Health-related quality of life in patients with diabetic foot ulcers in the Arab world: a systematic review.

OBJECTIVE: To conduct a systematic review to identify the impact of diabetic foot ulceration (DFU) on health-related quality of life (HRQoL) in individuals within the Arab world. METHOD: A PRISMA-guided systematic search for HRQoL studies in Arab populations was conducted in CINAHL, PubMed, Scopus and EBSCO. Relevant studies were critically appraised using the STROBE statement checklist. RESULTS: A total of five studies were included. Three studies originated from Saudi Arabia, one from Jordan and one from Tunisia. The studies consistently demonstrated lower (poorer) HRQoL in patients with DFU, and worse HRQoL compared with both patients with diabetes and no DFU, and with healthy subjects. CONCLUSION: This review confirmed the negative impact of DFU on HRQoL in individuals with diabetes. It also highlights the scarcity of HRQoL studies from the Arab world. However, given that all studies included were conducted between 2013-2019, this could reflect a growing interest in DFU and HRQoL in the Arab world, and could potentially indicate that more studies will follow. In light of this, there is a need for a renewed focus on the completion of a high-quality standardised approach to research in this region.

Pediatric Intensive Care Hybrid-Style Clinical Round During COVID-19 Pandemic: A Pilot Study.

Objectives: With the evolving COVID-19 pandemic and the emphasis on social distancing to decrease the spread of SARS-CoV-2 among healthcare workers (HCWs), our pediatric intensive care unit (PICU) piloted the integration of Zoom meetings into clinical rounds. We aimed to explore the feasibility of these hybrid virtual and physical clinical rounds for PICU patients. Design: Mixed quantitative and qualitative deductive thematic content analysis of narrative responses. Setting: PICU, single tertiary-care academic center. Participants: Multidisciplinary PICU HCWs. Interventions: Integration of Zoom meeting into clinical daily PICU rounds. Measurements: For the quantitative part, we gathered the details of daily PICU hybrid rounds in terms of times, number of HCWs, and type of files shared through Zoom. For the qualitative part, open-ended questions were used. Main Results: The physical round took statistically significantly less time (34.68 ± 14.842 min) as compared with the Zoom round (72.45 ± 22.59 min), p < 0.001. The most shared component in the virtual round was chest X-rays (93.5%). Thirty-one HCWs participated in focus group discussions and were included in the analysis. Some of the HCWs' perceived advantages of the hybrid rounds were enabling multidisciplinary discussions, fewer round interruptions, and practicality of virtual discussions. The perceived challenges were the difficulty of the bedside nurse attending the virtual round, decreased teaching opportunities for the trainees, and decreased interactions among the team members, especially if video streaming was not utilized. Conclusions: Multidisciplinary hybrid virtual and physical clinical rounds in the PICU were perceived as feasible by HCWs. The virtual rounds decreased the physical contact between the HCWs, which could decrease the possibility of SARS-CoV-2 spread among the treating team. Still, several components of the hybrid round should be optimized to facilitate the virtual team-members' interactions and enhance the teaching experience.

Methodological approaches for assessing the cost of diabetic foot ulcers: a systematic literature review.

OBJECTIVE: To evaluate the methodological approaches used to assess the cost consequences of diabetic foot ulcers (DFUs) in published scientific papers. METHOD: A systematic literature search was conducted in PubMed, Embase, Scopus, Web of Science and CINAHL. English language papers reporting on the cost of DFUs were identified. Additionally, bibliographies were inspected to identify other relevant cost studies. Following the PRISMA guidance, the review identified the study design, epidemiological approach, analytical perspective and data collection approach in each of the included studies. RESULTS: Relatively few studies of the cost consequences of DFUs were found (n=27). Most studies were conducted in Western countries with only five studies from countries in Asia and Africa. The identified studies used different study designs, epidemiological approaches, data collection strategies, and data sources, which in turn made a systematic comparison of cost estimates difficult. Detailed descriptions of the applied costing method and other methodological aspects were often limited or absent. Many studies only reported costs from a health-care payer's perspective and disregarded the costs to patients, their families and wider society. CONCLUSION: The costs of DFUs have been assessed using a wide range of different methodological approaches often restricted to the healthcare payer's perspective. Therefore, the cost analyses may fail to consider the true societal costs of DFUs.