Global Assessment Tool Research Articles

The state of global surgery assessment and data collection tools: A scoping review.

There has been a proliferation of global surgery assessment tools designed for use in low- and middle-income countries. This scoping review sought to categorize and organize the breadth of global surgery assessment tools in the literature. The search was conducted using PubMed from October 2022 to April 2023 according to PRISMA extension for scoping review guidelines. The search terms were (("global surgery"[All Fields]) AND ("assessment"[All Fields]) OR (data collection)). Only tools published in English that detailed surgical assessment tools designed for low- and middle-income countries were included. The search resulted in 963 papers and 46 texts described unique tools that were included for the final review. Of these, 30 (65%) tools were quantitative, 1 (2%) qualitative, and 15 (33%) employed mixed-methods. 25 (54%) tools evaluated surgery in general, whereas 21 (46%) were focused on various surgical subspecialties. Qualitatively, major themes among the tools were noted. There was significant overlap of many tools. Nonspecialty surgery was represented more than any specialty surgery and many specialties had little or no representation in the literature. Ideally, local leadership should be involved in surgical assessment tools. Different methodologies, such as checklists and observational studies, aimed to target varying aspects of surgery and had distinct strengths and weaknesses. Further efforts should focus on expanding tools in neglected specialties.

Frailty assessment and outcomes in primary care for patients with diabetes during Ramadan: implications for risk evaluation and care plans.

Frailty is a critical concern for older adults, impacting their susceptibility to adverse events and overall quality of life. This study aimed to determine the frailty status of patients 60 years or older in Abu Dhabi Ambulatory Healthcare Services (AHS) and assess its relation to the stress exerted by Ramadan fasting and the occurrence of any adverse outcomes. In this prospective observational study, participants were included if the attending physicians used the IDF-DAR risk stratification assessment tool. A tele-interview was conducted to complete the FRAIL score within 6 weeks before Ramadan 1,444 (CE 2022). The outcome was assessed through another tele-interview and an electronic medical record review after Ramadan. According to the FRAIL assessment tool, among the 204 patients aged 60 years or older included in the study, 109 (53.4%) were classified as either frail or pre-frail. In total, 20 (9.8%) patients were frail, that is, 1 out of 10, and 89 (43.6%) were pre-frail. The remaining 95 (46.6%) patients were robust. Using logistic regression to assess the occurrence of adverse outcomes after Ramadan fasting, a higher frailty score was identified as the third independent risk factor [B = 0.4, OR = 1.5 (1-2.02-1.86), and p = 0.039] for experiencing an adverse event. The identified factors associated with frailty were age, increased albumin-to-creatinine ratio (ACR), chronic kidney diseases (CKDs), and ischemic heart diseases (beta = 0.27, p = 0.003; beta = 0.24, p = 0.004; beta = 0.2, p = 0.039; and beta = 0.18, p = 0.041, respectively). One-third of the frail patients had an event, while the incidence in pre-frail patients was 11.2%, and among the robust patients, the incidence was 6.3%. Physicians' global assessment of frailty did not align well with the structured FRAIL scoring. Only five (25%) out of the 20 patients identified as frail by the FRAIL assessment tool were also judged as frail or having cognitive function impairment by the physicians' global assessment tool. Frailty is prevalent among elderly patients with diabetes. Disparity exists between subjective and objective frailty assessments, emphasizing the need for standardized evaluation methods. Using the FRAIL tool is recommended for patients aged 60 or older with diabetes in Abu Dhabi.

Mental Health Assessment in Hospitalised Patients In The Department Of General Surgery

Mental health is “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community. The goal of the study was to describe the mental health status in hospitalized patients in general surgery department. An educational observational study was carried out among 50 samples in the Department of General surgery, ESI PGIMSR, and Rajajinagar The data was collected by using global mental health assessment tool questionnaire (GMHAT). All information’s were processed and analyzed by using Microsoft excel. From the department of general surgery, the number of patients included from the male ward was 30; the majority of patients were from the age group of 46-55 (33.33%), with a mean age of 47.63 ± 12.18 years. In the female ward, the number of patients included was 20; the majority of patients were from the age group of 46-55 (30%), with a mean age of 51.75 ± 13.36 years. Based on the gender, the majority of patients were male, with 30 (60%) and the minority of them were females, 20 (40%). Compared to all the mental health diseases majority of the people said that thought disorders and psychotic symptoms as none and majority of the people said that do not have any severity. In this study, mental health almost all of the patients had responded as mild to moderate and for the severity they have responded very low. Out of 50 patients using Mann-Whitney U test, the p-value was found to be less than significant level. So, there is a significant difference in between gender and anxiety levels. And also, there was a significant difference in between the gender and panic attack levels using same statistical analysis.

FP2.2 - Does preoperative nutritional assessment correlate with postoperative outcomes of patients undergoing surgery due to colorectal cancer? A bicenter prospective observational study

Abstract Aims Preoperative nutritional status has been investigated as a risk factor for postoperative complications in patients undergoing surgery due to colorectal surgery. The aim of the present study was to investigate the predictive role of preoperative nutritional assessment in terms of morbidity and mortality in such patients. Methods Patients undergoing surgery due to colorectal cancer from March 2022 until March 2023 at two university surgical departments were included in the present study. Patients’ demographics and postoperative parameters, such as complications’ severity according to Clavien-Dindo classification and mortality, along with malignancy stage were reported. Preoperative nutritional assessment was conducted according to the Patient-Generated Subjective Global Assessment (PG-SGA) tool and the Geriatric Nutritional Risk Index (GNRI) tool. The present study was registered in ClinicalTrials.gov (NCT05795374). Results The present study included 159 patients with a mean age of 69 ± 12 years old. Severe malnutrition according to the PG-SGA tool was associated with advanced disease stage (66% vs 59%, p=0.006). In addition, the high risk of malnutrition according to the GNRI tool was correlated to major (Clavien-Dindo≥3) postoperative complications (19% vs 15%, p=0.026) and increased 30-day mortality (34% vs 9%, p=0.026). Conclusions Postoperative morbidity and mortality of patients undergoing surgery due to colorectal cancer seem to be associated with preoperative nutritional stratification, especially with the high malnutrition risk.

Research progress in stroke risk perception assessment tool.

One of the main illnesses in the globe that causes impairment and death in people is stroke. In the globe today, it ranks as the second leading cause of death and the leading cause of death in China. This paper analyses into the critical role of risk perception in developing individual awareness of stroke risk and encouraging proactive preventive health behaviors, essential for effective primary stroke prevention strategies and reduced stroke incidence. It discusses the concept of risk perception, the content and dimensions of global stroke assessment tools, and their application status, aiming to provide insights for their development and intervention research. Risk perception encompasses subjective assessments of stroke likelihood and severity, influenced by personal experiences, knowledge of risk factors, beliefs about prevention effectiveness, and emotional responses. Global stroke assessment tools, like the Framingham Stroke Risk Score and CHA2DS2-VASc Score, evaluate stroke risk based on factors such as age, gender, blood pressure, and cholesterol levels. In order to improve risk perception and proactive health management and lower the burden of strokes, the paper assesses the advantages and disadvantages of these tools and makes recommendations for improving accessibility, customizing interventions, running educational campaigns, promoting multidisciplinary collaboration, and integrating technology. By combining the research tools of stroke risk perception, it is found that the evaluation tools are mostly single-dimensional evaluation tools centered on the two dimensions of onset possibility and susceptibility. Some scholars have developed multi-dimensional evaluation tools, but the evaluation population is relatively limited, and the evaluation system lacks comprehensiveness and systematization.

Analyzing leukemia content on social media: a comprehensive cross-sectional examination of Instagram and YouTube

Introduction: Leukemia is a hematologic malignancy characterized by the uncontrolled proliferation of abnormal white blood cells. Patients with childhood leukemia may turn to social media for emotional support and information. This study aimed to identify the quality, reliability, understandability, and actionability of posts related to leukemia on YouTube and Instagram. Methods: Apify, a web scraping tool was used to gather relevant posts. The top 100 posts in each hashtag “leukemia,” “childhoodcancer,” “childhoodcancerawareness,” “leukemiaawareness” on Instagram, and the top 60 videos on YouTube for the term “leukemia” were scraped on 24 September 2023, resulting in the collection of 361 Instagram and 58 YouTube videos. All posts and videos in English and related to leukemia were included in the analysis, and thus, a total of 231 Instagram posts and 56 YouTube videos were evaluated, guided by the strengthening the reporting of cohort studies in surgery guidelines and utilized standardized tools [Global Quality Scale (GQS), modified DISCERN, and Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V)]. Data analysis was done in R Studio (4.3.1.); Kruskal–Wallis test was used to determine statistical significance. Results: YouTube videos demonstrated commendable standards with moderate quality and reliability (GQS 3.1, modified DISCERN 2.9, PEMAT-A/V understandability averaged 89%, and actionability averaged 50%). The impact of the uploader type on content quality and reliability was insignificant on both platforms. However, a notable correlation between YouTube video duration and quality scores underscored the potential influence of content length on information presentation. Instagram posts exhibited comparatively lower scores (GQS 2, modified DISCERN 1.8, PEMAT-A/V understandability averaged 56%, and actionability averaged 15%), indicating a need for enhanced content quality. Personal narratives emphasized the significant role of lived experiences in shaping content. Conclusion: Despite high understandability, actionable content, particularly on Instagram, necessitated improvement, revealing a potential gap in disseminating practical information. While personal narratives contributed significantly, lower reliability scores highlighted inherent challenges, underscoring the pivotal role of healthcare provider engagement and content validation.

Comprehensive analysis of nutritional parameters in patients with idiopathic achalasia: A prospective study in India.

Achalasia cardia, a primary motility disorder of the esophagus, poses significant malnutrition risks. This study aims at comprehensively assessing the nutritional status in untreated achalasia patients, contrasting it with functional gastrointestinal disorders (FGIDs) cases and impact of per-oral endoscopic myotomy (POEM) on nutrition at one-year. We conducted a prospective study, including consecutive achalasia cases, from December 2021 to April 2022 at a tertiary care centre. Biochemical parameters, anthropometry, subjective global assessment (SGA) and malnutrition universal screening tool were used for nutritional assessment. Cases diagnosed with FGIDs served as controls. As many as118 cases (41.2 ± 13.9years, 61% males) with achalasia and 200 controls (43.4 ± 11.9years, 69% males) were included in the study. Sub-types of achalasia included type I (16.9%), II (76.3%) and III (6.8%). Overall, 38.1% and 6.8% cases were moderately and severely malnourished, respectively. As compared to controls, cases with achalasia had lower pre-albumin (19.4 vs. 25.2; p = 0.001), serum calcium (p = 0.012), vitamin D (p = 0.001), serum iron (p = 0.001), triceps fold thickness (p = 0.002) and hand-grip strength (p = 0.001). On univariate analysis, type-I achalasia, body mass index, % weight loss, lower esophageal sphincter pressures and Eckardt scores were predictors of malnourishment (SGA). On multivariate analysis, type of achalasia, mid arm circumference and low body mass index were significant predictors of malnourishment in cases with achalasia. There was significant improvement in the nutritional status after POEM at one-year follow-up. Achalasia patients demonstrate a notably higher risk of malnutrition compared to individuals with FGIDs. Nutritional status significantly improves after POEM. (NCT05161923).

Analysis of Risk Factors Related to Malnutrition on Length of Stay Hospitalization: A Single-Center Observational Study at Klungkung General Hospital, Indonesia

Background: Malnutrition is a prevalent issue in hospital settings, significantly impacting patient outcomes and healthcare costs. This study aimed to identify and analyze risk factors associated with malnutrition and its influence on the length of stay (LOS) among hospitalized patients at Klungkung General Hospital, Indonesia. Methods: A retrospective observational study was conducted, including adult patients admitted to Klungkung General Hospital between January 1, 2023, and December 31, 2023. Malnutrition was assessed using the Subjective Global Assessment (SGA) tool. Patient demographics, medical history, nutritional status, laboratory parameters, and LOS were collected. Univariate and multivariate analyses were performed to identify risk factors associated with malnutrition and its impact on LOS. Results: A total of 43,949 patients were included in the study, with 1,084 (2.46%) identified as malnutrition. The mean LOS for malnutrition patients was significantly longer than for well-nutrition patients (7.8 days vs. 4.2 days, p < 0.001). Multivariate analysis revealed that age ≥ 60 years (OR 2.31, 95% CI 1.85-2.89), presence of comorbidities (OR 1.75, 95% CI 1.42-2.16), low albumin levels (OR 2.05, 95% CI 1.68-2.50), and inadequate dietary intake (OR 1.98, 95% CI 1.61-2.43) were independent risk factors for malnutrition. Malnutrition was also an independent predictor of prolonged LOS (OR 1.68, 95% CI 1.36-2.07). Conclusion: Malnutrition is a significant problem at Klungkung General Hospital, associated with increased LOS. Early identification of risk factors and implementation of targeted nutritional interventions are crucial to improve patient outcomes and reduce healthcare costs.

Autoimmune blistering diseases treated with glucocorticoids: An international study of steroid-induced myopathy.

Patients with autoimmune blistering diseases (AIBDs) are often exposed to chronic glucocorticoid (GC) treatment with many side effects. Glucocorticoid-induced myopathy (GIM) is a well-established side effect, which particularly affects the proximal muscles. The Glucocorticoid Toxicity Index (GTI) is a validated global assessment tool which quantifies GC toxicity over time. This study marks the first study which analyses GIM in patients with AIBDs. The objectives of this study were to utilize the GTI to investigate the nature and prevalence of GIM in AIBD patients and explore potential risk factors. This international cohort study was conducted in blistering disease clinics across Australia, China, Greece, Iran, Japan, the Philippines, Turkey and the United States of America between February 2019 and July 2023. The GTI tool was completed by a medical practitioner at each patient visit. Data related to glucocorticoid toxicity were entered into the Steritas GTI 2.0 to generate an aggregate improvement and cumulative worsening score at each visit. The study included 139 patients. There were 132 episodes of myopathy, and 47.5% of patients developed muscle weakness at some point during the study period. Cumulative GC dose correlated positively with myopathy risk, while average dose and treatment duration were not significant. Older age, male gender and obesity more than doubled the likelihood of developing GIM. GIM is a common side effect experienced by AIBD patients on GC treatment. Muscle weakness is less likely to occur if cumulative GC dose is less than 0.75 mg/kg/day. Studies of exercise programs to mitigate myopathy and newer alternative treatments to reduce cumulative GC dose should be considered.

Objective assessment tools in laparoscopic or robotic-assisted gynecological surgery: A systematic review.

There is a growing emphasis on proficiency-based progression within surgical training. To enable this, clearly defined metrics for those newly acquired surgical skills are needed. These can be formulated in objective assessment tools. The aim of the present study was to systematically review the literature reporting on available tools for objective assessment of minimally invasive gynecological surgery (simulated) performance and evaluate their reliability and validity. A systematic search (1989-2022) was conducted in MEDLINE, Embase, PubMed, Web of Science in accordance with PRISMA. The trial was registered with the Prospective Register of Systematic Reviews (PROSPERO) ID: CRD42022376552. Randomized controlled trials, prospective comparative studies, prospective single-group (with pre- and post-training assessment) or consensus studies that reported on the development, validation or usage of assessment tools of surgical performance in minimally invasive gynecological surgery, were included. Three independent assessors assessed study setting and validity evidence according to a contemporary framework of validity, which was adapted from Messick's validity framework. Methodological quality of included studies was assessed using the modified medical education research study quality instrument (MERSQI) checklist. Heterogeneity in data reporting on types of tools, data collection, study design, definition of expertise (novice vs. experts) and statistical values prevented a meaningful meta-analysis. A total of 19 746 titles and abstracts were screened of which 72 articles met the inclusion criteria. A total of 37 different assessment tools were identified of which 13 represented manual global assessment tools, 13 manual procedure-specific assessment tools and 11 automated performance metrices. Only two tools showed substantive evidence of validity. Reliability and validity per tool were provided. No assessment tools showed direct correlation between tool scores and patient related outcomes. Existing objective assessment tools lack evidence on predicting patient outcomes and suffer from limitations in transferability outside of the research environment, particularly for automated performance metrics. Future research should prioritize filling these gaps while integrating advanced technologies like kinematic data and AI for robust, objective surgical skill assessment within gynecological advanced surgical training programs.

Appraising LaQshya’s potential in measuring quality of care for mothers and newborns: a comprehensive review of India’s Labor Room Quality Improvement Initiative

BackgroundPoor intrapartum care in India contributes to high maternal and newborn mortality. India’s Labor Room Quality Improvement Initiative (LaQshya) launched in 2017, aims to improve intrapartum care by minimizing complications, enforcing protocols, and promoting respectful maternity care (RMC). However, limited studies pose a challenge to fully examine its potential to assess quality of maternal and newborn care. This study aims to bridge this knowledge gap and reviews LaQshya’s ability to assess maternal and newborn care quality. Findings will guide modifications for enhancing LaQshya’s effectiveness.MethodsWe reviewed LaQshya’s ability to assess the quality of care through a two-step approach: a comprehensive descriptive analysis using document reviews to highlight program attributes, enablers, and challenges affecting LaQshya’s quality assessment capability, and a comparison of its measurement parameters with the 352 quality measures outlined in the WHO Standards for Maternal and Newborn Care. Comparing LaQshya with WHO standards offers insights into how its measurement criteria align with global standards for assessing maternity and newborn care quality.ResultsLaQshya utilizes several proven catalysts to enhance and measure quality- institutional structures, empirical measures, external validation, certification, and performance incentives for high-quality care. The program also embodies contemporary methods like quality circles, rapid improvement cycles, ongoing facility training, and plan-do-check, and act (PDCA) strategies for sustained quality enhancement. Key drivers of LaQshya’s assessment are- leadership, staff mentoring, digital infrastructure and stakeholder engagement from certified facilities. However, governance issues, understaffing, unclear directives, competency gaps, staff reluctance towards new quality improvement approaches inhibit the program, and its capacity to enhance quality of care. LaQshya addresses 76% of WHO’s 352 quality measures for maternal and newborn care but lacks comprehensive assessment of crucial elements: harmful labor practices, mistreatment of mothers or newborns, childbirth support, and effective clinical leadership and supervision.ConclusionLaQshya is a powerful model for evaluating quality of care, surpassing other global assessment tools. To achieve its maximum potential, we suggest strengthening district governance structures and offering tailored training programs for RMC and other new quality processes. Furthermore, expanding its quality measurement metrics to effectively assess provider accountability, patient outcomes, rights, staff supervision, and health facility leadership will increase its ability to assess quality improvements.

Prevalence and factors associated with malnutrition on patients with cancer in Bangladesh: a cross-sectional study

IntroductionMalnutrition is related to the development of chronic diseases, including cancer and is a major cause of mortality in patients with cancer. The study aimed to understand the prevalence and...

Dietetics student contribution to addressing malnutrition in residential aged care facilities.

To test a model of malnutrition screening and assessment conducted by dietetics students on placement in residential aged care facilities. The secondary aim was to identify possible facilitators and barriers to the implementation of the model. The type 1 hybrid effectiveness-implementation trial study design and reporting outcomes were developed using the Consolidated Framework for Implementation Research. An innovative placement model was developed, where students on voluntary placement visited three residential aged care facilities to identify residents at risk of malnutrition using currently available screening tools for older people. Students completed malnutrition assessments for all residents using the subjective global assessment tool. Thirty-two students participated; 31 completed all three sessions, with malnutrition screening completed for 207 residents and malnutrition assessment for 187 residents (July and September 2022). Based on the subjective global assessment, 31% (n = 57) of residents were mildly/moderately malnourished, and 3% (n = 5) were severely malnourished. The Innovation Domain of the Framework was the most important consideration before implementation. Whilst previous research documented student learning opportunities in residential aged care facilities, this study provides the first available evidence of the direct contribution students can make to the health of aged care residents through malnutrition screening and assessment. The model enables students to conduct malnutrition screening and assessment feasibly and efficiently in facilities that do not routinely collate and act on these data. With a limited nursing aged care workforce to undertake this vital task, the potential role of student dietitians to fulfil this role must be considered.

Analysis of the top global emergency and disaster databases

Relevance. Despite advancements in industrial production technologies, no decrease is observed in global statistics for disasters and emergencies, as well as their identified precursors. Reliable and comprehensive inventory of global and regional disaster databases reinforces the development of effective national emergency prevention policies, improving the resilience of industrial facilities against adverse and thus generating extensive evidence for research. The objective is to study top global disaster information management databases and their inventory.Methods. The Internet, state reports, research papers available in the Russian Science Citation Index, Scopus and Web of Science bibliography databases were the major sources of data regarding top global disaster and emergency databases.Results and discussion. EM-DAT: OFDA/CRED (Emergency Events Database), NatCatSERVICE, SIGMA, GLIDE (Global IDEntifier Number), CatNat Global (The natural disasters database (NATDIS)), DesInventar (Disaster Inventory System) are among the top global databases, having quantitative assessment for disaster risk indexes and consequences. Comparative studies of emergency data entries across databases was performed to allow countries and regions to develop common global assessment tools for emergency consequences.Conclusion. Consistent terminology and uniformity of data submission procedures across top global international databases allows Russian and international experts to develop the most effective tools to predict and prevent various emergencies and build common consequence assessment strategies for countries and regions of the world.

Evaluation of Nutritional Status in Cancer Patients Underwent Radiotherapy: The Results of Biochemical, Body Composition with Bioelectrical Impedance Analysis, Anthropometric Measurements, and Patient-Generated Subjective Global Assessment

Aim: This study aims to evaluate the nutritional status and the effect of radiotherapy (RT) on nutrition in all ambulatory cancer patients. Material and Method: In this prospective observational study 105 cancer patients with various diagnoses treated between 2013 and 2014 were evaluated. All patients were ≥18 years old and had Karnofsky Performance Status ≥70. Anthropometric measurements, body composition with bioelectric impedance, and patient-generated Subjective Global Assessment (PG-SGA) tools were used. The height, weight, body mass index (BMI), triceps skin fold thickness, mid-upper arm circumference, hemoglobin, and serum albumin levels were determined twice before and after RT. Additionally, nutrition-related symptoms and short-term weight loss results were determined by PG-SGA questionnaires. Results: The patients’ median age was 53 years (range, 18-82 years). At initial evaluation 74 patients were well nourished using the PG-SGA global rating. Malnutrition developed in totally 33 of these 74 patients after RT. The PG-SGA results after RT were significantly worse than before treatment. PG-SGA revealed no significant relationship between nutritional status prior to RT and the parameters including gender, age, mean weight, BMI, disease duration, pre-RT hemoglobin and albumin levels. Post-RT evaluation showed a significant relationship between deterioration (PG-SGA B-C) and mean weight, BMI, serum albumin, hemoglobin levels, and concomitant chemotherapy. Gastrointestinal and head and neck cancer patients had the most deterioration after RT. The patients' weight, BMI, fat-free mass, total body water, and the percentage weight loss at the end of RT were significantly lower than the initial assessment. Conclusion: It is considerable to use multiple tools for nutritional monitoring. Patients who received RT to the head and neck and upper abdomen region had a high risk of deterioration after treatment. These patients should be monitored carefully during all treatment periods.

Hospital Associated Variation in Nutritional Status and Dietary Compliance of Elderly Patients

Background: Malnutrition is associated with detrimental aftermaths for patients including increased infections, complications, exacerbated muscle loss, prolonged hospital stay, and is often underdiagnosed. Objective: The study was carried out to determine the hospital associated variability of nutritional status, impact of length of stay on malnutrition in geriatrics. Methods: A sample of 100 participants was selected for a single group pretest posttest quasi experimental study. Interviewer administered questionnaire and Subjective Global Assessment (SGA) tool were used to collect data both at the time of admission and discharge. Within group pre-admission and post-discharge outcomes including nutrition practices, dietary compliance and nutritional status assessed by SGA were compared. Results: The BMI of the participants decreased at the time of discharge (22.89±4.44 kg/m2 pretest vs. 22.25±4.46 kg/m2 posttest) and more adults were categorized undernourished (13% in pretest vs.17% in posttest). A significant decrease in well-nourished participants (45.0% pretest vs. 32.0% posttest), and increased malnourished individuals (12.0% pretest vs. 25.0% posttest) was observed. Conclusion: Length of stay along with dietary constraints in geriatrics affects the nutritional status drastically. Targeted dietetic interventions can decrease hospital associated malnourishment. Dietary compliance of hospitalized patients can be ensured by educating the patient/caregiver to reduce the risk of malnutrition and hospital readmission. Patients already malnourished at admission are more prone to have deteriorating health.

An Analytical Cross-Sectional Study of Malnutrition in Hemodialysis Patients in Gorgan, Iran, 2020

Background: Malnutrition is relatively common in hemodialysis (HD) patients, which increases the risk of mortality. Seven Point Subjective Global Assessment (7-point SGA) tool is recommended to evaluate and monitor malnutrition in HD patients. The aim of this study was to investigate malnutrition using 7-point SGA in HD patients referred to dialysis centers in Gorgan city (north-eastern of Iran) in 2020. Methods: The nutritional status of 133 HD patients referred to Gorgan city dialysis center in 2020 were assessed using the 7-point SGA tool. Weight, percentage of fat, and muscle mass were measured by Omron BF511. Height was measured using the SECA portable stadiometer. Serum hemoglobin levels were recorded based on the latest recorded routine tests during the last month. A demographic information questionnaire was completed for all individuals. Medications and supplements taken by patients as well as visits by a nutrition consultant and adherence to a special diet were investigated by reviewing the medical file and asking the patient. Results: Out of 133 patients, 43.61% had no malnutrition and 56.39% had moderate malnutrition. The nutrition status was not different regarding gender and education level, but was different regarding household size (P=0.032). Patients with moderate malnutrition were older and had less weight and body mass index (BMI), but there was no statistically significant difference between height, dialysis time span, body fat and muscle mass percentage, and serum hemoglobin concentration. Conclusion: This study showed a considerable rate of malnutrition in HD patients, which should be regarded by clinicians and health policymakers.

Plenary C: Developing Tools for Global Neuropsychological Assessment

Abstract & Learning Objectives:During the 20th century, neuropsychology emerged as a research and clinical specialty, predominantly—though not exclusively—in Western Europe and North America. Formation of the International Neuropsychological Society has done much to foster globalization of the discipline, though we have yet to develop neuropsychological assessment instruments that are suitable for worldwide use. Test publishers have few financial incentives to undertake the development, standardization, and normative data collection required to create cognitive tests for worldwide use. And health-related funding organizations typically prioritize disease-focused etiologic, mechanistic, and treatment research in their resource allocation. Thus, developing such tools will likely require clinical data and other contributions from the entire international community of neuropsychologists. In this address, I will focus on two approaches to developing tests and norms that are suitable to global use, along with ongoing efforts and progress to date in each. I will also appeal to every member of the international community of neuropsychologists to help turn this vision into a reality now.Upon conclusion of this course, learners will be able to: 1.Describe two fundamental approaches to developing neuropsychological tests that are appropriate for international use.2.Explain at least one strength and limitation of each approach to global test and regression-based norms development.3.Assess how to personally engage in a project that aims to provide contributors with free access to a global neuropsychological test battery that is suitable for use worldwide in multiple languages.

Evaluating the usefulness of the Atopic Dermatitis Control Tool for assessing disease control in individuals with atopic dermatitis in Japan.

An online questionnaire assessed atopic dermatitis (AD)-related patient-reported outcome measures [including the Atopic Dermatitis Control Tool (ADCT)] in 5546 patients with AD. Spearman’s rank correlation coefficients showed that total ADCT scores had strong correlations with established AD assessment tools (including the DLQI, POEM and WI-NRS). ADCT subitem scores also had moderate correlations with the other AD assessment tools, except for Q4 (sleep) with the Global Questions assessment tool. This demonstrates that ADCT scores can effectively characterize multidimensional AD disease burden.

Clinical Nurses' Identification of a Wearable Universal Serial Bus Used for Pediatric Oncology Clinical Trial Participant Safety Management.

The expanded access to clinical trials has provided more patients the opportunity to participate in novel therapeutics research. There is an increased likelihood of a patient, as a pediatric oncology clinical trial participant, to present for clinical care outside the research site, such as at an emergency room or urgent care center. A novel wearable universal serial bus device is a proposed technology to bridge potential communication gaps, pertaining to critical information such as side effects and permitted therapies, between research teams and clinical teams where investigational agents may be contraindicated to standard treatments. Fifty-five emergency and urgent care nurses across the United States were presented, via online survey without priming to the context of clinical trials or the device, a picture of a pediatric patient wearing the novel wearable device prompted to identify significant, environmental cues important for patient care. Of the 40 nurses observing the patient photo, three identified the wearable device within Situational Awareness Global Assessment Tool formatted narrative response fields. Analysis of the narrative nurse-participant responses of significant clinical findings upon initial assessment of the pediatric patient photo is described, as well as the implications for subsequent prototyping of the novel universal serial bus prototype.