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1.
Cureus ; 16(4): e58648, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38770496

RESUMO

Background and aim Early childhood caries (ECC) is a profoundly impactful multifactorial condition that not only influences a child's overall well-being but also diminishes their quality of life. Given the limited availability of literature on the relationship between children's behavior and ECC, the present study utilized a standardized assessment tool to assess the association between ECC and behavioral changes in preschool children. Methodology Our study cohort consisted of 120 healthy preschool children, aged 18-60 months, evenly divided into two groups: caries-free (group I) and caries active (group II). Clinical features of ECC were meticulously inspected in each child, and the parents or caregivers completed the Child Behavior Checklist (CBCL), which comprises 100 questions related to a child's daily behavior. The total scores, the narrow-band subscales, and raw scores were obtained. Accordingly, for each raw score, t-scores were obtained using the graphic display. These scores were then subjected to various statistical analyses including the Kolmogorov-Smirnov test, Mann-Whitney U test, and Spearman's rank correlation method. Results Results of the present study revealed that there were no significant differences in behavior based on demographic factors such as gender and age. However notable differences were observed in several aspects of behavior between the two groups. Conclusion Caries-active children exhibited significantly higher levels of behavioral problems compared to their caries-free counterparts.

2.
Biodivers Data J ; 12: e120471, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38721271

RESUMO

Background: Algeria is situated at the crossroads between Europe and Africa. The northern part of the country is listed as an area of high biodiversity. Currently, the ecosystems (rivers, lakes, deserts, forests etc.) and the species are under more pressure than ever. The impact of humans is significant and many factors constitute a strong threat to this fauna, especially reptiles, which are the most vulnerable because of their low mobility. Thus, pollution, the drying up of wetlands and their conversion to agriculture have clearly affected the existence of many species. The herpetofauna of Algeria is one of the most diversified in the Mediterranean Basin, consisting of 104 species of which 16.98% are endemic. We suppose that the present list of reptilian fauna provided in this paper is not exhaustive and it is expected to include more species given the lack of research on reptiles in Algeria and its large area. New information: Our dataset contains information on reptile occurrences in Algeria. The dataset is based on original research by the staff of the Laboratory of Environmental Sciences and Agroecology of Chadli Bendjedid University in Algeria. The conservation status of all recorded species is given.

3.
Artigo em Inglês | MEDLINE | ID: mdl-38722568

RESUMO

Previous cross-sectional studies suggest that birth weight (BW) is associated with aggression-, social- and attention problems differently in boys and girls. We sought to test if these differences could be confirmed in a longitudinal study. The 1989 Raine Study provided prospectively collected data on perinatal variables and repeated child behaviour checklist assessments from ages 5 to 17. Linear mixed effects models provided crude and adjusted relationships between BW and childhood behaviour at a conservative significance threshold using prenatal maternal covariables in adjusted models. Sensitivity analyses included an age10 teacher assessment. Data on behaviour, BW and sex, was available in 2269 participants. Male sex was associated with increased aggression problems at lower BW compared to females in the crude model (Interaction B: -0.436, 98.3%CI: [-0.844, -0.0253]), but not the adjusted model (Interaction B: -0.310, 98.3%CI: [-0.742, 0.140]). Male sex was associated with increased attention problems at lower BW compared to females in both the crude model (Interaction B: -0.334, 98.3%CI: [-0.530, -0.137]) and the adjusted model (Interaction B: -0.274, 98.3%CI: [-0.507, -0.0432]). Male sex was associated with increased social problems at lower BW compared to females in both the crude model (Interaction B: -0.164, 98.3%CI: [-0.283, -0.0441]) and the adjusted model (Interaction B: -0.148, 98.3%CI: [-0.285, -0.00734]). Using repeated measures from ages 5-17 we were able to show a crude and adjusted male vulnerability to lower BW in the development of attention problems and social problems. We did not find a BW x sex interaction for the development of aggressive behaviour.

4.
J Exp Child Psychol ; 244: 105948, 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38754332

RESUMO

This study investigated the relationship between parental reports of children's behavioral problems and their cheating behaviors on simulated academic tests, addressing a significant gap in understanding early childhood academic cheating and its potential links to broader behavioral issues. We hypothesized that children's early problem behaviors would be predictive of their academic cheating. To test these hypotheses, children aged 4 to 12 years took part in six unmonitored academic tests that measured their cheating behaviors while their parents completed the Child Behavior Checklist and the Strengths and Difficulties Questionnaire elsewhere. Separate hierarchical linear regressions revealed that children's problem behaviors, as reported by parents, overall significantly predict children's cheating behaviors even after accounting for demographic variables such as age, gender, ethnicity, and parental religiosity. Specifically, the Conduct Problems subscale of the Strengths and Difficulties Questionnaire showed a significant and unique association with children's cheating behaviors above and beyond the common contributions of all predictors. However, the Child Behavior Checklist scores and the scores on the other Strengths and Difficulties subscales were not significantly or uniquely related to cheating. These findings offer new insight into simulated childhood academic cheating and its relation to problem behaviors observed by parents.

5.
Zookeys ; 1200: 41-63, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38736701

RESUMO

In this study, 21 species of Hybos Meigen, 1803 are reviewed in Huaping National Nature Reserve, China. Among these, three species, i.e., Hybosdenticulatussp. nov., Hybosforcipatasp. nov. and H.paraterminalissp. nov., are described as new to science. In addition, nine known species of this genus are reported for the first time in Guangxi. All the known species were enumerated, and an identification key to the species of Hybos from Huaping National Nature Reserve based on morphological characteristics is provided.

6.
Int J Pharm Pract ; 2024 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-38752525

RESUMO

OBJECTIVES: A recent applicability study highlighted the need for the existing checklist for reporting research using a simulated patient methodology (CRiSP) to be clearer and user-friendly. The aim of this study was to update the checklist to address these concerns. METHODS: A fourth round of the Delphi consensus study, used in the original checklist development work, was conducted. Previous participants, who had expertise in SP methodology, were invited to complete a questionnaire including a list of 13 checklist items developed in the previous study and revised following applicability testing. Closed questions were analysed for frequency. Consensus was predefined as >80% agreement. All items were discussed in a roundtable meeting and further modified as necessary. Responses to open questions were content analysed. KEY FINDINGS: Twenty-one authors participated. There was a statistical consensus in 12 out of 13 modified checklist items. CONCLUSIONS: A final reporting checklist for studies in health research using SP methodology has been developed using a consensus approach. Further refinements may be needed to increase the generalizability of the checklist in different contexts.

7.
Adv Ther ; 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38748332

RESUMO

Achondroplasia is a lifelong condition requiring lifelong management. There is consensus that infants and children with achondroplasia should be managed by a multidisciplinary team experienced in the condition. However, many people are lost to follow-up after the transition from paediatric to adult care, and there is no standardised approach for management in adults, despite the recent availability of international consensus guidelines. To address this, the European Achondroplasia Forum has developed a patient-held checklist to support adults with achondroplasia in managing their health. The checklist highlights key symptoms of spinal stenosis and obstructive sleep apnoea, both among the most frequent and potentially severe medical complications in adults with achondroplasia. The checklist acts as a framework to support individuals and their primary care provider in completing a routine review. General advice on issues such as blood pressure, pain, hearing, weight, adaptive aids, and psychosocial aspects are also included. The checklist provides key symptoms to be aware of, in addition to action points so that people can approach their primary care provider and be directed to the appropriate specialist, if needed. Additionally, the European Achondroplasia Forum offers some ideas on implementing the checklist during the transition from paediatric to adult care, thus ensuring the existing multidisciplinary team model in place during childhood can support in engaging individuals and empowering them to take responsibility for their own care as they move into adulthood.

8.
Eur Radiol Exp ; 8(1): 72, 2024 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-38740707

RESUMO

Overall quality of radiomics research has been reported as low in literature, which constitutes a major challenge to improve. Consistent, transparent, and accurate reporting is critical, which can be accomplished with systematic use of reporting guidelines. The CheckList for EvaluAtion of Radiomics research (CLEAR) was previously developed to assist authors in reporting their radiomic research and to assist reviewers in their evaluation. To take full advantage of CLEAR, further explanation and elaboration of each item, as well as literature examples, may be useful. The main goal of this work, Explanation and Elaboration with Examples for CLEAR (CLEAR-E3), is to improve CLEAR's usability and dissemination. In this international collaborative effort, members of the European Society of Medical Imaging Informatics-Radiomics Auditing Group searched radiomics literature to identify representative reporting examples for each CLEAR item. At least two examples, demonstrating optimal reporting, were presented for each item. All examples were selected from open-access articles, allowing users to easily consult the corresponding full-text articles. In addition to these, each CLEAR item's explanation was further expanded and elaborated. For easier access, the resulting document is available at https://radiomic.github.io/CLEAR-E3/ . As a complementary effort to CLEAR, we anticipate that this initiative will assist authors in reporting their radiomics research with greater ease and transparency, as well as editors and reviewers in reviewing manuscripts.Relevance statement Along with the original CLEAR checklist, CLEAR-E3 is expected to provide a more in-depth understanding of the CLEAR items, as well as concrete examples for reporting and evaluating radiomic research.Key points• As a complementary effort to CLEAR, this international collaborative effort aims to assist authors in reporting their radiomics research, as well as editors and reviewers in reviewing radiomics manuscripts.• Based on positive examples from the literature selected by the EuSoMII Radiomics Auditing Group, each CLEAR item explanation was further elaborated in CLEAR-E3.• The resulting explanation and elaboration document with examples can be accessed at  https://radiomic.github.io/CLEAR-E3/ .


Assuntos
Lista de Checagem , Humanos , Europa (Continente) , Radiologia/normas , Diagnóstico por Imagem/normas , Radiômica
9.
Healthcare (Basel) ; 12(9)2024 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-38727427

RESUMO

We aimed to evaluate the effectiveness of an intensive care unit (ICU) round checklist, FAST HUGS BID (Feeding, Analgesia, Sedation, Thromboembolic prophylaxis, Head-of-bed elevation, Ulcer prophylaxis, Glycemic control, Spontaneous breathing trial, Bowel regimen, Indwelling catheter removal, and De-escalation of antibiotics-abbreviated as FD hereafter), in improving clinical outcomes in patients with severe trauma. We included patients admitted to our trauma ICU from 2016 to 2020 and divided them into two groups: before (before-FD, 2016-2017) and after (after-FD, 2019-2020) implementation of the checklist. We compared patient characteristics and clinical outcomes, including ICU and hospital length of stay (LOS) and in-hospital mortality. Survival analysis was performed using Kaplan-Meier curves and multivariable logistic regression models; furthermore, multiple linear regression analysis was used to identify independent factors associated with ICU and hospital LOS. Compared with the before-FD group, the after-FD group had significantly lower in-hospital mortality and complication rates, shorter ICU and hospital LOS, and reduced duration of mechanical ventilation. Moreover, implementation of the checklist was a significant independent factor in reducing ICU and hospital LOS and in-hospital mortality. Implementation of the FD checklist is associated with decreased ICU and hospital LOS and in-hospital mortality.

10.
BMC Psychiatry ; 24(1): 332, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38693475

RESUMO

BACKGROUND: Adverse childhood events (ACEs), psychopathy, and self-harming behaviours are prevalent among individuals in the forensic psychiatry system. While existing literature suggests that ACEs, self-harm, and psychopathy are interrelated, little is known about the interplay of psychopathic traits in this relationship. The present study aimed to determine the mediating role of psychopathy in the relationship between ACEs and self-harming behaviours in forensic patients. METHODS: This was a retrospective study of patients under the Ontario Review Board (ORB) between 2014 and 2015. In the analysis, we included patients with complete data on ACEs, self-harming behaviours, and a Psychopathy Checklist-Revised (PCL-R) score - a measure of psychopathic traits and their severity conducted during the reporting period. Mediation analysis was based on the Baron and Kenny approach, and sensitivity analysis was performed based on the types of ACEs. RESULTS: ​​​The sample population (n = 593) was made up of adults, with a mean age of 41.21 (± 12.35) years and were predominantly males (92.37%). While there was a partial mediating effect of psychopathy on the relationship between ACEs and incidents of self-harming behaviours in the past year, the mediation was complete in the relationship between ACEs and a lifetime history of self-harming behaviours. Following sensitivity analysis based on the types of ACE, the mediating effects were more attributed to specific ACEs, especially having experienced child abuse or having an incarcerated household member before 18 years. CONCLUSION: Among forensic patients in Ontario, psychopathy mediates​ ​the relationship between experiencing ACEs and engaging in self-harming behaviours. Effective intervention to mitigate self-harming behaviours in this population should consider the potential role of psychopathy, especially among individuals who have experienced ACEs involving a history of child abuse and a family who was incarcerated.


Assuntos
Experiências Adversas da Infância , Comportamento Autodestrutivo , Humanos , Masculino , Comportamento Autodestrutivo/psicologia , Comportamento Autodestrutivo/epidemiologia , Feminino , Ontário/epidemiologia , Adulto , Estudos Retrospectivos , Experiências Adversas da Infância/psicologia , Experiências Adversas da Infância/estatística & dados numéricos , Pessoa de Meia-Idade , Transtorno da Personalidade Antissocial/psicologia , Transtorno da Personalidade Antissocial/epidemiologia , Psiquiatria Legal , Criança
11.
Eur J Investig Health Psychol Educ ; 14(5): 1171-1181, 2024 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-38785575

RESUMO

INTRODUCTION: Although gifted children can express high cognitive skills, they can also show socioemotional difficulties. Drawing from Olson's circumplex model, the present paper assessed the role of family functioning in internalizing and externalizing problems in gifted children. MATERIALS AND METHODS: 362 mothers and their 362 gifted children were included. The unbalanced subscales of the FACES IV-disengagement, enmeshment, rigidity, and chaos-and the CBCL were administered to mothers. The children completed the WISC-IV. RESULTS: The model predicting internalizing problems was significant and explained 5.6% of the variance. Only rigidity had an independent and positive effect on internalizing problems in gifted children over and above sociodemographic variables and QI, whereas disengagement, enmeshment, and chaos were not associated with internalizing problems. The model predicting externalizing problems was significant and explained 10% of the variance. Again, rigidity was the only variable that had an independent and positive effect on externalizing problems in gifted children over and above sociodemographic variables and QI, whereas disengagement, enmeshment, and chaos were not associated with externalizing problems in this population. DISCUSSION: Rigid families with a low ability to change in conditions that require readjustment appear to increase the risk of both internalizing and externalizing problems in gifted children. Although further studies are needed to support these preliminary findings, parental support interventions aimed at increasing flexibility appear to be useful.

12.
J Hand Surg Eur Vol ; : 17531934241249907, 2024 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-38780053

RESUMO

This paper is intended to support hand surgeons who, at the beginning of their research career, are planning a clinical study. Besides establishing the research methodology of the study, the organizational planning of the work itself is essential. A feasibility analysis carried out before or during the writing of the study protocol helps to estimate the required resources and duration of a project. We highlight some tips and tricks as well as provide checklists that outline the important points to consider before starting a study.

13.
Int J Urol ; 2024 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-38700051

RESUMO

To preserve the bladder without compromising survival, further treatments need to be optimized to prevent the recurrence and progression of non-muscle invasive bladder cancer. In clinical practice, transurethral resection of bladder tumors is essential for bladder cancer management. The primary goal of surgery is to achieve accurate pathological evaluation and complete resection of bladder cancer; high resection quality is required for the procedure. A representative surrogate indicator of the resection quality is the presence of the detrusor muscle in the resection specimen. Therefore, complete visual resection of bladder cancer with a muscle layer is crucial for decreasing the recurrence and progression rates of non-muscle-invasive bladder cancer. However, this procedure is complex and requires sufficient experience and knowledge to be performed thoroughly, safely, and efficiently. Surgical checklists represent an approach to filling the knowledge and experience gaps and improving the quality and safety of surgery. By checking items during transurethral resection, it is expected that the recording of risk factors related to recurrence and progression will improve, the rate of visually complete resection with muscles will increase, and the rate of intravesical recurrence will decrease. The simplicity of checklists is an additional benefit. In recent years, surgical checklists have received increasing attention in order to achieve high-quality resections and reduce disparities between surgeons and institutions. This literature review outlines the evolving treatment strategies for patients with non-muscle-invasive bladder cancer, focusing on surgical checklists for the transurethral resection of bladder tumors.

14.
Contemp Clin Trials ; 142: 107572, 2024 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-38740298

RESUMO

BACKGROUND: Variable data quality poses a challenge to using electronic health record (EHR) data to ascertain acute clinical outcomes in multi-site clinical trials. Differing EHR platforms and data comprehensiveness across clinical trial sites, especially if patients received care outside of the clinical site's network, can also affect validity of results. Overcoming these challenges requires a structured approach. METHODS: We propose a framework and create a checklist to assess the readiness of clinical sites to contribute EHR data to a clinical trial for the purpose of outcome ascertainment, based on our experience with the Strategies to Reduce Injuries and Develop Confidence in Elders (STRIDE) study, which enrolled 5451 participants in 86 primary care practices across 10 healthcare systems (sites). RESULTS: The site readiness checklist includes assessment of the infrastructure (i.e., size and structure of the site's healthcare system or clinical network), data procurement (i.e., quality of the data), and cost of obtaining study data. The checklist emphasizes the importance of understanding how data are captured and integrated across a site's catchment area and having a protocol in place for data procurement to ensure consistent and uniform extraction across each site. CONCLUSIONS: We suggest rigorous, prospective vetting of the data quality and infrastructure of each clinical site before launching a multi-site trial dependent on EHR data. The proposed checklist serves as a guiding tool to help investigators ensure robust and unbiased data capture for their clinical trials. ORIGINAL TRIAL REGISTRATION NUMBER: NCT02475850.

15.
Insects ; 15(5)2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38786912

RESUMO

A total of 281 coleopteran species from 41 families were recorded from different sites of an abandoned cut-over peatland designated as the Carbon Measurement Supersite in Kaliningrad Oblast. This beetle assemblage is considered a baseline (pre-impact) faunal assemblage for further investigations during the 'before-after' (BA) or 'before-after control-impact' (BACI) study on a peatland that is planned to be rewetted. The spontaneously revegetated peatland has a less specialised beetle assemblage than at an intact raised bog. Tyrphobiontic species are completely absent from the peatland, while some tyrphophiles (5.3% of the total beetle fauna) are still found as remnants of the former raised bog communities. The predominant coenotic coleopteran group is tyrphoneutral generalists from various non-bog habitats (72.9%). The species composition is associated with the vegetation structure of the disturbed peatland (fragmentary Sphagnum cover, lack of open habitats, and widespread birch coppice or tree stand), which does not correspond to that of a typical European raised bog. The sampled coleopteran assemblage is divided into several relative ecological groups, whose composition and peculiarities are discussed separately. Possible responses to the rewetting measurements in different coleopteran groups are predicted and briefly discussed. A complex assemblage of stenotopic peatland-specialised tyrphophiles (15 spp.) and the most abundant tyrphoneutral generalists (31 spp.) were assigned as indicators for the environmental monitoring of peatland development.

16.
Ann Med Surg (Lond) ; 86(5): 2684-2687, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38694363

RESUMO

Objectives: To assess the quality of the meta-analyses that review the WHO surgical safety checklist. Methods: A systematic review of meta-analysis studies was undertaken using the search terms "World Health Organization Surgical Safety Checklist" in PubMed, Embase, and Lilacs databases. The selected meta-analyses were rated using the AMSTAR 2 assessment tool. Results: In the three meta-analyses evaluated, the checklist was associated with a decrease in the rates of complications and mortality. Overall confidence in the results of the evaluated meta-analysis was critically low. Conclusions: The meta-analysis coincides with obtaining lower complications and mortality rates with the WHO surgical safety checklist. However, the studies included in the meta-analyses were mostly observational, with potential biases, and according to the AMSTAR 2 tool, the overall confidence in the results of the evaluated studies was critically low.

17.
Cereb Cortex ; 34(13): 63-71, 2024 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-38696609

RESUMO

To investigate potential correlations between the susceptibility values of certain brain regions and the severity of disease or neurodevelopmental status in children with autism spectrum disorder (ASD), 18 ASD children and 15 healthy controls (HCs) were recruited. The neurodevelopmental status was assessed by the Gesell Developmental Schedules (GDS) and the severity of the disease was evaluated by the Autism Behavior Checklist (ABC). Eleven brain regions were selected as regions of interest and the susceptibility values were measured by quantitative susceptibility mapping. To evaluate the diagnostic capacity of susceptibility values in distinguishing ASD and HC, the receiver operating characteristic (ROC) curve was computed. Pearson and Spearman partial correlation analysis were used to depict the correlations between the susceptibility values, the ABC scores, and the GDS scores in the ASD group. ROC curves showed that the susceptibility values of the left and right frontal white matter had a larger area under the curve in the ASD group. The susceptibility value of the right globus pallidus was positively correlated with the GDS-fine motor scale score. These findings indicated that the susceptibility value of the right globus pallidus might be a viable imaging biomarker for evaluating the neurodevelopmental status of ASD children.


Assuntos
Transtorno do Espectro Autista , Encéfalo , Ferro , Imageamento por Ressonância Magnética , Humanos , Transtorno do Espectro Autista/diagnóstico por imagem , Masculino , Feminino , Criança , Imageamento por Ressonância Magnética/métodos , Encéfalo/diagnóstico por imagem , Encéfalo/crescimento & desenvolvimento , Ferro/metabolismo , Ferro/análise , Pré-Escolar , Mapeamento Encefálico/métodos , Substância Branca/diagnóstico por imagem , Globo Pálido/diagnóstico por imagem
18.
Artigo em Inglês | MEDLINE | ID: mdl-38766896

RESUMO

The negative effects of excessive gestational weight gain (GWG) and obesity during pregnancy are well documented in the literature. However, lack of time, education, comfort, and confidence among health care providers often make it difficult to provide proper nutrition and weight gain guidance for pregnant persons. In response, the International Federation of Gynecology and Obstetrics (FIGO) has developed a nutrition checklist that can standardize recommendations for GWG, facilitate discussions with pregnant persons, and aid providers with nutrition education. The checklist is an innovative tool that can help reduce complications associated with excessive GWG. This article discusses the benefits of FIGO Nutrition Checklist and its implementation at a midwifery clinic that primarily serves Native American women. By using this quick, simple, guided, time-efficient tool, clinics can be successful in facilitating important conversations and education about nutrition and GWG during pregnancy.

19.
Radiologia (Engl Ed) ; 66(2): 155-165, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38614531

RESUMO

Patients attending the emergency department (ED) with cervical inflammatory/infectious symptoms or presenting masses that may involve the aerodigestive tract or vascular structures require a contrast-enhanced computed tomography (CT) scan of the neck. Its radiological interpretation is hampered by the anatomical complexity and pathophysiological interrelationship between the different component systems in a relatively small area. Recent studies propose a systematic evaluation of the cervical structures, using a 7-item checklist, to correctly identify the pathology and detect incidental findings that may interfere with patient management. As a conclusion, the aim of this paper is to review CT findings in non-traumatic pathology of the neck in the ED, highlighting the importance of a systematic approach in its interpretation and synthesis of a structured, complete, and concise radiological report.


Assuntos
Lista de Checagem , Radiologia , Humanos , Emergências , Tomografia Computadorizada por Raios X , Serviço Hospitalar de Emergência
20.
Int J Qual Health Care ; 36(2)2024 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-38581654

RESUMO

BACKGROUND: Quality of care has been systematically monitored in hospitals in high-income countries to ensure adequate care. However, in low- and middle-income countries, quality indicators are not readily measured. The primary aim of this study was to assess to what extent it was feasible to monitor the quality of intensive care in an ongoing health emergency, and the secondary aim was to assess a quality of care intervention (twinning project) focused on Intensive Care Unit (ICU) quality of care in public hospitals in Lebanon. METHODS: We conducted a retrospective cohort study nested within an intervention implemented by the World Health Organization (WHO) together with partners. To assess the quality of care throughout the project, a monitoring system framed in the Donabedian model and included structure, process, and outcome indicators was developed and implemented. Data collection consisted of a checklist performed by external healthcare workers (HCWs) as well as collection of data from all admitted patients performed by each unit. The association between the number of activities within the interventional project and ICU mortality was evaluated. RESULTS: A total of 1679 patients were admitted to five COVID-19 ICUs during the study period. The project was conducted fully across four out of five hospitals. In these hospitals, a significant reduction in ICU mortality was found (OR: 0.83, P < 0.05, CI: 0.72-0.96). CONCLUSION: We present a feasible way to assess quality of care in ICUs and how it can be used in assessing a quality improvement project during ongoing crises in resource-limited settings. By implementing a quality of care intervention in Lebanon's public hospitals, we have shown that such initiatives might contribute to improvement of ICU care. The observed association between increased numbers of project activities and reduced ICU mortality underscores the potential of quality assurance interventions to improve outcomes for critically ill patients in resource-limited settings. Future research is needed to expand this model to be applicable in similar settings.


Assuntos
COVID-19 , Cuidados Críticos , Hospitais Públicos , Unidades de Terapia Intensiva , Qualidade da Assistência à Saúde , Humanos , Líbano , COVID-19/terapia , Unidades de Terapia Intensiva/normas , Unidades de Terapia Intensiva/organização & administração , Estudos Retrospectivos , Hospitais Públicos/normas , Cuidados Críticos/normas , Cuidados Críticos/organização & administração , Qualidade da Assistência à Saúde/organização & administração , Feminino , Masculino , SARS-CoV-2 , Pessoa de Meia-Idade , Indicadores de Qualidade em Assistência à Saúde , Mortalidade Hospitalar , Idoso
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