Decision Quality Among Parents Who Are Offered Ventilation Tube Insertion for Their Children

2020 ◽  
Vol 129 (8) ◽  
pp. 748-754
Author(s):  
Maxwell D. Newby ◽  
Habib G. Zalzal ◽  
Jad Ramadan ◽  
Brian M. Kellermeyer ◽  
Michele M. Carr
Keyword(s):  
Tertiary Care ◽  
Knowledge Score ◽  
Decisional Conflict ◽  
Decision Quality ◽  
Ventilation Tube ◽  
Tube Insertion ◽  
Mean Values ◽  
Parental Treatment ◽  
The Mean ◽  
Potential Use

Objective: To develop a Decision Quality (DQ) tool to measure parents’ DQ concerning ventilation tube (VT) insertion in their children. Method: Parental survey during 2017 to 2018 in a tertiary care pediatric otolaryngology clinic comparing a validated Decisional Conflict (DC) scale with a DQ instrument including Shared Decision-Making (SDM) scale, parental treatment goals, and knowledge about VT. Results: Of 100 parent participants, 83% were mothers and 14% were fathers. 94% elected VT insertion, 6% elected monitoring or deferred the decision. 44% of the patients were <18 months, 42% were 19 months to 3 years, and the rest were older. The mean DC score was 8.26 out of 100 (95% CI 4.82-11.69), indicating low DC. Mean DQ score was 82.45 out of 100 (95% CI 80.18-84.72), including mean SDM of 87.71 (95% CI 83.53-91.88,), mean knowledge score of 87.5% (95% CI 84.56-91.59) and mean values score of 7.16 (95% CI 6.90-7.41). Comparisons between those who elected VT and those who did not showed that electors had lower DC scores (7.15 vs 24.74, P < .001), higher DQ scores (83.00 vs 72.61, P = .028) with higher SDM scores (88.70 vs 70.22, P = .044) and higher values score (7.20 vs 6.36, P = .034). Cronbach alpha for the DQ scale was 0.76. Spearman’s rho for DQ score versus DC score was −0.458, P < .001. Conclusions: DQ, as measured with this tool, was higher when parents chose to place tubes. Our DQ instrument has potential use for study of why parents may decline VT when their child meets criteria for them.

Development of a Decision Aid for Parents Who Elect Tonsillectomy for Obstructive Sleep Apnea

2021 ◽  
pp. 000348942110371
Author(s):  
Adrian Williamson ◽  
Maxwell Newby ◽  
Drew Phillips ◽  
Michele Carr
Keyword(s):  
Decision Making ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Decision Aid ◽  
Tertiary Care ◽  
Knowledge Score ◽  
Decisional Conflict ◽  
Obstructive Sleep ◽  
Parental Treatment ◽  
The Mean

Objective: To develop a novel patient decision aid (PtDA) for parents considering tonsillectomy for their children diagnosed with obstructive sleep apnea (OSA) and compare it to validated scales related to decision making in this context. These included scales for decisional conflict (DC) and shared decision making (SDM). Methods: A parental survey during 2017 to 2018 in a tertiary care pediatric otolaryngology clinic was conducted comparing a validated Decisional Conflict Scale (DCS) with a new PtDA that included an SDM scale, parental treatment goals, and knowledge about adenotonsillectomy and OSA. DCS scores range from 0 to 100 with values less than 25 considered to be low DC. The DQ was determined by a score on the PtDA. The PtDA was composed of a knowledge score, SDM score and 5 related values scored along a continuum (these were: resolution of symptoms, avoiding anesthesia, avoiding surgery, avoiding pain/bleeding, and resumption of normal behavior). A high score meant that all answers were consistent with choosing tonsillectomy and imply better DQ. Results: A total of 89 parents or guardians participated in the study. The mean DC score was 4.32 (95% CI: 2.57-6.07). The mean DQ score was 22.69 (95% CI: 21.86-23.51). Mean values score was 5.35 (95% CI: 5.05-5.65). The mean knowledge score was 9.00 (95% CI: 8.60-9.40). SDM score mean was 8.38 (95% CI: 7.85-8.91). Using Spearman’s rho, DC versus DQ inversely correlated with a coefficient −.209 via a 2-tailed test ( P = .05). Cronbach’s alpha for the DQ score was .78. Conclusion: DC scores overall were low for the group. DQ, as measured with the novel PtDA, had an inverse correlation with DC scores, suggesting validity of the proposed PtDA. Our instrument has potential use as a PtDA for parents who are offered tonsillectomy for their children.

scholarly journals Cognition, Comprehension and Application of Biostatistics in Research by Postgraduate Medical Students of a Tertiary Care Teaching Hospital: Pretest and Posttest Study Design

2016 ◽  
Vol 1 (1) ◽  
pp. 5-9
Author(s):  
Rajaat Vohra ◽  
Siddharth Pramod Dubhashi ◽  
Bhoopendra Nath Sharma ◽  
GN Saxena ◽  
Anusha Vohra
Keyword(s):  
Medical Students ◽  
Study Design ◽  
Teaching Hospital ◽  
Research Methodology ◽  
Tertiary Care ◽  
Knowledge Score ◽  
Postgraduate Students ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching ◽  
The Mean

ABSTRACT Introduction Biostatistics plays a key role in planning, conduct, analysis and reporting of a research. Teaching biostatistics and research methodology is often considered as a difficult task to medical students. The present study was undertaken to evaluate the cognition, comprehension and application of biostatistics in research in the 1st year postgraduate medical students. Materials and methods A predesigned and pretested questionnaire was used to collect data regarding knowledge and application of biostatistics from 65 postgraduate students registered. A series of 10 lectures were taken on various topics of biostatistics and research methodology. All students were subjected to Multiple Choice Questions covering all the topics before the 1st lecture and after the 10th lecture. Mean knowledge score was calculated and data were analyzed. Results Only 16.92% students had publication, 35.38% students have presented a paper/poster in any national or international conference while only 10.76% students have participated in any research methodology workshop. A total of 63.07% students said that they were aware of importance of biostatistics in research, 50.76% students said that they were having some knowledge of biostatistics. A total of 60% students have consulted statistician regarding the study while 23.07% students have attempted statistical analysis on their own. A total of 33.84% students are familiar with the use of MS-EXCEL spreadsheet. There was statistically significant improvement seen in the mean knowledge score of the students after the lectures in comparison to the mean knowledge score before the lectures. Conclusion Considering the fruitful outcome of structured training program in biostatistics, there is a need for provision of formal training in biostatistics to postgraduate students in all medical colleges. Capacity building initiative in this domain is the need of the hour. How to cite this article Vohra R, Dubhashi SP, Sharma BN, Saxena GN, Vohra A. Cognition, Comprehension and Application of Biostatistics in Research by Postgraduate Medical Students of a Tertiary care Teaching Hospital: Pretest and Posttest Study Design. J Mahatma Gandhi Univ Med Sci Tech 2016;1(1):5-9.

Efficacy of balloon Eustachian tuboplasty as a first line treatment for otitis media with effusion in children

2020 ◽  
pp. 1-4
Author(s):  
B Demir ◽  
C Batman
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Line Treatment ◽  
Ventilation Tube ◽  
First Line ◽  
Tube Insertion ◽  
The Mean ◽  
Group 2 ◽  
Balloon Eustachian Tuboplasty ◽  
First Line Treatment

Abstract Objective This study aimed to compare the outcomes of ventilation tube insertion and balloon Eustachian tuboplasty as a first line treatment for otitis media with effusion in children. Method This was a retrospective evaluation of 62 children, 30 cases that underwent balloon Eustachian tuboplasty (group 1) and 32 cases that underwent ventilation tube insertion (group 2), from July 2016 to April 2018. Results The pre-operative air–bone gap of patients who underwent balloon Eustachian tuboplasty was 15–35 dB (mean: 27.6 ± 8.2 dB). The mean pre-operative air–bone gap decreased to 9.6 dB after a mean of 14.4 months (p < 0.05). The air–bone gap decreased from 25.6 dB to 17.6 dB in the ventilation tube group. There was a significant improvement in the air–bone gap values in both groups; however, this decrease was significantly higher in the balloon Eustachian tuboplasty group (p = 0.043). Conclusion Balloon Eustachian tuboplasty may be an effective and safe method for use as a first-line treatment of otitis media with effusion in children.

Surveillance of Otitis Media With Effusion in Thai Children With Cleft Palate

2017 ◽  
Vol 55 (4) ◽  
pp. 590-595 ◽  
Author(s):  
Kitirat Ungkanont ◽  
Panrasee Boonyabut ◽  
Chulaluk Komoltri ◽  
Archwin Tanphaichitr ◽  
Vannipa Vathanophas
Keyword(s):  
Cleft Palate ◽  
Otitis Media ◽  
Cumulative Incidence ◽  
Otitis Media With Effusion ◽  
Hearing Level ◽  
Ventilation Tube ◽  
Tube Insertion ◽  
Hearing Outcome ◽  
Significant Difference ◽  
The Mean

Objective: To study the incidence and outcome of management of otitis media with effusion in Thai children with cleft palate. Design: Retrospective cohort study in the tertiary care center. Patients: Ninety-five children with cleft palate were referred for ear evaluation, from June 1997 to January 2015. Fifteen children (15.8%) had associated craniofacial syndromic anomalies. Main outcome measures: Cumulative incidence of otitis media with effusion, rate of ventilation tube insertion, duration of indwelling tubes, hearing outcome, and complications of ventilation tubes. Results: Ear examinations were done every 8 to 12 weeks throughout the study. Cumulative incidence of otitis media with effusion was 53.7% in children within 12 months of age and 81.1% within 24 months of age. At the end of the study, all of the patients had at least 1 episode of otitis media with effusion. Eighty-eight children (92.6%) had palatoplasty, and there was no significant difference in the incidence of otitis media before and after palatoplasty. The mean hearing level at recruitment was 40.8 ±18.4 dB. Ventilation tube insertion was done in 76 patients (80%). The median time for indwelling tubes was 11.7 months. Rate of ventilation tube insertion was 0.5/year. The mean hearing level at last follow-up was 23.5 ± 14 dB. Otorrhea through tube was found in 24 cases (31.6%). Conclusion: Otitis media with effusion was common in Thai children with cleft palate. Surveillance of middle ear effusion and ventilation tube insertion contributed to a favorable hearing outcome.

scholarly journals Evaluation of the Knowledge and Perceptions about Pharmacovigilance Activities among Pharmacy Students in Nigeria: A Cross-Sectional Study

2017 ◽  
Vol 20 (1) ◽  
pp. 1-13
Author(s):  
Osemene Kanayo Patrick ◽  
Afolabi Margaret Olubunmi
Keyword(s):  
Age Groups ◽  
Knowledge Score ◽  
Cross Sectional Study ◽  
Pharmacy Students ◽  
Sectional Study ◽  
Knowledge Domain ◽  
Cross Sectional ◽  
Mean Values ◽  
Significant Difference ◽  
The Mean

Studies on pharmacovigilance (PV) activities in Nigeria focused on perceptions of PV among professional healthcare workers are described here. There is paucity of information on pharmacy students’ knowledge about PV activities. Hence, this study, evaluated the knowledge and perceptions of final year pharmacy students about PV activities using descriptive and inferential statistics. A cross sectional study was undertaken in three Nigerian universities with a pretested questionnaire during the period of January and February, 2016. The questionnaire included closed-ended questions on demographic variables and questions designed to achieve the objectives of the study. Data was analyzed with IBM SPSS Statistics 20 and presented in percentages, means, standard deviations and median at 50% percentile. The mean knowledge score of pharmacovigilance and adverse drug reporting for the final year students was 4.25±0.18. There were significant differences in the mean scores of knowledge domain by age groups 21-24 years 4.8±0.70, 25-30 years 6.2 ± 0.84 and >30 years 4.6±0.72 at p=0.001; gender: male 4.1±1.20 and female 4.4±0.98 at (p=0.0001) as well as the current universities attended as follows University 1 with a scrore of 5.1±1.03, University 2 had a mean score of 6.3±0.99 at p=0.0120 and University 3 with a mean score of 4.3±1.01 at p=0.012. Furthermore, significant difference exist in the mean values of pharmacovigilance knowledge between those who had taking some courses in pharmacovigilance (7.3± 0.22) and those who did not (4.7 ± 0.13) at p=0.0001. Generally, the students had inadequate knowledge of PV activities. Therefore, emphasis on relevant PV courses in their curriculum is necessary.Bangladesh Pharmaceutical Journal 20(1): 1-13, 2017

scholarly journals Late diagnosis of pseudohypoparathyroidism in adulthood. Case series

2018 ◽  
Vol 66 (4) ◽  
pp. 643-649
Author(s):  
Maria Camila Trejo ◽  
Alejandro Roman-Gonzalez ◽  
Sebastian Ruiz ◽  
Catalina Tobón ◽  
Pablo Castaño ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Peripheral Resistance ◽  
Case Series ◽  
Hereditary Disease ◽  
Primary Diagnosis ◽  
Inclusion Criteria ◽  
Mean Values ◽  
The Mean ◽  
Tertiary Care Centers ◽  
Adequate Management

Introduction: Pseudohypoparathyroidism (PHP) is a rare hereditary disease, characterized by hypocalcemia/hyperphosphatemia secondary to peripheral resistance to parathyroid hormone (PTH). PHP diagnosis is usually precluded since hypocalcemia is considered as the primary diagnosis, thus delaying further diagnostic studies and preventing an adequate management of this clinical condition.Materials and methods: Retrospective review of the databases of the Endocrinology departments of two tertiary care centers of Medellin, Colombia from January 2012 to December 2016. Patients diagnosed with PHP based on clinical presentation and confirmatory laboratory values were included.Results: Four patients met the inclusion criteria. All PHP cases were diagnosed in adulthood despite strong early clinical and laboratory evidence of the disease. Three patients were diagnosed with Fahr’s syndrome and two with Albright’s hereditary osteodystrophy. The mean values obtained were PTH of 376.8 pg/mL, calcium of 6.17 mg/dL and phosphorus of 6.55 mg/dL.Conclusions: PHP is a rare disorder. This paper describes four PHP cases diagnosed during adulthood. Emphasis should be placed on the judicious approach to the patient with hypocalcemia and hyperphosphatemia with increased PTH and normal renal function, since these symptoms strongly suggest a diagnosis of PHP.

scholarly journals Healthcare workers knowledge, attitude and practices during the COVID-19 pandemic response in a tertiary care hospital of Nepal

2020 ◽  
Author(s):  
Dil K Limbu ◽  
Rano M Piryani ◽  
Avinash K Sunny
Keyword(s):  
Healthcare Workers ◽  
Tertiary Care ◽  
Knowledge Score ◽  
Demographic Characteristics ◽  
Control Measures ◽  
Care Hospital ◽  
Attitudes And Practices ◽  
The Mean ◽  
Pandemic Response ◽  
Prevention And Control Measures

Background To control the spread of ongoing COVID-19 infection, extremely important measures need to be adopted. Healthcare workers adherence to prevention and control measures is affected by their knowledge, attitudes, and practices (KAP) towards COVID-19. In this study, we assessed the KAP among healthcare workers towards COVID-19 during the ongoing pandemic. Method A self-developed piloted KAP questionnaire was used among the recruited healthcare workers working for the COVID-19 response in the Universal College of Medical Sciences Teaching Hospital (UCMSTH), in Bhairahawa, Nepal. The knowledge questionnaire consisted of questions regarding the clinical characteristics, prevention and management of COVID-19. Assessment on attitudes and practices towards COVID-19 included questions on behaviour and change in practices while working during this response. Knowledge scores were calculated and compared by demographic characteristics and their attitude and practices towards COVID-19. Data were analysed using bivariate statistics. Results A total of 103 healthcare workers participated in the study. The mean age of the participants was 28.24(6.11) years (range: 20-56); 60.2% were females; 61.2% were unmarried; 60.2% had medical degree and 39.8% were nursing staff. The mean knowledge score was 10.59(1.12) (range: 7-13) and it did not vary by demographic characteristics. Attitude was positive for 53.4% participants with a mean knowledge score of 10.35(1.19) and negative for 46.6% participants with a mean knowledge score of 10.88(0.98) (p=0.02). Practice was good (≥3 score) for 81.5% participants with a mean knowledge score of 10.73(1.12) and practice was poor for 18.5% participants with a mean knowledge score of 10.46(1.13) (p=0.24). The attitude of the participants improved with the increasing age of the participants (29.55(7.17), p=0.02). Conclusion There is comparably better knowledge regarding COVID-19 among healthcare workers along with appropriate practices, however attitude was less optimistic with better knowledge but more optimistic with higher age of the healthcare workers. Hence, protective measures for healthcare workers in order to improve their attitude is necessary during the pandemic response.

scholarly journals Knowledge and awareness regarding facemasks among medical professionals in a COVID dedicated hospital – Time for introspection and system strengthening.

2021 ◽  
Author(s):  
Sulakshna Aggarwal ◽  
Lovenish Bains ◽  
Anurag Mishra ◽  
Aashima Dabaas ◽  
Madhav Goel ◽  
...  
Keyword(s):  
Information Needs ◽  
Tertiary Care ◽  
Knowledge Score ◽  
North India ◽  
Medical Professionals ◽  
Accurate Information ◽  
Infected People ◽  
Different Types ◽  
The Mean ◽  
Regular Training

Abstract Background- There is a limited literature especially in India on the awareness regarding facemasks among medical professionals. Therefore the aim of the study is to assess the awareness, practices followed and problems faced in using different types of facemasks among medical professionals in a COVID dedicated hospital.Methodology- An e-survey via was conducted among medical professionals working in a tertiary care (COVID dedicated) hospital of North-India. The survey asked for the general demographic details, knowledge and awareness on facemask use, quality and various problems faced on regular or prolonged use, sanitization / disposal and recommendations to infected and non- infected people in community. Results- Survey was sent to around 368 medical professionals out of which a total of 150 participants completed the survey giving an overall response rate of 40.8%. The mean score was 9.8 +/- 2.375 out of 21 giving an overall correct rate of 46.67%. 38% and 31.33% participants knew the correct recommendations of facemasks to infected and non-infected people in the community respectively, Only 4.67% knew the correct sanitization procedures, 84% and 69.33% participants reported problems of discomfort on face and sweat issues respectively while 48.7% of the population felt some amount of breathlessness within 1-3 hours with N-95/FFP2 masks. Discussion- Awareness in this part of the world was low as compared to the western compared to countries (46.67%) which increases significantly with years of experience(p<0.001), however no such correlation of knowledge score with discipline of medical professionals was found. Since, it is the young medical force which is at the forefront to tackle the menace, therefore, institute should provide regular training and knowledge up gradation about the facemasks and adequate and accurate information needs to be disseminated to younger medical professionals via social media to prevent them from the risk of infection.

Correlation of thyroid hormone profile and acute physiology and chronic health evaluation II (APACHE II) score with the survival in sepsis in a tertiary care centre

2021 ◽  
Vol 12 (2) ◽  
pp. 19-24
Author(s):  
Akshatha Rao Aroor ◽  
Archana Bhat ◽  
Maroli Roshan
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Hormones ◽  
Thyroid Dysfunction ◽  
Tertiary Care ◽  
Apache Ii ◽  
Apache Ii Score ◽  
P Value ◽  
Thyroid Function Tests ◽  
Mean Values ◽  
The Mean

Background: Thyroid hormone plays a pivotal role in the adaptation of metabolic function to stress and critical illness like sepsis. Thyroid dysfunction is associated with increased mortality in sepsis. The role of thyroid dysfunction as a prognostic marker in sepsis remains unclear. Aims and Objectives: To correlate the baseline thyroid function tests with APACHE II score and mortality in adult patients admitted with sepsis in Intensive Care Unit (ICU). Materials and Methods: This was a cross sectional, observational study done for a period of one year from September 2019 to September 2020 in a tertiary care referral hospital. Patients admitted with sepsis to ICU were scored on admission using APACHE II score. Blood was sent for thyroid function tests on admission. Patients were divided into survivors and non-survivors based on the outcome. Statistical analysis was done by calculating mean values, Fisher’s exact test and Pearson’s correlation. Results: A total of 52 patients were included. The mean age was 55.65± 18.55 years with a male predominance (M: F=1.4:1). Pneumonia was the commonest cause of sepsis in the study (20 patients,38.5%). Mortality was seen in 20 patients (38.5%) The mean values of thyroid hormones were lower in non-survivors. APACHE II Score was higher among the non-survivors as compared to survivors. (21.7±5.571 vs 19.78 ± 5.939, p value>0.05). Thyroid hormones (T3, T4, FT3, FT4) had a negative correlation with APACHE II score in non-survivors. TSH had significant positive correlation with APACHE II score in non-survivors (p value=0.027). Conclusion: Thyroid hormone levels did not correlate significantly with APACHE II score and mortality among the non-survivors of sepsis.

scholarly journals Surgical intervention in middle-ear cholesterol granuloma

2003 ◽  
Vol 117 (5) ◽  
pp. 344-348 ◽  
Author(s):  
Manabu Maeta ◽  
Ryusuke Saito ◽  
Fumio Nakagawa ◽  
Takakazu Miyahara
Keyword(s):  
Surgical Treatment ◽  
Middle Ear ◽  
Surgical Intervention ◽  
Hearing Level ◽  
Cholesterol Granuloma ◽  
Ventilation Tube ◽  
Tube Insertion ◽  
Mastoid Obliteration ◽  
The Mean ◽  
Perforated Tympanic Membrane

Eleven patients who had been surgically treated from 1988 to 1999 were retrospectively reviewed in order to evaluate the efficacy of ventilation tube insertion and mastoidectomy with, or without, mastoid obliteration for intractable middle-ear cholesterol granuloma. The mean age registered was 17.2 years at the time of surgical treatment. All cases were unilaterally affected. Five ears were treated with simple mastoidectomy coupled with the insertion of a ventilation tube, while six others had additional mastoid obliteration. The hearing prognosis was excellent with an improved post-operative hearing level of 16.5 dB (cf. pre-operative 37.7 dB). However, morphological prognosis revealed two ears had a residual perforated tympanic membrane without otorrhoea after displacement of the ventilation tube. Of the remaining nine ears with intact placement of the ventilation tube, five had dry ears while four had occasional otorrhoea. Although the morphological prognosis was incomplete, treatments involving at least aninsertion of a ventilation tube with thorough mastoidectomy were thought to be necessary.

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