Representative Group Research Articles

Engaging stakeholders in embedded newborn health services/systems research in Kenya; a continuous process involving multiple actors.

Background Engaging relevant stakeholders throughout the research cycle is increasingly recognised as critical to conducting quality health systems research. There are few descriptions and analyses of stakeholder engagement in practice for embedded health systems research especially those that must navigate multi-level decentralised health systems. We describe and reflect on the stakeholder engagement activities of an international multi-disciplinary programme of research focused on newborn care in hospitals in Kenya. Methodology Our experienced project stakeholder engagement group coordinated engagement activities across multiple stakeholders with differing interests in the research. We conducted a stakeholder mapping and analysis using an engagement matrix to include national and county-level policymakers, professional communities, associations and regulators, health managers, frontline healthcare workers, patients, families and patient representative groups. Our engagement group maintained a log of engagement activities and had regular programme feedback meetings and discussions. As part of our analysis of stakeholder engagement, we drew on project documents and meeting minutes, and on a conceptual framework which distinguishes between the moral, strategic and practicaldimensions of stakeholder engagement. Results Stakeholder engagement was essential but complex in practice. Although we had significant prior engagement experience and relationships at the hospitals and the counties, introducing new staff into NBUs triggered complexities that required careful consultation along the bureaucracies at the counties. Despite the counties having similar hierarchical architectures, engagement processes varied and achieved different outcomes across counties. There were also multiple officeholder transitions over the research period, occasioned by factors in our external environment, often necessitating engaging afresh. Conclusion Even with a carefully developed stakeholder engagement plan, an experienced team, and a landscape backed by long-term embeddedness, health research stakeholder engagement can unfold in unexpected ways and requires continuous effort, resources, and adaptability. Meeting the moral, strategic, and practical potential of engagement requires flexibility, responsiveness, and commitment, including adequate resources.

Return to work after parenting in thoracic surgery: a call to action.

Women in our modern era are facing considerable challenges in the workplace, particularly in Cardiothoracic Surgery where women are underrepresented in leadership and academic roles. Returning to work after parental leave may potentially uncover or exacerbate existing gender biases within the workplace, with important consequences on professional and personal lives. Our goal was to characterize the experiences and the impact of return-to-work after parenting on Thoracic Surgery careers across Europe. All the participants to the European Society of Thoracic Surgeons Annual Meeting in 2023 were invited to complete this 32-items questionnaire. The Survey was subsequently distributed through the ESTS social media platform from November to January 2024. A descriptive and specific group analysis was performed according to the distribution. There were 152 participants, 92 of whom were female (61.0%) and 66 (43%) were between 31 and 40 years, constituting the most heavily represented age group. More women parents reported their role as the primary care provider of their child (89% vs 34%; P < 0.00001). Moreover, presence of In-Hospital childcare facilities was evaluated as more important by women. Approximately half of the parent-respondents reported breastfeeding (42, 52%), but only 26% (11) of this group indicated having any type of flexible hours for breast-feeding. Compared to men, women more often agreed that parenting might affect their career (81% vs 53%; P = 0.040) and felt less supported by their employers when having children (45% vs 68%; P = 0.37). This survey study identified main challenges to return to surgical work after parental leaves. Lack of structural or system-level support, and limited resources for childcare and breastfeeding were considerably affecting women surgeons. Institutional initiatives for new parents and breast-feeding colleagues are crucial for supporting a diverse workforce and any kind of discrimination derived by parental leaves should not be tolerated.

How University of Campinas is Coping with Continuous Improvement of Management of Hazardous Waste

This paper presents the approach that is being used to involve the community not only in handling the hazardous waste in accordance with the policy of the university but also in taking steps forward trying to improve the waste management practices and reduce the amount of waste generated by the campus operation. The approach involves the creation of a group of representatives of the Waste Management Group at each department who are responsible for disseminating the policy and best practices of waste management in their workspace. These representatives are trained to update or create the Local Waste Management Plans (LWMP) of the areas and as a result, currently, 52 areas of University of Campinas have their PGRL updated.

Intervention Mapping for Refining a Sport-Based Public Health Intervention in Rural Schools

Sport-based youth development programs, delivered through campus–community partnerships, can create impactful experiences for college students, meet university objectives, and improve the health of children in under-resourced rural communities. This study aimed to pilot test intervention mapping (IM), a systematic approach to intervention development and implementation, to refine the Hoosier Sport intervention, which is a local public health initiative that utilizes the Obesity-Related Behavioral Intervention Trials (ORBITs) model to improve physical activity in middle school children. The IM process, which included a diverse IM planning and advisory group of university representatives and local schools, was guided by self-determination theory (SDT) and social cognitive theory (SCT) and followed four steps: Logic Model of the Problem, Logic Model of Change, Program Design, and Program Production. Using SDT and SCT, we identified our personal determinants as autonomy, competence, and relatedness, while our environmental determinants were role-modeling and sports equipment access. We then created change methods and practical applications for refining and implementing our intervention and gathered pilot test data to assess the feasibility of the intervention. The IM process provided a more robust and evidence-based approach to intervention design and production, while involving stakeholders to foster meaningful collaboration and increase program success. By using IM in program development, public health interventions that promote youth development through sport will likely be more easily scaled up.

Digital health literacy in Norwegian patients with hip and knee arthroplasty: normative data from a cross-sectional study.

As digital health services become increasingly important in osteoarthritis treatment, understanding patients' digital health literacy (eHL) is crucial, including those undergoing total hip and knee arthroplasty (THA/TKA). We primarily aimed to provide eHL norms in a representative group of Norwegian patients, and secondarily to examine the relationships between eHL and health-related quality of life (QoL). We invited 800 randomly selected THA/TKA patients from the Norwegian Arthroplasty Register to complete a paper-based questionnaire, which included sociodemographic variables. eHL was measured using the eHealth Literacy Questionnaire (eHLQ) with 7 domains: Using technology, Understand, Engage, Control, Motivation, Access, and Needs, scored from 1 (strongly disagree) to 4 (strongly agree). The EuroQol EQ-5D-5L measured health-related QoL. We used multivariable regression to examine relationships between eHL domains and health-related QoL controlling for sociodemographic variables. Respondents' (N = 383, 48%) mean age was 70 years (SD 9.0) and 246 (64%) were female. Mean eHLQ and the proportion of patients with low eHL (≤ 2.5) were Technology 2.7 (34%), Understanding 3.0 (14%), Engage 2.7 (28%), Control 3.2 (7.7%), Motivation 2.8 (35%), Access 2.8 (33%), and Needs 2.6 (46%). Low eHL correlated with older age and low education, but not with sex or type of surgery. Regression analyses showed that lower scores on the domains Technology, Engage, Control, Access, and Needs were associated with poorer QoL after adjusting for sociodemographic factors. About one-third of THA/TKA patients have low eHL, and low eHL was associated with poor QoL.

The Unmet Needs of Lysosomal Storage Disorders from Early Diagnosis to Caregiving Pathways: An Italian Perspective

Background/Objective: Lysosomal storage diseases (LSDs) are a group of rare, inborn, metabolic errors characterized by deficiencies in normal lysosomal function and by the intralysosomal accumulation of undegraded substrates, resulting in the damage of multiple organ systems. The spectrum of clinical manifestations is extremely heterogeneous. LSD diagnosis and management still present many issues. Methods: A group of Italian experts and patients’ representatives met to discuss some critical aspects, and among the most impactful are early diagnosis, the transition of the patient from pediatric to adult age, territorial management, and the multidisciplinary approach. Results: Possible solutions to diagnostic delays may be a widespread newborn screening and screening programs on selected populations. The lack of a structured transition process could be helped by the drafting of shared diagnostic and therapeutic care pathways beyond the availability of databases accessible to the different levels that manage a patient. Territorial management could benefit from telemedicine, but a homogeneous diffusion of home therapy, not yet everywhere possible, is essential. A fundamental role is played by the patient associations, which should be increasingly involved in the political choices. It is also crucial to create structured multidisciplinary teams of experts for disease management and comorbidities. A transversal need appears to be greater training on LSDs. In Italy, the “Statement of Udine” was developed to guide further steps towards improvements in inherited metabolic medicine in adults, referencing the experience from the United Kingdom. Conclusions: Much can be done for the early diagnosis and management of LSDs with an effective treatment, but many aspects need improvement for the overall management of the patient. An investment in dedicated resources, formal recognition, and training is needed to address these unmet needs.

Survey on the Prevalence of Buruli Ulcer in Patients with Chronic Wounds in Pointe-Noire

Background &amp; objective: Buruli Ulcer (BU) is a human skin infection caused by Mycobacterium ulcerans, an environmental mycobacterium. This pathology is most prevalent in humid tropical regions, particularly near swampy or flood-prone areas. In Pointe-Noire, a coastal city in the Republic of Congo, Buruli ulcer is a health threat requiring ongoing surveillance and awareness-raising efforts to control its spread. The aim of this study was to determine the prevalence of Buruli ulcers in patients consulting for chronic wounds in Pointe-Noire. Methods: This was a descriptive cross-sectional study conducted from June 10, 2023 to September 18, 2024. We recruited 69 patients with chronic wounds consulted at the Adolphe Sicé General Hospital, the Tié Tié Referral Hospital, and the Pointe Noire Operational Sector. Mycobacterium ulcerans was systematically detected using the qPCR technique targeting the M. ulcerans IS 2404 specific insertion element on swab samples. Results: 69 patients with suspected BU were enrolled, with 57% (39) male and 43% (30) female subjects. The mean age was 47.7 ± 18.5, ranging from 6 to 94 years, and the most represented age group was [30-60] (66.7%). The wounds observed in our patients were mainly ulcerative in 94.2% (65) and localized to the lower limbs in 97.1% (67). The overall prevalence of Mycobacterium ulcerans infection was 2.89%. The age group affected was &lt; 15 years, with 01 positive male case and [30-60], with 1 positive female case. Conclusion: The study carried out in Pointe-Noire revealed a Buruli ulcer prevalence of 2.86% among the 69 patients with chronic wounds tested, with 02 positive cases.

Constructing representative group networks from tractography: lessons from a dynamical approach.

Human group connectome analysis relies on combining individual connectome data to construct a single representative network which can be used to describe brain organisation and identify differences between subject groups. Existing methods adopt different strategies to select the network structural features to be retained or optimised at group level. In the absence of ground truth, however, it is unclear which structural features are the most suitable and how to evaluate the consequences on the group network of applying any given strategy. In this investigation, we consider the impact of defining a connectome as representative if it can recapitulate not just the structure of the individual networks in the cohort tested but also their dynamical behaviour, which we measured using a model of coupled oscillators. We applied the widely used approach of consensus thresholding to a dataset of individual structural connectomes from a healthy adult cohort to construct group networks for a range of thresholds and then identified the most dynamically representative group connectome as that having the least deviation from the individual connectomes given a dynamical measure of the system. We found that our dynamically representative network recaptured aspects of structure for which it did not specifically optimise, with no significant difference to other group connectomes constructed via methods which did optimise for those metrics. Additionally, these other group connectomes were either as dynamically representative as our chosen network or less so. While we suggest that dynamics should be at least one of the criteria for representativeness, given that the brain has evolved under the pressure of carrying out specific functions, our results suggest that the question persists as to which of these criteria are valid and testable.

Finding representative group fairness metrics using correlation estimations

It is of critical importance to be aware of the historical discrimination embedded in the data and to consider a fairness measure to reduce bias throughout the predictive modeling pipeline. Given various notions of fairness defined in the literature, investigating the correlation and interaction among metrics is vital for addressing unfairness. Practitioners and data scientists should be able to comprehend each metric and examine their impact on one another given the context, use case, and regulations. Exploring the combinatorial space of different metrics for such examination is burdensome. To alleviate the burden of selecting fairness notions for consideration, we propose a framework that estimates the correlation among fairness notions. Our framework consequently identifies a set of diverse and semantically distinct metrics as representative of a given context. We propose a Monte Carlo sampling technique for computing the correlations between fairness metrics by indirect and efficient perturbation in the model space. Using the estimated correlations, we then find a subset of representative metrics. The paper proposes a generic method that can be generalized to any arbitrary set of fairness metrics. We showcase the validity of the proposal using comprehensive experiments on real-world benchmark datasets.

FOOD SELECTION OF CHILDREN WITH AUTISM SPECTRUM DISORDER ENROLLED IN NATEA CAETÉS

Introduction: Autism Spectrum Disorder (ASD) is understood as a neurological disorder characterized by behavioral heterogeneity, affective blunting, and stereotypical behaviors. Objective: To understand the eating habits of children with Autism Spectrum Disorder and the main foods and restrictions regarding the child's diet. Methodology: This is an observational, cross-sectional study with a qualitative descriptive approach, since the objective is to observe and delve deeper into the food selectivity of autistic children. The target population will be mothers of children with autism spectrum disorder registered with NATEA in the city of Capanema. Results: The sample consisted of 42 participants, of which 85.71% were male, reflecting the male predominance frequently observed in ASD diagnoses. The most represented age group was 5 to 12 years (61.90%), and the majority of participants identified as brown (85.72%). Regarding diagnosis, 64.29% of children were diagnosed between 1 and 5 years of age, and support levels ranged from mild (33.33%), moderate (40.48%) to intense (26.19%). Regarding feeding, 80.49% of children presented food selectivity, with a greater preference for carbohydrates and sweets, and low acceptance of vegetables and fats. Mealtimes were challenging for caregivers, with 70.97% reporting greater difficulty at the beginning of meals, suggesting initial resistance to food engagement. In addition, 80% of participants reported difficulties with food consistency, highlighting the importance of adapted nutritional interventions. Conclusion: The results indicate the need for integrated strategies to improve food acceptance and provide emotional support to caregivers. It is concluded that the demographic profile, associated with food selectivity and socioeconomic difficulties, reinforces the importance of multidisciplinary support programs to promote a balanced diet and well-being for this population.

Social determinants and oral health conditions in the elderly

Introduction: In older adults, the social determinants of health directly influence the health-disease process; oral health is no exception. Objective: Determine the behavior of social determinants and oral health conditions in older adults. Methods: A descriptive cross-sectional study was carried out on 221 individuals aged 60 years and over from office 19, La Demajagua, in June 2024. Questioning and clinical examination of the oral cavity were used, with prior informed consent of the participants and caregivers. The variables studied were: age, sex, occupation, economic well-being, family functioning, housing conditions, eating habits and oral health conditions. Results: The most represented age group was 60 to 74 years old with 72,8 %, with a predominance of males. Only 32,6 % of older adults worked and 11,8 % had good oral health conditions. 56,1 % of those examined reported not having economic well-being, and 73,8 % presented a regular oral health condition. Dysfunctional families predominated in 56,6 %, 46,2 % living in homes with regular conditions and 58,8 % with inadequate eating habits. Conclusions: The unfavorable behavior of the analyzed determinants reveals their negative influence on the oral health condition of older adults.

Identifying priorities for future research on reducing and stopping psychiatric medication: results of a James Lind Alliance priority-setting partnership.

The objective of this study is to identify the top 10 research priorities on reducing and stopping psychiatric medication that reflect the perspectives and unmet needs of three key stakeholder groups (people with lived experience, family members/carers/supporters and healthcare professionals). A priority-setting partnership was conducted using the James Lind Alliance's seven-step process. This involved (1) creating an international Steering Group of key stakeholder representatives and (2) identifying potential partners; (3) gathering stakeholders' uncertainties about reducing and stopping psychiatric medication using an online survey and summarising the survey responses; (4) checking the summary questions against existing evidence and verifying uncertainties; (5) shortlisting the questions using a second online survey; (6) determining the top 10 research questions through a prioritisation workshop; and (7) disseminating the results. A total of 3635 questions were collected in the initial survey from 884 respondents of which 32 questions were verified as uncertainties. These questions were then ranked in a second online survey by 526 respondents and the findings discussed in a final prioritisation workshop by 30 participants to produce the final top 10 list of research questions. These questions cover a range of areas including the most effective ways of safely reducing/stopping psychiatric medication and providing support to individuals undergoing the discontinuation process, as well as the best ways to educate healthcare professionals on this topic. The top 10 list of research priorities was produced through extensive engagement with key stakeholders and highlights important uncertainties and gaps in the existing evidence base that need to be addressed by future research.

The Effect of the Continuous Care Model on Oral Health, Self-Efficacy, and Self-Care in Patients With Head and Neck Cancer Undergoing Radiotherapy: A Study Protocol for a Quasi-Experimental Study.

Head and neck cancer, with its unique challenges, often involves radiotherapy as a primary treatment. This can lead to complications affecting patients' well-being. A continuous care model offers potential benefits, but its effectiveness requires validation through rigorous studies. This protocol aims to evaluate its impact on patients undergoing head and neck cancer radiotherapy, contributing to improved care strategies and well-being. The study is a double-arm and parallel-group quasi experimental study in which a 4-week intervention will be compared with usual care. A total of 70 eligible patients with head and neck cancer who are undergoing radiotherapy will be recruited to the intervention or control group. The patients in the intervention group will receive a continues care model designed for head and neck cancer patients in four phases of Orientation, Sensitization, Control, and Evaluation. The primary outcomes include dental plaque and gingival index, which will be measured by an approved dentist using The Gingival and Quigley-Hein index. The secondary outcomes are Oral hygiene self-efficacy and Dental and Oral Health Self-Care Behavior which will be assessed by the Oral and Dental Health Self-Efficacy and Dental and Oral Health Self-Care Behavior Questionnaires. Descriptive statistics will be used to describe variables. According to the types of variables, appropriate statistical tests, including two-sample t-tests, Χ 2, analysis of covariance, or linear regression will be performed. In conclusion, this study aims to evaluate the impact of a continuous care model on head and neck cancer patients undergoing radiotherapy. Findings will contribute to enhancing care strategies and well-being in this population. The trial has been approved by the Research Ethics Committees of Zahedan University Of Medical Sciences. In this study, written consent will be obtained from all participants. The results will be presented to representative groups and published in peer-reviewed journals.

Age-Dependent Enhancement in Fecundity and Ova Diameter of &lt;i&gt;Schizopyge niger&lt;/i&gt; (Heckel, 1838) in Dal Lake, Kashmir

Understanding the reproduction and recruitment pattern is essential for successful conservation of a species. Accurate estimates of fecundity plays acrucial role in comprehending fish population dynamics. The snowtrout, Schizopyge niger, is a Cyprinid fish widely distributed throughout the lakes of Kashmir valley and is one of the most important commercial fish species. In this study, we examined the age-dependent reproductive perfor-mance of female S. niger, aiming to gain insights into its breeding characteristics for the development of an optimal brood-stock management plan. The study involved 78 female S. niger specimens collected from Dal Lake during the spawning season, representing age groups of 2+, 3+, 4+, 5+, and 6+ years. Fecundity and ova diameter showed an increasing trend from age 2+ (3,971 eggs; 1.45 mm) to age 6+ (10,501 eggs; 2.00 mm). Total fecundity exhibited positive correlations with age, total weight, ovary weight, and ova diameter. Additionally, there was a positive correlation between ova diameter and fish age, with the highest fecundity and largest ova diameter observed in the 6+ years age group. Among each age group, fecundity and ova diameter varied significantly (p &lt;0.05). Based onthese findings, for optimal broodstock management of S. niger, it is recommended to use females of the6+ years age group after assessing the quality of eggs.

The New Healthcare: AI-Driven Population Stratification, Proactive Medicine, and Predictive Analysis

Abstract Background The Covid-19 pandemic has highlighted structural and functional weakness of local health services. Italy carried out its reorganization with DM 77/2022, financed by Mission 6 PNRR of the CE. The model adopted aims to move from a reactive to proactive medicine, to be implemented close to the places where citizens live. The priority objective is to know data on the progress of chronic pathologies and non self-sufficiency using advanced digitalization tools. Methods 14 types of administrative data from 2022 to 2023, concerning 180000 (ISTAT data) people in the Lecce Social Health District (DSS Lecce), were analyzed with AI (Chat GPT). Results Thanks to algorithms, 6 categories of clinical complexity were identified. The analysis showed that the population assisted is 198696, for temporary presences, with the most represented age group being 50-55 years. Births decreased by 36% in 10 years (from 1681 to 1076), with 2197 deaths in 2023. 42,38% of the population (average age 38,58 years) did not use healthcare resources, while 57,62% (average age 54,19 years) required them. 48646 patients have cardiovascular disease, but only 10% with heart failure were actively monitored. 25047 have metabolic disease, 11195 are diabetics, 5929 have chronic respiratory diseases, 8167 chronic neurological diseases and 907 are cancer patients. Increasing age leads to polymorbidity and show signs of social, economic and health fragility. Conclusions the strategic objective of the Lecce DSS was management of chronicity according to specific care pathways, PDTA. Create healthcare teams capable of being case managers depending on the level of complexity (family doctors, nurses, etc). With the 2024 data there will be 3 consecutive years of analysis which will allow the development of predictive systems to identify population clusters at risk of increasing complexity and in need of proactive medical interventions, use of telemedicine with the support of a Territorial Operations Center. Key messages • AI-driven stratification supports personalized health plans to improve healthcare delivery, patient outcomes, and optimize resource allocation. • A new model of Population Health Management supported by Artificial Intelligence.

Governing the Slovenian National Cancer Control Programme - Key Lessons Learnt

Abstract Issue Strategic documents addressing major public health concerns should extend beyond health sector. Cancer control is commonly perceived only as a health issue, thus involving diverse stakeholders is challenging. Description of the problem The inclusion of stakeholders within and beyond the health sector is crucial in the preparation, and through implementation of National Cancer Control Programmes (NCCP). Lessons learned on how to involve and maintain fruitful collaboration with diverse stakeholders in Slovenian NCCP are presented. Results Over the past 14 years Slovenia’s NCCP has built a reliable and reputable partnership with diverse stakeholders, a collaboration that continues to evolve. Efforts extend across multiple sectors, encompassing health, education, employment, research, environment, technology, and non-governmental organizations. NCCP has set up multistakeholder governance structures: an advisory board, board of experts, specialised expert groups, and a group of representatives of cancer hospitals. These groups engage a diverse range of experts and institutions nationwide. Whenever feasible, representatives of patient organizations are included. All these structures hold regular meetings, complemented by an annual event that convenes all stakeholders and also provides an invaluable platform for informal networking. To ensure seamless coordination of all activities, a dedicated team is essential. Our approach has evolved to embrace a dual leadership, comprising both a public health specialist and a clinical expert. Additionally, we benefit from the expertise of communication experts, who offer valuable insights into effectively reaching diverse audiences. Lessons Governing Slovenia’s NCCP by involving diverse stakeholders in planning and implementation activities has demonstrated its effectiveness. Furthermore, we are witnessing an increasing number of new stakeholders actively seeking out to participate in the NCCP. Key messages • Slovenia’s NCCP is recognized for its credibility and strategic approach. • Involving diverse stakeholders in cancer control endeavours has proven effective, fostering trust and partnerships.

A Study of Heavy Road Freight Transport in Poland in the Context of the Pursuit of Sustainable Road Transport

The efficiency of road freight transport determines—to a significant degree—the total environmental footprint and the amount of greenhouse gases and other pollutants released into the atmosphere by inland transport. The rate of empty or partially empty vehicles is one of the key metrics for improvement of the environmental performance of freight road transportation. This paper presents the characteristics of road freight transport in Poland on the basis of data collected by weigh-in-motion stations. Data aggregation for environmental analysis represents a novel aspect of the work. Indicators describing the degree of loading, the share of empty vehicles in traffic, and the share of vehicles of maximum permissible total weight in traffic were determined for a representative group of heavy goods vehicles. Based on the representative load factor value (LFA), a classification of the road section into four groups was proposed. The results obtained show a clear differentiation of the values of the indicators analyzed for individual groups and their variability in the three-year period covered by the analysis. The aggregation method presented can be used to identify the nature of the distribution of the weight categories of the heavy goods vehicles and provide input information for targeted analyses relating to sustainable road transport management and environmental protection. Finally, the grouped LFA values were linked with indicators of energy consumption (ECI) and on-road emissions (EI).

Ruthenium(II) complexes containing PEGylated N-heterocyclic carbene ligands for tunning biocompatibility in the fight against cancer

A synthetic procedure was designed for the preparation and characterization of Ag and Ru complexes containing NHC ligands functionalized with PEG fragments. Stability studies were conducted to gain insight of the species in water and other solvents like DMSO, or with reagents like imidazole as representative group for histidine amino acid. The presence of Cl atoms instead of H in the 4,5 positions of the N-heterocyclic carbene afforded higher water stability. The complexes containing PEG units must be considered inactive as anticancer agents. To enhance the anticancer activity of PEG-containing complexes, the balance between hydrophilicity and hydrophobicity was adjusted using a silane moiety, and an anionic carbosilane dendrimer as a lipophilic carrier.

Acute Ear, Nose and Throat Pain in Children in Brazzaville

Objective: To evaluate the intensity of acute pain associated with ENT conditions during consultations and the effectiveness of the analgesic prescribed. Patients and Methods: We conducted a prospective, experimental, randomised, double-blind study in the ENT CCF department of the CHUB. The study took place over a period of 9 months (01 March to 30 November 2021) and involved only children aged 2-12 years presenting with an acute ENT complaint and having been treated in the ENT consultation department of the CHUB. Paracetamol and ibuprofen were administered after pain assessment. Results: During the study period, 60 patients presented with acute ENT complaints and were managed on an outpatient basis. The mean age was 7.7 +/- 31 years, with extremes ranging from 2 to 12 years. Tekes were the most represented ethnic group at 58.4%. Schoolchildren represented the most common school level. Acute pain affected patients' life activities. Acute pharyngitis was the most common pathology. Acute ENT pain. Paracetamol and ibuprofen were the molecules most frequently used, and pain was virtually absent on the 3rd day of use (96.7% and 75% respectively for paracetamol and ibuprofen). Conclusion : Acute pain in children is often underestimated or sometimes inadequately treated.

What can we learn from pandemic educational methods?: military general practice trainees’ attitudes to feedback from recorded consultations

ABSTRACT Background Recorded consultations are a useful tool for developing consultation skills for general practice speciality trainees (GPSTs). Historical barriers to utility include a lack of recording equipment and trainee discomfort. Widespread use of online communication platforms during the pandemic led to the introduction of the Recorded Consultation Assessment (RCA), prompting an exploration of its impact on GPSTs’ attitudes and acceptability of using recorded consultations for feedback. Aim This sequential explanatory mixed methods study explored attitudes of military GPSTs towards using recorded consultations for feedback to develop consultation skills, and identify factors influencing GPST attitudes. Methods Participants of this study completed a questionnaire, followed by a representative sample focus group. Descriptive statistics were used to analyse quantitative data, reflexive thematic analysis was employed for qualitative data. Triangulation was conducted using a meta-matrix. Results Results indicated agreement among respondents on the usefulness of recorded consultations for developing consultation skills, particularly communication skills. Perceived trainer attitudes significantly influence the GPST utility of this tool. The RCA positively impacted attitudes, providing familiarity, free access to easy-to-use online recording platforms, simplified consenting procedures, secure data storage, and improved feedback quality from trainers. Conclusion Pre-pandemic studies cited equipment access and consent procedures as barriers to utilising recording as a method of feedback. The pandemic and RCA introduced online resources and imperative to utilise this method, resulting in largely positive GPST learning experiences. As we move away from the RCA it is important to retain institutional memory of the benefits gained from feedback using recorded methods.