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Assessment of Appropriateness of Diagnostic Lymph Node Tissue Collection from the Operating Theater and by Interventional Radiologist. A clinical audit

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Advances in Infectious Diseases 2024年第3期14卷 541-548页

作者： Kowthar Salman Hassan Divya Deodhar Abdullah T. Al-Rawahi Mahmood H. Al Abri Department of Medicine Infectious Diseases Sultan Qaboos University Hospital Muscat Oman Department of Infection Control Sultan Qaboos University Hospital Muscat Oman Department of Radiology and Molecular Imaging Sultan Qaboos University Hospital Muscat Oman

Background: Appropriate sample requesting, collecting and timely dispatch to the appropriate laboratory is essential in establishing diagnosis of pathologies with lesions. Much time and effort may be wasted if this is not done according to certain standards. We conducted this study to assess the route of lymph node samples from requests to reaching the laboratories. Methods: We conducted an audit over a period from 4th June until 10th Aug 2023. Data for all the procedures performed over this period on lymph node samples (was entered into and analysed using Excel. Results: A total of eighteen samples for sixteen patients were obtained during this period. Median age of the patients was 34 years (19 - 73) with a M:F ratio of 5:11. Among the IR samples, nine samples were from the neck, three from inguinal area and one from axilla. Seven samples (53.8%) were tru-cut biopsies, six samples (46.15%) were FNA. All samples were sent to the pathology laboratory fixed in formalin. Samples for TB were sent only for five cases (31.25%) and for only two cases (12.5%) were samples sent for bacterial culture. For the OR samples, none were sent for either bacterial culture or TB. Overall, eight patients (50%) were not investigated for any infectious etiologies like brucella, toxoplasmosis, CMV, EBV plus other possible causes. Repeat sampling was required for 25% of patients (within and out of the audit period). Conclusions: to avoid delays in making diagnoses, it is paramount to consider infectious etiologies as possible diagnosis for lymphadenopathy and request appropriate investigations. This requires liaising with infectious diseases/clinical microbiology experts to guide regarding types of samples, types of media and timely dispatch to the correct laboratory.

关键词： clinical audit clinical Samples Biopsies Lymph Nodes Saline Formalin Quality Improvement

Risk factors in cardiovascular patients:Challenges and opportunities to improve secondary prevention

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World Journal of Cardiology 2023年第7期15卷 342-353页

作者： Rahima Gabulova Anna Marzà-Florensa Uzeyir Rahimov Mahluga Isayeva Shahana Alasgarli Afag Musayeva Sona Gahramanova Firdovsi Ibrahimov Farid Aliyev Galib Imanov Rahmana Rasulova Ilonca Vaartjes Kerstin Klipstein-Grobusch Ian Graham Diederick E Grobbee Teaching-Therapeutical Hospital Azerbaijan Medical UniversityBaku AZ1022Azerbaijan Julius Center for Health Sciences and Primary Care University Medical Center UtrechtUtrecht 3508 GANetherlands Department of Cardiology Baku Medical PlazaBaku AZ1014Azerbaijan Department of CHD and Arrhythmias Scientific-Research Institute of CardiologyBaku AZ1072Azerbaijan Department of Cardiology Central Clinic HospitalBaku AZ1006Azerbaijan Heart Center Baku Health CenterBaku AZ1072Azerbaijan Teaching-Surgical Hospital Azerbaijan Medical UniversityBaku AZ1022Azerbaijan Department of Public Health Azerbaijan Medical UniversityBaku AZ1022Azerbaijan Department of Cardiology Trinity College DublinDublin Dublin-2Ireland

BACKGROUND Effective management of major cardiovascular risk factors is of great importance to reduce mortality from cardiovascular disease(CVD).The Survey of Risk Factors in Coronary Heart Disease(SURF CHD)II study is a clinical audit of the recording and management of CHD risk *** was developed in collaboration with the European Association of Preventive Cardiology and the European Society of Cardiology(ESC).Previous studies have shown that control of major cardiovascular risk factors in patients with established atherosclerotic CVD is generally *** is a country in the South Caucasus,a region at a very high risk for *** To assess adherence to ESC recommendations for secondary prevention of CVD based on the measurement of both modifiable major risk factors and their therapeutic management in patients with confirmed CHD at different hospitals in Baku(Azerbaijan).METHODS Six tertiary health care centers participated in the SURF CHD II study between 2019 and *** on demographics,risk factors,physical and laboratory data,and medications was collected using a standard questionnaire in consecutive patients aged≥18 years with established CHD during outpatient *** from 687 patients(mean age 59.6±9.58 years;24.9%female)were included in the *** Only 15.1%of participants were involved in cardiac rehabilitation *** rate of uncontrolled risk factors was high:Systolic blood pressure(BP)(SBP)(54.6%),low-density lipoprotein cholesterol(LDL-C)(86.8%),diabetes mellitus(DM)(60.6%),as well as overweight(66.6%)and obesity(25%).In addition,significant differences in the prevalence and control of some risk factors[smoking,body mass index(BMI),waist circumference,blood glucose(BG),and SBP]between female and male participants were *** cardiovascular health index score(CHIS)was calculated from the six risk factors:Non-or ex-smoker,BMI<25 kg/m2,moderate/vigorous physical activity,controlled BP(<140/90 mmHg;140/80 mmHg

关键词： Coronary heart disease Cardiovascular risk factors Secondary prevention clinical practice guidelines clinical audit Survey of risk factors

A Mixed Methods Evaluation of the Application of the REFLECT Framework to Psychological Services

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Open Journal of Applied Sciences 2024年第11期14卷 3316-3346页

作者： Christopher Lomas Counselling & Psychotherapy Department School of Health & Science University of Salford Manchester UK

The REFLECT Psychological Services audit Framework was developed to address critical gaps in the evaluation of mental health services, primarily within Employee Assistance Programmes (EAPs) and psychological services. This study aims to assess the framework’s impact on clinical outcomes, financial oversight, staff well-being, and risk management. A mixed-methods approach was employed, combining quantitative data—including paired t-tests, regression analysis, and Chi-square tests—with qualitative insights from semi-structured interviews and focus groups. Quantitative data were collected across 10 EAPs, evaluating 100 clients using the PHQ-9 and GAD-7 scales for depression and anxiety, respectively, and 50 staff members using the Maslach Burnout Inventory (MBI). Financial data included budget allocation efficiency and cost-effectiveness metrics. Risk management was assessed through safeguarding incidents and incident reporting time. Results revealed significant improvements across all key domains: client mental health outcomes (PHQ-9 and GAD-7 scores significantly reduced, p [1] offers a comprehensive, evidence-based tool for improving service quality, financial efficiency, and clinician support in psychological services.

关键词： REFLECT Framework clinical audit EAP Psychological Services Financial Efficiency Risk Management Staff Well-Being Safeguarding Protocols

Qualitative evaluation of the outcomes of care and treatment for children and adolescents with nodding syndrome and other epilepsies in Uganda

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Infectious Diseases of Poverty 2019年第2期8卷 93-93页

作者： Catherine Abbo Amos Deogratius Mwaka Bernard Toliva Opar Richard Idro Department of Psychiatry School of Medicine College of Health SciencesMakerere UniversityKampalaUgandd 不详

Background:In 2012,the Ugandan Government declared an epidemic of Nodding Syndrome(NS)in the Northern districts of Gulu,Kitgum,Lamwo and *** guidelines were developed and NS treatment centres were established to provide symptomatic control and ***,a wide gap remained between the predefined care standards and the quality of routine care provided to those *** study is to qualitatively assess adherence to accepted clinical care standards for NS;identify gaps in the care of affected children and offer clinical Support Supervision(CSS)to Primary Health Care(PHC)staff at the treatment centres;and identify psychosocial challenges faced by affected children and their ***:This case study was carried out in the districts of Gulu,Kitgum,Lamwo and Pader in Uganda from September to December in *** the 5-stage approach of clinical audit,data were collected through direct observations and interviews with PHC providers working in public and private-not-for-profit health facilities,as well as with caregivers and political *** qualitative data was analysed using Seidel model of data ***:clinical audit and CSS revealed poor adherence to treatment *** affected children had suboptimal NS management resulting in poor seizure control and complications including severe *** causes of these outcomes were frequent antiepileptic drugs stock outs,migration of health workers from their work stations and psychosocial *** was hardly any specialized multidisciplinary team(MDT)to provide for the complex rehabilitation needs of the patients and a task shifting model with inadequate support supervision was employed,leading to loss of skills *** psychosocial and psychosexual issues associated with NS included early pregnancies,public display of sexual behaviours and child ***:Despite involvement of relevant MDT members in the development of multidisciplinary NS

关键词： Nodding syndrome Epilepsy Multi-disciplinary clinical audit clinical support supervision Uganda