Retroperitoneal packing as part of damage control surgery in a Danish trauma centre – fast, effective, and cost-effective

<p>Abstract</p> <p>Background</p> <p>Retroperitoneal packing in patients with severe haemorrhage is a cornerstone of modern pelvic fracture management. However, few Danish trauma surgeons have experience with this procedure, and trauma audits show that many hesitate to perform the procedure, indicating a need for hands-on training for this simple and potentially lifesaving procedure.</p> <p>Materials and methods</p> <p>During a six-month period, trauma surgeons were taught the retroperitoneal packing procedure using human corpses at the Department of Pathology at Aarhus University Hospital.</p> <p>Results</p> <p>The course consisted of a 30 minute long single training session in retroperitoneal packing. Twenty-three sessions were held. Forty-two trauma surgeons (the entire staff at Aarhus Trauma Centre) and ten observers completed the course. Afterwards, all participants felt competent to perform the procedure.</p> <p>Conclusion</p> <p>All 42 surgeons at our local trauma organisation learned a simple lifesaving operation within a short time period. In the 12 months following the completion of the course, 11 patients were treated with packing without any hesitation and with success. Damage control surgery with packing was cost-effectively implemented at our centre with great ease and rapidity.</p

Buoy Gear- a Potential for Bycatch Reduction in the Small-Scale Swordfish Fisheries: a Florida Experience and Indian Ocean Perspective.

A swordfish buoy gear, an innovative fishing practice developed in USA in early 2000s, provide a possibility of direct swordfish targeting yielding high CPUE of target species and very low bycatch levels. Here we present a summary of US experience and discuss potential application of this gear in the Indian Ocean region in the perspective of small-scale fisheries development and bycatch reduction

Chicory roots improves the taste and odour of organic pork

The carbohydrate inulin is known to reduce the production of skatole in pigs. This is caused by inulin changing the intestinal flora, so that the bacteria that produce skatole are held in check. This change in intestinal flora also reduces the number of intestinal parasites in the pigs. However the high cost of inulin makes its use in pig feed impractical. Chicory root contains inulin and a series of other carbohydrates and secondary metabolites. Therefore we have examined whether chicory root can replace pure inulin and thereby reduce boar taint, improve the taste of pork and reduce the infection of pigs with pathogenic parasites and bacteria

Difference in postural stability between STarT Back Tool subgroups of patients with low back pain under conditions of sensory deprivation and cognitive load

Objective We explored differences in postural stability between subgroups of patients with low back pain (LBP) and varying risk levels for developing chronicity measured using the Subgroups for Targeted Treatment (STarT) Back Tool. Methods This was a cross-sectional, single-session, double-blind experimental study among 65 participants who had LBP for more than 14 days. Postural stability was assessed by measuring the center of pressure (COP) range, displacement area, and velocity in anterior–posterior and mediolateral directions under four sensory and cognitive conditions: (i) eyes open and counting forward, (ii) eyes closed and counting forward, (iii) eyes closed and counting forward in multiples of seven, and (iv) eyes closed and counting backward in multiples of seven. The participants were stratified into low-/medium- (n = 53) and high-risk (n = 9) subgroups. Results There were no significant between-group differences among patients with LBP stratified as having a low/medium or high risk of chronicity in postural stability and sensory and cognitive conditions. Conclusions Impaired postural stability is important to consider when treating patients with LBP. However, we found that these impairments were not strongly aggravated in groups with a higher risk of chronicity, as measured using the STarT Back Tool

The Online Patient Satisfaction Index for Patients With Low Back Pain:Development, Reliability, and Validation Study

BACKGROUND: Low back pain is highly prevalent, and most often, a specific causative factor cannot be identified. Therefore, for most patients, their low back pain is labeled as nonspecific. Patient education and information are recommended for all these patients. The internet is an accessible source of medical information on low back pain. Approximately 50% of patients with low back pain search the internet for health and medical advice. Patient satisfaction with education and information is important in relation to patients’ levels of inclination to use web-based information and their trust in the information they find. Although patients who are satisfied with the information they retrieve use the internet as a supplementary source of information, dissatisfied patients tend to avoid using the internet. Consumers’ loyalty to a product is often applied to evaluate their satisfaction. Consumers have been shown to be good ambassadors for a service when they are willing to recommend the service to a friend or colleague. When consumers are willing to recommend a service to a friend or colleague, they are also likely to be future users of the service. To the best of our knowledge, no multi-item instrument exists to specifically evaluate satisfaction with information delivered on the web for people with low back pain. OBJECTIVE: This study aims to report on the development, reliability testing, and construct validity testing of the Online Patient Satisfaction Index to measure patients’ satisfaction with web-based information for low back pain. METHODS: This is a cross-sectional validation study of the Online Patient Satisfaction Index. The index was developed with experts and assessed for face validity. It was subsequently administered to 150 adults with nonspecific low back pain. Of these, 46% (70/150) were randomly assigned to participate in a reliability test using an intraclass correlation coefficient of agreement. Construct validity was evaluated by hypothesis testing based on a web app (MyBack) and Wikipedia on low back pain. RESULTS: The index includes 8 items. The median score (range 0-24) based on the MyBack website was 20 (IQR 18-22), and the median score for Wikipedia was 12 (IQR 8-15). The entire score range was used. Overall, 53 participants completed a retest, of which 39 (74%) were stable in their satisfaction with the home page and were included in the analysis for reliability. Intraclass correlation coefficient of agreement was estimated to be 0.82 (95% CI 0.68-0.90). Two hypothesized correlations for construct validity were confirmed through an analysis using complete data. CONCLUSIONS: The index had good face validity, excellent reliability, and good construct validity and can be used to measure satisfaction with the provision of web-based information regarding nonspecific low back pain among people willing to access the internet to obtain health information. TRIAL REGISTRATION: ClinicalTrials.gov NCT03449004; https://clinicaltrials.gov/ct2/show/NCT0344900

Slim Epistemology with a Thick Skin

The distinction between ‘thick’ and ‘thin’ value concepts, and its importance to ethical theory, has been an active topic in recent meta-ethics. This paper defends three claims regarding the parallel issue about thick and thin epistemic concepts. (1) Analogy with ethics offers no straightforward way to establish a good, clear distinction between thick and thin epistemic concepts. (2) Assuming there is such a distinction, there are no semantic grounds for assigning thick epistemic concepts priority over the thin. (3) Nor does the structure of substantive epistemological theory establish that thick epistemic concepts enjoy systematic theoretical priority over the thin. In sum, a good case has yet to be made for any radical theoretical turn to thicker epistemology