Introduction of the ART approach in Egypt: Intentions,clinical effects and perceived barriers. A cohort study

Abstract

Aim. To evaluate the effect of the introduction of ART in Upper-Egypt and assess the participating General Dental Practitioners' (GDPs) opinions, intentions, expectations and experiences regarding barriers related to using ART. Methods. Thirty-five GDPs were selected and trained on ART for 5 days. Knowledge assessments were done immediately before and after the training, using a questionnaire. Regular evaluation and assessment data were collected after 6 and 12 months, through questionnaires with closed and open-ended questions. Clinical data in government and private clinics were collected, using clinical record-forms. GDPs' opinions, intentions, expectations and experiences regarding barriers related to ART were assessed, through questionnaires, at the start and after 1 year. The control group comprised 35 other GPDs. Results. At the start, the most GDPs were intended to make ART restorations. After 1 year 65% and 97% actually made ART restorations in their government and private clinics, respectively. The barriers faced by the GDPs to making ART restorations in the government clinics were mainly unavailability of suitable restoration material and of hand instruments. After 1 year post-training, ART restorations constituted 41% of the total plastic restorations made. Finally, the majority of GDPs believe that ART is suitable for use in their government and private practices. Conclusion. All participating GDPs intended to introduce ART in their government and private clinics. They successfully introduced this technique in their private clinics but, owing to the unavailability of suitable instruments and restoration materials, failed to do so in the government clinics. They liked the simplicity of the technique.     

Pilot study assessing the possible benefits of a higher level of implementation of biosecurity measures on farm productivity and health status in Belgian cattle farms

Over the last few years, the interest of decision‐makers and control agencies in biosecurity (BS), aiming at preventing and controlling the introduction and spread of infectious diseases, has considerably increased. Nevertheless, previous studies highlighted a low implementation level of biosecurity measures (BSM), especially in cattle farms; different reasons were identified such as perceived costs, utility, importance, increased workload and lack of knowledge. In order to convince cattle farmers to adopt BSM, it is necessary to gather more information and evidence on their cost‐effectiveness and their importance or utility in terms of disease prevention and control. The objectives of this study were to determine whether the farm or farmers’ profile correlated with the implementation level of BSM and if there was a positive correlation between the BSM implementation and the farm production and health parameters. Data were collected through face‐to‐face interviews conducted in 100 Belgian farms as part of a stratified and randomized survey. The Regional Animal Health Services provided the farm health status and production data. A general BS score and five sub‐scores related to the five BS compartments (bio‐exclusion, bio‐compartmentation, bio‐containment, bio‐prevention and bio‐preservation) were calculated for each farm based on the implementation level of different BSM grouped in 16 domains. The study highlighted a significant and negative correlation between the mortality rates in adult cattle (over 24 months of age) and young calves (aged 0–7 days) and different BS compartment scores. The study also demonstrated that the farms having a higher general BS score were indeed more likely to have a BVD‐free status. These evidence‐based findings are encouraging as they demonstrate the benefits of implementing BSM and could promote their adoption by farmers.     

Impact of a risk-stratified thromboprophylaxis protocol on the incidence of postoperative venous thromboembolism and bleeding

Efforts to reduce postoperative venous thromboembolism are challenging due to heterogeneity in thromboprophylaxis practice. As a result, a ‘one-size-fits-all’ approach that accounts for surgery-specific risk, but fails to account for patient-level variation, is often adopted by healthcare networks. Updated clinical practice guidelines have advocated an individualised risk-stratified approach that balances the risk:benefit ratio associated with thromboprophylaxis; however, there are limited data confirming effectiveness of these recommendations on the incidence of postoperative venous thromboembolism and bleeding. We developed the surgical-thrombo-embolism-prevention protocol, a novel risk-stratified algorithm that classified patients into low-, intermediate-, and high-risk profiles according to surgical procedure and patient baseline medical risk. Expert-endorsed risk-specific thromboprophylaxis strategies were then applied. A staged quality improvement program was developed to implement the protocol. We postulated that compliance with the protocol would reduce postoperative venous thromboembolism rates without increasing the incidence of postoperative bleeding. Between June 2013 and March 2018, we evaluated the efficacy, safety and sustainability of this risk-stratified approach in 24,953 surgical admissions at a dedicated cancer centre. By final implementation, program compliance was 91%. Postoperative venous thromboembolism rates reduced from 3.1 per 1000 surgical admissions to 0.6 per 1000 surgical admissions (relative risk reduction 79%; p < 0.005). Postoperative bleeding rates also declined from 10.0 per 1000 surgical admissions to 6.3 per 1000 surgical admissions (relative risk reduction 37%; p = 0.02). Sustained improvement was evident more than 3 years after implementation. Implementation of the surgical-thrombo-embolism-prevention protocol significantly reduced the incidence of postoperative venous thromboembolism supporting its validation at other institutions.     

中文版患者床边交班感知量表的信效度研究

目的翻译患者床边交班感知量表（PVNC-BR）,并初步评价其信度与效度。方法严格遵循翻译-回译-专家咨询步骤对量表进行跨文化调试,并通过对138例患者进行调查,检测中文版PVNC-BR的信效度。结果探索性因子分析共提取3个公因子,17个条目,累积贡献率为61．043％,各因子的负荷数为0．413～0．861;Cronbach’sα系数为0．821,各因子的Cronbach’sα系数为0．696～0．854;重测信度为0．879,各因子的重测信度为0．771～0．922。结论中文版PVNC—BR量表具有较好的信度、效度,符合心理学测量要求,可用于测评实施床边交班患者的感知评价。     

首发脑卒中患者康复锻炼行为执行意向及影响因素分析

目的 了解首发脑卒中患者康复锻炼行为执行意向水平及其影响因素,为脑卒中患者康复锻炼行为的干预提供参考.方法 采用一般资料调查表、中文版脑卒中康复自我效能量表、社会支持量表、自行设计的脑卒中患者康复锻炼行为执行意向问卷对177例首发脑卒中患者进行调查.结果 首发脑卒中患者康复锻炼行为执行意向得分62.69±17.27.回...