30 results
Search Results
2. Good Measures: Developing a Process for Authentic Assessment Creation in Food Education.
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Gomez, Paulina and Sutter, Carolyn
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NONPROFIT organizations , *SCHOOL environment , *HUMAN services programs , *INTERPROFESSIONAL relations , *EDUCATIONAL outcomes , *HIGH school students , *SCIENTIFIC observation , *LEADERSHIP , *FOOD security , *SCHOOL administrators , *DESCRIPTIVE statistics , *TEACHERS , *MIDDLE school students , *SCHOOL children , *HEALTH education , *FOOD preferences , *NUTRITION education - Abstract
BACKGROUND: This paper presents the process taken by a nonprofit educational organization to create authentic evaluation tools for Food Education in K‐12 schools. Development was a collaborative effort between organization staff and teachers during an Evaluation Summit. The program background, development of the Summit, and plans for post‐Summit work continuation are described. The Summit included 14 teacher participants (3‐4 per grade band in preK‐1, 2‐5, 6‐8, 9‐12). METHODS: The process of tool development was captured via direct observations and analysis of artifacts (eg, participants' brainstorming chart paper, online development documents) to identify themes in successful approaches and challenges. Additional post‐Summit activities were also captured via surveys and artifacts. Outcomes of this work are outlined, including the challenges in carrying out the creation of authentic assessments that accurately reflect the classroom teaching experience, and the value of in‐person community building in the Food Education space. RESULTS: Key findings relate to the importance of in‐person collaboration amongst teachers, centering students in evaluation, and equity and accessibility in tool development. CONCLUSIONS: Although outlining challenges and outcomes was not an a priori goal of this work, it provides important information for others working in the education nonprofit space—especially as it pertains to new approaches to classroom evaluation. [ABSTRACT FROM AUTHOR]
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- 2024
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3. High prevalence of medication errors in a secondary‐level Lithuanian hospital: A prospective cross‐sectional observational study.
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Butauskaite, J., Zumbakyte, A., Aukstikalne, L., Pancere, J., Zukaitiene, S., and Karinauske, E.
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MEDICATION errors ,CROSS-sectional method ,UNIVERSITY hospitals ,SCIENTIFIC observation ,DRUGSTORES ,PHYSICIANS ,HOSPITALS - Abstract
As the population continues to age, the occurrence of chronic illnesses and comorbidities that often necessitate the use of polypharmacy has been on the rise. Polypharmacy, among other factors that tend to coincide with chronic diseases, such as obesity, impaired kidney and liver function, and older age, can increase the risk of medication errors (MEs). Our study aims to evaluate the prevalence of MEs in the Internal medicine, Cardiology, and Neurology departments at the secondary‐level university hospital. We conducted a prospective observational study of 145 patients' electronic or paper‐based data of inpatient prescriptions and patients' pharmacokinetic risk factors, such as an impairment of renal and/or hepatic function, weight, and age. All included patients collectively received 1252 prescribed drugs. The median (Q1; Q3) number of drugs per patient was 8 (7;10). At least one ME was identified in 133 out of the 145 patients, indicating a significantly higher prevalence than hypothesized (91.7% vs. 50%; p <.001). There was moderate, positive correlation between the quantity of prescribed drugs and the number of MEs, meaning that the more drugs are prescribed, the higher the number of identified MEs (Spearman's ρ = 0.428; p <.001). These findings suggest that there is a need for continuous medication education activity for prescribing physicians, continuous evaluation of prescription appropriateness to objectively identify the MEs and to contribute to more rational patient treatment. [ABSTRACT FROM AUTHOR]
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- 2024
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4. Considerations for paediatric student‐led telepractice in speech‐language therapy: A pilot observational study from South Africa.
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Watermeyer, Jennifer, Nattrass, Rhona, Beukes, Johanna, Madonsela, Sonto, and Scott, Megan
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SPEECH therapists , *QUALITATIVE research , *OCCUPATIONAL adaptation , *MEDICAL technology , *RESEARCH funding , *HEALTH occupations students , *PILOT projects , *SCIENTIFIC observation , *UNIVERSITIES & colleges , *DIGITAL divide , *SOCIAL role , *DESCRIPTIVE statistics , *PEDIATRICS , *STUDENTS , *TELEMEDICINE , *THEMATIC analysis , *CLIENT relations , *INFORMATION literacy , *RESEARCH , *RESOURCE-limited settings , *SOCIAL support , *INTERNET service providers , *SPEECH therapy , *VIDEO recording - Abstract
Background: COVID‐19 necessitated emergency telepractice for student‐led speech‐language therapy clinical practicals in training institutions, with limited preparation and evidence‐based guidelines. Beyond the pandemic, practitioners and university training sites are likely to continue to offer telepractice necessitating thorough preparation for telepractice services underpinned by a comprehensive understanding of the complexities involved in online therapy. Aims: Adopting realist evaluation principles, our aim in this paper was to explore broadly what works and does not work in a set of student‐led telepractice sessions in a diverse, resource‐limited context. The broader goal of this project was to provide evidence‐based support to enhance the efficiency and success of telepractice sessions in student clinical training contexts. Methods & Procedures: We used qualitative observational methods with reflexive thematic analysis to analyse 28 video recordings and 61 observation notes of student‐led paediatric telepractice sessions from a South African university clinic as part of a pilot study. Outcomes & Results: We identified four overarching considerations for student‐led telepractice: (1) additional, specific preparation is required, (2) with greater management of technology and adaptation of tasks, especially during times of poor connectivity; (3) telepractice relies heavily on caregiver input and collaboration; and (4) promoting engagement online, holding a client's attention, building rapport and offering reinforcement are critical skills that are complicated by the lack of face‐to‐face contact. Conclusions & Implications: Our findings indicate that telepractice pedagogy needs to be explicitly taught and students require practical assistance as they learn how to use this service delivery approach effectively. There are some aspects peculiar to telepractice that require unique consideration and planning, especially in contexts where service providers and users may be unfamiliar with this form of service provision. The findings of this pilot study can be used by clinical educators and student clinicians to enhance clinical training opportunities involving telepractice. WHAT THIS PAPER ADDS: What is already known on this subject: Many speech‐language therapy (SLT) student clinicians had to transition quickly to telepractice service provision during COVID‐19 with limited existing guidelines and support, especially in contexts where teletherapy is typically non‐existent or difficult to access. Although there is some literature available on experiences of telepractice, there is very little evidence‐based research which explores the mechanics of such sessions in real‐time and which offers practical support to student clinicians and clinical educators engaging in this mode of service delivery. What this study adds: This pilot study examined video‐recorded, student‐led, paediatric, speech‐language teletherapy sessions to understand challenges and considerations involved in using telepractice as a clinical training tool. Findings show that additional preparation for telepractice sessions is required, particularly in contexts of poor digital literacy; students must learn to manage technology, especially when connectivity poses a challenge, and adapt therapy tasks for online work with clients; telepractice relies heavily on caregiver input and collaboration, more so than in in‐person consultations, and this relationship requires careful management; and promoting engagement online, holding a client's attention, building rapport and offering reinforcement are critical yet challenging skills in telepractice. What are the potential or actual clinical implications of this work?: Our findings highlight a need to teach telepractice pedagogy explicitly and support students practically in learning how to provide therapy effectively via this mode of service delivery. Observational methods for studying practices in recorded telepractice sessions can be used as part of a reflective approach to clinical training. Using already available data allowed us to unpack the 'messy reality' of clinical training using telepractice. [ABSTRACT FROM AUTHOR]
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- 2024
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5. Analysing applications of neuromarketing in efficacy of programmatic advertising.
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Bajaj, Radheyshyam, Ali Syed, Asif, and Singh, Surabhi
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NEUROMARKETING ,CONSUMER behavior ,ADVERTISING ,EYE tracking ,SCIENTIFIC observation ,BRAIN research - Abstract
In this paper, there is exploration of the concept of neuromarketing as a newly developed strategy with economic potential deriving from human brain research. The central notion of the essay is that programmatic advertising can be used to better comprehend the idea of neuromarketing and its impact on consumers' decision‐making. So neuromarketing involves the scientific observation of brainwave activity, eye tracking, and skin response to determine how people's brains react to advertisements and other brand‐related communications. By studying the brain, these neuromarketing strategies can forecast how consumers will make decisions. The neuromarketing tactics' benefits and constraints are studied on a number of market input devices in the paper. The influence of various techniques of neuromarketing is studied from the available research studies and literature. In the recent years, the neuromarketing concept has been able to garner a lot of importance in its contribution to the marketing, advertising, and programmatic advertising has been immensely helped by the understanding of consumer decision making. The consumer behaviour has been able to be comprehended through neuromarketing techniques which are one of the key pillars of the purpose and running of programmatic advertising. A neuromarketing study shall be the helping hand for increasing customer base, market leadership, and converting them to loyal customers. It will help in programmatic advertising through the understanding of the advertiser with respect to the likes and wants of the customers and how consumer attention can be drawn. The consumer behaviour can be understood by the marketers in terms of how the consumers react to the advertising. [ABSTRACT FROM AUTHOR]
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- 2024
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6. Successful aging after elective surgery II: Study cohort description.
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Ward, Michelle, Hshieh, Tammy T., Schmitt, Eva M., Arnold, Steven E., Cavallari, Michele, Dickerson, Bradford C., Dillon, Simon T., Fong, Tamara G., Jones, Richard N., Libermann, Towia A., Pascual‐Leone, Alvaro, Shafi, Mouhsin M., Touroutoglou, Alexandra, Weng, Karen, Xu, Guoquan, Earp, Brandon E., Kunze, Lisa, Lange, Jeffrey, Vlassakov, Kamen, and Marcantonio, Edward R.
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ELECTIVE surgery , *BIOMARKERS , *ACTIVE aging , *ALZHEIMER'S disease , *SCIENTIFIC observation , *TOTAL knee replacement , *TOTAL hip replacement , *MINORITIES , *PREOPERATIVE period , *HEALTH status indicators , *INTERVIEWING , *GERIATRIC assessment , *RISK assessment , *TREATMENT effectiveness , *ELECTROPHYSIOLOGY , *DEMENTIA , *DELIRIUM , *INDEPENDENT living , *HOSPITAL care , *DESCRIPTIVE statistics , *RESEARCH funding , *COGNITIVE testing , *NEURORADIOLOGY , *LONGITUDINAL method , *DISCHARGE planning , *COVID-19 pandemic , *DISEASE complications - Abstract
Background: The Successful Aging after Elective Surgery (SAGES) II Study was designed to examine the relationship between delirium and Alzheimer's disease and related dementias (AD/ADRD), by capturing novel fluid biomarkers, neuroimaging markers, and neurophysiological measurements. The goal of this paper is to provide the first complete description of the enrolled cohort, which details the baseline characteristics and data completion. We also describe the study modifications necessitated by the COVID‐19 pandemic, and lay the foundation for future work using this cohort. Methods: SAGES II is a prospective observational cohort study of community‐dwelling adults age 65 and older undergoing major non‐cardiac surgery. Participants were assessed preoperatively, throughout hospitalization, and at 1, 2, 6, 12, and 18 months following discharge to assess cognitive and physical functioning. Since participants were enrolled throughout the COVID‐19 pandemic, procedural modifications were designed to reduce missing data and allow for high data quality. Results: About 420 participants were enrolled with a mean (standard deviation) age of 73.4 (5.6) years, including 14% minority participants. Eighty‐eight percent of participants had either total knee or hip replacements; the most common surgery was total knee replacement with 210 participants (50%). Despite the challenges posed by the COVID‐19 pandemic, which required the use of novel procedures such as video assessments, there were minimal missing interviews during hospitalization and up to 1‐month follow‐up; nearly 90% of enrolled participants completed interviews through 6‐month follow‐up. Conclusion: While there are many longitudinal studies of older adults, this study is unique in measuring health outcomes following surgery, along with risk factors for delirium through the application of novel biomarkers—including fluid (plasma and cerebrospinal fluid), imaging, and electrophysiological markers. This paper is the first to describe the characteristics of this unique cohort and the data collected, enabling future work using this novel and important resource. [ABSTRACT FROM AUTHOR]
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- 2024
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7. G‐formula for observational studies under stratified interference, with application to bed net use on malaria.
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Kilpatrick, Kayla W., Lee, Chanhwa, and Hudgens, Michael G.
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MALARIA , *SCIENTIFIC observation , *COMMUNICABLE diseases , *DEMOGRAPHIC surveys , *HEALTH surveys - Abstract
Assessing population‐level effects of vaccines and other infectious disease prevention measures is important to the field of public health. In infectious disease studies, one person's treatment may affect another individual's outcome, that is, there may be interference between units. For example, the use of bed nets to prevent malaria by one individual may have an indirect effect on other individuals living in close proximity. In some settings, individuals may form groups or clusters where interference only occurs within groups, that is, there is partial interference. Inverse probability weighted estimators have previously been developed for observational studies with partial interference. Unfortunately, these estimators are not well suited for studies with large clusters. Therefore, in this paper, the parametric g‐formula is extended to allow for partial interference. G‐formula estimators are proposed for overall effects, effects when treated, and effects when untreated. The proposed estimators can accommodate large clusters and do not suffer from the g‐null paradox that may occur in the absence of interference. The large sample properties of the proposed estimators are derived assuming no unmeasured confounders and that the partial interference takes a particular form (referred to as 'weak stratified interference'). Simulation studies are presented demonstrating the finite‐sample performance of the proposed estimators. The Demographic and Health Survey from the Democratic Republic of the Congo is then analyzed using the proposed g‐formula estimators to assess the effects of bed net use on malaria. [ABSTRACT FROM AUTHOR]
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- 2024
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8. Supporting safe swallowing of care home residents with dysphagia: How does the care delivered compare with guidance from speech and language therapists?
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Griffin, Hannah, Wilson, Jennie, Tingle, Alison, Görzig, Anke, Harrison, Kirsty, Harding, Celia, Aujla, Sukhpreet, Barley, Elizabeth, and Loveday, Heather
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PATIENT safety , *RESEARCH funding , *MEDICAL care , *SCIENTIFIC observation , *ASPIRATION pneumonia , *DESCRIPTIVE statistics , *RESPIRATORY obstructions , *NURSING care facilities , *ETHICS , *SENIOR housing , *DEGLUTITION , *SOCIAL support , *COMPARATIVE studies , *DEGLUTITION disorders , *SPEECH therapy - Abstract
Introduction: Dysphagia affects up to 70% of care home residents, increasing morbidity and hospital admissions. Speech and language therapists make recommendations to support safe nutrition but have limited capacity to offer ongoing guidance. This study aimed to understand if recommendations made to support safe and effective care are implemented and how these relate to the actual care delivered. Methods: Eleven mealtimes with residents with dysphagia were observed during 2020 using a tool capturing 12 elements of expected practice. Staff actions during mealtimes were compared with adherence to residents' care plans and speech and language therapist recommendations. Results: Written recommendations predominantly focused on food and fluid modification. Observations (n = 66) revealed food texture, posture, and alertness were adhered to on 90% of occasions, but alternating food and drink, prompting and ensuring swallow completed adherence was less than 60%. Thickened fluids frequently did not align with required International Dysphagia Diet Standardisation Initiative levels. Nutrition care provided in the dining room was less safe due to a lack of designated supervision. Conclusion: Care homes need to be supported to establish a safe swallowing culture to improve residents' safety and care experience. WHAT THIS PAPER ADDS: What is already known on this subject?: Dysphagia is associated with considerable morbidity and mortality and has been identified as an independent risk factor for mortality in nursing home residents.There is evidence that compensatory swallowing strategies, safe feeding advice and dietary modifications can reduce the risk of aspiration pneumonia.Care for nursing home residents at mealtimes is often task‐centred and delegated to those with limited training and who lack knowledge of useful strategies to support the nutrition and hydration needs of residents with dysphagia. What this study adds?: Written advice from speech and language therapists on safe nutrition and hydration for residents with dysphagia is focused mainly on food and fluid modification.Nurses and healthcare assistants have limited understanding of International Dysphagia Diet Standardisation Initiative levels or safe swallowing strategies and recommended practices to support safe nutrition care for residents with dysphagia are inconsistently applied especially when residents are eating in dining areas.Care homes are not aware of Royal College of Speech and Language Therapists guidance on how safe nutrition care of residents with dysphagia should be supported. What are the clinical implications of this work?: Care homes need to prioritise a safe swallowing culture that ensures that residents with swallowing difficulties are assisted to eat and drink in a way that enhances their mealtime experience and minimises adverse events that may result in hospital admission.Speech and language therapists could play an important role in training and supporting care home staff to understand and use safe swallowing strategies with residents with dysphagia.The Royal College of Speech and Language Therapists could provide more assistance to care homes to support and guide them in how to implement safe feeding routines.Care home staff have limited knowledge about how to implement safe feeding routines and need more guidance from speech and language specialists on how they can support residents with dysphagia to eat safely.Creating a safe swallowing culture within care homes could help to improve nutrition care and enhance patient safety. [ABSTRACT FROM AUTHOR]
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- 2024
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9. Target trial emulation for comparative effectiveness research with observational data: Promise and challenges for studying medications for opioid use disorder.
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Christine, Paul J., Lodi, Sara, Hsu, Heather E., Bovell‐Ammon, Benjamin, Yan, Shapei, Bernson, Dana, Novo, Patricia, Lee, Joshua D., Rotrosen, John, Liebschutz, Jane, Walley, Alexander Y., and Larochelle, Marc R.
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MORTALITY prevention , *SUBSTANCE abuse , *CLINICAL trials , *SCIENTIFIC observation , *TREATMENT effectiveness , *RANDOMIZED controlled trials , *OPIOID analgesics , *MEDICAL research , *CONCEPTUAL structures , *INFERENTIAL statistics , *COMPARATIVE studies , *QUALITY assurance , *NALOXONE , *BUPRENORPHINE , *NALTREXONE , *EVALUATION - Abstract
Medications for opioid use disorder (MOUD) increase retention in care and decrease mortality during active treatment; however, information about the comparative effectiveness of different forms of MOUD is sparse. Observational comparative effectiveness studies are subject to many types of bias; a robust framework to minimize bias would improve the quality of comparative effectiveness evidence. This paper discusses the use of target trial emulation as a framework to conduct comparative effectiveness studies of MOUD with administrative data. Using examples from our planned research project comparing buprenorphine‐naloxone and extended‐release naltrexone with respect to the rates of MOUD discontinuation, we provide a primer on the challenges and approaches to employing target trial emulation in the study of MOUD. [ABSTRACT FROM AUTHOR]
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- 2024
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10. Designing observational studies for credible causal inference in addiction research—Directed acyclic graphs, modified disjunctive cause criterion and target trial emulation.
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Chan, Gary C. K., Sun, Tianze, Stjepanović, Daniel, Vu, Giang, Hall, Wayne D., Connor, Jason P., and Leung, Janni
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SUBSTANCE abuse , *MATHEMATICAL variables , *CAUSAL models , *SCIENTIFIC observation , *EXPERIMENTAL design , *RESEARCH bias , *CAUSALITY (Physics) , *MEDICAL research , *INFERENTIAL statistics , *RESEARCH , *ATTRIBUTION (Social psychology) - Abstract
Randomized controlled trials (RCTs) are considered the gold standard for causal inference. With a sufficient sample size, randomization removes confounding up to the time of randomization and allows the treatment effect to be isolated. However, RCTs may have limited generalizability and transportability and are often not feasible in addiction research due to ethical or logistical constraints. The importance of observational studies from real‐world settings has been increasingly recognized in research on health. This paper provides an overview of modern approaches to designing observational studies that enable causal inference. It illustrates three key techniques, Directed Acyclic Graphs (DAGs), modified Disjunctive Cause Criterion and Target Trial Emulation, and discusses the strengths and limitations of their applications. [ABSTRACT FROM AUTHOR]
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- 2024
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11. Artificial intelligence education for young children: A case study of technology‐enhanced embodied learning.
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Yang, Weipeng, Hu, Xinyun, Yeter, Ibrahim H., Su, Jiahong, Yang, Yuqin, and Lee, John Chi‐Kin
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DIGITAL technology , *SCHOOL environment , *CURRICULUM , *ELEMENTARY schools , *RESEARCH funding , *ARTIFICIAL intelligence , *SCIENTIFIC observation , *INTERVIEWING , *EDUCATIONAL outcomes , *TEACHING methods , *JUDGMENT sampling , *TEACHERS , *RESEARCH methodology , *CHILD development , *COMPUTER literacy , *STORYTELLING , *RESEARCH , *LEARNING strategies , *COMPUTER assisted instruction , *LITERACY , *CASE studies , *CHILDREN - Abstract
Background: Artificial Intelligence (AI) literacy is a crucial part of digital literacy that all individuals should possess in today's technologically advanced world. Despite the potential benefits that AI education offers, little research has been done on how to teach AI literacy to children. Objectives: This study aimed to fill that gap by investigating how children were engaged in AI literacy activities that are supported by intelligent agents. These activities were implemented in a Hong Kong kindergarten with a class of six 5‐year‐olds (Mage = 62.83 months, SD = 2.91) over a 6‐week period. Methods: The study gathered data from multiple sources, including classroom observations, teacher interviews, and documents/artefacts. Results and Conclusions: The results showed that children could learn about AI through interaction with intelligent agents in embodied learning contexts. The findings of this study have implications for the broader field of digital technology education, particularly in the context of early childhood education. Lay Description: What is already known about this topic: Artificial Intelligence (AI) literacy is essential in today's world.Little research exists on engaging young children in learning AI literacy. What this paper adds: Technology‐enhanced embodied learning approach affords multimodality in enabling young children's learning with AI‐related agents.Project‐based learning and real‐life examples can enhance children's learning. Implications for practice and/or policy: Early exposure to AI can help children navigate the increasingly digital world.Practical approaches, such as embodied and multimodal learning, seem to be effective.Teachers can enhance children's digital learning by using pedagogical strategies like project‐based learning and real‐life examples. [ABSTRACT FROM AUTHOR]
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- 2024
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12. Edentulism among diabetic patients compared to non‐diabetic controls: A systematic review and meta‐analysis.
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Žiūkaitė, Laura, Weijdijk, Lotte P. M., Tang, Jennifer, Slot, Dagmar Else, and van der Weijden, G. A.
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DIABETES prevention ,ONLINE information services ,MEDICAL databases ,META-analysis ,SCIENTIFIC observation ,CONFIDENCE intervals ,SYSTEMATIC reviews ,EDENTULOUS mouth ,PERIODONTAL disease ,MEDICAL screening ,PSYCHOSOCIAL factors ,DESCRIPTIVE statistics ,QUALITY assurance ,RESEARCH funding ,MEDLINE ,ODDS ratio ,PEOPLE with diabetes - Abstract
Objective: The purpose of this paper is to systematically and critically appraise the available scientific evidence concerning the prevalence of edentulism among diabetic patients compared to non‐diabetic people. Methods: MEDLINE‐PubMed and Cochrane‐CENTRAL databases were comprehensively searched up to April 2023 to identify appropriate studies. The inclusion criteria were observational studies conducted in human subjects ≥18 years of age with the primary aim of investigating the prevalence of edentulism among diabetic patients. Based on the extracted data, a meta‐analysis was performed. Recommendations based on the body of evidence were formulated using the GRADE approach. Results: Independent screening of 2085 unique titles and abstracts revealed seven publications that met the eligibility criteria. Study size ranged from 293 to 15,943 participants. Data from all seven studies were suitable for meta‐analysis. Overall, 8.3% of the studied population was edentulous. The weighted mean prevalence of edentulism among diabetic and non‐diabetics was 14.0% and 7.1%, respectively. The overall odds ratio for diabetic patients to be edentulous as compared to non‐diabetics was 2.39 (95% CI [1.73, 3.28], p < 0.00001). Conclusion: There appears to be moderate certainty that the risk of being edentulous for diabetic patients compared to non‐diabetic people is significant, but the odds ratio is estimated to be small. [ABSTRACT FROM AUTHOR]
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- 2024
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13. Hydrological modeling of the Silala River basin. 1. Model development and long‐term groundwater recharge assessment.
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Yáñez‐Morroni, Gonzalo, Suárez, Francisco, Muñoz, José F., and Lagos, Magdalena Sofía
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GROUNDWATER recharge , *WATERSHEDS , *HYDROLOGIC models , *SCIENTIFIC literature , *SCIENTIFIC observation , *WATER use - Abstract
The Silala is a small river, originating in the Andean Altiplano, which flows from Bolivia into Chile. Prior to a legal dispute between Chile and Bolivia over the status and use of the waters of the Silala, few hydrological studies had been performed in the basin. Further insights were required to better understand the surface‐water and groundwater discharges from Bolivia to Chile, and the effects of historical channelization of the Bolivian wetlands on these flows. A semi‐distributed hydrological model was therefore developed to estimate the discharges from the basin and provide recharge inputs to a groundwater model used to investigate the effects of channelization. Long‐term temperature and precipitation data were available for 1969–1992, while more detailed data were available for 2018–2019. 1969–1992 was selected as a suitable length of record for long‐term groundwater recharge estimation, and the recent data were reserved for model validation, reported in a companion paper. Prior model parameter ranges were identified based on field observations and scientific literature, and sampling of both input and parameter uncertainty allowed determination of representative, lower and upper groundwater recharge scenarios. Results show strong inter‐annual and seasonal variability, the largest groundwater recharge being observed during the Austral summer. A representative groundwater recharge rate of 39.5 mm/year was obtained for the basin to the international border, with feasible lower and upper bounds of 34.9 and 50.2 mm/year, respectively. This lies within the range of 21–51 mm/year estimated by Bolivia for 1969–2017, albeit higher than their best estimate (24 mm/year). This article is categorized under:Science of Water > Hydrological Processes [ABSTRACT FROM AUTHOR]
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- 2024
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14. Bioimpedance sensor array for monitoring chronic wounds: Validation of method feasibility.
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Antoszewska, Magdalena, Spychalski, Piotr, Kekonen, Atte, Viik, Jari, and Barańska‐Rybak, Wioletta
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PATIENT monitoring equipment ,WOUND healing ,ULCERS ,RESEARCH funding ,SCIENTIFIC observation ,BIOELECTRIC impedance ,DESCRIPTIVE statistics ,TRAUMATOLOGY diagnosis ,WOUND care ,CHRONIC wounds & injuries - Abstract
In an ageing society, the incidence of hard‐to‐heal wounds is rising. Chronic wound healing is a complex process, which requires specialised treatment. Clinical assessment of the wound is essential to establish care approaches but is usually based on visual evaluation and it remains challenging. Therefore, innovative quantitative methods for the assessment of chronic wounds are needed. We conducted a single‐centre observational study designed to assess the feasibility of a bioimpedance measurement method conducted with a multielectrode sensor array to monitor the wound healing process in patients with chronic wounds of venous, mixed venous–arterial and diabetic aetiology. In total, 104 measurements of bioimpedance were conducted in 18 ulcers during the study. Across all 7 patients analysed, the bioimpedance of the ulcers was consistently increasing as the wound surface was decreasing. The variables had significant (p < 0.001) and strong negative correlation (r = −0.86). We validated the feasibility of the bioimpedance measurement method for the monitoring of the wound healing process on the lower legs. It may be a promising quantitative method for monitoring the status of the wounds. However, long‐term measurements are needed to show the usability of the electrode dressing and bioimpedance measurement in the assessment of chronic wounds. [ABSTRACT FROM AUTHOR]
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- 2024
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15. Treatment patterns and clinical outcomes of resectable clinical stage III non‐small cell lung cancer in a Japanese real‐world setting: Surgery cohort analysis of the SOLUTION study.
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Tsuboi, Masahiro, Murakami, Haruyasu, Harada, Hideyuki, Sobue, Tomotaka, Kato, Tomohiro, Atagi, Shinji, Tokito, Takaaki, Mio, Tadashi, Adachi, Hirofumi, Kozuki, Toshiyuki, Sone, Takashi, Seike, Masahiro, Toyooka, Shinichi, Kitagawa, Hiroshi, Koto, Ryo, Yamazaki, Satoshi, and Horinouchi, Hidehito
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SURGERY ,PATIENTS ,THORACOTOMY ,RESEARCH funding ,SCIENTIFIC observation ,TREATMENT effectiveness ,CANCER patients ,DESCRIPTIVE statistics ,ADJUVANT chemotherapy ,LONGITUDINAL method ,RESEARCH ,COMBINED modality therapy ,LUNG cancer ,TUMOR classification ,COMPARATIVE studies ,PROGRESSION-free survival ,CONFIDENCE intervals ,PERIOPERATIVE care ,PNEUMONECTOMY ,OVERALL survival ,PROPORTIONAL hazards models ,REGRESSION analysis - Abstract
Background: To elucidate the treatment and surgery outcomes with or without perioperative therapies in Japanese patients with clinical stage III non‐small cell lung cancer (NSCLC) in real‐world settings. Methods: We performed subset analyses of the SOLUTION study, a multicenter, noninterventional, observational study of Japanese patients diagnosed with clinical stage III NSCLC, for those who started first‐line treatment (surgery±perioperative therapy) between January 2013 and December 2014 (study registration: UMIN000031385). Follow‐up data were obtained using medical records from diagnosis to March 1, 2018. Results: Of 149 eligible patients, 67 underwent surgery alone (median age 71 years) and 82 underwent surgery+perioperative therapy (median age 63 years). Lung resection was performed in 137 patients and the others underwent exploratory thoracotomy or other procedures. Perioperative therapies included adjuvant therapy only (n = 41), neoadjuvant therapy only (n = 24), and neoadjuvant+adjuvant therapy (n = 17). The median overall survival (OS) and 3‐year OS rate were 29.3 months and 44.0%, respectively, in patients who underwent surgery alone, and not reached and 61.1%, respectively, in patients who underwent surgery+perioperative therapy. The 3‐year progression‐free survival (PFS) and disease‐free survival (DFS) rates were 42.4% and 47.1%, respectively, in patients who underwent surgery+perioperative therapy and 28.5% and 28.9%, respectively, in patients who underwent surgery alone. In multivariable Cox regression, perioperative therapy was associated with improved OS (hazard ratio [95% confidence interval] 0.49 [0.29–0.81]), PFS (0.62 [0.39–0.96]), and DFS (0.62 [0.39–0.97]) versus surgery alone. Conclusions: Our study suggested that perioperative therapy may be associated with better survival among patients undergoing surgical treatment of clinical stage III NSCLC. [ABSTRACT FROM AUTHOR]
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- 2024
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16. Efficacy and Safety of Azvudine in Patients With COVID‐19 in China: A Meta‐Analysis of Observational Studies.
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Dong, Tao, Zhang, Wentao, Wu, Tingting, Ge, Yongxiang, Yang, Qi, Xu, Jia, and Liu, Yuna
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COVID-19 ,PATIENT safety ,COVID-19 treatment ,SCIENTIFIC observation ,LENGTH of stay in hospitals - Abstract
Background: Azvudine (FNC) is a novel small molecule antiviral drug for treating COVID‐19 that is available only on the Chinese market. Despite being recommended for treating COVID‐19 by the Chinese guidelines, its efficacy and safety are still unclear. This study aimed to evaluate the protective effect of FNC on COVID‐19 outcomes and its safety. Methods: We followed the PRISMA 2020 guidelines and searched the PubMed, Embase, Web of Science, Scopus, and China National Knowledge Infrastructure (CNKI) databases to evaluate studies on the effectiveness of FNC in treating COVID‐19 in China, focusing on mortality and overall outcomes. Additionally, its impact on the length of hospital stay (LOHS), time to first nucleic acid negative conversion (T‐FNANC), and adverse events was evaluated. The inclusion criterion was that the studies were published from July 2021 to April 10, 2024. This study uses the ROBINS‐I tool to assess bias risk and employs the GRADE approach to evaluate the certainty of the evidence. Results: The meta‐analysis included 24 retrospective studies involving a total of 11 830 patients. Low‐certainty evidence revealed no significant difference in mortality (OR = 0.91, 95% CI: 0.76–1.08) or LOHS (WMD = −0.24, 95% CI: −0.83 to 0.35) between FNC and Paxlovid in COVID‐19 patients. Low‐certainty evidence shows that the T‐FNANC was longer (WMD = 1.95, 95% CI: 0.36–3.53). Compared with the Paxlovid group, low‐certainty evidence shows the FNC group exhibited a worse composite outcome (OR = 0.77, 95% CI: 0.63–0.95) and fewer adverse events (OR = 0.63, 95% CI: 0.46–0.85). Compared with supportive treatment, low certainty shows FNC significantly reduced the mortality rate in COVID‐19 patients (OR = 0.61, 95% CI: 0.51–0.74) and decreased the composite outcome (OR = 0.67, 95% CI: 0.50–0.91), and very low certainty evidence shows significantly decreased the T‐FNANC (WMD = −4.62, 95% CI: −8.08 to −1.15). However, in very low certainty, there was no significant difference in LOHS (WMD = −0.70, 95% CI: −3.32 to 1.91) or adverse events (OR = 1.97, 95% CI: 0.48–8.17). Conclusions: FNC appears to be a safe and potentially effective treatment for COVID‐19 in China, but further research with larger, high‐quality studies is necessary to confirm these findings. Due to the certainty of the evidence and the specific context of the studies conducted in China, caution should be exercised when considering whether the results are applicable worldwide. Trial Registration: PROSPERO number: CRD42024520565 [ABSTRACT FROM AUTHOR]
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- 2024
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17. The incidence of surgical site infection following major lower limb amputation: A systematic review.
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Al‐Saadi, Nina, Al‐Hashimi, Khalid, Popplewell, Matthew, Fabre, Ismay, Gwilym, Brenig Llwyd, Hitchman, Louise, Chetter, Ian, Bosanquet, David C., and Wall, Michael L.
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LEG surgery ,AMPUTATION ,MEDICAL information storage & retrieval systems ,SCIENTIFIC observation ,PERIPHERAL vascular diseases ,DESCRIPTIVE statistics ,SYSTEMATIC reviews ,DISEASES ,MEDLINE ,LEG amputation ,SURGICAL site infections ,DIABETES - Abstract
Surgical site infections (SSIs) following major lower limb amputation (MLLA) in vascular patients are a major source of morbidity. The objective of this systematic review was to determine the incidence of SSI following MLLA in vascular patients. This review was prospectively registered with the International Prospective Register of Systematic Reviews (CRD42023460645). Databases were searched without date restriction using a pre‐defined search strategy. The search identified 1427 articles. Four RCTs and 21 observational studies, reporting on 50 370 MLLAs, were included. Overall SSI incidence per MLLA incision was 7.2% (3628/50370). The incidence of SSI in patients undergoing through‐knee amputation (12.9%) and below‐knee amputation (7.5%) was higher than the incidence of SSI in patients undergoing above‐knee amputation, (3.9%), p < 0.001. The incidence of SSI in studies focusing on patients with peripheral arterial disease (PAD), diabetes or including patients with both was 8.9%, 6.8% and 7.2%, respectively. SSI is a common complication following MLLA in vascular patients. There is a higher incidence of SSI associated with more distal amputation levels. The reported SSI incidence is similar between patients with underlying PAD and diabetes. Further studies are needed to understand the exact incidence of SSI in vascular patients and the factors which influence this. [ABSTRACT FROM AUTHOR]
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- 2024
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18. Association between hepcidin levels and inflammatory bowel disease: A systematic review and meta‐analysis of observational studies.
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Soltanieh, Samira, Salavatizadeh, Marieh, Gaman, Mihnea‐Alexandru, Kord Varkaneh, Hamed, Tan, Shing Cheng, Prabahar, Kousalya, Lozovanu, Oana Deliu, Santos, Heitor O., and Hekmatdoost, Azita
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INFLAMMATORY bowel diseases ,HEPCIDIN ,IRON in the body ,SCIENTIFIC observation - Abstract
Hepcidin has a crucial role in iron homeostasis upon inflammatory conditions such as inflammatory bowel disease (IBD). Thus, we conducted a systematic review and meta‐analysis to determine the overall association between serum hepcidin concentrations and IBD. Based on the preferred reporting items for systematic review and meta‐analysis (PRISMA) protocols, an electronic literature search was conducted on PubMed/MEDLINE, Scopus, and Web of Science until June 2020. Studies were deemed eligible for inclusion if they met the following criteria: (1) diagnosis of IBD, (2) observational design, and (3) measured serum hepcidin and prohepcidin concentrations in IBD patients and control group. Overall, 10 studies including 1184 participants were evaluated. Random‐effects meta‐analysis revealed that subjects with IBD had 7.22 ng/mL (95% CI: 2.10, 12.34; p =.006) higher serum hepcidin concentrations compared to control groups. A nonsignificantly lower serum prohepcidin concentration (0.522 ng/mL, 95% CI: −1.983 to 0.939; p =.484) was found for IBD patients compared to healthy subjects. However, there was significant heterogeneity among the studies regarding both hepcidin (I2 = 98%, p <.001) and prohepcidin levels (I2 = 96%, p <.001), respectively. In an age‐based subgroup analysis, patients aged ≥18 years with IBD displayed higher serum hepcidin levels when compared to healthy individuals (22.36 ng/mL, 95% CI, 2.12–42.61; p =.030). Hepcidin concentrations are elevated in subjects with IBD; however, the clinical relevance of this finding requires further evaluation in future investigations as the increase is relatively small compared to the wide range of normal hepcidin values. [ABSTRACT FROM AUTHOR]
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- 2024
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19. Diagnostic outcomes of radial endobronchial ultrasound bronchoscopy guided by manual navigation in the evaluation of peripheral pulmonary lesions: An observational study.
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Yuan, Mingli, Hu, Yi, Wang, Liangchao, Yin, Wen, and Xiao, Yang
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BRONCHOSCOPY ,ULTRASONIC imaging ,COMPUTED tomography ,ROAD maps ,SCIENTIFIC observation ,ODDS ratio - Abstract
Background and Aims: Manual navigation (MN), drawing a bronchoscopic road map simply by looking at the consecutive computed tomography (CT), is feasible and economical. However, scant data about the use of MN in radial endobronchial ultrasound (r‐EBUS) bronchoscopy have been documented till now. We aimed to evaluate the diagnostic performance of r‐EBUS bronchoscopy guided by MN for diagnosing peripheral pulmonary lesions (PPLs) and to determine clinical factors affecting the diagnostic yield. Methods: We performed a retrospective, cohort study of consecutive patients with PPLs who underwent r‐EBUS bronchoscopic biopsy via guidance of MN from May 2020 to June 2021 in our Respiratory Endoscopic Division. The overall diagnostic yield of MN‐guided r‐EBUS, the factors affecting the yield, and the diagnostic performance for malignancy were evaluated. Results: A total of 102 patients (103 lesions) were evaluated. The overall diagnostic yield of MN‐guided r‐EBUS was 82.0%, and it ranged from 79.6% to 82.5%, assuming the undermined cases were all positive cases (79.6%) or negatives (82.5%). The sensitivity of MN‐guided r‐EBUS for malignancy was 71.4%, ranging from 68.2% to 71.4%, the specificity was 100%, the positive predictive value was 100%, and the negative predictive value was 67.3%, ranging from 63.8% to 69.0%. The multivariate logistic regression showed that "bronchus sign on CT" was the only predictor of the overall diagnostic yield (odds ratio = 11.5, 95% confidence interval: 1.9–70.9, P = 0.009). Conclusions: MN‐guided r‐EBUS is feasible in diagnosing PPLs, especially for lesions with bronchus sign on CT. [ABSTRACT FROM AUTHOR]
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- 2024
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20. Psychophysical, electrofunctional, and morphological evaluation in naïve neovascular AMD patients treated with intravitreal anti‐VEGF.
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Nebbioso, Marcella, Franzone, Federica, Milanese, Alberto, Artico, Marco, Taurone, Samanta, La Cava, Maurizio, Livani, Maria Luisa, Bonfiglio, Vincenza, and Vestri, Annarita
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RETINA physiology ,RETINAL anatomy ,VASCULAR endothelial growth factor antagonists ,PSYCHOPHYSIOLOGY ,DATA analysis ,RETINAL degeneration ,INTRAVITREAL injections ,OPTICAL coherence tomography ,VISUAL evoked response ,SCIENTIFIC observation ,VISION testing ,NEOVASCULARIZATION inhibitors ,TREATMENT effectiveness ,DESCRIPTIVE statistics ,LONGITUDINAL method ,RECOMBINANT proteins ,RESEARCH ,FRIEDMAN test (Statistics) ,STATISTICS ,PATHOLOGIC neovascularization ,VISUAL acuity ,CONFIDENCE intervals ,ELECTROPHYSIOLOGY ,EVALUATION - Abstract
Objectives: The aim of this study was to investigate the retinal morpho‐functional characteristics of patients with neovascular wet age‐related macular degeneration (nAMD) treated with intravitreal injection (IV) of aflibercept (AFL). Methods: The study was conducted on 35 patients previously diagnosed with type 1 nAMD who received a fixed‐dosing regimen of aflibercept injections over 12 months. The goal was to assess trends in visual abilities over time by measuring visual acuity (VA), contrast sensitivity (CS), visual evoked potentials (VEPs), and spectral domain‐optical coherence tomography (SD‐OCT). The same psychophysical, electro‐functional, and morphological tests administered at baseline (T0) were repeated 4 to 8 weeks after the last aflibercept injection (Tn), resulting in a total of six examinations. Results: At Tn, all subjects exhibited improved VA for both far and near distances compared to values detected at T0. Similarly, VEP amplitude and latency values at Tn showed a greater P100 improvement than those observed at T0. Additionally, the CS examination at Tn demonstrated improvement, particularly at high spatial stimulation frequencies. The Tn SD‐OCT results highlighted a reduction in macular thickness compared to T0 values. Conclusions: This exploratory research indicates that intravitreal injections of AFL, following a fixed‐dosing regimen, represent a valuable therapeutic approach for enhancing visual performance. This conclusion is supported by comprehensive statistical analysis of psychophysical, electro‐functional, and morphological examinations within the same group of patients with nAMD, as demonstrated for the first time. [ABSTRACT FROM AUTHOR]
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- 2024
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21. A longitudinal observational study on the epidemiology of painful procedures and sucrose administration in hospitalized preterm neonates.
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Bueno, Mariana, Ballantyne, Marilyn, Campbell‐Yeo, Marsha, Estabrooks, Carole, Gibbins, Sharyn, Harrison, Denise, McNair, Carol, Riahi, Shirine, Squires, Janet, Synnes, Anne, Taddio, Anna, Victor, Charles, Yamada, Janet, and Stevens, Bonnie
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PREVENTION of surgical complications ,PAIN measurement ,THERAPEUTICS ,DRUG side effects ,RESEARCH funding ,NEONATAL intensive care units ,HOSPITAL care ,SCIENTIFIC observation ,NEONATAL intensive care ,TERTIARY care ,SEVERITY of illness index ,CHI-squared test ,DESCRIPTIVE statistics ,SURGICAL complications ,ANALGESICS ,LONGITUDINAL method ,PAIN ,PAIN management ,ANALYSIS of variance ,HEALTH outcome assessment ,DATA analysis software ,SUCROSE ,CHILDREN - Abstract
Although sucrose is widely administered to hospitalized infants for single painful procedures, total sucrose volume during the entire neonatal intensive care unit (NICU) stay and associated adverse events are unknown. In a longitudinal observation study, we aimed to quantify and contextualize sucrose administration during the NICU stay. Specifically, we investigated the frequency, nature, and severity of painful procedures; proportion of procedures where neonates received sucrose; total volume of sucrose administered for painful procedures; and incidence and type of adverse events. Neonates <32 weeks gestational age at birth and <10 days of life were recruited from four Canadian tertiary NICUs. Daily chart reviews of documented painful procedures, sucrose administration, and any associated adverse events were undertaken. One hundred sixty‐eight neonates underwent a total of 9093 skin‐breaking procedures (mean 54.1 [±65.2] procedures/neonate or 1.1 [±0.9] procedures/day/neonate) during an average NICU stay of 45.9 (±31.4) days. Pain severity was recorded for 5399/9093 (59.4%) of the painful procedures; the majority (5051 [93.5%]) were heel lances of moderate pain intensity. Sucrose was administered for 7839/9093 (86.2%) of painful procedures. The total average sucrose volume was 5.5 (±5.4) mL/neonate or 0.11 (±0.08) mL/neonate/day. Infants experienced an average of 7.9 (±12.7) minor adverse events associated with pain and/or sucrose administration that resolved without intervention. The total number of painful procedures, sucrose volume, and incidence of adverse events throughout the NICU stay were described addressing an important knowledge gap in neonatal pain. These data provide a baseline for examining the association between total sucrose volume during NICU stay and research on longer‐term behavioral and neurodevelopmental outcomes. [ABSTRACT FROM AUTHOR]
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- 2024
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22. Beyond the burn: An observational study of cardiovascular risk in burn survivors in the north of Iran.
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Samadi, Soroosh, Salari, Arsalan, Mobayen, Mohammadreza, Shakiba, Maryam, Bazi, Ali, Hojjati, Hamid, Hekmati Pour, Nafiseh, Farhadi, Bahar, Alizadeh Otaghvar, Hamidreza, Shirzadi, Alireza, and Farzin, Mohaya
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RISK assessment ,BURN care units ,HIGH density lipoproteins ,BODY mass index ,SCIENTIFIC observation ,LIPIDS ,SEX distribution ,HYPERTENSION ,CARDIOVASCULAR diseases risk factors ,DESCRIPTIVE statistics ,BURN patients ,LONGITUDINAL method ,LOW density lipoproteins ,CONVALESCENCE ,INFERENTIAL statistics ,CHOLESTEROL ,TRIGLYCERIDES ,ACTIVITIES of daily living ,PHYSICAL activity ,DIABETES ,TIME - Abstract
Burn survivors experience profound physiological changes following injury, which may have lasting implications for cardiovascular health. This study aims to investigate the cardiovascular risk profile among burn survivors treated at a burn center in northern Iran. This observational study was conducted from 2022 to 2023 at the burn centre affiliated with Guilan University of Medical Sciences, Rasht, Iran. This study assessed a cohort study of 210 burn survivors, focusing on individuals with ≥20% TBSA burn injuries who had recovered and returned to their daily lives. This study assessed patients' lipid profiles, Framingham General Cardiovascular Risk Score (FGCRS) and risk factors, including demographics, clinical variables and physical activity. Statistical analysis employed descriptive and inferential statistics. The mean age was 49.23 years, and the mean TBSA burned was 37.06%. The risk of cardiovascular disease in 66% of the study population was less than 10%, and in 13%, it was more than 20%. Significant associations were identified between CVD risk and sex, diabetes, hypertension, BMI, TBSA burned, years after burn, physical activity level and LDL. Of the lipid profile measures, LDL, triglycerides and TC/HDL exceeded the desirable levels. This research highlights the heightened cardiovascular risk in burn survivors, emphasizing the necessity for targeted interventions and regular monitoring. Identifying modifiable risk factors enables healthcare practitioners to develop tailored strategies, enhancing cardiovascular health in this vulnerable population and improving overall outcomes and quality of life. [ABSTRACT FROM AUTHOR]
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- 2024
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23. Effect of right internal mammary artery versus radial artery as a second graft vessel in coronary artery bypass grafting on postoperative wound infection in patients: A meta‐analysis.
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Du, Hong, Gu, Xiaowei, Zhang, Zhiyuan, Dong, Zichao, Ran, Xiaofei, and Zhou, Li
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POSTOPERATIVE care ,RADIAL artery ,INTERNAL thoracic artery ,SCIENTIFIC observation ,WOUND infections ,META-analysis ,CORONARY artery bypass ,SYSTEMATIC reviews ,ODDS ratio ,REOPERATION ,CONFIDENCE intervals ,HEMORRHAGE - Abstract
Few studies have shown that radial artery (RA), which is used as a secondary arterial graft, offers superior results compared with right internal thoracic artery (RIMA) in coronary artery bypass grafting (CABG). In a meta‐analysis of observational studies starting in 2023, we looked at the effect of re‐operation on postoperative infection and haemorrhage in CABG with RA vs. RIMA. The electronic database up to October 2023 was examined in the course of the research. Analysis was carried out on the clinical trials of postoperative wound infections and haemorrhage re‐surgery. Among 912 trials associated with CABG, we selected 8 trials to be included in the final data analysis. The main results were secondary wound infection and re‐operation after surgery. The odds ratios (OR) and confidence intervals (CIs) were computed on the basis of a randomized or fixed‐effect model of wound infection and re‐operation. Seven trials showed a significant reduction in the risk of wound infection in RA treated as a secondary artery transplant compared with RIMA (OR, 1.60; 95% CI, 1.03, 2.47 p = 0.04); Four trials showed that RIMA was not significantly different from RA in the rate of re‐operation for postoperative bleeding (OR, 1.31; 95% CI, 0.60, 2.88 p = 0.50). In CABG, RA is used as a secondary arterial conduit graft to lower the risk of wound infection in CABG patients. [ABSTRACT FROM AUTHOR]
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- 2024
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24. Pressure injury prevalence in critical care settings: An observational pre‐post intervention study.
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Alshahrani, Bassam, Middleton, Rebekkah, Rolls, Kaye, and Sim, Jenny
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RESEARCH ,LENGTH of stay in hospitals ,STATISTICS ,NURSING ,SCIENTIFIC observation ,PRESSURE ulcers ,CRITICALLY ill ,EPIDEMIOLOGY ,PATIENTS ,PREVENTIVE health services ,PRE-tests & post-tests ,SEVERITY of illness index ,CRITICAL care medicine ,HOSPITAL nursing staff ,DESCRIPTIVE statistics ,CHI-squared test ,WOUNDS & injuries ,PREDICTION models ,LOGISTIC regression analysis ,EDUCATIONAL outcomes ,NURSING interventions - Abstract
Aim: To explore pressure injury prevention practices and evaluate the impact of an educational intervention on PI prevalence before and after an educational intervention. Design: A multi‐centre observational study. Method: Data were collected at two time points in May 2021 and April 2022 using a Qualtrics® online form. Two Registered Nurses at each site collected observational data at each time point by diagnosing and staging any identified pressure injuries as part of a prevalence study. Patients admitted to participating units were included. Results: A total of 181 patients in critical care units were included at the two‐time points. Pressure injury prevalence was 60.9% at the outset, with 52.9% hospital‐acquired, 37.9% unit‐acquired and 23.0% medical device‐related. Post‐intervention prevalence decreased significantly to 28.7%, including 21.3% hospital‐acquired, 14.9% unit‐acquired, and 8.5% medical device‐related. Pressure injuries were prominent in the sacral region, head area, and heels. Stages I and II pressure injuries were the most common. Increased age and longer ICU stays are linked to a heightened risk of pressure injury development in critically ill patients, whereas higher haemoglobin levels show an inverse relationship with the development of both pressure injury and severe stages in the univariate analysis. The predictive models revealed that increased age and longer ICU stays are predictors for both pressure injury development and progression to severe stages, while Braden scores predict the likelihood of developing severe stages of pressure injuries. Conclusions: This study has identified a benchmark for pressure injury prevalence in critical care units in Saudi Arabia. The results demonstrate that pressure injuries can be prevented in critically ill patients when evidence‐based education strategies are implemented. Patient Care Impact: Pressure injuries are an important issue for critically ill patients and can be prevented with proper investments. Strategies to prevent pressure injuries from admission will result in fewer pressure injuries. Reporting Method: Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines and the Template for Intervention Description and Replication (TIDieR) checklist. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]
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- 2024
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25. Inter‐device agreement of sacral subepidermal oedema measurement in healthy adults during prolonged 60° head of bed elevation.
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Latimer, Sharon L., Bone, Madeline, Walker, Rachel M., Thalib, Lukman, and Gillespie, Brigid M.
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EDEMA prevention ,SACRUM injuries ,SCANNING electron microscopy equipment ,SCIENTIFIC observation ,CONFIDENCE intervals ,PRESSURE ulcers ,SCANNING electron microscopy ,REGRESSION analysis ,PATIENTS' attitudes ,RISK assessment ,T-test (Statistics) ,DESCRIPTIVE statistics ,STATISTICAL sampling ,DATA analysis software ,PATIENT positioning ,LONGITUDINAL method ,DISEASE risk factors ,ADULTS - Abstract
Aim: To investigate the level of agreement between the SEM 200 and Provisio® subepidermal moisture sacral delta measurements, which may indicate increased pressure injury risk, in healthy adults during 120 min of prolonged 60° head of bed elevation. This position, which requires the elevation of the patient's upper body at a 60° angle above the horizontal plane for an extended period, is used by clinicians to prevent or manage a patient's medical or surgical conditions. Design: This prospective exploratory study recruited 20 healthy adults during October 2021 and collected sacral subepidermal moisture delta measurements using the SEM 200 and Provisio® devices. Methods: Delta measurements were taken at 20‐min intervals over 120 min resulting in seven data collection timepoints. Descriptive statistics and a Bland Altman plot analysis were conducted. Results: A total of 280 sacral subepidermal moisture delta measurements were gathered or 140 per device. There were good levels of agreement between the two devices at baseline (T0) [mean 0.025; SD 0.137] and following 60‐ (T3) [mean 0.025; SD 0.111], 80‐ (T4) [mean −0.01; SD 0.177] and 100 min (T5) [mean 0.01; SD 0.129] of prolonged 60° head of bed elevation. Head of bed elevations can increase a patient's risk of sacral pressure injuries. In some countries, nurses have access to the SEM 200 and/or the Provisio® device, so our findings may increase nurses' confidence in the interchangeability of the device measurements, although further research is needed to confirm this. The SEM 200 and Provisio® subepidermal moisture scanners show promise in gathering similar objective pressure injury risk data which could prompt clinicians to implement prevention strategies. Impact: Current pressure injury risk assessment is largely subjective in nature. This quantitative study on healthy human sacral tissue found a good level of agreement in the SEM 200 and Provisio® subepidermal moisture scanners, which may increase nurses' confidence in the interchangeability of the devices in clinical practice. [ABSTRACT FROM AUTHOR]
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- 2024
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26. Prevalence of non‐convulsive seizures and electroencephalographic abnormalities in critically ill patients—A retrospective observational study.
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Karki, Bipin, Shrestha, Pramesh S., Shrestha, Ninadini, Shilpakar, Olita, Acharya, Subhash P., and Neupane, Ashru
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ELECTROENCEPHALOGRAPHY ,CRITICALLY ill ,CHI-squared test ,STATUS epilepticus ,SCIENTIFIC observation ,HUMAN abnormalities - Abstract
Objective: Electroencephalographic (EEG) abnormalities especially non‐convulsive status epilepticus (NCSE) have been found to be associated with worse outcomes in critically ill patients. We aimed to assess the prevalence of non‐convulsive seizures and electroencephalographic abnormalities in critically ill patients. Furthermore, we aimed to investigate any association between the type of EEG abnormality and outcomes including ICU mortality and successful ICU discharge. Methods: This was a cross‐sectional observational study carried out among critically ill patients in a mixed medical‐surgical ICU from January 1, 2018 to May 15, 2020. A total of 178 records of 30 min bedside EEG records were found. EEG findings were grouped as normal, non‐convulsive seizures (NCS), non‐convulsive status epilepticus (NCSE), and other abnormalities. Descriptive analytical tools were used to characterize the case details in terms of the type of EEG abnormalities. Chi square test was used to describe the EEG abnormalities in terms of mortality. The status epilepticus severity scores (STESS) were further calculated for records with NCSE. These data were then analyzed for any association between STESS and mortality for cases with NCSE. Results: The prevalence of EEG abnormality in our cohort of all critically ill patients was found to be 7.3% (170/2234). Among the patients with altered sensorium in whom EEG was done, 42.9% had non‐conclusive seizure activity with 25.2% in NCSE. Though the study was not adequately powered, there was a definite trend towards a lower proportion of successful ICU discharge rates seen among patients with higher STESS (>2) with only 33.3% being discharged for patients with a STESS of 6 versus 92.9% for those with STESS 3. Significance: When combined with a strong clinical suspicion, even a 30‐min bedside EEG can result in detection of EEG abnormalities including NCS and NCSE. Hence, EEG should be regularly included in the evaluation of critically ill patients with altered sensorium. Plain Language Summary: Electroencephalographic (EEG) abnormalities and seizures can have high prevalence in critically ill patients. These abnormalities notably, non‐convulsive status epilepticus (NCSE) has been found to be associated with poor patient outcomes. This was a retrospective observational study analyzing 178 EEG records, from a mixed medical‐surgical ICU. The indication for obtaining an EEG was based solely on the clinical suspicion of the treating physician. The study found a high prevalence of EEG abnormalities in 96.5% in whom it was obtained with 42.9% having any seizure activity and 28.8% having NCSE. The study was not powered for detection of association of the EEG abnormalities with clinical outcomes. However, a definite trend towards decreased chances of successful discharge from the ICU was seen. This study used strong clinical suspicion in patients with altered sensorium to obtain an EEG. High detection rates of EEG abnormalities were recorded in this study. Hence, combination of clinical judgement and EEG can improve detection of EEG abnormalities and NCSE. [ABSTRACT FROM AUTHOR]
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- 2024
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27. Efficacy and tolerability of add‐on stiripentol in real‐world clinical practice: An observational study in Dravet syndrome and non‐Dravet developmental and epileptic encephalopathies.
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Gil‐Nagel, Antonio, Aledo‐Serrano, Angel, Beltrán‐Corbellini, Álvaro, Martínez‐Vicente, Laura, Jimenez‐Huete, Adolfo, Toledano‐Delgado, Rafael, Gacía‐Morales, Irene, and Valls‐Carbó, Adrián
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PEOPLE with epilepsy ,STATUS epilepticus ,SCIENTIFIC observation ,SYNDROMES ,AGE of onset ,CHILDREN with developmental disabilities ,CUCUMBER mosaic virus - Abstract
Objective: To assess efficacy and tolerability of stiripentol (STP) as adjunctive treatment in Dravet syndrome and non‐Dravet refractory developmental and epileptic encephalopathies (DREEs). Methods: Retrospective observational study of all children and adults with DREE and prescribed adjunctive STP at Hospital Ruber Internacional from January 2000 to February 2023. Outcomes were retention rate, responder rate (proportion of patients with ≥50% reduction in total seizure frequency relative to baseline), seizure freedom rate, responder rate for status epilepticus, rate of adverse event and individual adverse events, reported at 3, 6, and 12 months and at final visit. Seizure outcomes are reported overall, and for Dravet and non‐Dravet subgroups. Results: A total of 82 patients (55 Dravet syndrome and 27 non‐Dravet DREE) were included. Median age was 5 years (range 1–59 years), and median age of epilepsy onset was younger in the Dravet group (4.9 [3.6–6] months) than non‐Dravet (17.9 [6–42.3], P < 0.001). Median follow‐up time STP was 24.1 months (2 years; range 0.3–164 months) and was longer in the Dravet group (35.9 months; range 0.8–164) than non‐Dravet (17 months range 0.3–62.3, P < 0.001). At 12 months, retention rate, responder rate and seizure free rate was 68.3% (56/82), 65% [48–77%] and 18% [5.7–29%], respectively. There were no statistically significant differences between groups on these seizure outcomes. Adverse events were reported in 46.3% of patients (38/82), without differences between groups. Significance: In this population of patients with epileptic and developmental encephalopathies, outcomes with adjunctive STP were similar in patients with non‐Dravet DREE to patients with Dravet syndrome. [ABSTRACT FROM AUTHOR]
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- 2024
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28. Prevalence and risk factors of exposure keratopathy among critically ill patients: A systematic review and meta‐analysis.
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Chen, Yulu, He, Jing, Wu, Qiuping, Pu, Shi, and Song, Caiping
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MEDICAL databases ,ONLINE information services ,CINAHL database ,LAGOPHTHALMOS ,META-analysis ,MEDICAL information storage & retrieval systems ,SCIENTIFIC observation ,HOSPITAL medical staff ,CORNEA diseases ,SYSTEMATIC reviews ,CRITICALLY ill patient psychology ,RISK assessment ,QUALITY assurance ,GLASGOW Coma Scale ,DESCRIPTIVE statistics ,HOSPITAL nursing staff ,MEDLINE ,CORNEA ,DISEASE risk factors - Abstract
Aims: To identify the incidence, prevalence and risk factors of exposure keratopathy (EK) among critically ill patients. Design: Systematic review and meta‐analysis, in accordance with the PRISMA 2020 Statement. Methods: The Cochrane Library, PubMed, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), China Knowledge Resource Integrated Database (CNKI), Chinese Biomedical Database (CBM), Weipu Database (VIP) and WanFang Database were systematically searched from inception to June 2022. Observational studies that reported EK among paediatric and adult critically ill patients were screened and included original articles based on the inclusion criteria. Two reviewers independently completed data extraction and quality assessments. Subgroup analysis investigated potential causes of heterogeneity. Results: Of the 4508 studies identified, 23 studies involving 3519 subjects were included. The pooled prevalence of EK was 34.0%, and the pooled incidence rate of EK was 23.0%. Risk factors associated with EK in critically ill patients included lagophthalmos, chemosis, eye blinks <5 times per minute, mechanical ventilation, sedation, lower Glasgow Coma Scale (GCS) score and higher Acute Physiology and Chronic Health Evaluation (APACHE) II score. Conclusion: This review shows that EK rates are high in critically ill patients and are influenced by multiple factors. Medical staff should pay more attention to EK in critically ill patients, conduct professional evaluations and implement targeted eye care protocols to reduce its occurrence. Implications for Practice: This study shows the frequency of and multiple risk factors for EK in critically ill patients, which provides evidence‐based guidance for nurses to evaluate the risk of EK in critically ill patients and take appropriate precautions to reduce the risk. Protocol Registration: The protocol was registered in PROSPERO (https://www.crd.york.ac.uk/prospero/) (CRD42022346964). Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]
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- 2024
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29. Nurse‐to‐patient ratios and readiness for hospital discharge: A moderated mediation model.
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Lei, Shuang‐yan, Sun, Jia‐ru, Wang, Cai‐hua, Zhang, Xiao‐fang, Han, Wen‐jin, Wang, Xiao‐qin, and Xie, Juan
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CANCER patient psychology ,HOSPITALS ,KRUSKAL-Wallis Test ,SCIENTIFIC observation ,CONFIDENCE intervals ,PERIPHERALLY inserted central catheters ,CROSS-sectional method ,AGE distribution ,EMPLOYEE recruitment ,MANN Whitney U Test ,GASTROINTESTINAL tumors ,PATIENTS' attitudes ,SEX distribution ,FACTOR analysis ,HOSPITAL care ,CHI-squared test ,DESCRIPTIVE statistics ,COMMUNICATION ,RESEARCH funding ,DATA analysis software ,NURSE-patient ratio ,DISCHARGE planning - Abstract
Aim: To explore whether and to what extent, nurse–patient assessment differences mediate the association between nurse‐to‐patient ratios and readiness for hospital discharge, and examine whether nurse–patient characteristics moderate the indirect and/or direct effect of mediation model. Design: A cross‐sectional study was carried out from March 2021 to December 2022. Methods: A total of 523 pairs of gastrointestinal cancer patients with PICC and their nurses were recruited. All the participants were invited to complete the general information questionnaire and the Readiness for Hospital Discharge Scale. Outcome measure was patient‐reported readiness for hospital discharge. This study was reported according to the STROBE checklist. Results: The patients reported a low level of readiness for hospital discharge. Nurse–patient assessment differences were positively associated with nurse‐to‐patient ratios but negatively associated with readiness for hospital discharge. Furthermore, nurse–patient assessment differences fully mediated the effect of nurse‐to‐patient ratios on readiness for hospital discharge, and age and gender of patients only moderated the indirect path of mediation model. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
30. Investigating how tamsulosin combined with levofloxacin impacts wound healing in patients with chronic prostatitis who may also have perineal or urethral wounds.
- Author
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Yang, Jingruo, Bao, Congcong, and Gu, Jianglin
- Subjects
ADRENERGIC alpha blockers ,WOUND healing ,URETHRA ,DRUG efficacy ,COMBINATION drug therapy ,SCIENTIFIC observation ,CLINICAL trials ,CHRONIC diseases ,PROSTATITIS ,CROSS-sectional method ,PATIENT satisfaction ,DESCRIPTIVE statistics ,QUINOLONE antibacterial agents ,WOUNDS & injuries ,WOUND care ,PERINEUM ,EVALUATION - Abstract
Chronic prostatitis, which frequently manifests with perineal or urethral ulcers, can have substantial impact on the quality of life experienced by affected individuals. Present treatment approaches primarily target the alleviation of symptoms and control of complications. In patients with chronic prostatitis, this investigation examined the potential synergistic effects of tamsulosin and levofloxacin on urinary function and urethral and perineal wounds healing. This cross‐sectional observational study was carried out at Chongqing Western Hospital, China, from February to November 2023. The participants comprised 88 males aged 40–75 years who had been clinically diagnosed with chronic prostatitis and complications that accompany the wound healing process. The participants were equally distributed into two groups: one assigned to the treatment group, which received a daily combination of levofloxacin (500 mg) and tamsulosin (0.4 mg) and other to receive conventional care. The wound healing rate and improvement in urinary function were the primary outcomes evaluated monthly for 9 months. Patient satisfaction and symptom amelioration were secondary outcomes, in addition to the surveillance of adverse effects. In comparison to the control, treatment group exhibited significantly higher rate of wound closure (78.08% at 1 month and 79.38% at 9 months) and urinary function improvement (66.69% at 1 month and 67.95% at 9 months). In addition, the treatment group exhibited a greater degree of symptom amelioration; however, a rise in adverse effects was observed. In every domain, patient satisfaction scores were significantly higher in the treatment group. Thus the combination of tamsulosin and levofloxacin improved urinary function and wound repair in patients with chronic prostatitis, while also exhibiting tolerable profile of adverse effects. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
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