15 research outputs found
Prevalence of Frailty in European Emergency Departments (FEED): an international flash mob study
Introduction
Current emergency care systems are not optimized to respond to multiple and complex problems associated with frailty. Services may require reconfiguration to effectively deliver comprehensive frailty care, yet its prevalence and variation are poorly understood. This study primarily determined the prevalence of frailty among older people attending emergency care.
Methods
This cross-sectional study used a flash mob approach to collect observational European emergency care data over a 24-h period (04 July 2023). Sites were identified through the European Task Force for Geriatric Emergency Medicine collaboration and social media. Data were collected for all individuals aged 65â+âwho attended emergency care, and for all adults aged 18â+âat a subset of sites. Variables included demographics, Clinical Frailty Scale (CFS), vital signs, and disposition. European and national frailty prevalence was determined with proportions with each CFS level and with dichotomized CFS 5â+â(mild or more severe frailty).
Results
Sixty-two sites in fourteen European countries recruited five thousand seven hundred eighty-five individuals. 40% of 3479 older people had at least mild frailty, with countries ranging from 26 to 51%. They had median age 77 (IQR, 13) years and 53% were female. Across 22 sites observing all adult attenders, older people living with frailty comprised 14%.
Conclusion
40% of older people using European emergency care had CFS 5â+â. Frailty prevalence varied widely among European care systems. These differences likely reflected entrance selection and provide windows of opportunity for system configuration and workforce planning
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and lowâmiddle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of âsingle-useâ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for lowâmiddle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both highâ and lowâmiddleâincome countries
Progress testing of information literacy versus information literacy self-efficay in medical students
Progress testing is a common assessment tool within medical schools. A similar assessment tool, the âProgress Test of Information Literacyâ (PTIL) has been created. To become an information literate person, information literacy selfefficacy (ILSE) is a meaningful part and important to evaluate. In this study, every PTIL-item has been mapped with an item of the 38-ILSE scale. Even though the mapping turned out to be delicate and context related, the results of this study suggests a relation between PTIL and specific ILSE items. Students of the first two medical years scored better for certain PTIL questions compared to students in the last years. In addition, students from year 1 were less certain about their answers. Once extra-integrated IL courses were organized, students were much more certain about their answers. Integrated and repeated IL-courses are necessary throughout the whole curriculum
Endoscopically Assisted Crawford Tube Placement Results in Shorter General Anesthesia Times in Pediatric Patients
Relationships Between the Phase Transformation Kinetics, Texture Evolution, and Microstructure Development in a 304L Stainless Steel Under Biaxial Loading Conditions: Synchrotron X-ray and Electron Backscatter Diffraction Studies
Growth, photosynthetic efficiency and metabolic alterations associated with exogenous hydrogen peroxide in Artemisia annua: Overproduction of artemisinin
Mechanical Characterization of an Additively Manufactured Inconel 718 Theta-Shaped Specimen
Krapina atlases suggest a high prevalence of anatomical variations in the first cervical vertebra of Neanderthals
The first cervical vertebra, atlas, and its anatomical variants have been widely studied in Homo sapiens. However, in Neanderthals, the presence of anatomical variants of the atlas has been very little studied until very recently. Only the Neanderthal group from the El SidrĂłn site (Spain) has been analysed with regard to the anatomical variants of the atlas. A high prevalence of anatomical variants has been described in this sample, which points to low genetic diversity in this Neanderthal group. Even so, the high prevalence of anatomical variations detected in El SidrĂłn Neanderthal atlases needs to be confirmed by analysing more Neanderthal remains. In this context, we analysed the possible presence of anatomical variants in the three Neanderthal atlases recovered from the Krapina site (Croatia) within the Neanderthal lineage. Two of the three Krapina atlases presented anatomical variations. One atlas (Krapina 98) had an unclosed transverse foramen and the other (Krapina 99) presented a non-fused anterior atlas arch. Moreover, an extended review of the bibliography also showed these anatomical variations in other Middle and Upper Pleistocene hominins, leading us to hypothesise that anatomical variations of the atlas had a higher prevalence in extinct hominins than in modern humans.This research was funded by grants from the Ministry of Economy, Industry and Competitiveness (grant number: CGL2015â63648âP) and the University of Valencia (grant number: UVâINV_AE18â773873). D.G.M. is funded by the Juan de la Cierva FormaciĂłn programme (FJCIâ2017â32157), from the Spanish Ministry of Science, Innovation and Universities