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nd societal burden associated with prosthetic infections.The anterior talofibular ligament and the calcaneofibular ligament were sonographically investigated in 16 patients with functional ankle instability (FAI) and 16 controls under neutral and standardized stress conditions of 15 kp with a TELOS device. Clinical investigation revealed a significantly higher rate of a positive anterior drawer and talar tilt (p less then 0.001, respectively), significantly increased supination (p = 0.047) of the right ankle joint and increased plantarflexion (p = 0.009) of the left ankle joint in the FAI group compared with controls. Significantly higher rates of inhomogeneity and hypo-echogenicity were sonographically observed in both ligaments in the FAI group (p less then 0.05, respectively). The anterior talofibular ligament was significantly longer under stress conditions, and the calcaneofibular ligament was significantly longer under both neutral and stress conditions in the FAI group (p less then 0.05, respectively). Peritendinous edema of the peroneal tendons was found in 22% of the FAI group and 6% of controls.
Health behaviors shape more than 30% of one's physical and mental health, as well as overall well-being. Yet, changing behavior is difficult. This paper aims first at operationalizing the concept of health behavior by focusing on its main components and determinants. BBI608 Second, it gives insights into how to influence health behavior by providing an overview of some of the most commonly used approaches to the design of behavioral interventions.
This is a position paper that presents a selection of evidence-based theories, models and approaches to understand and address behavior.
A health behavior broadly refers to every individual action affecting health, disease, disability, or mortality. Behavior is shaped by factors within the skin (biological, psychological) and outside the skin (interpersonal, environmental, policy). Behavior change has therefore to be addressed from an ecological perspective. Specifically, behavior change can be influenced by changing capability, opportunity and motivation. Depending on the specific determinants of the behavior at stake, there are numerous approaches that can be taken. The main steps to design interventions are defining the problem, selecting and analyzing the target audience, setting objectives, designing the intervention, planning and implementing an evaluation.
Behaviors should not be targeted in isolation but within a socio-ecological approach that accounts for both their individual and environmental determinants.
This paper provides practitioners with the bases of behavior change. It offers a road-map of the main factors to consider and shows how to address behavior by planning an intervention in all its main steps.
This paper provides practitioners with the bases of behavior change. It offers a road-map of the main factors to consider and shows how to address behavior by planning an intervention in all its main steps.
The study aimed to determine the effects of preoperative individualized audiovisual education for laparoscopic cholecystectomy patients on postoperative anxiety and comfort (pain, nausea, and vomiting).
This study was a randomized clinical trial on 124 patients undergoing laparoscopic cholecystectomy. Patients were randomized into an intervention group (individualized audiovisual education) or a control group (standard education). The primary outcome was change in anxiety and comfort levels between the intervention and control groups at baseline and follow-up. Secondary outcomes were change between groups in Patient Learning Needs Scale scores and vital signs.
Although the preoperative visual analog scale (VAS)-pain and VAS-nausea scores of the patients in both groups were similar, the postoperative VAS-pain and VAS-nausea levels of the intervention group were significantly lower than that of the control group (p < 0.05). The anxiety levels of the intervention group were also lower both before (42.79 ± 4.29) and after (39.08 ± 3.49) surgery than that of the control group (50.98 ± 5.45 and 44.41 ± 4.77, respectively).
This study showed that preoperative individualized audiovisual education was effective in reducing anxiety and improving patient comfort.
Preoperative individualized audiovisual education is crucial for clinical care and can be integrated into other patients because of its positive effects on postoperative recovery outcomes.
Preoperative individualized audiovisual education is crucial for clinical care and can be integrated into other patients because of its positive effects on postoperative recovery outcomes.
This article reviews the usability of the Integrated Atlases of Mental Health as a decision support tool for service planning following a health ecosystem research approach.
This study describes the types of atlases and the procedure for their development. Atlases carried out in Spain are presented and their impact in mental health service planning is assessed. Atlases comprise information on the local characteristics of the health care system, geographical availability of resources collected with the DESDE-LTC instrument and their use. Atlases use geographic information systems and other visualisation tools. Atlases follow a bottom-up collaborative approach involving decision-makers from planning agencies for their development and external validation.
Since 2005, Integrated Atlases of Mental Health have been developed for nine regions in Spain comprising over 65% of the Spanish inhabitants. The impact on service planning has been unequal for the different regions. Catalonia, Biscay and Gipuzkoa, and Andalusia reach the highest impact. In these areas, health advisors have been actively involved in their co-design and implementation in service planning.
Atlases allow detecting care gaps and duplications in care provision; monitoring changes of the system over time, and carrying out national and international comparisons, efficiency modelling and benchmarking. The knowledge provided by atlases could be incorporated to decision support systems in order to support an efficient mental health service planning based on evidence-informed policy.
Atlases allow detecting care gaps and duplications in care provision; monitoring changes of the system over time, and carrying out national and international comparisons, efficiency modelling and benchmarking. The knowledge provided by atlases could be incorporated to decision support systems in order to support an efficient mental health service planning based on evidence-informed policy.Vaccination has contributed greatly to the control of infectious diseases; however, regional and individual differences are occasionally observed in the efficacy of vaccination. As one explanation for these differences, much attention has focused on the intestinal environment constructed by the interaction of diet and the gut microbiota. The intestinal environment has several physiological effects on the host immune system, both locally and systemically, and consequently influences the efficacy of vaccination. In this review, we discuss the impact of the gut microbiota and dietary nutrients on systemic and oral vaccination as well as their applications in various strategies for immunoregulation, including use as vaccine adjuvants. This information could contribute to establishing methods of personalized vaccination that would optimize host immunity by changing the gut environment to maximize vaccine effects.Serological results obtained in a single laboratory from twin-studies on maternal immunisation, in Vietnam and Belgium offer the opportunity to compare antibody kinetics in infants before and after infant vaccination in the presence of vaccine-induced maternal antibodies. Nonlinear mixed-effects models (NLMMs) making use of a hypothesised dynamic evolution that captures the change in antibody titres over time, were employed to model anti-PT and anti-Prn antibody dynamics. Our proposed modelling approach provided useful insight into understanding the differences in the infants' antibody kinetics in both countries since NLMMs offer the possibility of pooling all data in one analysis and incorporate relevant covariates of interest. In both controlled cohort studies, pregnant women were vaccinated with a tetanus, diphtheria, acellular pertussis (Tdap) vaccine (Boostrix®, Belgium; Adacel®, Vietnam), and children were followed before and after primary vaccination, and before and after booster vaccination (Infanrix hexa®). From our models, both anti-PRN and anti-PT antibody titres at birth of Vietnamese infants were significantly lower than those of Belgian infants born to vaccinated women groups. Even though the antibody titres in the cord at birth of Belgian infants were also higher than those of Vietnamese infants born to the control women groups, the difference was not significant. The significant difference between infants born to vaccinated women in the two countries was likely due to the use of different vaccine brands in pregnant women and the different vaccination histories of women in these two countries. Our analyses also suggested that the blunting effect was present during the primary immunisation but went away afterward for anti-PT data. In contrast, for anti-PRN antibodies, the blunting effect persisted after the primary vaccination and possibly went away after the booster dose. Countries should be aware of the regional situation in view of recommending maternal immunization.High-risk organisations (HRO), including aviation, undergo formal communication training, with emphasis on safety-critical moments. Such training is not widespread or mandatory in healthcare, and while there are many differences both share the 'human element' with circumstances leading to an increased risk of harm. A typical operating theatre consists of an operating surgeon, and an assisting surgeon, roles that may change throughout the course of a procedure. Similarly, a training aircraft or multi-crew cockpit (flight deck) has a pilot in control, or 'pilot flying', and a 'pilot not flying'. Both interact with wider teams, for example the scrub team and air traffic controllers, respectively. Surgical error is the second most prevalent cause of preventable harm to patients after drug errors. Every year in the UK National Health Service (NHS), there are typically 500 never events, 21,000 serious incidents, and many more episodes of physical or psychological harm. Ineffective communication (46%) is the most common behavioural factor leading to a never event. In this review, we examine the concept of 'sterile cockpit', use of unambiguous terminology, callsigns, important information readback, sharing of mental models, and the mini-brief, and how these may be used to reduce patient harm during safety-critical moments.The current study assesses the persistent organic pollutants (POPs) in water and their bioaccumulation in Brown Trout (BT) and Rainbow Trout (RT) present in the remote alpine lakes (RALs) of Himalayas, Pakistan. Hence, these environments might receive POPs by long range atmospheric transport (LRAT) with little interferences from local anthropogenic activities. The potential transportation pathways for such accumulation can be atmospheric precipitation, melting ice and glacial runoff. The results indicated that the sum of mean concentrations of organochlorine pesticides (OCPs (DDTs + HCHs)) in water of Glacial-fed lakes, Ice melting-fed lake and Rain-fed lake ranged from 0.21 to 317, 0.14-293, 0.16-235 pg L-1, respectively, while those of polychlorinated biphenyls (PCBs) are 0.275-16.02, 0-15.88, 0.234-14.46 pg L-1, respectively. Similarly, the sum of mean concentrations of all investigated PCBs and OCPs in BT ranged from 0.008 to 0.715 ng g-1 and 0.003-3.835 ng g-1 based on wet weight (ww), while for RT these concentrations were 0.
