Pain is underrecognized and undertreated in patients with dementia. It has been suggested that nurses’ attitudinal barriers may contribute to the challenges surrounding pain assessment and management in dementia.

This integrative literature review aims to identify and explore nurses’ knowledge and attitudes towards pain assessment in older people with dementia and how it may affect pain management in this patient group.

Electronic searches were conducted in Web of Science, MEDLINE, Scopus, ProQuest, PubMed, and EBSCOhost from January 2008 to December 2018 for articles specifically focusing on nurses’ knowledge and attitudes towards pain assessment in older patients with dementia.

Ten studies were included in the review after meeting the inclusion criteria. Data extracted from each study included study design, aims and objectives, setting/sample, findings, and limitations. Patients with dementia are at greater risk of experiencing underassessment, undertreatment, and delayed treatment of pain due to nulisten and prioritize pain assessment and management.Even in the hands of highly experienced bariatric surgeons, perioperative complications are inevitable. Of these, leaks and fistulas are amongst the scariest complications. Intrathoracic gastric fistulas (ITGF) can be associated with serious morbidity, mostly when cases are misdiagnosed or detected with delay. This is a systematic review of the literature to investigate the clinical and surgical outcomes of morbidly obese adult patients with a confirmed diagnosis of ITGF following bariatric surgery. A pooled analysis of 25 articles, encompassing 76 patients with post-bariatric ITGF, showed that the clinical outcome depends on the initial presentation, timing of the diagnosis in relation to symptom onset, and prompt and effective treatment. Any septic or unstable patient must undergo urgent surgical intervention, while stable patients might tolerate a step-up approach and watchful waiting for nonsurgical treatment. Among those who undergo surgery, treatment failure and the mortality rate are substantially high. Contingent upon a prompt management strategy, patients with postbariatric ITGF can generally have a favorable outcome in the long term.

Patient-reported outcomes (PRO) obtained from follow-up survey data are essential to understanding the longitudinal effects of bariatric surgery. However, capturing data among patients who are well beyond the recovery period of surgery remains a challenge, and little is known about what factors may influence follow-up rates for PRO.

To assess the effect of hospital practices and surgical outcomes on patient survey completion rates at 1 year after bariatric surgery.

Prospective, statewide, bariatric-specific clinical registry.

Patients at hospitals participating in the Michigan Bariatric Surgery Collaborative are surveyed annually to obtain information on weight loss, medication use, satisfaction, body image, and quality of life following bariatric surgery. Hospital program coordinators were surveyed in June 2017 about their practices for ensuring survey completion among their patients. Hospitals were ranked based on 1-year patient survey completion rates between 2011 and 2015. Selleckchem VPS34 inhibitor 1 Multivariable regressionlower rates were associated with hospitals that had higher complication rates. Hospitals with the highest completion rates were more likely to physically hand surveys to patientsduring clinic visits. Given the value of PRO on longitudinal outcomes of bariatric surgery, improving data collection across multiple hospital systems is imperative.

Hospitals vary considerably in completion rates of patient surveys at 1 year after bariatric surgery, and lower rates were associated with hospitals that had higher complication rates. Hospitals with the highest completion rates were more likely to physically hand surveys to patients during clinic visits. Given the value of PRO on longitudinal outcomes of bariatric surgery, improving data collection across multiple hospital systems is imperative.The coronavirus disease 2019 (COVID-19) pandemic not only challenged deeply-rooted daily patterns but also put a spotlight on the role of computational modeling in science and society. Amid the impromptu upheaval of in-person education across the world, this article aims to articulate the need to train students in computational and systems biology using research-grade technologies.

Conflicting data persists for use of wound protectors in pancreatoduodenectomy (PD) to prevent surgical site infection (SSI). We aimed to examine, at a multi-institutional level, the effect of wound protectors on superficial or deep SSI following elective open PD.

The American College of Surgeons National Surgical Quality Improvement Program pancreatectomy procedure targeted participant use file was queried from 2016 to 2018. Planned open PD procedures were extracted. Univariable, multivariable, and propensity score matched analyses were conducted.

11,562 patients undergoing PD were evaluated, 27% of which used wound protectors. Wound protectors decreased superficial or deep SSI risk in all patients (5.7% vs. 9.5%, P<0.001), patients who have (6.6% vs. 12.2%, P<0.001) and who did not have (4.6% vs. 6.5%, P=0.011) a biliary stent. Propensity score matched analysis confirms such results (OR=0.56, 95% CI 0.46-0.69, P<0.001 overall, OR=0.66, 95% CI 0.46-0.95, P=0.03 without biliary stent, OR=0.57, 95% CI 0.44-0.73, P<0.001 with biliary stent).

Wound protectors reduce risk of superficial or deep SSI in patients undergoing PD, yet only a quarter of PD were associated with their use. This protective effect is seen whether patients have or have not had preoperative biliary stenting.

Wound protectors reduce risk of superficial or deep SSI in patients undergoing PD, yet only a quarter of PD were associated with their use. This protective effect is seen whether patients have or have not had preoperative biliary stenting.

Travel medicine has gained importance in recent years; however, there is little data regarding travel medicine departments in Japanese hospitals.

This cross-sectional study contacted 488 hospitals designated by either the Japanese government or major Japanese associations. A questionnaire comprising 11 questions pertaining to the availability of pre-travel consultation, out-of-hours service for travel-related patients, number of medical doctors engaged in travel medicine and infectious disease specialists, and the number of negative pressure rooms available for inpatients and outpatients was distributed. It also asked about the facilities available to combat specific diseases like malaria, dengue, and post-exposure prophylaxis for rabies as these are most common diseases affecting returning travelers.

Of the 263 hospitals (58.7%) that responded to our questionnaire, 82 hospitals (31.2%) provided pre-travel consulting, 188 hospitals (72.0%) accepted travel-related patients out-of-hours, median (interquartile range [IQR]) number of medical doctors involved in travel medicine was 1 (0-3), and median (IQR) number of patients accepted for admission was 2 (1-4).