Effect of Educational Program on Compliance of Myocardial Infarction (MI) Patients in Gaza Strip

Myocardial infarction is a major cause of death and disability worldwide and in Palestine as well. Acute myocardial infarction is considered the main cause of death among males 15-59 year old.  Mortality rate from MI is 18.7% in males and 7.7% in females worldwide. However, recently it has become evidenced that there are certain modifiable factors that may contribute to the occurrence of MI. Such factors if recognized and acted upon may prevent MI or its recurrence. The aim of this study; was to determine the effect of an educational program on compliance of myocardial infarction patients in Gaza Strip. Research design; Quasi-experimental design (pre-test/post-test) was used in this study. The study sample; consisted of 65 clients suffering from myocardial infarction who were selected randomly from cardiac outpatient clinics in Shifa and Nasser hospital in Gaza Strip. Tools for data collection included structured interviewing questionnaire that was used to collect data on socio-demographic characteristics, pretest and post-test questionnaire about patient's knowledge and reported practices, then biochemical lipid profile levels results were taken from patients' health records. Study results revealed a statistically significant difference between pre and post educational program in most variables related to patient's knowledge about the nature of myocardial infarction, causes, signs and symptoms, complications and medication. Also, a highly statistically significant difference was found between pre and post educational program in relation to subject's reported practices. The study concluded that, educational program implicated changes in myocardial infarction subjects' knowledge, and reported practices. The study recommended generalizing such educational program in other cardiac clinics in Gaza Strip in order to improve myocardial infarction patients' compliance to medication, diet, exercise, smoking cessation and stress management. This would ultimately increase the quality of life for myocardial infarction patients and decrease the incidence of complications. Keyword: compliance, myocardial infarction, educational program, knowledge, reported practic

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

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population