Effective Patient Care Research Articles

Cancer Nursing Frameworks to Guide Clinical Capability, Education and Careers: A Scoping Review of the International Literature.

This review aimed to provide a current global profile of all existing cancer nursing competency, capability, education and career frameworks and map capabilities and competencies to the clinical, facilitation of education, management and research pillars of practice. Scoping review. Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Epistemonikos, Google Scholar, Medline, and PubMed. Gray literature searches and reference list searches were also performed. This review was guided by Arksey and O'Malley's method and followed PRISMA guidelines for reporting. Screening and data extraction was conducted independently by two or more authors. The quality of frameworks were assessed using The Joanna Briggs Institute (JBI) critical appraisal checklist for textual evidence: policy/consensus guidelines. Data were analyzed and narratively synthesized by experienced cancer nurse researchers. Thirty-four articles were included, comprising of 29 cancer nursing frameworks. Frameworks were categorized as competency frameworks, career and education frameworks, education/learning pathways, and career/professional development frameworks. Competencies and capabilities described in the frameworks were mapped to the four pillars of practice including clinical (n = 27), facilitation of learning (n = 20), leadership and management (n = 23), and research and scholarship (n = 24). Comprehensive cancer nursing frameworks are pivotal in enabling nurse leaders to grow and develop the cancer nursing workforce globally. They are also integral to support cancer nurses in providing high-quality, effective, and safe care for patients and their families across the cancer continuum. This is the first review to comprehensively capture and synthesize the capabilities, educational components, and career pathways outlined in existing cancer nursing frameworks worldwide and highlights where areas of improvement are needed to support professional growth, job satisfaction and retention of cancer nurses. This article is a review of frameworks and does not include patient or public contribution.

A Critical Analysis of the Integration of Evidence-Based Practice among Nurses and Nursing Assistants and Its Impact on Patient-Centered Care in Multidisciplinary Healthcare Teams

This article focuses on the implementation of EBP concerning nurses and nursing assistants and studies the effects of that implementation on the properly targeted and patient-specialized healthcare process with the help of MDTs. EBP is critical in today’s healthcare needs since it allows for the basis for decision-making and frames the latest practices influencing patients' health. Nevertheless, there are challenges that nursing assistants face when implementing EBP in clinics because they have no formal training in EBPs. From the literature review and synthesis of this paper, we demonstrate the elements of EBP that improve team communication, patient satisfaction, and decreased medical errors, but what has been left unanswered is the experiences of the nursing assistants in EBP. Future strategies include evidence-based practice specialist schooling and hiring to catalyze increased EBP across multiple discipline teams and promote highly effective patient care.

Identifying factors associated with disparities in accessing an Integrative Oncology program

Introduction: Integrative oncology (IO) programs provide patients with evidence-based complementary medicine therapies within a supportive and palliative cancer care setting. This study retrospectively examined characteristics of patients with lung cancer predicting utilization of a freely-provided IO consultation at two medical centers in Israel. Methods: Electronic medical files of 832 patients with lung cancer attending/not attending the IO consultation were searched for socio-demographic (age, gender, country of birth, place of residence, primary language spoken) and personal health (Body Mass Index; smoking; disability) characteristics; cancer-related parameters (primary tumor site, localized vs. metastatic); and reported pain- and emotional-related concerns. Results: Only 120 (14.4%) of eligible patients attended the IO consultation, with multivariate analysis finding a significantly lower likelihood of attendance among patients who were older (OR: 0.98, 95%CI=0.96-0.99; p=0.02); male (OR: 0.53, 95%CI=0.34-0.83; p=0.005); primarily non Hebrew-speaking (i.e., primarily Arabic or Russian speakers; OR: 0.34, 95%CI=0.14-0.82; p=0.016); without disability (OR: 0.52, 95%CI=0.33-0.92; p=0.025); and not reporting pain (OR=0.40,95%CI=0.17-0.98-; p=0.046). Conclusions: The present study suggests that age, gender and culture-related factors (reflected by the patient's primary language) may contribute to disparities in accessing a freely-provided IO consultation, as shown in a diverse population of patients with lung cancer from two medical centers in Israel. Further research is needed to better understand the role of these programs within a diverse, equitable and inclusive setting of effective and safe integrative care of oncology patients.

Nurses’ Knowledge, Attitudes, and Implementation of Evidence- based Practice in Medina, Saudi Arabia

Background: The EBP is an essential competency that all healthcare professionals, including nursing staff, should master. The importance of EBP lies in that it facilitates the delivery of effective, efficient, and safe patient care. Thus, examining the use of EBP among nurses in Madinah's hospitals is essential. Aim: The aim of the study is to identify the knowledge, attitudes, and practices of nurses regarding evidence-based practice, and the relationship between the subscales. Methods: The study used a descriptive cross-sectional design with a self-administered survey. Results: In this study, the nurses had positive views regarding EBP. Specifically, the knowledge/skills subscale had the highest score followed by the practice subscale and then the attitude subscale. There was a significant difference between nurses' work experiences and knowledge/and skills. There was a significant positive relationship between EBP subscales. Conclusion: The hospitals in Medina need to improve their infrastructure in order to support evidence- based practice (EBP) and research.

Recommendation Letter Language for Applicants Selected to Interview at Integrated Cardiothoracic Surgery Residency: A Qualitative Assessment by Gender

ObjectiveCardiothoracic (CT) surgery remains a male-dominated specialty. Letters of recommendation (LORs) influence trainee selection and are vulnerable to biases. We aimed to qualitatively assess differences in LORs to integrated residency based on applicant gender. MethodsLORs for applicants who interviewed at a single integrated CT residency program during one cycle were selected and pooled by applicant gender. Gendered and identifying references were redacted. Letters were analyzed by a thematic analysis approach and managed through NVivo software. Results30 LORs across eight male applicants and 43 LORs across 11 female applicants were analyzed. There was no noticeable difference between the frequency of positive attributes assigned to each gender. Research accomplishments was the most emphasized competency, with no gender-based difference identified. LORs for female applicants tended to be longer and include stronger positive adjectives. For male applicants, descriptions of external recognition were almost exclusively via mention of scholarships or research, whereas female applicants were more likely to receive word-of-mouth recognition. Letter writers often attested to male applicants’ commitment to cardiothoracic surgery, whereas female applicants received more commentary around effective patient care. ConclusionLetters for men tended to focus on research accolades and career commitment, while letters for women were longer and more likely to emphasize patient care or faculty endorsement. Future studies may discern whether this phenomenon reflects stronger applicant-writer relationships for female applicants, or a disadvantageous approach by letter writers for female applicants that relies on subjective rationale.

Clinical Readiness for Practice of Nursing Students: A Concept Analysis

Introduction: The concept of clinical readiness for practice among nursing students is yet to be analyzed, and there is a lack of empirical evidence on its usage among academics and clinicians. Methods: This concept analysis is anchored on a systematic literature review that adhered to the PRISMA guidelines and incorporated the eight iterative steps of Walker and Avant’s concept analysis method. This concept analysis method involved: (1) choosing a concept; (2) determining the objectives of the analysis; (3) identifying usages of the concept; (4) determining the defining attributes; (5) identifying a model case; (6) identifying other cases, including borderline, contrary, and related cases; (7) identifying antecedents and consequences; and (8) defining empirical references. The integrative thematic data synthesis method was adopted. Results: The concept of nursing students’ clinical readiness for practice is said to have four interrelated attributes. These attributes included (1) professional skills, (2) communication skills, (3) self-management skills, and (4) self-confidence. The two antecedents for nursing students’ clinical readiness to practice are (1) personal factors, including demographic characteristics, prior healthcare experience, income, and emotional intelligence; and (2) educational factors, including the clinical learning environment, clinical internship program, learning resource, and learning strategy. The consequence of clinical readiness for the practice of nursing students includes obtaining practice skills that can lead to more personal and job-related satisfactory outcomes. Conclusions: clinical readiness for practice in nursing encompasses the acquisition and integration of professional knowledge, skills, effective communication abilities, and self-management capabilities and the application of these competencies with confidence toward the provision of high-quality care to patients. Clinical Relevance: Understanding the components of clinical readiness is crucial for nursing educators, preceptors, and healthcare institutions to ensure that nursing students are adequately prepared for the challenges they will face in clinical practice. By recognizing the importance of professional knowledge, skills, communication, and self-management in clinical readiness, educators and training institutions can tailor their curricula, programs, and support systems to better prepare nursing students for the demands of real-world healthcare settings. This focus on clinical readiness ultimately delivers safe, effective, and compassionate patient care.

Classification of Pneumonia, Tuberculosis and Covid-19 from Chest X-Ray Images Using Convolution Neural Network Model

Accurate and timely diagnosis of respiratory ailments like pneumonia, tuberculosis (TB), and COVID-19 is pivotal for effective patient care and public health interventions. Deep learning algorithms have emerged as potent tools in medical image classification, offering promise for automated diagnosis and screening. This study presents a deep learning-based approach for categorizing chest X-ray images into three classes: pneumonia, tuberculosis, and COVID-19. Utilizing convolutional neural networks (CNNs) as the primary architecture, owing to their ability to automatically extract relevant features from raw image data. The proposed model is trained on a sizable dataset of chest X-ray images annotated with ground truth labels for pneumonia, TB, and COVID-19. Extensive experiments are conducted to evaluate the model's performance in terms of classification accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUC-ROC). Furthermore, we compare the performance of our deep learning model with traditional machine learning approaches and assess its generalization ability on an independent test set. Our findings demonstrate that the proposed deep learning model achieves high accuracy in classifying chest X-ray images of pneumonia, TB, and COVID-19, outperforming traditional methods and showing potential for clinical deployment as a screening tool, especially in resource-limited settings.

Organisational support and strategies to address nurse burnout and enhance resilience.

The vital role of nurses in the delivery of safe and effective patient care is widely recognised. However, due to the significant stress associated with the role and its responsibilities, including ongoing challenges in healthcare organisations, there are high burnout rates among nurses. Burnout is defined as unmanaged workplace stress that causes physical, mental and emotional fatigue, and it has been recognised as an occupational phenomenon. It is essential to identify the early warning signs of nurse burnout so that it can be addressed in a timely manner. Resilience has an important role in supporting nurses to cope with and adapt to adverse experiences, thereby supporting them to improve their health and well-being and subsequently to provide high-quality patient care. This article outlines the support and strategies that nurse managers and organisational leaders can put in place to manage burnout and develop resilience among nurses.

Handoff Mnemonics Used in Perioperative Handoff Intervention Studies: A Systematic Review.

Perioperative handoffs are known to present unique challenges to safe and effective patient care. Numerous national accrediting bodies have called for standardized, structured handoff processes. Handoff mnemonics provide a memory aid and standardized structure, as well as promote a shared mental model. We set out to identify perioperative handoff intervention studies that included a handoff mnemonic; critically assess process and patient outcome improvements that support specific mnemonics; and propose future recommendations. We conducted a systematic review of the English language perioperative handoff intervention literature designed to identify handoff mnemonic interventions. A comprehensive protocol was developed and registered (CRD42022363615). Searches were conducted using PubMed, Scopus, ERIC (EBSCO), Education Full Text (EBSCO), EMBASE (Elsevier), and Cochrane (January 1, 2010 to May 31, 2022). Pairs of trained reviewers were involved in all phases of the search and extraction process. Thirty-seven articles with 23 unique mnemonics met the inclusion criteria. Most articles were published after 2015 (29/37; 78%). Situation, Background, Assessment, Recommendation (SBAR), and SBAR variants were used in over half of all studies (22/37; 59%), with 45% (10/22) reporting at least 1 statistically significant process improvement. Seventy percent of handoff mnemonics (26/37) were expanded into lists or checklists. Fifty-seven percent of studies (21/37) reported using an interdisciplinary/interprofessional team to develop the intervention. In 49% of all studies (18/37) at least 1 measurement tool was either previously published or the authors conducting some form of measurement tool validation. Forty-one percent of process measurement tools (11/27) had some form of validation. Although most studies used training/education as an implementation strategy (36/37; 97%), descriptions tended to be brief with few details and no study used interprofessional education. Twenty-seven percent of the identified studies (10/37) measured perception alone and 11% (4/37) measured patient outcomes. While the evidence supporting one handoff mnemonic over others is weak, SBAR/SBAR variants have been studied more often in the perioperative environment demonstrating some process improvements. A key finding is that 70% of included studies converted their handoff mnemonic to a list or checklist. Finally, given the essential nature of effective handoffs to perioperative patient safety, it is crucial that handoff interventions are well developed, implemented, and evaluated. We propose 8 recommendations for future perioperative handoff mnemonic clinical interventions and research.

Aggressive end-of-life care in patients with gastrointestinal cancers - a nationwide study from Denmark.

Knowledge of determinants of aggressive end-of-life care is crucial to organizing effective palliative care for patients with gastrointestinal (GI) cancer. This study aims to investigate the determinants of aggressive end-of-life care in patients with GI cancer. A national register-based cohort study using data from the Danish Register on Causes of Death, the Danish National Patient Register, and the Danish Palliative Database was the method of study employed. All Danish patients who died from GI cancers from 2010 to 2020 comprised the study setting. There were 43,969 patients with GI cancers in the cohort, of whom 62% were hospitalized in the last 30 days of life, 41% of patients died in the hospital, 10% had surgery, 39% were subjected to a radiological examination during the last 30 days of life and 3% had antineoplastic treatment during the last 14 days of life. Among all types of GI cancers, pancreatic cancer was significantly associated with all outcomes of aggressive end-of-life care except surgery. Patients in specialized palliative care (SPC) had lower odds of receiving aggressive end-of-life care and dying in the hospital. We found that patients with comorbidity and those who were divorced had higher odds of being hospitalized at the end of life and dying in the hospital. Aggressive end-of-life care is associated with disease factors and socio-demographics. The potential to reduce aggressive end-of-life care is considerable in patients with GI cancer, as demonstrated by the impact of SPC. However, we need to address the needs of patients with GI cancer who do not receive SPC.

New Graduate Nurses Experience During the Internship Year: Transitioning from a Student to a Professional Nurse

The global shortage of nursing professionals and increasing healthcare demands, mandates the importance of providing newly qualified nurses with the necessary clinical skills, confidence, and adequate support during their transition from student to professional nurse. Transition of newly graduate nurse to professional practice is challenging and considered as a period of stress, role adjustment and shock reality. The aim of this study is to explore the internship year as a transition period for graduate nurse to professional nurse. Methodology: A longitudinal prospective Cross-Sectional quantitative study included 88 newly graduate nurses throughout the internship year were included using a survey. Result: New graduate nurses indicated that they do not feel comfortable performing independently some of the complex skills or procedure. The sequence of the means of the five sub-scale of the Comfort and Confidence scale were the same in Phase I and II. Support was the highest score followed by professional satisfaction, organizing and prioritizing, then communication and leadership, and last was stress. Results also revealed a highly significant difference between the two phases of internship year. Source of stress was mainly due to transportation, family issues, and job performance. There were significant differences identified in those three factors. It was found that there was different between phase I and II regarding factors that lead to job satisfaction (P < 0.01). Conclusions: This study highlights the need for healthcare and educational organizations to offer necessary support and resources to new graduate nurses during their transition into professional practice.. By addressing areas where new graduate nurses feel less confident and providing opportunities for ongoing learning and feedback, organizations can help new nurses build the knowledge, skills, and confidence they need to provide safe, high quality, and effective patient care.

Implementing MATRIX acuity tool to improve nursing satisfaction on a stroke and epilepsy monitoring unit

PurposeNursing satisfaction is a critical component of effective patient care. In the Acute Stroke Unit (ASU) and Epilepsy Monitoring Unit (EMU), patients have specialized needs that require critical nursing skills. The purpose of this study was to examine nurse satisfaction after implementation of the MATRIX acuity tool. MethodsThis prospective observational study used pre- and post- implementation data to determine if the revised staffing model improved nursing satisfaction on the ASU and EMU. Results30 nurses were enrolled in this study, with a mean of 12.9 (11.2) years of nursing experience. Following the implementation of the MATRIX, nurse opinions on staffing and workload were more favorable. A statistically significant finding was obtained in reducing a heavy workload (P < .01) post-implementation. ConclusionsThe MATRIX acuity tool is associated with improved nursing satisfaction. Improving nurse satisfaction may have a positive downstream impact on patient safety by improving the ability of nurses to provide care.

Enhancing Resurrection Practices for Unusable General Inventory Items in Hospital Settings

Background: Effective patient care in hospitals relies on the proper functioning of medical equipment. Malfunctioning general inventory items, such as patient beds, wheelchairs, and saline stands, pose significant challenges to hospital operations and patient care. D.G.H. Negombo needs help maintaining these items due to limited financial resources and inadequate technical expertise.Objective: To improve the resurrection practices of selected unusable general inventory items at D.G.H. Negombo.Methodology: This cross-sectional descriptive study was conducted from August 1, 2022, to November 15, 2023, and involved three phases: pre-intervention (assessment), intervention (implementation), and post-intervention (evaluation). Data collection methods included key informant interviews (K.I.I.), self-administered questionnaires (S.A.Q.), and desk reviews. The study targeted general inventory items marked for condemnation and included unit heads and maintenance technicians in its scope.Results: Pre-intervention assessments identified key issues such as inadequate technical skills, poor coordination, and insufficient infrastructure. Interventions implemented included skill development workshops, improved documentation practices, and enhanced communication strategies. Post-intervention evaluations demonstrated significant improvements in repair times, resource availability, and satisfaction among unit heads. Notably, 78% of wheelchairs, 79% of patient trolleys, and 76% of patient beds were successfully resurrected.Conclusions: The interventions enhanced the resurrection of unusable general inventory items, extended equipment lifespans, and achieved substantial cost savings.

Machine Learning for Mental Health: Applications, Challenges, and the Clinician's Role.

This review aims to evaluate the current psychiatric applications and limitations of machine learning (ML), defined as techniques used to train algorithms to improve performance at a task based on data. The review emphasizes the clinician's role in ensuring equitable and effective patient care and seeks to inform mental health providers about the importance of clinician involvement in these technologies. ML in psychiatry has advanced through electronic health record integration, disease phenotyping, and remote monitoring through mobile applications. However, these applications face challenges related to health equity, privacy, translation to practice, and validation. Clinicians play crucial roles in ensuring data quality, mitigating biases, promoting algorithm transparency, guiding clinical implementation, and advocating for ethical and patient-centered use of ML tools. Clinicians are essential in addressing the challenges of ML, ensuring its ethical application, and promoting equitable care, thus improving the effectiveness of ML in practice.

Perioperative Management of Opioid-Tolerant Patients: A Comprehensive Guide

The perioperative management of opioid-tolerant patients presents significant challenges, necessitating a tailored approach to pain management and the prevention of opioid-related complications. This review discusses the essential aspects of preoperative assessment, intraoperative strategies, and postoperative care for opioid-tolerant patients. Emphasis is placed on the continuation of baseline opioid therapy, the use of multimodal analgesia, and the importance of individualized opioid dosing to achieve effective pain control while minimizing the risk of withdrawal, respiratory depression, and opioid-induced hyperalgesia. The role of a multidisciplinary team in optimizing patient outcomes and the necessity of thorough discharge planning and follow-up are also highlighted. By addressing these critical factors, healthcare providers can ensure safe and effective perioperative care for opioid-tolerant patients.

Accuracy of Outsourced Radiology Reports in Emergency Surgical Care: Do They Provide a High-Quality, Cost-Effective Service?

Background Computed tomography (CT) scans play a crucial role in emergency surgical care, serving both diagnostic and prognostic functions. They significantly contribute to timely and effective patient care. This study aims to compare abdominal CT scan reports prepared by locally employed radiologists with those from outsourced radiology reporting services for patients presenting with acute surgical conditions. Additionally, the study evaluates how different reporting styles, such as free-text versus structured formats, influence the overall quality of the reports. Methods The study was conducted in the general surgery unit of North Manchester General Hospital, Manchester, a district general hospital in North West England. Patients admitted through the accident and emergency (A&E) under the general surgery team who underwent abdominal CT scans between August 2023 and October 2023 were included. Trauma patients and those who received non-abdominal CT scans were excluded. Local radiology reports were compared to outsourced reports using statistical analysis. The clarity and comprehensiveness of the reports were carefully evaluated, and the impact of free-text versus structured reporting formats was also considered. Results A total of 192 patients were included in the study, with a median age of 59 years. Compared to locally reported scans, outsourced radiology reports frequently omitted commentary on key anatomical structures, including the biliary system, spleen, kidneys, lymph nodes, mesentery and peritoneum, vasculature, bones and soft tissues, and lung bases. Reports using a structured format provided more thorough commentary on the spleen, adrenal glands, mesentery and peritoneum, and bones and soft tissues compared to free-text reports. Conclusion Outsourced radiology reports significantly underreported important abdominal anatomical structures. Free-text reporting was associated with significant omissions in abdominal anatomical structures, which could negatively affect clinical decision-making and management plans. Further studies are recommended to evaluate the comprehensiveness of outsourced radiology reporting and to ensure standardization in reporting, ultimately providing patients with high-quality emergency care.

PSYCHOLOGICAL DISORDERS IN BURN PATIENTS: A META-ANALYSIS OF DISORDERS AND TREATMENTS

The main subject of this paper is the psychological disorders experienced by burn patients, with a particular emphasis on the necessity of psychological intervention in their treatment. The research seeks to investigate prevalent mental health conditions, including post-traumatic stress disorder, depression, and anxiety, and assess the efficacy of various therapeutic approaches.The method relied on a comprehensive review of prior literature and a thorough evaluation of the outcomes from relevant studies. The findings indicated that a significant portion of burn victims experience various psychological disorders. This includes post-traumatic stress disorder (PTSD), depression impacting, and anxiety affecting. The research also highlighted the significance of providing psychosocial support to enhance treatment results, as well as the effectiveness of Eye Movement Desensitization and Reprocessing (EMDR), Cognitive-Behavioral Therapy (CBT) and Virtual Reality (VR) techniques in addressing these conditions.To ensure comprehensive and effective patient care, it is recommended to integrate psychological interventions into burn treatment protocols, as stated in the paper's conclusion.

Hsa_circ_0078767 Enhances Osteosarcoma Chemoresistance to Doxorubicin Through the Regulation of the miR-188-3p/GPX4 Axis.

Osteosarcoma (OS) is a primary malignancy of bone. The emergence of chemoresistance represents a persistent barrier to effective cancer patient care. This analysis sought to examine hsa_circ_0078767 as a mediator of doxorubicin (DOX) resistance in OS. Levels of hsa_circ_0078767, miR-188-3p, and glutathione peroxidase 4 (GPX4) in OS clinical tissue samples and cell lines were evaluated by quantitative polymerase chain reaction (qPCR) and Western blotting. Associations between hsa_circ_0078767 levels in clinical samples and patient overall survival were assessed with Kaplan-Meier curves. CCK-8 assays were utilized as a means of examining DOX half-inhibitory concentration (IC50) values. RNA immunoprecipitation and pull-down, as well as reporter assays, investigated interactions between hsa_circ_0078767, miR-188-3p, and GPX4 within OS cells exhibiting DOX resistance. OS patient tissues and cell lines resistant to DOX exhibited elevated hsa_circ_0078767 and GPX4 expression together with a reduction in miR-188-3p levels. Inhibiting hsa_circ_0078767 expression contributed to a profound decrease in the ability of OS tumors to resist DOX. Mechanistically, it was determined that hsa_circ_0078767 can enhance DOX chemoresistance through its ability to bind and sequester miR-188-3p, which otherwise negatively modulates GPX4 to enhance chemosensitivity. Accordingly, the sequestration of miR-188-3p by hsa_circ_0078767 led to the derepression and upregulation of GPX4. Hsa_circ_0078767 was found to modulate miR-188-3p/GPX4 signaling to enhance OS cell resistance to DOX treatment and facilitate disease progression. As such, hsa_circ_0078767 may represent a valuable biomarker or target for use in the context of OS patient management.

Comparison of a two-step Tempus600 hub solution single-tube vs. container-based, one-step pneumatic transport system.

Efficient and timely transportation of clinical samples is pivotal to ensure accurate diagnoses and effective patient care. During the transportation process, preservation of sample integrity is crucial to avoid pre-analytical aberrations on laboratory results. Here, we present a comparative analysis between a two-step Tempus600 hub solution single-tube and a one-step, container-based pneumatic transport system (PTS) from Airco, for the in-house transportation of blood samples. Ten blood samples from healthy volunteers were split in 10 mL collection tubes filled at full or half capacity for transportation with the two PTS (about 250 m). To compare the impact of transportation, markers of hemolysis such as lactate dehydrogenase (LDH), potassium (K+), and the hemolysis index (HI), were determined. Additionally, differences in HI in routine samples and repeated transportation was investigated. To assess and compare the mechanistic impact profiles, we recorded the acceleration profiles of the two PTS using a shock data logger. Transportation using the Tempus600 hub solution resulted in 49 and 46 % higher HI with samples filled to total or half capacity, respectively. Routine samples transported with the Tempus600 hub solution showed a higher median HI by 23 and 33 %. Additionally, shock logger analysis showed an elevated amount of shocks (6.5 fold) and shock intensities (1.8 fold). The Tempus600 hub solution caused an increased number of unreportable LDH or K+ results based on the hemolysis index. However, it was only statistically significant for LDH (p<0.01 and p<0.08)- while the comparisons for K+ were not statistically significant (p<0.28 and p<0.56).

Challenges posed by climate hazards to cardiovascular health and cardiac intensive care: implications for mitigation and adaptation.

Global warming, driven by increased greenhouse gas emissions, has led to unprecedented extreme weather events, contributing to higher morbidity and mortality rates from a variety of health conditions, including cardiovascular disease (CVD). The disruption of multiple planetary boundaries has increased the probability of connected, cascading, and catastrophic disasters with magnified health impacts on vulnerable populations. While the impact of climate change can be manifold, non-optimal air temperatures (NOTs) pose significant health risks from cardiovascular events. Vulnerable populations, especially those with pre-existing CVD, face increased risks of acute cardiovascular events during NOT. Factors such as age, socio-economic status, minority populations, and environmental conditions (especially air pollution) amplify these risks. With rising global surface temperatures, the frequency and intensity of heatwaves and cold spells are expected to increase, emphasizing the need to address their health impacts. The World Health Organization recommends implementing heat-health action plans, which include early warning systems, public education on recognizing heat-related symptoms, and guidelines for adjusting medications during heatwaves. Additionally, intensive care units must be prepared to handle increased patient loads and the specific challenges posed by extreme heat. Comprehensive and proactive adaptation and mitigation strategies with health as a primary consideration and measures to enhance resilience are essential to protect vulnerable populations and reduce the health burden associated with NOTs. The current educational review will explore the impact on cardiovascular events, future health projections, pathophysiology, drug interactions, and intensive care challenges and recommend actions for effective patient care.