Lindseyborregaard6709

BACKGROUND Minimally invasive surgery is heavily dependent on indirect visualization and image guidance, often resulting in non-ergonomic postures. Minimally invasive surgeons are more likely to experience neck pain, shoulder pain, and fatigue compared to open surgeons. Spinal endoscopy is rapidly increasing in popularity amongst minimally invasive spine surgeons. A primary ergonomic issue is the position of the endoscope display, which is often not in line with the operative field or the surgeon's natural line of sight. METHODS Smart glasses providing a head-up display are used in a case of percutaneous endoscopic lumbar discectomy to bring the surgeon's line of sight into parallel with the operative field. RESULTS Bringing the surgeon's visual and motor axes into parallel resulted in a more comfortable and ergonomic operating position. CONCLUSIONS Head-up displays may provide an elegant and relatively simple solution to the issue of inadequate ergonomics in minimally invasive surgery. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.AIM To raise awareness of a patient-related antecedent of missed nursing care. BACKGROUND Missed nursing care is negatively associated with patient outcomes; accordingly, hospitals employ strategies to mitigate missed care. While antecedents of missed nursing care resulting from the work environment of nurses are recognized, sexual harassment by patients is not. METHODS This study is a hidden population study using respondent-driven sampling. We analysed data from thirty letters of frontline nurses from a tertiary Israeli hospital using the six steps of Aronson's thematic analysis. Compound C inhibitor FINDINGS Six themes emerged. Nurses (a) felt objectified and that the sacred nurse-patient therapeutic space was desecrated; (b) felt a lack of support from ward managers; (c) felt unprotected, lonely, and alienated; (d) did not share the experience with managers; (e) coped with sexual harassment by ending treatment quickly and later realized they missed some tasks; and (f) considered leaving nursing. CONCLUSION (S) Policymakers are called upon to adopt the eight steps suggested for effectively coping with sexual harassment by patients and thus to reduce missed nursing care. IMPLICATIONS FOR NURSING MANAGEMENT Managers are called upon to modify their management style and to provide support to nurses who experience sexual harassment in order to alleviate their stress, which is an also antecedent of missed nursing care. © 2020 John Wiley & Sons Ltd.AIM To examine nursing care left undone and its relationship with the nursing practice environment and perceived quality of nursing care in small Australian rural hospitals. BACKGROUND Nurses in small rural hospitals often work with few resources, limited backup and staff shortages. The relationship between this rural practice environment and care left undone has not been fully explored. METHOD A descriptive cross-sectional survey. RESULTS Over half participants (n = 241, 62.9%) reported having left some activities undone on their most recent shift. There were moderately significant correlations between care left undone and nursing practice environment and overall quality of care. Nurses who reported leaving care left undone had statistically significant lower perceptions of the nursing practice environment than those who had no care left undone. CONCLUSION Nursing care activities are being left undone in rural hospitals. link2 Both care left undone and quality of nursing care may be affected by the nursing practice environment. IMPLICATIONS FOR NURSING MANAGEMENT To maximize care quality, rural hospital managers must consider the prevalence of care left undone and may use this information as a predictor of both patient outcomes and staffing and resource requirements. Given the challenges of rural hospitals, rural nurse managers can use this evidence to support their requests for increased staffing and resources. © 2020 John Wiley & Sons Ltd.OBJECTIVES Voice patients with voice disorders have a high prevalence of distress and mental health (MH) comorbidities, but it is unknown to what extent distress precedes or follows voice disorder diagnoses. Objectives were to compare 1) proportions of voice patients with MH diagnoses who received MH diagnoses first versus voice-related diagnoses first, 2) voice-related diagnoses and care utilization, and 3) time to specialty evaluation in each group. METHODS Patients with voice and MH diagnoses were identified using International Classification of Diseases, Ninth and Tenth Revisions codes in a large health system data repository from January 2005 through July 2017. Sociodemographics, comorbidities, MH- and voice-related diagnoses, and voice-related care utilization were analyzed using descriptive statistics and multivariable regression modeling. RESULTS Among the 11,419 patients with both voice and MH diagnoses, 63% (n = 7,251) received MH diagnoses prior to voice diagnoses, compared with 37% with a voice diagnosis first (P less then  0.0001). The latter group received more specific voice-related diagnoses (e.g., laryngeal cancer [odds ratio (OR) 4.27], benign laryngeal neoplasm [OR 1.60]), and were more likely to ever see an otolaryngologist than those receiving MH diagnoses first (P less then  0.0001). CONCLUSION Most patients with voice and MH diagnoses received a MH diagnosis first. Patients who receive MH diagnoses first appeared to have different voice-related healthcare compared to those who received voice diagnoses first. LEVEL OF EVIDENCE NA Laryngoscope, 2019. © 2019 The American Laryngological, Rhinological and Otological Society, Inc.NEW FINDINGS What is the central question of this study? Astronauts onboard the International Space Station (ISS) perform daily exercises designed to prevent muscle atrophy and bone demineralisation. The present study assessed the effect of resistive exercise performed by subjects while exposed to the same level of hypercapnia as on the ISS on intraocular pressure (IOP). What is the main finding and its importance? The static exercise-induced IOP elevation in intraocular pressure during 6° prone head down tilt (simulating the headward shift of body fluids in microgravity) is augmented by hypercapnia, and exceeds the ocular hypertension threshold. ABSTRACT The present study assessed the effect of 6° head down (establishing the cephalad displacement noted in astronauts in microgravity) prone (simulating the effect on the eye) tilt during rest and exercise (simulating exercise performed by astronauts to mitigate the sarcopenia induced by unloading of weight-bearing limbs), in normocapnic and hypercapnic conditio hypercapnia. The observed IOP measured during prone 6°HDT in all phases of the NCAP and HCAP trials exceeded the threshold pressure defining ocular hypertension. The exercise-induced increase in IOP is exacerbated by hypercapnia. This article is protected by copyright. link3 All rights reserved. This article is protected by copyright. All rights reserved.OBJECTIVES/HYPOTHESIS In recent years, basic fibroblast growth factor (bFGF) injection has been used in the treatment of aging-related vocal fold atrophy. This injection not only improves closure by increasing the mass of the vocal fold but also improves its viscoelasticity. However, it has been reported that fibroblasts targeted by bFGF treatment decrease in number with age. The purpose of this study was to examine the effects of local injection of bFGF on age-related vocal atrophy as well as the influence of age on phonological outcomes. STUDY DESIGN Retrospective chart review. METHODS Fifty-three patients with age-related vocal fold atrophy underwent single injections of bFGF in their vocal folds. Phonological outcomes were evaluated 3 and 6 months after injection by acoustic and aerodynamic measurements. RESULTS Voice Handicap Index (VHI), maximum phonation time (MPT), jitter, shimmer, and pitch range improved after injection, and the effects continued for 6 months. In those over 70 years of age, VHI and MPT showed improvement at 3 and 6 months after injection. In addition, the degree of improvement in VHI and MPT did not differ significantly between those older than 70 years and those younger than 70 years. CONCLUSIONS Regenerative treatments dependent on bFGF single injection was safe and effective for both early and late elderly patients suffering of vocal fold atrophy. LEVEL OF EVIDENCE 2c Laryngoscope, 2020. © 2020 The American Laryngological, Rhinological and Otological Society, Inc.Five biologicals have been approved for severe eosinophilic asthma, a well-recognized phenotype. Systematic reviews (SR) evaluated the efficacy and safety of benralizumab, dupilumab, mepolizumab, omalizumab and reslizumab (alphabetical order) compared to standard of care for severe eosinophilic asthma. PubMed, Embase and Cochrane Library were searched to identify RCTs and health economic evaluations, published in English. Critical and important asthma-related outcomes were evaluated for each of the biologicals. The risk of bias and the certainty of the evidence were assessed using GRADE. 19 RCTs (three RCTs for benralizumab, three RCTs for dupilumab, three RCTs for mepolizumab, five RCTs for omalizumab and five RCTs for reslizumab), including subjects 12 to 75 years old (except for omalizumab including also subjects 6-11 years old), ranging from 12 to 56 weeks were evaluated. All biologicals reduce exacerbation rates with high certainty of evidence benralizumab incidence rate ratio (IRR) 0.53 (95% CI 0.39 to mab for reducing OCS. There is moderate certainty for improving asthma control, QoL, FEV1 . More data on long-term safety are needed together with more efficacy data in the paediatric population. © 2020 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.OBJECTIVES Although lateral osteotomy is an important part of rhinoplasty, it is known to be closely associated with postoperative eyelid edema and ecchymosis after rhinoplasty. There is no consensus on which osteotomy methods are effective in reducing morbidity from rhinoplasty. This study compared the effects of different osteotomy methods on edema and ecchymosis after lateral osteotomy using a meta-analysis. STUDY DESIGN A literature search using MEDLINE, SCOPUS, and Cochrane databases. METHODS Two authors independently reviewed the databases published until May 2019. Randomized controlled trials that compared lateral osteotomy methods (external approach) with different methods (internal approach), for which the outcomes of interest were mucosal injury, edema, and ecchymosis on postoperative days, were included. Sufficient data for meta-analysis was found in six studies with a total of 224 patients. RESULTS In a comparison of the external approach with the internal approach, mucosal injury was significantly lower in the external approach (odds ratio = 0.41; 95% confidence interval = [0.11; 0.99], I2 = 29%). There were significant differences between the external and internal approach in eyelid ecchymosis and edema, except for eyelid ecchymosis at 7 days postoperatively. However, all significant results showed a small effect size with a standardized mean difference near 0.2. CONCLUSIONS The external approach during lateral osteotomy had no significant advantage in edema and ecchymosis compared to the internal approach. Further studies with good research methodology should be carried out to determine the effect on the postoperative complications of different lateral osteotomy methods. Laryngoscope, 2020. © 2020 The American Laryngological, Rhinological and Otological Society, Inc.