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1.
Prostate ; 2024 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-38888199

RESUMO

OBJECTIVE: To analyse the adverse events (AEs) associated with apalutamide and the impact of a multidisciplinary team (MDT) protocol on its management at a tertiary care hospital in a real-world setting. METHODS: This was an observational, prospective, cohort study based on real-world evidence at the Hospital Clínic de Barcelona. Includes patients diagnosed with metastatic hormone-sensitive prostate cancer (mHSPC) or high-risk nonmetastatic castration-resistant prostate cancer (nmCRPC) and who started treatment with apalutamide between May 2019 and March 2023 in a real-world clinical setting. RESULTS: Of the 121 patients treated with apalutamide, 52.1% experienced an AE, 19.8% experienced temporarily interruption or a reduction in the dose of apalutamide, and 13.2% discontinued treatment due to AEs. Without MDT protocol (49 patients), 24.5% of patients had to temporarily interrupt or reduce the dose of apalutamide due to AEs, with a median time from the start of treatment of 10.1 months, and 24.5% discontinued apalutamide due to AEs, with a median time from the start of treatment of 3.1 months. Meanwhile, whit MDT protocol (72 patients), 16.7% of patients had to temporarily interrupt or reduce the dose of apalutamide due to AEs, with a median time from the start of treatment of 1.6 months, and 5.6% discontinued apalutamide due to AEs, with a median time from the start of treatment of 4 months. The risk reduction associated with treatment discontinuation was statistically significant (p-value = 0.003). CONCLUSIONS: This study highlights the importance of MDT management of AEs associated with apalutamide to reduce treatment discontinuation.

2.
Int J Colorectal Dis ; 38(1): 28, 2023 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-36735059

RESUMO

PURPOSE: Team management strategies for complex colorectal polyps are recommended by professional guidelines. Multi-disciplinary meetings are used across the UK with limited information regarding their impact. The aim of this multi-centre observational study was to assess procedures and outcomes of patients managed using these approaches. METHOD: This was a retrospective, observational study of patients managed by six UK sites. Information was collected regarding procedures and outcomes including length of stay, adverse events, readmissions and cancers. RESULTS: Two thousand one hundred ninety-two complex polyps in 2109 patients were analysed with increasing referrals annually. Most presented symptomatically and the mean polyp size was 32.1 mm. Primary interventions included endoscopic therapy (75.6%), conservative management (8.3%), colonic resection (8.1%), trans-anal surgery (6.8%) or combined procedures (1.1%). The number of primary colonic resections decreased over the study period without a reciprocal increase in secondary procedures or recurrence. Secondary procedures were required in 7.8%. The median length of stay for endoscopic procedures was 0 days with 77.5% completed as day cases. Median length of stay was 5 days for colonic resections. Overall adverse event and 30-day readmission rates were 9.0% and 3.3% respectively. Malignancy was identified in 8.8%. Benign polyp recurrence occurred in 13.1% with a median follow up of 30.4 months. Screening detected lesions were more likely to undergo bowel resection. Colonic resection was associated with longer stays, higher adverse events and more cancers on final histology. CONCLUSION: Multi-disciplinary team management of complex polyps is safe and effective. Standardisation of organisation and quality monitoring is needed to continue positive effects on outcomes and services.


Assuntos
Pólipos do Colo , Humanos , Pólipos do Colo/patologia , Colonoscopia/efeitos adversos , Colonoscopia/métodos , Colo/patologia , Estudos Retrospectivos , Encaminhamento e Consulta
3.
Hered Cancer Clin Pract ; 21(1): 14, 2023 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-37460934

RESUMO

BACKGROUNDS: This study aimed to evaluate the changes in the rates of genetic counseling and genetic testing as well as the diagnosis rate of Lynch syndrome (LS)-associated colorectal cancer before and after multistep approach with multidisciplinary team in Japanese. METHODS: In September 2016, we started universal screening for LS by mismatch repair protein immunohistochemistry and prospectively collected the records. Following patient interviews, we started multistep approach with multidisciplinary team (MA) in January 2020. MA consists of six surgeons, one genetic counselor, one medical geneticist, and six pathologists. MA is set up to compensate for patients' lack of knowledge about genetic diseases and make case selection for elderly colorectal cancer patients with deficient mismatch repair (dMMR). MA is designed as a system that could be performed by a small number of medical genetic specialists. A total of 522 patients were included during the study duration, 323 and 199 patients in the pre-MA (P-MA) and MA groups, respectively. RESULTS: The frequency of dMMR in all patients was 10.0%. The patient interview results indicated a significant lack of patient education regarding genetic diseases. The rates of genetic counseling and genetic testing was significantly higher in MA group than in P-MA group (genetic counseling: MA 34.6% vs. P-MA 7.7%, p = 0.04; genetic testing: MA 30.8% vs. P-MA 3.8%, p = 0.02). Moreover, the diagnosis rate of LS-associated colorectal cancer was significantly higher in MA group (2.5%) than in P-MA group (0.3%) (P = 0.03). In addition, MA could be performed without problems despite the small number of medical and human genetics specialists. CONCLUSIONS: MA has achieved appropriate pickup of suspected hereditary colorectal cancer patients and complemented the lack of knowledge about genetic diseases. The introduction of MA increased LS-associated colorectal cancer after universal screening. MA is an appropriate LS screening protocol for Japanese patients who lag behind in medical and human genetics education.

4.
Med Teach ; 45(10): 1118-1122, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37262301

RESUMO

BACKGROUND: Introverted individuals comprise up to half of the population, but are often overlooked in a culture that privileges extraversion. This misunderstanding of introversion has downstream effects for introverts in academic medicine, including lower grades on clinical rotations, increased stress, and under-representation in leadership positions. AIMS: To increase support for and awareness of the unique strengths of introverted individuals at all stages of a career in academic medicine. DESCRIPTION: This article offers twelve tips, based in the educational, business, and personality literature, to empower introverted students, residents, and faculty members for success in academic medicine. While many of the tips apply broadly, certain tips may be more relevant to those in a particular career stage. CONCLUSION: Increased understanding of the natural tendencies and strengths of introversion will promote a more inclusive working environment for all personality types in medicine and allow introverts at all levels of training and practice to thrive.


Assuntos
Medicina , Personalidade , Humanos , Liderança , Docentes , Estudantes
5.
Inf Technol Manag ; 24(2): 99-113, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36311472

RESUMO

Covid 19 presents a great challenge and opportunity for remote working, highlighting the need for electronically-mediated leadership in team tasks and performance. What is the role of leadership in improving utilization of information communication technologies (ICTs) in teamwork? Framed within the e-leadership and project management literature and employing a longitudinal field observation method over 8 months that involves 52 subjects and 172 observations, this study finds that (1) first, strong leaders employ a consistent and high-level use of ICTs throughout the whole process of group work, especially at the planning and closing stages of a project. (2) Second, strong leaders alternate the use of various ICTs to match specific tasks at different phases of the project. Two media platforms-team discussion forum and document sharing- stand out as the most important for strong leaders to build trust and execute tasks. (3) Finally, in a project management setting with a group of transient members with clearly-defined tasks and time-sensitive responsibilities, trust-building is a continual and highly significant leadership responsibility that precedes other leadership responsibilities. Trust is built largely through alternating the use of two rich ICT media (discussion forum and instant messaging) with two lean ICT media (document sharing and presentation display). These findings highlight a significant role of e-leadership in organizations which see the emergence of ICTs especially during crises like Covid 19. Supplementary Information: The online version contains supplementary material available at 10.1007/s10799-021-00354-4.

6.
J Med Libr Assoc ; 109(4): 637-642, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34858095

RESUMO

BACKGROUND: The proliferation of systematic reviews has impacted library operations and activities as librarians support, collaborate, and perform more tasks in the systematic review process. This case report describes a toolkit that librarians with extensive experience in supporting multiple review teams use to manage time, resources, and expectations in the systematic review process. CASE PRESENTATION: The toolkit is a compilation of documents that we use to effectively communicate with and help review teams understand and navigate each stage of the systematic review process. Elements included in the toolkit and discussed in this case report are intake forms, communication templates and memoranda, a process flow diagram, library guides on tools for retrieval and data appraisal, and established standards for guidance during the write-up stage. We describe the use of the toolkit for both education and project management, with a focus on its use in helping manage team time, resources, and expectations. DISCUSSION: The systematic review toolkit helps librarians connect systematic review steps and tasks to actionable items. The content facilitates and supports discussion and learning by both librarians and team members. This toolkit helps librarians share important information and resources for each stage of the process.


Assuntos
Bibliotecários , Motivação , Comunicação , Humanos , Aprendizagem , Revisões Sistemáticas como Assunto
7.
J Med Libr Assoc ; 109(4): 643-647, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34858096

RESUMO

BACKGROUND: Every step in the systematic review process has challenges, ranging from resistance by review teams to adherence to standard methodology to low-energy commitment to full participation. These challenges can derail the project and result in significant delays, duplication of work, and failure to complete the review. Communication during the systematic review process is key to ensuring it runs smoothly and is identified as a core competency for librarians involved in systematic reviews. CASE PRESENTATION: This case report presents effective communication approaches that our librarians employ to address challenges encountered while working with systematic review teams. The communication strategies we describe engage teams through information, questions, and action items and lead to productive collaborations with publishable systematic reviews. CONCLUSIONS: Effective communication with review teams keeps systematic review projects moving forward. The techniques covered in this case study strive to minimize misunderstandings, educate collaborators, and, in our experience, have led to multiple successful collaborations and publications. Librarians working in the systematic review space will recognize these challenges and can adapt these techniques to their own environments.


Assuntos
Bibliotecários , Comunicação , Humanos , Revisões Sistemáticas como Assunto
8.
Pediatr Blood Cancer ; 66(1): e27416, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30152039

RESUMO

BACKGROUND/OBJECTIVE: This study evaluates the outcome of Wilms tumor (WT) following introduction of multidisciplinary team management and patient treatment stratification by tumor histology in two referral centers in southeastern Nigeria. METHODS: We analyzed histologically confirmed WT cases managed from January 2008 to June 2017. RESULTS: There were 45 patients, peak age incidence of 2 to 5 years who presented after mean symptom duration of 4.9 months (range, 1-12 months), with mean tumor weight of 1040 g (range, 350-4200 g). Overall, 14 (31.1%) had unfavorable histology of WT. A total of 22 (48.9%) patients received preoperative chemotherapy, 43 (95.6%) received postoperative chemotherapy based on stage of disease and histopathology, but none received adequate radiotherapy. Of these, 19 (44.2%) patients complied with chemotherapy regimen, 15 (33.3%) were lost to follow-up and 12 (26.7%) cases relapsed. With 30 cases available for evaluation and mean follow-up duration of 23 months (range, 6-80 months), the overall 5-year survival is 53.3% (16 cases). Survival in children who complied with postoperative chemotherapy was 73.7%, and abandonment-sensitive survival was 35.6%. Persisting challenges were late presentation, poor compliance to treatment, and lack of radiotherapy treatment. CONCLUSION: Multidisciplinary team management and chemotherapy based on tumor histology might have resulted in slight improvement of outcome since our last report. However, to ensure survival that may approach global benchmarks, there is need for public health measures to improve time to diagnosis, and improvement of facilities and healthcare funding to ensure compliance to all phases of standard therapy.


Assuntos
Renda/estatística & dados numéricos , Neoplasias Renais/terapia , Assistência Centrada no Paciente/economia , Assistência Centrada no Paciente/normas , Pobreza/estatística & dados numéricos , Tumor de Wilms/terapia , Adolescente , Criança , Pré-Escolar , Terapia Combinada , Feminino , Seguimentos , Acessibilidade aos Serviços de Saúde , Humanos , Neoplasias Renais/economia , Neoplasias Renais/epidemiologia , Masculino , Nigéria , Prognóstico , Tumor de Wilms/economia , Tumor de Wilms/epidemiologia
9.
Heart Vessels ; 34(3): 452-461, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30238352

RESUMO

Palliative care for end-stage heart failure should be provided by a multidisciplinary team. However, the influence of each occupational category on patients receiving palliative care for end-stage heart failure remains unclear. Thus, this study investigated the relationships between palliative care conferences and positive outcomes of palliative care for end-stage heart failure patients. We sent questionnaires to all cardiology training hospitals authorized by the Japanese Circulation Society (n = 1004); of these, responses from the directors at 554 institutions were analyzed. We divided the responding institutions into two groups according to their implementation of palliative care conferences for patients with end-stage heart failure. The institutions that had held such conferences (n = 223) had a larger number of hospital beds, beds in the cardiovascular department, and patients admitted to the cardiovascular department, compared with institutions that had not held these conferences (n = 321). The usage rates of opioids, non-steroidal anti-inflammatory drugs, and sedatives were significantly higher in institutions that held these conferences. Multivariate analysis revealed that nutritionists and medical social workers had greater involvement in the improvement of mental symptoms and ensuring that patients could stay where they wished, respectively. The presence of palliative care physicians, physical therapists, or pharmacists was associated with multiple positive outcomes. This study indicated that there are possible associations between palliative care conferences and positive outcomes when performing palliative care for patients with end-stage heart failure.


Assuntos
Congressos como Assunto , Insuficiência Cardíaca/terapia , Cuidados Paliativos/métodos , Equipe de Assistência ao Paciente/organização & administração , Qualidade da Assistência à Saúde/organização & administração , Inquéritos e Questionários , Estudos Transversais , Feminino , Humanos , Masculino
10.
Int J Health Plann Manage ; 34(4): e1937-e1947, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31313351

RESUMO

To prevent rigidity within teams in health care and to support teams in detecting early warning signs of decreasing flexibility, a program has been co-created in collaboration with mental healthcare teams. This program is intended to systematically monitor team behavior, and by doing so to facilitate team intervention. We aim to lay foundations for the further development of methods that can help teams to recognize and respond to processes going on under the surface. This paper introduces the program to the reader; and describes its premises and the co-creation process, leading to a program of nine steps. Then, it describes the application of the program within a team, what a team needs to use the program, and whether the nine steps are sufficient. This pilot shows that the program is a helpful framework within which teams can talk about rigidity, define indicators of their flexibility, and think about appropriate actions and interventions for maintaining or restoring their flexibility. Team ownership and the customizability of the program are important attributes. The program appears to provide a useful framework that helps a team to observe and discuss processes. Team members become aware of the indicators of their team and make their goals explicit.


Assuntos
Equipe de Assistência ao Paciente/organização & administração , Humanos , Modelos Organizacionais , Projetos Piloto , Desenvolvimento de Programas
11.
Br J Community Nurs ; 24(10): 478-481, 2019 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-31604053

RESUMO

Sickness absence in the NHS is around 2.3% higher than in the rest of the economy. Although policies and guidelines are in place to manage this problem, stress-related illness is on the rise. Managing sickness, absence and declared disabilities in district nursing teams is an issue that must be handled by staff members, team managers and the wider organisation. Occupational health services are a crucial component in both preventing and managing staff sickness and absence, but these may well not have adequate resources to cope with increased stress-related illness. Ensuring that occupational health services are adequately resourced and able to respond appropriately to both the needs of staff in need of their support and managers is part of the organisational responsibilty. This article aims to guide managers in caring for their staff properly and meeting service demand, a difficult balancing act.


Assuntos
Absenteísmo , Enfermagem em Saúde Comunitária/organização & administração , Enfermeiros Administradores , Equipe de Assistência ao Paciente , Carga de Trabalho , Humanos , Relações Interprofissionais , Medicina Estatal , Reino Unido
12.
J Paediatr Child Health ; 53(10): 976-980, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28600851

RESUMO

AIM: Neonatal surgery in low-income and middle-income countries has a poorer outcome when compared with high-income countries. This study evaluated the management challenges and outcomes of neonatal surgery before and after the introduction of focused interdisciplinary team management in 2013. METHODS: We retrospectively analysed neonatal surgery undertaken at two referral hospitals in Enugu, south-eastern Nigeria from January 2011 to November 2015. Cases managed prior to July 2013 (group A) were compared with those managed from July 2013 (group B). RESULTS: There were 91 cases (group A, 47; group B, 44). The common neonatal conditions were oesophageal atresia (21), anorectal malformation (18) and intestinal atresia (18). The surgical conditions, birthweight, age at presentation and associated anomalies did not differ in the two groups. The treatment was also similar except in oesophageal atresia, where cardiac banding was added to the temporary gastrostomy in late presenting cases with undernutrition in group B. Postoperative complications occurred in 43 (47.3%) cases (group A, 55.3%; group B, 38.6%; P > 0.05), and the overall mortality was 33 (35.3%: group A, 48.9%; group B, 22.7%: P < 0.05). Causes of mortality were unremitting sepsis (group A, 11; group B, 5), anaesthesia complications (group A, 5; group B, 0) and respiratory complication (group A, 7; group B, 5). Delayed presentation, inadequate facilities and defective health insurance scheme were challenges in the two groups. CONCLUSION: Despite the persisting challenges, co-ordinated team management may result in the modest improvement of outcomes of neonatal surgery in our setting. Addressing these challenges may further improve outcomes.


Assuntos
Comunicação Interdisciplinar , Equipe de Assistência ao Paciente , Procedimentos Cirúrgicos Operatórios , Diagnóstico Tardio , Feminino , Humanos , Recém-Nascido , Masculino , Nigéria , Complicações Pós-Operatórias/classificação , Estudos Retrospectivos
13.
Global Health ; 12(1): 29, 2016 06 02.
Artigo em Inglês | MEDLINE | ID: mdl-27255370

RESUMO

Human capital requires opportunities to develop and capacity to overcome challenges, together with an enabling environment that fosters critical and disruptive innovation. Exploring such features is necessary to establish the foundation of solid long-term partnerships. In this paper we describe the experience of the CRONICAS Centre of Excellence in Chronic Diseases, based at Universidad Peruana Cayetano Heredia in Lima, Peru, as a case study for fostering meaningful and sustainable partnerships for international collaborative research. The CRONICAS Centre of Excellence in Chronic Diseases was established in 2009 with the following Mission: "We support the development of young researchers and collaboration with national and international institutions. Our motivation is to improve population's health through high quality research." The Centre's identity is embedded in its core values - generosity, innovation, integrity, and quality- and its trajectory is a result of various interactions between multiple individuals, collaborators, teams, and institutions, which together with the challenges confronted, enables us to make an objective assessment of the partnership we would like to pursue, nurture and support. We do not intend to provide a single example of a successful partnership, but in contrast, to highlight what can be translated into opportunities to be faced by research groups based in low- and middle-income countries, and how these encounters can provide a strong platform for fruitful and sustainable partnerships. In defiant contexts, partnerships require to be nurtured and sustained. Acknowledging that all partnerships are not and should not be the same, we also need to learn from the evolution of such relationships, its key successes, hurdles and failures to contribute to the promotion of a culture of global solidarity where mutual goals, mutual gains, as well as mutual responsibilities are the norm. In so doing, we will all contribute to instil a new culture where expectations, roles and interactions among individuals and their teams are horizontal, the true nature of partnerships.


Assuntos
Saúde Global , Cooperação Internacional , Pesquisa Biomédica/organização & administração , Fortalecimento Institucional/organização & administração , Doença Crônica/prevenção & controle , Humanos , Estudos de Casos Organizacionais , Peru
14.
Nurse Res ; 23(2): 36-40, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26563930

RESUMO

AIM: To explore what is meant by a 'research team' and offer practical suggestions for supporting an effective and productive, collaborative research team. BACKGROUND: Collaborative research has become one of the main objectives of most higher education institutions and running effective research teams is central to achieving this aim. However, there is limited guidance in the literature about how to run or steer a research team. DATA SOURCES: Search engines/databases used: CINAHL, Nursing and Allied Health Source, Primo search, Google search and Health Collection to access research articles and publications to support this topic. Literature search was extended to the end of 2014. REVIEW METHODS: Publications were reviewed for relevance to the topic via standard literature search. DISCUSSION: Research teams vary in size and composition, however they all require effective collaboration if they are to establish successful and flexible working relationships and produce useful and trustworthy research outputs. This article offers guidance for establishing and managing successful collaborative research relationships, building trust and a positive research team culture, clarifying team member roles, setting the teams' research agenda and managing the teams' functions so that team members feel able to contribute fully to the research goals and build a culture of support and apply 'emotional intelligence' throughout the process of building and running a successful research team. CONCLUSION: Collaboration is a central component of establishing successful research teams and enabling productive research outputs. This article offers guidance for research teams to help them to function more effectively and allow all members to contribute fully to each team's goals. IMPLICATIONS FOR PRACTICE/RESEARCH: Research teams that have established trust and a positive team culture will result in more efficient working relationships and potentially greater productivity. The advice offered reinforces the value of having research teams with diverse members from different disciplines, philosophical roots and backgrounds. Each of these members should be able to contribute skills and expertise so that the parts of the team are able to develop 'synergy' and result in more productive, positive and rewarding research experiences, as well as more effective research.


Assuntos
Pesquisa em Enfermagem/organização & administração , Pesquisadores , Austrália , Cultura Organizacional
15.
J Exerc Rehabil ; 20(3): 112-123, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38973980

RESUMO

The objective of this study was to assess the perceived usefulness, actual use and limitations for the application of recovery strategies among water polo (WP) players and their coaches around the world. A total of 231 WP players and 76 coaches representing all continents, both genders and all levels of competition, completed a freely accessible online survey. This was divided into three sections: sociodemographic data (8 questions), importance of perceived usefulness of recovery strategies (3 questions), and actual use of recovery methods (6 questions). The majority of players and coaches considered recovery strategies as very important (52.4% and 59.2%, respectively) and posttraining session (28.1% and 26.5%) were the most frequently used times. The most selected reasons to justify their use were to reduce the injury risk (30.4% and 26.9%) and the most limitation to the use of recovery strategies were that they are too time-consuming (34.9% and 29%). In the case of the players, stretching were the strategies perceived as most useful and used (12.7% and 18.1%); and in the case of the coaches, it was active recovery (11.2% and 15%). The present study suggests a degree of discrepancy between the scientific literature and the research participants' perceptions and usages of recovery methods. This information may be of interest for coaches and technical staff of WP teams to look for appropriate recovery strategies for the improvement of their players' performance.

16.
Diabetol Metab Syndr ; 16(1): 2, 2024 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-38172998

RESUMO

BACKGROUND: Glycemic control for patients with diabetes in the surgical department is often unsatisfactory. Compounding this issue is the fact that conventional glucose management models are often inefficient and difficult to monitor over time. OBJECTIVE: To investigate the impact of inpatient glucose team-based management on glycemic control and hospital days in surgical patients with diabetes. METHODS: A retrospective analysis was conducted on 4156 patients with diabetes in the surgical department who received inpatient management of diabetes at a tertiary medical center from June 2020 to May 2022. Based on whether they received inpatient glucose team-based management, the surgical patients with diabetes were divided into two groups: the inpatient glucose team-based management (GM group, consisting of 1698 participants) and the conventional blood glucose management group (control group, consisting of 2458 participants). We compared the two groups in terms of glycemic control, hospital days, and health-care costs. Multiple logistic regression analysis was performed to build the hospital days prediction model and nomogram. Finally, the performance of the model was evaluated. RESULTS: The rate of glucose detection was higher in the GM group at 2 h postprandial (P < 0.01). The incidence of hypoglycemia and severe hyperglycemia, blood glucose attainment time, pre-operative preparation days, hospital days, and health-care costs were lower in the GM group than in the control group (P < 0.01). The linear regression model revealed that blood glucose attainment time, incidence of hypoglycemia (< 3.9mmol/L), preoperative preparation days, perioperative complications, and health-care costs were the factors influencing the hospital days (Total Point 83.4 points, mean hospital days 9.37 days). Receiver operating characteristic (ROC) curve analysis demonstrated that the nomogram had good accuracy for predicting hospital days (area under the ROC curve 0.83, 95% confidence interval [CI], 0.74 to 0.92). CONCLUSION: Inpatient glucose team-based management demonstrated significant improvements in glycemic control among surgical patients with diabetes, resulting in reduced hospital days and associated costs. The developed nomogram also exhibited promising potential in predicting hospital days, offering valuable clinical applications.

17.
Int J Exerc Sci ; 16(3): 1052-1065, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37649464

RESUMO

Acute noncontact Lower Extremity (LE) injuries constitute a significant problem in team sports. Despite extensive research, current knowledge on the risk factors of LE injuries is limited to static simplistic models of instantaneous cause and effect relationships ignoring the time dimension and the embedded complexity of LE injuries. Even though complex systems approaches have been used in various cases to improve policy and intervention effectiveness, there is limited research on predicting and managing LE injuries. This creates an opportunity to fill the gap in the current literature by applying the System Dynamics (SD) methodology to model LE injuries. The proposed approach allows for synthesizing risk factors and examining their interaction. This paper makes the first step towards such an approach by developing a causal loop model revealing the etiology of LE injuries. A causal loop model for LE injuries is developed via an extensive literature review and brainstorming with experts. In contrast to the traditional static approaches, the proposed model reveals some of the complexity and nonlinear relationships of the various sports injury risk factors. The derived causal loop model may then be used to quantify these interactions and develop a simulation model. This will be achieved by operationalizing and incorporating the main risk factors that impact LE injuries in an integrated sports injury prediction model. In this way, plausible strategies for preventing LE injuries can be tested prior implementation and thereby achieve optimization of intervention programs.

18.
Front Psychol ; 13: 809731, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35356347

RESUMO

There are hardly any instruments to measure teamwork behaviors from an individual approach. This applies both in interprofessional teams or not, and in teams involved in health, social care, and other areas. The Individual Behavior Analysis (IBA) scale measures efficacious behavior in work teams. It is one of the few instruments proposed in the literature to measure personal skills necessary for teamwork. Only a previous exploratory analysis of the scale was informed in another study. This article analyzes its internal structure using different confirmatory factor analyses and its internal consistency, with a sample of 815 employees working for Spanish social organizations in the geriatric field, both private and public. The results of the definitive version adapted to Spanish, referred to as Individual Behavior Analysis -25, indicate a good fit of the model to the data and good reliability. Factor analysis confirmed the existence of two factors: Communication skills and Acceptance, with good internal consistency coefficients. This scale is a useful instrument for assessing, based on the reviewed literature, two of the most important individual skills an efficacious team should have.

19.
Front Psychol ; 13: 861929, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35529555

RESUMO

Improving the performance and success rate of college students' new ventures has attracted increasing attention globally. In this study, a questionnaire survey was conducted among 1500 college students who were directly involved in entrepreneurial activities in 23 provinces in China. The study explores the effects of team management and risk prevention abilities on college students' entrepreneurial performance. The results show that risk prevention ability significantly increases university students' entrepreneurial performance (e.g., profit and loss status, capital flow, and staff flow). Team management ability enhances these entrepreneurial indicators to varying degrees, with a "threshold" effect of its impact on entrepreneurial performance. With a continued increase in team management ability, the effect of risk prevention ability on entrepreneurial performance becomes increasingly more significant. Specifically, when team management ability reaches a medium level and above, risk prevention ability significantly improves capital flow and staff stability; and when team management ability reaches a high level, risk prevention ability significantly improves enterprise profitability indicators.

20.
J Vasc Access ; : 11297298221075166, 2022 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-35674111

RESUMO

OBJECTIVE: To establish a multidisciplinary management model based on Delphi method to guide nursing practice and reduce the incidence of CVAD-associated Skin Impairment (CASI) in tumor patients. METHODS: On the basis of literature review and focus group interview, the initial item pool of CASI management model for cancer patients was determined. The Delphi method was used to conduct two rounds of letter consultation with 36 authoritative and representative experts to determine the content and weight of indicators of CASI multidisciplinary management model for cancer patients. RESULTS: Most of the research group were experts with bachelor degree or above. More than 90% of experts have worked for more than 10 years; Areas of expertise include oncology care, venous therapy, wound stomatology, and dermatology. The recovery rate of the two rounds of expert correspondence questionnaire was 100%. The authority coefficient of experts was 0.898, indicating a good degree of authority. Kendall's harmony coefficients were 0.193 and 0.250, with statistically significant differences (p < 0.001). After two rounds of expert letter consultation, a multidisciplinary management model of CASI for cancer patients was initially formed, which included 15 first-level prevention indexes and 38 second-level prevention indexes of CASI for cancer patients. There were 9 first-level indexes and 16 second-level indexes of CASI treatment in tumor patients. CONCLUSION: Cancer patients based on Delphi method to construct CASI multidisciplinary management model has high reliability and scientificity, multidisciplinary management model in the management of patients with tumor CASI exploration will provide new methods for central venous catheter nursing and the new way of thinking, will also be intravenous fluids will provide a scientific basis for professional development and quality improvement and practical experience.

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