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OBJECTIVES: To demonstrate how researchers can identify and translate reporting gaps from a systematic review into checklist items for reporting guidelines. STUDY DESIGN AND SETTING: Good quality research reporting ensures transparency, reproducibility, and utility, facilitated by reporting guidelines. Conducting a systematic review is an essential step in the development of these guidelines. The EQUATOR Network's toolkit (2010) assists researchers in this process and is due for an update to address current gaps and evolving research methods. One significant gap is the translation of systematic review findings into checklist items. Reflecting on our experience developing the ACcurate Consensus Reporting Document (ACCORD), we illustrate this translation process aiming to empower researchers developing reporting guidelines to address potential biases and promote transparency. We highlight the challenges faced and how they were addressed. RESULTS: The systematic review search process was iterative, involving multiple adjustments to balance precision and sensitivity. Excessively stringent exclusion criteria may lead to missed valuable insights, especially when studies offer relevant content. An information specialist was invaluable in developing the search strategy. Key lessons learned include the necessity of maintaining flexibility and openness during data extraction, continuous adaptation based on panelist feedback and promoting clear communication through understandable language. These principles can guide the development of future reporting guidelines and the updating of the EQUATOR toolkit, promoting transparency and robustness in research reporting. CONCLUSION: Maintaining flexibility, capturing evolving insights, clear communication, and accommodating changes in research and technologies are key to translating systematic review findings into effective reporting checklists.
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BACKGROUND: Frailty has become a key concern in an aging population. A comprehensive geriatric assessment (CGA) service framework was developed and evaluated aiming to target and connect frail older adults who are at high risk of requiring long-term care services. METHODS: A community-based pilot study was conducted in fiscal year 2016 and 2017 in Kure city, Hiroshima, Japan. Participants aged 65 and over living in Kure city, and 393 persons were extracted from the Kihon Check List (KCL) responses. Among the eligible individuals, 101 consented to participate and received CGA and referred to services based on individual health needs. The efficacy was evaluated by referral rate of services, continuity of the service usage, evaluation of participant's health condition and the quality of life (QoL) after the 6-month follow-up. RESULTS: Ninety-nine (98.0%) participants needed support for the instrumental activity of daily living, 97 (96.0%) were categorized as locomotive syndrome, and 64 (63.4%) had a depressive tendency. Afterward, 60 participants (59.4%) subsequently accepted the referral services, however, 34 (33.7%) used the services and the remaining 26 (25.7%) did not use the services. The health condition improvements in the service-uses group were statistically significant (p < 0.001), however, QoL score did not change between the baseline and 6th -month. CONCLUSION: KCL extracted high-risks older people, and CGA revealed related diseases and health conditions. However, the high refusal rate of referral services indicates a necessity to modify the service framework such as by collaborating with community general support centers, which could increase the efficacy of service framework.
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Idoso Fragilizado , Avaliação Geriátrica , Assistência de Longa Duração , Humanos , Idoso , Projetos Piloto , Masculino , Feminino , Avaliação Geriátrica/métodos , Japão/epidemiologia , Idoso de 80 Anos ou mais , Assistência de Longa Duração/métodos , Qualidade de Vida , Atividades Cotidianas , Encaminhamento e ConsultaRESUMO
This study provides a comprehensive overview of the genus Zygota Förster combining DNA barcoding and current morphology. Nineteen species of Zygota were found throughout Germany, including the newly described species Zygotawalli sp. nov. First species records for Germany are: Zygotabalteata Macek, 1997; Z.comitans Macek, 1997; Z.spinosipes (Kieffer, 1908); Z.sordida Macek, 1997; Z.angularis Macek, 1997 and Z.vigil Nixon, 1957. We also clarify diagnoses for the two related genera, Pantoclis Förster and Zygota to designate the boundaries of the Zygota genus and propose new synonymies: Zygotacaligula Buhl, 1997 is a junior synonym of Z.congener (Zetterstedt, 1840); Z.reticulata Kozlov, 1978 is a junior synonym of Z.ruficornis (Curtis, 1831). Thirteen species of Zygota sensu Nixon (1957) are transferred to the genus Pantoclis with the following new combinations proposed: Zygotabrevinervis (Kieffer, 1908) (= Pantoclisbrevinervis (Kieffer, 1909), comb. nov.); Z.brevipennis (Kieffer, 1908) (= P.brevipennis (Kieffer, 1908), comb. nov.); Z.caecutiens (Kieffer, 1908) (= P.caecutiens (Kieffer, 1908), comb. nov.); Z.cursor (Kieffer, 1908) (= P.cursor (Kieffer, 1908), comb. nov.); Z.fossulata (Thomson, 1858) (=P.fossulata (Thomson, 1858), comb. nov.); Z.fuscata (Thomson, 1858) (= P.fuscata (Thomson, 1858), comb. nov.); Z.hemiptera (Thomson, 1858) (= P.hemiptera (Thomson, 1858), comb. nov.); Z.microtoma (Kieffer, 1909) (= P.microtoma (Kieffer, 1909), comb. nov.); Z.soluta (Kieffer, 1907) (= P.soluta (Kieffer, 1907), comb. nov.); Z.striata (Kieffer, 1909) (= P.striata (Kieffer, 1909), comb. nov.); Z.subaptera (Thomson, 1858) (= P.subaptera (Thomson, 1858), comb. nov.); Z.sulciventris (Kieffer, 1909) (= P.sulciventris (Kieffer, 1909), comb. nov.), and Z.unicolor (Kieffer, 1908) (= P.unicolor (Kieffer, 1908), comb. nov.).
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BACKGROUND: Surgical safety checklists reduce adverse events, but monitoring adherence to checklists is confounded by observation bias. The ORBB platform can monitor checklist compliance and correlate compliance with outcomes. This study aims to evaluate the association between checklist compliance and patient outcomes using the ORBB platform. METHODS: This is a retrospective analysis of data from the electronic medical record of cases performed in ORBB-equipped operating rooms at a single quaternary referral center. All patients who did not opt out and underwent surgery at UT Southwestern Medical Center in ORBB-equipped rooms from August 2020 to September 2022 were included. The ORBB platform was set-up in five operating rooms and surgical safety checklist compliance was monitored by way of AI-based video review. RESULTS: Overall, 4581 patients were included in this analysis.. Performance on the checklist was associated with lower mortality (OR, 0.96; 95% CI, 0.94-0.98; P < 0.05), and decreased length of stay (estimate [E]: -0.02 days; 95% CI, -0.03 to -0.005; P < 0.05). Performance during "timeouts" was associated with mortality (OR, 0.97; 95% CI, 0.94-0.99; P < 0.05). "Debriefings" were independently associated with mortality (OR, 0.98; 95% CI, 0.96-0.99; P < 0.05), length of stay (Estimate, -0.0009 days; 95% CI, -0.02 to -0.001; P < 0.05), and ICU admission (OR, 0.99; 95% CI, 0.98-0.99; P < 0.05). CONCLUSION: Procedures performed by surgical teams who performed better on the surgical safety checklist tended to have better outcomes. This innovative technology could substantially enhance our ability to understand and mitigate threats to patients in real-time.
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INTRODUCTION: The purpose of this study was to investigate the creation, implementation, and harmonisation of medical Standard Operating Procedures (SOP) in Finnish Helicopter Emergency Medical Services (HEMS). The research questions are: (1) What factors influence the creation and implementation of medical SOPs for Finnish HEMS units? and (2) What can be done to harmonise the medical SOPs of Finnish HEMS units? METHODS: The research was conducted as a qualitative interview study with HEMS physicians who worked full-time in Finnish HEMS units or had worked in HEMS for more than five years. Three HEMS physicians from each of the six HEMS units in Finland participated in the study (n = 18). The thematic interviews (average duration 32 min) were transcribed (70,176 words in Finnish) and analysed using inductive content analysis. RESULTS: The results of the first research question formed three main categories: (1) Background to developing medical SOPs and checklists (CLs), (2) Creation of medical SOPs in Finnish HEMS units, and (3) Implementation of medical SOPs and CLs. The main categories were divided into eight upper categories and twelve subcategories. The results of the second research question formed four main categories: (1) Prerequisites for harmonising procedures, (2) System-level changes needed, (3) Integrating common medical SOPs into HEMS, and (4) Cultural change. The main categories were divided into nine upper categories and nine subcategories. CONCLUSIONS: Medical SOPs and CLs are an integral part of Finnish HEMS. Each unit creates its own SOPs and CLs; their development, implementation, and follow-up are relatively unstructured. Harmonising existing SOPs would be possible, but developing common SOPs would require structural changes in HEMS and a stronger sense of community belonging among HEMS physicians.
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Resgate Aéreo , Lista de Checagem , Finlândia , Humanos , Resgate Aéreo/normas , Serviços Médicos de Emergência/normas , Serviços Médicos de Emergência/organização & administração , Pesquisa Qualitativa , Masculino , Entrevistas como AssuntoRESUMO
Along with emerging technologies electrolysed water (EW) systems have been proposed for cleaning and/or disinfection in clinical areas. There is evidence for the use of EW in food-handling and the dairy industry however there is lack of evidence for EW as an effective cleaning and disinfecting agent in a clinical setting. Existing publications mostly are either laboratory based or from non-clinical settings. This is in direct contrast to other approaches used in healthcare cleaning. The aim of this paper is to provide infection prevention and control professionals with a risk assessment checklist using an evaluation of electrolysed water as an example of the analysis and consideration required prior to the introduction of any new technology and, in particular, the inclusion of sustainability.
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BACKGROUND: There is a growing awareness of the need to adequately integrate sex and gender into health-related research. Although it is widely known that the entangled dimensions sex/gender are not comprehensively considered in most studies to date, current publications of conceptual considerations and guidelines often only give recommendations for certain stages of the research process and - to the best of our knowledge - there is a lack of a detailed guidance that accompanies each step of the entire research process. The interdisciplinary project "Integrating gender into environmental health research" (INGER) aimed to fill this gap by developing a comprehensive checklist that encourages sex/gender transformative research at all stages of the research process of quantitative health research. In the long term this contributes to a more sex/gender-equitable research. METHODS: The checklist builds on current guidelines on sex/gender in health-related research. Starting from important key documents, publications from disciplines involved in INGER were collected. Furthermore, we used a snowball method to include further relevant titles. The identification of relevant publications was continued until saturation was reached. 55 relevant publications published between 2000 and 2021 were identified, assessed, summarised and included in the developed checklist. After noticing that most publications did not cover every step of the research process and often considered sex/gender in a binary way, the recommendations were modified and enriched based on the authors' expertise to cover every research step and to add further categories to the binary sex/gender categories. RESULTS: The checklist comprises 67 items in 15 sections for integrating sex/gender in quantitative health-related research and addresses aspects of the whole research process of planning, implementing and analysing quantitative health studies as well as aspects of appropriate language, communication of results to the scientific community and the public, and research team composition. CONCLUSION: The developed comprehensive checklist goes beyond a binary consideration of sex/gender and thus enables sex/gender-transformative research. Although the project INGER focused on environmental health research, no aspects that were specific to this research area were identified in the checklist. The resulting comprehensive checklist can therefore be used in different quantitative health-related research fields.
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Lista de Checagem , Humanos , Lista de Checagem/métodos , Lista de Checagem/normas , Masculino , Feminino , Fatores Sexuais , Projetos de Pesquisa/normas , Pesquisa Biomédica/métodos , Pesquisa Biomédica/normas , Identidade de GêneroRESUMO
OBJECTIVE: To evaluate the reporting quality of randomized controlled trials (RCTs) of acupuncture for depression. METHODS: Systematic searches were performed in PubMed, the Cochrane Library, EMbase, CNKI, Wanfang, SinoMed and VIP Database for RCTs of acupuncture in treatment of depression. The search time was from the establishment of database to December 1, 2023, and the language restriction was Chinese and English. The reporting quality of RCTs of acupuncture for depression was evaluated using the CONSORT statement, the international standardization for trial reporting, STRICTA, the international standard for clinical trial interventions of acupuncture, and SHARE, the guideline and checklist for reporting sham acupuncture controls. RESULTS: According to the CONSORT statement items, the items with the reporting rate less than 50% was accounted for 54.05% of all of the items for Chinese articles, and there were 8 and 1 items with a reporting rate of 0% and 100%, respectively. For the English articles, the items with the reporting rate less than 50% was accounted for 35.14% of all of the items, and there were 3 and 7 items with a reporting rate of 0% and 100%, respectively. The reporting rate of 15 items in Chinese and English articles was greater than 50%, e.g. structured abstract, background and purpose. Based on STRICTA criteria, the reporting rate of either Chinese or English articles was relatively high. The items for Chinese articles with the reporting rate less than 50% was accounted for 23.53% of all of the items, and there were 1 and 4 items with a reporting rate of 0% and 100%, respectively. For English articles, the items with the reporting rate less than 50% was accounted for 11.76% of all of the items, and there was 1 item with a reporting rate of either 0% or 100%. In compliance with SHARE checklist, the reporting rate was low for either Chinese or English articles. The items with the reporting rate less than 50% was accounted for 57.89% of all of the items for Chinese articles, and there were 2 and 0 items with a reporting rate of 0% and 100%, respectively. For English articles, the items with the reporting rate less than 50% was accounted for 52.63% of all of the items, and there was 1 item with a reporting rate of 0% and 100%, respectively. CONCLUSION: The overall reporting quality of RCTs of acupuncture for depression is low currently. It is urgent to enhance the reporting of the details on sham acupuncture control especially. It is suggested that RCTs should be reported strictly in compliance with the CONSORT statement, STRICTA criteria, and SHARE checklist in the future.
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Terapia por Acupuntura , Depressão , Ensaios Clínicos Controlados Aleatórios como Assunto , Terapia por Acupuntura/normas , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto/normas , Depressão/terapia , Lista de Checagem/normas , Projetos de Pesquisa/normasRESUMO
PURPOSE: Postpartum depression (PPD) affects 10-15% of postpartum women with increased risk among women with trauma history. The purpose of this study was to investigate the relationship between adverse life events and postpartum depressive symptoms among Bedouin and Jewish women. METHODS: A cross-sectional study was performed in a tertiary hospital in the southern district of Israel on women with singleton deliveries between November 2021 and March 2022. Eligible women completed two questionnaires to determine exposure to childhood trauma (CT) and other potentially traumatic events (PTE), including the Childhood Trauma Questionnaire (CTQ), and Lifetime Events Checklist questionnaire (LEC). To measure risk for PPD we used the Edinburgh Postnatal Depression Scale (EPDS). The associations between CT, PTE, and risk for PPD were analyzed and multivariable logistic regression models were constructed to control for potential confounders. RESULTS: A total of 201 women were included, 120 Bedouin (59.7%) and 81 Jewish (40.2%). In the entire study population, both CT and PTE were independently associated with risk for PPD (adjusted OR = 2.13, 95% CI 1.02-4.44, p = 0.043 and adjusted OR = 3.42, 95%, CI 1.46-8.00, p = 0.004, respectively). While among Bedouin women, PTE was independently associated with PPD risk (adjusted OR = 4.83, 95% CI 1.66-14.05, p = 0.004), no significant association was found among Jewish women. CONCLUSION: Both CT and PTE were associated with increased PPD risk in Bedouin and Jewish women. Only PTE, and not CT, was associated with PPD among Bedouin women. Understanding risk factors for PPD, and differences among minority groups, could promote prevention efforts for PPD.
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BACKGROUND: Advances in emergency and critical care have improved outcomes, but gaps in communication and decision-making persist, especially in the emergency department (ED), prompting the development of a checklist to aid in serious illness conversations (SIC) in China. METHODS: This was a single-centre prospective interventional study on the quality improvement of SIC for life-sustaining treatment (LST). The study recruited patients consecutively for both its observational baseline and interventional stages until its conclusion. Eligible participants were adults over 18 years old admitted to the Emergency Intensive Care Unit (EICU) of a tertiary teaching hospital, possessing full decisional capacity or having a legal proxy. Exclusions were made for pregnant women, patients deceased upon arrival, those who refused participation, and individuals with incomplete data for analysis. First, a two-round Delphi process was organized to identify major elements and generate a standard process through a checklist. Subsequently, the efficacy of SIC in adult patients admitted to the EICU was compared using the Decisional Conflict Scale (DCS) score before (baseline group) and after (intervention group) implementing the checklist. RESULTS: The study participants presented with the most common comorbidities, such as diabetes, myocardial infarction, cerebrovascular disease, moderate-to-severe renal disease, congestive heart failure, and chronic pulmonary disease. The median Charlson Index did not differ between the baseline and intervention cohorts. The median length of hospital stay was 11.0 days, and 82.9% of patients survived until hospital discharge. The total DCS score was lower in the intervention group than in the baseline group. Three subscales, including the informed, values clarity, and support subscales, demonstrated significant differences between the intervention and baseline groups. Fewer intervention group patients agreed with and changed their minds about cardiopulmonary resuscitation (CPR) compared to the baseline group. CONCLUSION: The use of a SIC checklist in the EICU reduced the DCS score by increasing medical information disclosure, patient value awareness, and decision-making support.
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Lista de Checagem , Serviço Hospitalar de Emergência , Humanos , Projetos Piloto , Feminino , Masculino , Estudos Prospectivos , Pessoa de Meia-Idade , China , Idoso , Adulto , Comunicação , Técnica Delphi , Melhoria de Qualidade , Tomada de Decisões , Estado Terminal/terapia , Unidades de Terapia Intensiva , Cuidados para Prolongar a VidaRESUMO
Background: Coiba National Park is an offshore region on the Pacific side of Panama, which hosts several endemic species of animals and plants. It was declared a UNESCO World Heritage Site in 2005. Despite the title awarded to the Park, knowledge about basic elements of its biodiversity are still lacking, which are of vital relevance for management and conservation policies. For instance, until now, no study had ever monitored the araneofauna diversity of the Park. New information: Here, we provide the first checklist of spider species in Coiba National Park, including the main island and several surrounding islands. We sampled during several field trips carried out from August 2021 to August 2023. We identified at least 152 species (98 genera and 30 families) and we report three new spiders species for Panama, namely Ctenusnigrolineatus Berland (1913), Chapodagitae Zhang & Maddison (2012) and Sarindanigra Peckham & Peckham (1892). We discuss the implications of our results and recommend future lines of work that include DNA barcoding, monitoring of population and community dynamics, plus linkage of climatic data from the newly-installed meteorological station on the Island.
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Introduction The World Health Organization (WHO) Safe Surgery Checklist significantly decreases morbidity and mortality in regular operating room cases. However, significant differences in workflow and processes exist between regular operating room cases and cesarean sections performed on the labor and delivery unit. The aim of this study is to adapt the WHO Safe Surgery Checklist for the labor and delivery unit and cesarean sections to improve communication and patient safety. Methods A multidisciplinary team consisting of all major stakeholders reviewed and revised the WHO Safe Surgery Checklist making it more applicable to cesarean section operations. The new Safe Cesarean Section Checklist was tested and then integrated into the electronic medical record and utilized on the labor and delivery unit. A specific cesarean section safety attitudes questionnaire was developed, validated, and administered prior to and one year after implementation. Results Usage of the Safe Cesarean Section Checklist was greater than 95% after initial implementation. Significant improvements were reported by the staff on the cesarean section attitudes questionnaire for several key areas including the feeling that all necessary information was available at the beginning of the procedure, decreases in communication breakdowns and delays, and fewer issues related to not knowing who was in charge during the procedure. Discussion Implementation of the Safe Cesarean Section Checklist was successfully adopted by the staff, and improvements in staff perceptions of several key safety issues on our unit were demonstrated. Additional studies should be undertaken to determine if clinical outcomes from this intervention are comparable to those seen with the use of the WHO Safe Surgery Checklist.
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Background: Kidney transplantation is the therapy of choice for end-stage kidney disease, and a fast-growing transplant procedure worldwide. Diverse clinical practices for recipients and donors' selection and management between transplant centers hinder the creation and dissemination of an anesthesia-surgical checklist. Methods: Components of the anesthesia-surgical checklist were selected after a review of the English literature using PubMed search for donor, recipient and graft protocols and outcomes of existing practices in the field of kidney transplantation. Key elements of the most relevant articles were combined with our own center's experience and formulated into the proposed checklist. The checklist is intended to be used perioperatively, once patient receives an offer. Results: The perioperative checklist centers primarily on the following donor and recipient's factors: (i) Review of the pretransplant candidate workup; (ii) Assessment of donor/graft status; (iii) Hypothermic machine perfusion parameters; (iv) Operating room management; (v) Sign out. The proposed kidney transplant checklist was designed to ensure consistency and completeness of diverse tasks and facilitates team communication and coordination. Conclusion: We present a novel standardized combined anesthesia-surgical checklist framework for kidney transplant aimed at increasing perioperative safety and streamline the perioperative care of recipients. Future validation studies will determine its clinical feasibility and post-implementation efficacy.
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The genus Troporhogas Cameron, 1905 from the Indo-Malayan region is reviewed. Six new species, Troporhogasalboniger Quicke, Loncle & Butcher, sp. nov., T.benjamini Quicke, Loncle & Butcher, sp. nov., T.hugoolseni Quicke, Loncle & Butcher, sp. nov., T.rafaelnadali Quicke, Loncle & Butcher, sp. nov., and T.rogerfedereri Quicke, Loncle & Butcher, sp. nov. from Thailand, and T.anamikae Ranjith, sp. nov. from India are described and illustrated photographically, bringing the total number of species of the genus known from the Indo-Malayan Region to 19. Troporhogas is recorded for the first time from India. A key is included to differentiate Troporhogas species. A four-gene ML tree based on COI, Cytb, 16S and 28S is reconstructed, representing the six new species. Troporhogascontrastus Long, 2014, originally described from Vietnam, is recorded from Thailand for the first time. The holotypes of the type species, Troporhogastricolor Cameron, 1905 and that of its junior synonym Iporhogas are illustrated, and photographs are presented of all the species known only from China and Sri Lanka. Sexual colour dimorphism of males of several species is described for the first time. Drawings summarising the different patterns of black marks on the metasoma that aid species recognition are presented.
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Background: The Children's Communication Checklist-Second Edition (CCC-2) uniquely assesses overlooked communication elements such as pragmatics and context use, which are rarely addressed by conventional language assessments. This study focuses on the psychometric assessment of the CCC-2's Arabic version, tailored to evaluate communication challenges in Arabic-speaking children. Aim: This study aims to validate the Arabic version of CCC-2 by testing its reliability and validity specifically for three higher-order constructs: Specific Language Impairment (SLI), Social Communication Disorder (SCD), and Impaired Behaviour within the Arabic-speaking population. Methods: A total of 121 participants in Saudi Arabia, showcasing diverse age and gender distributions, participated in the validation process. The study employed a Reflective-Reflective Higher-Order Construct (R-R HOC) model using partial least squares-structural equation modeling (PLS-SEM) to ensure content validity and cross-cultural adaptation of the translated items. Metrics such as Cronbach's alpha for reliability and Average Variance Extracted (AVE) for convergent validity were specifically examined. Results: The study confirmed the reliability and validity of the Arabic CCC-2, demonstrating robust psychometric properties, with Cronbach's alpha and AVE scores indicating satisfactory reliability and convergent validity across constructs. Structural model evaluation further supported the strong interrelations among the constructs of SLI, SCD, and Impaired Behaviour. Conclusion: The results substantiate the Arabic CCC-2 as a reliable and valid tool for assessing communication challenges in Arabic-speaking children, particularly for diagnosing SLI, SCD, and Impaired Behaviour. Implications: The validated Arabic CCC-2 has significant potential for application in clinical and educational settings and suggests directions for future research to explore its utility further in diverse clinical populations.
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Introduction In certain fields such as anesthesia and critical care, technical incidents are rare events; however, when they occur, they disrupt workflow, optimal patient care, and survival, with human factors often implicated. In pediatric resuscitation, the impact of these incidents on patient care has not yet been thoroughly explored through simulation. Consequently, we investigated how healthcare teams integrate technical incidents in critical situations and whether this interferes with the adequate management of patients. Materials & methods In a single-blind randomized study utilizing high-fidelity simulation, we incorporated a pediatric scenario involving hypoxemia in an intubated and ventilated infant where the endotracheal tube (ETT) was obstructed. A technical incident (disconnected oxygen supply) was either present (TI+) or absent (TI-) in the scenario. We compared reaction times for "removal of the obstructed ETT" between the two groups (TI+ and TI-). Additionally, we recorded and analyzed reaction times for "bag ventilation" and "repair of the technical incident" in the TI+ group. To assess the scenario's credibility, we conducted an analysis comparing the medians of evaluation forms that were anonymously completed by participants at the end of the sessions. Results In total, 10 simulation sessions were conducted, five TI+ and five TI-. The time required for removal of the obstructed ETT in the presence of a technical incident was significantly prolonged compared to controls (Mann-Whitney test, p=0.03). Furthermore, bag ventilation precedes tube removal in the TI+ group, a contrast to the TI- group, which quickly removes the obstructed ETT before stabilizing the patient with bag-mask ventilation. Conclusion Technical incidents in simulated pediatric scenario adversely affect urgent care in ventilated children. Developing and validating a procedural response to these situations through further simulation is imperative.
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CONTEXT: Health simulation is a recognized educational method for teaching and validating surgical procedural skills. The latter requires the development of adapted assessment tools, reaching different validity criteria. The aim of this study was to validate a multimodal assessment tool for a complex skin suturing exercise, combining a manual knot, an intradermal linear suturing and a needle holder tied knot. METHODOLOGY: The suturing exercise was realized on a synthetic skin model by voluntary participants after having obtained their written consent, including 9 postgraduate medical students, 40 surgical residents of different levels of experience, and a group of 9 senior surgeons. The multimodal assessment tool (MAT) combined a checklist, a speed score and a global rating scale. Each exercise was scored by two evaluators. Medical students' performances were filmed anonymously so that they could be scored iteratively. Content validity was tested through a satisfaction questionnaire randomly completed by participants. RESULTS: The MAT was considered relevant or very relevant by 98% of the participants, with a better appreciation for the checklist than for the global rating scale. Internal consistency was strong with a Cronbach α coefficient at 0.78, and a good correlation between the results of the checklist and the global rating scale (r=0.79, P<0.0001). The MAT showed continuous improvement in mean scores from 34.4±3.6 for novices to 47.4±2.5/50 points for experts, passing through three intermediate levels groups, and allowed for significant discrimination between groups. The MAT was reliable, with a coefficient of correlation set at 0.88 for intra-observer reliability, and 0.72 for inter-observer reliability. On sub score analysis, the global rating scale and the speed score better discriminated between groups than the checklist, the latter moreover showing slightly lower reliability than the global rating scale. CONCLUSION: Despite its banality in any surgeon's practice and the fact that it is taught from the 2nd cycle of medical studies, suturing and its technical components have rarely been the subject of publications dedicated to the validation of specific assessment tools. Hence, this work on the MAT and its sub scores made it possible to validate them on many validity and reliability criteria. They can therefore be proposed to surgical teachers for evaluating a complex suturing exercise, with a checklist that is easier to use even for novices and a global rating scale showing better discrimination capacity.
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Purpose: The AYA Psycho-Oncology Screening Tool was developed to assess adolescent and young adult (AYA) patients' distress during cancer treatment. The on-treatment distress screening tool has been validated with AYAs and includes a 10-point distress thermometer (DT) and a 53-item problem checklist (PCL). However, previous studies have not solely examined AYA cancer distress within a children's hospital. Therefore, our project aimed to explore AYA distress in a pediatric cancer setting. Methods: AYA-aged participants (aged ≥15) were given the distress screener initially within 1 month of diagnosis and every 2, 4, or 6 months, depending on their previous distress score. Chi-square, independent t-tests, and binary logistic regressions were conducted for data analysis. Results: Between January 2021 and July 2022, we completed 123 screenings in 68 AYAs (age 15-30) on treatment. Average DT score was 2.96 with 30% of participants endorsing distress levels of 5 and above. There were statistically significant differences by sex as females endorsed higher levels of distress compared with males. Adolescents (<18) endorsed statistically significant higher frequency of emotional PCL items in comparison with young adults (≥18). There were no differences by race or diagnosis. Conclusions: Our team gained awareness of specific areas of concerns for AYAs, allowing for more targeted interventions for distressed participants. Certain demographic variables may put participants at risk for increased distress. As a result of the project, a protocol has been developed to follow up with participants if they report a certain distress score (5 or above) and/or endorse critical items.
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Transport and mining machinery cabins are still not well adapted to their users, while checklists for their evaluation are not common in the literature. This article proposes a new checklist for ergonomic evaluation and tests its universality empirically with a sample of 96 transport and mining machine operators. The objective of the article is two-fold. First, the article checks whether there are anthropometric dimension differences between different machines' operators. Second, statistical significance testing regarding items in the proposed checklist is performed to check its universality. Significant differences have not been found between anthropometric dimensions of transport and mining machine operators. Group comparisons prove that mining machines have better ergonomics characteristics of the chair, manual controls and vision field. The recommendation for crane designers is to examine mining machines solutions and analyze the possibility of adapting these solutions, due to anthropometric fit. Wide usage of the checklist is recommended.
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Background In their academic lives, students progress from the stage of primary learning to the stage of adolescent learning and then to the stage of adult learning. At every step of learning, learners display particular learning habits, which must be mapped out to maximize learning. Objectives The objective of the present study is to evaluate the person-centered behaviors that influence learning among learners in adolescent and adult age groups by employing a learning behavior questionnaire that has been previously validated. Material and methods A cross-sectional study in which 944 participants were enrolled, including 456 adolescents from English-medium schools (aged 11 to 16 years) and 488 adults from a health professional institute (aged 18 to 23 years). The validated learning behavior questionnaire, which study participants rated on a scale of 0, 1, and 2, served as the study's quantitative component. The focus group discussion that was held for a group of adult and teenage students comprised the study's qualitative component. Using STATA-14 software (StataCorp LLC, College Station, USA), all of the responses were tallied and statistically examined. Results The mean scores of person-centered learning behaviors were significantly higher for learners in the adult age group than for learners in the adolescent age group. The findings of the component, which was qualitative in nature, were consistent with the findings of the learning behavior questionnaire analysis. For both adults and adolescents, the difference in mean person-centered learning scores was statistically negligible at a 5% level of significance (p=0.415 and p=0.368, respectively). Conclusion The study's checklist, which is self-monitoring in nature, may aid in the evaluation of learning behaviors and make it simpler for adult and adolescent learners to establish excellent learning habits.