scholarly journals The QUality of Interhospital Transportation in the Euregion Meuse-Rhine (QUIT-EMR) score: a cross-validation study

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e051100
Author(s):  
Ulrich Strauch ◽  
Micheline C D M Florack ◽  
Jochen Jansen ◽  
Bas C T van Bussel ◽  
Stefan K Beckers ◽  
...  
Keyword(s):  
Airway Patency ◽  
Medical Interventions ◽  
Organ Systems ◽  
Interhospital Transport ◽  
Mobile Intensive Care Unit ◽  
Sum Score ◽  
Registration Number ◽  
Expert Classification ◽  
Level Of Agreement

ObjectivesInterhospital transports of critically ill patients are high-risk medical interventions. Well-established parameters to quantify the quality of transports are currently lacking. We aimed to develop and cross-validate a score for interhospital transports.SettingAn expert panel developed a score for interhospital transport by a Mobile Intensive Care Unit (MICU), the QUality of Interhospital Transportation in the Euregion Meuse-Rhine (QUIT-EMR) score. The QUIT-EMR score is an overall sum score that includes component scores of monitoring and intervention variables of the neurological (proxy for airway patency), respiratory and circulatory organ systems, ranging from −12 to +12. A score of 0 or higher defines an adequate transport. The QUIT-EMR score was tested to help to quantify the quality of transport.ParticipantsOne hundred adult patients were randomly included and the transport charts were independently reviewed and classified as adequate or inadequate by four transport experts (ie, anaesthetists/intensivists).Outcome measuresSubsequently, the level of agreement between the QUIT-EMR score and expert classification was calculated using Gwet’s AC1.ResultsFrom April 2012 to May 2014, a total of 100 MICU transports were studied. The median (IQR) QUIT-EMR score was 1 (0–2). Experts classified six transports as inadequate. The percentage agreement between the QUIT-EMR score and experts’ classification for adequate/inadequate transport ranged from 84% to 92% (Gwet’s AC10.81–0.91). The interobserver agreement between experts was 87% to 94% (Gwet’s AC10.89–0.98).ConclusionThe QUIT-EMR score is a novel validated tool to score MICU transportation adequacy in future studies contributing to quality control and improvement.Trial registration numberNTR 4937.

scholarly journals Quality of interhospital transport of the critically ill: impact of a Mobile Intensive Care Unit with a specialized retrieval team

Critical Care ◽  
2011 ◽  
Vol 15 (1) ◽  
pp. R75 ◽  
Author(s):  
Janke S Wiegersma ◽  
Joep M Droogh ◽  
Jan G Zijlstra ◽  
Janneke Fokkema ◽  
Jack JM Ligtenberg
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Interhospital Transport ◽  
Mobile Intensive Care Unit ◽  
Retrieval Team

Practice Guidelines: How Good are Medicine's New Recipes?

1995 ◽  
Vol 23 (1) ◽  
pp. 47-48 ◽  
Author(s):  
Alexander Morgan Capron
Keyword(s):  
Health Care ◽  
Nonprofit Organizations ◽  
Medical Knowledge ◽  
Medical Specialty ◽  
Therapeutic Interventions ◽  
Medical Interventions ◽  
Practice Parameters ◽  
Wide Range ◽  
Standard Of Practice

Over the last decade, standards for when and how to undertake a wide range of medical interventions have poured forth from medical specialty groups, commercial and nonprofit organizations, and state and federal panels. Known by a variety of names—from practice parameters to clinical guidelines—and intended for a range of purposes—from diminishing the incidence of maloccurences in hospitals to cutting the costs of health care—these guidelines share one important feature: the intention of decreasing the range of variation in medical practice. Such standardization immediately appeals to anyone interested in improving the quality of health care and, in particular, reducing inappropriate medical interventions, in light of the difficulties for a conscientious physician today in adhering to the best standard of practice when faced with ever increasing medical knowledge and the growing number and complexity of diagnostic, preventive, and therapeutic interventions.

scholarly journals Estimating the minimum important difference in the DEMQOL instrument in people with dementia

2021 ◽  
Author(s):  
Ellen C. Lee ◽  
Jessica Wright ◽  
Stephen J. Walters ◽  
Cindy L. Cooper ◽  
Gail A. Mountain
Keyword(s):  
Quality Of Life ◽  
Controlled Trial ◽  
Minimum Important Difference ◽  
Absolute Change ◽  
People With Dementia ◽  
Related Quality ◽  
Registration Number ◽  
Clinically Significant ◽  
Randomised Controlled

Abstract Purpose The Dementia-Related Quality of Life (DEMQOL) measure and the DEMQOL-Utility Score (DEMQOL-U) are validated tools for measuring quality of life (QOL) in people with dementia. What score changes translate to a clinically significant impact on patients’ lives was unknown. This study establishes the minimal important differences (MID) for these two instruments. Methods Anchor-based and distribution-based methods were used to estimate the MID scores from patients enrolled in a randomised controlled trial. For the anchor-based method, the global QOL (Q29) item from the DEMQOL was chosen as the anchor for DEMQOL and both Q29 and EQ-5D for DEMQOL-U. A one category difference in Q29, and a 0.07 point difference in EQ-5D score, were used to classify improvement and deterioration, and the MID scores were calculated for each category. These results were compared with scores obtained by the distribution-based methods. Results A total of 490 people with dementia had baseline DEMQOL data, of these 386 had 8-month data, and 344 had 12-month DEMQOL data. The absolute change in DEMQOL for a combined 1-point increase or decrease in the Q29 anchor was 5.2 at 8 months and 6.0 at 12 months. For the DEMQOL-U, the average absolute change at 8 and 12 months was 0.032 and 0.046 for the Q29 anchor and 0.020 and 0.024 for EQ-5D anchor. Conclusion We present MID scores for the DEMQOL and DEMQOL-U instruments obtained from a large cohort of patients with dementia. An anchored-based estimate of the MID for the DEMQOL is around 5 to 6 points; and 0.02 to 0.05 points for the DEMQOL-U. The results of this study can guide clinicians and researchers in the interpretation of these instruments comparisons between groups or within groups of people with dementia. Trial Registration Number and date of registration: ISRCTN17993825 on 11th October 2016.

scholarly journals Psychological resilience during COVID-19: a meta-review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e051417
Author(s):  
Katie Seaborn ◽  
Mark Chignell ◽  
Jacek Gwizdka
Keyword(s):  
Systematic Reviews ◽  
Well Being ◽  
Measurement Tool ◽  
Psychological Resilience ◽  
Key Points ◽  
Meta Review ◽  
Ethical Approval ◽  
Registration Number ◽  
Review Protocol

IntroductionThe global COVID-19 pandemic continues to have wide-ranging implications for health, including psychological well-being. A growing corpus of research reviews has emerged on the topic of psychological resilience in the context of the pandemic. However, this body of work has not been systematically reviewed for its quality, nor with respect to findings on the effectiveness of tools and strategies for psychological resilience. To this end, a meta-review protocol is proposed with the following objectives: (1) identify review work on the topic of psychological resilience during COVID-19; (2) assess the quality of this review work using A MeaSurement Tool to Assess systematic Reviews; (3) assess the risk of bias in this work; (4) generate a narrative summary of the key points, strengths and weaknesses; (5) identify the psychological resilience strategies that have been reviewed; (6) identify how these strategies have been evaluated for their effectiveness; (7) identify what outcomes were measured and (8) summarise the findings on strategies for psychological resilience so far, providing recommendations, if possible.Methods and analysisA systematic meta-review will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews for Protocols and Joanna Briggs Institute umbrella review guidelines. Electronic searches of general databases, especially Web of Science, Scopus and PubMed, will be conducted. Only results from January 2020 onwards will be considered, coinciding with the COVID-19 pandemic. Only results in English will be included. Descriptive statistics, thematic analysis and narrative summaries describing the nature of the reviewed work and evaluation of psychological resilience strategies will be carried out.Ethics and disseminationEthical approval is not needed for systematic review protocols. The results of the meta-review will be published in an international peer-reviewed journal. The raw and summarised data will be shared in the journal or other open venues.PROSPERO registration numberCRD42021235288.

scholarly journals Non-attendance rates among patients attending different grades of psychiatrist and a clinical psychologist within a community mental health clinic

2004 ◽  
Vol 28 (1) ◽  
pp. 5-7 ◽  
Author(s):  
Ronan McIvor ◽  
Emma Ek ◽  
Jerome Carson
Keyword(s):  
Health Clinic ◽  
Clinical Psychologist ◽  
Junior Doctors ◽  
Attendance Rates ◽  
Administration System ◽  
Medical Interventions ◽  
Community Mental Health Clinic ◽  
Linear Contrast ◽  
Patient Administration System

Aims and MethodTo examine non-attendance rates in patients seen by psychiatrists of different grades and a consultant clinical psychologist. Rates were obtained from the patient administration system over a 21-month period.ResultsA planned linear contrast showed that the clinical psychologist's patients had the lowest rate of non-attendance (7.8%), followed in turn by those of consultant psychiatrists (18.6%), specialist registrars (34%) and senior house officers (37.5%).Clinical ImplicationsFactors such as continuity of care, perceived clinical competence and the provision of non-medical interventions might have an impact on attendance rates. These results indicate the difficulty in reconciling the training needs of junior doctors with the provision of continuity and quality of care for patients. Reminder systems for people seeing training doctors might be an effective way of reducing non-attendance rates.

scholarly journals What does my neighbourhood have to do with my weight? A protocol for systematic review and meta-analysis of the association between neighbourhood socioeconomic status and body weight

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017567
Author(s):  
Shimels Hussien Mohammed ◽  
Mulugeta Molla Birhanu ◽  
Tesfamichael Awoke Sissay ◽  
Tesfa Dejenie Habtewold ◽  
Balewgizie Sileshi Tegegn ◽  
...  
Keyword(s):  
Systematic Review ◽  
Socioeconomic Status ◽  
Data Extraction ◽  
Meta Analysis ◽  
Cross Sectional ◽  
Registration Number ◽  
Newcastle Ottawa Scale ◽  
Neighbourhood Socioeconomic Status ◽  
Using Data

IntroductionIndividuals living in poor neighbourhoods are at a higher risk of overweight/obesity. There is no systematic review and meta-analysis study on the association of neighbourhood socioeconomic status (NSES) with overweight/obesity. We aimed to systematically review and meta-analyse the existing evidence on the association of NSES with overweight/obesity.Methods and analysisCross-sectional, case–control and cohort studies published in English from inception to 15 May 2017 will be systematically searched using the following databases: PubMed, EMBASE, Web of Sciences and Google Scholar. Selection, screening, reviewing and data extraction will be done by two reviewers, independently and in duplicate. The Newcastle–Ottawa Scale (NOS) will be used to assess the quality of evidence. Publication bias will be checked by visual inspection of funnel plots and Egger’s regression test. Heterogeneity will be checked by Higgins’s method (I2statistics). Meta-analysis will be done to estimate the pooled OR. Narrative synthesis will be performed if meta-analysis is not feasible due to high heterogeneity of studies.Ethics and disseminationEthical clearance is not required as we will be using data from published articles. Findings will be communicated through a publication in a peer-reviewed journal and presentations at professional conferences.PROSPERO registration numberCRD42017063889.

The Keloid Intervention Benefit Inventory 21: A New Assessment Tool for the Quality of Life of Patients with Auricular Keloids

2021 ◽  
Author(s):  
Daniel Häussler ◽  
Stefanie Hüttemann ◽  
Christel Weiß ◽  
Nicole Karoline Rotter ◽  
Haneen Sadick
Keyword(s):  
Quality Of Life ◽  
Internal Consistency ◽  
Social Impact ◽  
Assessment Tool ◽  
Clinical Symptoms ◽  
Physical Symptoms ◽  
Medical Intervention ◽  
Medical Interventions ◽  
Before And After

Abstract Purpose The assessment of the quality of life (QoL) of patients with chronic diseases before and after medical interventions has gained increasing importance in recent decades. Particularly for patients with visible keloid scars in the head and neck region, standardized measurement tools are either absent or have been shown to be insufficient. The aim of the present study was to create a new standardized questionnaire that is specific to auricular keloid patients and reflects their clinical symptoms and QoL. Methods The Keloid Intervention Benefit Inventory 21 (KIBI-21) questionnaire was developed in two stages. First, a group of experts identified a pool of 26 questions and modified and supplemented the items through a comparison with existing QoL assessments so that they related to keloid-specific clinical symptoms and the QoL of patients with auricular keloids before and after a medical intervention. This questionnaire was distributed to 27 outpatients who had undergone medical interventions for visible auricular keloids. Second, a sequential statistical analysis was conducted. This included a single-item assessment and reduction, analysis for internal consistency, construct validity, and divergence validity as well as a factor analysis. The analyses were performed for the entire questionnaire and for the items in the subcategories General Health, Physical Symptoms, Self-Esteem, and Social Impact. Results The final version of this newly validated and standardized KIBI questionnaire consisted of 21 items, of which each item was assigned to only one subscale. The questionnaire showed a Cronbach's α of 0.84 with a good internal consistency. In the item correlation validity, strong associations were found in all subscales, except for the Social Impact Subscale. Conclusion The keloid-specific QoL questionnaire KIBI-21 proved to be a reliable and reproducible instrument to assess the QoL and clinical symptoms in patients suffering from auricular keloids before and after a medical treatment.

Genderdysforie en ASS

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Tatiana Brandsma ◽  
Kirsten Visser
Keyword(s):  
Peer Support ◽  
Support Group ◽  
Autism Spectrum ◽  
Gender Variance ◽  
Medical Interventions ◽  
Peer Support Group ◽  
And Gender ◽  
Gender Presentation ◽  
Adolescents With Asd

There is a growing interest in the co-occurrence of autism spectrum disorder (ASD) and gender dysphoria (GD). Research has shown that people with ASD show more gender variance than people without ASD. Due to the difficulties associated with ASD (limited social skills, problems in information processing and difficulty with change), regular GD treatment does not seem to be adequately equipped for this specific group. In this study we want to gain insight into the clinical needs of adolescents with ASD and GD and their parents. We are conducting a pilot study to the effects of a specific peer support group for adolescents with ASD and GD on quality of life. A pre-posttest design is used. Prior to the start of the support group, during each meeting and at the end of the support group, the adolescents fill out several short questionnaires. The ASD and Gender support group consists of nine monthly meetings for the adolescents, covering topics such as autism and gender-related needs, psychoeducation on medical interventions, environmental factors, gender expression and practicing gender presentation skills. Simultaneously, parents can follow the parent meetings. Currently, three rounds of the peer support group have started (each round with about 10-12 adolescents).

scholarly journals A Systematic Review on Psychological and Biological Mediators Between Adversity and Psychosis: Potential Targets for Treatment

2019 ◽  
Author(s):  
Luis Alameda ◽  
Victoria Rodriguez ◽  
Ewan Carr ◽  
Monica Aas ◽  
Giulia Trotta ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Samples ◽  
Traditional Treatment ◽  
Affective Dysregulation ◽  
Cognitive Behavioural ◽  
Study Results ◽  
Registration Number ◽  
Meta Analyses ◽  
Competing Pathways

AbstractVarious psychological and biological pathways have been proposed as mediators between childhood adverse events (CA) and psychosis. A systematic review of the evidence in this domain is needed. The aim of this work is to systematically review the evidence on psychological and biological mediators between CA and psychosis across the psychosis spectrum. This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (registration number: CRD42018100846). Articles published between 1979 and July 2019 were identified through a literature search in OVID (PsychINFO; Medline and Embase). The evidence by each analysis and each study results are presented by group of mediator categories found in the review. The percentage of total effect mediated was calculated. 47 studies were included, with a total of 79,668 from general population (GP) and 3,189 from clinical samples. The quality of studies was judged as “fair”. Our results showed (i) solid evidence of mediation between CA and psychosis by negative cognitive schemas about the self, the world, and others (NS); by dissociation and other PTSD symptoms; (ii) evidence of al mediation through an affective pathway (affective dysregulation, anxiety, and depression) in GP; (iii) lack of studies exploring biological mediators. To conclude, we found evidence suggesting that various overlapping and not competing pathways contribute partially to the link between adversity and psychosis. Experiences of adversity, along with relevant mediators such as PTSD and mood related symptoms and NS, should be routinely assessed in patients with psychosis. Targeting such mediators through cognitive behavioural aproaches using trauma-focused therapy and/or pharmacological means could be a useful addition to the traditional treatment of positive symptoms.

scholarly journals Physiochemical and Bacteriological Analysis of Selected Sachet Water in Jere and Maiduguri, Borno State Nigeria

2015 ◽  
Vol 4 (1) ◽  
pp. 48-57 ◽  
Author(s):  
Mohammed Modu Aji ◽  
Shettima Abba Kyar ◽  
Mustapha Hussaini
Keyword(s):  
Total Alkalinity ◽  
World Health ◽  
Most Probable Number ◽  
Expiry Date ◽  
Probable Number ◽  
Bacteriological Analysis ◽  
Batch Number ◽  
Registration Number ◽  
Sachet Water

 The study involved the determination of some physiochemical and bacteriological properties in sachet-water samples taken within selected geopolitical wards in Jere and Maiduguri Metropolis. The purpose was to ascertain the quality of sachet water sold for consumption within the area. Ten samples were drawn, five from each study area. The samples were analysed for temperature, colour, turbidity, pH, conductivity, iron, total alkalinity and total dissolved solid. Bacteriological analysis was also carried out using multiple tube (most probable number) technique for enumeration of both total coli form count and differential Escherichia coli count. Other physical examination like volume, National Agency for Food and Drugs Administration and Control (NAFDAC) registration number, batch number, production date and expiry date were also examined. The results obtained were compared with World Health Organization (WHO), NAFDAC and Nigeria Standard of Drinking Water Quality (NSDWQ). Variations were observed among the entire samples in comparison with the standard. Some of the parameters conform to the standard like the Tempreture, pH, colour, odour, iron content and NAFDAC registration number while others like TDS, total alkalinity and volumetric quantity fell below the standard. The bacteriological analysis also showed that 80% of the samples studied revealed the presence of coliforms. Hence, there is need for regulatory agencies like NAFDAC and Standard Organisation of Nigeria (SON) to intensify effort in the routine monitoring of quality of sachet water marketed for consumption.DOI: http://dx.doi.org/10.3126/ije.v4i1.12177 International Journal of Environment Volume-4, Issue-1, Dec-Feb 2014/15, page: 48-57  

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