Improve Patient Care Research Articles

Development of an assessment process for digital medical devices in Austria

Abstract Issue/problem Digital medical devices have experienced a rapid development in recent years and are playing an increasingly important role in healthcare. These devices offer numerous benefits and can improve patient care. However, despite their potential benefits, the use of digital medical devices also poses risks and regulation from governmental side is needed from a Public Health Perspective. This is why some countries already implemented assessment processes for Digital Medical Devices (e.g. Germany and France) leading to the question how such a process could be established in Austria too. Description of the problem While digital medical devices must fulfil requirements set by the medical device regulation to enter market, several other aspects are of interests when offering digital medical devices in routine care. These include e.g. medical effectiveness, data security and interoperability. The objective of the ongoing pilot project is to develop a process for the assessment of quality-assured digital medical devices in Austria in 2024. For this, a combination of literature research, interviews and workshops with relevant stakeholders is used in order to gain all necessary information. Process and assessment criteria will be tested and revised in a pilot phase with several digital medical devices. Results At the end of the project, an assessment framework as well as a potential evaluation process will be designed in accordance with relevant stakeholders. Moreover, legals aspects and the potential integration into the austrian health telematics infrastrucutur will be assessed. This will form a basis for implementing digital medical devices within the austrian healthcare system. Key messages • The result of this project aims to build the basis for implementing an evaluation process for digital medical devices in Austria. • The establishment of an evaluation process for digital medical devices supports the integration of quality assured digital medical devices in healthcare.

Impact of baseline thrombocytopenia on outcomes in hospitalizations for acute coronary syndrome and non-elective percutaneous coronary intervention: meta-analysis

Abstract Background Thrombocytopenia's impact on acute coronary syndromes (ACS) outcomes is poorly understood. A systematic review and meta-analysis aim to elucidate its influence on both short-term and long-term clinical endpoints, guiding tailored management strategies for improved patient care. Methods Our meta-analysis is registered on PROSPERO (CRD42024511832). We conducted a systematic search of PubMed and SCOPUS databases up to February 2024, utilizing keywords to identify studies on ACS or non-elective PCI populations with or without baseline thrombocytopenia (TP) reporting on in-hospital and long-term outcomes. Baseline TP was defined as a platelet count less than 150 x 10⁹/L and had to be established before hospitalization or ACS management or intervention. Binary random effects models were used to estimate pooled unadjusted odds ratios (OR) and 95% confidence intervals (CI). Sensitivity analysis was done by the leave-one-out method, and the heterogeneity was assessed with the I² statistics. Results From 2,831 identified studies, 10 were identified as eligible for inclusion in our pooled analysis and included 6,588,688 patients. Thrombocytopenia was associated with higher risks of in-hospital mortality (OR=1.89, 95% CI:1.55-2.30, p<0.01), in-hospital Major adverse cardiovascular events (MACE) (OR=1.99, 95% CI:1.63-2.43, p<0.01), and in-hospital bleeding (OR=2.62, 95% CI:1.89-3.64, p<0.01). Long-term follow-up revealed increased risks of MACE (OR=1.80, 95% CI 1.49-2.18, p<0.01), bleeding (OR=1.63, 95% CI:1.63-2.25, p<0.01), and cardiovascular mortality (OR=2.07, 95% CI:1.76-2.42, p<0.01) with thrombocytopenia. No significant difference was found in in-hospital stroke outcomes and long-term outcomes for stroke and recurrent myocardial infarction between thrombocytopenic and non-thrombocytopenic groups. Conclusion Thrombocytopenia worsens ACS outcomes. Vigilance and tailored management are crucial for mitigating its impact on patient prognosis. Further research is needed for better interventions.Secondary outcomes forest plot

Development and Measurement Properties of the Danish Translation of the Groin Hernia-Q: Protocol for a Validation Study

Background: The patient reported outcome questionnaire Abdominal Hernia-Q is probably the most thoroughly validated patient-reported outcome measure specifically developed for patients undergoing ventral hernia repair. The present study aims to adapt and validate the Danish translation of the Abdominal Hernia-Q for patients undergoing groin hernia repair: the Groin Hernia-Q. Methods: This validation study will involve a total of 250 participants and it is divided into two substudies. Substudy 1 will focus on adapting the Abdominal Hernia-Q into the Groin Hernia-Q and assessing its content validity using the QQ-10 questionnaire. Substudy 2 will evaluate the structural validity, internal consistency, test-retest reliability, measurement error and construct validity of the Groin Hernia-Q, while also utilizing and comparing the results to the Carolinas Comfort Scale and Short-Form 12. Participants will be recruited both in a clinical setting and electronically. Data collection will be conducted through the platform Research Electronic Data Capture (REDCap). In addition to questionnaire data, this study will also involve perioperative and patient-related data extracted from the Danish National Patient Registry and the Danish Hernia Database. This study is part of the AFTERHERNIA Project. Conclusion: This study will provide a comprehensive validation of the Groin Hernia-Q, ensuring it becomes a valuable tool for assessing patient-reported outcomes in patients undergoing groin hernia repair. The questionnaire will contribute significantly to improved patient care through the AFTERHERNIA Project.

Patient-Reported Indicator Surveys (PaRIS): making the case for co-development and adaptation to national contexts

Abstract In this presentation we discuss the early implementation of the OECD’s Patient-Reported Indicator Surveys (PaRIS) in primary care, highlighting the importance of co-development and national adaptation. The PaRIS initiative focuses on collecting patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) from individuals with chronic conditions and their primary care providers. This data collection is critical as populations age and the prevalence of chronic conditions increases, necessitating health systems that prioritize patient-centered care. The co-development process of the PaRIS survey involved extensive international collaboration, incorporating feedback from policymakers, healthcare providers, patients, and academics, thereby enhancing the relevance and ownership of the project. An example of successful stakeholder engagement is the creation of the PaRIS Patient Advisory Panel, which included representatives from various patient organizations who participated in all stages of the survey’s development. Challenges encountered during pilot implementations varied by country, influenced by factors like existing data infrastructures and regulatory environments. For instance, countries lacking robust data collection systems faced more significant hurdles in adapting the survey to their contexts. The article emphasizes that while rigorous standardization is essential for making international comparisons, adaptation to local contexts is crucial for addressing specific implementation challenges. The joint efforts of all stakeholders are vital for the success of international initiatives like the PaRIS survey. Such collaborative efforts not only facilitate the collection of meaningful data but also contribute to the enhancement of primary care quality through informed policymaking and improved patient care practices.

Where should health system investments be made to protect the mental health of healthcare workers?

Abstract Background This study explores trends and work-related determinants of mental health and wellbeing among health and care workers in Europe since the COVID-19 pandemic. The aim is to determine where investments can best be made to protect and support mental health and wellbeing among health and care workers to improve retention and recruitment. Methods Data are analysed from the National Health Service staff survey in England and the Health Service Executive ‘Your Opinion Counts’ survey in Ireland to explore trends in mental health and wellbeing and burnout. Evidence is then taken from a series of European Observatory policy briefs, based on expert-led literature reviews, to explore determinants of poor mental health and wellbeing and to identify potential areas for investment. Results Rates of burnout and poor mental health and wellbeing have increased in England and Ireland since the start of the pandemic among all professional groups. Workplace-based factors are important determinants of poor mental health and wellbeing, and can be grouped into: macro-level structural factors such as staff shortages, poor working conditions and low pay; meso-level organisational factors including poor leadership, and insufficient education, training and support; micro-level individual factors such as insufficient self-care or not seeking support. However, determinants at the micro-level, especially seeking support from others, are largely shaped by structural or organisational factors. Conclusions Increased financing to address structural and organisational determinants of mental health and wellbeing contributes to improved patient care, better staff experience, lower rates of absenteeism, and enhanced recruitment and retention. It is therefore one of the best health system investments that can be made.

Acquaintance, attitude, and perceived barriers regarding scientific research publications among clinical nurses: a cross-sectional study at tertiary care hospitals in western Rajasthan.

In today's era, conducting nursing research is crucial for the advancement of the nursing profession. Scientific publications in clinical research aim to improve patient care outcomes and foster a sense of importance for nurses within the healthcare team. However, clinical nurses often fall behind due to factors such as limited familiarity, attitudes toward research, and encountered barriers. This study was conducted to assess the knowledge, attitude, and perceived barriers regarding scientific research publications among clinical nurses at tertiary care hospitals in western Rajasthan. A cross-sectional descriptive study was conducted among the clinical nurses. The participants were assessed for their knowledge, attitude, and perceived barriers regarding scientific research publications through a self-administered questionnaire. The study revealed that 92% of the participants lacked sufficient knowledge about scientific research publications and 78.3% experienced moderate perceived barriers. Pearson's correlation coefficient indicated a weak positive correlation (r = 0.143, p = 0.007) between knowledge and attitude and a significant negative correlation (r = -0.143, p = 0.012) between knowledge and perceived barriers. However, multiple linear regression analysis showed no significant relationship among the clinical nurses in terms of knowledge, attitude, and perceived barriers toward scientific research publications. This study on clinical nurses revealed that the majority had insufficient knowledge about scientific research, while over half had neutral attitudes toward research publications. In addition, a significant portion of the clinical nurses reported experiencing moderate perceived barriers.

Navigating Burnout: Exploring Pharmacists’ Attitudes toward Patient Care

Abstract Background The study aimed to investigate the link between pharmacists’ burnout levels and their attitudes toward patient care, crucial for addressing burnout’s impact on service quality and fostering positive patient interactions. Methods The study utilized the Shirom-Melamed Burnout Questionnaire (SMBQ) to assess burnout levels among 442 community pharmacists. Additionally, the five-point Likert Scale of General Attitudes and Beliefs of Pharmacists about their Work with Patients (SOSUF), developed by the authors, was employed to measure pharmacists’ cognitive, affective, and behavioral attitudes toward patient care. Statistical analyses involved correlation and regression procedures. Results Moderate burnout levels among pharmacists observed (mean SMBQ score: 4.18 ± 0.96, range: 1.45 to 6.55), alongside generally positive attitudes toward patient care (mean SOSUF score: 3.44 ± 0.37). Regression analysis revealed a moderate positive correlation between burnout and attitudes toward patient care (R = 0.336, R Square = 0.113, Adjusted R Square = 0.111, p < .001). Burnout impacted pharmacists’ attitudes, notably in perceptions of patients not appreciating their efforts (r = -0.317, p < 0.001), finding patient interactions challenging (r = -0.409, p < 0.001), and disregarding their advice (r = -0.333, p < 0.001). Conclusions Despite generally positive attitudes toward patient care, burnout moderately correlates with negativity, notably impacting perceptions of patient appreciation, interaction challenges, and adherence to advice. Addressing burnout is crucial for maintaining positive patient care attitudes and ensuring quality service delivery. Key messages • Burnout impacts pharmacists’ patient care attitudes, emphasizing the need for intervention to enhance healthcare delivery. • Implementing strategies to reduce burnout among pharmacists can improve patient care outcomes.

A cross‐sectional study of the vulval dermatology clinic population over a 4‐year period and development of a national vulval disease database

AbstractBackgroundVulval disease significantly impacts quality of life but is historically under‐researched. The epidemiology and aetiology of many vulval conditions is unclear. Data to optimise patient care are lacking.ObjectivesTo describe the population attending a specialist vulval dermatology clinic and achieve consensus amongst vulval experts on data items to be collected for a future national vulval database.MethodsThis descriptive cross‐sectional study analysed data that was prospectively collected during clinical contact with consecutive new patients at a vulval dermatology clinic over 4 years.A two‐stage electronic‐Delphi survey was performed with British vulval experts. Consensus was defined as ≥75% agreement on items for inclusion.ResultsThe database included 424 (including 29 paediatric) patients. Most patients were White British (71%), with a significant Asian population (13%). Long symptom duration (9.5% > 10 years) and multiple diagnoses, up to 4, were common. Exploratory associations were identified between irritant contact dermatitis and urinary and faecal incontinence, frequent vulval washing and lichen simplex, urinary incontinence and lichen sclerosus and a negative association between candidiasis and age.Following two rounds of the electronic‐Delphi survey, consensus was achieved for 18 items that 28 participants agreed were important for a future database.ConclusionsWe report disease incidence, patient pathways, outcome measures and potential associations. Though not generalisable, this large UK‐based study could inform future projects to improve patient care and support ongoing research, such as a national vulval disease database, for which we also achieve expert consensus on the most valuable items to include.

Advanced functional polymer materials for biomedical applications

AbstractPolymer structures are essential in biomedical applications due to their biocompatibility, biodegradability, and ability to form intricate structures on micro‐ to nanometer scales. This review, emphasizing electrospinning and phase inversion techniques, examines the fabrication strategies and chemical design of polymer structures for biomedical use. Electrospinning, particularly needleless electrospinning, produces nanofibres with high porosity and flexibility and is widely applied in tissue engineering and drug delivery. Phase inversion, including thermal, nonsolvent‐, vapor‐ and evaporation‐induced phase separation, allows precise control over polymer properties but faces challenges in terms of cooling rates and solvent characteristics. Chemical design through doping, functionalization, cross‐linking and copolymerization enhances the biocompatibility, biodegradability and mechanical properties of polymers, facilitating advanced applications in drug delivery, tissue scaffolding and biosensors. Advanced functional polymers are revolutionizing biomedical fields, offering innovative solutions for therapeutic medicine delivery, disease detection, diagnostics, and regenerative medicine. Despite remarkable progress, challenges, such as scalability, cost‐effectiveness, and environmental impact, persist. This review underscores the transformative potential of advanced polymer materials in medical treatments and advocates for continuous research and interdisciplinary collaboration to overcome existing challenges and fully exploit the capabilities of these materials in improving patient care and medical outcomes. Future perspectives highlight enhancing precision control mechanisms, integrating phase inversion with other techniques and developing large‐scale production methods to advance the field further.

Perioperative Point-of-Care Ultrasound (POCUS) for Anaesthetists: Is It Time to Introduce Formal Training?

This article reviews point-of-care ultrasound (POCUS) in the perioperative period. Ultrasound-guided techniques for regional anaesthesia and vascular access have been well-established in anaesthesia for many years. However, integration of whole-body POCUS into UK anaesthetic practice remains limited. There is a growing body of evidence highlighting the benefits of POCUS throughout the perioperative period. Widespread use may help to improve patient care in anaesthesia.

Preoperative Calcium or Vitamin D Supplement in Thyroidectomy: A Systematic Review and Meta-Analysis.

The objective of this systematic review and meta-analysis was to assess the role of preoperative calcium and vitamin D supplementation in patients who underwent total thyroidectomy. The search for randomized controlled trials was performed in the OVID Medline and Embase databases. The last search was made on September 16, 2024. Three independent reviewers evaluated full-text articles from relevant reports based on eligibility criteria. The quality of the included studies was assessed by two reviewers according to the ROB 2 tool. This systematic review and meta-analysis considered 13 studies with 1504 participants. There were positive results in treatment outcomes including the mean postoperative calcium level (MD, 0.30 mg/dL: 95% CI, 0.15 to 0.44); the 48 h of postoperative hypocalcemia (OR, 0.41; 95% CI, 0.27 to 0.62); the postoperative symptomatic hypocalcemia (OR, 0.38; 95% CI, 0.24 to 0.62); the IV calcium supplementation (OR, 0.32; 95% CI, 0.18 to 0.58); and length of hospital stays (MD, -0.29; 95% CI, -0.51 to -0.07) as compared to the control group. Readmission rates showed no significant differences between the groups (OR, 0.15; 95% CI, 0.01 to 3.08). Preoperative calcium and vitamin D supplementation in patients who underwent total thyroidectomy results in reduction of postoperative symptomatic hypocalcemia. The finding is critical because it offers a feasible and effective solution that could improve patient care while potentially reducing the burden of numerous blood tests during the postoperative period. This systematic review protocol was registered with PROSPERO (registration number CRD42021278859). Level 1 Laryngoscope, 2024.

Innovations in Pain Management for Abdominoplasty Patients: A Systematic Review

Background/Objectives: Abdominoplasties are prevalent surgical procedures for improving lower abdominal contours, necessitating effective pain management. Insufficient management can increase opioid usage, dependency risks, and adverse effects. This review investigates various strategies in abdominoplasty pain management, aiming to reduce opioid dependence and improve patient care. Methods: A comprehensive systematic literature search (MEDLINE, Cochrane, PubMed, Web of Science, EMBASE) was conducted, spanning from their inception to January 2024, using keywords such as ‘abdominoplasty’ and ‘postoperative pain management’. Included studies focused on nonopioid interventions in adults, encompassing various study designs. Non-English publications and those not meeting outcome criteria were excluded. Bias in studies was assessed using specific tools for randomized and non-randomized trials. Results: Thirty-five studies, published between 2005 and 2024, were included, involving 3636 patients with an average age of 41.8. Key findings highlighted the effectiveness of transversus abdominis plane blocks in reducing opioid use and pain. Pain pump catheters also showed promise in improving pain management and reducing opioid dependency. Local anesthetics demonstrated varying degrees of efficacy, while other alternatives like ketamine and NSAIDs successfully reduced postoperative pain and opioid requirements. The bias assessment of the RCTs revealed “low” and “some concerns” ratings, indicating a need for more detailed methodology reporting and management of missing data. The cohort studies generally attained “moderate” risks of bias, primarily due to confounding variables and outcome data reporting. Conclusions: Nonopioid analgesics show potential in postoperative pain management for abdominoplasties, but further research is needed to confirm their effectiveness and optimize patient care.

MH workers strike against Kaiser Permanente in Southern California

More than 2,000 unionized mental health workers in Southern California went on strike against Kaiser Permanente last week after the two sides failed to reach a new labor agreement, CNN reported Oct. 21. The National Union of Healthcare Workers (NUHW) — which represents 19,000 health care workers in California and Hawaii, including 4,700 mental health workers — picketed outside Kaiser facilities in Los Angeles, San Diego, Anaheim and Fontana, seeking an increase in salaries, restoration of pensions and increased staffing. When announcing the impending strike earlier this month, the union cited its 10‐week strike in Northern California in 2022, which resulted in higher wages, better working conditions to improve patient care and prevented rapid staff turnover (see “Kaiser agrees to historic settlement to overhaul its BH care system,” MHW, Oct. 25, 2023; https://doi.org/10.1002/mhw.33828). Union members on strike in Southern California have said their demands are in line in with what Kaiser has provided to the majority of its workforce. “Unless we strike, our coworkers are going to keep leaving and our patients are going to keep struggling in an underfunded, understaffed system that doesn't meet their needs,” Josh Garcia, a psychologist for Kaiser in San Diego, said in a press statement from the NUHW. The strike comes as employment in the mental health field — for psychiatrists, psychologists, therapists, counselors, psychiatric aides and social workers — is expected to grow three times faster than the average US job position, according to CNN's analysis of data released in September by the Bureau of Labor Statistics. A survey in 2022 from CNN in partnership with the Kaiser Family Foundation showed that nine out of 10 US adults believe the country has a mental health crisis.

ADVANCED PREDICTIVE MODELING FOR THE BIOFIRE FILMARRAY SYSTEM IN INFECTIOUS DISEASE DIAGNOSTICS

The Bio Fire Film Array System has emerged as a powerful tool in clinical diagnostics, offering rapid and multiplexed detection of infectious pathogens. This study presents the development of a comprehensive mathematical model aimed at predicting the accuracy and sensitivity of the BioFire FilmArray System under diverse conditions. Key factors such as sample type, pathogen load, specimen characteristics, and environmental variables were systematically analyzed to elucidate their impact on the system's performance. The model incorporates a range of parameters including sample volume, specimen complexity, microbial diversity, and system-specific variables to generate probabilistic estimates of diagnostic outcomes. By leveraging large datasets encompassing diverse clinical scenarios and pathogen profiles, the model achieves robustness and generalizability, thereby facilitating its applicability across different healthcare settings and populations. Validation of the model against independent datasets demonstrates its efficacy in accurately predicting the performance of the BioFire FilmArray System across a spectrum of conditions. Overall, this mathematical model represents a significant advancement in optimizing the utility of the BioFire FilmArray System for infectious disease diagnosis. Its integration into clinical practice holds promise for improving patient care, guiding sample processing protocols, and informing decision-making processes in infectious disease management.

Turkish Retinoblastoma Research: A Bibliometric Analysis (1966-2024).

To conduct the first bibliometric analysis of retinoblastoma research in Türkiye and identify leading institutions, authors, collaboration patterns, and potential growth areas. We conducted a search on international databases (Web of Science [WoS] and Scopus), a national database (TR Dizin), and gray literature sources (thesis/Scientific and Technological Research Council of Türkiye project reports). Data were cleaned and analyzed using bibliometric tools, including Open Refine and VOSviewer. Bibliometric indicators such as number of publications, journals, h-index, collaboration patterns, and co-occurrence of keywords were examined. A search of WoS and Scopus entries published between 1966 and 2024 yielded 122 relevant publications, with articles (n=78, 63.9%) being the most common document type. More than two-thirds of the publications were from 4 institutions: İstanbul University (n=48, 23.8%), Hacettepe University (n=34, 16.8%), Ankara University (n=33, 16.3%), and İstanbul University-Cerrahpaşa (n=22, 10.9%). The total number of citations was 1,148, with an average of 10.16 per publication and an h-index of 16. Excluding 8 internationally collaborated articles, the citations and h-index decreased to 661 and 14, respectively. Pediatric Blood & Cancer was the most preferred journal, with 22 publications (19.5%). The national database search yielded 18 publications with 0 citations. Of 29 relevant theses, only 4 (13.8%) were published. The estimated publication growth predicted an increase in publication numbers per year until 2030. This study represents the first bibliometric analysis of retinoblastoma research conducted in Türkiye. Our findings underscore the concentration of research in a few institutions, the importance of international collaborations, and the potential for growth in particular areas. Addressing these areas strategically can empower Turkish researchers to enhance their contributions to the field and improve patient care.

From Code to Care: The Impact of Software Engineering and QA on Healthcare Delivery Systems

The rapid digitalization of healthcare has led to an unprecedented reliance on software systems to improve patient care, streamline operations, and ensure regulatory compliance. This article presents a comprehensive analysis of the critical role that software engineering and quality assurance (QA) play in three key areas of modern healthcare: Electronic Health Records (EHRs), telemedicine platforms, and medical device software. Through an examination of current practices, challenges, and case studies, we demonstrate how robust software engineering methodologies and rigorous QA processes contribute to the development of reliable, secure, and efficient healthcare applications. Our findings highlight the importance of data integrity, interoperability, user experience, and regulatory compliance in healthcare software development. Furthermore, we explore emerging trends such as artificial intelligence, blockchain, and the Internet of Medical Things (IoMT), discussing their implications for future software engineering and QA practices in healthcare. This article provides valuable insights for healthcare organizations, software developers, and policymakers, offering recommendations to enhance the quality and safety of software-driven healthcare solutions.

Medication adherence in geriatric patients attending medical outpatient department.

Adherence to medication represents a challenge in managing chronic conditions in the geriatric population. This study assessed adherence rates and factors affecting adherence of geriatric patients attending the Helen Joseph Hospital outpatient department. This was a prospective cross-sectional study of 130 patients aged 65 years and older, with at least two chronic conditions. Participants were administered a survey incorporating the Medication Adherence Rating Scale and the Adherence Barrier Questionnaire to identify medication adherence and patient-specific barriers to adherence, respectively. These instruments are reliable and valid. Descriptive statistics and logistic regression were used for analysis. Most patients were female (63%) with a mean age of 72 (67-78) years. Common comorbidities included type 2 diabetes mellitus (63%), hypertension (98%), dyslipidaemia (92%) and congestive cardiac failure (38%). Polypharmacy was prevalent, affecting 53% of the participants. Despite 96% of participants being adherent, all had at least one barrier to adherence, with the majority (65%) having more than one barrier. The main barriers were forgetfulness (59%), fear of side effects (39%), problems with taking the medications (26%) and believing medications are poisonous (22%). Although most participants accessed the pharmacy easily, only 83% reported consistent medication availability and 11% could not afford to collect their medication. Polypharmacy is common in the population. Despite high adherence rates, barriers such as believing medications are poisonous remain significant. A good patient-doctor relationship improves adherence.Contribution:Understanding the barriers to adherence in older adults with polypharmacy and multimorbidity can assist practitioners improve patient care.

Empowering Pharmacy Graduates to Diagnose and Prescribe

This commentary underscores the diagnosis and prescribing skills essential to the pharmacists' role on the healthcare team. It advocates for the integration of these skills into pharmacy curricula and emphasizes the urgent need for collaboration among pharmacy educators and the academy to address the omission of diagnosis and prescribing from key frameworks and standards, including the Pharmacists' Patient Care Process (PPCP), the Curricular Outcomes and Entrustable Professional Activities (COEPA), and the Accreditation Council for Pharmacy Education (ACPE) Draft Accreditation Standards 2025. The commentary draws on a case study of one college of pharmacy's integration of diagnosis and prescribing skills into its PharmD curriculum, in a state where pharmacists were granted full diagnostic and prescriptive authority. The integration was achieved through faculty-led modifications to the PPCP and COEPA, making diagnosis and prescribing an explicit part of the curriculum. The commentary concludes with a call to action for educational organizations to recognize and include these aspects in educational outcomes, accreditation standards, and practice frameworks. By doing so, the future of pharmacy education can be reshaped to improve patient care and advance the profession forward.

The psychometric properties of Chinese version of the Gilles de la Tourette syndrome-quality of life scale (GTS-QOL) for children and adolescents

BackgroundGilles de la Tourette syndrome (GTS) is a persistent neurological disorder that profoundly affects the quality of life for afflicted individuals, however, tailored health-related quality of life (QOL) measures for Chinese pediatric GTS patients are lacking. This pioneering study aims to develop a QOL scale for Chinese children with GTS.MethodsA cohort of 1,121 children (aged 6–16 years) diagnosed with GTS participated in scale development. Internal consistency was evaluated using Cronbach’s alpha. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to assess the factor structure of the GTS-QOL-Chinese, examining goodness-of-fit indices, factor loadings of individual items, and covariances between factors. Validity was determined through interscale correlations and comparisons with external measures to establish convergent and discriminant validity.ResultsFollowing reliability and validity analyses, a Chinese version of the 24-item GTS-specific quality of life scale was conclusively established, encompassing five subscales (psychological, compulsive, cognitive, physical, social). The scale demonstrated high internal consistency with a Cronbach’s alpha coefficient of 0.93, and validity was substantiated through interscale correlations ranging from 0.46 to 0.68. EFA identified five factors, explaining 61.26% of the total variation. CFA further confirmed the scale’s robustness, with all goodness-of-fit indicators meeting acceptable criteria (AGFI = 0.86, PCFI = 0.78, GFI = 0.89, CFI = 0.89, RMSEA = 0.07, SRMR = 0.06).ConclusionsThe Chinese version of the GTS-QOL scale has exhibits robust reliability and validity and is valuable for assessing the quality of life of Chinese children and adolescents with GTS. This scale may assist in tailoring interventions and improving patient care.

Smartphone Magnetometers for Assessing Programmable Shunt Valve Settings: A Proof-of-Concept Study.

Programmable shunt valves (PSVs) used to treat hydrocephalus require specialized valve-specific devices that determine their setting. However, these devices are typically only accessible in major medical centers. This study explores the feasibility of using smartphone magnetometers to assess PSV settings. We investigated 2 PSVs, the Codman Certas Plus and Medtronic Strata II, using 3 different smartphones. Free open-source software was used to measure magnetic flux densities of the shunts, and PSV-specific algorithms were developed to interpret these measurements. All measurements were performed ex vivo. We demonstrated that this method could accurately determine PSV settings with 100% accuracy in ex vivo blinded trials. The technique was effective even with a scalp analog simulating different skin thicknesses. This proof-of-concept study suggests that smartphones can be used for PSV assessment. However, further development and validation are needed to refine this method for clinical use. This technology could enhance PSV management accessibility, allowing for remote or at-home evaluations by trained individuals or caregivers, thus improving patient care in underserved areas.