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Item Gynaecologic oncology referrals to specialist palliative care in a tertiary referral centre: population, characteristics and outcomes(BMJ Journals, 2024) Goodings, Anthony James; Kajitani, Sten; Pastrak, Mila; Cunningham, Elaine; O’Brien, Hannah; Weadick, Catherine; Dennehy, KarieBackground The early integration of a specialist palliative care team is demonstrated to have numerous benefits for patients. These extend beyond end-of-life care to include reducing depressive symptoms, improving quality of life and reducing unnecessary interventions. Aims This study aims to characterise the patient population referred to the specialist palliative care service with a diagnosis of gynaecological cancer. It also assesses referral frequency and response time in order to understand palliative care utilisation in an acute hospital setting. Methods A retrospective chart review and database analysis were performed to extract data on demographics, cancer diagnoses and referral reasons for patients referred to the specialist palliative care service over 3 years. The study focuses on identifying patterns in the characteristics of the referred patient population. Results Analysis of 162 patients revealed a distribution across cancer subtypes: 62% ovarian, 22% endometrial, 12% cervical and 4% vulvar. A notable finding was that the outcomes for patients with ovarian cancer were more likely to be discharged home with or without community care (62%) compared with those with endometrial cancer (41%). A rapid response to referrals was observed, with 70% reviewed within 3 days and 98% within a week. This highlights the service’s efficiency and the demographic and diagnostic profile of the patient served. Conclusions This study gives insight into the demographic and diagnostic profiles of patients with gynaecological cancer referred for palliative care, alongside demonstrating rapid response to such referrals. Despite the rapid assessment times, the research importantly identifies differences in outcomes among different cancer subtypes, with a particular emphasis on the variance in discharge destinations. These findings reflect both patient preferences and medical needs, demonstrating the role of tailoring palliative care approaches to meet the individual needs and desires of this diverse patient population.Item Prescriber adherence to antihypertensive prescription guidelines and the impact of patient socioeconomic factors: a cross‐sectional study using data from the irish longitudinal study on ageing(Wiley, 2024) Akhtar, Alizeh; Burton, Edel; Bermingham, Margaret; Kearney, Patricia M.; Irish Research eLibraryPurpose Uncontrolled hypertension causes significant morbidity and mortality worldwide. Several prescribing guidelines have been created to address this, however, prescriber adherence to guidelines is influenced by various sociodemographic patient factors. This study aims to determine the effects of these patient factors on prescriber adherence to antihypertensive prescription guidelines. Methods A secondary analysis of data from the first wave of The Irish Longitudinal Study on Ageing (TILDA), was conducted. Participants were included if they reported previous hypertension diagnoses. Antihypertensive medication regimes were compared with the prescribing guidance in the 2011 NICE hypertension guidelines. The effects of patient sociodemographic factors on prescriber adherence to guidelines, and the effect of prescriber adherence on blood pressure control (≥ 140/90 mmHg), were determined using binomial logistic regression models. Results A total of 2992 participants were included in this analysis; 54.9% female with mean age 65.7 years (±9.23). Male sex and older age, and lower socioeconomic status were associated with increased prescriber guideline adherence. Prescribers were less likely to adhere to guidelines in female patients ≥ 55 years (Relative Risk [RR] 0.75 [0.62, 0.91]), and female patients across all age groups (RR 0.80 [0.67, 0.95]). Better blood pressure control was seen with medication regimes adherent to prescription guidelines (140.38 (±18.98)/83.09 (±11.02) mmHg adherent vs. 141.66 (±19.86)/84.77 (±11.71) mmHg non-adherent). Conclusions This study highlights the effect of patient sex on prescriber adherence to antihypertensive prescription guidelines, emphasizing a larger issue of systemic undertreatment of females observed within healthcare. Further research is needed to determine the reasons for such differences in hypertensive care.Item Evolving radiographic practice: Identifying possible skill requirements for future radiographers practicing in the United Arab Emirates (UAE)(Elsevier Inc., 2024-05-07) David, Leena R.; Elshami, Wiam; Lawal, Olanrewaju; Panakkal, Nitika; Visakh , T.; Abuzaid, Mohamed; England, Andrew; McEntee, Mark; Somasundaram, T.; Sukumar, Suresh; Ravichandran, Sneha; Yuvali, MelizAim: This study aims to identify the prospective skill requirements for future radiographers practising in the United Arab Emirates (UAE). Such information will inform educational institutions, healthcare organisations, and policymakers in developing effective strategies. Methods: A cross-sectional study was conducted involving currently practising radiographers, nuclear medicine technologists, sonographers, and radiation therapists in the UAE (n =74). A comprehensive survey questionnaire was developed and validated through piloting and expert consultations. Ethical approval was obtained, and data were collected through purposive sampling. Descriptive statistics, reliability analysis, Chi-square tests, and factor analysis were employed in the data analysis. Results: The results showed that 73%, 47.3%, 43.2%, 40.5%, 39.2%, 33.8% interested in radiology safety, image interpretation, interprofessional and interpersonal skills, research and managerial skills, Picture Archiving and Communication System (PACS) administration and AI (Artificial Intelligence) and, clinical supervision and assessment, respectively. The factor analysis showed four factors factor considered for CPD training are training settings (15.12), training topics (1.88), CPD credits (1.72) and, presenter and expenses (1.49). Conclusion: This study sheds light on the CPD requirements and aspirations of radiographers in the UAE, offering insights into their preferences and challenges. These findings can inform strategies for improving CPD opportunities and ensuring that radiographers are equipped to meet the evolving healthcare demands in the UAE, including performing enhanced practice. Implications for practice: Development of flexible and comprehensive CPD programmes tailored to radiographers' career interests is required. Employers should provide financial support and flexibility in training options. Regulatory bodies should continue to mandate CPD, fostering a culture of lifelong learning. Supportive work environments, interdisciplinary collaboration, and technological fluency are crucial. Emphasising patient-centred care, research opportunities, and continuous assessment further enhances radiography practice.Item Recommendations for blood sampling in emergency departments from the European Society for Emergency Medicine (EUSEM), European Society for Emergency Nursing (EuSEN), and European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for the Preanalytical Phase. Executive summary(De Gruyter, 2024-04-08) Garcia-Castrillo, Luis; Cadamuro, Janne; Dodt, Christoph; Lauwaert, Door; Hachimi-Idrissi, Said; Van Der Linden, Christien; Bergs, Jochen; Costelloe, Sean; Grossmann, Florian; Koca, Ayca; Palomäki, Ari; Ruiz, Jose Luis; Stonys, Ricardas; Thorsteinsdottir, Thordís Katrín; von Meyer, Alexander; Vermeersch, Pieter; Abellas Alvarez, Maria Concepción; Eker, Pinar; Golea, Adela; Kurland, Lisa; Lippi, Giuseppe; Zhilenkova, Yulia; Sehmi, Kawaldip; BDAim: Blood Sampling Guidelines have been developed to target European emergency medicine-related professionals involved in the blood sampling process (e.g. physicians, nurses, phlebotomists working in the ED), as well as laboratory physicians and other related professionals. The guidelines population focus on adult patients. The development of these blood sampling guidelines for the ED setting is based on the collaboration of three European scientific societies that have a role to play in the preanalytical phase process: EuSEN, EFLM, and EUSEM. The elaboration of the questions was done using the PICO procedure, literature search and appraisal was based on the GRADE methodology. The final recommendations were reviewed by an international multidisciplinary external review group. Results: The document includes the elaborated recommendations for the selected sixteen questions. Three in pre-sampling, eight regarding sampling, three post-sampling, and two focus on quality assurance. In general, the quality of the evidence is very low, and the strength of the recommendation in all the questions has been rated as weak. The working group in four questions elaborate the recommendations, based mainly on group experience, rating as good practice. Conclusions: The multidisciplinary working group was considered one of the major contributors to this guideline. The lack of quality information highlights the need for research in this area of the patient care process. The peculiarities of the emergency medical areas need specific considerations to minimise the possibility of errors in the preanalytical phase.Item COVID‐19 pandemic and allergen immunotherapy - an EAACI survey(John Wiley & Sons, Inc., 2021-03-02) Pfaar, Oliver; Agache, Ioana; Bonini, Matteo; Brough, Helen Annaruth; Chivato, Tomás; Del Giacco, Stefano R.; Gawlik, Radoslaw; Gelincik, Aslı; Hoffmann‐Sommergruber, Karin; Jutel, Marek; Klimek, Ludger; Knol, Edward F.; Lauerma, Antti; Ollert, Markus; O’Mahony, Liam; Mortz, Charlotte G.; Palomares, Oscar; Riggioni, Carmen; Schwarze, Jürgen; Skypala, Isabel; José Torres, María; Untersmayr, Eva; Walusiak‐Skorupa, Jolanta; Chaker, Adam; Giovannini, Mattia; Heffler, Enrico; Jensen‐Jarolim, Erika; Quecchia, Cristina; Sandoval‐Ruballos, Mónica; Sahiner, Umit; Tomić Spirić, Vesna; Alvaro‐Lozano, MontserratBackground: As in many fields of medical care, the coronavirus disease 2019 (COVID-19) resulted in an increased uncertainty regarding the safety of allergen immunotherapy (AIT). Therefore, the European Academy of Allergy and Clinical Immunology (EAACI) aimed to analyze the situation in different countries and to systematically collect all information available regarding tolerability and possible amendments in daily practice of sublingual AIT (SLIT), subcutaneous AIT (SCIT) for inhalant allergies and venom AIT. Methods: Under the framework of the EAACI, a panel of experts in the field of AIT coordinated by the Immunotherapy Interest Group set-up a web-based retrospective survey (SurveyMonkey®) including 27 standardized questions on practical and safety aspects on AIT in worldwide clinical routine. Results: 417 respondents providing AIT to their patients in daily routine answered the survey. For patients (without any current symptoms to suspect COVID-19), 60% of the respondents informed of not having initiated SCIT (40% venom AIT, 35% SLIT) whereas for the maintenance phase of AIT, SCIT was performed by 75% of the respondents (74% venom AIT, 89% SLIT). No tolerability concern arises from this preliminary analysis. 16 physicians reported having performed AIT despite (early) symptoms of COVID-19 and/or a positive test result for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Conclusions: This first international retrospective survey in atopic diseases investigated practical aspects and tolerability of AIT during the COVID-19 pandemic and gave no concerns regarding reduced tolerability under real-life circumstances. However, the data indicate an undertreatment of AIT, which may be temporary, but could have a long-lasting negative impact on the clinical care of allergic patients.