Hallux valgus surgery affects kinematic parameters during gait

Background The aim of our study was to compare spatiotemporal parameters and lower limb and pelvis kinematics during the walking in patients with hallux valgus before and after surgery and in relation to a control group. Methods Seventeen females with hallux valgus, who underwent first metatarsal osteotomy, constituted our experimental group. The control group consisted of thirteen females. Kinematic data during walking were obtained using the Vicon MX system. Findings Our results showed that hallux valgus before surgery affects spatiotemporal parameters and lower limb and pelvis kinematics during walking. Hallux valgus surgery further increased the differences that were present before surgery. Specifically after hallux valgus surgery, the walking speed decreased even more (p = 0.09, η2 = 0.19) while step time increased (p = 0.002, η2 = 0.44) on both legs. The maximum ankle plantar flexion of the operated leg during toe-off decreased to a greater extend (p = 0.03, η2 = 0.26). The asymmetry in the hip and the pelvis movements in the frontal plane (present preoperatively) persisted after surgery. Interpretation Hallux valgus is not an isolated problem of the first ray, which could be just surgically addressed by correcting the foot\u27s alignment. It is a long-term progressive malfunction of the foot affecting the entire kinematic chain of the lower extremity

What are the effects of teaching Evidence-Based Health Care (EBHC) at different levels of health professions education? An updated overview of systematic reviews

BackgroundEvidence-based healthcare (EBHC) knowledge and skills are recognised as core competencies of healthcare professionals worldwide, and teaching EBHC has been widely recommended as an integral part of their training. The objective of this overview of systematic reviews (SR) was to update evidence and assess the effects of various approaches for teaching evidence-based health care (EBHC) at undergraduate (UG) and postgraduate (PG) medical education (ME) level on changes in knowledge, skills, attitudes and behaviour.Methods and findingsThis is an update of an overview that was published in 2014. The process followed standard procedures specified for the previous version of the overview, with a modified search. Searches were conducted in Epistemonikos for SRs published from 1 January 2013 to 27 October 2020 with no language restrictions. We checked additional sources for ongoing and unpublished SRs. Eligibility criteria included: SRs which evaluated educational interventions for teaching EBHC compared to no intervention or a different strategy were eligible. Two reviewers independently selected SRs, extracted data and evaluated quality using standardised instrument (AMSTAR2). The effects of strategies to teach EBHC were synthesized using a narrative approach. Previously published version of this overview included 16 SR, while the updated search identified six additional SRs. We therefore included a total of 22 SRs (with a total of 141 primary studies) in this updated overview. The SRs evaluated different educational interventions of varying duration, frequency, and format to teach various components of EBHC at different levels of ME (UG, PG, mixed). Most SRs assessed a range of EBHC related outcomes using a variety of assessment tools. Two SRs included randomised controlled trials (RCTs) only, while 20 reviews included RCTs and various types of non-RCTs. Diversity of study designs and teaching activities as well as aggregated findings at the SR level prevented comparisons of the effects of different techniques. In general, knowledge was improved across all ME levels for interventions compared to no intervention or pre-test scores. Skills improved in UGs, but less so in PGs and were less consistent in mixed populations. There were positive changes in behaviour among UGs and PGs, but not in mixed populations, with no consistent improvement in attitudes in any of the studied groups. One SR showed improved patient outcomes (based on non-randomised studies). Main limitations included: poor quality and reporting of SRs, heterogeneity of interventions and outcome measures, and short-term follow up.ConclusionsTeaching EBHC consistently improved EBHC knowledge and skills at all levels of ME and behaviour in UGs and PGs, but with no consistent improvement in attitudes towards EBHC, and little evidence of the long term influence on processes of care and patient outcomes. EBHC teaching and learning should be interactive, multifaceted, integrated into clinical practice, and should include assessments.Study registrationThe protocol for the original overview was developed and approved by Stellenbosch University Research Ethics Committee S12/10/262.Update of the overviewYoung T, Rohwer A, Volmink J, Clarke M. What are the effects of teaching evidence-based health care (EBHC)? Overview of systematic reviews. PLoS One. 2014;9(1):e86706. doi: .10.1371/journal.pone.0086706.</p

COVID-19 Vaccines Safety Tracking (CoVaST): Protocol of a Multi-Center Prospective Cohort Study for Active Surveillance of COVID-19 Vaccines' Side Effects.

Coronavirus disease (COVID-19) vaccine-related side effects have a determinant role in the public decision regarding vaccination. Therefore, this study has been designed to actively monitor the safety and effectiveness of COVID-19 vaccines globally. A multi-country, three-phase study including a cross-sectional survey to test for the short-term side effects of COVID-19 vaccines among target population groups. In the second phase, we will monitor the booster doses' side effects, while in the third phase, the long-term safety and effectiveness will be investigated. A validated, self-administered questionnaire will be used to collect data from the target population; Results: The study protocol has been registered at ClinicalTrials.gov, with the identifier NCT04834869. CoVaST is the first independent study aiming to monitor the side effects of COVID-19 vaccines following booster doses, and the long-term safety and effectiveness of said vaccines.This study protocol preparation was funded by Masaryk University, grant numbers MUNI/IGA/1543/2020 and MUNI/A/1608/2020.S

Effectiveness of comprehensive pain management in hard-to heal ulcers – a protocol of systematic review

The objective of the systematic review is to determine the effectiveness of inpatient comprehensive pain management in patients with hard to heal ulcers

Nástroje hodnocení používané pro sebehodnoceni bolesti u pacienti po mozkové příhodě s komunikačními problémy: scoping review Nástroje hodnocení používané pro sebehodnoceni bolesti u pacienti po mozkové příhodě s komunikačními problémy: scoping review

Abstract Objective: The objective of this scoping review was to identify assessment instruments used for the self-report of pain by hospitalized patients who have had a stroke and who have communication problems. Introduction: Pain assessment in various patient groups has received considerable attention and a variety of pain assessment instruments exists. Nevertheless, there is a lack of consensus regarding which pain assessment instruments are used for self-report of pain in stroke patients with communication problems. Inclusion criteria: This review included articles that focused on hospitalized adults who have had a stroke, have communication problems attributable to a stroke, and describe the use of an assessment instrument for the self-report of pain. The scoping review considered systematic reviews, quantitative and qualitative studies, and mixed method studies. Methods: Ten databases were searched with a search limit of database inception to August 2020, using Embase as the key information source (it yielded 424 sources). Hand-searching of the references of the included articles yielded an additional 12 papers. Papers written in any language were considered. A data extraction table was created to record relevant information in line with the goals and results of each article, the sample studied, and the pain assessment instrument used. Results: Ten papers were included in the review, most of which were descriptive studies. Most papers were from the United Kingdom and the USA. The most common communication problem in stroke patients was aphasia. The participants received care in various hospital settings (eg, rehabilitation units, comprehensive stroke units, palliative care). Eleven different assessment instruments were identified. In most cases, the assessment instruments focused on assessing pain presence and pain intensity. The most frequently used unidimensional pain intensity instrument was the numerical rating scale. Four instruments were multidimensional, of which two assessed health-related quality of life, including pain. The most thorough pain assessment instrument was the ShoulderQ, which contains 10 verbal questions and three visual vertical graphic rating scales that focus on the assessment of stroke-related shoulder pain. Conclusions: A range of both unidimensional and multidimensional self-report pain instruments was identified; however, of all the possible communication problems, most studies focused solely on patients with mild to moderate aphasia. Therefore, further research is recommended, including studies that also enroll patients with various stroke-related communication problems other than aphasia. In addition, the instruments should be translated for research in non-Western countries. Finally, apart from descriptive studies, experimental research with a robust randomized control trial design is needed to examine the effect of pain-inducing procedures on the perceived pain in patients with stroke-related communication problems.Abstraktní Cíl: Cílem tohoto přehledu bylo identifikovat nástroje hodnocení používané pro self-report bolesti u hospitalizovaných pacientu, kteří prodělali cévní mozkovou příhodu a kteří mají problémy s komunikací. Úvod: Hodnocení bolesti u různých skupin pacientů je věnováno značné pozornosti a existuje řada nástrojů pro hodnocení bolesti. Přesto neexistuje shoda ohledně toho, jaké nástroje pro hodnocení bolesti se používají k vlastnímu hlášení bolesti u pacientů s cévní mozkovou příhodou s komunikačními problémy

Prevalence and Risk Factors of CoronaVac Side Effects: An Independent Cross-Sectional Study among Healthcare Workers in Turkey

Background: COVID-19 vaccine hesitancy is a serious threat to mass vaccination strategies that need to be accelerated currently in order to achieve a substantial level of community immunity. Independent (non-sponsored) studies have a great potential to enhance public confidence in vaccines and accelerate their uptake process. Methods: A nationwide cross-sectional study for the side effects (SE) of CoronaVac was carried out in February 2021 among Turkish healthcare workers who were recently vaccinated. The questionnaire inquired about local and systemic SEs that occurred in the short-term, within four weeks, following vaccination. Results: A total of 780 healthcare workers were included in this study; 62.5% of them experienced at least one SE. Injection site pain (41.5%) was the most common local SE, while fatigue (23.6%), headache (18.7%), muscle pain (11.2%) and joint pain (5.9%) were the common systemic SEs. Female healthcare workers (67.9%) were significantly more affected by local and systemic SEs than male colleagues (51.4%). Younger age, previous infection, and compromised health status (chronic illnesses and regular medicines uptake) can be associated with an increased risk of CoronaVac SEs; Conclusions: The independent research shows a higher prevalence of CoronaVac SEs than what is reported by phase I-III clinical trials. In general, the results of this study confirm the overall safety of CoronaVac and suggest potential risk factors for its SEs. Gender-based differences and SEs distribution among age groups are worth further investigation.Masaryk University [MUNI/IGA/1543/2020, MUNI/A/1608/2020]; INTER-EXCELLENCE grant Towards an International Network for Evidence-based Research in Clinical Health Research in the Czech Republic [LTC20031]This study was funded by Masaryk University, grant numbers MUNI/IGA/1543/2020 and MUNI/A/1608/2020. The work of A.R., A.P., J.K. and M.K. was supported by the INTER-EXCELLENCE grant number LTC20031-Towards an International Network for Evidence-based Research in Clinical Health Research in the Czech Republic

Oral Microbiome Response to Powered vs Manual Toothbrush: Protocol for a Systematic Review &amp; Meta-Analysis

Subclinical changes in response to different types and generations of toothbrushes represent a challenging knowledge gap in the context of self-administered oral hygiene regimes. The aim of this project is to evaluate the current evidence regarding the microbiological changes and how they correlate with empirical findings namely the clinical parameters

Oral ulcers of COVID-19 patients: a scoping review protocol

This scoping review aims to systematically identify the types, characteristics, and possible pathophysiologic etiologies of the oral ulcers that emerge in COVID-19 patients