Survey Of Practices Research Articles

Procedural Integrity in Applied Settings: A Survey of Training, Practices, and Barriers

Procedural Integrity in Applied Settings: A Survey of Training, Practices, and Barriers

An exploration of UK speech and language therapists' treatment and management of functional communication disorders: A mixed-methods online survey.

Functional Communication Disorders (FCDs) are one specific presentation of Functional Neurological Disorder (FND). FND is characterised by neurological symptoms, such as sensory and motor symptoms, which are not explained by neurological disease. Speech and language therapists (SLTs) have expertise in managing communication disorders, including FCDs, though is not known is what clinicians do in practice to treat and manage FCDs. To explore the clinical practices of SLTs who regularly manage FCDs in the UK, including the assessment and intervention approaches taken. An online survey was developed using Qualtrics software and piloted before dissemination. Participants were experienced SLTs working in the UK who managed at least three FCD referrals a year. The survey was developed with a mix of qualitative and quantitative questions. The survey was disseminated via social media and professional networks. There were 73 completed responses to the survey. Participants reported working with a range of FCDs clinically, with functional stuttering and articulation disorders seen most frequently. SLTs reported working with a wide range of multidisciplinary professionals when managing patients with FCDs, though lack of access to mental health professionals was raised as an issue. SLTs reported using a combination of formal and informal communication assessments. Interventions varied, with a wide range of psychological approaches informing treatment. Lack of specific training, evidence base and negative attitudes around functional neurological disorder (FND) were raised as ongoing issues. Therapists encountered a wide range of FCDs as part of their clinical practice, though there was a significant disparity in the service and interventions offered. SLTs feel their input can be effective, but lack the resources, training and evidence-based interventions to provide adequate care. What is already known on the subject FCDs are one manifestation of FND and can present as a wide range of communication disorders. SLTs encounter FCDs as part of clinical practice, but report feeling unsure and underprepared to manage these disorders. Consensus recommendations have provided some guidance on how to manage these disorders, though what was not known was what practising SLTs are doing in practice with FCD patients: what assessment, intervention and management strategies they use, and what they feel are the facilitators and barriers to effective management. What this study adds to the existing knowledge This is the first UK-wide survey of FCD SLT clinical practice. The survey found that SLTs are seeing a range of FCDs as part of their clinical practice. SLTs reported that they feel their input is effective, that they had confidence in their ability to provide assessment and intervention, and that SLT for FCDs should be routine. SLTs reported using a wide variety of approaches to assessment and intervention. Barriers to effective management included a lack of resources, training, negative staff attitudes towards FND, and lack of research and evidence-based interventions. What are the practical and clinical implications of this work? This survey has found that SLTs working across the UK are providing input for patients with FCDs, but frequently reported feeling isolated and lacking clinical peer support. This shows the potential for networking groups to support SLTs to learn and share resources. There is a training need for SLTs and other healthcare professionals to tackle pervasive negative attitudes towards FND. Common themes in intervention approaches were found, but there was variability in the specific approach taken. This requires further research to guide SLTs on the best evidence-based practice.

Sexuality after breast cancer treatment: A physician’s survey of current clinical practice

BackgroundSide effects of breast cancer treatment (BCT) impact patients’ general and sexual wellbeing. Sexuality related complaints are reported by 70% of breast cancer survivors mainly due to the genitourinary syndrome of menopause (GSM). In clinical care, sexual side effects are often un(der)detected because physicians as well as patients experience barriers to discuss sexuality-related issues. Materials and methodsWe composed an online survey ourselves using known definitions about sexuality and menopause and known factors for not discussing sexuality. We used multiple-choice questions with a Likert scale to optimize interpretation of the statements. 64 practitioners completed the survey. With this online survey, we examined physicians’ knowledge of −and attitude towards- sexual wellbeing and detection and treatment of GSM in breast cancer survivors (BCS). ResultsVaginal dryness and dyspareunia were the symptoms most associated with menopause (n = 63/64 (98 %) and n = 56/64 (87 %)) and sexuality (n = 63/64 (98 %) and n = 61/64 (95 %)). These 2 complaints were also the most discussed symptoms of menopause (vaginal dryness n = 51/64 (80 %) and dyspareunia n = 45/64 (70 %)). The main reason to not discuss these issues were absence of reporting GSM (n = 40/64 (62 %)) and absence of a direct cause to discuss GSM (n = 35/64 (55 %). 64 % (n = 41/64) of practitioners don’t feel sufficiently educated to discuss and treat GSM. They proposed vaginal estrogens to treat GSM as first or second line respectively in 12 % (n = 8/64) and 46 % (n = 30/64) of symptomatic BCS. DiscussionAlthough sexuality related complaints are common in BCS, 64% of all participating physicians feel they are not adequately trained to handle them. More attention towards training of physicians is needed to discuss GSM related complaints also when they are not spontaneously reported by a patient and with clear guidance towards the medical treatment of GSM in BCS.

Undergraduate rheumatology teaching in the UK: a survey of current practice by teachers and students.

The last major UK survey of medical undergraduate rheumatology teaching was 25 years ago. This study aimed to describe current teaching practice, the perceptions of teachers and students and their engagement with Versus Arthritis teaching resources and future challenges and opportunities. Electronic surveys were distributed by e-mail and/or social media to relevant teachers and students identified within all 37 UK medical schools. A total of 34/37 (91%) teacher and 30/37 (81%) student surveys were returned. Compared with the last survey, the proportion of schools delivering rheumatology-identifiable teaching has fallen from 100% to 86% and the mean number of teaching days from 30 to 10. Rheumatology teaching is now more dispersed throughout the curriculum. Students preferred active learning methods such as simulation and expert patient teaching, while teachers preferred small-group teaching, online learning and lectures. The Versus Arthritis resources appeared underutilized by students but were considered useful. Most students thought rheumatology careers were not promoted within their medical school. A decrease in dedicated rheumatology teaching time was noted since the last survey 25 years ago. Greater promotion of rheumatology as a speciality and future career is required to maintain its professional identity and prevent marginalization.

Deferred Cord Clamping in Twin Pregnancies Across Canada: A National Survey of Practices

ObjectiveGuidelines recommending deferred cord clamping (DCC), delaying cord clamping for at least 30 seconds post-birth, have shown significant benefits in preterm singleton births. However, evidence supporting DCC in twins is scarce due to limited trial data, leading to practice variations. This study aims to assess current reported DCC practices for twin pregnancies in tertiary hospitals across Canada. MethodsA web-based survey was distributed to neonatologists and obstetrician investigators associated with the Canadian Neonatal and Preterm Birth Networks operating maternity and neonatal units. ResultsThe site response rate was 93% (28/30 sites), with 83% (25/30) for neonatologists and 56% (17/30) for obstetricians. The majority had a local protocol for twin pregnancies (obstetricians 13/17, neonatologists 21/25). While all centres practised DCC in dichorionic-diamniotic twins, a difference was noted for monochorionic-diamniotic twins, with 56% of neonatologists and 65% of obstetricians performing DCC. During cesarean delivery, most obstetricians (76.5%) placed the firstborn on the mother’s thighs. Neonatologists varied in their practices, with 32% placing the baby on the mother’s abdomen, 32% on the mother’s thighs, and 28% holding the baby at the height of the perineum. Divergent opinions were observed regarding contraindications, including risks of postpartum hemorrhage and velamentous cord insertion. ConclusionsDCC is reported to be practised in most twin deliveries among Canadian Neonatal and Preterm Birth Network centres. However, there are wide variations in practice, especially concerning the characteristics of the twins in which DCC is performed. Future research should investigate optimal cord clamping management in twins to standardize practices and maximize benefits.

A Perception Survey of Lean Management Practices for Safer Off-Site Construction

Lean practice is recognised for having a great potential in promoting safety risk management in off-site construction (OSC). This paper presents results of a study conducted to assess the impact of lean practice on safety risk management in OSC in a developing country. A quantitative approach using a survey-based questionnaire was adopted. Lean management practices (LMPs) identified from a literature review were empirically tested using a sample survey of 103 OSC contractors. The survey responses were subjected to descriptive and inferential statistics. The top ranked LMPs for safety risk management in OSC included two mistake-proofing practices, i.e., use of personal protective equipment (PPE) and use of hazard warning equipment; two last planner system (LPS) practices, i.e., involvement of workers in safety planning and providing necessary working equipment; and one first run studies (FRS) practice, i.e., critical analysis of work methods. These LMPs are useful in controlling high-consequence safety risks in OSC. Based on evidence found in this study, the paper argues that lean practice can bring great value to safety risk management in OSC in countries where OSC is transitioning.

Knowledge, attitude, and practice (KAP) survey regarding COVID-19 and factors associated with intention to receive a vaccine in kidney transplant recipients: A cross-sectional study

Post-kidney transplant recipients were recommended to take appropriate infection control measures and receive the third or additional doses of COVID-19 vaccines to reduce the risk of severe COVID-19. However, it remained unclear whether prevention of infection was being adequately implemented and what factors were related to vaccination intention. A cross-sectional questionnaire survey was conducted in March 2022 at Yochomachi Clinic in Tokyo, Japan. The purpose of this study was to identify factors associated with vaccine intentions based on the Knowledge, Attitude, and Practice (KAP) survey regarding COVID-19 and how to promote vaccine acceptance to reduce mortality not only during the COVID-19 pandemic but also in future emerging infectious disease pandemics. Of the 497 participants, 435 intended to receive the third dose of COVID-19 vaccines (including those who actually got it), and 62 did not have such intention. Multivariate logistic regression analysis revealed that male sex (OR: 2.856, 95% CI: 1.377-5.921), positive attitude toward COVID-19 (OR: 1.950, 95% CI: 1.399-2.718), and television as a source of information (OR: 4.165, 95% CI: 1.964-8.831) were associated with vaccination intention, whereas patients who trusted family and friends (OR: 0.343, 95% CI: 0.121-0.968) and those who trusted no-one (OR: 0.173, 95% CI: 0.049-0.613) had no vaccination intention. When considering vaccination policies, media outreach to patients should be given high priority, especially for people at higher risk of developing severe symptoms. This approach can promote vaccine acceptance to reduce mortality not only during the COVID-19 pandemic but also in future emerging infectious disease pandemics.

SP1.4 - PRESS survey: PREvention of surgical site infection—a global pan-specialty survey of prophylactic practices

Abstract Aims This survey aimed to establish current global practice across surgical subspecialties in the prevention of surgical site infection (SSI) using prophylactic measures. Methodology A cross-sectional survey was formulated following a published protocol, aligning with established guidelines for SSI prevention. A panel of experts provided guidance during iterative rounds of internal validation, incorporating consensus-based modifications. Prior to online dissemination via QualtricsXM link and QR code through international surgical societies, the survey underwent external validation. Recruitment strategies were through international societies, snowballing and social media. Results There were 1232 responses from 97 countries, with 698(56.7%) participants completing all inquiries. Responses were primarily provided by consultants or equivalent (766,75.2%), spanning all ten Royal College of Surgeons-recognised subspecialties. Almost all surgeons (734/779,94.2%) give pre-operative antibiotic prophylaxis at or within one hour of incision. Nutritional assessments do not routinely occur, with less than half (314/734,42.8%) performed often or always. Intraoperatively, normothermia is often or always maintained with standard blankets (389/734,53.0%) and forced air warming (435/734,59.3%) and less frequently with warmed fluids (277/734,37.7%) and heated mattresses (176/734,24.0%). Most surgeons (615/734,83.8%) would use non-iodinated drapes, whereas iodinated are used less frequently (472/734,64.3%). Triclosan coated sutures are never used by almost half of all surgeons (365/734,49.7%). Most surgeons (528/734,71.9%) use a simple wound dressing after skin closure. Conclusions Most prophylactic measures for SSI prevention display considerable variation in practice. Surgeons agree upon pre-operative antibiotic timing, in line with strong evidence and guidance. Other measures, such as antimicrobial sutures which have strong NICE recommendations, are used invariably.

A Survey of Preoperative, Perioperative, and Postoperative Management Practices for Testicular Torsion in Pediatric Patients among European Surgeons.

Management of testicular torsion varies between specialties resulting in lack of standardization. The aim of this survey was to assess pre-, peri-, and postoperative differences. An online questionnaire was distributed in 2023 to general and pediatric surgeons, pediatric urologists, and urologists by the Trainees of European Pediatric Surgery. Among 88 respondents (92% tertiary referral hospital), 38% always or usually perform sonography in case of suspected torsion respectively. In addition, 15% always attempt manual detorsion and 44% depending on the clinical presentation. Most surgeons (93%) favor a scrotal approach. Interestingly, pediatric surgeons choose a transscrotal while other specialties opt for a midline incision (p = 0.002). The majority (57%) employ a three-point fixation, while 42% opt for a two-point fixation. In case of necrotic testis, 61% puncture the testis with 52% opting for surgical removal, while 33% perform orchiectomy and 6% leave it in situ. Regarding necrotic or borderline-appearing testis, 54% take a biopsy. Furthermore, 82% perform prophylactic orchidopexy of the contralateral side during the same session. Postoperative antibiotics are always administered by 12%, while 52% do so sometimes. Most perform sonographic (58%) or clinical (57%) follow-up 3 months postoperatively. Notably, pediatric surgeons and urologists perform follow-up more frequently themselves, while general surgeons/urologists recommend follow-up by pediatricians (p = 0.002). In addition, 76% of responders affirm adhering to European Association of Urology guidelines. Unawareness of guidelines and institutional practices are reasons most commonly cited for nonadherence. Our study reveals significant disparities in the pre-, peri-, and postoperative management of testicular torsion underscoring the need for establishing standardized practices.

SP1.5 - PRESS survey: PREvention of surgical site infection—a global pan-specialty survey of practice

Abstract Aims This survey aimed to establish current global practice across surgical subspecialties in the prevention of surgical site infection (SSI). Methodology A cross-sectional survey was formulated following a published protocol, aligning with established global guidelines for SSI prevention. A panel of experts provided guidance during iterative rounds of internal validation, incorporating consensus-based modifications. Prior to online dissemination via QualtricsXM link and QR code through international surgical societies, the survey underwent final external validation. Recruitment strategies were through international societies, snowballing and social media. Findings There were 1232 responses from 97 countries, with 698(56.7%) participants completing all inquiries. Responses were primarily provided by consultants or equivalent (766,75.2%), spanning all ten Royal College of Surgeons-recognised subspecialties. A significant majority (786/889,88.4%) routinely employs clinical examination for SSI diagnosis, while one-third (305/889,34.3%) never use the CDC criteria. Regarding surgical field preparation, less than half regularly use alcoholic povidone-iodine (339/778,43.6%) or chlorhexidine gluconate (370/778,47.6%). However, approximately one-third often or always use aqueous (478/1556,30.7%) or alcoholic (454/1556,29.2%) solutions for hand scrub. Surgeons exhibit a higher likelihood of changing gloves (614/734,83.7%) than instruments (513/734,69.9%) to facilitate clean skin closure. Most UK surgeons (181/206,87.9%) express equipoise in randomising patients for interventions in a potential platform trial evaluating SSI prevention. Conclusions Significant diversity characterizes global and subspecialty-specific practices in various SSI prevention measures, attributable to conflicting guidance and limited evidentiary support for recommendations. Encouragingly, a substantial number of surgeons express readiness to contribute to a robust evidence base through participation in potential platform trials for SSI prevention.

Survey of pediatric massive transfusion protocol practice at United States level I trauma centers: An AABB Pediatric Transfusion Medicine Subsection study.

Trauma remains the leading cause of pediatric mortality in the United States. Although use of massive transfusion protocols (MTPs) in this population is widespread, optimal pediatric resuscitation is not well established. We sought to assess contemporary pediatric MTP practice in the United States. A web-based survey was designed by the Association for the Advancement of Blood & Biotherapies (AABB) Pediatric Transfusion Medicine Subsection and distributed to select American College of Surgeons (ACS) Level I Verified pediatric trauma centers. The survey assessed current MTP policy, implementation, and recent changes in practice. Response rate was 55% (22/40). Almost half of the respondents were from the South. The median RBC:plasma ratio was 1 (interquartile range 1-1.5). Protocolized fibrinogen supplementation was common while integration of antifibrinolytic therapy into MTPs was infrequent. Viscoelastic testing (VET) was available at most sites, 71% (15/21, one site did not respond), and was generally utilized on an ad-hoc basis. Roughly, a third of sites had changed their MTP in the past 3 years due to blood supply issues, and about a third reported having group O Whole Blood on-site. MTP practice is similar throughout the United States. Though fibrinogen supplementation is common-other emerging interventions such as antifibrinolytic therapy or utilization of routine viscoelastic testing-are not widespread. Pediatric transfusion medicine experts must continue to follow practice change, as contemporary large trials begin to characterize new supportive modalities to optimize resuscitation in pediatric trauma patients.

Survey of international pediatric nutritional supportive care practices: a report from the Pediatric Study Group of the Multinational Association of Supportive Care in Cancer (MASCC)

PurposeMalnutrition is common in children with cancer. While multiple validated malnutrition screens exist, there is no universal, standardized approach to screen or diagnose malnutrition. The Multinational Association of Supportive Care in Cancer (MASCC) Pediatric Study Group is focused on oncologic supportive care for children and young adults. This subgroup designed and administered a pilot study to characterize global malnutrition screening, diagnosis, and treatment practices for pediatric patients with cancer after identifying variations in malnutrition practice patterns within its members.MethodsA novel, exploratory survey was iteratively developed and distributed in early 2020 to 45 MASCC Pediatric Study Group members. The survey included multiple questions with standard patient presentations and nutritional scenarios, and the respondents selected the answer that best reflected the care patients would receive at their institution.ResultsA validated screening tool to assess for malnutrition was routinely used by 15 of 26 respondents (58%). No single validated screen was used by more than 24% of responders, and 11 of 26 (42%) reported not having a standard malnutrition treatment screen. When the same patient was presented with the survey using different malnutrition indicators, patient care plans varied greatly. This was particularly true for z-scores compared to weight percentiles.ConclusionsDevelopment of consensus recommendations for screening practices, preferred malnutrition indicators, and treatment guidelines could help reduce the underdiagnosis of malnutrition and subsequent variation in its management and ought to be a focus of the global pediatric cancer supportive care community.

Progestin-Based Non-Surgical Contraception in dogs and cats: A National Survey of Practices among Thai Veterinarians

Progestin-Based Non-Surgical Contraception in dogs and cats: A National Survey of Practices among Thai Veterinarians

Joint-optimized coverage path planning framework for USV-assisted offshore bathymetric mapping: From theory to practice

Designing effective coverage routes for unmanned surface vehicles (USVs) is crucial to improve the efficiency of offshore bathymetric surveys. However, existing coverage planning methods for practical use are limited, primarily due to the large-scale surveying areas and intricate region geometries caused by coastal features. This study aims to address these challenges by introducing a coverage path planning framework for USV-assisted bathymetric mapping, specifically aimed at the joint optimization of paths to cover numerous complex regions. Initially, we conceptualize the large-scale bathymetric survey mission as an integer programming model. The model uses four distinct decision variables to meticulously formulate length calculations, inter-regional connections, entry and exit point selections, and line sweep direction. Then, a novel hierarchical algorithm is devised to solve the problem. The method first incorporates a bisection-based convex decomposition method to achieve optimal partitioning of complex regions. Additionally, a hierarchical heuristic optimization algorithm that seamlessly integrates the optimization of all influencing factors is designed, which includes order generation, candidate pattern finding, tour finding, and final optimization. The reliability of the framework is validated through semi-physical simulations and lake trials using a real USV. Through comparative studies, our model demonstrates clear advantages in computational efficiency and optimization capability compared to state-of-the-arts, with its superiority becoming more pronounced as the problem scale increases. The results from lake trials further affirm the efficient and reliable performance of our model in practical bathymetric survey tasks.

Organ Donation through the Eyes of Jordanian Medical Students

Background: Organ donation is a critical component in the field of transplantation medicine, offering lifesaving opportunities for patients with end-stage organ failure. This study investigated the knowledge, attitude, and practice (KAP) survey regarding organ donation among medical students in Jordan. Methods: A cross-sectional survey was conducted among medical students across six Jordanian universities. Using a convenience sampling method, participants were invited via email, social media, and professional networks to complete a structured online questionnaire. The survey captured data on demographics, knowledge about organ donation processes, attitudes toward organ donation, and self-reported practices. Statistical analyses explored associations between students’ KAP and their demographic characteristics. Results: A total of 539 medical students participated in the study. Findings revealed moderate knowledge and generally positive attitudes toward organ donation, with significant variability influenced by demographic factors. Students from various universities demonstrated different levels of knowledge and attitudes. Notably, religious and cultural beliefs significantly affected students’ attitudes toward organ donation. Conclusions: The study highlighted a gap between the positive attitudes and the actual commitment to organ donation among the participants, revealing a need for targeted educational interventions to address misconceptions and enhance the willingness to donate organs. Promoting organ donation education within medical schools could foster a more supportive environment for organ donation, ultimately contributing to increased donor rates and improved transplantation outcomes in Jordan.

Current experience and future potential of facilitating access to digital NHS primary care services in England: the Di-Facto mixed-methods study.

Current National Health Service policy in England encourages enhanced digital access in primary care service provision. In this study, we investigate 'digital facilitation' - that range of processes, procedures and personnel which seeks to support National Health Service primary care patients in their uptake and use of online services. Identify, characterise and explore the potential benefits and challenges associated with different models of digital facilitation currently in use in general practice which are aimed at improving patient access to online services in general practice in England. Use the resulting intelligence to design a framework for future evaluations of the effectiveness and cost effectiveness of such interventions. Explore how patients with mental health conditions experience digital facilitation and gauge their need for this support. Observational mixed-methods study (literature review, surveys, ethnographic observation and interviews); formal synthesis of findings. General practice in four regions of England. Practice survey: 156 staff. Patient survey: 3051 patients. Mental health survey: 756 patients. General practitioner patient survey: 3 million responders. Ethnographic case-studies: 8 practices; interviews with 36 staff, 33 patients and 10 patients with a mental health condition. Stakeholder interviews: 19 participants. Digital facilitation as undertaken in general practice. Patient and practice staff reported use of, and views of, digital facilitation. Surveys, qualitative research; national General Practitioner Patient Survey (2019-22). Scoping-review methodology applied to academic and grey literature published 2015-20. While we did find examples of digital facilitation in routine practice, these often involved using passive or reactive modes of support. The context of COVID, and the necessary acceleration (at that time) of the move to a digital-first model of primary care, shaped the way digital facilitation was delivered. There was lack of clarity over where the responsibility for facilitation efforts lay; it was viewed as the responsibility of 'others'. Patients living with mental health conditions had similar needs and experiences regarding digital facilitation to other patients. The context of the COVID pandemic placed limitations on the project. Fewer practices responded to the practice survey than anticipated; reconfiguration of general practices to support COVID measures was a key consideration during non-participant observation with social distancing and other measures still in place during fieldwork. Digital facilitation, while not a widely recognised concept, is important in supporting the move to a National Health Service with enhanced digital opportunities and enhanced digital access. General practice staff are allocating resources to provide such efforts in general practices in England. The establishment of clear lines of responsibility, the development of digital tools and platforms that work for patients and practice staff, and investment in staff time and training are needed if digital facilitation is to support the intended digital revolution. We did not find one single dominant or preferred model of digital facilitation which might reasonably be considered to form the basis of an intervention to be tested. Rather, there is a need to co-develop such an intervention with patients, general practice staff and relevant policy experts. We outline a framework for a future evaluation of such an intervention. This study is registered as ResearchRegistry6523 (www.researchregistry.com/browse-the-registry#home/?view_2_search=Di-Facto&view_2_page=1) and PROSPERO CRD42020189019 (www.crd.york.ac.uk/prospero/display_record.php?RecordID=189019). This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR128268) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 32. See the NIHR Funding and Awards website for further award information.

125 Patterns of Practice Survey on Radiation Therapy for Pancreatic Cancer in Korea

125 Patterns of Practice Survey on Radiation Therapy for Pancreatic Cancer in Korea

Practice survey on recent changes in post cardiac arrest care and temperature management in French intensive care units

BackgroundRecent guidelines for post-cardiac arrest (CA) management have undergone significant changes regarding targeted therapeutic management (TTM), transitioning from hypothermia to temperature control. We aimed to assess changes in post-CA management in French intensive care units following the new recommendations. MethodsTwo declarative web surveys were conducted from March to August 2023. We compared the doctors' survey to that previously published in 2015. We contacted 389 departments from 276 French centers. ResultsThree hundred thirty-four physicians from 189 distinct ICUs departments participated in the survey. TTM was used by 95.5 % of respondents. TTM with temperature feedback device was used by 64 % of respondents. In multivariate analysis, use of TTM with temperature feedback was associated with university hospital responder [OR 1.99 (1.19–3.34, p = 0.009)], high CA admissions rate [OR 2.25 (1.13–4.78, p = 0.026)], use of a written CA procedure [OR 1.76 (1.07–2.92, p = 0.027)] and presence of a cath-lab performing coronary angiography [OR 2.42 (1.33–4.44, p = 0.004)]. The targeted temperature rose from 32 to 34 °C in 2015, to 35–36 °C in 2023 (p < 0.001). Proportions of TTM with temperature feedback devices switched from 45 % to 65 % (p < 0.001). 660 nurses responses from 150 ICUs were analyzed. According to TTM users, gel-coated water circulating pads and intravascular cooling were considered the most effective devices and were found to be easily adjustable. ConclusionsThese surveys provide insights into post-resuscitation care and TTM practice in France. One year after their publication, the latest recommendations concerning TTM have not been fully implemented, as the majority of ICUs continue to use moderate hypothermia. They widely reported employing specific TTM, with the use of TTM with temperature feedback devices increasing significantly. Heterogeneity exists regarding the TTM systems used, with a significant proportion lacking temperature feedback. This aspect requires specific attention, depending on local constraints and devices costs.

A Survey of Practice and Factors Affecting Physiotherapist-Led Health Promotion for People at Risk or with Cardiovascular Disease in Cameroon.

Cardiovascular diseases (CVDs) and associated risk factors are a growing concern in Cameroon. Physiotherapists (PTs) can play a crucial role in prevention and management. However, the extent of Cameroonian PT involvement in health promotion (HP) activities remains unclear. This study assessed Cameroonian physiotherapists' current HP practices for people at risk of or with CVDs (pwCVDs). A cross-sectional survey was administered online to PTs practising in Cameroon. Out of 181 PT responses, 95% reported providing a variety of HP activities, including weight management (74%), dietary advice (73%), physical activity (69%), smoking cessation (69%), stress management (61%), and sleep promotion (48%). While PTs were confident in lifestyle assessments, they felt less confident about sleep interventions. Strong beliefs, confidence, team support, and time allocation enhanced HP practice. However, preference for passive modalities, patient adherence issues, organisational challenges, role ambiguity among healthcare providers, inadequate training opportunities, and the absence of established guidelines for CVD prevention negatively affect HP practice. These findings highlight the challenges and opportunities for enhancing HP delivery within the physiotherapy profession in Cameroon. The findings are useful for future strategies by clinical practitioners and policy makers to address barriers and leverage facilitators effectively for scaling up HP initiatives in Cameroon.

Surgical Management of Irreparable Rotator Cuff Tears: A Survey of Current Practice and Literature Review.

Introduction Irreparable rotator cuff tears (RCTs) are a complex challenge encountered by shoulder surgeons. Despite a range of repair strategies, the preferencesand indications of these remain unclear. Our study aims to identify current practices, preference for graft choice and indications for capsular reconstruction amongst UK-based surgeons. Methods An online survey was sent to members of the British Elbow and Shoulder Society (BESS). Procedural preferences, operative frequency, indications/contra-indications for superior capsular reconstruction (SCR) and graft choice were ascertained. An independent t-test was used to determine statistical significance. Results One hundred and ten upper limb surgeons responded to the survey. Of this cohort, 90/110 (81.8%) would be able to perform a partial cuff repair, 89/110 (80.9%) could offer a reverse shoulder arthroplasty (RSA) and 82/110 (74.6%) could perform debridement only. Less commonly, 35/110 (31.8%) could offer an InspaceTM balloon device, 31/110 (28.2%) SCR and 16/110 (14.6%)a tendon transfer. None of the respondents had performed more than 10 InspaceTM balloons in the previous year. 72/105 (68.6%) had never performed a SCR and 86/105 (82%) had never performed a tendon transfer. Over 58/105 (55.2%) had performed >10 RSA in the previous year. The graft of choice for SCR was human dermal allograft 33/100 (33%) and this choice was most frequently guided by surgeon preference. Conclusion Our study demonstrates that various treatment options can be offered for the management of irreparable RCTs. The commonest procedure offered is a partial cuff repair followed by RSA. Newer, novel procedures such as InspaceTM balloon and tendon transfers are less commonly offered in UK-based practices and their indications for use are less well defined. Future high-powered, multi-centre studies are required to identify the role and outcomes of these procedures.