Phone Contact Research Articles

Multidisciplinary protocol to reduce surgical readmissions in Australia: American College of Surgeons National Surgical Quality Improvement Program.

Unplanned readmissions in general surgery are an important quality indicator of patient care and are associated with increased costs to healthcare services. This study aims to implement a multidisciplinary protocol in a single institution in a tertiary referral hospital to monitor and reduce unplanned readmission rates. A prospective cohort study using an institution-based protocol was conducted over an 18-month period including patients undergoing a general surgical procedure. The protocol included: (i) implementation of a surgical readmissions nurse-patient liaison; (ii) access to a surgical walk-in clinic; and (iii) early post-discharge phone contact. Data included demographic details, index procedure, hospital length of stay (LOS), and whether contact between patient/nurse occurred upon discharge. The primary outcome was the cause and rate of 30-day readmissions. Secondary outcomes were mortality, use of surgical clinic, emergency department presentations, and complications. After protocol implementation, 874 patients underwent a general surgical procedure, with 354 (49%) being male and an overall median age of 53.0 years (interquartile range: 36.0-67.0). The overall readmission rate was 5.6% (n = 49), with a median LOS after readmission of 4 days. Compared with historical pre-protocol ACS-NSQIP data, this reflects a 30% reduction compared to that of readmission rate of 7.9%, P = 0.03. The multidisciplinary protocol was efficacious in significantly reducing unplanned readmissions. Continued audits and monitoring of factors associated with readmissions are required to help design targeted projects that may lead to improved outcomes, lower costs, increased patient satisfaction, and better efficiency within our healthcare system.

Gender inequality in intergenerational contact after parental separation in the digital era

AbstractObjectiveThe goal of this brief report is to analyze parent‐adult child contact frequency in intact and non‐intact families by focusing on parent and child gender and the type of contact.BackgroundParental separation increases gender differences in parent–child relationships, with separated fathers having less frequent contact with their adult children compared to separated mothers. We investigate whether the father–mother gap in post‐separation contact varies according to parent–child gender mismatch and the type of contact, that is, face‐to‐face, phone, or digital (e.g., via video calls).MethodWe use data on Italian families from the Family and Social Subjects survey to examine parent–child contact frequency among 6770 adult children aged 30–55 (11,041 parent–child dyads). We estimate random and fixed effects models on the probability of having frequent contact with biological parents in intact and non‐intact families (parental separation before age 18).ResultsFathers' reduced contact frequency compared to mothers is particularly evident with daughters, more pronounced in face‐to‐face and phone contact than in digital contact, and greater among younger daughters at the time of separation. Gender differences in phone and digital contact are larger for fathers who have also less frequent face‐to‐face contact compared to mothers.ConclusionWe interpret these findings by focusing on the centrality of mother–daughter ties and the loyalty that children have with the same‐gender parent. We also suggest that different types of contact reinforce gender differences between parents and may lead to a polarization of older parents with “strong” and “weak” family ties.

Contact resolution among Veterans Crisis Line phone andtext contacts regarding Veterans Health Administration enrollees.

To expand access to suicide prevention and support services, the Veteran Crisis Line (VCL) added text capabilities in 2011. It is unknown whether the likelihood of a contact being terminated by the user varies by contact type. We aimed to assess whether contact resolution varies by contact type after accounting for Veterans' sociodemographic and clinical characteristics, contact risk, and reasons for contact. A retrospective cohort study of VCL phone and text contacts regarding identified VHA enrollees between 2016 and 2021 was performed. To examine differences in contact resolution between contact types, inverse probability of treatment weights were used to balance characteristics of text and phone contacts. Relative to phone contacts, text contacts were associated with 3.39 percentage point (PP) (95% CI, 3.27-3.50; p < 0.001) lower likelihood of receiving an emergency dispatch/welfare check, 2.65 PP (95% CI, 2.55-2.76; p < 0.001) lower likelihood of requiring arrangement for same-day care, and 9.47 (95% CI, 9.34-9.59; p < 0.001) PP higher likelihood of being terminated by the user. VCL text contact was associated with an increased likelihood of being terminated by the user. Further investigation is needed to understand the reasons for terminating contact for those who texted VCL.

Partner Characteristics and HIV Outcomes among Partners Reached by Phone vs. In-person for Assisted Partner Services in Western Kenya.

Assisted partner services (APS) is an effective strategy for testing people with undiagnosed HIV but there is limited information on the relative reach and effectiveness of phone versus in-person contact. We analyzed data from 31 facilities in Western Kenya providing APS to female index clients newly HIV-diagnosed, their male partners, and female partners of men newly HIV-diagnosed. APS providers attempted contacting partners using phone first and, if unsuccessful, in-person in the community. Using log-linear mixed models, we estimated relative risks (RR) between phone being the final contact method and partner characteristics and HIV outcomes. From May 2018-March 2020, 2534 female index clients named 7614 male partners, of whom 772 (10.1%) tested positive and named an additional 4956 non-index female partners. Of 11,912 (94.7%) partners reached, 5179 (43.5%) were via phone and 6733 (56.5%) in-person. Of 8076 testing-eligible partners, 99.7% tested and 11.2% first-time tested. Of those tested, 13.1% were newly-diagnosed, of whom 87.0% linked to care. Newly-diagnosed partners were less likely to have been reached by phone vs. in-person (9.8% vs. 15.9%; adjusted RR:0.61, 95%CI:0.53-0.70). Being reached by phone was not significantly associated with testing, first-time testing, or linkage to care. In an APS program that reached 94% of elicited partners, fewer than half were successfully contacted by phone. A combined phone and in-person approach is likely essential for equitable, effective APS.

Improving post-injury follow-up survey response: incorporating automated modalities

BackgroundIncorporating post-discharge data into trauma registries would allow for better research on patient outcomes, including disparities in outcomes. This pilot study tested a follow-up data collection process to be incorporated into existing trauma care systems, prioritizing low-cost automated response modalities.MethodsThis investigation was part of a larger study that consisted of two protocols with two distinct cohorts of participants who experienced traumatic injury. Participants in both protocols were asked to provide phone, email, text, and mail contact information to complete follow-up surveys assessing patient-reported outcomes six months after injury. To increase follow-up response rates between protocol 1 and protocol 2, the study team modified the contact procedures for the protocol 2 cohort. Frequency distributions were utilized to report the frequency of follow-up response modalities and overall response rates in both protocols.ResultsA total of 178 individuals responded to the 6-month follow-up survey: 88 in protocol 1 and 90 in protocol 2. After implementing new follow-up contact procedures in protocol 2 that relied more heavily on the use of automated modalities (e.g., email and text messages), the response rate increased by 17.9 percentage points. The primary response modality shifted from phone (72.7%) in protocol 1 to the combination of email (47.8%) and text (14.4%) in protocol 2.ConclusionsResults from this investigation suggest that follow-up data can feasibly be collected from trauma patients. Use of automated follow-up methods holds promise to expand longitudinal data in the national trauma registry and broaden the understanding of disparities in patient experiences.

Loneliness and Mode of Social Contact in Late Life.

Social contact may alleviate loneliness, but little is known about within-person daily fluctuations in loneliness and social encounters. Older adults who feel lonely may engage in different modes of social contact (in-person, phone, digital). This study asked how different forms of contact are associated with loneliness throughout the day. Participants were 313 community-dwelling older adults (aged 65-90). They completed ecological momentary assessments reporting on their social encounters (e.g., type of social partner, mode of contact) and their loneliness every 3 hr for 5-6 days. We differentiated close social ties from ties not identified as close (i.e., weak ties). We examined within-person effects using multilevel models. Findings revealed that momentary loneliness predicted a greater likelihood of phone contact in the next 3 hr. However, only in-person contact was associated with lower levels of loneliness. Regarding close and weak ties, momentary loneliness was associated with more in-person and phone contact with close ties, yet fewer in-person contacts with weak ties. In-person contact with both close and weak ties predicted lower levels of loneliness. Although older adults engage in both in-person and phone contact when they feel lonely, it appears that only in-person contact may reduce loneliness. Digital contact was not widely adopted as a response to momentary loneliness among these older adults. Findings underscore older adults' willingness to maintain regular contact with close ties. Interventions addressing older adults who are lonely may consider innovative approaches to increase in-person contact.

Risk Factors for Positive Resection Margins in Breast-Conserving Surgery for Breast Cancer-Retrospective Analysis.

The primary objective of this study was to identify preoperative factors that could be associated with positive resection margins. We also tried to analyze the local recurrence and overall survival in patients who received conservative treatment for early-stage breast cancer and correlate these parameters with preoperative factors. A retrospective examination was conducted on the medical records and pathological reports of 143 patients who underwent breast-conserving surgery (BCS) for breast cancer in our department from 2009 to 2017. Postoperative outcomes were assessed through phone contact and statistical analyses, including GraphPad Prism, and Fisher's exact test, the Chi-square test, and the log-rank test were employed. The results revealed positive resection margins in 7.69% (11 cases) of the 143 patients, with an overall mortality rate of 16.66% for those with positive margins and 6.59% for those with negative margins. Statistical analysis indicated no significant differences in the overall (p = 0.5) or specific (p = 0.53) survival between the positive and negative margin groups. The positive margins were significantly associated with neoadjuvant chemotherapy (p < 0.0001) and the presence of ductal carcinoma in situ (DCIS) (p = 0.01). Among the analyzed factors, two out of sixteen were significantly linked to positive resection margins in BCS, emphasizing their importance in surgical management planning for early-stage breast cancer.

The Physician Is on Campus

Abstract The purpose of this project was to determine if physician participation in simulation affects students’ perceptions of nurse/physician communication and collaboration. Fifty-five students participated in six groups. Three groups had a physician present and involved during their eight-hour pediatric simulation; the others continued with current practice, which involved phone contact with an individual posing as a physician. There was a statistically significant difference in two items on the Nurse Attitudes About Communicating and Collaborating With Physicians tool when pre- and post-simulation means were compared. Findings are consistent with previous research, indicating simulation-based learning can improve students’ perceptions of nurse-physician collaboration.

#596 The Borg Scale—efficient and safe for exercise prescription in self-administered balance and strength exercise in patients with CKD

Abstract Background and Aims With the continued rise in chronic kidney disease (CKD), there is a critical need for sustainable, home-based exercise interventions. While supervised, centre-based exercise improves physical performance in CKD patients, unsupervised, self-administered exercise poses challenges in ensuring adherence, safety, and efficacy. This study investigates the Borg Rating of Perceived Exertion (RPE) scale, a subjective measure of exertion, as a method for prescribing and monitoring the intensity of balance and strength exercise in non-dialysis dependent CKD patients. The aims of this study were: Method This sub study of the RENEXC-trial included 148 patients with CKD stages 3-5, with a mean age of 66 ± 14 years and mean measured GFR of 22 ± 8 ml/min/1.73 m2. Patients were prescribed 90 minutes/week of balance or strength exercise at a Borg RPE of 13-17 (corresponding to an exercise intensity of somewhat hard to very hard), along with 60 minutes/week of endurance exercise. Exercise programs were individually prescribed by a physiotherapist according to randomization and each patient's baseline performance and were performed at home or in a gym according to the patient's preference. Duration and RPE of the performed exercise were reported in an exercise diary. Progress was monitored by the physiotherapist through phone contact, every week for the first three months of the study and every other week for the rest of the study year. The continuous follow up provided motivation and enabled adjustments of the exercise program to maintain the goal RPE, adapt intensity and the weekly duration of exercise. Outcome measures included the Berg Balance Scale (BBS) and Functional Reach Test (FRT), the 30-second sit-to-stand test (30STS) and isometric quadriceps strength (IQS). Balance and strength measures were evaluated at baseline and after 12 months of exercise. Previous publications of the RENEXC-trial showed no difference between patients who performed balance exercise and patients who performed strength exercise; therefore, this sub-study analysed all included patients as one group. Results Of 148 participants, 112 completed the study. At 12 months, 79% reported performed exercise, with 86% of these patients adhering to the prescribed intensity. The median (25th-75th percentile) exercise intensity was a RPE of 14 (13-15) on the Borg scale, and the median (min-max) exercise duration was 48 (0-241) minutes/week. Only 18% of the patients reached the 90-minute/week target. No exercise-related incidents were reported. Significant improvements were noted in BBS (p = 0.0464), FRT (p = 0.009), 30STS (p = 0.047), and IQS (right/left p = 0.022 / p = 0.049). Conclusion The Borg RPE scale is an effective and safe method for prescribing and monitoring self-administered balance and strength exercise in patients with CKD. Using the Borg scale for prescribing and monitoring exercise intensity during balance and strength exercise resulted in a good level of adherence to the 12-months exercise program and the prescribed exercise intensity. As no exercise related incidents were reported, we conclude that the self-administered exercise was safe to perform. Significant improvements in balance and strength were observed with a moderate to high exercise intensity prescription within a wide range of performed weekly duration of exercise, suggesting the Borg scale's value in exercise prescription in both well- and deconditioned patients with CKD. These findings show that the integration of the Borg scale into routine exercise prescription in people with CKD can promote patient autonomy and efficient resource utilization in healthcare.

Prevalence of high-risk human papillomavirus genotypes in outpatient Malian women living with HIV: a pilot study.

Long-term exposure to high-risk human papillomavirus (Hr-HPV) is a well-known necessary condition for development of cervical cancer. The aim of this study is to screen for Hr-HPV using vaginal self-sampling, which is a more effective approach to improve women's adherence and increase screening rates. This pilot study included a total of 100 Women living with HIV (WLWHIV), recruited from the Center for Listening, Care, Animation, and Counseling of People Living with HIV in Bamako. Hr-HPV genotyping was performed on Self-collected samples using the Cepheid GeneXpert instrument. The median age of WLWHIV was 44 (interquartile range [IQR], 37-50) years. Approximately 92% of the study participants preferred self-sampling at the clinic, and 90% opted to receive result notifications via mobile phone contact. The overall prevalence of Hr-HPV among study participants was 42.6%, and the most frequent Hr-HPV sub-types observed were HPV18/45 (19.1%), HPV31/35/33/52/58 (13.8%), and HPV39/68/56/66 (12.8%), followed by HPV16 (5.3%), and HPV51/59 (5.3%). WLWHIV under 35 years of age had a higher frequency of Hr-HPV compared to their older counterparts, with rates of 30% versus 11.1% (p = 0.03). The duration of antiretroviral treatment showed an inverse association with Hr-HPV negativity, with patients on treatment for 15 (IQR, 10-18) years versus 12 (IQR = 7-14) years for Hr-HPV positive patients (95% CI [1.2-5.8], t = 3.04, p = 0.003). WLWHIV with baseline CD4 T-Cell counts below 200 exhibited a higher frequency of Hr-HPV compared to those with baseline CD4 T-Cell counts above 200 (17.9% versus 1.9%, p = 0.009). However, other demographics and clinical factors, such as marital status, age of sexual debut, parity, education, history of abortion, history of preeclampsia, and cesarean delivery, did not influence the distribution of Hr-HPV genotypes. Our findings indicate that WLWHIV under the age of 35 years old exhibited the highest prevalence of Hr-HPV infection, with HPV18/45 being the most prevalent subtype. Additionally, WLWHIV with baseline CD4 T-Cell counts below 200 showed the highest infection rates.

What does clean energy attract? Evidence from the transfer structure of energy-intensive projects in China

The transfer of energy-intensive projects to areas abundant in clean energy resources holds promise for optimizing the energy structure. After obtaining specific information on transferred projects of listed energy-intensive firms through search or phone contact, this paper innovatively constructs a three-dimensional panel containing 1,859,220 observations to empirically examine the attraction of clean energy to energy-intensive projects under the carbon intensity constraint policy (CICP). Our findings reveal that: (1) the CICP promotes the transfer of gray energy-intensive projects, leading to the transfer structure trending towards graying. (2) Furthermore, we observe a positive correlation between the proportion of thermal power in transfer-out areas and the outflow of gray energy-intensive projects. Conversely, areas with higher wind power and photovoltaics attract a greater inflow of gray energy-intensive projects. (3) Notably, clean energy predominantly attracts the inflow of gray projects rather than green projects. Our findings provide micro evidence and valuable insights into the transfer of energy-intensive industries, informing the design and implementation of future environmental policies for policymakers and stakeholders.

Survival Trends in Hepatocellular Carcinoma Patients with Portal Vein Tumor Thrombosis: A 3-Month Outcome Assessment

Objective To assess the survival trends among hepatocellular carcinoma (HCC) patients presenting with portal vein tumor thrombosis (PVTT) over a 3-month period. Methodology: This descriptive case series study was conducted at Gastroenterology and hepatology department of Asian Institute of Medical Sciences, Hyderabad from March 2019 to September 2019. Patients of all age groups, both genders diagnosed with hepatocellular carcinoma based on ultrasonography and CT scan imaging as well as screening alpha fetoprotein levels, with evidence of portal vein tumor thrombosis (PVTT) detected through imaging modalities and patients with available medical records containing relevant clinical, laboratory, and imaging data were included. To monitor the survival status of patients, a three-month follow-up period was initiated, facilitated through regular follow-up and phone contact. Throughout this follow-up period, records were maintained, and all relevant data were entered and analyzed using SPSS version 26. Results: The mean age of the patients was 56.4 years, with a standard deviation of 5.7 years. Average Body mass index (BMI) was 23.4 kg/m². Majority of participants were male 80.0%, while females were 20.0%. Regarding the three-month survival rate, only 17.5% of the patients were found to have survived during and remaining patients did not survive. The three-month survival rate did not show statistically significant differences across various demographic factors such as patients' age, gender, and BMI categories (p ? 0.05). Conclusion: Study revealed poor survival outcomes among patients diagnosed with portal vein tumor thrombosis associated with hepatocellular carcinoma, with only 17.5% of patients surviving rat. The overwhelming majority, died to this aggressive malignancy within the observed timeframe.

Assess the Knowledge Regarding Nomophobia and Its Prevention among Nursing Students at Selected Nursing College, Lucknow with a View to Develop an Information Booklet

“Assess the knowledge regarding Nomophobia and its prevention among nursing students at selected nursing college, Lucknow with a view to develop an information booklet”. In Today’s Contemporary digital and virtual society, anxiety is the affliction of life. Social media and digital communication have become a part of life. Many things were made easy through online connectivity. The mobile phones not only connect people at anytime, anywhere and with anybody, but also movable and portable. A new addition to the stress list is ‘Nomophobia’, the fear of being out of mobile phone contact. This may cause a number of physical and psychological problems. In nomophobia people, especially teenagers, get very anxious when they lose their mobile phone, run out of battery or credit or due to led network coverage. This study is a preliminary investigation of extent of knowledge regarding nomophobia and its prevention level in a college of nursing where sample were 114 students (B.Sc(N) first and second year students). This study was conducted using a knowledge questionnaire, and information booklets.

Acceptability of automatic referrals to supportive and palliative care by patients living with advanced lung cancer: qualitative interviews and a co-design process

PurposeTimely access to supportive and palliative care (PC) remains a challenge. A proposed solution is to trigger an automatic referral process to PC by pre-determined clinical criteria. This study sought to co-design with patients and providers an automatic PC referral process for patients newly diagnosed with stage IV lung cancer.MethodsIn Step 1 of this work, nine one on one phone interviews were conducted with advanced lung cancer patients on their perspectives on the acceptability of phone contact by a specialist PC provider triggered by an automatic referral process. Interviews were thematically analysed. Step 2: Patient advisors, healthcare providers (oncologists, nurses from oncology and PC, clinical social worker, psychologist), and researchers were invited to join a working group to provide input on the development and implementation of the automatic referral process. The group met biweekly (virtually) over the course of six months.ResultsFrom interviews, the concept of an automatic referral process was perceived to be acceptable and beneficial for patients. Participants emphasized the need for timely support, access to peer and community resources. Using these findings, the co-design working group identified eligibility criteria for identifying newly diagnosed stage IV lung cancer patients using the cancer centre electronic health record, co-developed a telephone script for specialist PC providers, handouts on supportive care, and interview and survey guides for evaluating the implemented automatic process.ConclusionA co-design process ensures stakeholders are involved in program development and implementation from the very beginning, to make outputs relevant and acceptable for stage IV lung cancer patients.

Depression and Medierranean diet: analysis of the PREDIDEP randomised trial

IntroductionUnipolar depression is a growing global Public Health challenge. During last years, life factors such as diet, have been identified as a target for the development of adjunctive treatment that could reduce the rates of depression. The Mediterranean Diet (MD) is one of the most studied dietary factors that has been inversely associated with depression (Rahe et al. Eur J Nutr. 2014;53:997–1013). The PREDIDEP study is an ongoing secondary prevention trial aimed at assessing the effect of a MD enriched with extra virgin olive oil (EVOO) on depression recurrence (Sánchez-Villegas et al. BMC Psychiatry. 2019 Feb 11;19(1):63).ObjectivesThis study aims to assess the effectiveness of a remote Mediterranean diet–based nutritional intervention in the context of a trial of depression.MethodsThe PREDIDEP study is a 2-year multicenter, randomized, single-blinded trial designed to analyse the effect of the MD enriched with extra virgin olive oil (EVOO) on the prevention of depression recurrence. The inervention group received phone contacts with dietist and had access to web-based information, and the control group had usual care for depressed patients. The 14-item MD Adherence Screener (MEDAS) questionnaire and a semiquantitative food frequency questionnaire (FFQ) were collected by dietitians at baseline and at 1-year and 2-year of follow-up. We used mixed effects linear models to assess changes in nutritional variables according to the group of intervention. The trial was registered at ClinicalTrials.gov NCT03081065.ResultsWe observed that participants in the MD group increased their adherence to MD (between-group difference: 2.50; 95% CI 1.88-3.12; p&lt;0.001) after one and two years (between-group difference: 2.57; 95% CI 1.93-3.22; p&lt;0.001) of intervention compared with control group. MEDAS questionnaire Control, mean (95% CI) Intervention, mean (95% CI) Between group difference, mean (95% CI)P valueBaseline6.96 (6.54-7.39)7 (6.63-7.39)N/AN/A1 year7.2 (6.82-7.58)9.74 (9.3-10.18)N/AN/A1-year change0.23 (-0.19-0.65)2.74 (2.28-3.19)2.50 (1.88-3.12)&lt;0.0012 years7.06 (6.66-7.46)9.68 (9.28-10.07)N/AN/A2-years change0.10 (-0.38-0.58)2.67 (2.24-3.1)2.57 (1.93-3.22)&lt;0.001Calculated using mixed-effect models with center as random factor.P value between group intervention difference.N/A: not applicable.MEDAS: Mediterranean Diet Adherence ScreenerConclusionsWe found that this multifaceted remote nutritional intervention is a useful tool kit to maintain the quality of the diet according to the goals of the MD among patients at risk of depression.Disclosure of InterestNone Declared

Impact of Clinical and Sociodemographic Factors on Quality of Life Following Coronary Artery Bypass Grafting: A Mixed-Methods Study.

Coronary artery bypass grafting (CABG) is an essential surgical management modality for patients with coronary artery disease. Health-related quality of life (HRQoL) has become important because of the significant decrease in the mortality rate associated with CABG. We aimed to explore the factors that affect the quality of life after CABG. This study used a descriptive correlational design to assess the determinants of HRQoL using the 36-item Short Form Health Survey questionnaire (SF-36). Patients who underwent CABG at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia, between March 2015 and December 2021 were enrolled in this study. Overall, 275 participants were eligible for our study, of which 84 were found to be valid for analysis. Phone contacts were made directly with the patient after briefly explaining the study. Scores and clinical data were investigated using multivariable linear regression analysis. Subscales of role limitations due to physical issues had the lowest mean scores, followed by vitality and general health (57.4 ± 44.7; 60.4 ± 25.6; 64.1 ± 22.6), respectively. However, social functioning (78.9 ± 29.0) and pain (75.1 ± 29.9) had the highest scores of all subscales. A history of congestive heart failure (CHF) was independently associated with lower scores for physical role limitations (p = 0.021), vitality (p = 0.001), general health (p< 0.001), and mental health (p = 0.011). Lower mental health scores were also predicted by being a widow (p = 0.030), whereas lower general health scores were predicted by being unemployed (p = 0.001) and having a peripheral vascular disease (PVD) (p = 0.043). Additionally, the development of postoperative complications was an independent predictor of lower physical functioning (p = 0.028) and vitality (p = 0.043). Regarding the number of grafts, cardiopulmonary bypass, and cross-clamp time, no significant impact was found on any of the SF-36 subscales (p> 0.05). The postoperative decline in HRQoL was attributed to comorbidities such as CHFand PVD, postoperative complications including bleeding and wound infection, as well as unemployment and widowed status. Therefore, choosing the appropriate patients for surgery and post-discharge follow-up may enhance HRQoL.

Vertebral Fracture and Its Outcomes in Emergency Patients of Kowsar Hospital in Sanandaj: An Epidemiological Study

Background: Vertebral fracture, one of the most incidents in human life, is associated with many complications. Due to the importance of this complication, this study was conducted to epidemiologically investigate vertebral fractures and their consequences in the emergency department of Kowsar Hospital in Sanandaj in 2017. Methods: In this retrospective cross-sectional study, 350 patients who visited the emergency department of Kowsar Sanandaj Hospital in 2017 due to vertebral fractures were included. The data was extracted from information collected through phone contact and patients’ medical documents. V Kramer and ETA tests were performed to analyze the hypotheses using SPSS 25 software. Results: Men constituted 61% of the patients. The average age of the patients was 42.18 (6.86) years, and almost 41% of the patients lived in Sanandaj. The most common trauma mechanism was fall injury with 44.8%, 59.55% of which were in the lumbar region. Compression and burst fractures had the highest fracture rates with 47.85 and 21.9 percent, respectively. Conclusion: According to the findings, the fractures were more prevalent in men, young people, and in labor and agricultural occupations, and there is a significant relationship between the consequences of fractures with age, sex, and occupation, which indicates the need for more safety considerations in these people. Therefore, it is necessary to identify and subsequently modulate the risk factors associated with falling injuries to reduce this type of injury.

User Experience of Access to Sexual Assault Nurse Examiner and Emergency Contraception in Emergency Departments in the United States: A National Survey.

Despite the prevalence of sexual assault presentations to emergency departments (ED) in the United States, current access to sexual assault nurse examiners (SANE) and emergency contraception (EC) in EDs is unknown. In this study we employed a "secret shopper," cross-sectional telephonic survey. A team attempted phone contact with a representative sample of EDs and asked respondents about the availability of SANEs and EC in their ED. Reported availability was correlated with variables including region, urban/rural status, hospital size, faith affiliation, academic affiliation, and existence of legislative requirements to offer EC. Over a two-month period in 2019, 1,046 calls to hospitals were attempted and 960 were completed (91.7% response rate). Of the 4,360 eligible hospitals listed in a federal database, 960 (22.0%) were contacted. Access to SANEs and EC were reported to be available in 48.9% (95% confidence interval [CI] 45.5-52.0) and 42.5% (95% CI 39.4-45.7) of hospitals, respectively. Access to EC was positively correlated with SANE availability. The EDs reporting SANE and EC availability were more likely to be large, rural, and affiliated with an academic institution. Those reporting access to EC were more likely to be in the Northeast and in states with legislative requirements to offer EC. Our results suggest that perceived access to sexual assault services and emergency contraception in EDs in the United States remains poor with regional and legislative disparities. Results suggest disparities in perceived access to EC and SANE in the ED, which have implications for improving ED practices regarding care of sexual assault victims.

An Innovative Topical Medical Device with Hyaluronic Acid and Polypeptides in Patients with Reduced Knee Function.

A topical medical device, AI500®, constituted of a single-chain polypeptide embedded in hyaluronic acid, was tested and evaluated in patients with reduced knee function due to osteoarthritis and other knee conditions. A total of 35 participants with reduced knee function assessed by the WOMAC Physical Function score were recruited. Four study visits were planned, from the first application at V0 to 1 week follow up at V3. Patient symptomatology was evaluated after 24 h (V1) and after 48 h (V2) through phone contact, and after 1 week from V0, on site (V3). The overall duration of the follow up was one week. An amelioration of 40% in WOMAC Physical Functional scores after 1 week of treatment was recorded, thus achieving the primary endpoint of 20%. Furthermore, a reduction of 29% in Physical Functional scores and of 28% in total WOMAC scores between V0-V2 was registered, together with a decrease of 39% between V0 and V3. The NRS scale showed a 29% and 37% reduction in pain between V0-V1 and V0-V2, respectively. Product safety was confirmed by the very low rate of adverse effects, non-device related, observed in only 2 patients out of 35, resolved spontaneously within 24-48 h. No safety concerns or risks associated with the use of the device were highlighted. There are few the studies on the topical use of HA-based gels for the treatment of knee problems. Compared to invasive intra-articular injections and oral pharmacological therapies used in cases of knee pain, the topical application of AI500® is non-invasive, safe, and appreciated by patients. Good results in terms of functional improvement and symptoms resolution were obtained in less than 1 week.

Factors associated with postoperative quality of life in patients with intertrochanteric fracture

Introduction: Intertrochanteric fractures, which make up the majority of hip fractures, are a common and serious injury that can greatly impact quality of life. Treatment of such fractures comprises nearly half of the costs contributed to hip fractures. Identifying the factors affecting the functional outcomes of patients after intertrochanteric fracture can help to reduce burden of disease for the patient and healthcare system. The present study investigated the factors underlying the worsening of short form-36 score (SF-36) scores for intertrochanteric fracture patients. Materials and methods: This retrospective cohort study was designed based on data from our clinic. All consecutive patients with intertrochanteric fractures from November 2016 to September 2020 were reviewed. The exclusion criteria included patients having a second injury or having had previous surgery related to the hip and those with incomplete data. Baseline characteristics of patients were extracted from annotated records. The lab data were acquired from the electronic hospital system. The outcomes were SF-36 scores obtained by phone contact with patients or their families. Statistical analysis was conducted in SPSS. Results: A total of 310 patients were included in the current study. The female gender, advanced age, history of diabetes, thyroid malfunction, cancer, osteoporosis, anticoagulant use and blood transfusion were identified as risk factors for lower SF-36 scores. Low levels of haemoglobin before surgery, blood urea nitrogen (BUN), BUN/Creatinine, and white blood count values correlated with lower SF-36 scores. Conclusion: Numerous contextual variables affected the functional outcomes of the patients. Consideration of these factors could be helpful in reducing costs and improving the quality of life for intertrochanteric fracture patients.