Panel Of Professionals Research Articles

Does compassionate nurse leadership exist in practice, or just in theory?

Our panel of nurses and healthcare professionals consider a topical nursing issue and share their views in a personal capacity only

PERMANOVA testing and Poisson Log-Normal modelling unravel how two traditional cheeses are distinguished through sorting and verbalization tasks

This study uses two statistical methods (PLN modelling and PERMANOVA) to investigate the differences in the ways in which different panels perceive and describe two French uncooked PDO cheeses in a free sorting task and then in a verbalization task.Panelists studied 10 cheeses from two categories Salers and Cantal cheese made from Salers-breed cow’s milk or cow’s milk from other breeds. We selected three types of panel based on their technical expertise in relation to the supply chain (professional technical experts, wholesalers, and consumers) and verified their level of expertise using a knowledge questionnaire to test o their knowledge of cheese in general and Salers and Cantal cheeses in particular. Data from the sorting task was analyzed using the DISTATIS method, and data from the verbalization task was analyzed using a basic correspondence analysis. Furthermore, we employed an original approach mobilising PERMANOVA and a Poisson log-normal (PLN) model enabling us to investigate and quantify which exogeneous variables contribute most to explain verbalization data.The results unsurprisingly showed broadly overlapping cheese configurations between the three panels. However, none of the panels clearly separated Cantal from Salers cheeses. In the verbalization task, different types of panel used different sets of terms to describe the categories. The professional panel preferentially used descriptive terms related to flavor whereas the wholesaler and consumer panels both tended to use quantitative (intensity) and hedonic terms. PLN modelling revealed that the knowledge variable was one of the variables that best explains the use of different word categories between panels. PERMANOVA testing and PLN modelling emerged as novel approaches for identifying the key variables that explain the use of terms in the description task.

Public Perceptions of Harms and Benefit of COVID-19 Immunity Certificate: A Cross-Sectional Study in the Italian Setting.

A cross-sectional survey between 29 January 2022 and 3 February 2022 was conducted to understand the public rationale for accepting or rejecting the use of COVID-19 immunity certificates and to identify the psychosocial factors that mostly predict the positive/negative individuals’ perceptions of this measure. One thousand twenty-two Italian adults were recruited by a professional panel provider by employing a stratified sampling strategy controlled for gender, age, geographical area of residence, size of the urban centre of residence, employment, and wage. Eight Welch’s ANOVAs were then carried out to compare the perception of benefits and the perception of harms among different population groups. Multiple linear regression was carried out to measure the explained variance of benefits perception and harms perception by age, trust in institutions, and concern for health emergencies. The results shows that age, trust in institution, and concern for the COVID-19 emergency explain more variance of perceived benefits than of perceived harms of COVID-19 immunity certificates but the opposite regarding political orientation which explains perceived harms better than perceived benefits. The need for policy improvements is pressing because a large share of the world’s population remains unvaccinated. Moreover, our results can serve as vital information for similar health crises that may occur in the future. In addition, our results are expected to offer useful insights into public feelings around the use of digital health information tools.

Gaps and barriers in the implementation and functioning of antimicrobial stewardship programmes: results from an educational and behavioural mixed methods needs assessment in France, the United States, Mexico and India.

BackgroundEvidence shows limited adherence to antimicrobial stewardship (AMS) principles.ObjectivesTo identify educational gaps and systemic barriers obstructing adherence to AMS principles.MethodsA mixed-methods study combining a thematic analysis of qualitative interviews (January–February 2021) and inferential analysis of quantitative surveys (May–June 2021) was conducted. Participants from France, the USA, Mexico and India were purposively sampled from online panels of healthcare professionals to include infectious disease physicians, infection control specialists, clinical microbiologists, pharmacologists or pharmacists expected to apply AMS principles in their practice setting (e.g. clinic, academic-affiliated or community-based hospital). A gap analysis framework guided this study.ResultsThe final sample included 383 participants (n = 33 interviews; n = 350 surveys). Mixed-methods findings indicated suboptimal knowledge and skills amongst participants to facilitate personal and collective application of AMS principles. Survey data indicated a gap in ideal versus current knowledge of AMS protocols, especially amongst pharmacologists (Δ0.95/4.00, P < 0.001). Gaps in ideal versus current skill levels were also measured and were highest amongst infectious control specialists (Δ1.15/4.00, P < 0.001), for convincing hospital executives to allocate resources to AMS programmes. Already existing systemic barriers (e.g. insufficient dedicated time/funding/training) were perceived as being aggravated during the COVID-19 pandemic (72% of survey participants agreed). Reported gaps were highest in India and France.ConclusionsThe educational needs of professionals and countries included in this study can inform future continuous professional development activities in AMS. Additional funding should be considered to address perceived systemic barriers. Local assessments are warranted to validate results and suitability of interventions.

Partner with legal counsel to navigate compliance issues

LAS VEGAS — Compliance administrators can more effectively navigate the ongoing changes in college athletics by building partnerships with legal counsel. That's according to a panel of legal and compliance professionals who spoke at the annual convention for the National Association for Athletics Compliance. The panel was moderated by Todd Vardaman, Senior Associate Athletic Director for Administration at the University of North Alabama.

Drivers and Challenges for Implementing Sustainability-oriented Upgrading in Social Housing in Brazil

Social housing (SH) development is, in general, triggered by policies and regulations, which stimulate interventions, create financing mechanisms, and designate agents conducive to retrofit processes. European directives for energy efficiency and the recent call for a ‘retrofit wave’ have an evident influence. In Brazil, delivery and management of SH are based on the public offer of housing units and their immediate ownership transfer. National or state housing agencies are responsible for basic maintenance for five years, but other post-delivery interventions depend exclusively on the effort and expenses of the occupant. SH budgets leave little or no margin for extra spending and bringing SH to international sustainability standards is yet not mandatory. The issues that arise to implement upgrading in this context are therefore related to the following questions: What are the priority actions in upgrading processes? What type of financing would be required or is available? What is the project execution model and who are the stakeholders involved? This article focuses on the issue of prioritization of actions for upgrading SH. A systematic literature review examined reported sustainability-related housing improvements. A critical review of a Brazilian building label and two international sustainability assessment methods then supported ranking the upgrading actions according to the relevance assigned in their respective contexts. Finally, a panel of construction professionals provided insights regarding the technical feasibility and intrusiveness of their implementation in both single- and multi-family SH projects. Findings show that minor upgrading actions, such as changing hydraulic or electrical fixtures or landscaping, usually do not cost more than implementing them from the outcome and are equally applicable to single- and multi-family SH projects. But, when high-level (deep upgrading) interventions are on the table, costs rapidly increase due to the need to substantially change existing systems or supporting structures, which makes them often financially and/or technically unfeasible.

The Development of Schematics to Illustrate Women's Experiences with Adjuvant Hormone Therapy in the Treatment of Breast Cancer.

ObjectiveNon-adherence to adjuvant hormone therapy prescribed orally in the treatment of breast cancer is complex as the literature has shown. Many women find it hard to adhere to the hormonal medicines they are prescribed and expected to take for at least 5 years following the initial management of their breast cancer. Arguably, communicating other women’s ‘trials, tribulations, and triumphs’ with medication-taking could help newly-diagnosed patients to better prepare for the journey ahead. Our objective was to visually represent women’s experiences with these medicines using data synthesized in the literature.MethodsThree schematics were drawn for each phase of medication-taking, namely, starting out, adherence, and cessation. The schematics were validated by interviewing a panel of healthcare professionals (n=10) and calculating a Content Validity Index (CVI). The edited drawings were discussed with a separate panel of breast cancer survivors (n=14) whose responses were elicited qualitatively in one-to-one interviews.ResultsA total of 76 individual pictograms were drawn across the three schematics. The 13 pictograms that had an item-level CVI<0.8 were modified according to feedback resulting in three final schematics with an overall CVI of 87%, 87% and 80%, respectively.ConclusionSynthesised summaries of women’s experiences with oral hormone therapy for breast cancer were visualised via three validated schematics. The schematics could aid patient-professional communication to help anticipate and tackle negative experiences and support decisions to take hormone medication in breast cancer.

Developing Parenting Guidelines to Support Transgender and Gender Diverse Children's Well-being.

Parents and caregivers' responses to their child's gender identity or expression play a pivotal role in their mental health. Despite increasing visibility of transgender and gender diverse (TGD) children, few scientific resources exist to advise their parents and caregivers. We used an online Delphi study to generate expert consensus. Expert adult participants (N = 93; 55% cisgender women, 12% cisgender men, 33% gender minority; 83% White race or ethnicity) rated statements describing parenting strategies compiled from a systematic search of community-generated online literature. Participants represented 3 distinct "panels" of expertise: parents and caregivers of a TGD child, TGD persons, and/or professionals working with TGD populations. Statements rated as essential or important by 80% to 100% of each panel were endorsed as a guideline. Three rounds of surveys were used with iterative feedback to develop consensus. Of 813 total statements, only 125 were endorsed by all 3 panels. Key domains of consensus included: supportive strategies for parents (eg, open communication, listening), behaviors to avoid (eg, pressuring a child into a gender transition), strategies for navigating healthcare and school systems, and common responses for parents (eg, confusion). Areas of disagreement, in which professional and TGD panels concurred but the parent panel did not, included whether to allow gender identity experimentation during childhood, the value of providing access to gender diverse media, and how to avoid misgendering a child. These consensus-based guidelines offer a unique and needed resource for parents and caregivers and clinicians and can be used to promote the mental health and well-being of TGD children.

Should nurses’ employers in the NHS be offering menopause leave?

Our panel of nurses and healthcare professionals consider a topical nursing issue and share their views in a personal capacity only

Skin Sensory Assessors Highly Agree on the Appraisal of Skin Smoothness and Elasticity but Fairly on Softness and Moisturization

We tested the reliability of sensory evaluations of tactile sensation on bare skin and investigated the reliability among evaluation attributes by trained and untrained assessors. Two trained professional panelists and two untrained researchers evaluated skin in terms of several attributes: smooth–rough, elastic–not elastic, soft–hard (surface), soft–hard (base), moisturized–dry. Twenty-two women aged 25–57 years were evaluated, and the sensory evaluation was repeated twice. Correlation coefficients and intraclass correlation coefficients (ICCs) were used to examine intra- and inter-assessor reliability. The sensory evaluation and physical quantities acquired by commercial and non-commercial instruments were moderately correlated. Smooth–rough and elastic–not elastic showed high or moderate inter-assessor reliabilities with mean correlation coefficients between panelists of 0.81 and 0.58, respectively. Further, the ICC (2,1) values were 0.64 and 0.51, respectively, and the ICC (2,2) values were 0.77 and 0.67, respectively. Conversely, the reliabilities of soft–hard (surface), soft–hard (base), and moisturized–dry were low; the mean correlation coefficients between the panelists were 0.36, 0.23, and 0.22; the ICC (2,1) values were 0.27, 0.23, and 0.17; and the ICC (2,2) values were 0.42, 0.29, and 0.26, respectively. Reliability differed between attributes. We found no meaningful differences between the trained and untrained panelists regarding intra- or inter-assessor reliability.

Prostate MRI Qualification: AJR Expert Panel Narrative Review.

Prostate MRI is now established as a first-line investigation for individuals presenting with suspected localized or locally advanced prostate cancer. Successful delivery of the MRI-directed pathway for prostate cancer diagnosis relies on high-quality imaging as well as the interpreting radiologist's experience and expertise. Radiologist certification in prostate MRI may help limit interreader variability, optimize outcomes, and provide individual radiologists with documentation of meeting predefined standards. This AJR Expert Panel Narrative Review summarizes existing certification proposals, recognizing variable progress across regions in establishing prostate MRI certification programs. To our knowledge, Germany is the only country with a prostate MRI certification process that is currently available for radiologists. However, prostate MRI certification programs have also recently been proposed in the United States and United Kingdom and by European professional society consensus panels. Recommended qualification processes entail a multifaceted approach, incorporating components such as minimum case numbers, peer learning, course participation, continuing medical education credits, and feedback from pathology results. Given the diversity in health care systems, including in the provision and availability of MRI services, national organizations will likely need to take independent approaches to certification and accreditation. The relevant professional organizations should begin developing these programs or continue existing plans for implementation.

Group Concept Mapping Conceptualizes High-Quality Care for Long-Stay Pediatric Intensive Care Unit Patients and Families

To describe and conceptualize high-quality care for long-stay pediatric intensive care unit (PICU) patients using group concept mapping (GCM). We convened an expert panel to elucidate domains of high-quality care for this growing patient population for which transitory care models fail to meet their needs. Thirty-one healthcare professionals and 7 parents of patients with previous prolonged PICU hospitalizations comprised a diverse, interprofessional multidisciplinary panel. Participants completed the prompt "For PICU patients and families experiencing prolonged lengths of stay, high quality care from the medical team includes ______", with unlimited free text responses. Responses were synthesized into individual statements, then panelists sorted them by idea similarity and rated them by perceived importance. Statement analysis using GCM software through GroupWisdom generated nonoverlapping clusters representing domains of high-quality care. Participants submitted 265 prompt responses representing 313 unique ideas, resulting in 78 final statements for sorting and rating. The resultant cluster map best representing the data contained 8 domains: (1) Family-Centered Care and Shared Decision Making, (2) Humanizing the Patient, (3) Clinician Supports and Resources, (4) Multidisciplinary Coordination of Care, (5) Family Well-Being, (6) Anticipatory Guidance and Care Planning, (7) Communication, and (8) Continuity of Care. GCM empowered a panel of healthcare professionals and parents to explicitly describe and conceptualize high-quality care for patients and families experiencing prolonged PICU stays. This information will aid the effort to address shortcomings of transitory PICU care models.

Evaluation of an interprofessional collaborative practice training module for the management of children with autism spectrum disorder

BackgroundProtocols instituted for behavioral treatment and skills training programs for the management of autism spectrum disorder (ASD) suffer from lack of collaborative approaches. The tenets of interprofessional collaborative practice (IPCP) focus on preparing a panel of health care professionals (HCPs) from different professions who can work together to enable the common goal of ensuring that children with ASD can participate in society. This study was designed to pilot this approach through an IPCP training module on ASD for care providers from multiple professions. MethodsAn interventional study with pre-post analysis began with formation of the interprofessional (IP) team, who developed an IPCP module, addressing the knowledge and skills needed for the collaborative management of neurodevelopmental issues of children with ASD. This module was delivered through an online training workshop using various teaching learning methods to the participants from seven different health professions after obtaining informed consent. Perceptions of interprofessional collaboration and competencies of IPCP were assessed using standard IP tools and reflective summaries and analyzed through a mixed-methods approach. ResultsA total of 42 HCPs from seven professions, including speech and hearing, occupational therapy, clinical psychology, physiotherapy, pediatrics, nursing, and pedodontics, participated in the study. Pre-post analysis of PINCOM-Q and Dow-IPEC data and thematic analysis revealed a significant difference in the perceptions of interprofessional collaboration and competencies’ levels of IPCP. ConclusionThis study suggests that use of IPCP principles in the training of professionals working with ASD is a promising and feasible option to develop more competent health professionals. The training enhanced the abilities of professionals to work in field of ASD as conveyed by the participants. They also expressed confidence in the knowledge of IP core competencies after the completion of the module.

S2k-Leitlinie SARS-CoV-2, COVID-19 und (Früh-) Rehabilitation – eine Kurzfassung mit allen Empfehlungen im Überblick

The consensus-based SARS-CoV-2, COVID-19, and Rehabilitation Practice Guideline provides recommendations that take both infection prevention and the pursuit of therapeutic goals in rehabilitation settings during the coronavirus pandemic into account. The Practice Guideline provides guidance how to prevent SARS-CoV-2 infections in rehabilitation settings in a first part. The guideline's second part addresses rehabilitation for patients affected by COVID-19 starting with interventions on intensive care units, during early rehabilitation, post-acute rehabilitation, in outpatient and community rehabilitation settings, as well as long-term care, e. g. for COVID-19 survivors with Long- or Post-COVID.The updated second version of the Practice Guideline (dating from 01.11.2021) is a consensus-based guideline developed by a representative panel of healthcare professionals from 15 medical societies covering various rehabilitation disciplines, infectious diseases, hospital hygiene, and epidemiology. The abbreviated version provides an overview of all recommendations given.

Development of a Pictorial Patient Education Handout on Tracheostomy Care: A Mixed-Method Study.

This article describes a qualitative and quantitative approach to the development and iterative revision process of producing valid, user-friendly pictorial patient education handouts (infographics) on tracheostomy care. An iterative user-centered design with health professional, patient, and family caregiver panels was used. The authors first developed a new evaluation tool for pictorial education handouts, the Perceived Infographics Usability Measurement (PIUM). The patient education handout, consisting of three A3-size posters with illustrations on key steps of daily tracheostomy care, reached a high consensus among health professional experts (88.3%) and patients and family caregivers (89.1%) on PIUM usability indexes. Patients and family caregivers expressed that the patient education handout would be an understandable teaching tool and procedure reminder, which would help alleviate fears about tracheostomy care. The PIUM demonstrated satisfactory content validity and reliability properties and was a quality tool to guide the transformation of text-based content to a pictorial patient education handout.

Measuring multimorbidity in research: Delphi consensus study

ObjectiveTo develop international consensus on the definition and measurement of multimorbidity in research.DesignDelphi consensus study.SettingInternational consensus; data collected in three online rounds from participants between 30 November 2020 and 18...

Surveillance of long-term complications after treatment of adult brain tumor survivors-review and evidence-based recommendations.

As a result of treatment and diagnosis, adults with primary or metastatic brain tumors experience comorbidities that impacts their health and well-being. The Children's Oncology Group has guideline recommendations for childhood survivors of brain tumors; however, guidelines for monitoring long-term sequela among adult brain tumor survivors are lacking. The purpose of this review is to present the screening recommendations for the long-term complications after brain tumor treatment from a multidisciplinary panel of healthcare professionals. Chronic complications identified include cognitive dysfunction, vasculopathy, endocrinopathy, ophthalmic, ototoxicity, physical disability, sleep disturbance, mood disorder, unemployment, financial toxicity, and secondary malignancy. We invited specialists across disciplines to perform a literature search and provide expert recommendations for surveillance for long-term complications for adult brain tumor survivors. The Brain Tumor Center Survivorship Committee recommends routine screening using laboratory testing, subjective assessment of symptoms, and objective evaluations to appropriately monitor the complications of brain tumor treatments. Effective monitoring and treatment should involve collaboration with primary care providers and may require referral to other specialties and support services to provide patient-centered care during neuro-oncology survivorship. Further research is necessary to document the incidence and prevalence of medical complications as well as evaluate the efficacy of screening and neuro-oncology survivorship programs.

Mobile app and digital system for patients after myocardial infarction (afterAMI): study protocol for a randomized controlled trial

BackgroundTreatment of acute myocardial infarction has been the subject of studies over the past years. However, the initial months after myocardial infarction are crucial from the perspective of the patient’s prognosis. It is extremely important to take care of all cardiovascular risk factors and undergo a full rehabilitation program. Telemedical solutions are becoming more and more relevant in everyday practice. We describe a protocol of a study evaluating the use of the mobile application “afterAMI” in patients after myocardial infarction. The app offers an educational mode, calendar, vital signs diary, medication reminders, medical history card, and healthcare professional contact panel. It offers several solutions, which individually proved to be effective and improve a patient’s prognosis. Despite general promising results from previous studies regarding telemedical tools, there is a paucity of evidence when it comes to prospective randomized trials. Our aim was to perform a comprehensive evaluation of a newly developed mobile application in the clinical setting.MethodsA group of 100 patients with myocardial infarction on admission at the 1st Chair and Department of Cardiology, Medical University of Warsaw, will be recruited into the study. The project aims to assess the impact of the application-supported model of care in comparison with standard rehabilitation. At the end of the study, cardiovascular risk factors will be analyzed, along with rehospitalizations, the patients’ knowledge regarding cardiovascular risk factors, returning to work, and quality of life. In this prospective, open-label, randomized, single-center study, all 100 patients will be observed for 6 months after discharge from the hospital. Endpoints will be assessed during control visits 1 and 6 months after inclusion into the study.DiscussionThis project is an example of a telemedical solution application embracing everyday clinical practices, conforming with multiple international cardiac societies’ guidelines. Cardiac rehabilitation process enhancements are required to improve patients’ prognosis. The evidence regarding the use of the mobile application in the described group of patients is limited and usually covers a small number of participants. The described study aims to discuss whether telemedicine use in this context is beneficial for the patients.Trial registrationClinicalTrials.govNCT04793425. Registered on 11 March 2021.

Effect of spontaneous fermentation location on the fingerprint of volatile compound precursors of cocoa and the sensory perceptions of the end-chocolate.

Cocoa pod-opening delay and bean fermentation promote the organoleptic quality of chocolate. The present research investigated the changes in the volatile fingerprint of cocoa harvested at a traditional plantation. Cocoa beans extracted from 2-days pod-opening delay were simultaneously fermented for 5days using container and then sun-dried to 7-8% moisture content at five different locations: Akoupé, San Pedro, Soubré, Djekanou and Daloa. The aromatic analysis were done on cocoa using the HS-SPME-GC/MS technique. Professional panelists evaluated the sensory perceptions of the chocolate. The results shows that cocoa fermented in both Daloa and Soubré regions were differentiated by 2,3-butanediol while those processed in other regions presented highest acetoin content. However, fermented cocoa from Soubré region exhibited most amount of 2,3-butanediol, diacetate A whereas 2,3,5,6-tetramethylpyrazine differentiated those from Daloa region. Sensory properties of chocolate were not linked to the aromatic compound precursors profile of beans. The fermentation performed in San Pédro region promote both the generation of more desirable aromatic compounds of cocoa and sensory attributes of the finished chocolate. The fermentation location generates a greater differentiation of the volatile fingerprint of cocoa and the sensory perceptions of the finished chocolate.

ONS Guidelines™ to Support Patient Adherence to Oral Anticancer Medications.

This evidence-based guideline intends to support patients, clinicians, and others regarding interventions and processes to support patient adherence to oral anticancer medications (OAMs). A panel of healthcare professionals and patient representatives developed a clinical practice guideline to support patients taking OAMs. GRADE (Grading of Recommendations Assessment, Development, and Evaluation) methodology and criteria for trustworthy guidelines were followed. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool. A quantitative or narrative synthesis of the evidence was completed. Certainty of the evidence was assessed using GRADE. The panel agreed on recommendations and suggested an adherence risk assessment, education addressing adherence, ongoing assessment, proactive follow-up, coaching, and motivational interviewing in addition to usual care. The panel suggested the implementation of a structured OAM program. As cancer treatment shifts from clinic to home settings, interventions and programs to support patients on OAMs are needed.