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Questions regarding surgical fusion techniques, postoperative treatment, and indications for return to sport after chronic syndesmosis injury or its comorbidities remain unanswered.
An international group of experts representing the field of injuries in the foot and ankle area was invited to collaboratively advance toward consensus opinions based on the best available evidence regarding chronic syndesmosis injury. All were members of the Asia-Pacific Knee, Arthroscopy and Sports Medicine Society (APKASS).
Consensus statement.
From November to December 2020, a total of 111 international experts on sports medicine or ankle surgery participated in a 2-stage Delphi process that included an anonymous online survey and an online meeting. A total of 13 items with 38 statements were drafted by 13 core authors. Of these, 4 items with 6 clinical questions and statements were related to surgical fusion techniques, comorbidity treatments, postoperative rehabilitation, and return-to-sports indications and are presented here. Each statement was individually presented and discussed, followed by a general vote. The strength of consensus was characterized as follows consensus, 51% to 74%; strong consensus, 75% to 99%; and unanimous, 100%.
Of the 6 questions and statements, 5 achieved unanimous support and 1 reached strong consensus.
This APKASS consensus statement, developed by international experts in the field, will assist surgeons and physical therapists with surgical and postoperative treatment strategies for chronic syndesmosis injury.
This APKASS consensus statement, developed by international experts in the field, will assist surgeons and physical therapists with surgical and postoperative treatment strategies for chronic syndesmosis injury.
Clinical manifestation, radiologic examination, diagnostic criteria, classification, and nonoperative treatment strategies regarding chronic syndesmosis injury remain unclear.
An international group of experts representing the fields of sports injuries in the foot and ankle area were invited to collaboratively advance toward consensus opinions based on the best available evidence regarding chronic syndesmosis injuries. All were members of the Asia-Pacific Knee, Arthroscopy and Sports Medicine Society (APKASS).
Consensus statement.
From November to December 2020, a total of 111 international experts on sports medicine or ankle surgery participated in a 2-stage Delphi process that included an anonymous online survey and an online meeting. A total of 13 items with 38 statements were drafted by 13 core authors. Of these, 4 items with 15 clinical questions and statements were related to the clinical manifestation, radiologic examination, diagnostic criteria, classification, and nonoperative treatment strategies for chronic syndesmosis injury and are presented here. Each statement was individually presented and discussed, followed by a general vote. The strength of consensus was characterized as follows consensus, 51% to 74%; strong consensus, 75% to 99%; unanimous, 100%.
Of the 15 questions and statements, 5 reached unanimous support and 10 achieved strong consensus.
This APKASS consensus statement, developed by international experts in the field, will assist surgeons and physical therapists with diagnosis, classification, and nonoperative treatment strategies for chronic syndesmosis injury.
This APKASS consensus statement, developed by international experts in the field, will assist surgeons and physical therapists with diagnosis, classification, and nonoperative treatment strategies for chronic syndesmosis injury.
Quality of life (QOL) and marital contentment, especially marital satisfaction, are important aspects of life. These items are more important in couples involved in HIV due to the present social stigma among this population considering women more vulnerable. The aim of this study was to determine the QOL and marital contentment status among seroconcordant and serodiscordant HIV couples compared to non-HIV ones.
In this cross-sectional study, 66 serodiscordant, 74 seroconcordant, and 70 non-HIV couples who referred to Lavan High-risk Behavior Counseling Center, Shiraz during September 2017 and December 2019 were studied. QOL and marital contentment were assessed by World Health Organization Quality of Life-BRIEF (WHOQOL BREF) and ENRICH questionnaire, respectively. Chi-square test for qualitative variables, independent T-test and ANOVA followed by LSD post hoc test for quantitative variables were performed. All statistical analyses were performed using SPSS 19.0, and P<0.05 was set as the significant level.
The score of QOL questionnaire was significantly higher in non-HIV couples than serodiscordant and seroconcordant groups (P<0.001). There was no significant difference among seroconcordant and serodiscordant groups (P=0.99), and infected males vs. females (P=0.13). Non-HIV couples had significantly higher marital contentment in comparison to serodiscordant and seroconcordant groups (P<0.001). No difference was detected among seroconcordant and serodiscordant groups (P=0.81) although more contentment was observed among the males (P=0.01).
Our study revealed that QOL and marital contentment were different among non-HIV and HIV infected couples. Besides, marital contentment was higher among males than female's in infected patients.
Our study revealed that QOL and marital contentment were different among non-HIV and HIV infected couples. Besides, marital contentment was higher among males than female's in infected patients.
Midwives are at high-risk during the coronavirus disease (COVID-19) pandemic outbreak. Risks include virus exposures, extra working hours, psychological stressors, fatigue, work burnout, stigma, and physical and psychological violence. However, attention is needed to prepare the midwives during this crisis and help them overcome their challenges. The current study aims to explore Jordanian midwives' experiences of providing health care during the COVID-19 pandemic crisis.
A descriptive phenomenological qualitative study was used. Semi-structured interviews using telephone calls were conducted to collect data from April to May 2020. Each interview lasted for 30-45 minutes. Purposive and snowball sampling strategies were used to recruit 20 midwives from two hospitals. Colaizzi's method was used to analyze the data manually.
Four main themes and eight subthemes were obtained. The main themes included "Living in turmoil"; "Communication dilemma"; "Positive experience over time", and "Seeking support".
Jorgood information resources, and financial rewards.
Non-adherence complicates the management of patients with cardiovascular disease. This study aimed to determine the effect of applying the information-motivation-behavioral skills (IMB) model on the treatment adherence among these patients.
This quasi-experimental study was conducted on 112 patients with cardiovascular disease in Nemazee and Al-zahra hospitals in Shiraz, Iran, from October 2019 to July 2020. Eligible patients were selected and divided into intervention and control groups. The intervention was based on an integration of IMB model constructs and included 10 motivational-educational sessions for three months, followed by telephone consultations for six months. Data were collected before, and three and six months after the end of the motivational-educational sessions using adherence questionnaire in patients with chronic diseases, and adherence in chronic disease scale for medication adherence. Data were analyzed using SPSS 22, and descriptive statistics, chi-square, independent t-test, and re recommended for these patients.
Nowadays, burnout syndrome (BS) symptoms appear to have increased in healthcare workers, specifically midwives, but there are no studies on burnout among midwives in Catalonia. The present study aimed to assess and describe the prevalence of BS in midwives working in labour rooms.
A cross-sectional descriptive study was conducted on 122 midwives working in 24 maternity hospitals in the Barcelona (region) which were selected using purposive sampling from January to March 2017. Data were collected using two questionnaires (demographic information, job burnout using Spanish Burnout Inventory with 20 items and four subscales).Data analysis was performed using SPSS software version 21 and Chi-Square, U Mann-Whitney, and Kruskall-Wallis. P<0.05 was considered statistically significant.
None of the participants obtained a critical level of BS. 37 (30.33%) participants scored medium burnout and 47 (38.52%) recorded low burnout. Statistically, work stress (P=0.01), marital status (P=0.006), attendance of more than three women per shift (P=0.001), the number of children (P=0.01), parity (P=0.005), health status (P=0.04), and being on sick leave over last year (P=0.04) were significantly correlated with medium-high levels of burnout. Burnout scores were higher in midwives having a life partner and those without children.
Following the results, no participant obtained a critical level of BS; about one-third of them scored medium-high burnout. However, specific interventions are suggested to be conducted to maintain the midwives' motivation and prevent burnout development.
Following the results, no participant obtained a critical level of BS; about one-third of them scored medium-high burnout. However, specific interventions are suggested to be conducted to maintain the midwives' motivation and prevent burnout development.
Chronic heart failure can lead to frequent hospitalizations. Improving the discharge planning is an approach to reduce hospitalization. Since there has not been enough structured and effective discharge plan in Iranian hospitals, the present study was designed to optimize this program.
This is a participatory action research based on Hart and Bond's framework, conducted in a cardiovascular center in Iran from June 2016 to April 2018 during two cycles. Based on the optimization strategies obtained through semi-structured interviews with 15 participants, three focus group discussions and six expert panels, the operational discharge plan, including three areas of patient empowerment, telephone follow-up and home visit, was designed, implemented for three months and evaluated for 23 patients. European Heart Failure Self-Care Behavior Scale and information registration form to record the number of hospitalization and length of hospital stay were used to collect the quantitative data. The non-parametric Wilcoxon test was used to analyze the data by SPSS 16. Qualitative participatory evaluation was performed during a group discussion and analyzed based on qualitative content analysis method with conventional approach P<0.05 was statistically significant.
Considering the solutions provided by the participants, the operational discharge plan was designed and implemented with the cooperation of relevant stakeholders. Evaluation showed significant effects of designed discharge plan on self-care behavior (P<0.001), number of hospitalizations (P<0.001), and length of hospital stay (P<0.001).
Changes were made to improve the heart failure patients' discharge plan using action research, which resulted in reduced re-hospitalization and improved self-care behavior.
Changes were made to improve the heart failure patients' discharge plan using action research, which resulted in reduced re-hospitalization and improved self-care behavior.
