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Journal of Patient Safety Dec 2021The primary aim was to measure patient safety culture in two home care services in Belgium (Flanders). In addition, variability based on respondents' profession was...
OBJECTIVES
The primary aim was to measure patient safety culture in two home care services in Belgium (Flanders). In addition, variability based on respondents' profession was examined.
METHODS
A cross-sectional study was conducted by administering the SCOPE-Primary Care questionnaire in two home care service organizations.
RESULTS
In total, 1875 valid questionnaires were returned from 2930 employees, representing a response rate of 64%. The highest mean patient safety culture score was found for "organizational learning" (mean [SD] = 3.81 [0.53]), followed by "support and fellowship" (mean [SD] = 3.76 [0.61]), "open communication and learning from error" (mean [SD] = 3.73 [0.64]), and "patient safety management" (mean [SD] = 3.71 [0.60]). The lowest mean scores were found for "handover and teamwork" (mean [SD] = 3.28 [0.58]) and "adequate procedures and working conditions" (mean [SD] = 3.30 [0.56]). Moreover, managers/supervisors scored significantly higher on the dimensions "open communication and learning from error," "adequate procedures and working conditions," "patient safety management," "support and fellowship," and "organizational learning" than clinical and nonclinical staff.
CONCLUSIONS
In conclusion, organizational learning is perceived as most positive. However, large gaps remain in the continuity of care as "handover and teamwork" is perceived as the most negative safety culture dimension. With knowledge of the current patient safety culture, organizations can redesign processes or implement improvement strategies to avoid patient safety incidents and patient harm in the future.
Topics: Attitude of Health Personnel; Cross-Sectional Studies; Humans; Organizational Culture; Patient Safety; Primary Health Care; Safety Management; Surveys and Questionnaires
PubMed: 29394195
DOI: 10.1097/PTS.0000000000000458 -
JAMA Network Open Jul 2023Obesity is a major global health concern. A better understanding of temporal patterns of weight gain will enable the design and implementation of interventions with...
IMPORTANCE
Obesity is a major global health concern. A better understanding of temporal patterns of weight gain will enable the design and implementation of interventions with potential to alter obesity trajectories.
OBJECTIVE
To describe changes in daily weight across 12 months among Australian adults.
DESIGN, SETTING, AND PARTICIPANTS
This cohort study conducted between December 1, 2019, and December 31, 2021 in Adelaide, South Australia, involved 375 community-dwelling adults aged 18 to 65 years. Participants wore a fitness tracker and were encouraged to weigh themselves, preferably daily but at least weekly, using a body weight scale. Data were remotely gathered using custom-developed software.
EXPOSURE
Time assessed weekly, seasonally, and at Christmas/New Year and Easter.
MAIN OUTCOMES AND MEASURES
Data were visually inspected to assess the overall yearly pattern in weight change. Data were detrended (to remove systematic bias from intraindividual gradual increases or decreases in weight) by calculating a line of best fit for each individual's annual weight change relative to baseline and subtracting this from each participant's weight data. Multilevel mixed-effects linear regression analysis was used to compare weight across days of the week and seasons and at Christmas/New Year and Easter.
RESULTS
Of 375 participants recruited, 368 (mean [SD] age, 40.2 [5.9] years; 209 [56.8%] female; mean [SD] baseline weight, 84.0 [20.5] kg) provided at least 7 days of weight data for inclusion in analyses. Across the 12-month period, participants gained a median of 0.26% body weight (218 g) (range, -29.4% to 24.0%). Weight fluctuated by approximately 0.3% (252 g) each week, with Mondays and Tuesdays being the heaviest days of the week. Relative to Monday, participants' weight gradually decreased from Tuesday, although not significantly so (mean [SE] weight change, 0.01% [0.03%]; P = .83), to Friday (mean [SE] weight change, -0.18% [0.03%]; P < .001) and increased across the weekend to Monday (mean [SE] weight change for Saturday, -0.16% [0.03%]; P < .001; mean [SE] weight change for Sunday, -0.10% [0.03%]; P < .001). Participants' weight increased sharply at Christmas/New Year (mean [SE] increase, 0.65% [0.03%]; z score, 25.30; P < .001) and Easter (mean [SE] weight change, 0.29% [0.02%], z score, 11.51; P < .001). Overall, participants were heaviest in summer (significantly heavier than in all other seasons), were lightest in autumn (mean [SE] weight change relative to summer, -0.47% [0.07%]; P < .001), regained some weight in winter (mean [SE] weight change relative to summer, -0.23% [0.07%]; P = .001), and became lighter in spring (mean [SE] weight change relative to summer, -0.27% [0.07%]; P < .001).
CONCLUSIONS AND RELEVANCE
In this cohort study of Australian adults with weekly and yearly patterns in weight gain observed across 12 months, high-risk times for weight gain were Christmas/New Year, weekends, and winter, suggesting that temporally targeted weight gain prevention interventions may be warranted.
Topics: Humans; Adult; Female; Male; Seasons; Cohort Studies; Australia; Weight Gain; Obesity; Body Weight
PubMed: 37498598
DOI: 10.1001/jamanetworkopen.2023.26038 -
Journal of Children's Orthopaedics Jun 2020Treatment of moderate to severe stable slipped capital femoral epiphysis (SCFE) remains a challenging problem. Open reduction by modified Dunn procedure carries a... (Review)
Review
PURPOSE
Treatment of moderate to severe stable slipped capital femoral epiphysis (SCFE) remains a challenging problem. Open reduction by modified Dunn procedure carries a considerable risk of osteonecrosis (ON). Imhauser osteotomy is capable of realigning the deformity without the risk of ON, but the remaining metaphyseal bump is implicated with significant chondro-labral lesions and accelerated osteoarthritis. We conducted this study to evaluate the efficacy and safety of Imhauser osteotomy combined with osteochondroplasty (OCP) through the surgical hip dislocation (SHD) approach.
METHODS
A prospective series of 23 patients with moderate-severe stable SCFE underwent Imhauser osteotomy and OCP through SHD. The mean age was 14.4 years (13 to 20) and the mean follow-up period was 45 months (24 to 66). The outcome measures included clinical and radiological parameters and Harris hip score (HHS) was used as a functional score.
RESULTS
The mean HHS improved significantly from 65.39 to 93.3. The limb length discrepancy improved by a mean of 1.72 cm. The mean flexion and abduction arcs showed a significant improvement (mean increase of 37.5° and 18.5°, respectively). The mean internal rotation demonstrated the most significant improvement (mean increase of 38.5°). All the radiographic parameters improved significantly; including anterior and lateral slip angles (mean improvement 37.52° and 44.37°, respectively). The mean alpha angle decreased by 39.19°. The articulo-trochanteric distance significantly increased to a mean of 23.26 mm. No cases of ON or chondrolysis were identified.
CONCLUSION
Combined Imhauser osteotomy and OCP through the surgical dislocation approach provide a comprehensive and safe management of moderate to severe stable SCFE.
LEVEL OF EVIDENCE
IV.
PubMed: 32582386
DOI: 10.1302/1863-2548.14.200021 -
PloS One 2017It is well documented that people are good at the rapid representation of multiple objects in the form of ensemble summary statistics of different types (numerosity, the...
It is well documented that people are good at the rapid representation of multiple objects in the form of ensemble summary statistics of different types (numerosity, the average feature, the variance of features, etc.). However, there is not enough clarity regarding the links between statistical domains. The relations between different-type summaries (numerosity and the mean) are of particular interest, since they can shed light on (1) a very general functional organization of ensemble processing and (2) mechanisms of statistical computations (whether averaging takes into account numerical information, as in regular statistics). Here, we show no correlation between the precision of estimated numerosity and that of the estimated mean. We also found that people are very good at dividing attention between numerosity and the mean size of a single set (Experiment 1); however, they show some cost of dividing attention between two same-type (two numerosities or two mean sizes, Experiment 2) and two different-type (one numerosity and one mean size, Experiment 3) summaries when each summary is ascribed to a different set. These results support the idea of domain specificity of numerosity and mean size perception, which also implies that, unlike regular statistics, computing the mean does not require numerosity information. We also conclude that computational capacity of ensemble statistics is more limited by encoding several ensembles than computing several summaries.
Topics: Adolescent; Cues; Female; Humans; Male; Pattern Recognition, Visual; Photic Stimulation; Size Perception; Statistics as Topic; Time Factors; Young Adult
PubMed: 28957361
DOI: 10.1371/journal.pone.0185452 -
European Journal of Ophthalmology Jan 2022To investigate the peripapillary retinal nerve fiber layer thickness (RNFLT), macular RNFLT, ganglion cell layer (GCL), and inner plexiform layer (IPL) thickness in...
PURPOSE
To investigate the peripapillary retinal nerve fiber layer thickness (RNFLT), macular RNFLT, ganglion cell layer (GCL), and inner plexiform layer (IPL) thickness in recovered COVID-19 patients compared to controls.
METHODS
Patients previously diagnosed with COVID-19 were included, while healthy patients formed the historic control group. All patients underwent an ophthalmological examination, including macular and optic nerve optical coherence tomography. In the case group, socio-demographic data, medical history, and neurological symptoms were collected.
RESULTS
One hundred sixty patients were included; 90 recovered COVID-19 patients and 70 controls. COVID-19 patients presented increases in global RNFLT (mean difference 4.3; CI95% 0.8 to 7.7), nasal superior (mean difference 6.9; CI95% 0.4 to 13.4), and nasal inferior (mean difference 10.2; CI95% 2.4 to 18.1) sectors of peripapillary RNFLT. Macular RNFL showed decreases in COVID-19 patients in volume (mean difference -0.05; CI95% -0.08 to -0.02), superior inner (mean difference -1.4; CI95% -2.5 to -0.4), nasal inner (mean difference -1.1; CI95% -1.8 to -0.3), and nasal outer (mean difference -4.7; CI95% -7.0 to -2.4) quadrants. COVID-19 patients presented increased GCL thickness in volume (mean difference 0.04; CI95% 0.01 to 0.07), superior outer (mean difference 2.1; CI95% 0.8 to 3.3), nasal outer (mean difference 2.5; CI95% 1.1 to 4.0), and inferior outer (mean difference1.2; CI95% 0.1 to 2.4) quadrants. COVID-19 patients with anosmia and ageusia presented an increase in peripapillary RNFLT and macular GCL compared to patients without these symptoms.
CONCLUSIONS
SARS-CoV-2 may affect the optic nerve and cause changes in the retinal layers once the infection has resolved.
Topics: COVID-19; Humans; Nerve Fibers; Optic Nerve; Retinal Ganglion Cells; SARS-CoV-2; Tomography, Optical Coherence
PubMed: 33719624
DOI: 10.1177/11206721211001019 -
Journal of Surgical Education 2022Understand the characteristics of residents' favorite rotations to improve the ability of educators to maximize positive learning experiences.
OBJECTIVE
Understand the characteristics of residents' favorite rotations to improve the ability of educators to maximize positive learning experiences.
DESIGN
Novel cross-sectional survey developed through thematic analysis of focus groups with residents using 4-point Likert scales ranked from "Not at all important" to "Extremely important."
SETTING
Single university-affiliated urban hospital PARTICIPANTS: Clinical surgical residents BACKGROUND: Resident assessments of learning experiences vary between rotations leading to the development of "favorite" rotations.
MATERIALS AND METHODS
A novel survey instrument containing 31 characteristics divided into 4 thematic categories was developed following analysis of surgical resident focus groups. Clinical surgical residents were asked how important each characteristic was for determining their favorite rotation on a 4-point Likert Scale from "not at all important" to "extremely important." Two-sided independent sample T-tests were used.
RESULTS
The response rate was 59% (33/56) with proportional representation of postgraduate levels. Overall, 67% (22/33) of residents reported their favorite rotation was in their preferred specialty, 70% (23/33) reported their favorite rotation required >70 hours per week in the hospital, and 97% (32/33) of residents reported their favorite rotation required <2 days of clinic. Overall, the average ranking of the categories from most to least important was content (mean = 2.84, SD = 0.48), learning environment (mean = 2.67, SD = 0.57), working environment (mean = 2.38, SD = 0.56), and accomplishment (mean = 2.31, SD = 0.57). The only category with a statistically significant difference between junior and senior resident was content with seniors ranking it most important (mean = 3.35, SD = 0.93) compared to junior residents who ranked it least important (mean = 2.21, SD = 1.25), p = 0.01. Personal characteristics such as "Attendings cared about my learning" (mean = 3.56, SD = 0.50) and "I felt good at my job" (mean = 3.45, SD = 0.67), tended to be more important than structural characteristics such as "call schedule" (mean = 2.71, SD = 0.86), "formal didactics" (mean = 2.67, SD = 1.04), and "work-life balance" (mean = 2.70, SD = 0.99).
CONCLUSIONS
This study demonstrates a novel understanding of the factors that contribute to resident preferences for certain rotations. Junior and senior residents attribute importance differently, which may provide the basis for level-appropriate improvements. Personal factors tended to be more contributory than structural factors, highlighting additional dimensions to examine when considering how to optimize certain rotations.
Topics: Humans; Internship and Residency; Cross-Sectional Studies; Learning
PubMed: 35907699
DOI: 10.1016/j.jsurg.2022.07.009 -
Physiological Measurement Nov 2017Local arterial wave speed, a surrogate of vessel stiffness, can be estimated via the pressure-velocity (PU) and diameter-velocity (ln(D)U) loop methods. These assume...
OBJECTIVE
Local arterial wave speed, a surrogate of vessel stiffness, can be estimated via the pressure-velocity (PU) and diameter-velocity (ln(D)U) loop methods. These assume negligible early-systolic reflected waves (RWes) and require measurement of cross-sectionally averaged velocity (U ), which is related to volumetric blood flow. However, RWes may not always be negligible and Doppler ultrasound typically provides maximum velocity waveforms or estimates of mean velocity subject to various errors (U ). This study investigates how these issues affect wave speed estimation and explores more robust methods for obtaining local wave speed and U .
APPROACH
Using aortic phase-contrast MRI (PCMRI, n = 34) and a simulated virtual cohort (n = 3325), we assessed errors in calculated wave speed caused by RWes and use of U rather than true U . By combining PU and ln(D)U loop wave speed values, (i) a corrected wave speed (ln(D)P), insensitive to RWes and velocity errors, was derived; and (ii) a novel method for estimating U from U was proposed (where U can be any scaled version of U ).
MAIN RESULTS
Proof-of-principle was established via PCMRI data and in the ascending aorta, carotid, brachial and femoral arteries of the virtual cohort, with acceptably low wave speed and U errors obtained even when local pressure was estimated from diameter and mean/diastolic brachial pressures.
SIGNIFICANCE
Given a locally measured diameter waveform and brachial cuff pressures, (i) the velocity- and RWes-independent ln(D)P method can be applied non-invasively and is likely more robust than ln(D)U and PU loop methods; and (ii) U can be estimated from routinely-acquired U .
Topics: Adolescent; Arteries; Blood Flow Velocity; Female; Humans; Male; Models, Cardiovascular; Pulsatile Flow
PubMed: 28930095
DOI: 10.1088/1361-6579/aa8de3 -
The Laryngoscope Dec 2022Comparing Derkay anatomical score at time of procedure, disease characteristics, and mean treatment interval among adult and pediatric patients with recurrent...
OBJECTIVES/HYPOTHESIS
Comparing Derkay anatomical score at time of procedure, disease characteristics, and mean treatment interval among adult and pediatric patients with recurrent respiratory papillomatosis (RRP).
STUDY DESIGN
Restrospective study.
METHODS
Retrospective review of juvenile-onset (JO) and adult-onset (AO) RRP patients treated longitudinally at pediatric and adult institutions from 1999 to 2019. Patients were included if they had a tissue diagnosis of papilloma and had at least a 12-month follow-up.
RESULTS
One hundred and twelve patients met inclusion criteria (68 JO-RRP and 44 AO-RRP). All patients were stratified into either potassium titanyl phosphate (KTP) (n = 42), CO (n = 21), or microdebrider (n = 49) treatment groups. The Derkay score improved between first and last procedure in the KTP group (mean difference, 3.5; P < .001), CO group (mean difference, 4.4; P < .001), and microdebrider group (mean difference, 4.1; P < .001), but overall improvement did not differ across groups (P = .73). Baseline mean to last mean Derkay score improved for nine patients during bevacizumab treatments (mean difference, 3.0; P = .01) but did not improve for these same patients during an interval prior to receiving bevacizumab treatments. Baseline mean to last mean Derkay score improved for 19 patients during cidofovir treatments (mean difference, 3.84; P < .001) but did not improve for these same patients during the interval prior to receiving cidofovir treatments. The AO-RRP population had more patients with dysplasia (50%) compared to JO-RRP population (10%) (P < .001).
CONCLUSION
Various surgical modalities appear to be equally effective treatments for RRP. Adult and pediatric patients have decreased recurrent disease burden when receiving bevacizumab or cidofovir. AO-RRP patients have more concomitant dysplasia.
LEVEL OF EVIDENCE
3 Laryngoscope, 132:2420-2426, 2022.
Topics: Adult; Child; Humans; Cidofovir; Bevacizumab; Carbon Dioxide; Papillomavirus Infections; Respiratory Tract Infections
PubMed: 35119691
DOI: 10.1002/lary.30042 -
Environmental Science and Pollution... Jan 2021This experiment was conducted to provide a better insight into the plant responses to nitric oxide (NO) and selenium nanoparticle (nSe). Chicory seedlings were sprayed...
Nitric oxide and selenium nanoparticles confer changes in growth, metabolism, antioxidant machinery, gene expression, and flowering in chicory (Cichorium intybus L.): potential benefits and risk assessment.
This experiment was conducted to provide a better insight into the plant responses to nitric oxide (NO) and selenium nanoparticle (nSe). Chicory seedlings were sprayed with nSe (0, 4, and 40 mg l), and/or NO (0 and 25 μM). NO and/or nSe4 improved shoot and root biomass by an average of 32%. The nSe40 adversely influenced shoot and root biomass (mean = 26%), exhibiting moderate toxicity partly relieved by NO. The nSe and NO treatments transcriptionally stimulated the dehydration response element B1A (DREB1A) gene (mean = 29.6-fold). At the transcriptional level, nSe4 or NO moderately upregulated phenylalanine ammonia-lyase (PAL) and hydroxycinnamoyl-CoA quinate transferase (HCT1) genes (mean = sevenfold). The nSe4 + NO, nSe40, and nSe40 + NO groups drastically induced the expression of PAL and HCT1 genes (mean = 30-fold). With a similar trend, hydroxycinnamoyl-CoA Quinate/shikimate hydroxycinnamoyl transferase (HQT1) gene was also upregulated in response to nSe and/or NO (mean = 25-fold). The activities of nitrate reductase and catalase enzymes were also induced in the nSe- and/or NO-treated seedlings. Likewise, the application of these supplements associated with an increase in ascorbate concentration (mean = 31.5%) reduced glutathione (mean = 35%). NO and/or nSe enhanced the PAL activity (mean = 36.4%) and soluble phenols (mean = 40%). The flowering was also influenced by the supplements in dose and compound dependent manner exhibiting the long-time responses. It appears that the nSe-triggered signaling can associate with a plethora of developmental, physiological, and molecular responses at least in part via the fundamental regulatory roles of transcription factors, like DREB1A as one the most significant genes for conferring tolerance in crops.
Topics: Antioxidants; Cichorium intybus; Gene Expression; Nanoparticles; Nitric Oxide; Risk Assessment; Selenium
PubMed: 32902749
DOI: 10.1007/s11356-020-10706-2 -
Physical Chemistry Chemical Physics :... Jan 2017In this work the property of total pore anisotropy in porous solids is introduced. Its calculation is based on a combination of the specific surface area S and the...
In this work the property of total pore anisotropy in porous solids is introduced. Its calculation is based on a combination of the specific surface area S and the specific pore volume V estimated via typical nitrogen porosimetry data and tested in two kinds of porous materials: a group of spinels CoAlO with differentiated random porosities and a second group of silicas SiO with ordered porosity modulated by the addition of LaFeO nanoparticles. Two basic complementary expressions of total pore anisotropy were estimated: (i) the specific total mean pore anisotropy b = (N·b) ≈ [S]/[V] corresponding to the total anisotropy value of all N hypothetical similar pores in one gram of a solid with mean size D = 4V/S and anisotropy b = L/D. The b takes a unique value for each particular porous material. (ii) The specific differential mean pore anisotropies b = (N·b) ≈ [S]/[V] corresponding to the spectrum of partial anisotropy values b = L/D of N pores with similar size D = 4V/S possessing differential pore volume V and differential specific surface area S. The b takes different values at each particular partial pressure and exhibits a distribution as a function of pore radius b = f(r). It is shown that plots of log(b) = f(log(r)) lead to the ranking of pores according to the Zipf's law log(N) = A - B log(V). This ranking is not obeyed by the pores exhibiting appreciable local pore anisotropy.
PubMed: 27976762
DOI: 10.1039/c6cp07680g