this MS cohort, validated through a decision tree analysis. Patients were stratified into low- or high-risk categories for adverse outcomes, taking into account LASr, age, TR severity, and C _n.

PMID:39224865 | PMC:PMC11367946 | DOI:10.1093/ehjimp/qyae067

Eur Heart J Imaging Methods Pract. 2024 Aug 5;2(2):qyae080. doi: 10.1093/ehjimp/qyae080. eCollection 2024 Apr.

ABSTRACT

AIMS: Tricuspid regurgitation (TR) is associated with heart failure (HF) and reduced survival. Within a short-time period, transcatheter tricuspid valve repair or replacement (TTVR/TTVr) for TR has evolved from innovation to clinical reality. The present study’s aim is to provide 1-year results between TR patients treated with TTVR and TTVr compared with untreated patients, in terms of cardiac survival, rehospitalization, right-side HF symptom development, and New York Heart Association (NYHA) improvement.

METHODS AND RESULTS: Seventy-seven patients (pts) have been prospectively inserted into a dedicated database from January 2020 till January 2023. Twenty-six patients (33.8%) have been treated with TTVR/r [treated group (TG)], and 51 pts (66.2%) have been left untreated with medical therapy optimization [untreated group (UNTG)]. Analysing the cardiac death between the two groups, there was a significant statistical difference since TG has less incidence of exitus in the general population (P = 0.05). Concerning HF hospitalization, TG has a lower incidence with a P = 0.005. In TG, there was a significant improvement in NYHA class at follow-up (FUP) (P = 0.001) as well as an improvement in right-side HF symptoms (P = 0.001).

CONCLUSION: This study shows that treatment in the case of TR with right-side HF has a positive impact on cardiac death and HF hospitalization at 1 year. And there is a significant improvement in clinical and echocardiographic status at FUP in the TG.

PMID:39224864 | PMC:PMC11367954 | DOI:10.1093/ehjimp/qyae080

ScientificWorldJournal. 2024 Aug 26;2024:6208571. doi: 10.1155/2024/6208571. eCollection 2024.

ABSTRACT

This research aims to create and evaluate an assessment tool termed Older Adults’ First Aid Knowledge Scale, which measures the knowledge and attitude of Iranian grandparents about first aid. In accordance with COSIM guidelines, 485 individuals in southern Iran completed the instrument as part of a psychometric investigation. Rasch partial credit model (PCM), exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and receiver operating characteristic (ROC) analysis were used to analyze the results. The final version of OFAKS consisted of 18 items that were validated through EFA, CFA, and item response theory (IRT) analysis. All items showed measurement invariance and consecutive response groupings in the predictable order, and the instrument had strong internal consistency. Although Rasch’s analysis demonstrated the significance of OFAKS, further investigations and testing in different settings are required to confirm the validity of the tool.

PMID:39224860 | PMC:PMC11368547 | DOI:10.1155/2024/6208571