Care Education Research Articles

Evaluation of TikTok social media posts on side effect information for popular weight loss medications

AbstractIntroductionThe prevalence of overweight and obesity is increasing in America, contributing to various health risks. Glucagon‐like peptide‐1 (GLP‐1) and gastric inhibitory peptide (GIP) receptor agonists have bloomed in popularity due to their efficacy and United States Food and Drug Administration (FDA) approval for weight loss, igniting popularity on social media. This study focuses on the role of TikTok™ (ByteDance, Haidian, Beijing, China), a popular social media platform, in disseminating understandable and actionable information about the side effects of weight loss medications.MethodsThe study analyzed the top 50 TikTok videos for each of the following hashtags: #ozempicsideeffects, #semaglutidesideeffects, #mounjarosideeffects, and #wegovysideeffects. Videos were evaluated based on their understandability and actionability using the Patient Education Materials Assessment Tool (PEMAT) for audio‐visual (AV) products. PEMAT‐AV scores and popularity of videos were compared between hashtags utilizing one‐way analysis of variance (ANOVA). An alpha of 0.05 was used, with Bonferroni correction.ResultsA total of 165 videos were reviewed for PEMAT‐AV understandability and actionability scores. The total visibility of the videos reached over 19.4 million views. A majority of the videos were personal experiences (89%), with only 5% being health care education videos. The average understandability and actionability scores for all videos were 43% and 20%, respectfully. The data presented a difference between searched hashtags for both evaluation scores, p‐values of <0.001 and 0.093, respectively.ConclusionTikTok videos covering weight loss medication side effects have poor understandability and actionability scores. This study highlights the opportunity for more educational videos produced by health care professionals on TikTok, and a potential need for health care organizations and/or colleges of pharmacy to provide education to health care providers on how to create quality content for medication education on social media‐based platforms. Further research is needed to evaluate the credibility of content.

Hemorrhagic intramedullary spinal cord metastasis from renal cell carcinoma: a rare case 15 years after cured renal cell carcinoma. Illustrative case.

Renal cell carcinoma (RCC), the most common kidney cancer, often metastasizes to bones, lungs, liver, and the central nervous system. Intramedullary spinal metastasis from RCC is rare but can cause significant neurological deficits, necessitating prompt diagnosis and treatment through surgical intervention, radiotherapy, and immunotherapy. An 86-year-old man presented with progressive right lower-limb weakness and reduced sensation over 3 weeks. His medical history included a right nephrectomy for RCC 15 years earlier and L4-S1 spondylosis. Imaging identified a bleeding lesion in the conus medullaris at T11-12 and an incidental left kidney mass. Urgent surgical exploration led to a T12 laminectomy and en bloc removal of the lesion, which was confirmed as RCC metastasis. Postoperatively, the patient received focused radiotherapy and immunotherapy, showing significant motor and sensory improvement before dying 3 months later. This case underscores the importance of comprehensive diagnostic imaging for the accurate identification and characterization of spinal lesions. An interdisciplinary approach involving neurosurgeons, oncologists, radiologists, and pathologists is crucial for optimal treatment planning. Urgent surgical intervention can effectively address acute neurological deficits caused by intramedullary lesions. Additionally, adhering to postoperative care instructions, such as deep venous thrombosis prophylaxis, is vital to prevent fatal complications. https://thejns.org/doi/10.3171/CASE24349.

Urban green spaces in early childhood education and care: insights from teachers in Stavanger, Norway

ABSTRACT This study explores the role of urban green spaces (UGSs) in Early Childhood Education and Care (ECEC) teachers’ pedagogical practices and their impact on young children's environmental and sustainability learning. Utilizing observations, teacher interviews, conversations, and a comprehensive survey conducted in Stavanger, Norway, the study reveals the crucial role of UGSs in shaping both teachers’ pedagogical practices and children’s learning across various subject areas. The research highlights the educational significance of diverse UGSs in providing varied and tailored learning experiences that are crucial for children's education and development. In line with this, the study provides findings supporting the application of experiential learning theory within UGSs and ECEC settings. Additionally, the findings reveal a growing concern among teachers about the reduction of UGSs due to increasing urbanization. These results underscore the need for both teachers’ advocacy and strategic policy to preserve UGSs, ensuring their availability for future generations.

More Than Body Parts: A New Ethos of Anatomy Education

Abstract A new ethos of anatomy education goes beyond the learning of body parts in the traditional curriculum. In the traditional curriculum, the focus of only providing information on the structure of the human body left certain learning opportunities overlooked, marginalized, or dismissed as irrelevant; thus, opportunities to foster and shape professional attributes in health care learners were lost. Furthermore, changes in curricula structures and reductions in anatomy teaching hours have necessitated a transformation in how anatomy education is perceived and delivered. This article presents an examination of a contemporary ethos of anatomy education that draws together concepts from teaching theory, educational trends, and emerging research to maximize the anatomy learning experience with body donors. Social constructivism, the spiral curriculum, and the hidden curriculum can be leveraged to facilitate a unique educational experience. Furthermore, contemporary perspectives on the ethics and history of anatomy that support contextual learning indicate how these subjects are well suited to authenticate and consolidate learning, while supporting the relational and humanistic delivery of health care education. When anatomy education is conceptualized as a first clinical experience in a health care curriculum, it provides the opportunity to develop and enhance professional identity formation at a foundational stage. By embracing and incorporating a wider range of considerations into educational practice, a new ethos for anatomy education fosters history-informed professional identity formation that offers transformative learning opportunities for an ethical practice in the art of healing.

Suitability of ChatGPT as a Source of Patient Information for Screening Mammography.

ChatGPT3.5 and ChatGPT4 were released publicly in late November 2022 and March 2023, respectively, and have emerged as convenient sources of patient health education and information, including for screening mammography. ChatGPT4 offers enhanced capabilities; however, it is only available by paid subscription. The purported benefits of ChatGPT for health education need to be objectively evaluated. To assess performance differences, ChatGPT3.5 and GPT4 were used between 13 April and 29 May 2023 to generate breast screening patient information sheets, which were evaluated using the Patient Education Materials Assessment Tool for printed materials (PEMAT-P) and the CDC Clear Communication Index (CDC Index) Score Sheet; and benchmarked against gold standard content in BreastScreen NSW's patient information sheet. Mean scores were reported for comparison. GPT3.5 provided the appropriate tone and currency of information but lacked accuracy, omitting key insights: PEMAT-P understandability 68.0% (SD = 6.56) and actionability 36.7% (SD=20.4); CDC Index 58.8% (SD = 15.3). GPT4 was deemed superior to GPT3.5 but included several key omissions: PEMAT-P understandability 75.0% (SD = 17) and actionability 53.3% (SD = 11.54); CDC Index 66.0% (SD = 4.1). Both ChatGPT versions exhibited poor understandability and actionability and were unclear in their messaging. Those with poor health literacy will not benefit from accessing current versions of ChatGPT and may be further disadvantaged if they do not have access to a paid subscription. ChatGPT is evidenced to be an unreliable and inaccurate source of information concerning breast screening that may undermine participation and risk increased morbidity and mortality from breast cancer. ChatGPT may increase the demand on health care educators to rectify misinformation.

The Role of the Specialized Educational Care Teacher in Professional and Technological Education at the Federal Institute of Minas Gerais

Objective: The objective of this study is to investigate how ESA professionals can facilitate the academic and social integration of students with Specific Educational Needs (SEN). Theoretical Framework: In relation to the theoretical framework, Decree No. 6,571 will be used, which presents the importance of inclusive education in conjunction with the LBD (Law of Guidelines and Bases), which provides for the necessary adaptations for students with SEN. In addition, it was based on Mendes (2011), who corroborates the discourse that the inclusion of ESA is a significant advance in the educational context. Another important point is CNR/CEB Resolution 4/2009, which standardizes and aligns the work of the EEA professional. In addition to this, another theoretical reference used was the Law of Persons with Disabilities, so that we could analyze the task that should be carried out by the ESL in accordance with the constitutional rights of students with SEN. Finally, Mantoan (2003) stresses that inclusion must not only take place in the classroom but must permeate the student's entire school context. Method: documentary research, which aims to examine the recruitment notices and job descriptions for ESA at IFMG, in order to identify the qualifications required, responsibilities assigned and competencies expected of these professionals. This analysis will allow the construction of a basis for assessing the alignment of IFMG's practices with national and international inclusive education policies. It is important to mention that the documentary research of the public notices followed the following order: 1. pre-analysis; 2. organization of the material and 3. treatment of the data. Results and Discussion: The results obtained revealed that, despite structural and operational challenges, IFMG's inclusion initiatives are largely effective. In this context, the policies and practices observed reflect the commitment to inclusive education, demonstrating well-structured approaches that support the integration of students with SEN, which are based on the analysis of institutional documents that show how IFMG has structured its EEA practices to better serve its students. Research Implications: It is recommended that other institutions consider IFMG's practices when developing or improving their own inclusion strategies, ensuring that ESA professionals are well equipped to respond to students' needs and to promote an inclusive educational environment. The practical recommendations derived from this study are aimed at improving inclusion strategies, strengthening the support offered to students with SEN, and enriching the educational experience of all students. Originality/Value: This study contributes to the literature by presenting the need to optimize the role of ESE professionals in EFA contexts, which are challenging due to special practical and technical requirements. In addition, this study indicates that inclusive educational practices that respond to the needs of students, considering that, at IFMG, the preparation and performance of ESL professionals are fundamental to ensuring that inclusion is more than a policy, but an effective practice that enriches the educational experience of students.

Incorporating the Pillars of Lifestyle Medicine into Physician Assistant/Associate Education: A Benefit for Patients, Physician Assistants/Associate Education, and Physician Assistants/Associates.

The value of using lifestyle medicine (LM) to prevent disease is well established, yet medical education about LM is inconsistent, for both physicians and physician assistants/associates (PAs). As medical providers, PAs are uniquely positioned, with careers in a variety of disciplines from primary care to intensive care, as well as an ability to move across disciplines throughout their career lifespan. Therefore, the addition of LM principles in PA education can affect patients across the lifespan and in a wide variety of clinical settings. In addition, with burnout prevalent among PA students, the addition of LM to PA education may be able to give these future clinicians the tools they need to manage stress and improve overall wellness. The purpose of this study was to share with PA educators the valuable lessons learned when introducing LM into PA curriculum in hopes of broader adoption. The American College of Lifestyle Medicine (ACLM) provides modules for teaching LM to medical providers which was adopted into the Northeastern University PA Program's didactic curriculum in the summer of 2023. An online survey was administered to first-year PA students in July 2023 to evaluate the PA students' perspectives on the value of adding a LM curriculum as part of their education to care for patients and the content provided through ACLM and to determine their perceived value in using the information for themselves as part of preventing future provider burnout. Most respondents (91%) indicated that they were either "likely" or "very likely" to use the information learned in the LM modules as part of their future patient care, and 86.4% indicated that they would use the information as part of their own self-care. Most PA student respondents (88.6%) thought that the components of LM complemented the existing PA curriculum in primary care and (86.4%) indicated that they will use the information as part of their own self-care. However, given the intense volume of information provided to PA students for their general primary care education, it was suggested to pare down the volume of materials to streamline the curriculum. Overall, these PA students believe that LM should comprise a portion of their PA medical education curricula for their patients and for themselves.

Evaluation of the effects of a team-based systematic prevention and management program for postoperative orthopedic older patients: A retrospective cohort study.

This study aimed to evaluate a team-based systematic prevention and management program for delirium (a multicomponent intervention addressing potentially modifiable risk factors based on the DELirium Team Approach [DELTA]) in older patients undergoing orthopedic surgery within a real-world clinical setting. The DELTA program was initiated at our hospital in January 2019. A retrospective before-after study was conducted during a preintervention period (January 1, 2017 to December 31, 2018) and a postintervention period (January 1, 2020 to December 31, 2021) at orthopedic wards of an advanced acute care hospital in Japan. A total of 787 inpatients were evaluated before the preintervention period, and 833 inpatients were evaluated after the postintervention period. After the DELTA program's implementation, a significant decrease in benzodiazepine receptor agonist prescriptions (odds ratio [OR], 0.39; 95% confidence interval [CI], 0.29-0.53) and an increase in prescriptions of either melatonin receptor agonists or dual orexin receptor antagonists (OR, 3.83; 95% CI, 2.49-5.88) were observed. However, no significant difference was observed in the incidence of falls, self-extubation, or required level of medical and nursing care, including risky behavior and inability to follow medical or care instructions following the intervention, despite a reduction in the length of hospital stay and institutionalization. Implementing the DELTA program for older patients undergoing orthopedic surgery contributed to optimizing the prescription of hypnotics; however, the impact on other patient outcomes, such as falls, self-extubation, and required level of medical and nursing care was limited.

“The patient as teacher” - thematic analysis of undergraduate medical students’ experiences with an experiential learning project in palliative care

BackgroundExperiential learning holds high potential for medical students’ education in palliative care. At RWTH Aachen University in Germany, medical students can participate in the course “The Patient as Teacher” offering a one-to-one exchange with a terminally ill patient over a period of several weeks complemented with four supervision sessions and writing of a reflective essay. The course had run from 2005 to 2020 before it was paused due to the Covid-19 pandemic. This study aimed to assess the course’s value as a palliative care teaching tool by investigating students’ motivation and experiences over the years 2005–2020.MethodsA stratified sample of 24 essays was taken from all submitted essays (n = 78), eight essays from the years 2005–2009, 2010–2014, and 2015–2020. Subsequently, a thematic analysis of the selected essays was conducted.ResultsThe students felt motivated by the opportunity to gain more experience in palliative care, to improve their communication skills and to decrease insecurities in interaction with terminally ill patients. They learned about the patient’s biography and medical history, and encountered physical, psychological, social, and spiritual dimensions of living with a life-limiting disease. Moreover, they experienced relationship building and communication with a terminally ill patient outside their role as future doctors. Ultimately, they considered their participation as a beneficial experience on both a personal and professional level.ConclusionsThe course “The Patient as Teacher” presents a valuable tool for experiential learning in palliative care, which has elicited an unceasingly positive response among the students who participated over the years. It has facilitated medical students in overcoming insecurities in dealing with terminally ill patients and supported them in further developing their professional identity.

Emerging Artificial Intelligence-Based Pedagogies in Didactic Nursing Education: A Scoping Review.

Artificial intelligence pedagogies are increasingly commonplace in health care education, and limited information guides their application in didactic nursing environments. To examine the current state of artificial intelligence-based pedagogies used in didactic nursing education. The review was conducted using Arksey and O'Malley's scoping review framework and the Joanna Briggs Institute's System for the Unified Management, Assessment, and Review of Information platform. Literature is reported using the Preferred Reporting Items for Systematic Reviews Extension for Scoping Reviews. The review included articles published between January 1, 2013, and July 23, 2024, in MEDLINE (via PubMed), Cumulative Index to Nursing and Allied Health Literature, Education Resources Information Center, World Science, and Google Scholar. Two reviewers independently assessed all articles. Themes for the 16 included articles were generative artificial intelligence and pairing artificial intelligence with other pedagogical strategies. More research is needed to examine artificial intelligence-based pedagogies in didactic nursing education.

A CROSS-SECTIONAL STUDY ON KNOWLEDGE AND PRACTICE REGARDING MENSTRUAL HYGIENE AMONG FEMALE NURSING STUDENTS IN A TERTIARY CARE HOSPITAL

Objectives: Menstruation, though a normal physiological process in the females of reproductive age group, is surrounded by various misconceptions and social taboos. Inadequate knowledge and unhygienic menstrual practices can adversely affect female health. Poor menstrual hygiene practice has been negatively associated with infection of the reproductive and genitor-urinary tract, cervical cancer, absenteeism from school, or drop-out, poor academic performance, lower self-esteem, and poor quality of life. We conducted this study to evaluate the knowledge and practices regarding menstruation in female nursing students in a tertiary care hospital. Methods: An observational, cross-sectional, questionnaire-based study was conducted over for three months on female B.Sc nursing students in the first year to the fourth year through face-to-face interview at the department of Pharmacology in a tertiary care hospital. Data regarding socio-demographic profile, knowledge of obstetric and gynaecological factors, perception of menstruation, and hygienic practice of the participants during their menstruation were collected. Results: Responses from 165 participants were analyzed. The mean (± SD) age of the students was 19.64 (± 1.09) years. Most of their parents had education up to a diploma and above (47.27% among mothers and 70.9% among fathers). The majority of the participants used to experience dysmenorrhea (52.72%) and had pre-menarcheal ideas about menstruation (78.18%). Mother was the most common source of information (54.54%) followed by teachers (16.96%) and media (13.33%). The majority knew the source (89.09%) and cause (100%) of menstrual bleeding. A considerable portion (45.45%) thought menstruation as the sign of conception. The majority (96.36%) used commercially made sanitary pads, and used to dispose of the used sanitary pads in the dustbin (98.19%) by wrapping them with paper (98.19%). Conclusion: Present study found an encouraging picture regarding knowledge and hygienic practices during menstruation among the participants. Education about menstrual hygiene needs to be imparted at the grass root level. In this regard Anganwadi and health care workers, teachers and media can play a major role. All mothers need to be taught about the importance of hygienic practices during menstruation, convey correct information to their daughters, and should be encouraged to break the age-old myths and taboos associated with menstruation.

Adolescent and Young Adult Development in Transplant Recipients.

Solid organ transplantation (SOT) is the gold standard of therapy for individuals with end-organ dysfunction. Improved survival outcomes after SOT can help adolescent and young adult (AYA) recipients lead long and healthy life. However, successful SOT during adolescence and young adulthood is often complicated by the innate developmental challenges of this age group. The psychosocial tasks of adolescence include identity development, autonomous decision-making, establishing social networks, educational and vocational preparation, and navigating romantic relationships. These goals may be amplified or delayed for pediatric SOT recipients. Adolescence is also marked by rapid physical changes in linear growth and the development of secondary sexual characteristics. Yet AYA may experience physical and pubertal delays related to transplantation, as well as exaggerated body image dissatisfaction due to medication side effects. Strict adherence to medication and post-transplant regimens may interfere with adolescents' desire for normalcy and fitting in with peers. Healthcare providers should be aware that AYA value education and self-empowerment in transplant care. Transplant success needs to be defined by both medical and psychosocial outcomes, particularly when it relates to the vulnerable AYA population. Fortunately, investment from the patient, family, and care team can aid in transplant recovery and success. This article will identify the developmental challenges faced by AYA undergoing solid organ transplantation as well as strategies to engage positive outcomes.

Investigating Alterations in Blood Parameters Pre-lipolysis and Post-lipolysis Surgical Intervention

Background: Laser lipolysis is one of the most prevalent liposuction techniques and is widely preferred in cosmetic surgical procedures globally. Compared to traditional liposuction, some investigations have demonstrated a reduction in complications when using the laser lipolysis technique. However, the amount of research in this area remains limited. Objectives: This study aims to investigate changes in pre- and post-operative blood parameters, including hemoglobin level, hematocrit, WBC count, and platelet level. Additionally, the research explores potential complications following laser lipolysis. Methods: This retrospective study, conducted at the Isfahan Clinical Center (Najaf Abad Branch), included 100 patients (without previous hematological disorders) who underwent laser lipolysis. Demographic information about the patients was collected. Blood parameters (hemoglobin, hematocrit, WBC, and platelets) were measured before and 24 hours after the operation. Laser liposuction was performed using a 1064-nm Nd laser. Postoperative care instructions were provided. Statistical analysis included t-tests and mixed linear regression using SPSS 20 software for data analysis, with a significance level of P < 0.005. Results: Significant alterations were observed in hemoglobin, WBC, and platelet levels. Hemoglobin and platelet levels showed a notable reduction of 16.9% and 7.9%, respectively. Conversely, the WBC count increased by 100.5%. Conclusions: Our study found a significant decrease in hemoglobin levels following laser lipolysis surgery, likely due to intraoperative bleeding. Further research is recommended to compare hemoglobin level changes using different laser types.

Study on the Management of Diabetic Foot Ulcer in Diabetic Patients at a Tertiary Care Hospital

AIM: To study the treatment pattern of diabetic foot ulcer and to assess the effect of patient counselling on diabetic foot ulcer patients. OBJECTIVE: 1. To study the various modalities of treatment used for Diabetic Foot Ulcer patients in a tertiary care hospital. 2. To assess the effect of patient counselling on diabetic foot ulcer patients with standard questionaries METHODS: The protocol was reviewed, revised, and approved by the Institutional Review Committee of MVJ Medical College and Research Hospital before commencement of the study. Over the course of six months, a tertiary care hospital conducted prospective research. Following the giving of written informed permission, diabetic patients with foot ulcers of both genders who were visiting the hospital were invited to participate and enrolled. A total of 150 patients participated in the study. The patients were recruited according to the inclusion and exclusion criteria mentioned. The study was attempted to improve the patient’s knowledge and attitude towards the self-management of diabetic foot ulcer. And thus, patient counselling is an essential component of clinical pharmacy practice in hospital. RESULTS: In this study, majority of the study participants belonged to the age group 61-70 years (30.7%) of age. 22% of the study participants were of the age group between 51-60 years of age. Majority (64.7%) of the study participants were males. In this study, Nottingham Assessment of Functional Footcare (Revised 2015) was used and an improvement in the total score was found i.e., from 18.27+5.85 before counselling jym oof ff\c b to 44.07+4.70 post counselling which was found to be statistically significant (P<0.001). Thus, a proper foot care education program has been shown to reduce the risk of ulceration. CONCLUSION: The present study was conducted to study the effect of patient counselling on diabetic foot ulcer patients using NAFFC score. Majority in the study belonged to 61-70 years and were males. Most of them had type 2 DM and grade 1 foot ulcer. In this study, Nottingham Assessment of Functional Footcare (Revised 2015) was used and an improvement in the total score was found i.e., from 18.27+5.85 before counselling to 44.07+4.70 post counselling which was found to be statistically significant (P<0.001). NAFFC score played an important role in the study to assess the functional outcome among diabetics with foot ulcers. Though there is development of new therapies for the management of diabetic foot ulcers, a high rate of failure ending with amputation still exists. Hence a counselling session to the diabetics with foot ulcers can prevent further complications.

Championing nurse education in neurological care

Championing nurse education in neurological care

Australian women’s experiences and perceptions of interconception care: a qualitative descriptive study

BackgroundInterconception, the time between pregnancies, is an opportunity to improve the health outcomes of women, infants and subsequent pregnancies. Interconception care involves the assessment of previous pregnancy outcomes, management of...

Systematic integration of a rubric in first-year engineering calculus courses

ABSTRACT For many first-year engineering students, their first calculus or pre-calculus courses can be a substantial barrier for initial success and persistence to subsequent engineering courses. One approach that may mitigate this challenge for some students is to support their development as stronger metacognitive learners – learning how to self-evaluate and improve based on informed feedback. A structured mathematical problem-solving rubric designed to offer feedback on how to develop and communicate mathematical solutions to engineering problems can be a helpful tool to support metacognitive development. After a semester of careful and systematic instruction, practice, and use of such a rubric in engineering calculus courses, we found significant improvement in pre-calculus students' metacognitive awareness. A median split analysis showed that for both calculus and pre-calculus courses, the lower metacognitive half of each class improved significantly in their metacognitive abilities, as was the intent for the rubric. Students reported an overwhelmingly positive perception of the value of the rubric for their own learning, and the subset of calculus I students who improved in their sophistication of rubric use had significantly higher (12.5%) final exam scores compared to those who did not improve.

Hospice educators' perspectives on e-learning in palliative care education in Ireland.

Knowledge of and understanding the palliative care approach should be a core competency in all healthcare settings. E-learning offers the potential to deliver palliative care education and meet this challenge. To examine hospice educator's perspectives of e-learning in palliative care education. Semi-structured interviews were conducted with a purposeful sample of hospice educators on the island of Ireland (Republic of Ireland and Northern Ireland). These were transcribed and the data was analysed thematically. Many factors were considered when using e-learning: objectives of the programme, learner's characteristics, topic suitability (as palliative care is very emotive) and organisational factors. Barriers to using e-learnning were the preparation time required and developing expertise in e-learning. Support mechanisms for hospice educators to share knowledge would be beneficial. Educators were keen to adopt a blended approach in their teaching. While acknowledging the challenges and limitations of e-learning, educators felt that e-learning has a positive role in palliative care education.

Evaluation and Improvement of the Quality of Surgical Operative Notes in the Department of General Surgery at Dongola Teaching Hospital, Sudan.

Background Surgical operative notes are essential for patient care and legal documentation. However, inconsistencies in the quality of these notes at Dongola Teaching Hospital, Sudan, highlighted the need for improvement. In line with guidelines from the Royal College of Surgeons of England (RCSEng), this study aimed to enhance the documentation practices in the hospital by implementing a standardized format. Methods A retrospective audit was conducted over three months at the General Surgery Department of Dongola Training Hospital. In the first audit cycle, 81 surgical notes were assessed, revealing significant deficiencies in adherence to RCSEng standards. An intervention was introduced, including a standardized template, training for surgeons, and widespread dissemination of the new format. A second audit cycle followed to assess improvements. Results In the first audit cycle, adherence to documentation standards was 50.3%, with missing or incomplete information in key areas. After the intervention, adherence improved to 71.9%. Notable improvements included documentation of extra procedures (18% to 100%), prosthesis details (0% to 100%), and antibiotic prophylaxis (71% to 97%). However, a slight decline was observed in postoperative care instructions, dropping from 100% to 90%. Conclusion The introduction of a standardized template and training significantly improved the quality of surgical documentation. Continuous efforts are necessary to maintain these improvements, particularly in areas where adherence remains suboptimal, such as postoperative care instructions.

Somatosensory and dynamic balance improvement in older adults with diabetic peripheral neuropathy through sensorimotor exercise: A multisite randomized controlled trial

PurposeTo examine the effect of the Feldenkrais method on lower legs and foot somatosensory postural control-related function, dynamic balance, fear of falling and quality of life in adults with diabetic polyneuropathy in the short and mid-term. MethodsA single-blinded, parallel, multicentric randomized control trial was conducted in two health hospitals. Subjects with diabetic polyneuropathy and older than 55 years with a history of falls or dynamic balance dysfunction were recruited from the hospital databases and randomly allocated to the experimental or control group. The experimental group received 16 sessions of sensorimotor training based on the Feldenkrais method. Both groups received diabetic foot care instructions. The results were measured at the 3 and 6-month follow-up periods. ResultsThe mean age was 70 ± 8. A total of 44 participants were enrolled in the study, and 27 completed the process. No adverse events were reported. After the intervention, significant somatosensory results were obtained (p < 0.001). The results of the Up and Go and POMA tests were significant after the intervention (p < 0.001) and during the 3-month follow-up period for POMA (p = 0.018). The fear of falling showed significant results at the 3-month follow-up period (p = 0.03), and the quality of life in all measurements. ConclusionsSignificant short-term effects were obtained on somatosensory postural control-related function, dynamic balance, and fear of falling. Significant short and mid-term effects were achieved on quality of life. Older adults with diabetic polyneuropathy, dynamic balance impairment, or a history of falls can improve their abilities through the Feldenkrais method. Trial registrationClinicaltrials.gov: NCT05262946.