The Influence of Demographic and Job-related Characteristics on Nurses’ Compassion Satisfaction and Fatigue

Introduction: Growing stress and declining job satisfaction are the major challenges in nursing. Demographic and work-related factors may influence nurses’ compassion satisfaction and fatigue levels. Therefore, the study examined the impact of demographic and occupational factors on nurses’ professional quality of life. Methods: A cross-sectional study was conducted on 172 nurses working in two tertiary care hospitals in Pokhara using proportionate stratified random sampling. Data was gathered using the Professional Quality of Life (ProQOL) scale version 5 in September 2019. SPSS was used for bivariate and multivariate analysis to determine a significant relationship between socio-demographic and work-related variables and three professional quality-of-life subscales. The ethical approval was taken from the Institutional Review Committee (IRC) of Pokhara University (Reference Number: 83-075-76). Results: Most of the participants showed an average level of compassion satisfaction (79.1%, n=136), burnout (77.9%, n=134), and secondary traumatic stress (85.5%, n=147). The study revealed a significant mean difference between demographic characteristics (marital status and having children at home) and three professional quality of life subscales. Similarly, the study did not yield significant mean differences between the work-related variables and three professional quality-of-life subscales. Conclusion: Nurses in tertiary care hospitals exhibited moderate to high levels of compassion satisfaction while experiencing moderate to low levels of burnout and secondary traumatic stress. Despite moderate to low levels of burnout and secondary traumatic stress, it is imperative to address these issues as they have the potential to lead to medical errors and compromise patient care standards

Role of Alfuzosin in Ureteral Stent Related Urinary Symptoms Score: A Comparative Study

Background: Ureteral stent placement is a routine urological procedure. However, patients inserted with ureteral stent exhibited increased urinary symptoms that compromise patients’ quality of life. Objective: To assess the efficacy of alpha blockers (Alfuzosin) in the management of ureteral stent related urinary symptoms. Methods: Total of 60 patients after ureteral stent insertion was randomly divided into two equal groups; 30 in alfuzosin group and the remaining 30 in control group. Urinary symptoms questionnaire was filled after two weeks and results were statistically analyzed. Results: Urinary symptoms like urgency, frequency and flank pain were significantly less in the alfuzosin group when compared with control group. Conclusion: Alpha blocker (Alfuzosin) was found to be effective in reducing ureteral stent related urinary symptoms. Journal of Gandaki Medical College Vol. 10, No. 1, 2017, page: 28-3

Effectiveness of Systematic Echocardiographic Screening for Rheumatic Heart Disease in Nepalese Schoolchildren: A Cluster Randomized Clinical Trial.

Importance Echocardiographic screening allows for early detection of subclinical stages of rheumatic heart disease among children in endemic regions. Objective To investigate the effectiveness of systematic echocardiographic screening in combination with secondary antibiotic prophylaxis on the prevalence of rheumatic heart disease. Design, Setting, and Participants This cluster randomized clinical trial included students 9 to 16 years of age attending public and private schools in urban and rural areas of the Sunsari district in Nepal that had been randomly selected on November 17, 2012. Echocardiographic follow-up was performed between January 7, 2016, and January 3, 2019. Interventions In the experimental group, children underwent systematic echocardiographic screening followed by secondary antibiotic prophylaxis in case they had echocardiographic evidence of latent rheumatic heart disease. In the control group, children underwent no echocardiographic screening. Main Outcomes and Measures Prevalence of the composite of definite or borderline rheumatic heart disease according to the World Heart Federation criteria in experimental and control schools as assessed 4 years after intervention. Results A total of 35 schools were randomized to the experimental group (n = 19) or the control group (n = 16). After a median of 4.3 years (interquartile range [IQR], 4.0-4.5 years), 17 of 19 schools in the experimental group (2648 children; median age at follow-up, 12.1 years; IQR, 10.3-12.5 years; 1308 [49.4%] male) and 15 of 16 schools in the control group (1325 children; median age at follow-up, 10.6 years; IQR, 10.0-12.5 years; 682 [51.5%] male) underwent echocardiographic follow-up. The prevalence of definite or borderline rheumatic heart disease was 10.8 per 1000 children (95% CI, 4.7-24.7) in the control group and 3.8 per 1000 children (95% CI, 1.5-9.8) in the experimental group (odds ratio, 0.34; 95% CI, 0.11-1.07; P = .06). The prevalence in the experimental group at baseline had been 12.9 per 1000 children (95% CI, 9.2-18.1). In the experimental group, the odds ratio of definite or borderline rheumatic heart disease at follow-up vs baseline was 0.29 (95% CI, 0.13-0.65; P = .008). Conclusions and Relevance School-based echocardiographic screening in combination with secondary antibiotic prophylaxis in children with evidence of latent rheumatic heart disease may be an effective strategy to reduce the prevalence of definite or borderline rheumatic heart disease in endemic regions. Trial Registration ClinicalTrials.gov Identifier: NCT01550068

Toward a multi-level strategy to reduce stigma in global mental health: overview protocol of the Indigo Partnership to develop and test interventions in low- and middle-income countries

There is increasing attention to the impacts of stigma and discrimination related to mental health on quality of life and access to and quality of healthcare. Effective strategies for stigma reduction exist, but most evidence comes from high-income settings. Recent reviews of stigma research have identified gaps in the field, including limited cultural and contextual adaptation of interventions, a lack of contextual psychometric information on evaluation tools, and, most notably, a lack of multi-level strategies for stigma reduction. The Indigo Partnership research programme will address these knowledge gaps through a multi-country, multi-site collaboration for anti-stigma interventions in low- and middle-income countries (LMICs) (China, Ethiopia, India, Nepal, and Tunisia). The Indigo Partnership aims to: (1) carry out research to strengthen the understanding of mechanisms of stigma processes and reduce stigma and discrimination against people with mental health conditions in LMICs; and (2) establish a strong collaborative research consortium through the conduct of this programme. Specifically, the Indigo Partnership involves developing and pilot testing anti-stigma interventions at the community, primary care, and mental health specialist care levels, with a systematic approach to cultural and contextual adaptation across the sites. This work also involves transcultural translation and adaptation of stigma and discrimination measurement tools. The Indigo Partnership operates with the key principle of partnering with people with lived experience of mental health conditions for the development and implementation of the pilot interventions, as well as capacity building and cross-site learning to actively develop a more globally representative and equitable mental health research community. This work is envisioned to have a long-lasting impact, both in terms of the capacity building provided to participating institutions and researchers, and the foundation it provides for future research to extend the evidence base of what works to reduce and ultimately end stigma and discrimination in mental health

Toward a multi-level strategy to reduce stigma in global mental health: overview protocol of the Indigo Partnership to develop and test interventions in low- and middle-income countries

There is increasing attention to the impacts of stigma and discrimination related to mental health on quality of life and access to and quality of healthcare. Effective strategies for stigma reduction exist, but most evidence comes from high-income settings. Recent reviews of stigma research have identified gaps in the field, including limited cultural and contextual adaptation of interventions, a lack of contextual psychometric information on evaluation tools, and, most notably, a lack of multi-level strategies for stigma reduction. The Indigo Partnership research programme will address these knowledge gaps through a multi-country, multi-site collaboration for anti-stigma interventions in low- and middle-income countries (LMICs) (China, Ethiopia, India, Nepal, and Tunisia). The Indigo Partnership aims to: (1) carry out research to strengthen the understanding of mechanisms of stigma processes and reduce stigma and discrimination against people with mental health conditions in LMICs; and (2) establish a strong collaborative research consortium through the conduct of this programme. Specifically, the Indigo Partnership involves developing and pilot testing anti-stigma interventions at the community, primary care, and mental health specialist care levels, with a systematic approach to cultural and contextual adaptation across the sites. This work also involves transcultural translation and adaptation of stigma and discrimination measurement tools. The Indigo Partnership operates with the key principle of partnering with people with lived experience of mental health conditions for the development and implementation of the pilot interventions, as well as capacity building and cross-site learning to actively develop a more globally representative and equitable mental health research community. This work is envisioned to have a long-lasting impact, both in terms of the capacity building provided to participating institutions and researchers, and the foundation it provides for future research to extend the evidence base of what works to reduce and ultimately end stigma and discrimination in mental health

Adapting and piloting a social contact-based intervention to reduce mental health stigma among primary care providers:Protocol for a multi-site feasibility study

Stigma among primary care providers (PCPs) is a barrier to successful integration of mental health services in primary healthcare settings globally. Therefore, cross-culturally adaptable and feasible strategies are needed to reduce stigma among PCPs. This protocol is for a multi-site pilot study that aims to adapt and evaluate cross-cultural feasibility and acceptability of a social contact-based primary healthcare intervention in 7 sites in 5 low-and-middle-income countries. A mixed methods pilot study using an uncontrolled before-after study design will be conducted in China (Beijing, Guangzhou), Ethiopia (Sodo), India (Bengaluru, Delhi), Nepal (Syangja), and Tunisia (Testour). The intervention, entitled REducing Stigma among HealthcAre ProvidErs (RESHAPE), is a collaboration with people with lived experience of mental health conditions (PWLE), their family members, and aspirational figures (who are PCPs who have demonstrated high motivation to integrate mental health services). PWLE and their family members are trained in a participatory technique, PhotoVoice, to visually depict and narrate recovery stories. Aspirational figures conduct myth busting exercises and share their experiences treating PWLE. Outcomes among PCPs will include stigma knowledge, explicit and implicit attitudes, and mental healthcare competencies. To understand the feasibility, and acceptability of the intervention, qualitative interviews will be carried out with PWLE, family members, and aspirational figures, PhotoVoice trainers, mental health specialists co-leading the primary care trainings, and PCPs receiving mental health training. The sites will also generate evidence regarding feasibility, acceptability, recruitment, retention, fidelity, safety, and usefulness of the intervention to make further adaptations and modifications. The results will inform cross-cultural guidelines for collaboration with PWLE when conducting mental health training of primary healthcare workers. The results will be used to design future multi-site hybrid trials focusing on effectiveness and implementation

Toward a multi-level strategy to reduce stigma in global mental health: overview protocol of the Indigo Partnership to develop and test interventions in low- and middle-income countries

There is increasing attention to the impacts of stigma and discrimination related to mental health on quality of life and access to and quality of healthcare. Effective strategies for stigma reduction exist, but most evidence comes from high-income settings. Recent reviews of stigma research have identified gaps in the field, including limited cultural and contextual adaptation of interventions, a lack of contextual psychometric information on evaluation tools, and, most notably, a lack of multi-level strategies for stigma reduction. The Indigo Partnership research programme will address these knowledge gaps through a multi-country, multi-site collaboration for anti-stigma interventions in low- and middle-income countries (LMICs) (China, Ethiopia, India, Nepal, and Tunisia). The Indigo Partnership aims to: 1) carry out research to strengthen the understanding of mechanisms of stigma processes and reduce stigma and discrimination against people with mental illness in LMICs; and 2) establish a strong collaborative research consortium through the conduct of this programme. Specifically, the Indigo Partnership involves developing and pilot testing anti-stigma interventions at the community, primary care, and mental health specialist care levels, with a systematic approach to cultural and contextual adaptation across the sites. This work also involves transcultural translation and adaptation of stigma and discrimination measurement tools. The Indigo Partnership operates with the key principle of partnering with people with lived experience of mental illness for the development and implementation of the pilot interventions, as well as capacity building and cross-site learning to actively develop a more globally representative and equitable mental health research community. This work is envisioned to have a long-lasting impact, both in terms of the capacity building provided to participating institutions and researchers, and the foundation it provides for future research to extend the evidence base of what works to reduce and ultimately end stigma and discrimination in mental health

The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy

Background: The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations. Methods: Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves. Results: After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p  90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score. Conclusion: The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome