An Evaluation Of Successful Aging Levels Of Nursing Home Residents

This study was conducted to evaluate the successful aging levels of nursing home residents.This descriptive study was conducted based on Rowe and Kahn’s model. The following was used to obtain data from the participants; Personal Well-Being Index-Adult, Katz Index, Standardized Mini-Mental State Examination, Social Connectedness Scale, Timed Up and Go Test, Berg Balance Scale and Handgrip Strength Test.Participants’ mean scores of Personal Well-Being Index-Adult, Katz Index of Independence in Activities of Daily Living, Standardized Mini-Mental State Examination, Social Connectedness Scale, Timed Up and Go Test, Berg Balance Scale were found to be 51.68±18.60, 5.53±1.38, 23.57±3.02, 25.23±8.89, 16.10±8.81 and 43.48±17.23, respectively.Participants had chronic disease incidence and diabetes, adversely affected successful aging and physical functionality, respectively. Participants also had the following characteristics: vulnerable cognitive functionality, high fall risk, above average personal well-being that may positively affect aging in terms of life engagement, and social connectedness

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract 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 low–middle-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 ‘single-use’ 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 low–middle-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 high– and low–middle–income countries

Investigation of Cervical Posture, Sleep Quality and Perceived Health Risk in Technology Addicted Adolescents and Young Adults: A Comparative Study

Objective: The aim of this study was to compare the cervical posture, sleep quality, and perceived health risk of technology-addicted adolescents, young adults and their controls. Methods: Adolescents and young-adults participants (n=160) were divided into four groups as addicted and non-addicted according to their age and Technology Addiction Scale scores. Cervical posture assessments were obtained by photographic analysis. Craniovertebral (CVA), craniohorizontal (CHA) and sagittal shoulder angle (SSA) values were recorded. Sleep quality was assessed with the Pittsburg Sleep Quality Scale. Participants' Perceived Health Risk was evaluated with a single-item, five-point Likert questionnaire. Results: The addicted participants had worse CVA than both their controls (p=0.000). Participants' CHA and SSA angles were similar in addicted groups (p=0.710 and p=0.612, respectively). Addicted adolescents had worse sleep quality than addicted young-adults (p=0.005). Perceived Health Risk is low level in all groups and there were no significant differences (p=0.055). Conclusion: Technology addiction affects the adolescent group more negatively than the young-adults. In the sample of adolescents and young-adults, individuals did not perceive excessive use of technological tools as a risk factor for their health. The degradation of CVA due to overuse of technological tools precedes the degradation of CHA and SSA. This can be explained by the fact that CVA is a more general angle that includes both the head- neck position and the vertebrae. It is necessary for public health and future health expenditures to educate and raise awareness of the more vulnerable adolescent group

Global Incidence and Risk Factors Associated With Postoperative Urinary Retention Following Elective Inguinal Hernia Repair

Importance Postoperative urinary retention (POUR) is a well-recognized complication of inguinal hernia repair (IHR). A variable incidence of POUR has previously been reported in this context, and contradictory evidence surrounds potential risk factors.Objective To ascertain the incidence of, explore risk factors for, and determine the health service outcomes of POUR following elective IHR.Design, Setting, and Participants The Retention of Urine After Inguinal Hernia Elective Repair (RETAINER I) study, an international, prospective cohort study, recruited participants between March 1 and October 31, 2021. This study was conducted across 209 centers in 32 countries in a consecutive sample of adult patients undergoing elective IHR.Exposure Open or minimally invasive IHR by any surgical technique, under local, neuraxial regional, or general anesthesia.Main Outcomes and Measures The primary outcome was the incidence of POUR following elective IHR. Secondary outcomes were perioperative risk factors, management, clinical consequences, and health service outcomes of POUR. A preoperative International Prostate Symptom Score was measured in male patients.Results In total, 4151 patients (3882 male and 269 female; median [IQR] age, 56 [43-68] years) were studied. Inguinal hernia repair was commenced via an open surgical approach in 82.2% of patients (n = 3414) and minimally invasive surgery in 17.8% (n = 737). The primary form of anesthesia was general in 40.9% of patients (n = 1696), neuraxial regional in 45.8% (n = 1902), and local in 10.7% (n = 446). Postoperative urinary retention occurred in 5.8% of male patients (n = 224), 2.97% of female patients (n = 8), and 9.5% (119 of 1252) of male patients aged 65 years or older. Risk factors for POUR after adjusted analyses included increasing age, anticholinergic medication, history of urinary retention, constipation, out-of-hours surgery, involvement of urinary bladder within the hernia, temporary intraoperative urethral catheterization, and increasing operative duration. Postoperative urinary retention was the primary reason for 27.8% of unplanned day-case surgery admissions (n = 74) and 51.8% of 30-day readmissions (n = 72).Conclusions The findings of this cohort study suggest that 1 in 17 male patients, 1 in 11 male patients aged 65 years or older, and 1 in 34 female patients may develop POUR following IHR. These findings could inform preoperative patient counseling. In addition, awareness of modifiable risk factors may help to identify patients at increased risk of POUR who may benefit from perioperative risk mitigation strategies

Common surgical procedures in pilonidal sinus disease: A meta-analysis, merged data analysis, and comprehensive study on recurrence

Abstract We systematically searched available databases. We reviewed 6,143 studies published from 1833 to 2017. Reports in English, French, German, Italian, and Spanish were considered, as were publications in other languages if definitive treatment and recurrence at specific follow-up times were described in an English abstract. We assessed data in the manner of a meta-analysis of RCTs; further we assessed non-RCTs in the manner of a merged data analysis. In the RCT analysis including 11,730 patients, Limberg & Dufourmentel operations were associated with low recurrence of 0.6% (95%CI 0.3–0.9%) 12 months and 1.8% (95%CI 1.1–2.4%) respectively 24 months postoperatively. Analysing 89,583 patients from RCTs and non-RCTs, the Karydakis & Bascom approaches were associated with recurrence of only 0.2% (95%CI 0.1–0.3%) 12 months and 0.6% (95%CI 0.5–0.8%) 24 months postoperatively. Primary midline closure exhibited long-term recurrence up to 67.9% (95%CI 53.3–82.4%) 240 months post-surgery. For most procedures, only a few RCTs without long term follow up data exist, but substitute data from numerous non-RCTs are available. Recurrence in PSD is highly dependent on surgical procedure and by follow-up time; both must be considered when drawing conclusions regarding the efficacy of a procedure