scholarly journals A Systematic Review of the Abdominal Surgeon’s Personality: Exploring Common Traits in Western Populations

2020 ◽  
Vol 11 (1) ◽  
pp. 2
Author(s):  
Carly Nichola Bisset ◽  
Tracey McKee ◽  
Mary Cawley ◽  
Elliot Tilling ◽  
Susan Joan Moug

The personality traits commonly seen in abdominal surgeons remains undefined, and its potential influence on decision-making and patient outcomes underexplored. This systematic review identified studies on abdominal surgeons who had undergone validated personality testing, with assessment of decision-making and post-operative patient outcomes. The study protocol was registered on PROSPERO (University of York, UK (CRD42019151375)). MEDLINE, Embase, PsycInfo and Cochrane Library databases were searched using the keywords: surgeon; surgeon personality; outcomes. All study designs were accepted including adult visceral surgeons published in English. Five articles from 3056 abstracts met our inclusion criteria and one article was identified from hand searches with two reviewers screening studies. Bias was assessed using the Newcastle-Ottawa scale. Six studies included 386 surgeons. Studies assessing personality using the Five Factor Model (four studies, 329 surgeons) demonstrated higher levels of conscientiousness (self-discipline, thoughtfulness), extraversion (sociability, emotional expression) and openness (creative, conventional) in surgeons versus population norms. Surgeon characterisation of agreeableness and emotional stability was less clear, with studies reporting mixed results. Post-operative outcomes were reported by only one study. Further exploration of the influence of surgeon personality and its influence on decision-making is necessary to deliver patient-centred care and targeted non-technical skills training for surgeons.

2021 ◽  
Vol 12 ◽  
Author(s):  
Rune Strømme ◽  
Karine Holthe Børstad ◽  
Andrea Eftang Rø ◽  
Eilin Kristine Erevik ◽  
Dominic Sagoe ◽  
...  

Objectives: The aim of the present meta-analysis was to synthesize results from the association between problem gambling (PG) and dimensions of the five factor model of personality and to identify potential moderators (gambling diagnosis: yes/no, comorbidity: yes/no and trait assessment: four or fewer items vs. five items or more) of these associations in meta-regressions.Methods: Searches were conducted in six databases; Medline, Web of Science, PsychInfo, Google Scholar, OpenGrey, and Cochrane Library (conducted on February, 22, 2021). Included studies: (1) reported a relationship between PG and at least one of the personality traits in the five-factor model, (2) contained information of zero-order correlations or sufficient data for such calculations, and (3) were original articles published in any European language. Case-studies, qualitative studies, and reviews were excluded. All articles were independently screened by two authors. Final agreement was reached through discussion or by consulting a third author. Risk of bias of the included studies was assessed by the Newcastle-Ottawa Scale. Data were synthesized using a random effects model.Results: In total 28 studies, comprising 20,587 participants, were included. The correlations between PG and the traits were as follows: Neuroticism: 0.273 (95% CI = 0.182, 0.358), conscientiousness −0.296 (95% CI = −0.400, −0.185), agreeableness −0.163 (95% CI = −0.223, −0.101), openness −0.219 (95% CI = −0.308, −0.127), and extroversion −0.083 (95% CI = −0.120, −0.046). For all meta-analyses the between study heterogeneity was significant. Presence of gambling diagnosis was the only moderator that significantly explained between-study variance showing a more negative correlation to extroversion when participants had a gambling diagnosis compared to when this was not the case.Discussion: The results indicated some publication bias. Correcting for this by a trim-and-fill procedure showed however that the findings were consistent. Clinicians and researchers should be aware of the associations between personality traits and PG. Previous studies have for example showed neuroticism to be related to treatment relapse, low scores on conscientiousness to predict treatment drop-out and agreeableness to reduce risk of treatment drop-out.Systematic Review Registration: PROSPERO (CRD42021237225).


2021 ◽  
pp. 030802262110113
Author(s):  
Catarina Oliveira ◽  
Raquel Simões de Almeida ◽  
António Marques

Introduction This study aims to determine the guidelines for the design of a social skills training programme for people with schizophrenia using virtual reality. Methods This article encompasses two studies: Study 1, a systematic review of five articles indexed in the databases B-on, PubMed, Clinical trials and Cochrane Library (2010–2020); Study 2, a focus group of occupational therapists trained in mental health and multimedia professionals, in which they discussed the outline of such a programme. Results A set of guidelines were identified as central and consensual which should be included in the programme. It must have multilevel logic and gradual learning, with simulations of everyday situations, in which it is possible to practise the skills of conversation and communication. Virtual reality provides people with schizophrenia with unlimited opportunities, enhancing a personalized intervention. Conclusion Social skills training could be part of the treatment for people with schizophrenia, and virtual reality is a promising tool to complement traditional training, although still little implemented in mental health services. Occupational therapists have a prominent role in the development and application of this because of their knowledge of activity analysis and their ability to facilitate the generalization of skills in different contexts.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sharare Taheri Moghadam ◽  
Farahnaz Sadoughi ◽  
Farnia Velayati ◽  
Seyed Jafar Ehsanzadeh ◽  
Shayan Poursharif

Abstract Background Clinical Decision Support Systems (CDSSs) for Prescribing are one of the innovations designed to improve physician practice performance and patient outcomes by reducing prescription errors. This study was therefore conducted to examine the effects of various CDSSs on physician practice performance and patient outcomes. Methods This systematic review was carried out by searching PubMed, Embase, Web of Science, Scopus, and Cochrane Library from 2005 to 2019. The studies were independently reviewed by two researchers. Any discrepancies in the eligibility of the studies between the two researchers were then resolved by consulting the third researcher. In the next step, we performed a meta-analysis based on medication subgroups, CDSS-type subgroups, and outcome categories. Also, we provided the narrative style of the findings. In the meantime, we used a random-effects model to estimate the effects of CDSS on patient outcomes and physician practice performance with a 95% confidence interval. Q statistics and I2 were then used to calculate heterogeneity. Results On the basis of the inclusion criteria, 45 studies were qualified for analysis in this study. CDSS for prescription drugs/COPE has been used for various diseases such as cardiovascular diseases, hypertension, diabetes, gastrointestinal and respiratory diseases, AIDS, appendicitis, kidney disease, malaria, high blood potassium, and mental diseases. In the meantime, other cases such as concurrent prescribing of multiple medications for patients and their effects on the above-mentioned results have been analyzed. The study shows that in some cases the use of CDSS has beneficial effects on patient outcomes and physician practice performance (std diff in means = 0.084, 95% CI 0.067 to 0.102). It was also statistically significant for outcome categories such as those demonstrating better results for physician practice performance and patient outcomes or both. However, there was no significant difference between some other cases and traditional approaches. We assume that this may be due to the disease type, the quantity, and the type of CDSS criteria that affected the comparison. Overall, the results of this study show positive effects on performance for all forms of CDSSs. Conclusions Our results indicate that the positive effects of the CDSS can be due to factors such as user-friendliness, compliance with clinical guidelines, patient and physician cooperation, integration of electronic health records, CDSS, and pharmaceutical systems, consideration of the views of physicians in assessing the importance of CDSS alerts, and the real-time alerts in the prescription.


BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e044472
Author(s):  
Saar Hommes ◽  
Ruben Vromans ◽  
Felix Clouth ◽  
Xander Verbeek ◽  
Ignace de Hingh ◽  
...  

ObjectivesTo assess the communicative quality of colorectal cancer patient decision aids (DAs) about treatment options, the current systematic review was conducted.DesignSystematic review.Data sourcesDAs (published between 2006 and 2019) were identified through academic literature (MEDLINE, Embase, CINAHL, Cochrane Library and PsycINFO) and online sources.Eligibility criteriaDAs were only included if they supported the decision-making process of patients with colon, rectal or colorectal cancer in stages I–III.Data extraction and synthesisAfter the search strategy was adapted from similar systematic reviews and checked by a colorectal cancer surgeon, two independent reviewers screened and selected the articles. After initial screening, disagreements were resolved with a third reviewer. The review was conducted in concordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. DAs were assessed using the International Patient Decision Aid Standards (IPDAS) and Communicative Aspects (CA) checklist.ResultsIn total, 18 DAs were selected. Both the IPDAS and CA checklist revealed that there was a lot of variation in the (communicative) quality of DAs. The findings highlight that (1) personalisation of treatment information in DAs is lacking, (2) outcome probability information is mostly communicated verbally and (3) information in DAs is generally biased towards a specific treatment. Additionally, (4) DAs about colorectal cancer are lengthy and (5) many DAs are not written in plain language.ConclusionsBoth instruments (IPDAS and CA) revealed great variation in the (communicative) quality of colorectal cancer DAs. Developers of patient DAs should focus on personalisation techniques and could use both the IPDAS and CA checklist in the developmental process to ensure personalised health communication and facilitate shared decision making in clinical practice.


2020 ◽  
Author(s):  
Ziyi Zhao ◽  
Leilei Zheng ◽  
Xiaoya Huang ◽  
Caiyu Li ◽  
Jing Liu ◽  
...  

Abstract BACKGROUND: Mouth breathing is closely related to the facial skeletal development and malocclusion. The purpose of this systematic review and meta-analysis was to assess the effect of mouth breathing on facial skeletal development and malocclusion in children. METHODS: An electronic search in PubMed, the Cochrane Library, Medline, Web of Science, EMBASE and Sigle through February 23rd, 2020, was conducted. Methodological quality assessments of the selected articles were performed using the Newcastle-Ottawa Scale. Review Manager 5.3, was used to synthesize various parameters associated with the impact of mouth breathing on facial skeletal development and malocclusion. RESULTS: Following full-text evaluations for eligibility, 7 studies (387 mouth-breathing subjects and 433 nasal-breathing controls) were included in the final quantitative synthesis; they were all high-quality. The included indicators were SNA (p>0.050), ANS-PNS (p>0.050), 1.NB (p>0.050), MP-H (p>0.050), FMA (p>0.050), SNB (MD: -1.99, P <0.0001), ANB (MD: 0.95, P = 0.0005), SN-OP (MD: 3.20, P < 0.0001), SNGoGn (MD: 4.34, P < 0.0001), 1-NA (MD: 0.72, P = 0.004), 1. NA (MD: 1.98, P = 0.020), 1-NB (MD: 1.06, P < 0.0001), SPAS (MD: -5.23, P < 0.0001), PAS (MD: -2.11, P < 0.0001), and C3-H (MD: -1.34, P < 0.0001). CONCLUSIONS: The results showed that mouth breathing can cause underdevelopment of the mandible. The mandible rotated backward and downward, and the occlusal plane was steep. However, there was little effect on the maxilla. In addition, mouth breathing presented a tendency of lip inclination of the upper and lower anterior teeth. Airway stenosis was common in mouth-breathing children. TRIAL REGISTRATION: [email protected]; registration number CRD42019129198 KEYWORDS: Mouth breathing; Facial skeletal development; Children; Systematic review, Meta-analysis.


Author(s):  
David R. Street ◽  
Kathleen T. Helton

The purpose of our investigation was to determine if personality testing and a five-factor model could improve the selection of Landing Craft Air Cushion (LCAC) vehicle operators. Vehicle operators for the LCAC are currently selected on the basis of their performance on a computer-based psychomotor selection system. The various psychomotor tests in the selection system have demonstrated predictive validity in LCAC crew training. Certain personality characteristics may also be involved in the LCAC vehicle operator training success. In fact, various researchers have found that personality testing may improve the selection of Navy/Marine Corps aviators. There is increasing evidence that a five-factor model may be useful in describing the personality characteristics involved in training success. We believe that a five-factor model may improve the selection system used for LCAC vehicle operators. A principal component analysis with varimax rotation was conducted to determine the underlying structure of the Adult Personality Inventory (API) with 168 LCAC crew candidates. The resulting factor scores were then entered into a series of hierarchical multiple regression analyses to determine the relation of the personality factor scores and the performance-based test to an underway grade in training criterion. The results indicated that one personality factor, openness, significantly improved predictions of the criterion ( p < 0.05). Based on these results, we believe that personality testing may improve the selection of LCAC vehicle operators.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Kanthee Anantapong ◽  
Nathan Davies ◽  
Justin Chan ◽  
Daisy McInnerney ◽  
Elizabeth L. Sampson

Abstract Background This systematic review aimed to explore the process of decision-making for nutrition and hydration for people living with dementia from the perspectives and experiences of all involved. Methods We searched CINAHL, the Cochrane Library, EMBASE, MEDLINE and PsycINFO databases. Search terms were related to dementia, decision-making, nutrition and hydration. Qualitative, quantitative and case studies that focused on decision-making about nutrition and hydration for people living with dementia were included. The CASP and Murad tools were used to appraise the quality of included studies. Data extraction was guided by the Interprofessional Shared Decision Making (IP-SDM) model. We conducted a narrative synthesis using thematic analysis. PROSPERO registration number CRD42019131497. Results Forty-five studies were included (20 qualitative, 15 quantitative and 10 case studies), comprising data from 17 countries and 6020 patients, family caregivers and practitioners. The studies covered a range of decisions from managing oral feeding to the use of tube feeding. We found that decisions about nutrition and hydration for people living with dementia were generally too complex to be mapped onto the precise linear steps of the existing decision-making model. Decision-making processes around feeding for people living with dementia were largely influenced by medical evidence, personal values, cultures and organizational routine. Although the process involved multiple people, family caregivers and non-physician practitioners were often excluded in making a final decision. Upon disagreement, nutrition interventions were sometimes delivered with conflicting feelings concealed by family caregivers or practitioners. Most conflicts and negative feelings were resolved by good relationship, honest communication, multidisciplinary team meetings and renegotiation. Conclusions The decision-making process regarding nutrition and hydration for people living with dementia does not follow a linear process. It needs an informed, value-sensitive, and collaborative process. However, it often characterized by unclear procedures and with a lack of support. Decisional support is needed and should be approached in a shared and stepwise manner.


2017 ◽  
Vol 52 (9) ◽  
pp. 607-616 ◽  
Author(s):  
Drayton A. Hammond ◽  
Jordan M. Rowe ◽  
Adrian Wong ◽  
Tessa L. Wiley ◽  
Kristen C. Lee ◽  
...  

Purpose: Benzodiazepines are the drug of choice for alcohol withdrawal syndrome (AWS); however, phenobarbital is an alternative agent used with or without concomitant benzodiazepine therapy. In this systematic review, we evaluate patient outcomes with phenobarbital for AWS. Methods: Medline, Cochrane Library, and Scopus were searched from 1950 through February 2017 for controlled trials and observational studies using [“phenobarbital” or “barbiturate”] and [“alcohol withdrawal” or “delirium tremens.”] Risk of bias was assessed using tools recommended by National Heart, Lung, and Blood Institute. Results: From 294 nonduplicative articles, 4 controlled trials and 5 observational studies (n = 720) for AWS of any severity were included. Studies were of good quality (n = 2), fair (n = 4), and poor (n = 3). In 6 studies describing phenobarbital without concomitant benzodiazepine therapy, phenobarbital decreased AWS symptoms ( P < .00001) and displayed similar rates of treatment failure versus comparator therapies (38% vs 29%). A study with 2 cohorts showed similar rates of intensive care unit (ICU) admission (phenobarbital: 16% and 9% vs benzodiazepine: 14%) and hospital length of stay (phenobarbital: 5.85 and 5.30 days vs benzodiazepine: 6.64 days). In 4 studies describing phenobarbital with concomitant benzodiazepine therapy, phenobarbital groups had similar ICU admission rates (8% vs 25%), decreased mechanical ventilation (21.9% vs 47.3%), decreased benzodiazepine requirements by 50% to 90%, and similar ICU and hospital lengths of stay and AWS symptom resolution versus comparator groups. Adverse effects with phenobarbital, including dizziness and drowsiness, rarely occurred. Conclusion: Phenobarbital, with or without concomitant benzodiazepines, may provide similar or improved outcomes when compared with alternative therapies, including benzodiazepines alone.


2014 ◽  
Vol 35 (10) ◽  
pp. 1209-1228 ◽  
Author(s):  
Brittin Wagner ◽  
Gregory A. Filice ◽  
Dimitri Drekonja ◽  
Nancy Greer ◽  
Roderick MacDonald ◽  
...  

ObjectiveEvaluate the evidence for effects of inpatient antimicrobial stewardship programs (ASPs) on patient, prescribing, and microbial outcomes.DesignSystematic review.MethodsSearch of MEDLINE (2000 through November 2013), Cochrane Library, and reference lists of relevant studies. We included English language studies with patient populations relevant to the United States (ie, infectious conditions and prescriptions required for antimicrobials) that evaluated ASP interventions and reported outcomes of interest. Study characteristics and outcomes data were extracted and reviewed by investigators and trained research personnel.ResultsFew intervention types (eg, audit and feedback, guideline implementation, and decision support) substantially impacted patient outcomes, including mortality, length of stay, readmission, or incidence of Clostridium difficile infection. However, most interventions were not powered adequately to demonstrate impacts on patient outcomes. Most interventions were associated with improved prescribing patterns as measured by decreased antimicrobial use or increased appropriate use. Where reported, ASPs were generally associated with improvements in microbial outcomes, including institutional resistance patterns or resistance in the study population. Few data were provided on harms, sustainability, or key intervention components. Studies were typically of short duration, low in methodological quality, and varied in study design, populations enrolled, hospital setting, ASP intent, intervention composition and implementation, comparison group, and outcomes assessed.ConclusionsNumerous studies suggest that ASPs can improve prescribing and microbial outcomes. Strength of evidence was low, and most studies were not designed adequately to detect improvements in mortality or other patient outcomes, but obvious adverse effects on patient outcomes were not reported.


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