Validation and use of the Second Victim Experience and Support Tool questionnaire: a scoping review.

OBJECTIVES: Patient safety incidents can impact not only patients and families but also healthcare providers, who may experience negative emotions and symptoms, such as anxiety, guilt, stress, and loss of confidence. To identify and support these "second victims," a screening tool called the Second Victim Experience and Support Tool (SVEST) has been developed. This scoping review aims to map our current knowledge of the SVEST in terms of its scope of use, validation and limitations. STUDY DESIGN: Scoping review. METHODS: In accordance with the framework outlined by Arksey and O'Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews, we conducted a literature search in MEDLINE, CINAHL, Cochrane Library, SCOPUS, Embase and PsycINFO databases from database inception up till 1 March 2023. RESULTS: A total of 31 studies were reviewed. The SVEST has been cross-culturally adapted from English into other languages. The SVEST has been successfully used in different contexts and with various healthcare professionals, including doctors, nurses, allied health professionals, midwives and pharmacists. The tool has been used to assess the impact of second victim experiences and the effectiveness of support interventions in addressing the phenomenon. Validity assessment of translated versions of SVEST in the reviewed studies revealed good content validity in most cases, although some studies did not report clear values for scale-level Content Validity Index. On the whole, SVEST is generally a reliable and valid tool, although further refinements and modifications may improve its validity and reliability. CONCLUSIONS: The review highlights the significance of SVEST as a crucial resource for healthcare providers and organisations that prioritise well-being and safety in health care. It also underscores the importance of recognising the needs of second victims and offering them appropriate interventions to manage the aftermath of adverse events.

Author Correction: Checkpoint blockade immunotherapy reshapes the high-dimensional phenotypic heterogeneity of murine intratumoural neoantigen-specific CD8+ T cells.

The original version of this Article omitted a declaration from the competing interests statement, which should have included the following: 'R.D.S. is a cofounder, stock holder, and scientific advisory board member of Jounce Therapeutics and Neon Therapeutics, and a member of the scientific advisory boards of BioLegend, Constellation, Lytix, and NGM. He also received research funding from Janssen and Agios.'. This has now been corrected in both the PDF and HTML versions of the Article.

Checkpoint blockade immunotherapy reshapes the high-dimensional phenotypic heterogeneity of murine intratumoural neoantigen-specific CD8+ T cells.

The analysis of neoantigen-specific CD8+ T cells in tumour-bearing individuals is challenging due to the small pool of tumour antigen-specific T cells. Here we show that mass cytometry with multiplex combinatorial tetramer staining can identify and characterize neoantigen-specific CD8+ T cells in mice bearing T3 methylcholanthrene-induced sarcomas that are susceptible to checkpoint blockade immunotherapy. Among 81 candidate antigens tested, we identify T cells restricted to two known neoantigens simultaneously in tumours, spleens and lymph nodes in tumour-bearing mice. High-dimensional phenotypic profiling reveals that antigen-specific, tumour-infiltrating T cells are highly heterogeneous. We further show that neoantigen-specific T cells display a different phenotypic profile in mice treated with anti-CTLA-4 or anti-PD-1 immunotherapy, whereas their peripheral counterparts are not affected by the treatments. Our results provide insights into the nature of neoantigen-specific T cells and the effects of checkpoint blockade immunotherapy.Immune checkpoint blockade (ICB) therapies can unleash anti-tumour T-cell responses. Here the authors show, by integrating MHC tetramer multiplexing, mass cytometry and high-dimensional analyses, that neoantigen-specific, tumour-infiltrating T cells are highly heterogeneous and are subjected to ICB modulations.

A clinical survey on compliance in the treatment of rhinitis using nasal steroids.

BACKGROUND: In the treatment of persistent rhinitis, the observed efficacy with intranasal steroids in clinical practice often falls short of that reported in clinical trials. We postulate that this could be due to patient non-compliance and thus designed this study to evaluate the impact of patient compliance on the efficacy of treatment in patients with persistent rhinitis. METHODS: Sixty-three consecutive adult patients with allergic and non-allergic rhinitis, treated with intranasal triamcinolone acetonate, were included in the study. Compliance was determined both by direct questioning and by measuring the weight of medication consumed (WMC) after 30 days of therapy. Nasal symptom scores were used to determine treatment efficacy. RESULTS: Forty-nine patients (77.8%) reported a forgetfulness of using medication for a few times (1-5 times) during the treatment period. Less than 50% compliance was reported by one patient (1.6%) but detected in seven patients (11%) by WMC. There was a significant (P < 0.001) improvement in mean total symptom score before (7.45 +/- 1.99) and after (3.59 +/- 2.72) treatment in patients with WMC of at least 50%, but not when WMC was <50% (8.43 +/- 1.72 vs 6.29 +/- 2.43; P = 0.114). With >50% WMC, the positive predictive values for relief of each symptom were rhinorrhoea: 78%, nasal itch: 70%, nasal obstruction: 67% and sneezing: 65%. CONCLUSION: Patients compliance has a significant impact on treatment efficacy with intranasal steroids. There is a discrepancy between reported and actual compliance. It is thus important to establish the actual compliance when evaluating patients who fail to respond to therapy.

Hypertension in young adults--an under-estimated problem.

AIM: To study the prevalence of hypertension and "white coat hypertension" in young adult Asian males, and identify the associated risk factors. METHODS: Population-based descriptive analysis of 3,352 Singapore military conscripts presenting consecutively for medical screening, followed by case-control study of subjects with elevated blood pressure. A standard protocol for assessing elevated blood pressure, 24-hour ambulatory monitoring and detailed interviews were performed. Main study outcomes are prevalence rate of hypertension and "white coat hypertension", mean blood pressure readings, and adjusted odds ratios for associated variables. RESULTS: Prevalence of hypertension and "white coat hypertension" was 1.6% (95% CI 1.2, 2.0) and 2.0% (95% CI 1.5, 2.5) respectively. Twenty-four-hour ambulatory monitoring was required to differentiate the two conditions, with a fall of 22.5 mmHg (95% CI 19.7, 25.3) observed between first visit and day-time ambulatory mean systolic blood pressures. There was strong association between hypertension and obesity (adjusted odds ratio using Body Mass Index: 1.19, p<0.001). Other important variables included parental history of hypertension, Malay ethnicity and low socio-economic status, although there was no significant correlation in our regression model. CONCLUSION: This study provides population-based data on hypertension in young Asian adults. While the prevalence of hypertension is low compared to older age groups, it remains important to detect cases early, as appropriate treatment may mitigate long-term cardiovascular risks and reduce target organ damage. There is a clear role for ambulatory blood pressure monitoring for differentiating true hypertension from "white coat hypertension". There may be a role for targeted screening of high-risk groups, particularly the obese.

Effects of vagal perineural capsaicin treatment on vagal efferent and airway neurogenic responses in anesthetized rats.

The acute effect of vagal perineural capsaicin treatment (VPCT) on parasympathetic bradycardia and tracheal neurogenic protein extravasation was examined. In nine anesthetized male Wistar rats the effect of VPCT on the bradycardia induced by electrical stimulation of the vagus was examined. In 24 anesthetized male Wistar rats the effect of VPCT on the tracheal protein extravasation induced by the inhalation of capsaicin aerosols was also studied. VPCT did not alter the bradycardia induced by vagal stimulation or the tracheal protein extravasation induced by the inhalation of capsaicin aerosol. The results of these studies further demonstrate the selectivity of perineural capsaicin treatment on vagal sensory nonmyelinated fibers in the rat and indicate that it is a useful tool for examining the role of sensory vagal C-fibers in pulmonary and cardiovascular reflexes and in isolating C-fiber-mediated reflex responses from those mediated by the release of neuropeptides.