16 research outputs found
Dressing use issues in primary abdominal wounds:a qualitative study of healthcare professionals' and patients' views
Validation of the Bluebelle Wound Healing questionnaire (WHQ) for assessment of surgical site infection in primary surgical wounds after hospital discharge
Background
Accurate assessment of surgicalâsite infection (SSI) is crucial for surveillance and research. Selfâreporting patient measures are needed because current SSI tools are limited for assessing patients after leaving hospital. The Bluebelle Wound Healing Questionnaire (WHQ) was developed for patient or observer completion; this study tested its acceptability, scale structure, reliability and validity in patients with closed primary wounds after abdominal surgery.
Methods
Patients completed the WHQ (selfâassessment) within 30 days after leaving hospital and returned it by post. Healthcare professionals completed the WHQ (observer assessment) by telephone or faceâtoâface. Questionnaire response rates and patient acceptability were assessed. Factor analysis and Cronbach's α examined scale structure and internal consistency. Testâretest and selfâ versus observer reliability assessments were performed. Sensitivity and specificity for SSI discrimination against a faceâtoâface reference diagnosis (using Centers for Disease Control and Prevention criteria) were examined.
Results
Some 561 of 792 selfâassessments (70·8 per cent) and 597 of 791 observer assessments (75·5 per cent) were completed, with few missing data or problems reported. Data supported a singleâscale structure with strong internal consistency (α greater than 0·8). Reliability between testâretest and selfâ versus observer assessments was good (Îș 0·6 or above for the majority of items). Sensitivity and specificity for SSI discrimination was high (area under the receiver operating characteristic (ROC) curve 0·91).
Conclusion
The Bluebelle WHQ is acceptable, reliable and valid with a singleâscale structure for postdischarge patient or observer assessment of SSI in closed primary wounds
Developing outcome measures assessing wound management and patient experience:a mixed methods study
A mixed-methods feasibility and external pilot study to inform a large pragmatic randomised controlled trial of the effects of surgical wound dressing strategies on surgical site infections (Bluebelle Phase B): study protocol for a randomised controlled trial
A Horizon Scan to Support Chemical PollutionâRelated Policymaking for Sustainable and ClimateâResilient Economies
While chemicals are vital to modern society through materials, agriculture, textiles, new technology, medicines, and consumer goods, their use is not without risks. Unfortunately, our resources seem inadequate to address the breadth of chemical challenges to the environment and human health. Therefore, it is important we use our intelligence and knowledge wisely to prepare for what lies ahead. The present study used a Delphiâstyle approach to horizonâscan future chemical threats that need to be considered in the setting of chemicals and environmental policy, which involved a multidisciplinary, multisectoral, and multinational panel of 25 scientists and practitioners (mainly from the United Kingdom, Europe, and other industrialized nations) in a threeâstage process. Fifteen issues were shortlisted (from a nominated list of 48), considered by the panel to hold global relevance. The issues span from the need for new chemical manufacturing (including transitioning to nonâfossilâfuel feedstocks); challenges from novel materials, food imports, landfills, and tire wear; and opportunities from artificial intelligence, greater data transparency, and the weightâofâevidence approach. The 15 issues can be divided into three classes: new perspectives on historic but insufficiently appreciated chemicals/issues, new or relatively new products and their associated industries, and thinking through approaches we can use to meet these challenges. Chemicals are one threat among many that influence the environment and human health, and interlinkages with wider issues such as climate change and how we mitigate these were clear in this exercise. The horizon scan highlights the value of thinking broadly and consulting widely, considering systems approaches to ensure that interventions appreciate synergies and avoid harmful tradeâoffs in other areas. We recommend further collaboration between researchers, industry, regulators, and policymakers to perform horizon scanning to inform policymaking, to develop our ability to meet these challenges, and especially to extend the approach to consider also concerns from countries with developing economies
Finishing the euchromatic sequence of the human genome
The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers âŒ99% of the euchromatic genome and is accurate to an error rate of âŒ1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead
Association of exercise participation levels with cardiometabolic health and quality of life in individuals with hepatitis C
Objective Hepatitis C virus (HCV) infection is associated with an increased risk of cardiovascular disease (CVD) and reduced health-related quality of life (HRQoL). Although physical activity (PA)/exercise has been shown to reduce CVD risk and improve HRQoL in patients with liver disease, there is limited data in HCV. We aimed to explore the association between PA/exercise levels, CVD risk and HRQoL in patients with HCV and assess individualsâ attitudes to PA/exercise.Design Cross-sectional observational study recruiting consecutive patients with HCV from viral hepatitis clinics. Data were collected on CVD risk factors, anthropometry, HRQoL and the Exercise Benefits and Barriers Scale (EBBS).Results 86 patients were recruited (71% men, 94% white, age 52±13 years); 49% of the cohort self-reported to be currently active. Although HRQoL was reduced across the cohort, patients that were regularly âactiveâ reported significantly higher HRQoL scores across Short-Form 36v2 domains compared with their inactive counterparts (p<0.05). Metabolic and cardiovascular characteristics were no different between groups stratified by PA/exercise status (p>0.05). EBBS scores were similar in the âactiveâ versus âinactiveâ groups, however, patients categorised as âactiveâ scored significantly higher on the psychological outlook and social interaction subscales (p<0.05) than those that were âinactiveâ. There were significant associations between EBBS scores and HRQoL (p<0.05).Conclusions PA/exercise is associated with increased HRQoL in patients with HCV irrespective of clinical parameters. Addressing specific motivators/barriers to exercise for patients will be key to designing effective PA/exercise interventions in this patient population to ensure maximum uptake and adherence
Association of exercise participation levels with cardiometabolic health and quality of life in individuals with hepatitis C
Objective Hepatitis C virus (HCV) infection is associated with an increased risk of cardiovascular disease (CVD) and reduced health-related quality of life (HRQoL). Although physical activity (PA)/exercise has been shown to reduce CVD risk and improve HRQoL in patients with liver disease, there is limited data in HCV. We aimed to explore the association between PA/exercise levels, CVD risk and HRQoL in patients with HCV and assess individualsâ attitudes to PA/exercise.
Design Cross-sectional observational study recruiting consecutive patients with HCV from viral hepatitis clinics. Data were collected on CVD risk factors, anthropometry, HRQoL and the Exercise Benefits and Barriers Scale (EBBS).
Results 86 patients were recruited (71% men, 94% white, age 52±13 years); 49% of the cohort self-reported to be currently active. Although HRQoL was reduced across the cohort, patients that were regularly âactiveâ reported significantly higher HRQoL scores across Short-Form 36v2 domains compared with their inactive counterparts (p0.05). EBBS scores were similar in the âactiveâ versus âinactiveâ groups, however, patients categorised as âactiveâ scored significantly higher on the psychological outlook and social interaction subscales (p<0.05) than those that were âinactiveâ. There were significant associations between EBBS scores and HRQoL (p<0.05).
Conclusions PA/exercise is associated with increased HRQoL in patients with HCV irrespective of clinical parameters. Addressing specific motivators/barriers to exercise for patients will be key to designing effective PA/exercise interventions in this patient population to ensure maximum uptake and adherence
Increased cardiovascular risk and reduced quality of life are highly prevalent among individuals with hepatitis C
Objective Hepatitis C virus (HCV) infection is common. Although treatment is effective, with oral antivirals curing >95% of patients, most individuals have comorbidities that persist long term. Therefore, our aim was to determine the prevalence of potentially modifiable health problems in patients with HCV and develop an HCV care bundle to identify and target comorbidities.
Design Cross-sectional, observational single-centre study that recruited consecutive patients with HCV from our viral hepatitis clinics. Data were collected on cardiovascular (CV) risk factors, lifestyle behaviours, anthropometry and health-related quality of life (HRQoL). QRISK 3 was used to predict 10-year CV event risk.
Results 100 patients were recruited (67% male, 93% white, median age 52 years (range 24â80); 71% were treated for HCV; 34% had cirrhosis; 14% had diabetes; 61% had hypertension; 31% had metabolic syndrome; and 54% were smokers). The median 10-year CV event risk was 8.3% (range 0.3%â63%). 45% had a predicted 10-year CV event risk of >10%. Only 10% of individuals were treated with statins and 27% with antihypertensives. 92% had a predicted âheart ageâ greater than their chronological age (median difference +7 (â4 to +26) years). HRQoL was reduced in all SF36v2 domains in the cohort. Factors independently associated with HRQoL included cirrhosis, metabolic syndrome, history of mental health disorder, sedentary behaviour and HCV viraemia.
Conclusion A large proportion of patients with HCV presented with increased risk of CV events, and rates of smoking and sedentary behaviour were high, while prescribing of primary prophylaxis was infrequent. HRQoL was also reduced in the cohort. A âcare bundleâ was developed to provide a structured approach to treating potentially modifiable health problems