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5 and interquartile range≤1.5) and stability (marginal changes of medians between round 2 and round 3<15%).

Seventeen eligible HF experts, including 10 cardiologists, 3 hospital pharmacists and 4 academic pharmacists, participated in the study. The initial list of PIMHF consisted of 100 medication items. From round 1, 8 medication items were excluded from the initial list. Thus, 92 medication items were considered in the second and the third round, respectively. After 3 surveys, 47 medication items reached the consensus and agreed as PIMHF.

This Delphi survey on opinion about PIMHF among an HF expert panel produced a list of 47 medication items as PIMHF which may be used as a screening tool for PIMHF in Thai HF patients.
This Delphi survey on opinion about PIMHF among an HF expert panel produced a list of 47 medication items as PIMHF which may be used as a screening tool for PIMHF in Thai HF patients.
The use of cemented fixation for hip arthroplasty for femoral neck fractures has been advocated to limit the postoperative and intraoperative risk of periprosthetic fractures. However, there are concerns with the potential effects of cementing on patient mortality, particularly at the time of cementation.

This study examined the mortality rates of cemented compared to cementless hip arthroplasty fixation in a group of 5883 femoral neck fracture patients from 2001 to 2017. The data were derived from large administrative databases and census data. Confounders were identified and controlled with a multivariate analysis. The data were also stratified into 2 time frames, 2001-2008 and 2009-2017, to determine if there was an effect of more recent improvements in patient care or implant technology.

Cemented fixation had a statistically significant reduction in mortality rates at 30, 90, and 365 days after surgery. There was no difference in mortality in 0, 1, or ≤7 days after discharge or during the admission. The mortality rate decreased but was still significantly increased with cementless fixation when the subjects were grouped from 2001 to 2008 and 2009 to2017.

Based on this evidence, the cemented fixation of hip arthroplasty should be considered for patients with femoral neck fractures.
Based on this evidence, the cemented fixation of hip arthroplasty should be considered for patients with femoral neck fractures.There is a paucity of research examining the phenomenology and energetic effects of spiritually transformative experiences with an energetic component, often referred to as kundalini awakenings (KAs). This limits our ability to understand and support individuals who have these often unexpected and powerful experiences. This study aimed to explore not only the nature of these experiences but also their subsequent behavioral and physiological transformative effects. Methods An interview questionnaire was used to collect detailed descriptions of both the physical and metaphysical experiences of persons having a spiritually transformative experience (STE) (e.g., spontaneous energetic awakenings, awakenings occurring through near-death experiences, and through spiritual practices). Results Subjects reported that the entire energetic awakening experience was mystical, involving feelings of expansion (including conscious awareness leaving the body), and a sense of being enveloped in light or love. Of 18 descriptors of experiences of energy, 85% of participants reported unusual flows of energy through or around the body. Principle triggers for these experiences included concentrating on spiritual matters, the presence of a spiritually developed person, and intense meditation or prayer. Transformational changes in participants included, e.g., increased sensory sensitivity, creativity, and changes in beliefs, including a desire to serve others, a sense of unity with all, and the immortality of the spirit. Most participants reported a lack of understanding of the STE phenomenon by healthcare professionals, resulting in their inability to address the needs of experiencers when they came to clinicians for help.
Eliciting informed consent is a clinical skill that many residents are tasked to conduct without sufficient training and before they are competent to do so. Even senior residents and often attending physicians fall short of following best practices when conducting consent conversations.

This is a perspective on strategies to improve how residents learn to collect informed consent based on current literature.

We advocate that surgical educators approach teaching informed consent with a similar framework as is used for other surgical skills. Informed consent should be defined as a core clinical skill for which attendings themselves should be sufficiently competent and residents should be assessed through direct observation prior to entrustment.
We advocate that surgical educators approach teaching informed consent with a similar framework as is used for other surgical skills. Informed consent should be defined as a core clinical skill for which attendings themselves should be sufficiently competent and residents should be assessed through direct observation prior to entrustment.
Entrustment is a key component connecting to resident preparedness for surgical practice in the operating room (OR). Residents' self-entrustment of their surgical competencies closely associates with their OR training experience and granted autonomy. Some recent studies have investigated how attending surgeons entrusted residents in the OR. There is little to no data, however, in examining these issues from the resident perspective. The goal of this study was to identify the perception and expectations of autonomy from residents' perspective, as well as the self-entrustment of their surgical competencies in obstetrics (OB) and gynecologic (GYN) procedures.

Focus group interviews of OB/GYN residents were performed. Residents were selected by convenience sampling. Audio recordings of each interview were transcribed, iteratively analyzed, and emergent themes identified, using a framework method.

A total of 123 minutes of interviews were recorded. Eight junior residents (PGY1-2) and 12 senior residents (PGYt and autonomy upon graduation.
Always Events® are defined as "those aspects of the care experience that should always occur when patients, their family members or other care partners, and service users interact with health care professionals and the health care system". It is a quality improvement methodology that starts by asking our patients the simple question "what matters to you?" and then through coproduction, works out a way to achieve this.

This article tells our story and highlights the value of undertaking an Always Event® within the Radiology department at Warrington and Halton Hospitals. It will demonstrate how this approach combines research, an evaluation of findings and implementation of those findings within a very short timeframe. Embedded within the article are comments from our staff, volunteers and patients which reflect upon their experiences, our limitations, the outcomes we achieved and the impact it has had upon our patients and staff.

It was important to our patients that they would be informed of how long thnefits this can lead to. It has also encouraged a positive research culture within our department (optimisation studies, working with industry, quality projects), helping to progress our profession and resulting in a quality service for our patients.
Magnetic resonance imaging (MRI) is an important modality in diagnostics and treatment follow-up. However, MRI can be perceived as unpleasant even though the examination is non-invasive. Patients' knowledge of the MRI procedure is usually scarce, which may enhance patient anxiety at examination. We investigated the effects on anxiety and satisfaction with an information booklet on MRI compared to a placebo booklet delivered to adult patients prior to their first MRI examination.

This randomized, single-blind, placebo-controlled trial included 197 patients. The intervention group (n=95) received a booklet about MRI prior to the examination, whereas the control group (n=102) received a placebo booklet of the same size and layout but containing general information. The State Trait Anxiety Inventory with supplementary questions from the Quality from the Patient's Perspective questionnaire were used as patient-reported outcome measures.

Anxiety did not differ between the groups, either prior to MRI or during the examination, but those who received the placebo booklet were at higher risk of experiencing high anxiety prior to the MRI examination (odds ratio 2.64; P=0.029). The intervention group was more satisfied with the information received (P=0.044), and a majority of participants in both groups (≥87%) considered it important to obtain information on the MRI procedure.

Written MRI information decreases the risk of high anxiety levels before MRI and improves patient satisfaction with the information. Further research is needed to investigate whether written information prior to MRI is beneficial not only from the perspective of the patient but may also be cost-effective.

Written MRI information prior to the examination is recommended in radiography care.
Written MRI information prior to the examination is recommended in radiography care.
Despite the existence of opportunities for postgraduate studies in radiography, the number of radiographers involved in postgraduate education is low and their research production is also considered low compared to other professions. The main aim of this study was to understand the profile of radiography Doctorate holders across the Arab countries, document their current role and identify barriers that may influence research and professional publication activity.

There is no formal database of doctoral radiographers in Arab countries, therefore a snowball sampling technique was used to recruit participants beyond those identified through organizational websites. An online survey was distributed to the participants with implied consent being applied through completion of the survey.

From 53 responses, 78% were male and 98% were diagnostic radiographers. Fifty-one percent completed their PhD in non-Arab countries and 55% self-funded (paid for themselves) their PhD study. An increase in doctoral students w is through these opportunities that practitioner research enhancement and capability is improved. Potential Arabian regional and wider international collaborations should be pursued in future as a developmental approach.Iron is a key element for normal cellular function and plays a role in many cellular processes including mitochondrial respiration. The role of iron deficiency (ID) in heart failure (HF) has been a subject of debate amid increasing advocacy for intravenous (IV) supplementation. Both the definition and the approach to treatment of ID in HF have been adapted from the experience in patients with chronic kidney disease (CKD). In this review, we highlight the differences in regulatory mechanisms as well as pathophysiology of ID in CKD and HF population both at the systemic and cellular levels. TAK-901 mouse We will review the major clinical trials in HF patients that have shown symptomatic benefit from IV iron supplementation but without effect on clinical outcomes. Intravenous iron loading bypasses the mechanisms that tightly regulate iron uptake and can potentially cause myocardial and endothelial damage by releasing reactive oxygen species. By contrast, newer oral iron preparations do not have similar toxicity concerns and might have a role in heart failure.
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