scholarly journals A Nationwide Cross-Sectional Online Survey on the Treatment of COVID-19-ARDS: High Variance in Standard of Care in German ICUs

2021 ◽  
Vol 10 (15) ◽  
pp. 3363
Author(s):  
Steffen Dickel ◽  
Clemens Grimm ◽  
Maria Popp ◽  
Claudia Struwe ◽  
Alexandra Sachkova ◽  
...  
Keyword(s):  
Intensive Care ◽  
Online Survey ◽  
Scientific Literature ◽  
Treatment Strategies ◽  
Standard Of Care ◽  
Future Research ◽  
High Peep ◽  
Care Providers ◽  
Cross Sectional ◽  
German Icus

Introduction: Coronavirus disease (COVID-19) has recently dominated scientific literature. Incomplete understanding and a lack of data concerning the pathophysiology, epidemiology, and optimal treatment of the disease has resulted in conflicting recommendations. Adherence to existing guidelines and actual treatment strategies have thus far not been studied systematically. We hypothesized that capturing the variance in care would lead to the discovery of aspects that need further research and—in case of proven benefits of interventions not being performed—better communication to care providers. Methods: This article is based on a quantitative and qualitative cross-sectional mixed-methods online survey among intensive-care physicians in Germany during the COVID-19 pandemic by the CEOsys (COVID-19 Evidence Ecosystem) network, endorsed by the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI) conducted from December 3 to 31 December 2020. Results: We identified several areas of care with an especially high variance in treatment among hospitals in Germany. Crucially, 51.5% of the participating ICUs (n = 205) reported using intubation as a last resort for respiratory failure in COVID-19 patients, while 21.8% used intubation early after admission. Furthermore, 11.5% considered extracorporeal membrane oxygenation (ECMO) in awake patients. Finally, 72.3% of respondents used the ARDS-network-table to titrate positive end-expiratory-pressure (PEEP) levels, with 36.9% choosing the low-PEEP table and 41.8% the high-PEEP table. Conclusions: We found that significant differences exist between reported treatment strategies and that adherence to published guidelines is variable. We describe necessary steps for future research based on our results highlighting significant clinical variability in care.

Fashion designers' attitude-behaviour inconsistencies towards a sustainable business model: a neutralisation theory perspective

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Asphat Muposhi ◽  
Brighton Nyagadza ◽  
Chengedzai Mafini
Keyword(s):  
South Africa ◽  
Online Survey ◽  
Emerging Market ◽  
Survey Study ◽  
Future Research ◽  
Cross Sectional ◽  
Content Type ◽  
Study Results ◽  
Sustainable Fashion ◽  
Fashion Designers

PurposeFashion designers in South Africa remain ambivalent in embracing sustainable fashion. This study examines the role of neutralisation techniques on attitude towards sustainable fashion. The study was conducted in South Africa, an emerging market known for water scarcity and pollution emanating from the textile industry.Design/methodology/approachA structured questionnaire was used to collect cross-sectional data from a sample of 590 fashion designers using a web-based online survey. Study constructs were drawn from the neutralisation theory and theory of planned behaviour.FindingsStandard multiple regression analysis results identified denial of injury, appeal to higher loyalties and external locus of control as the major rationalisation techniques influencing South African designers' negative attitudes towards sustainable fashion.Research limitations/implicationsResearch was conducted in South Africa where the concept of sustainable fashion is still at developmental stages. The generalisation of the study findings may be enhanced by extending the study to other markets with a fully developed market for sustainable fashion.Practical implicationsThe study results underscore the necessity of reducing social, structural and institutional barriers associated with the adoption of sustainable fashion. This study provides input towards efforts to develop attitude change strategies to stimulate designers to embrace sustainable fashion.Originality/valueThe research study contributes to theory, practice and future research.

scholarly journals Predeath Grief, Resourcefulness, and Perceived Stress Among Caregivers of Partners With Young-Onset Dementia

2018 ◽  
Vol 41 (7) ◽  
pp. 973-989 ◽  
Author(s):  
Karie Ruekert Kobiske ◽  
Abir K. Bekhet ◽  
Mauricio Garnier-Villarreal ◽  
Marilyn Frenn
Keyword(s):  
Perceived Stress ◽  
Online Survey ◽  
Theoretical Framework ◽  
Future Research ◽  
Resilience Theory ◽  
Moderating Effects ◽  
Cross Sectional ◽  
Young Onset ◽  
Young Onset Dementia ◽  
The Relationship

More than 200,000 Americans are currently diagnosed with young-onset dementia (YOD). YOD is dementia diagnosed prior to the age of 65. Most persons of YOD are cared for by their partners. Using the theoretical framework of Resilience Theory, this cross-sectional, correlational study examined the moderating effects of personal and social resourcefulness on the relationship between predeath grief and perceived stress among 104 YOD caregiving partners (life partners/spouses) using an online survey platform. Results indicated a large positive correlation between predeath grief and caregiver perceived stress ( r = .65; p < .001). Together predeath grief, personal resourcefulness and social resourcefulness explained 51.5% of the variance in perceived stress. Personal resourcefulness did not moderate the relationship. Social resourcefulness did positively moderate this relationship between predeath grief and perceived stress. These findings allow for a better understanding of the caregiving experience for a partner with YOD and creates opportunities for future research studies.

scholarly journals Behavioral interventions to benefit cognition (Intervenciones cognitivas para beneficiar la cognición)

Retos ◽  
2015 ◽  
pp. 197-202
Author(s):  
Jennifer L. Etnier ◽  
Chia-Hao Shih ◽  
Aaron Piepmeier
Keyword(s):  
Cognitive Function ◽  
Cognitive Decline ◽  
Behavioral Interventions ◽  
Animal Studies ◽  
Exercise Intervention ◽  
Treatment Strategies ◽  
Future Research ◽  
Dietary Interventions ◽  
Cross Sectional ◽  
Age Related

With the growing population of older adults, the identification of treatment strategies to prevent or ameliorate age-related cognitive decline has been an important topic in recent years. After reviewing cross-sectional, longitudinal, and experimentally designed studies, as well as evidence from narrative and meta-analytic reviews, the authors concluded that behavioral approaches such as physical activity, cognitive training, and dietary interventions show promising results. In addition, given the likelihood that multiple underlying mechanisms support cognitive function, research is currently focusing on how to combine lifestyle factors into multi-component interventions to generate greater and more meaningful effects. Though evidence for these enhanced benefits exists from animal studies, few multi-component studies have been performed with humans. However, the findings from these studies are promising and a continued pursuit of multi-component behavioral interventions to benefit cognitive performance is warranted. Given the world’s aging population and accompanying age-related health issues such as cognitive decline and dementia, future research should focus on understanding the biological mechanisms responsible for these effects in order to allow for the development of behavioral lifestyle prescriptions to benefit cognitive performance.Keywords. aging, cognitive function, exercise intervention, oxidative stress, cognitive engagement.Resumen. Con la creciente población de adultos mayores, la identificación de las estrategias de tratamiento para prevenir o mejorar el deterioro cognitivo relacionado con la edad ha sido un tema importante en los últimos años. Después de revisar estudios con diseños transversales, longitudinales y experimentales, así como la evidencia de revisiones de literatura narrativa y meta-analítica, los autores concluyen que los enfoques conductuales como la actividad física, el entrenamiento cognitivo y las intervenciones dietéticas muestran resultados prometedores. Además, dada la probabilidad de que múltiples mecanismos subyacentes apoyan la función cognitiva, las investigaciones se enfocan actualmente en la manera de cómo combinar factores del estilo de vida en las intervenciones con múltiples componentes para generar efectos mayores y más significativos. Aunque existe evidencia de estos beneficios a partir de estudios en animales, se han realizado pocos estudios de componentes múltiples en humanos. Sin embargo, los resultados de estos estudios son prometedores y se garantiza un seguimiento continuo de las intervenciones conductuales de componentes múltiples para beneficiar el rendimiento cognitivo. Teniendo en cuenta el envejecimiento de la población mundial y los problemas de salud relacionados con la edad que la acompañan, tales como el deterioro cognitivo y la demencia, la investigación futura debería centrarse en la comprensión de los mecanismos biológicos responsables de estos efectos con el fin de permitir el desarrollo de las prescripciones de comportamiento de estilo de vida para beneficiar el rendimiento cognitivo.Palabras claves. envejecimiento, funcionamiento cognitivo, intervención con ejercicio, estrés oxidativo, participación cognitiva.

scholarly journals 149 Virtual Care: A Quality Improvement Project on the Experience of Paediatricians during the COVID-19 Pandemic

2021 ◽  
Vol 26 (Supplement_1) ◽  
pp. e102-e104
Author(s):  
Emma McCrady ◽  
Julie Strychowsky ◽  
Jessica Woolfson
Keyword(s):  
Quality Improvement ◽  
Online Survey ◽  
Local Level ◽  
Standard Of Care ◽  
Subject Area ◽  
Future Research ◽  
Improvement Project ◽  
Diagnostic Uncertainty ◽  
Virtual Care ◽  
Practice Efficiency

Abstract Primary Subject area Practice/Office Management Background Prior to the COVID-19 pandemic, in-person visits were the standard of care for paediatricians at our centre. With the pandemic onset, virtual care (VC) was adopted at an unprecedented scale and pace. Studies have reported positive patient VC experience; however, few have explored physician experience. This quality improvement (QI) initiative sought to qualify the VC experience of local paediatricians during the pandemic, with the intention of implementing VC clinical practice changes at the department level. Objectives To determine key factors that have supported and challenged the adoption of, and that will support integration of, VC in the future. Design/Methods The Donabedian model for healthcare QI was used to evaluate VC experience through an online survey with a focus on structure, process, and outcome measures. All physicians affiliated with the Department of Paediatrics (generalists and subspecialists in medicine and surgery) were invited to participate via email. Three reminder emails were sent at 2-week intervals. Descriptive statistics were reported. Results The response rate was 32.3% (63 of 195 physicians). The majority of respondents were subspecialists (84.1%), and at academic centres (87.5%) (Table 1). Pre-pandemic, only 30.1% used VC and saw &lt;10% of patients virtually. During March-May 2020, 93.8% transitioned to VC, with &gt; 50% seeing over 75% of patients virtually. By summer 2020, VC use declined, but remained higher than pre-pandemic (53.6% seeing &lt; 25% of patients). OTN and telephone were platforms most used (32.8% and 28.6%, respectively). Most conducted visits from their work location (55.2%) versus home (44.8%). VC experience was considered positive by most physicians (73.6%), and only 18.8% found VC difficult to use despite technical difficulties reported by 41.5% (Figure 1). Physicians with ≤ 5 years in practice were most likely to find VC convenient (93.8%). Challenges with VC included lack of physical exam, diagnostic uncertainty, lower patient volumes, and poor patient VC etiquette. Regardless of practice location, specialty, years in practice, and prior experience, 96% would continue VC to 25% of patients, ideally for patients who live far away (26.4%) and for follow-ups of patients with established diagnoses (21.4%). Conclusion A rapid transition to VC during the COVID-19 pandemic was associated with challenges but also positive experiences. Willingness to continue VC was high. VC experience could be improved with greater patient education and focus on select patient populations. Future research is needed to improve practice efficiency and to inform regulatory guidelines for VC at a local level.

Translation, cultural adaptation, and validation of the mindful self-care scale among Brazilian palliative care providers

2021 ◽  
pp. 1-7
Author(s):  
Ana Cláudia Mesquita Garcia ◽  
Laura Soares Rodrigues Silva ◽  
Ana Cristina Gonçalves Ferreira ◽  
Vander Monteiro da Conceição ◽  
Everson Meireles ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cultural Adaptation ◽  
Self Care ◽  
Well Being ◽  
Future Research ◽  
Care Providers ◽  
Cross Sectional ◽  
Reliability Indices ◽  
Self Compassion ◽  
Hospice And Palliative Care

Abstract Objective This study aimed to translate, culturally adapt, and validate the Mindful Self-Care Scale (MSCS, 33-item) in a Brazilian hospice and palliative care context. Method This was a cross-sectional study with a sample of 336 Brazilian hospice and palliative care providers. The European Organisation for Research and Treatment of Cancer — Quality of Life Group Translation Procedure protocol was used for the translation and the cultural adaptation process. Psychometric properties supporting the use of the MSCS were examined through confirmatory factor analysis (CFA) and correlation analysis with other instruments to assess congruence to related constructs (resilience and self-compassion). The reliability of the Brazilian-Portuguese version of the MSCS was assessed using Cronbach's α and composite reliability coefficients. Results The six-factor (33-item) model showed a good fit to the data, with satisfactory reliability indices and adequate representation of the scale's internal structure. Further validity is evidenced in the significant, positive correlations found between the MSCS, and similar well-being constructs, namely the Self-Compassion and Resilience scales. Significance of results The findings reveal that the MSCS (33-item) is a valid, reliable, and culturally appropriate instrument to examine the practice of mindful self-care by hospice and palliative care providers in Brazil. More broadly, it represents a promising instrument for future research into self-care practices and well-being among Brazilian healthcare providers.

scholarly journals Current therapy for the upper limb after stroke: a cross-sectional survey of UK therapists

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e030262 ◽  
Author(s):  
Rachel Stockley ◽  
Rosemary Peel ◽  
Kathryn Jarvis ◽  
Louise Connell
Keyword(s):  
Upper Limb ◽  
Online Survey ◽  
Current Therapy ◽  
Future Research ◽  
Evidence Based ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Constraint Induced Movement Therapy ◽  
Therapy Interventions ◽  
The Uk

ObjectivesTo survey the reported content, frequency and duration of upper limb treatment provided by occupational and physiotherapists for people after stroke in the UK.DesignA cross-sectional online survey was used. Description and analysis of the data were based on items from the Template for Intervention Description and Replication (Who, Where, What and How much).SettingThe online survey was distributed via professional and social networks to UK-based therapists.ParticipantsRespondents were occupational or physiotherapists currently working clinically in the UK with people after stroke. Over the 6 week data collection period, 156 respondents opened the survey, and 154 completed it. Respondents comprised 85 physiotherapists and 69 occupational therapists.ResultsRespondents reported treating the upper limb a median of three times a week (range: 1 to 7) for a mean of 29 min (SD: 18). Most (n=110) stated this was supplemented by rehabilitation assistants, family and/or carers providing additional therapy a median of three times a week (range 1 to 7). Functional training was the most commonly reported treatment for people with mild and moderate upper limb deficits (>40%). There was much less consistency in treatments reported for people with severe upper limb deficits with less than 20% (n=28) reporting the same treatments.ConclusionsThis study provides a contemporaneous description of reported therapy in the UK for people with upper limb deficits after stroke and a detailed template to inform standard therapy interventions in future research. Several evidence-based therapies were reported to be used by respondents (eg, constraint induced movement therapy), but others were not (eg, mental imagery). The findings also highlight that the current reported provision of upper limb therapy is markedly less than what is likely to be effective. This underlines an urgent need to configure and fund services to empower therapists to deliver greater amounts of evidence-based treatment for people with upper limb deficits after stroke.

scholarly journals Age-related factors influence HIV testing within subpopulations: a cross-sectional survey of MSM within the Celtic nations

2019 ◽  
Vol 95 (5) ◽  
pp. 351-357
Author(s):  
Jenny Dalrymple ◽  
Kareena McAloney-Kocaman ◽  
Paul Flowers ◽  
Lisa M McDaid ◽  
Jamie Scott Frankis
Keyword(s):  
Hiv Testing ◽  
Online Survey ◽  
Future Research ◽  
Sociocultural Factors ◽  
Health Improvement ◽  
Cross Sectional Survey ◽  
Related Factors ◽  
Cross Sectional ◽  
Factors Influencing ◽  
Age Related

ObjectivesDespite a recent fall in the incidence of HIV within the UK, men who have sex with men (MSM) continue to be disproportionately affected. As biomedical prevention technologies including pre-exposure prophylaxis are increasingly taken up to reduce transmission, the role of HIV testing has become central to the management of risk. Against a background of lower testing rates among older MSM, this study aimed to identify age-related factors influencing recent (≤12 months) HIV testing.MethodsCross-sectional subpopulation data from an online survey of sexually active MSM in the Celtic nations—Scotland, Wales, Northern Ireland and Ireland (n=2436)—were analysed to compare demographic, behavioural and sociocultural factors influencing HIV testing between MSM aged 16–25 (n=447), 26–45 (n=1092) and ≥46 (n=897).ResultsMultivariate logistic regression demonstrated that for men aged ≥46, not identifying as gay (OR 0.62, CI 0.41 to 0.95), location (Wales) (OR 0.49, CI 0.32 to 0.76) and scoring higher on the personalised Stigma Scale (OR 0.97, CI 0.94 to 1.00) significantly reduced the odds for HIV testing in the preceding year. Men aged 26–45 who did not identify as gay (OR 0.61, CI 0.41 to 0.92) were also significantly less likely to have recently tested for HIV. For men aged 16–25, not having a degree (OR 0.48, CI 0.29 to 0.79), location (Republic of Ireland) (OR 0.55, CI 0.30 to 1.00) and scoring higher on emotional competence (OR 0.57, CI 0.42 to 0.77) were also significantly associated with not having recently tested for HIV.ConclusionKey differences in age-related factors influencing HIV testing suggest health improvement interventions should accommodate the wide diversities among MSM populations across the life course. Future research should seek to identify barriers and enablers to HIV testing among the oldest and youngest MSM, with specific focus on education and stigma.

scholarly journals EXPERIENCE OF LGBT PATIENTS AND FAMILY WITH HOSPICE AND PALLIATIVE CARE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S623-S624
Author(s):  
Gary L Stein ◽  
Cathy Berkman
Keyword(s):  
Palliative Care ◽  
Staff Training ◽  
Online Survey ◽  
Research Policy ◽  
Cross Sectional Study ◽  
Care Staff ◽  
Future Research ◽  
Policy And Practice ◽  
Cross Sectional ◽  
Hospice And Palliative Care

Abstract This study examines the degree to which hospice and palliative care staff observe or perceive inadequate, disrespectful, or abusive care to LGBT patients and family members. A cross-sectional study using an online survey completed by 865 providers, including social workers, physicians, nurses, and chaplains. Among respondents, 55% reported that LGB patients were more likely to experience discrimination at their institution than non-LGB patients; 24% observed discriminatory care; 65% reported that transgender patients were more likely than non-transgender patients to experience discrimination; 20% observed discrimination to transgender patients; 14% observed the spouse/partner of LGBT patients having their treatment decisions disregarded or minimized; and 13% observed the spouse/partner being treated disrespectfully. Findings reported also include: institutional non-discrimination policy, staff training, intake procedures, and comfort in assessing LGBT status. Implications for future research, policy, and practice will be presented.

scholarly journals Online paediatric chronic pain management: assessing the needs of UK adolescents and parents, using a cross-sectional survey

2020 ◽  
pp. 204946372094034
Author(s):  
Anna Hurley-Wallace ◽  
Daniel E Schoth ◽  
Suzanne Lilley ◽  
Glyn Williams ◽  
Christina Liossi
Keyword(s):  
Social Media ◽  
Chronic Pain ◽  
Pain Management ◽  
Online Survey ◽  
Interdisciplinary Treatment ◽  
Future Research ◽  
Chronic Pain Management ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Social Media Platforms

Background: Adolescent chronic pain is prevalent, and interdisciplinary treatment is recommended. Although it is well known that technology is a key part of adolescents’ daily lives, there have not been any online, interdisciplinary interventions developed for adolescents with chronic pain in a UK healthcare context. Little is known about how adolescents currently use online resources to manage chronic pain, or what guidance they seek. Methods: Ninety-five participants from the community answered this mixed-methods, online survey (adolescent n = 54, parent n = 41), which assessed the needs of UK-based adolescents for a new online chronic pain management resource. Results: Findings indicated that, at the time of the survey, adolescents frequently used social media platforms, such as Instagram, for chronic pain management. Desired techniques for a new interdisciplinary resource for adolescents included ‘advice on explaining chronic pain to others’ (86.7% of adolescents) and sleep hygiene (82.2% of adolescents), though access to a range of pain management techniques was desired. Qualitative results indicated endorsement of a new programme by adolescents and parents. Conclusions: Adolescents and parents had a positive outlook towards the development of a UK-specific online resource to help manage chronic pain. Such an intervention should aim to be made accessible via the National Health Service. Adolescent use of social media platforms to seek support for chronic pain requires further exploration in future research.

scholarly journals Recreational physical activity context and type preferences among male and female Emirati university students

2019 ◽  
Vol 11 (6) ◽  
pp. 507-512 ◽  
Author(s):  
C B Doyle ◽  
A Khan ◽  
N W Burton
Keyword(s):  
Physical Activity ◽  
University Students ◽  
United Arab Emirates ◽  
Online Survey ◽  
Cross Sectional Study ◽  
Future Research ◽  
Recreational Physical Activity ◽  
Cross Sectional ◽  
Activity Types ◽  
Competitive Activities

Abstract Background This study assessed recreational physical activity type and context preferences of Emirati university students. Method This was a cross-sectional study in which a stratified random sample (n=628) (female 69.1%, male 30.9% mean age 20.79±3.81 y) completed an online survey. Relationships between gender and preferences were assessed using regression analysis, adjusted for body mass index and age. Results Activities with a fun element were the most preferred context (87.1%). Walking (66.7%) and swimming (61.7%) were the most preferred activity types. Males had significantly higher odds of preferring competitive activities, and activity types such as football, fitness/weights and jogging. Females had significantly higher odds of preferring activities with people of the same gender, with supervision and done at home, and activity types such as walking, aerobics, cycling, squash and yoga. Conclusion These results can inform physical activity planning for university students in the United Arab Emirates. Fun activity opportunities involving walking or swimming and in the local neighbourhood may be popular for both males and females. Future research could explore uptake and maintenance of activity options, based on preferred activity attributes.

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