202 Consenting Practice for Post-Cholecystectomy Diarrhoea After Laparoscopic Cholecystectomy – Are We Missing A Trick?

Aim The landmark case of Montgomery v Lanarkshire Health Board led to the defensive Bolam test being discredited and paved the way healthcare professionals (HCP) obtain informed consent. The recent GMC guidance on Decision Making and Consent 2020, states that the HCP should discuss recognised risks that they believe anyone in the patient’s position would want to know. Laparoscopic cholecystectomy is one of the most common general surgical procedures performed in the UK. Chronic diarrhoea is a well-recognised complication with significant impact on patient quality of life (QoL). We aimed to assess quality of consent forms for laparoscopic cholecystectomies with emphasis on documentation of chronic diarrhoea being a consequence of the procedure. Method A retrospective review of all elective laparoscopic cholecystectomy consent forms over a 2-month consecutive period from July 1st 2020 to August 31st 2020 was carried out. Results 43 consent forms were audited. The majority of these consent forms were done by consultants (74.4%: 32/43) while 23.2% (10/43) by registrars. Overall, 39.5% (17/43) of patients were consented for experiencing chronic diarrhoea. Registrars more commonly mentioned diarrhoea (60%: 6/10) compared to consultants (31.2%: 10/32). Conclusions The majority of patients undergoing laparoscopic cholecystectomy are not consented for post-cholecystectomy diarrhoea which is a significant QoL-altering complication. Education combined with a standardised consent form and issuing of patient leaflets will improve consenting for chronic diarrhoea.

Characteristics and Trends of the Hospital Standardized Readmission Ratios for Pneumonia: A Retrospective Observational Study Using Japanese Administrative Claims Data from 2010 to 2018

Previous studies indicated that optimal care for pneumonia during hospitalization might reduce the risk of in-hospital mortality and subsequent readmission. This study was a retrospective observational study using Japanese administrative claims data from April 2010 to March 2019. We analyzed data from 167,120 inpatients with pneumonia ≥15 years old in the benchmarking project managed by All Japan Hospital Association. Hospital-level risk-adjusted ratios of 30-day readmission for pneumonia were calculated using multivariable logistic regression analyses. The Spearman’s correlation coefficient was used to assess the correlation in each consecutive period. In the analysis using complete 9-year data including 54,756 inpatients, the hospital standardized readmission ratios (HSRRs) showed wide variation among hospitals and improvement trend (r = −0.18, p = 0.03). In the analyses of trends in each consecutive period, the HSRRS were positively correlated between ‘2010–2012’ and ‘2013–2015’ (r = 0.255, p = 0.010), and ‘2013–2015’ and ‘2016–2018’ (r = 0.603, p < 0.001). This study denoted the HSRRs for pneumonia could be calculated using Japanese administrative claims data. The HSRRs significantly varied among hospitals with comparable case-mix, and could relatively evaluate the quality of preventing readmission including long-term trends. The HSRRs can be used as yet another measure to help improve quality of care over time if other indicators are examined in parallel.

FIKWaste: A Waste Generation Dataset from Three Restaurant Kitchens in Portugal

In the era of big data and artificial intelligence, public datasets are becoming increasingly important for researchers to build and evaluate their models. This paper presents the FIKWaste dataset, which contains time series data for the volume of waste produced in three restaurant kitchens in Portugal. Organic (undifferentiated) and inorganic (glass, paper, and plastic) waste bins were monitored for a consecutive period of four weeks. In addition to the time series measurements, the FIKWaste dataset contains labels for waste disposal events, i.e., when the waste bins are emptied, and technical and non-technical details of the monitored kitchens.

Reflections on a journey with Accounting History as an international refereed journal, 1995–2019

Accounting History is the journal of the Accounting History Special Interest Group of the Accounting and Finance Association of Australia and New Zealand. My journey as the Founding Editor (1995–2007) and as Joint Editor (from 2008) of the New Series (NS) of Accounting History, as an international refereed journal, commenced on 1 January 1995 and will conclude on 31 December 2019. The first issue of the NS was published in May 1996, with 1995 being devoted to relaunching the journal for international leadership in the field. The journal’s development has been supported by periodic conferences, colloquia and symposia, namely the Accounting History International Conference, the Accounting History Doctoral Colloquium, which was later replaced by the Accounting History International Emerging Scholars’ Colloquium, and the Accounting History Symposium. This contribution provides personal reflections of this journey from 1995 to 2019, a consecutive period of 25 years, and comprises four sections: Introduction, Looking back, Looking ahead and Conclusions.

Implementing Prescribing Guidelines for Upper Extremity Orthopedic Procedures: A Prospective Analysis of Postoperative Opioid Consumption and Satisfaction

Background: A lack of established opioid-prescribing guidelines has prompted recent studies to propose preliminary guidelines to mitigate inadvertent overprescribing, diversion, and abuse. The purpose of our study was to assess the efficacy of a specific set of opioid-prescribing guidelines by prospective evaluation of patient consumption and satisfaction. Methods: During a consecutive period, all patients undergoing outpatient upper extremity surgical procedures were postoperatively prescribed opioids based on published guidelines that were specific to the anatomical location and procedure being performed. At the first postoperative visit, surgical details, opioid consumption patterns, and prescription efficacy and satisfaction were recorded. Results: A total of 201 patients reported any amount of prescription use, resulting in a mean consumption of 5.5 pills. Patients who underwent soft tissue procedures reported the lowest requirement (4.2 pills) compared with those who underwent fracture repairs (6.7 pills) or arthroscopy and arthroplasty/fusion procedures (8.7 pills). Patients undergoing hand procedures consumed fewer opioids (3.9 pills) compared with those undergoing wrist (6.3 pills) or elbow (8.1 pills) procedures. Of the patients requiring opioids, 82% reported being satisfied or at least neutral to the prescribed quantity ( P < .001), and 92% reported being satisfied or at least neutral to the prescribed opioid analgesic efficacy ( P < .001). Overall, the study refill request rate was 13%. Conclusions: Although the proposed guidelines tended to exceed patient need, the study confirmed strong patient satisfaction and an overall refill request rate of only 13%. We conclude that following anatomical and procedure-specific opioid-prescribing guidelines is an effective method of prescribing opioids postoperatively after upper extremity.

Actual versus recommended storage temperatures of oral anticancer medicines at patients’ homes

Background Substantial quantities of unused medicines are returned by patients to the pharmacy each year. Redispensing these medicines would reduce medicinal waste and health care costs. However, it is not known if medicines are stored by patients as recommended in the product label. Inadequate storage may negatively affect the medicine and reduce clinical efficacy whilst increasing the risk for side effects. Objective To investigate the proportion of patients storing oral anticancer medicines according to the temperature instructions in the product label. Methods Consenting adult patients from six Dutch outpatient hospital pharmacies were included in this study if they used an oral anticancer medicine during February 2014 – January 2015. Home storage temperatures were assessed by inclusion of a temperature logger in the original cancer medicines packaging. The primary outcome was the proportion of patients storing oral anticancer medicines as specified in the Summary of Product Characteristics, either by recalculating the observed temperature fluctuations to a single mean kinetic temperature or by following the temperature instructions taking into account a consecutive 24-h tolerance period. Results Ninety (81.1%) of the 111 included patients (47.8% female, mean age 65.2 (SD: 11.1)) returned their temperature loggers to the pharmacy. None of the patients stored oral anticancer medicines at a mean kinetic temperature above 25℃, one patient stored a medicine requiring storage below 25℃ longer than 24 h above 25℃. None of the patients using medicines requiring storage below 30℃ kept their medicine above 30℃ for a consecutive period of 24 h or longer. Conclusion The majority of patients using oral anticancer medicines store their medicines according to the temperature requirements on the product label claim. Based on our results, most oral anticancer medicines will not be negatively affected by temperature conditions at patients’ homes for a maximum of three months and are likely to be suitable for redispensing.

APROPRIAÇÕES MIDIÁTICAS DO FEMINISMO NEGRO NA CONTEMPORANEIDADE BRASILEIRA

RESUMO Este artigo examina apropriações midiáticas pelo feminismo negro baseadas em reflexões teórico-conceituais sobre a problemática da comunicação em sociedades midiatizadas e suas relações com a literacia midiática. O Instituto da Mulher Negra Geledés, fundado em 1998 no período da redemocratização brasileira, constitui-se no objeto de investigação. O movimento Geledés foi observado e mapeado em sua página no site de rede social Facebook, durante um período consecutivo de oito semanas em 2016, com o propósito de identificar modalidades de interações entre seus visitantes. A análise dedica-se, para além das postagens do Geledés, a apreender e compreender o que acontece na esfera da recepção quando se trata de tipos de usos, apropriações e produções de sentidos. Um construto metodológico baseado na Cartografia de Controvérsias (CC) foi operacionalizado para analisar as interações dos actantes sociais do Geledés no Facebook, revelando predominância de interações passivas e elevado número de comentários participativos desqualificados sob a ótica do debate público racional. PALAVRAS-CHAVE: Comunicação; Redes Sociais; Feminismo Negro; Literacia Midiática; Cartografia de Controvérsias. ABSTRACT This article examines media appropriations by black feminism based on theoretical-conceptual reflections on the problem of communication in mediatized societies and their relations with media literacy. The Geledés Black Women's Institute, founded in 1998 in the period of Brazilian redemocratization, is the object of this research. The Geledés movement was observed and mapped on its page on the social networking site Facebook, during a consecutive period of eight weeks in 2016, with the purpose of identifying modalities of interactions among its visitors. The analysis is dedicated, in addition to the posts of the Geledés, to apprehend and to understand what happens in the sphere of the reception when it comes to types of uses, appropriations and of production of meanings. A methodological construct based on the Cartography of Controversies (CC) was operationalized to analyze the interactions of Geledés social actants on Facebook, revealing predominance of passive interactions and a high number of participatory comments disqualified from the perspective of rational public debate. KEYWORDS: Communications; Social Networks; Black Feminism; Media Literacy; Controversy Cartography. RESUMEN Este artículo examina las apropiaciones de medios por el feminismo negro a partir de reflexiones teórico-conceptuales sobre el problema de la comunicación en las sociedades mediáticas y sus relaciones con la alfabetización mediática. El Instituto Geledés de Mujeres Negras, fundado en 1998 en el período de la redemocratización brasileña, es el objeto de esta investigación. El movimiento Geledés fue observado y mapeado en su página en el sitio de redes sociales Facebook, durante un período consecutivo de ocho semanas en 2016, con el propósito de identificar modalidades de interacción entre sus visitantes. El análisis se dedica, además de los puestos de los Geledés, a aprehender y entender lo que sucede en la esfera de la recepción en lo que se refiere a tipos de usos, apropiaciones y de producción de significados. Se implementó un constructo metodológico basado en la Cartografía de Controversias (CC) para analizar las interacciones de actores sociales de Geledés en Facebook, revelando predominio de interacciones pasivas y un alto número de comentarios participativos descalificados desde la perspectiva del debate público racional. PALABRAS CLAVE: Comunicación; Redes Sociales; Feminismo Negro; Alfabetización Mediática; Cartografía de Controversias.

Broadcast television flow scheduling and the viewers’ zapping: conflicting practices

Broadcast television and its audiences live a paradoxical situation: on the one hand, channels still schedule according to the concept of flow; on the other hand, viewers’ zapping counters it. This paper wishes to ascertain the audiences’ practices regarding their fidelity to flow. The research tries to answer these questions: how many viewers watch the same channel during a long consecutive period? How many viewers watch a complete programme? Are there significant differences in zapping versus flow faithfulness according to sex, age, socio-demographic class and cable TV access? Is “companionship television” still a viewers’ consume practice? The research verifies the effectiveness of flow scheduling, which, while being an ideology and a scheduling and self-promotion practice, is not a practice of most viewers. The results show that flow faithfulness flow is a minority behaviour mainly of older people, women, lower classes and viewers without occupation.

COMPARE THE EFFECT OF BODY WEIGHT SUPPORTED TREADMILL TRAINING WITH OVERGROUND GAIT TRAINING ON BALANCE IN SPASTIC CEREBRAL PALSY

OBJECTIVE Compare the effect of body weight supported treadmill training with over ground gait training on balance in spastic cerebral palsy. STUDY DESIGN Randomized Control Trail STUDY SETTINGS & PARTICIPANTS This study was conducted in a Rehabilitation Centre. Twenty eight participants were recruited, fifteen in experimental group and thirteen in control group. All participants were spastic and classified I, II & III at GMCFS. INTERVENTIONS Treatment was given for three days in a week for consecutive period of six weeks which includes BWSTT and overground gait training OUTCOME MEASURES The outcome was measured by using Berg Balance Scale, Brunel Balance Scale, TUG, and TST and Timed 360 Turn. RESULTS Both the techniques shown positive results but BWSTT had shown better result with the mean improvement in Berg Balance Scale (29±7.91 from 25.6±7.46), TUG (22.2±4.2sec from 19.4±4.1sec), Brunel Balance Scale (7.4±2.34 from 6.27±2.52),TST (5.73±1.6 from 4.07±1.58) & Timed 360 Turn (9.4±2.02 sec to 7.87±2.23 sec) with comparison to control group which had a mean improvement in Berg Balance Scale (28.08±7.11 from 26.38±7.14), TUG (21.46±4.0sec from 19.54±3.79), Brunel Balance Scale (7.31±2.32 from 6.54±2.60), TST(5.46±1.56 from 4.31±1.54) & Timed 360 Turn (9.23±1.69sec to 7.85±1.67secs).

Effect of fresh pasture forage quality, feeding level and supplementation on methane emissions from growing beef cattle

The objectives of this study were to determine the effect of fresh pasture forage quality (vegetative and mature pasture in different seasons), feeding level and supplementation with maize silage or palm kernel expeller on methane (CH4) production (g/day) and yield (g/kg dry matter intake; DMI) in growing beef cattle. The null hypothesis was that pasture quality, DMI level and supplementation have no effect on the CH4 yield (g/kg DM) in beef cattle. Four experiments were conducted and in three experiments (Exp. 1–3) freshly cut vegetative or mature pasture was fed to 14 growing beef animals in two consecutive periods, respectively, at intake levels of 1.5, 1.8 and 1.1 × maintenance metabolisable energy requirements (MEm) in Exp. 1–3, respectively. For Exp. 3, 100% maize silage was fed in a third consecutive period to the same cattle used in Periods 1 and 2. In Exp. 4, 4 animals were fed one of three treatments at 1.6 × MEm of 100% fresh pasture, fresh pasture supplemented with 35% DM maize silage or fresh pasture supplemented with 35% DM palm kernel expeller. After acclimatisation to respective diets, DMI and CH4 were measured for 12 animals in individual open circuit respiration chambers for two consecutive days in each experiment. Methane yield (g/kg DMI) was similar when animals were fed vegetative or mature pasture in Exp. 1 (20.0) and 2 (25.8), whereas in Exp. 3 feeding vegetative pasture resulted in a higher CH4 yield (25.7; P < 0.05) compared with feeding mature pasture (23.3), with feeding 100% maize silage intermediate (23.8). Methane yield of cattle fed pasture supplemented with maize silage in Exp. 4 was 10% higher (P < 0.05) compared with cattle fed mature pasture only or supplemented with palm kernel expeller (25.9, 23.3, 23.4 g/kg DMI, respectively). The regression between DMI and CH4 yield was similar for vegetative and mature pasture and pasture composition could explain up to 26% of variation in CH4 yield (P < 0.05). The CH4 yield in cattle fed 100% pasture (Exp. 1–3) was not affected by DMI and averaged 24.1 ± 2.78 g/kg DMI. In conclusion, fresh pasture forage quality, feeding level and supplementation had only minor, but some significant, effects on CH4 yield in beef cattle.