Conectar
Coronary revascularisation practices have evolved over the last three decades. This study sought to examine the variations in percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) rates, alongside mortality from acute myocardial infarction (AMI) across a group of 16 high-income countries between 2006 and 2020.
Retrospective observational analysis using data from the Organisation for Economic Co-operation and Development (OECD) database between 2006 and 2020. Estimated annual percent change in revascularisation was analysed using Joinpoint regression model, and mortality rates were evaluated using the locally weighted scatterplot smoothing model.
Publicly available data on PCI and CABG procedure rates alongside AMI mortality rate from 2006 to 2020.
16 countries from the OECD database.
Not applicable.
Standardised PCI and CABG procedure rates and AMI age-standardised mortality rate (ASMR) from 2006 to 2020.
Over the 15 year period, 14.0 million PCI and 2.8 million CABG procedures were collectively recorded across 16 countries. PCI rates varied among nations, but from 2006 to 2020 increased in 11 of the 16 nations overall, led by Finland (+36.0%), Ireland (+34.5%) and France (+31.5%). Meanwhile, CABG rates declined in 14 out of the 16 countries, with Luxembourg (–71.3%), the UK (–62.6%) and Finland (–60.6%) experiencing the most substantial decreases. Throughout the study period, the PCI-to-CABG ratio increased, while AMI ASMR decreased consistently across all countries.
Despite evidence supporting CABG over PCI in specific scenarios, CABG rates have declined, and PCI rates have increased. Possible factors for this trend may include patient preference and advancement in interventional techniques. The varied use of PCI among these nations, alongside a sustained decline in AMI mortality rates, may be expected given the importance of optimal medical therapy in the management of ischaemic heart disease. The results further suggest the significance of factors beyond revascularisation in driving improved outcomes.
To increase Chlamydia trachomatis screening in adolescents 15–19 years of age from 7.8% to 15% following a 6-week implementation of universal chlamydia screening at three paediatric primary care (PPC) sites.
Pre-implementation (1 January 2022–19 October 2022) and post-implementation (20 October 2022–1 June 2023) screening rates were tracked through run charts and compared via Chi-square testing. Universal opt-out chlamydia screening with universal urine collection for 15- to 19-year-old was implemented at well visits, along with patient and staff education, and sexually transmitted infection treatment protocols.
Chlamydia trachomatis screening increased from 7.8% to 34.1% with implementation of universal opt-out chlamydia screening. Proportions of patients screened increased significantly among White individuals, males and privately insured individuals.
A universal C. trachomatis screening project can be feasibly implemented in pediatric primary care and successfully increase adolescent chlamydia screening rates.
Implementing a universal opt-out C. trachomatis screening project is feasible in PPC and can help achieve the public health goal of chlamydia identification and treatment.
These findings will be impactful for both paediatric primary care and adolescent patients. The universal, opt-out C. trachomatis screening approach facilitated screening increases, improved equity in screening and led to increased case detection and treatment which has vast significance for those patients.
This manuscript is submitted using the SQUIRE 2.0 guidelines for quality improvement reporting.
Patient contribution included de-identified data collection of chlamydia screening rates of eligible adolescents 15–19 years old who attended routine well visits at the three PPC locations. The data were reviewed on a dashboard, then stratified by race, ethnicity, payor and sex assigned at birth.
To identify gait biomechanical characteristics associated with pain and cartilage damage in individuals with patellofemoral joint osteoarthritis (PFJ OA) during a stair descent activity.
Cross-sectional observational study.
University-based motion analysis laboratory and musculoskeletal imaging centre.
83 participants entered the study; 66 participants (41 female, 25 male) completed all components required for this analysis. Participants were recruited via electronic health records following clinical knee MRI. Inclusion criteria included MRI-confirmed patellofemoral cartilage lesions using Whole Organ MRI Score (WORMS) gradings (WORMS >1), pain during stair ambulation, body mass index (BMI) ≤35 and informed consent. Exclusion criteria were tibiofemoral abnormalities (WORMS >1), prior knee trauma, gait-altering conditions, MRI contraindications or pregnancy.
Primary outcomes included knee joint kinematics and during stair descent, assessed during three-dimensional motion capture, patient-reported outcomes from the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire and WORMS gradings to assess severity of cartilage abnormalities. Regression analyses were performed to examine correlations of biomechanics, age and BMI with pain and cartilage damage. Analyses were also performed on male and female participants separately.
Significant associations were found between biomechanical characteristics and KOOS scores (pain, symptoms and patellofemoral) as well as cartilage damage. For the whole cohort, greater knee flexion at late stance was linked to worse KOOS scores (β=0.53 to 0.71, p
Altered knee biomechanics during stair descent are linked to worse knee pain, function and cartilage damage in PFJ OA, with sex-specific differences emphasising the need for individualised interventions to address movement abnormalities.
Commentary on: Chen HW, Cheng SF, Hsiung Y, et al. Training perinatal nurses in palliative communication by using scenario-based simulation: A quasi-experimental study. Nurse Educ Pract. 2024. 75:103885. doi: 10.1016/j.nepr.2024.103885
Implications for practice and research Scenario-based simulation (SBS) is an effective method of enhancing the confidence and competence of nurses supporting families who require perinatal palliative care. Further research should focus on the durability of skills acquired through SBS as well as exploring the impact of SBS on a more diverse sample.
Communication is a cornerstone of nursing practice and fundamental to establishing and maintaining relationships with individuals and their families. Nurses involved in the provision of perinatal palliative care work with women, babies and their families, during pregnancy, delivery and in the neonatal period. Effective therapeutic relationships with women and families empower parents, providing control and validation,
by Star W. Lee, Haley Miyasato, Jocelyn Tirado, Stephanie Dingwall, Richard A. Cardullo
There are many benefits for students who participate in undergraduate research experiences, including increased retention and persistence in science, technology, engineering, and mathematics (STEM). By doing research, minoritized students increase their likelihood of pursuing graduate school and STEM careers. The benefits of research experiences are partially mediated by students’ interactions with their faculty research mentor. Building trust in the relationship requires students to believe that their faculty mentors are both competent and caring. Here, we used a mixed-methods approach to evaluate the relationship between students and their research mentors. We surveyed both minoritized students’ and their faculty mentors’ perceptions of the mentor’s ability and benevolence. Students rated the faculty mentors’ abilities higher than how mentors rated themselves. In contrast, students rated the faculty mentors’ benevolence significantly lower than how mentors rated themselves. In follow-up interviews focused on benevolence, students emphasized that faculty mentors demonstrated caring through instrumental support (i.e., research skills or career guidance); faculty mentors described providing psychosocial (i.e., social or emotional) support to students. Our results show that there was a difference in how minoritized students and their faculty mentors communicate care in mentor-mentee relationships in research. Findings from this study indicate how faculty mentors may better support minoritized students in undergraduate research experiences.
FreshRSS 