Palliative care in nursing homes (NHS) is a major challenge, because it gives the demands of the knowledge and skills of nursing staff to provide high-quality care.
The purpose of this study was to ...assess the knowledge of palliative care among nursing home staff.
A descriptive study design was used, 124 nurses, aged over 30 years and most of them were male working in the nursing home in Jordan. Around 109 participants were responded to the questionnaire. All licensed nurses were included in the study, except of that will be excluded. The knowledge of palliative care was measured via the palliative care survey. knowledge scores were ranged 0-1, with higher scores indicate greater knowledge.
Descriptive statistics was used. The Knowledge of palliative care issues is 0.21 in Jordan (95% confidence interval (CI) 0.19-0.24). Knowledge of physical aspects that can contribute to pain is 0.22 (95% CI 0.2-0.25), and knowledge of psychological aspects that can contribute to pain is 0.21 (95% CI 0.2-0.22).
Education for nursing staff needs to be enhanced to address the specific knowledge gaps. Additional studies with large sample size recommended to explore the effect of educational programs in regard of palliative care in nursing homes.
In this article, we aim to review Liver Imaging Reporting and Data System version 18 (LI-RADS v2018). Hepatocellular carcinoma (HCC) is the most common primary hepatic malignancy. Liver Imaging ...Reporting and Data System developed for standardizing interpreting, reporting, and data collection of HCC describes 5 major features for accurate HCC diagnosis and several ancillary features, some favoring HCC in particular or malignancy in general and others favoring benignity. Untreated hepatic lesions LI-RADS affords 8 unique categories based on imaging appearance on computed tomography and magnetic resonance imaging, which indicate the possibility of HCC or malignancy with or without tumor in vein. Furthermore, LI-RADS defines 4 treatment response categories for treated HCCs after different locoregional therapy. These continuous recent updates on LI-RADS improve the communication between the radiologists and the clinicians for better management and patient outcome.
تصف هذه الورقة عملية تقييم الطلبة عن بعد في التعليم الطبي أثناء فترة الحظر في جائحة كوفيد-١٩، وتشارك الخبرات المستندة إلى البيانات في حل المشكلات الناشئة عن ذلك.
قمنا بتحليل بيانات الاختبارات الورقية ...النهائية والاختبارات المستندة على الويب، التي أجريت على مدار العام الدراسي ٢٠١٩/٢٠٢٠. وتم تضمين اثني عشر اختبارا، أربعة اختبارات لكل مستوى دراسي، من السنة الأولى وحتى الثالثة. منها ثمانية اختبارات كانت ورقية، وأربعة اختبارات مستندة على الويب. قارنا متوسط درجات كل نوع من الاختبارات، وبين الاختبارات والمستوى الدراسي. بالإضافة إلى ذلك، قمنا بمقارنة درجات الاختبارين الورقي والمستند على الويب التي حصل عليها الطلاب العشرة الأوائل والعشرة الطلاب الأدنى تحصيلا.
تم العثور على اختلافات في درجات الطلاب من كل دفعة من المجموعات الثلاث في الاختبارات المختلفة، سواء كانت ورقية أو مستندة على الويب. في بعض الحالات، كان الفرق ذا دلالة إحصائية. ولم يتم العثور على اتجاه / نمط محدد للاختلاف بين الدرجات في أي نوع من الاختبارات. كما كان متوسط الدرجات في الاختبارات المستندة على الويب وسطا بين المتوسطات الحسابية لطلاب السنة الأولى والثانية، ولكن أقل بالنسبة لطلاب السنة الثالثة. وأظهرت علامات الطلاب الفردية في الاختبارات المختلفة ارتباطا إيجابيا. وكان معامل الارتباط للاختبارات الورقية مرتفعا دائما.
كشفت الدراسة الحالية عن عدم وجود فرق ملحوظ في نتائج الاختبارات الورقية والمستندة على الويب، سواء في متوسط الفصل أو لنتائج الطلاب الفرديين. على الرغم من وجود بعض الاختلافات بين نتائج نهجي التقييم، لم يكن هناك اتجاه ملحوظ.. ستوفر الاختبارات المستندة على الويب نهجا مثاليا للتقييم التكويني، والاختبار التحصيلي، والتقييم المتواصل.
This study describes the process of remote assessment in medical education during the COVID-19 lockdown and shares data-driven experiences in resolving emerging concerns.
We analysed the data of end-of-course paper-based exams (PBEs) and web-based exams (WBEs) conducted during the academic year 2019/2020. Twelve end-of-block exams were included. There were four exams each for the first-, second-, and third-year students. Eight exams were conducted as PBEs, and four were administered as WBEs. We compared the mean scores of PBEs and WBEs between exams and batches. Additionally, we compared the PBE and WBE scores obtained by 10 high-performance and 10 lowest-achieving students.
Variations were found in the scores of students from each of the three batches in PBEs or WBEs. In a few instances, the difference was statistically significant. No specific trend or pattern was detected in the difference between the scores of PBEs and WBEs. The mean score for the WBEs was intermediate among the means of PBEs for the first- and second-year students, but lower for the third-year students. Individual students’ marks in different exams consistently showed a positive correlation. The correlation was always high for PBEs (r = 0.782, 0.847).
The present study showed that average and individual scores in WBEs and PBEs are comparable. Although there were some variations between the results of the two assessment modalities, no remarkable trend or pattern was observed. WBEs offer an ideal approach for formative assessment, progress testing, and the low-weight, but frequent, nature of continuous assessment.
This study aimed to assess the interobserver agreement of magnetic resonance (MR) imaging of Liver Imaging Reporting and Data System version 2018 (LI-RADS v2018).
Retrospective analysis was done for ...119 consecutive patients (77 male and 42 female) at risk of hepatocellular carcinoma who underwent dynamic contrast MR imaging. Image analysis was done by 2 independent and blinded readers for arterial phase hyperenhancement, washout appearance, enhancing capsule appearance, and size. Hepatic lesions were classified into 7 groups according to LI-RADS v2018.
There was excellent interobserver agreement of both reviewers for LR version 4 (κ = 0.887, P = 0.001) with 90.76% agreement. There was excellent interobserver agreement for nonrim arterial phase hyperenhancement (κ = 0.948; 95% confidence interval CI, 0.89-0.99; P = 0.001), washout appearance (κ = 0.949; 95% CI, 0.89-1.0; P = 0.001); and enhancing capsule (κ = 0.848; 95% CI, 0.73-0.97; P = 0.001) and excellent reliability of size (interclass correlation, 0.99; P = 0.001). There was excellent interobserver agreement for LR-1 (κ = 1.00, P = 0.001), LR-2 (κ = 0.94, P = 0.001), LR-5 (κ = 0.839, P = 0.001), LR-M (κ = 1.00, P = 0.001), and LR-TIV (κ = 1.00; 95% CI, 1.0-1.0; P = 0.001), and good agreement for LR-3 (κ = 0.61, P = 0.001) and LR-4 (κ = 0.61, P = 0.001).
MR imaging of LI-RADS v2018 is a reliable imaging modality and reporting system that may be used for standard interpretation of hepatic focal lesions.
Bone morphogenetic proteins (BMPs) are members of the transforming growth factor-β (TGF-β) family and may play an important role in the regulation of malignant cells in bladder cancer. The aim of the ...present study was to investigate BMP expression in non-muscle invasive bladder cancer. Tumor tissue samples from 71 patients treated with transurethral resection and 10 samples of normal bladder tissue were stained using immunohistochemistry for BMP-2, -4, -6 and -7. The levels of BMP were correlated with the number and size of tumors in the bladder, the pathohistological findings as well as with tumor recurrence and progression. The results of the present study demonstrated that BMP-2 and -7 are highly expressed in normal bladder tissue, but significantly downregulated in cancer samples. This reduction correlates with a faster rate of tumor recurrence as well as with an increase in the number of recurrent tumors. There was no evident interrelation between BMP-2 and -7 reduction and changes in tumor grade and stage. In conclusion, BMP-2 and -7 are potential prognostic factors for tumor recurrence and further studies on BMP and bladder cancer are needed to confirm these results.
Accurate rectal tumor staging guides the choice of treatment options. EUS and MRI are the main modalities for staging.
To compare the performance of EUS and MRI for loco-regional staging of anorectal ...cancer after neo-adjuvant therapy.
Seventy-three (37 male, 36 female) patients with rectal cancer after neo-adjuvant chemoradiotherapy were enrolled. Histopathological staging after surgery were used as reference for comparing the yield of loco-regional staging for EUS and MRI. EUS and MRI were done 1 month after completion of neo-adjuvant therapy.
Regarding post-surgical T staging, eight patients had early tumor (T2 = 16 and T1 = 9) and thirty six were locally advanced (T3 = 36), while N staging, forty patients with negative nodes and 33 were positive (N1 = 22 and N2 = 11). Comparing EUS to MRI, it showed a higher sensitivity (95.7% vs. 78.7%), specificity (84.6% vs. 68.0%) and accuracy (91.8% vs. 75.3%) for staging early and locally advanced tumor. Also, it had a higher sensitivity (78.8% vs. 69.7%), specificity (75.0% vs. 65.0%) and accuracy (76.7% vs. 67.1%) for detection of lymph nodes.
EUS appears to be more accurate than MRI in loco-regional staging of rectal carcinoma after neo-adjuvant therapy.
This study evaluates cardiac diseases and prognosis in young adults and adults presenting with ventricular tachyarrhythmias (VTA).
The present longitudinal, observational, registry-based, monocentric ...cohort study includes all consecutive patients 45 years old or younger presenting with VTA at admission from 2002 to 2016. Rates of coronary angiography, coronary artery disease (CAD) and need for percutaneous coronary intervention (PCI), cardiac diseases associated with VTA, and differences in long-term prognostic endpoints for young adults (20-34 years old) were analyzed and compared to those of adults (35-45 years old), for whom multivariable risk prediction models were developed. Kaplan-Meier analyses were performed according to age and type of VTA.
A total of 259 consecutive patients were included in the study (36% young adults and 64% adults). At admission, 38% of young adults had VTA due to CAD that required PCI. Furthermore, VTA in young adults was commonly idiopathic (27%), or had underlying channelopathies (18%), primary cardiomyopathies (13%) or acute myocardial infarction (AMI, 11%). In adults, VTA was mostly associated with AMI (28%), though the rate of idiopathy was still high (20%). A total 41% of all patients received cardiopulmonary resuscitation (CPR), for whom AMI (STEMI 17%, NSTEMI 24%) was most frequently observed. Irrespective of the type of VTA, all-cause mortality was similar for young adults and adults. In young adults, left ventricular ejection fraction (LVEF) < 35% (HR = 33.590) was associated with increased long-term all-cause mortality.
Despite high rates of idiopathic ventricular tachyarrhythmias, CAD and AMI are common causes of VTA and CPR in adults 45 years old and younger. Young adults and adults had comparable survival at index hospitalization and after 2.5 years irrespective of the type of VTA. Clinical trial registration clinicaltrials.gov identifier: NCT02982473.
Purpose
The aim of this study was to compare the preperitoneal versus the preaponeurotic mesh positioning in open paraumbilical hernia repair.
Methods
During the period from January 2011 until July ...2012, 60 adult patients were randomly assigned to two equal groups. The patients in group A were treated by preperitoneal mesh repair and those in group B underwent preaponeurotic mesh repair. Both groups were assessed and compared.
Results
There were no significant differences between the two groups in the demographics, hernia characteristics, risk factors, type of anesthesia, American Society of Anesthesiologists score or the mean follow-up period. The length of the operation was significantly shorter in group B than in group A (
P
value = 0.01). There were no significant differences in the early postoperative complications except for the development of a seroma, which developed only in group B (
P
value = 0. 044). The postoperative pain was significantly lower in group A than in group B (
P
value = 0.01). The time of return to normal daily activities was significantly shorter in group A than in group B (
P
value = 0.001).
Conclusion
The preperitoneal mesh placement during the repair of paraumbilical hernias is superior to the preaponeurotic placement, because it is associated with fewer complications, less pain and a shorter time of return to normal daily activities.
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