scholarly journals Anaesthetic management of maxillofacial surgeries: A cross-sectional survey to analyze current trend of practices

2021 ◽  
Vol 8 (2) ◽  
pp. 331-334
Author(s):  
Ayya Syama Sundar ◽  
Akhya Kumar Kar ◽  
Emmala Mounika
Keyword(s):  
Head Injury ◽  
Current Trend ◽  
Operative Management ◽  
Anaesthetic Management ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Operative Care ◽  
Delayed Extubation ◽  
Operative Evaluation ◽  
Special Subset

Anaesthetic management of maxillo-facial surgeries considered as special subset of surgery where the airway management needs proper attention. Most of the time it varies depending on the resources and skill availability. We tried to evaluate the current trend of practices in managing maxilla-facial surgeries among various practicing anaesthesiologists. This is a retrospective questionnaire based survey conducted among practicing anaesthesiologists to determine the trend of practices and institutional protocols followed for maxillo-facial surgeries. A set of questionnaires prepared to ask about the preferred mode of securing airway, frequency of facing complications and plan for extubation and post-operative management. Total of 86 responses were collected which were analyzed. A total of 91% evaluated the airway with history and physical examination. Fiberoptic broncoscope available in 46% of cases, 51% cases video laryngoscope was preferred as gadget. Naso-tracheal is the commonest route for securing the airway which was preferred by 53% respondents. Only 38% respondents were in favor of extubation of the patients inside the operation theatres after surgery for patients without head injury. In patients with head injury 90% responders believed either a delayed extubation in the ICU or elective ventilation for some hours before extubation is a better option. Most of the anaesthesiologists (61%) preferred shifting the patients to the ICU for post-operative care. Theanaestheticmanagement ofmaxillo-facial surgeries need special attention. It necessitates proper pre-operative evaluation, shared decision making with the surgeons, timely decision of extubation and post-operative care are keys to successfully manage the airway.

Sport-Related Structural Brain Injury and Return to Play: Systematic Review and Expert Insight

Neurosurgery ◽  
2021 ◽  
Author(s):  
Scott L Zuckerman ◽  
Aaron M Yengo-Kahn ◽  
Alan R Tang ◽  
Julian E Bailes ◽  
Kathryn Beauchamp ◽  
...  
Keyword(s):  
Systematic Review ◽  
Brain Injury ◽  
Case Reports ◽  
Operative Management ◽  
Return To Play ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Expert Opinions ◽  
Meta Analyses ◽  
Structural Brain

Abstract BACKGROUND Sport-related structural brain injury (SRSBI) is intracranial pathology incurred during sport. Management mirrors that of non-sport-related brain injury. An empirical vacuum exists regarding return to play (RTP) following SRSBI. OBJECTIVE To provide key insight for operative management and RTP following SRSBI using a (1) focused systematic review and (2) survey of expert opinions. METHODS A systematic literature review of SRSBI from 2012 to present in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and a cross-sectional survey of RTP in SRSBI by 31 international neurosurgeons was conducted. RESULTS Of 27 included articles out of 241 systematically reviewed, 9 (33.0%) case reports provided RTP information for 12 athletes. To assess expert opinion, 31 of 32 neurosurgeons (96.9%) provided survey responses. For acute, asymptomatic SRSBI, 12 (38.7%) would not operate. Of the 19 (61.3%) who would operate, midline shift (63.2%) and hemorrhage size > 10 mm (52.6%) were the most common indications. Following SRSBI with resolved hemorrhage, with or without burr holes, the majority of experts (>75%) allowed RTP to high-contact/collision sports at 6 to 12 mo. Approximately 80% of experts did not endorse RTP to high-contact/collision sports for athletes with persistent hemorrhage. Following craniotomy for SRSBI, 40% to 50% of experts considered RTP at 6 to 12 mo. Linear regression revealed that experts allowed earlier RTP at higher levels of play (β = –0.58, 95% CI –0.111, –0.005, P = .033). CONCLUSION RTP decisions following structural brain injury in athletes are markedly heterogeneous. While individualized RTP decisions are critical, aggregated expert opinions from 31 international sports neurosurgeons provide key insight. Level of play was found to be an important consideration in RTP determinations.

scholarly journals Consensus-based classification system for intra-operative management of labral tears during hip arthroscopy—aggregate recommendations from high-volume hip preservation surgeons

2021 ◽  
Author(s):  
Ajay C Lall ◽  
Shawn Annin ◽  
Jeff W Chen ◽  
Samantha Diulus ◽  
Hari K Ankem ◽  
...  
Keyword(s):  
Decision Making ◽  
Classification System ◽  
High Volume ◽  
Operative Management ◽  
Labral Repair ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
System A ◽  
Labral Tears ◽  
Comprehensive Classification

Abstract The purpose of this study was to survey high-volume hip preservation surgeons regarding their perspectives on intra-operative management of labral tears to improve decision-making and produce an effective classification system. A cross-sectional survey of high-volume hip preservation surgeons was conducted in person and anonymously, using a questionnaire that is repeated for indications of labral debridement, repair and reconstruction given the torn labra are stable, unstable, viable or non-viable. Twenty-six high-volume arthroscopic hip surgeons participated in this survey. Provided the labrum was viable (torn tissue that is likely to heal) and stable, labral debridement would be performed by 76.92% of respondents for patients >40 years of age and by >84% of respondents for stable intra-substance labral tears in patients without dysplasia. If the labrum was viable but unstable, labral repair would be performed by >80% of respondents for patients ≤40 years of age and > 80% of respondents if the labral size was >3 mm and located anteriorly. Presence of calcified labra or the Os acetabuli mattered while deciding whether to repair a labrum. In non-viable (torn tissue that is unlikely to heal) and unstable labra, labral reconstruction would be performed by 84.62% of respondents if labral size was <3 mm. The majority of respondents would reconstruct calcified and non-viable, unstable labra that no longer maintained a suction seal. Surgeons performing arthroscopic hip labral treatment may utilize this comprehensive classification system, which takes into consideration patient age, labral characteristics (viability and stability) and bony morphology of the hip joint. When choosing between labral debridement, repair or reconstruction, consensus recommendations from high-volume hip preservation surgeons can enhance decision-making.

scholarly journals Soft-shell headgear, concussion and injury prevention in youth team collision sports: a systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e044320
Author(s):  
Jennifer Makovec Knight ◽  
Jack V. K. Nguyen ◽  
Biswadev Mitra ◽  
Catherine Willmott
Keyword(s):  
Head Injury ◽  
Injury Risk ◽  
Female Athletes ◽  
In Vivo Studies ◽  
Cochrane Library ◽  
Injury Incidence ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Body Regions ◽  
Soft Shell

ObjectivesTo assess the association between soft-shell headgear (HG) use and sports-related concussion (SRC). Secondary objectives were to assess the association between HG and superficial head injury and investigate potential increase in injury risk among HG users.DesignA systematic search in Ovid MEDLINE, Cochrane Library, Scopus, PsycINFO and SPORTDiscus was conducted in April 2020. Inclusion criteria were youth <18, English language, in vivo studies published after 1980 that evaluated SRC and other injury incidence in HG users compared with non-users.Outcome measuresIncidence rates of SRC, superficial head injury or other injuries.ResultsEight studies were eligible. The majority (n=5) reported no difference in the rate of SRC among HG users versus non-users. One rugby study identified significantly lower risk of SRC for non-HG users (risk ratio (RR) 0.63; 95% CI 0.41 to 0.98) compared with HG users, whereas a cross-sectional survey of soccer players indicated higher risk of SRC for non-HG users (RR 2.65; 95% CI 1.23 to 3.12) compared with HG users. Three of the four studies investigating superficial head injury found no significant differences with HG use, though the soccer survey reported reduced risk among HG users (RR 1.86; 95% CI 0.09 to 0.11). Increased incidence of injuries to all body regions for rugby HG users was reported in two studies with adjusted RRs of 1.16 (95% CI 1.04 to 1.29) and 1.23 (95% CI 1.00 to 1.50).ConclusionsHG use was not associated with reduced rates of SRC or superficial head injury in youth soccer and rugby. The possibility of increased injury risk to all body regions for rugby HG users was raised. The need for research specific to youth and female athletes was highlighted.PROSPERO registration numberCRD42018115310.

Testing the Strain Theory of Suicide – The Moderating Role of Social Support

Crisis ◽  
2020 ◽  
Vol 41 (2) ◽  
pp. 82-88 ◽  
Author(s):  
Bob Lew ◽  
Ksenia Chistopolskaya ◽  
Yanzheng Liu ◽  
Mansor Abu Talib ◽  
Olga Mitina ◽  
...  
Keyword(s):  
Social Support ◽  
Suicidal Behavior ◽  
Online Survey ◽  
Perceived Social Support ◽  
Strain Theory ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Psychological Strains ◽  
Moderating Role

Abstract. Background: According to the strain theory of suicide, strains, resulting from conflicting and competing pressures in an individual's life, are hypothesized to precede suicide. But social support is an important factor that can mitigate strains and lessen their input in suicidal behavior. Aims: This study was designed to assess the moderating role of social support in the relation between strain and suicidality. Methods: A sample of 1,051 employees were recruited in Beijing, the capital of China, through an online survey. Moderation analysis was performed using SPSS PROCESS Macro. Social support was measured with the Multidimensional Scale of Perceived Social Support, and strains were assessed with the Psychological Strains Scale. Results: Psychological strains are a good predictor of suicidality, and social support, a basic need for each human being, moderates and decreases the effects of psychological strains on suicidality. Limitations: The cross-sectional survey limited the extent to which conclusions about causal relationships can be drawn. Furthermore, the results may not be generalized to the whole of China because of its diversity. Conclusion: Social support has a tendency to mitigate the effects of psychological strains on suicidality.

Fit and Congruency

2019 ◽  
Vol 18 (3) ◽  
pp. 148-156
Author(s):  
Mary Hogue ◽  
Lee Fox-Cardamone ◽  
Deborah Erdos Knapp
Keyword(s):  
Role Theory ◽  
Social Role ◽  
Gender Diversity ◽  
Job Fit ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Working Adults ◽  
Role Congruity ◽  
Self Selection ◽  
Selection Of

Abstract. Applicant job pursuit intentions impact the composition of an organization’s applicant pool, thereby influencing selection outcomes. An example is the self-selection of women and men into gender-congruent jobs. Such self-selection contributes to a lack of gender diversity across a variety of occupations. We use person-job fit and the role congruity perspective of social role theory to explore job pursuit intentions. We present research from two cross-sectional survey studies (520 students, 174 working adults) indicating that at different points in their careers women and men choose to pursue gender-congruent jobs. For students, the choice was mediated by value placed on the job’s associated gender-congruent outcomes, but for working adults it was not. We offer suggestions for practitioners and researchers.

Oscillation between identities and Subjective psychological health objectives among an informed audience in therapeutic patient education

2018 ◽  
Vol 10 (1) ◽  
pp. 10202
Author(s):  
Sandrine Roussel ◽  
Alain Deccache ◽  
Mariane Frenay
Keyword(s):  
Patient Education ◽  
Psychological Health ◽  
Healthcare Professionals ◽  
Cross Sectional Survey ◽  
Chi Square ◽  
Cross Sectional ◽  
Therapeutic Patient Education ◽  
French Speaking ◽  
Health Objectives ◽  
Self Administered Questionnaire

Introduction: The implementation of Therapeutic Patient Education (TPE) remains a challenge. An exploratory study highlighted two tendencies among practitioners of TPE, which could hamper this implementation: an oscillation between identities (as caregivers versus as educators) and an inclination towards subjective psychological health objectives. Objectives: To verify whether these tendencies can be observed among an informed audience in TPE. Next, to explore the variables associated with one or other of these tendencies. Method: A quantitative cross-sectional survey by a self-administered questionnaire was carried out among 90 French-speaking healthcare professionals. Statistical analyses (chi-square, logistic regression) were then conducted. Results: Sixty percent of respondents displayed identity oscillation, which was found to be linked to task oscillation, patient curability, scepticism towards medicine and practising in France. Fifty-six percent pursued subjective psychological health objectives, which was found to be associated with health behaviour objectives and a locus of power in the healthcare relationship distinct from those seen in the pre-existing health models (biomedical, global). This tendency seems to constitute an alternative model of TPE. Discussion & conclusion: Identity oscillation and subjective psychological health objectives can be both observed. This study stresses the need to deliberate on the form(s) of TPE that is/are desired.

PERCEIVED EFFECTS OF STREET HAWKING ON THE WELL-BEING OF CHILDREN IN ANYIGBA, DEKINA LOCAL GOVERNMENT AREA OF KOGI STATE, NIGERIA

2018 ◽  
Vol 8 (1) ◽  
pp. 01-07
Author(s):  
Alfred Eboh
Keyword(s):  
Local Government ◽  
Survey Design ◽  
Sampling Technique ◽  
Well Being ◽  
Local Government Area ◽  
Negative Consequences ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Perceived Effects ◽  
The Government

Background: The hawking of wares by children has been a serious issue confronting the Nigerian society. Children hawk in some of the most horrible conditions conceivable, where they face a serious risk of injury, chronic illness, kidnapping, rape or death. Objective: The focus of this study was to assess the perceived effects of street hawking on the well-being of children in Anyigba, Dekina Local Government Area of Kogi State. Methods: The population of this study consists of parents of the street hawkers in Anyigba while cross-sectional survey design was used through the purposive sampling technique to choose the sample size of one hundred and sixty-two (162) respondents. The validated structured questionnaire and In-Depth Interviews (IDIs) served as the instruments for the data collection respectively. The hypotheses were tested using Chi-Square at a predetermined 0.05 level of significance. The quantitative data were analysed with the aid of the SPSS (version 20). Results: The results indicated among others that street hawking had significant social implications and physical consequences on children's moral behaviour as well as health status in the study area. Conclusion: The study, therefore, concluded that the government of Kogi State should carry out an enlightenment campaign through the media and religious institutions on the negative consequences of street hawking are recommended as panacea. Also, the child right act instrument and its implementation should be strengthened in order to curb street hawking in the study area.

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