Poročila Trobec, Tajan; Stojilković, Borut; Rogelj, Boštjan ...
Dela (Univerza v Ljubljani. Oddelek za geografijo),
12/2022
58
Journal Article
Recenzirano
Odprti dostop
Terensko proučevanje prsti
Geografsko raziskovanje slovenske Istre 1
Slovenske manjšine v sosednjih državah
Izvajanje pristopa LEADER/CLLD v Sloveniji
Slovenske srenje kot izročilo in priložnost
...Mesec prostora 2022
Zaključek projekta na temo potencialno onesnaženih območij v Sloveniji – vzpostavitev baze ter izdelava modela za ocenjevanje potrebe po njihovi prednostni obravnavi
CELSA bilateralni raziskovalni projekt s KU Leuven na temo podpornega okolja za nove pristopnike v kmetijstvo
Modra fakulteta: odgovor Univerze v Ljubljani na dolgoživost
Trajnostni razvoj turizma – prakse in pristopi v Srbiji in Sloveniji
Poročila Potočnik Slavič, Irma; Zupančič, Jernej; Kušar, Simon ...
Dela (Univerza v Ljubljani. Oddelek za geografijo),
12/2021
56
Journal Article
Recenzirano
Odprti dostop
Krajevna skupnost pod drobnogledom v prostoru in času
Pregled zgodovine slovenske skupnosti v Elyju, Minnesota/Politična participacija slovenskih etničnih skupnosti v ZDA. Študija primerov v ...Clevelandu, Ohio, in Elyju, Minnesota
Priročnik za prepoznavanje in načrtovanje zelene infrastrukture
Novi pristopniki v kmetijstvo: uporaba in učinki rezultatov projekta NEWBIE
Poročilo delavnice projekta SYStem (Share Your Soils) v Estremaduri
Social Enterprises (SEs) have become the focus of increased policy attention internationally and at the EU level in recent years. Not as much attention, however, has been given to identifying and ...eliminating their skills gaps and training needs. Following the principles of the Training Needs Analysis (TNA) methodology and collecting data from different stakeholders on the social entrepreneurship sector of four EU countries (Italy, Ireland, Greece, and Slovenia) participating in the EU project ‘SocialB’, this paper examines the development of its training content, and how this addresses the SEs’ training challenges regarding management, sustainability and growth issues. This paper outlines the steps this project followed in tackling these issues through developing innovative learning content and training delivery methodology.
ABSTRACT
Purpose
There is no consensus regarding how best to measure postoperative quality of recovery after anesthesia/surgery (e.g., using 24-hour survey instruments) in veterans or active ...military. Our goals were to (1) describe health-related quality-of-life (HRQoL) and recovery across time in veterans, (2) examine the commonality between the quality of recovery (QoR-15) and short-form (SF) surveys (including the SF-8, 24-hour version), and (3) examine the responsiveness of these surveys.
Materials and Methods
This study was approved by the Institutional Review Boards from the University of Pittsburgh, the VA Pittsburgh, and the Human Research Protection Office of the Department of Defense. Secondary analyses of data were executed based on a randomized trial dataset of knee/hip arthroplasty patients, the study having recruited 135 total veterans. QoR-15 and HRQoL SF surveys were completed and self-reported before surgery (pre-op), on postoperative day 2 (PO-D2), and 6 weeks postoperatively. Descriptive statistics were used to examine scores across time. Common content was examined using Pearson’s r. Responsiveness was examined using distribution-based methods.
Results
Average veteran age was 67 year, 89% were male, 88% white, and average body mass index was 33 kg∙m−2. QoR-15 scores declined from pre-op to PO-D2 but were higher than pre-op at 6 weeks. SF physical component summary (PCS) scores were low both pre-op and PO-D2, but were elevated over baseline at 6 weeks. SF mental component summary (MCS) scores declined from baseline to PO-D2 but were higher than pre-op at 6 weeks. Associations of the QoR-15 total score and PCS/MCS were medium/large and statistically significant at P ≤ .01. Both instruments were responsive to changes.
Conclusion
QoR-15 and SF-8 have high content commonality and performed similarly in veterans across time. SF-8 has added benefits of (1) brevity, (2) assessment of physical and mental health components, and (3) being normed to the general population. The SF-8, if used without the QoR-15 in tandem in future study of anesthesia-related outcomes, would need to be supplemented by separate questions addressing postoperative nausea/vomiting (a frequent outcome after anesthesia that is relevant to same-day and next-day mobilization after elective joint replacement surgery).
ABSTRACT
Introduction
Valid measures of pain are helpful to adjust treatment plans in real time after total joint replacement (TJR). We enhanced the existing Defense and Veterans Pain Rating Scale ...(DVPRS) with items related to pain at rest and movement, in specific reference to operative and nonoperative joints, creating the TJR-DVPRS. This manuscript is presented to validate the modified survey instrument. The aims of this psychometric study were to evaluate (1) the latent structure of the TJR-DVPRS, (2) the relationships among the pain dimensions represented on the TJR-DVPRS and the reference-standard Short-Form McGill Pain Questionnaire (version 2, SF-MPQ-2), and (3) the responsiveness of these two measures before and after TJR.
Materials and Methods
This report involves a secondary analysis of pain surveys from 135 veterans undergoing TJR at one center who participated in a randomized trial. The study was approved by the institutional review boards from participating institutions. The TJR-DVPRS and SF-MPQ-2 were completed preoperatively, during postoperative day 1, and 6 weeks post-surgery. Standard psychometric evaluations included correlations, principal component analysis, and internal consistency of survey items and subscales, using preoperative baseline data as a frame of reference. Responsiveness analysis included assessing both effect size and thresholds of clinically important change for survey subscales using data from all three time points.
Results
Two reliable subscales were identified for the TJR-DVPRS, one including items about pain intensity and interference related to the operative joint (Cronbach’s α = .809) and the other including two pain items on the nonoperative joint. Combining the subscales indicated a two-factor solution: The first valid factor entailed the four subscales of the SF-MPQ-2 and the TJR-DVPRS operative joint subscales, indicating that these subscales validly represent the same pain dimension. The second valid factor entailed the TJR-DVPRS subscale addressing the nonoperative joint. Responsiveness analysis following accepted psychometric methods demonstrated significant decreases in pain from the preoperative period to 6 weeks postoperatively for all subscales. The TJR-DVPRS and SF-MPQ-2 subscales were similarly responsive, except for the SF-MPQ-2 neuropathic and TJR-DVPRS nonoperative joint subscales, which were minimally responsive during the preoperative to 6-week period.
Conclusions
The TJR-DVPRS is valid for use among veterans undergoing TJR and poses significantly less respondent burden than does the SF-MPQ-2. The brevity and ease of use of the TJR-DVPRS make it a practical tool for use during surgical recovery to monitor pain intensity at rest and with movement in the operative joint, and to assess pain interference with activity, sleep, and mood. The TJR-DVPRS is at least as responsive as the SF-MPQ-2, but the SF-MPQ-2 neuropathic and TJR-DVPRS nonoperative joint subscales were minimally responsive. Limitations of this study include the small sample size, under-representation of women (which would be expected in the veteran population), and using only veterans. Future validations studies should include civilians and active military TJR patients.
Abstract
Objective
We tested the hypothesis that buprenorphine-clonidine-dexamethasone (BCD) extends perineural analgesia compared with plain bupivacaine (BPV) nerve blocks used for hip and knee ...replacement surgery.
Design
Prospective, parallel-arms, randomized, double-blind trial.
Setting
A single veterans’ hospital.
Subjects
Seventy-eight veterans scheduled for total hip or knee replacement with plans for spinal as the primary anesthetic.
Methods
Participants underwent nerve/plexus blocks at L2–L4 and L4–S3 in advance of hip or knee joint replacement surgery. Patients were randomized to receive BPV-BCD or plain BPV in a 4:1 allocation ratio. Patients answered four block duration questions (listed below). Time differences between treatments were analyzed using the t test.
Results
Significant (P < 0.001) prolongation of the time parameters was reported by patients after the BPV-BCD blocks (N = 62) vs plain BPV (N = 16). The time until start of postoperative pain was 26 vs 11 hours (mean difference = 15 hours, 95% CI = 8 to 21). The time until no pain relief from the blocks was 32 vs 15 hours (mean difference = 17 hours, 95% CI = 10 to 24). The time until the numbness wore off was 37 vs 21 hours (mean difference = 16 hours, 95% CI = 8 to 23). The time until the worst postoperative pain was 39 vs 20 hours (mean difference = 19 hours, 95% CI = 11 to 27).
Conclusions
BPV-BCD provided 26–39 hours of perineural analgesia in the L2–L4 and L4–S3 nerve distributions after hip/knee replacement surgery, compared with 11–21 hours for plain BPV.
Abstract
Objective
To compare pain outcome reports of patients undergoing hip or knee replacement who received single-injection nerve/plexus blocks with plain bupivacaine (BPV) with those of patients ...who received injections of buprenorphine-clonidine-dexamethasone (BCD) admixed with BPV.
Design
Prospective, parallel-arm, randomized, double-blind trial.
Setting
A single veterans’ hospital.
Subjects
Ninety-eight veterans scheduled for total hip or knee replacement surgery with spinal as the primary anesthetic.
Methods
Participants were randomized to BPV-BCD or plain BPV groups. They underwent nerve/plexus blocks in the L2–L4 and L4–S3 distributions in advance of joint replacement surgery. The primary outcome was change in pain from baseline during the postoperative day, as assessed by the total pain score on the short-form McGill Pain Questionnaire-v2 (SF-MPQ-2). Secondary outcomes were pain during movement, pain interference, range of motion, mobility, and quality of recovery.
Results
On postoperative day one, the SF-MPQ-2 total score for the BPV-BCD group demonstrated greater pain reduction than that of the plain BPV group (mean difference 1.8 points, 95% confidence interval 0.6 to 3.0, P = 0.003). The BPV-BCD group also had larger reductions in pain during movement in the surgical joint and less pain interference, along with increased range of hip and knee flexion, compared with the plain BPV group. Outcomes of mobility and quality of recovery were not different between groups.
Conclusions
Preoperative BPV-BCD blocks in the L2–L4 and L4–S3 nerve distributions for hip and knee replacements led to less pain on postoperative day one and increased knee and hip range of motion, compared with plain BPV blocks.
Trial registration
ClinicalTrials.gov ID NCT02891798.
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