National Research Database Research Articles

Assessing the Impact of Nicotine Dependence on 90-Day Major Complications and 2-Year Hardware Outcomes in Open Reduction and Internal Fixation of the Distal Radius Fracture.

This study aims to assess the impact of nicotine dependence on both 90-day major postoperative outcomes and 2-year implant-related outcomes in patients undergoing open reduction internal fixation (ORIF) for distal radius fractures. We queried TriNetX, a national research database that provides real-time access to deidentified medical records, for patients of all ages who underwent an ORIF of the distal radius (Current Procedural Technology codes 25607, 25608, 25609) between 2001 and 2021. Patients were categorized by nicotine dependence history (International Classification of Diseases, Tenth Revision code: F17), with groups 1:1 propensity matched for age, sex, race, ethnicity, body mass index, type 2 diabetes, hypertension, cerebrovascular disease, and chronic obstructive pulmonary disease. The primary analysis examined major postoperative complications within 90 days, while the secondary analysis assessed hardware-related issues within 2 years. Risk ratios and 95% confidence intervals were generated for each outcome. Of 62 137 patients treated with distal radius ORIF, 7764 had nicotine dependence, and 54 373 did not. Each group comprised 7591 patients after 1:1 matching. Nicotine dependence was associated with increased risk of skin infections, sepsis, and wound disruption in the 90-day postoperative period (P < .001). Within the 2-year postoperative period, nicotine dependence was associated with increased risk of mechanical complication of internal fixation device (P < .001), nonunion (P < .01), and surgical intervention for nonunion (P = .009). Nicotine dependence is associated with increased risk of infection, sepsis, wound disruption within 90 days, and hardware complication, nonunion, and nonunion repair at 2 years. These data emphasize the importance of nicotine counseling by treating surgeons.

Low-code and ai-augmented Code for an Archaeological Database: Arkas 2.0

Abstract This data paper presents Arkas 2.0, a national research database and research infrastructure containing data on all archaeological sites and monuments in Slovenia. The new database is a hybrid cloud microservice built on low-code platforms (Caspio and ArcGIS Experience builder) and augmented by generative ai (ChatGPT-3.5). The data paper describes the Arkas 2.0 dataset and how it fits into the research context by discussing the challenges archaeologists face in setting up and curating datasets and the associated digital infrastructure. In response to these challenges, the data paper highlights the benefits of low-code platforms and ai-augmented code for archaeological research. It also describes the Arkas 2.0 development workflow, its new data structure, and its archiving process. The data paper concludes by suggesting that the use of low-code platforms combined with generative ai can democratise access to cutting-edge digital research infrastructure, bringing positive disruption to archaeology and the humanities.

Associations between type 1 diabetes and educational outcomes: an Aotearoa/New Zealand nationwide birth cohort study using the Integrated Data Infrastructure

Aims/hypothesisType 1 diabetes is one of the most common chronic diseases of childhood. It is hypothesised that the metabolic and psychosocial consequences of type 1 diabetes may affect educational outcomes; however, existing literature presents conflicting results. This study aimed to assess whether educational outcomes differ for young people with and without type 1 diabetes in Aotearoa/New Zealand (NZ).MethodsThis was a nationwide 9 year birth cohort study of all people born in NZ from 1993 to 2001 using linked administrative data held within the Integrated Data Infrastructure, a national research database containing linked health and non-health data. Educational outcomes of high school attainment, high school attendance and university enrolment were measured from age 13 years until 20 years. Generalised linear regression models with log link and Gaussian distributions were used to compare educational outcomes between those with and those without type 1 diabetes, adjusting for sociodemographic and maternal characteristics.ResultsOf the 442,320 children in the birth cohort, type 1 diabetes was identified in 2058 (0.47%) (mean [SD] age of type 1 diabetes diagnosis 7.7 [3.4] years). Educational outcomes were significantly lower for children with type 1 diabetes than for those without type 1 diabetes, including for any high school qualification (RR 0.97 [95% CI 0.95, 0.99]), university entrance-level high school attainment (RR 0.88 [95% CI 0.84, 0.92]), regular high school attendance (RR 0.91 [95% CI 0.85, 0.97]) and university enrolment (RR 0.93 [95% CI 0.88, 0.98]), even after adjusting for sociodemographic and maternal factors. In addition, educational outcomes were substantially lower for those with post type 1 diabetes diagnosis hospitalisations for diabetic ketoacidosis and hypoglycaemia.Conclusions/interpretationIn this whole NZ birth cohort study, type 1 diabetes was associated with lower educational outcomes spanning secondary school and into university enrolment. Ongoing efforts to support students with type 1 diabetes are needed, particularly for those with a greater risk profile.Graphical

Evaluating Firefighter On-Scene Decontamination Practices Using a National Fire Records Management System.

This study describes firefighters' on-scene decontamination procedure use post-working fire and frequency of adherence to best practice. This retrospective analysis of working fires was conducted using records from the ESO Data Collaborative (Austin, TX) national research database from January 1, 2021, to December 31, 2021. Documentation of decontamination procedures was examined among records with smoke or combustion products exposure. Firefighter and incident characteristics were evaluated. Descriptive statistics and univariable odds ratios were calculated. Among the 31,281 firefighters included in the study, 8.0% documented a fire-related exposure. Of those, 82% performed at least one on-scene decontamination procedure; 5% documented all decontamination procedures defined as best practices. The odds of documenting any decontamination procedure were significantly decreased among firefighters responding to incidents in rural areas compared with urban areas (odds ratio, 0.70). Fire personnel may not be taking all necessary decontamination steps post-working fires.

291 Hypernatremia Is Associated with Acute Renal Dysfunction in Severe Burn Patients

Abstract Introduction Hypernatremia often occurs concurrently with acute kidney disease and is associated with increased mortality. It is a common electrolyte disorder presenting in severe burn patients, who are additionally at high risk for acute kidney disease. The purpose of this study is to determine if burn patients presenting with hypernatremia are at greater risk of developing acute kidney disease and related complications. Methods Patients diagnosed with severe burns (20% or more of total body surface area) were identified using the TriNetX Research Network and the relevant ICD-10 Codes. TriNetX is a national research database that provides real-time access to de-identified medical records. Burn patients were stratified into hypernatremic (serum sodium ≥ 145 mmol/L) and eunatremic (serum sodium between 135 and 145 mmol/L) groups. Both groups excluded patients with a prior diagnosis of diabetes or hypothyroidism, as both may render patients more susceptible to electrolyte dysregulation. Patients with a personal history of diseases involving the circulatory, urinary, and respiratory systems were also excluded to control for pre-existing conditions that may affect the outcomes of this study. We analyzed acute kidney disease, mortality, pulmonary edema, and respiratory failure one month after the onset of hypernatremia; these latter two complications are often associated with kidney injury. Statistical analysis was performed within TriNetX to generate the risk ratios and risk differences for each outcome. Results A total of 10,352 patients across 53 healthcare organizations were identified. Excluded from the study were 1,039 (10.04%) patients who were diagnosed with comorbidities. The remaining 9,313 patients were sorted respectively into the hypernatremic (n = 1,116) and eunatremic (n = 6,656) groups. The two cohorts were balanced using (1:1) propensity score matching for age, race, sex, ethnicity, and burn surface area. The hypernatremic group showed a greater risk of developing acute kidney disease (risk ratio [RR], 4.343, p &amp;lt; 0.001) and associated complications. Severe burn patients with hypernatremia had a 1.987 times greater risk of developing pulmonary edema (p &amp;lt; 0.001), a 2.896 times greater risk of developing respiratory failure (p &amp;lt; 0.001), and a 2.873 times greater 30-day mortality rate (p &amp;lt; 0.001). Conclusions Hypernatremia in severe burn patients is associated with an increased risk of developing acute kidney injury, mortality, and related pulmonary complications. Applicability of Research to Practice This study indicates that hypernatremia is a potential marker for the development of renal and pulmonary complications.

63 Adjunctive Ketamine Reduces the Risk of Developing Chronic Opioid Use in Burn Patients

Abstract Introduction Opioid use for perioperative pain management in burn patients is associated with a high risk of developing chronic opioid use. Ketamine is commonly used as an analgesic adjunct due to its opioid-sparing effects. The purpose of this study is to determine whether analgesia with adjunctive ketamine reduces the risk of developing chronic opioid use in burn patients. Methods Burn patients who underwent burn-related surgeries were identified using relevant ICD-10 Codes. Data were collected using the TriNetX Research Network, a national research database providing de-identified patient medical records. Burn patients undergoing surgical procedures were identified based on their use of opioids alone or in combination with ketamine as adjunctive analgesia. Both groups excluded patients with a prior history of opioid-related and psychiatric disorders to control for potential pre-existing conditions affecting the study outcomes. Outcome analysis included continued opioid use and related psychiatric disorders, including nicotine dependence and anxiety, up to one year after burn injury. Risk ratios for each outcome were then generated using a measure of association analysis through TriNetX. Results We identified 107,270 patients across 51 health care organizations who underwent burn-related surgeries within one month after burn injury. Excluded from the study were 3,296 (3.07%) patients who had a prior history of opioid-related and psychiatric disorders. The remaining 103,974 patients were sorted into respective groups that received opioids with ketamine (n = 8,328) and without ketamine (n = 51,413). The two cohorts were balanced using (1:1) propensity score matching for age, sex, race, ethnicity, and burn surface area. Patients without ketamine had a higher risk of continuing opioid use (risk ratio [RR], 1.14, p &amp;lt; 0.001), developing nicotine dependence ([RR], 1.32, p &amp;lt; 0.001), and developing anxiety disorders ([RR], 1.21, p = 0.007) at least one year after burn injury. Conclusions Burn patients whose pain management included adjunctive ketamine ceased opioid use sooner and demonstrated a lesser risk of developing various psychiatric disorders associated with chronic opioid use. Applicability of Research to Practice This study supports the use of adjunctive ketamine as part of a multimodal approach to pain management in burn patients in order to minimize the risk of chronic opioid use.

Abstract P4-07-09: Identifying Drivers of First-Line HR+/HER2- Metastatic Breast Cancer Treatment Choices

Abstract Background: Despite demonstrated clinical benefits of first line (1L) cyclin-dependent kinases 4/6 inhibitors (CDK4/6i) and their preferred status in the NCCN guidelines, many appropriate patients with hormone receptor positive (HR+)/human epidermal growth factor receptor 2 negative (HER2-) metastatic breast cancer (mBC) in the United States (US) may still receive chemotherapy or endocrine monotherapy. US oncologists may consider treatment expectations, patient clinical characteristics, and non-clinical factors (e.g., cost, anticipated adherence) when selecting 1L mBC treatment regimens. However, little is known about how prevalent these decision factors are among US oncologists. Comprehensively understanding the decision-making process in 1L treatment selection is a critical step towards ensuring equitable care for patients with HR+/HER2- mBC. Objective: To describe self-reported clinical and non-clinical factors considered by US oncologists in selection of 1L treatment for HR+/HER2- mBC. Methods: Data were collected through from an anonymous cross-sectional online survey from a convenience sample of US oncologists from August-October 2021. Eligible oncologists were board certified, in practice 2-30 years, ≥50% of time spent in direct patient care, and managed ≥5 1L patients with HR+/HER2- mBC in past 3 months. Respondents were sampled from a national research database of physicians sourced from multiple databases (e.g., American Medical Association Physician Masterfile). The survey captured self-reported demographic and practice characteristics and reported importance of the following factors in selecting 1L treatment for patients with HR+/HER2-mBC: anticipated treatment efficacy and safety, patient demographics, and clinical and non-clinical characteristics. Study variables were summarized via descriptive statistics. Correlation analyses evaluated associations between patient demographics, clinical characteristics, treatment expectations, and non-clinical characteristics and oncologists’ self-reported 1L prescribing rates of CDK4/6i, aromatase inhibitor (AI) monotherapy, and chemotherapy. Results: 250 oncologists participated; 67% from community practice and the remainder from academic institutions (Table 1). Anticipated treatment efficacy and safety/tolerability were ranked as the most important factor considered by oncologists when selecting 1L treatments. 1L CDK4/6i prescribing was most strongly correlated with patient Medicare eligibility (r, 0.54, p&amp;lt; 0.05) and postmenopausal status (r, 0.67, p&amp;lt; 0.05). 1L chemotherapy prescribing was most strongly correlated with patient premenopausal status (r, 0.42, p&amp;lt; 0.05) and perimenopausal status (r, 0.31, p&amp;lt; 0.05), and physician consideration for patient symptom burden (r, 0.31, p&amp;lt; 0.05). 1L AI monotherapy prescribing was most strongly correlated with concerns with expected patient compliance to treatment (r, 0.42, p&amp;lt; 0.05) and patient cost/logistical challenges (r, 0.41, p&amp;lt; 0.05). Conclusion: This study found a variety of patient, clinical, and non-clinical factors may underlie US oncologists’ selection of 1L treatment for HR+/HER2- mBC. Anticipated efficacy and safety/tolerability were reported as the most important factors in 1L treatment decisions. Patient demographics, clinical characteristics, and considerations for cost and compliance challenges varied in association with 1L CDK4/6i, chemotherapy, and AI monotherapy prescribing patterns among US oncologists. Table 1. Oncologist Demographic and Practice Characteristics Citation Format: Adam M. Brufsky, Martine C. Maculaitis, Lewis Kopenhafer, Patrick Olsen, Ashley S. Cha, Lillian Shahied Arruda, Wendy Heck, Samantha K. Kurosky. Identifying Drivers of First-Line HR+/HER2- Metastatic Breast Cancer Treatment Choices [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P4-07-09.

Stratifying sudden death risk in adults with drug-resistant focal epilepsy: The SUDEP-CARE score.

A clinical risk score for sudden unexpected death in epilepsy (SUDEP) in patients with drug-resistant focal epilepsy could help improve prevention. A case-control study was conducted including (i) definite or probable SUDEP cases collected by the French National Sentinel Mortality Epilepsy Network and (ii) control patients from the French national research database of epilepsy monitoring units. Patients with drug-resistant focal epilepsy were eligible. Multiple logistic regressions were performed. After sensitivity analysis and internal validation, a simplified risk score was developed from the selected variables. Sixty-two SUDEP cases and 620 controls were included. Of 21 potential predictors explored, seven were ultimately selected, including generalized seizure frequency (>1/month vs. <1/year: adjusted odds ratio [AOR] 2.6, 95% confidence interval [CI] 1.25-5.41), nocturnal or sleep-related seizures (AOR 4.49, 95% CI 2.68-7.53), current or past depression (AOR 2.0, 95% CI 1.19-3.34) or the ability to alert someone of an oncoming seizure (AOR 0.57, 95% CI 0.33-0.98). After internal validation, a clinically usable score ranging from -1 to 8 was developed, with high discrimination capabilities (area under the receiver operating curve 0.85, 95% CI 0.80-0.90). The threshold of 3 has good sensitivity (82.3%, 95% CI 72.7-91.8), whilst keeping a good specificity (82.7%, 95% CI 79.8-85.7). These results outline the importance of generalized and nocturnal seizures on the occurrence of SUDEP, and show a protective role in the ability to alert someone of an oncoming seizure. The SUDEP-CARE score is promising and will need external validation. Further work, including paraclinical explorations, could improve this risk score.

Increased risk of subsequent cardiovascular disease among men aged 31-60 years with erectile dysfunction

ABSTRACT Background Men presenting with erectile dysfunction (ED) or coronary artery disease (CAD) can be regarded as two different manifestation of vascular occlusion incident. ED has been proven to be an independent predictor of CAD, especially young men aged 40-49 years. Although psychogenic ED is more prevalent in younger patients less than 40 years of age, but the ED presentation can also be related to vasculogenic etiology. The purpose of this study is to evaluate the subsequent CAD risk in young ED patients and also determine the relative CAD risk in ED men stratified by age. Methods A total of 3091 ED patients and 9273 randomly-selected controls without ED were selected from the National research database and studied retrospectively from January 1,1997 to December 31, 2007. The comparison cohort without ED was matched for age and comorbidities (diabetes, hypertension, hyperlipidemia and ischemic stroke). All subjects were followed up by the end of 2009. Cox proportional hazards regression models were used to explore the connection between ED and the development of CAD. Results The ED patients have a greater chance of developing cardiovascular disease compared to controls (460/3091, 14.9% vs. 1021/9273, 11.0%, p-values &amp;lt; 0.0001). Cox proportional hazards regression suggested ED increases the risk of CAD development (HR 1.37, 95% CI [1.22-1.53], p&amp;lt;0.0001). Results stratified by 10-year age decades demonstrate ED men aged 31-40 years, 41-50 years, and 51-60 years pose greater risk of developing CAD comparing to the controls (HR 1.61, 95% CI [1.04-2.52], p=0.03; HR 1.79, 95% CI [1.38-2.32], p&amp;lt; 0.0001; HR 1.68, 95% CI [1.35-2.09], p&amp;lt; 0.0001, respectively). On the contrary, the incident cardiac events were not increased in ED men aged 21-30 years, 61-70 years and 71-80 years comparing to the controls (HR 1.77, 95% CI [0.50-6.29], p=0.38; HR 1.17, 95% CI [0.95-1.44], p=0.15; HR 0.88, 95% CI [0.65-1.19], p=0.40, respectively). Conclusion Erectile dysfunction is a harbinger of cardiovascular clinical events in men aged 31-60 years. Erectile dysfunction should prompt investigation and close follow up for further cardiac events. Disclosure Work supported by industry: no.

26 Opioid Prescription in Burns: A Large Database Analysis from 1990 to 2021

IntroductionThe use of opioids in the medical field has contributed to the growing opioid epidemic. Nonetheless, opioids remain imperative in the treatment for pain management in burns. While some studies have addressed the use of opioids in surgery, a comprehensive analysis of the pattern of opioids use in burns has not been investigated. This study aims to identify trends of opioid use and investigate the risk of opioid related disorders in burn patients.MethodsData was obtained from TriNetX, a national research database that provides medical records of de-identified patients. The study population includes patients that were prescribed an opioid, ICD-10 code CN101, on or after any instance of burn between January 1st, 1990 and September 19th, 2021. Patient population was further stratified by the decade in which patients received opioids for pain following burn injury: 1990-1999, 2000-2009, 2010-2019, and 2020-September 19th, 2021. Five outcomes were investigated: opioid related disorders, opioid dependence, opioid abuse, intentional self-harm, and mental and behavioral disorders due to psychoactive substance use. Cohorts were matched for age at index, sex, and race. Statistical analysis used risk ratios with a 95% confidence interval, and p< 0.05 was considered significant.ResultsWe identified 8,421 patients that were prescribed an opioid between 1990-1999, 30,846 patients from 2000-2009, 169,991 patients from 2010-2019, and 30,966 patients from 2020-present. When compared to the 2000s cohorts, the 1990s patients had a 47% decrease in risk of opioid related disorders, with a 53% decrease in risk of opioid dependence, 45% decrease in risk in opioid abuse, 11% decrease in risk of mental and behavioral disorders due to psychoactive substance use, and 63% reduced risk of intentional self-harm.Comparison of the 2000-2009 to 2010-2019 cohorts showed increased risk of opioid related disorders (RR= 1.912), opioid dependence (RR=1.569), opioid abuse (RR=1.677), mental and behavioral disorders (RR =1.733), and intentional self-harm (RR=2.027). When compared to 2020-present, the 2010-2019 patient cohort had 10 times the risk of developing opioid-related disorders, with 3 times the risk for opioid dependence and behavioral disorders, and 5 times the risk for opioid abuse and intentional self-harm.ConclusionsThe risk of opioid related disorders in the 1990s was lower compared to the 2000s. Since 2000, the risk of opioid related disorders has significantly increased. Recognizing the risks of opioid prescriptions in burn patients is imperative when addressing the role of physicians in controlling the constantly growing opioid epidemic.

82 Early Skin Excision Decreased the Risk of Skin Infection, Sepsis and Mortality Among Burn Patients

IntroductionIn lieu of outdated and limited patient studies on excision for severe burns, a more comprehensive analysis is indicated to determine the effects of early skin excision following burn. This study aims to address the outcomes of early excision.MethodsData collection and analysis was performed using TriNetX, a national research database. The study population included patients ranging from 0 to 90 years old who underwent excision for burns. Groups were stratified by the number of days after injury in which they received a skin excision treatment. Five outcomes were analyzed: death, cardiac stress, wound infection, blood transfusion, and sepsis. Risk and incidence of various health outcomes were compared between groups after matching for age, gender and race, using a z-test with p< 0.05 considered significant.ResultsWe identified 2,522 patients who underwent excision between 0-3 days, 825 between 4-7 days, and 419 between 8-14 days following burn. We found a significant decrease in risk of skin infection and sepsis for skin excision 0-3 days after burn compared to 4-7 days (p< 0.05). Additionally, the frequency of blood transfusion significantly increased for those with excision 0-3 days after burn when compared to 4-7 days (p< 0.05). There was a significant increase in the risk of mortality for patients who received skin excision 8-14 days after injury as compared to both 0-3 days (p< 0.05) and 4-7 days (p< 0.05). However, we found no statistical difference in cardiac stress, skin infection, blood transfusion or sepsis between 0-3 and 8-14 days nor 4-7 and 8-14 days.ConclusionsSkin excision 0-3 days after burn injury results in a significantly lowered risk of skin infection and sepsis as compared to skin excision 4-7 days and 8-14 days after burn. Skin excision within the first 7 days after burn decreased the risk of mortality as compared to excision 8-14 days after burn. The risk of blood transfusion increased with early excision, which may be explained by the severity of the injury.

Agricultural Research in Zimbabwe: An Author-level Bibliometric Analysis of Publication Outlets and Research Collaboration

What can be learnt from an application of author-level bibliometrics to the field of agricultural research in Zimbabwe for the period 2012–2016? The study addressed the question by integrating data from three sources: Scopus, the Web of Science and the National Research Database of Zimbabwe. A set of fifteen bibliometric indicators was constructed for 2,873 Zimbabwean authors, of which 248 (9%) were in agricultural sciences and 295 (10%) in multidisciplinary agricultural sciences. The indicators represented three dimensions: volume of article output, scholarly publication outlet and research collaboration. Results are discussed in terms of the Zimbabwean government’s policy for agriculture. Part of the lessons learnt calls for author-level bibliometric studies to connect more closely with the local, regional and global politics of knowledge production.

Tabagismo como hábito de vida de acadêmicos de Enfermagem e enfermeiros: uma revisão de literatura

O tabagismo é considerado uma epidemia e é a primeira causa evitável de doença e de morte prematura. Este estudo tem por objetivos: identificar o tabagismo entre acadêmicos de enfermagem e enfermeiros e descrever as ações de combate ao tabagismo realizadas por acadêmicos e enfermeiros. Questões norteadoras: Como se dá o tabagismo como estilo de vida entre acadêmicos de enfermagem e enfermeiros? Quais as ações de combate ao tabagismo realizadas por acadêmicos e enfermeiros? Trata-se de uma revisão literatura que trilhou as seguintes etapas: estabelecimento da hipótese e objetivos da revisão de literatura, estabelecimento de critérios de inclusão e exclusão de artigos. Foram selecionados no período de março de 2020. Foi estabelecido um recorte temporal de 5 anos, na intenção de mapear o processo de desenvolvimento de publicações mais recentes da temática no país, e utilizadas as seguintes bases de dados de pesquisa nacionais, utilizou-se a Biblioteca Virtual de Saúde (BVS). Posteriormente, os achados foram agrupados em categorias, de acordo com o conteúdo. O estudo traz à tona a preocupação com os acadêmicos de enfermagem e profissionais no sentido de estimular a adoção de hábitos mais saudáveis e responsáveis em seu estilo de vida.

Acolhimento à pessoa com transtorno do espectro autista: um desafio para assistência de Enfermagem

O acolhimento à pessoa com Transtorno do Espectro Autista (TEA) tem sido um desafio para as equipes de enfermagem, pois autismo é ainda um tema que demanda relevância. Este estudo tem por objetivos: identificar a importância da equipe de enfermagem diante do tratamento de uma pessoa com TEA, apresentar as características da pessoa com TEA que devem ser reconhecidas pela equipe de enfermagem e descrever como acontece a abordagem ao paciente com TEA. Trata-se de uma revisão literatura que trilhou as seguintes etapas: estabelecimento da hipótese e objetivos da revisão de literatura, estabelecimento de critérios de inclusão e exclusão de artigos. Foram selecionados no período de março de 2020.Foi estabelecido um recorte temporal de 5 anos, na intenção de mapear o processo de desenvolvimento de publicações mais recentes da temática no país, e utilizadas as seguintes bases de dados de pesquisa nacionais, utilizou-se a Biblioteca Virtual de Saúde (BVS). A partir da verificação dos artigos, foi percebido que há pouca incidência de artigos voltados para assistência/cuidados de enfermagem há pessoa com TEA, e que a maioria dos artigos relata transtorno em si e suas característica, e não especificamente a assistência/cuidado necessário. Cabe ao enfermeiro, a competência de investimento em sua equipe de trabalho, numa educação continuada em relação às pessoas com TEA, demonstrando assim para família que a equipe sabe lidar com o seu parente com TEA, que estão entre nós e necessitando de um acolhimento efetivo.

Continued publications by health science PhDs, 5 years post PhD-Defence

There is an increased focus on the outcomes of Health Science PhD-education, particularly if PhD-graduates remain active in research. There is a gap in our knowledge about the extent the investment in Health Science PhDs is moving science forward and no definition of expected investment return from PhD exists. We explore the research production of Danish Health Science PhDs, 5–9 years post PhD-defence, to find the fraction of PhD-graduates that are still actively publishing internationally. Secondary endpoints include analyses of the number of publications over time, identification of consecutive publishers, gender differences, and differences between medical doctors with a PhD (MDs) and non-MDs with a PhD. PhD-theses defended in 2005 and 2006 were identified and collected using the Danish National Research Database and via the four Danish universities offering Health Science PhD-programmes. Publication data were collected from Years 5 to 9 post PhD-defence to allow publications produced during the PhD-period to be washed out. Total 532 unique PhD-graduates (300 female and 232 male) produced a total of 4,530 PubMed-indexed publications. Results show zero publishers represented 31.2% (n = 166), while 25.8% (n = 137) of PhD-graduates published 10 or more publications during the 5-year observation window. Overall publication count increased from post PhD Years 5–9 with 68% (from 720 to 1,049). Number of publications did not differ between MDs and non-MDs. Our results evidence that not all graduates continue in research. Consequently, we need to identify early factors that make graduates remain in research, to identify future PhD-candidates that will continue publication post PhD.

Higher Risk of Intervertebral Disc Herniation among Neurosurgeons Than Neurologists: 15 Year-Follow-Up of a Physician Cohort.

High physical activity or workload has been associated with intervertebral disc degeneration. However, there is little data on physicians’ risks of disc disease. The study aimed to investigate the incidences of spinal problems among neurologists and neurosurgeons. A cohort of neurologists and neurosurgeons was derived from Taiwan’s national research database. During the study period, the incidences of intervertebral disc herniation or spondylosis among these specialists were calculated. Another one-to-one by propensity score matched cohort, composed of neurologists and neurosurgeons, was also analyzed. A Cox regression hazard ratio (HR) model and Kaplan-Meier analysis were conducted to compare the risks and incidences. The entire cohort comprised 481 and 317 newly board-certified neurologists and neurosurgeons, respectively. During the 15 years of follow-up, neurosurgeons were approximately six-fold more likely to develop disc problems than neurologists (crude HR = 5.98 and adjusted HR = 6.08, both p < 0.05). In the one-to-one propensity-score matched cohort (317 neurologists versus 317 neurosurgeons), there were even higher risks among neurosurgeons than neurologists (crude HR = 8.15, and adjusted HR = 10.14, both p < 0.05). Neurosurgeons have a higher chance of intervertebral disc disorders than neurologists. This is potentially an occupational risk that warrants further investigation.

Patients with chronic periodontitis are more likely to develop upper urinary tract stone: a nation-wide population-based eight-year follow up study.

BackgroundThe purpose of this study was to investigate the relationship between chronic periodontitis (CP) and upper urinary tract stone (UUTS) in Taiwan by using a population-based data set.MethodsA total of 16,292 CP patients and 48,876 randomly-selected controls without chronic periodontitis were selected from the National research database and studied retrospectively. Subjects selected have not been diagnosed with UUTS previously. These subjects were prospectively followed for at least eight years. Cox regression models were used to explore the connection between risk factors and the development of UUTS.ResultsThe CP patients have a greater chance of developing UUTS compared to controls (1761/16292, 10.8% vs. 4775/48876, 9.8%, p-values < 0.001). Conditioned logistic regression suggested CP increases the risk of UUTS development (HR 1.14, 95% CI [1.08–1.20], p < 0.001). After respective adjustment for age, gender, hypertension and diabetes, results showed that CP still increases the risk of developing UUTS (HR 1.14, 95% CI [1.08–1.20], p < 0.001).ConclusionBy using a population-based database with a minimum eight 8 follow-up of CP in Taiwan, we discovered patients with CP are more likely to develop UUTS.

PROTOCOL: Voluntary work for the physical and mental health of older volunteers.

PROTOCOL: Voluntary work for the physical and mental health of older volunteers.

Improving data quality in a UK out-of-hospital cardiac arrest registry through data linkage between the Out-of-Hospital Cardiac Arrest Outcomes (OHCAO) project and NHS Digital

Purpose: The Out-of-Hospital Cardiac Arrest Outcomes (OHCAO) project is a national research database, which aims to understand the epidemiology and outcomes of out-of-hospital cardiac arrests (OHCA) across the UK. This study is a sub-project of OHCAO and aimed to establish the feasibility of linking OHCAO data to National Health Service (NHS) patient demographic data and Office for National Statistics (ONS) mortality data held on the NHS Personal Demographics Service (PDS) database, through the NHS Digital list cleaning service, to improve data quality and establish accurate 30-day survival from OHCA.

Consumer attitudes towards the establishment of a national Australian familial cancer research database by the Inherited Cancer Connect (ICCon) Partnership.

Clinical genetics units hold large amounts of information which could be utilised to benefit patients and their families. In Australia, a national research database, the Inherited Cancer Connect (ICCon) database, is being established that comprises clinical genetic data held for all carriers of mutations in cancer predisposition genes. Consumer input was sought to establish the acceptability of the inclusion of clinical genetic data into a research database. A qualitative approach using a modified nominal group technique was used to collect data through consumer forums conducted in three Australian states. Individuals who had previously received care from Familial Cancer Centres were invited to participate. Twenty-four consumers participated in three forums. Participants expressed positive attitudes about the establishment of the ICCon database, which were informed by the perceived benefits of the database including improved health outcomes for individuals with inherited cancer syndromes. Most participants were comfortable to waive consent for their clinical information to be included in the research database in a de-identified format. As major stakeholders, consumers have an integral role in contributing to the development and conduct of the ICCon database. As an initial step in the development of the ICCon database, the forums demonstrated consumers' acceptance of important aspects of the database including waiver of consent.