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Recovery From Anorexia Nervosa: A Concept Analysis

ABSTRACT

Aim

Despite decades of research, we still know surprisingly little about how best to bring about lasting recovery from anorexia nervosa (AN). Furthermore, there is a lack of consensus in the research and treatment communities about what constitutes recovery from AN, or whether “recovery” is even an appropriate term to use in this context. The aim of this study was to analyse the concept of AN recovery from the perspectives of various stakeholders.

Design

Concept analysis.

Method

Walker and Avant's eight-stage concept analysis method.

Results

There continues to be a lack of consensus around the defining criteria for AN recovery. However, there are certain clinical, psychological and quality-of-life attributes that are recurrent in those defined as being in recovery.

Conclusions

Though BMI and rate of weight gain are the primary criteria used to define recovery from AN, in recent years it has become clear that the definition of healthy weight varies and that weight alone is insufficient to fully define recovery. With recent advancements in biomarker and genetics research, there is hope that more objective measures of recovery will be defined. Quality of life as defined by both patients and caregivers is also critical to recovery; however, it is often not adequately assessed in studies of AN. Though the path to recovery is highly individualised, and there are risks in implementing strict criteria for recovery, in research, consensus is needed for adequate comparison of studies evaluating different treatment modalities. Additionally, such criteria are needed to help clinicians with decision-making authority, including advanced practice nurses, provide the most effective treatment options to their patients. Future research should focus on better defining recovery from AN and on facilitating nurse-led system-level advocacy to educate and equip advanced practice nurses in helping those with AN move toward recovery.

Implications

This concept analysis provides an overview of recovery from AN from the perspectives of a wide array of stakeholders and the last 20 years of published data.

Patient or Public Contribution

This study did not include patient or public involvement in its design, conduct, or reporting.

A Comprehensive Scoping Review on the Use of Point‐Of‐Care Infrared Thermography Devices for Assessing Various Wound Types

ABSTRACT

This scoping review investigates the use of point-of-care infrared thermography devices for assessing various wound types. A comprehensive search across four databases yielded 76 studies published between 2010 and 2024 that met the inclusion criteria. The review highlights thermography applications in burns, surgical wounds, diabetic foot ulcers, pressure injuries, and other lower limb wounds. Key findings indicate its effectiveness in detecting early signs of inflammation and healing delays, facilitating timely interventions. The technology shows promise in accurately predicting wound healing trajectories and assessing treatment outcomes. Recent advancements have made thermographic devices more affordable and user-friendly, expanding their clinical potential. However, challenges persist, including reimbursement, training requirements, and integration with electronic medical records (EMRs), with EMR integration identified as a critical barrier to widespread adoption. While preliminary findings are promising, the current evidence base is constrained by small sample sizes, retrospective study designs, and limited consideration of skin tone variability. Large, prospective studies are essential to validate the clinical utility of thermography in wound care and to inform the development of standardised protocols that support equitable, bias-reduced assessment across diverse populations. Addressing these gaps is critical for advancing research, enhancing clinician training, and improving patient outcomes in wound care. Overall, point-of-care thermography demonstrates significant potential to enhance wound assessment and monitoring, thereby elevating care quality and patient outcomes.

Impact of a community-based asynchronous review clinic on appointment attendance delays across an eye hospital network in London, UK: an interrupted time series analysis

Por: Ndwandwe · S. · Fu · D. J. · Adesanya · J. · Bazo-Alvarez · J. C. · Ramsay · A. I. G. · Fulop · N. J. · Magnusson · J. · Napier · S. · Cammack · J. · Baker · H. · Kumpunen · S. · Alarcon Garavito · G. A. · Elphinstone · H. · Mills · G. · Scully · P. · Symons · A. · Webster · P. · Wilson
Objective

To assess the impact of opening a large community-based asynchronous review ophthalmic clinic on attendance delays among patients with stable chronic eye disease attending a London teaching eye hospital network.

Design

Interrupted time-series analysis of routine electronic health records of appointment attendances.

Setting

A large eye hospital network with facilities across London, UK, between June 2018 and April 2023.

Participants

We analysed 69 257 attendances from 39 357 patients, with glaucoma and medical retina accounting for 62% (n=42 982) and 38% (n=26 275) of visits, respectively. Patients over 65 made up 54% (n=37 824) of attendances, while 53% (n=37 014) were from the more deprived half of the population, and 51% (n=35 048) were males.

Intervention

An asynchronous review clinic opened in a shopping centre in London, in autumn 2021, following the COVID-19 lockdown in spring 2020.

Main outcome measures

Average attendance delays (days), calculated as the difference between follow-up attendance date and the latest clinically appropriate date determined at the preceding attendance.

Results

Pre-COVID-19, attendance delays for chronic eye disease monitoring were increasing by 0.9 days per week (95% CI, 0.8 to 0.9) on average, worsening to 2.0 days per week (95% CI, 2.0 to 2.0) after the first COVID-19 national lockdown, mid-March 2020. Opening the asynchronous review clinic increased appointment capacity, with delays decreasing on average by 8.1 days per week (95% CI, 8.1 to 8.2) shortly after opening. The rate of decrease slowed to 0.3 days per week (95% CI, 0.3 to 0.3) after 5 months. We found no significant differences in average attendance delays by age, gender or level of deprivation.

Conclusion

The asynchronous review clinic significantly reduced attendance delays across the hospital network, addressing pre-existing backlog for stable chronic eye diseases. The reduction appeared to be maintained after the initial backlog had been cleared.

Sex-based outcomes of mitral surgery for ischaemic mitral regurgitation: protocol for a systematic review and meta-analysis

Por: Rahmouni · K. · Gauthier · N. M. · Kang · N. · Voisine · P. · Edwards · J. · Ramsay · T. · Chan · V.
Introduction

Patients with ischaemic mitral regurgitation (MR) have markedly increased cardiovascular mortality compared with those with primary MR. The sex-based prognosis of patients with ischaemic MR undergoing mitral surgery remains unclear. The goal of this systematic review is to evaluate long-term mortality, reoperation, heart failure rehospitalisation and MR recurrence in women who undergo mitral valve surgery for chronic ischaemic MR, compared with men.

Methods and analysis

The MEDLINE, EMBASE, Scopus and Cochrane Central Register of Controlled Trials databases will be searched for studies reporting surgical outcomes for ischaemic MR. Studies published before 10 June 2024 and those stratifying outcomes by sex will be included. The primary outcome of this systematic review is long-term (≥1 year) mortality following mitral surgery. Secondary outcomes include operative mortality, mitral valve reintervention, heart failure rehospitalisation and MR recurrence, as assessed by echocardiography.

Risk of bias will be ascertained with the Newcastle–Ottawa scale. Heterogeneity will be assessed using Higgin’s I2 statistic. If the included studies demonstrate adequate homogeneity in their design and comparator, meta-analyses with a random-effects model will be conducted to combine estimates.

Ethics and dissemination

This systematic review uses data from previously published studies and does not involve interaction with human subjects or access to individual patient data. Therefore, ethical approval is not required for this study. The findings from this review will be disseminated through publication in a peer-reviewed journal and various media, including but not limited to, conferences, congresses and symposia.

Trial registration number

In accordance with the guidelines, our systematic review protocol was registered with the International Prospective Register of Systematic Reviews on 5 July 2024 and was last updated on 4 April 2025 (Registration number: CRD42024560892).

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