Patient satisfaction during and following procedural sedation for ambulatory surgery

Background: Patient satisfaction is multidimensional. The clinician's perspective of a good outcome and the patient's experience of a satisfactory service are often two different end-points. The primary aim of our study was to assess the perioperative experience of patients undergoing procedural sedation. A secondary aim was to create a postoperative questionnaire which could be used as a measurement tool. The questions could also be used as an audit to assist with adherence to quality assurance and clinical governance. Method: A questionnaire was compiled to attempt to assess the perioperative aspects of procedural sedation. Five hundred consecutive patients undergoing procedural sedation for dental-related outpatient procedures were asked to complete a questionnaire. Patients who didn't complete it were excluded. Ninety-eight per cent of the patients returned the questionnaire and 489 questionnaires were evaluated. Results: A total of 489 patients were included. Ninetythree per cent of the patients expressed a good (7+/10) overall experience of procedural sedation, and 92.6% indicated that they would recommend it to others. Conclusion: Our study population showed a high level of satisfaction with their sedation experience. It is suggested that the devised questionnaire could be used successfully in future as an assessment tool or audit of patient satisfaction following procedural sedation for ambulatory surgery.DHE

Patient satisfaction during and following procedural sedation for ambulatory surgery

Background: Patient satisfaction is multidimensional. The clinician’s perspective of a good outcome and the patient’s experience of a satisfactory service are often two different end-points. The primary aim of our study was to assess the perioperative experience of patients undergoing procedural sedation. A  secondary aim was to create a postoperative questionnaire which could be used as a measurement tool. The questions could also be used as an audit to assist with adherence to quality assurance and clinical governance.Method: A questionnaire was compiled to attempt to assess the perioperative aspects of procedural  sedation. Five hundred consecutive patients undergoing procedural sedation for dental-related outpatient  procedures were asked to complete a questionnaire. Patients who didn’t complete it were excluded.  Ninety-eight per cent of the patients returned the questionnaire and 489 questionnaires were evaluated.Results: A total of 489 patients were included. Ninety-three per cent of the patients expressed a good (7+/10) overall experience of procedural sedation, and 92.6% indicated that they would recommend it to others.Conclusion: Our study population showed a high level of satisfaction with their sedation experience. It is suggested that the devised questionnaire could be used successfully in future as an assessment tool or audit of patient satisfaction following procedural sedation for ambulatory surgery.Keywords: patient satisfaction, postoperative questionnaire, procedural sedatio

Cancer incidence and mortality in patients with insulin-treated diabetes: a UK cohort study

Raised risks of several cancers have been found in patients with type II diabetes, but there are few data on cancer risk in type I diabetes. We conducted a cohort study of 28 900 UK patients with insulin-treated diabetes followed for 520 517 person-years, and compared their cancer incidence and mortality with national expectations. To analyse by diabetes type, we examined risks separately in 23 834 patients diagnosed with diabetes under the age of 30 years, who will almost all have had type I diabetes, and 5066 patients diagnosed at ages 30–49 years, who probably mainly had type II. Relative risks of cancer overall were close to unity, but ovarian cancer risk was highly significantly raised in patients with diabetes diagnosed under age 30 years (standardised incidence ratio (SIR)=2.14; 95% confidence interval (CI) 1.22–3.48; standardised mortality ratio (SMR)=2.90; 95% CI 1.45–5.19), with greatest risks for those with diabetes diagnosed at ages 10–19 years. Risks of cancer at other major sites were not substantially raised for type I patients. The excesses of obesity- and alcohol-related cancers in type II diabetes may be due to confounding rather than diabetes per se

Profiling Diuraphis noxia (Hemiptera: Aphididae) Transcript Expression of the Biotypes SA1 and SAM Feeding on Various Triticum aestivum Varieties

The intimate relationship between an aphid and its host is mediated by the composition of the secreted saliva. In the present study, aphid heads were sampled and transcript profiling conducted after aphids were fed on their preference host and transferred to a variety of preference and nonpreference hosts. It was found that the virulent Diuraphis noxia (Kurdjumov) (Hemiptera: Aphididae) biotype SAM was able to selectively up-regulate more transcripts when confronted with feeding on a variety of hosts, than was the case with the less virulent D. noxia biotype SA1, suggesting increased genomic regulation when coping with a stressful environment. Collectively, the observed transcriptomic changes are supported by previous findings that host changes induce significant changes in the proteome of phytophagous hemipterans, unlike in many other entomophagous generalist species. The current data suggest that highly specialized hemipterans may be able to counter plant defenses with inducible salivary transcripts with resulting protein biosynthesis, as demonstrated here.The Winter Cereal Trust, the National Research Foundation, the Technology and Human Resources for Industry Programme, and the Department of Trade and Industry. The research was funded through THRIP Grant: TP2010072900011; NRF Competitive Programme for Rated Researchers (CPRR) Grant: CPR20110615000019459; and NRF Incentive Funding for Rated Researchers Programme (IFR) Grant: IFR201004200013.https://academic.oup.com/jee2018-04-01hj2018Genetic