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Physical activity is important for healthy ageing. Despite strong evidence on the benefits of physical activity for health and well-being, physical inactivity remains a significant problem among older adults. This study aims to determine the feasibility and acceptability of implementing an online volunteer-led group exercise for older adults.
A quasi-experimental mixed-methods approach will be used in this study. A training programme will be developed to train volunteers to deliver online group exercises to older adults aged >65 years (n=30). The primary outcome is the feasibility of implementing the intervention. This will be assessed by the number of volunteers recruited, trained, and retained at the end of the study, and the number of exercise sessions delivered and completed by participants. Secondary outcomes include physical activity levels measured using the Community Health Model Activities Programme for Seniors questionnaire, Barthel Index, EQ-5D-5L as a measure of health-related quality of lie intervention.
NCT04672200.
NCT04672200.
The Literature is no report support material on Shared Decision-making applied to breast cancer screening that is intended for Spanish health professionals. The researcher created both a handbook and a guide for this topic using an adaption of the Three-talk model.
A Delphi method will be used to reach an agreement among experts on the contents and design of a manual and guide, designed by the research team, and to be used by health professionals in the application of SDM in breast cancer screening.
A qualitative study. The content and design of the handbook and the guide was discussed by 20 experts. The Delphi techniques was in an online mode between July and October 2020 and researchers used Google forms in three rounds with open and closed questions. The criterion established for consensus was a coefficient of concordance (Cc) above 75, for questions using a Likert scale of 1-6-in which 1 meant 'completely disagree' and 6 'completely agree'-with a cut-off point equal to or higher than 4.
Participaneen developed. The handbook and guide are useful and innovative as supporting material for health professionals, but training strategies for SDM and a piloting plan for the use of materials are requested, in order to facilitate its implementation.
Until now, there have been few tools to evaluate whether a surgeon was technically ready to perform a safe pancreaticojejunostomy (PJ). In the current study, we aimed to evaluate whether a three-dimensional model could mimic a real surgical situation and distinguish between surgeons of different levels of experiences.
A three-dimensional PJ dry laboratory model was printed. Eight experienced pancreatic surgeons were tasked to evaluate the appearance and tactile sensation of the model. Proficiency was scored based on 15 surgeons with various levels of pancreatic experience performing a PJ on the three-dimensional model. Additionally, the time of manipulation and NASA Task Load Index (NASA-TLX) scores were recorded for each operation.
Our study was conducted in multimedical centre in China.
Compared with real surgical situations, this model had similar appearance (3.96±0.55 out of five points) and tactile sensation (3.85±0.46 out of five points) according to the expert evaluation. Additionally, the chief surgeon group scored the best in proficiency (based on NASA-TLX scores and operative time), and there were statistical differences for performances among surgeons of various levels (p
0.05).
The three-dimensional PJ model could mimic a real surgical situation and can distinguish between surgeons of different levels of experiences.
The three-dimensional PJ model could mimic a real surgical situation and can distinguish between surgeons of different levels of experiences.
The use of muscle relaxants is an indispensable in the general anaesthesia but is prone to accidents, which are often related to residual muscle relaxant. Therefore, how to timely and effectively eliminate the residual effect of muscle relaxants after surgery has become an urgent clinical problem. Rocuronium is a non-depolarising muscle relaxant that is primarily metabolised by the liver. Patients with liver dysfunction can affect the metabolic process of rocuronium, thereby delaying the recovery of muscle relaxation. Sugammadex (SUG) is a novel-specific antagonist of aminosteroidal muscle relaxants, which can effectively antagonise muscle relaxants at different depths. However, whether liver dysfunction affects the antagonistic effect of SUG against rocuronium has not been reported. Therefore, we hypothesise that with the increase of patients' liver Child-Pugh grade, the recovery time of rocuronium antagonised by the same dose of SUG after surgery will be prolonged, and the incidence of muscle relaxation reer-reviewed scientific journals.
NCT05028088.
NCT05028088.
Hypoglycaemia is a frequent adverse event and major barrier for achieving optimal blood glucose levels in people with type 1 or type 2 diabetes using insulin. The Hypo-RESOLVE (Hypoglycaemia-Redefining SOLutions for better liVEs) consortium aims to further our understanding of the day-to-day impact of hypoglycaemia. The Hypo-METRICS (Hypoglycaemia-MEasurement, ThResholds and ImpaCtS) application (app) is a novel app for smartphones. This app is developed as part of the Hypo-RESOLVE project, using ecological momentary assessment methods that will minimise recall bias and allow for robust investigation of the day-to-day impact of hypoglycaemia. In this paper, the development and planned psychometric analyses of the app are described.
The three phases of development of the Hypo-METRICS app are (1) establish a working group-comprising diabetologists, psychologists and people with diabetes-to define the problem and identify relevant areas of daily functioning; (2) develop app items, with user-testing, and implmission der Medizinischen Universität Graz, Videnskabsetisk Komite for Region Hovedstaden and the Comite Die Protection Des Personnes SUD Mediterranne IV). SPOP-i-6lc purchase The results from the study will be published in peer review journals and presented at national and international conferences.
NCT04304963.
NCT04304963.
To investigate the interrelationships between maternal socioeconomic status (SES), race and congenital heart diseases (CHD) among infants.
Retrospective cohort study.
Ontario, Canada.
All singleton stillbirths and live births born in hospitals between 1 April 2012 and 31 March 2018 in Ontario, Canada (n=804 292).
CHD.
Multivariable logistic regression models were performed to assess associations between maternal neighbourhood household income, education level, race and CHD while adjusting for maternal age at birth, assisted reproductive technology, obesity, pre-existing health conditions, substance use during pregnancy, maternal rural residence and infant's sex.
Compared with infants whose mothers lived in the highest median household income neighbourhoods, infants whose mothers lived in the lowest median income neighbourhoods had a higher likelihood of having CHD (adjusted OR 1.15, 95% CI 1.06 to 1.24). Compared with infants whose mothers lived in neighbourhoods with more people with a university or higher degree, those infants whose mothers lived in neighbourhoods with less people with a university or higher degree had a higher chance of developing CHD (adjusted OR 1.26, 95% CI 1.16 to 1.36). Compared with white mothers, black mothers had a higher odds of giving birth to a child with CHD (adjusted OR 1.40, 95% CI 1.27 to 1.54). No association was detected between White and Asian mothers and CHD among infants.
Our study indicates that there are inequities in CHD burden by maternal SES and race in Ontario, Canada. Further investigation is needed to examine racial variation in CHD using more detailed ethnic data.
Our study indicates that there are inequities in CHD burden by maternal SES and race in Ontario, Canada. Further investigation is needed to examine racial variation in CHD using more detailed ethnic data.
Inflammation and myocardial damage caused by cardiovascular surgery with cardiopulmonary bypass (CPB) have been shown to be the major contributors to postoperative morbidity and mortality. Colchicine can reduce myocardial ischaemia-reperfusion injury in patients with chronic coronary artery disease. However, there is a lack of evidence whether colchicine could reduce myocardial injury after cardiovascular surgery. In this study, we aim to evaluate the effect of low-dose colchicine on myocardial protection during perioperative period in patients who undergo cardiovascular surgery with CPB.
In this randomised controlled trial, a total of 132 patients will be recruited from the Department of Cardio-Thoracic Surgery, Nanjing Drum Tower Hospital. Patients will be randomised into the colchicine treatment group and control group with a ratio of 11. Patients in the colchicine treatment group will receive 0.5 mg of colchicine daily for 3 days before surgery and 0.5 mg of colchicine daily for 5 days after surgery. Patients in the control group will receive placebo instead of colchicine for the same schedule. Level of postoperative myocardial injury will be assessed as the primary outcome. The secondary outcomes are biomarker levels for myocardial injury (such as creatine kinase-MB, cardiac troponin I, myohaemoglobin, type B natriuretic peptide, D-dimer) and inflammatory response markers (white blood cell, procalcitonin, interleukin-6, C reactive protein) for 5 consecutive days after surgery and poor postoperative outcomes.
This study has been approved by Medical Ethics Committee of Affiliated Nanjing Drum Tower Hospital, Nanjing University Medical College (approval number 2020-293-01). Study results will be disseminated through publication in an open access journal.
ChiCTR2000040129.
ChiCTR2000040129.
To evaluate the potential for change to costs from a decision to adopt a novel diagnostic pathway for referrals to cardiology outpatients with symptoms of chest pain.
Costs modelling study using existing observational data, with a cost year of 2018.
Specialist Heart Centre in Singapore.
All new referrals (n=10 622) to the outpatient clinics for investigation between January 2017 and December 2017.
Two competing testing regimes are compared in a decision tree model. Current practice includes classification of patients by their risk and the use of treadmill tests, calcium scores, functional testing and CT angiogram. New practice offers a fundamental difference in use of diagnostics for patients, with some offered angiogram directly and for low-risk patients a calcium score is used to refine risk stratification.
The expected cost difference between testing alternatives.
The expected cost saving from 'New Practice' as compared with 'Current Practice' is $S764 per patient. There is a 50% probability the savings per patient range between $S764 and $S824 and a 90% probability they are between $S616 and $S912. The expected savings to Singapore national health services are $S26.8 million annually, with a range of $S16.2 to $S41.1 million.
We find some evidence that using a coronary calcium score, which can be performed with a fraction of the time and cost of a CT coronary angiogram, saves costs to health services.
We find some evidence that using a coronary calcium score, which can be performed with a fraction of the time and cost of a CT coronary angiogram, saves costs to health services.
