Kjergentry5898

was feasible across multiple sites. Overall adherence was much higher than expected despite prescreening for at-risk individuals. SmartADHERE illustrates the challenges of trials of behavioral and technology interventions, where enrollment itself may lead to selection bias or treatment effects. Pragmatic study designs, such as cluster randomization or stepped-wedge implementation, should be considered to improve enrollment and generalizability.

The present study aimed to investigate the effects of oral steroids on olfactory disturbances in patients with chronic rhinosinusitis with nasal polyps (CRSwNP).

This is a prospective randomized non-blinded study. Selected CRSwNP patients (n=140), with hyposmia, were devided into two groups; group A received a 7-day course of oral steroids with a 12-weeks course of nasal steroids and douching; group B received a 12-weeks course of nasal steroids and douching. Assessment included Sniffin' Sticks scores, visual analogue scale score for olfaction and discomfort (VASsmell, VASdis), the Sinonasal Outcome Test-22, Greek-version (SNOT22-Gr) and the endoscopic appearance (EAS).

The main objective was to compare the olfactory effect of the different therapy in group A and group B, at 2, 12 and 24 weeks. Accessory objectives included the comparison of EAS, VASdis and SNOT22-Gr between groups, the evaluation of the therapeutic outcome duration, and, the investigation of potential correlation between the evaluated parameters.

The 2-weeks evaluation showed a significant statistical difference (P<0.001) for all parameters except VASdis. Olfactory outcomes (Sniffin' Sticks and VASsmell scale scores) were found significantly better in group A at the 24-weeks evaluation (P<0.001). Within groups, the therapeutic result remained stable between the 12-weeks and 24-weeks evaluation (P>0.05). Sniffin' Sticks score was strongly correlated at 12-weeks evaluation with EAS (rho=0.58, P<0.001).

Our results suggest that a combination treatment of oral and nasal steroids in well-selected patients with CRSwNP may result in early olfaction restoration with a possible long-term effect.

Our results suggest that a combination treatment of oral and nasal steroids in well-selected patients with CRSwNP may result in early olfaction restoration with a possible long-term effect.

COVID-19 has brought unprecedented demands to general practitioners (GPs) worldwide. We examined their knowledge, preparedness, and experiences managing COVID-19 in Australia.

A cross-sectional online survey of GPs members of the Royal Australian College of General Practitioners (RACGP) was conducted between June and September 2020.

Out of 244 survey responses, a majority of GPs (76.6%) indicated having good knowledge of COVID-19, relying mostly on state/territory department of health (84.4%) and the RACGP (76.2%) websites to source up-to-date information. Most felt prepared to manage patients with COVID-19 (75.7%), yet over half reported not receiving training in the use of PPE. The majority were concerned about contracting SARS-CoV-2, more stressed than usual, and have heavier workloads. Their greatest challenges included scarcity of PPE, personal distress, and information overload.

Access to PPE, training, accurate information, and preparedness are fundamental for the successful role of general practices during outbreaks.

Access to PPE, training, accurate information, and preparedness are fundamental for the successful role of general practices during outbreaks.

Pervasive polemics of differing approaches to and values of maternity care limit possibilities of nuanced and productive understandings of how maternity care is experienced.

To explore how maternity care identities (midwife, obstetrician, childbearing woman) are shaped by binarised conceptualisations of childbirth.

The diffractive analysis of data gathered in collective biography research groups.

Maternity care identities are not complete, pre-established entities, but rather are, 'in the making', remade in every maternity care encounter.

Maternity care identities are defined by their encounters with other maternity care identities, and therefore, each maternity care identity plays a role in which experiences of maternity care come into being.

Maternity care identities are defined by their encounters with other maternity care identities, and therefore, each maternity care identity plays a role in which experiences of maternity care come into being.

Woman centred care is purported to underpin Midwifery philosophy. However, the evidence and focus of this concept within midwifery professional standards has yet to be verified. Further to this, woman centred care is, at this time, mostly depicted as a way of assisting, supporting and interacting with a woman and her family. It is however, without a substantive universally accepted definition.

This study aimed to review midwifery standards documents. An organised and targeted methodology was conducted to identify the approaches to woman centred care that currently underpin midwifery governance.

A comprehensive and specific search for 'woman centred care' was conducted across a global collection of midwifery standards. A professional document was included if it represented either or all of the underpinnings of midwifery education, contained statements related to standards of practice, overall governance or any equivalence. Individual documents were initially searched for the words 'woman centred care', feration of Midwives (ICM). The World Health Organisation (WHO), yielded midwifery information from a further sixty-one nations. The phrase 'woman centred care' was located within 3.5% of the documents reviewed. Overall, five examples were found that directly referred to the actual phrase 'woman centred care' and one to the use of 'person centred care'. M4344 Therefore, it was established, that at the time of this review, there was limited formal depiction of the concept of woman centred care.Percutaneous revascularization of chronic total occlusions (CTOs) is known for the high technical complexity. Considering the constant increase in CTO procedures, subsequent peri-procedural complications will rise too, thus they need to be promptly recognized and evaluated for their potential risk of clinical sequelae. We report the case of a newly described complication during trans-septal retrograde CTO intervention a septal collateral artery dissection due to endothelial avulsion.