Author: Jason Curtis

The Effects of Vitamin D on Markers of Glucose and Obesity in Postmenopausal Women: A Meta-Analysis of Randomized Controlled Trials (2023)

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Type of publication:Systematic Review

Author(s):Hao, Lei; Lu, Aiyangzi; Gao, Hui; Niu, Jianfei; Prabahar, Kousalya; *Seraj, Shaikh Sanjid; Pan, Yongmei.

Citation:Clinical Therapeutics. 2023 Aug 17. [epub ahead of print]

Abstract:PURPOSE: The effect of vitamin D effect on glucose markers and obesity in postmenopausal women remains controversial. The current literature contains little information on vitamin D dosage and duration for optimal efficacy in postmenopausal women. This meta-analysis was undertaken to assess the impact of vitamin D on glucose markers and obesity in postmenopausal women. METHODS: A number of databases were used dated up to January 5, 2023, with no language restrictions (PubMed/MEDLINE, Web of Science, EMBASE, and Scopus). Treatment response from baseline was estimated from the mean within-group analysis, and SDs were used to calculate the treatment response. FINDINGS: Nine eligible articles with 12 comparisons qualified for the final quantitative analysis. An overall decrease was noted in fasting blood glucose (weighted mean difference [WMD], -3.56 mg/dL; 95% CI, -5.49 to -1.64; P < 0.001), homeostatic model assessment for insulin resistance (WMD, -1.168 mm; 95% CI, -2.001 to -0.33; P = 0.006), insulin (WMD, -2.26 units; 95% CI, -4.35 to -0.18; P = 0.033), and glycosylated hemoglobin (WMD, -0.41%; 95% CI, -0.54 to -0.29; P < 0.001) after vitamin D administration in postmenopausal women. In subgroup analyses, a notable decrease in fasting blood glucose was detected when the intervention course was >6 months and dosage <=1000 IU/d (WMD, -3.48 mg/dL). The present study showed that vitamin D was not associated with body mass index, body weight, or waist circumference in postmenopausal women. IMPLICATIONS: Vitamin D is beneficial for glucose markers but not obesity in postmenopausal women. An individualized dosage regimen of vitamin D should be followed depending on the clinical outcome target of postmenopausal women.

Introducing ACHILES, a new decision tool for accurate heel ulcer diagnosis (2023)

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Type of publication:Poster presentation

Author(s):*Beard, Nicola; *Merlin-Kwan, Elizabeth

Citation:Wounds UK annual conference, 6th – 8th November 2023, Harrogate

Abstract:The ACHILES tool is an innovative and inclusive tool that offers value and sustainability due to its ease of use. The Tool has been designed to be simple and practical to use, with very little training and equipment required, regardless of clinical designation, yet support standardisation and a consistent approach to define, treat and report heel ulcers.

Link to PDF poster

Surgical experience and identification of errors in laparoscopic cholecystectomy (2023)

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Type of publication:
Journal article

Author(s):
Humm, Gemma L; Peckham-Cooper, Adam; *Chang, Jessica; Fernandes, Roland; Gomez, Naim Fakih; Mohan, Helen; Nally, Deirdre; Thaventhiran, Anthony J; Zakeri, Roxanna; Gupte, Anaya; Crosbie, James; Wood, Christopher; Dawas, Khaled; Stoyanov, Danail; Lovat, Laurence B.

Citation:
British Journal of Surgery. 2023 Aug 23. [epub ahead of print]

Abstract:
BACKGROUND: Surgical errors are acts or omissions resulting in negative consequences and/or increased operating time. This study describes surgeon-reported errors in laparoscopic cholecystectomy. METHODS: Intraoperative videos were uploaded and annotated on Touch SurgeryTM Enterprise. Participants evaluated videos for severity using a 10-point intraoperative cholecystitis grading score, and errors using Observational Clinical Human Reliability Assessment, which includes skill, consequence, and mechanism classifications. RESULTS: Nine videos were assessed by 8 participants (3 junior (specialist trainee (ST) 3-5), 2 senior trainees (ST6-8), and 3 consultants). Participants identified 550 errors. Positive relationships were seen between total operating time and error count (r2 = 0.284, P < 0.001), intraoperative grade score and error count (r2 = 0.578, P = 0.001), and intraoperative grade score and total operating time (r2 = 0.157, P < 0.001). Error counts differed significantly across intraoperative phases (H(6) = 47.06, P < 0.001), most frequently at dissection of the hepatocystic triangle (total 282; median 33.5 (i.q.r. 23.5-47.8, range 15-63)), ligation/division of cystic structures (total 124; median 13.5 (i.q.r. 12-19.3, range 10-26)), and gallbladder dissection (total 117; median 14.5 (i.q.r. 10.3-18.8, range 6-26)). There were no significant differences in error counts between juniors, seniors, and consultants (H(2) = 0.03, P = 0.987). Errors were classified differently. For dissection of the hepatocystic triangle, thermal injuries (50 in total) were frequently classified as executional, consequential errors; trainees classified thermal injuries as step done with excessive force, speed, depth, distance, time or rotation (29 out of 50), whereas consultants classified them as incorrect orientation (6 out of 50). For ligation/division of cystic structures, inappropriate clipping (60 errors in total), procedural errors were reported by junior trainees (6 out of 60), but not consultants. For gallbladder dissection, inappropriate dissection (20 errors in total) was reported in incorrect planes by consultants and seniors (6 out of 20), but not by juniors. Poor economy of movement (11 errors in total) was reported more by consultants (8 out of 11) than trainees (3 out of 11). CONCLUSION: This study suggests that surgical experience influences error interpretation, but the benefits for surgical training are currently unclear.

Link to full-text [open access - no password required]

UEC WS2 - +14 day Length of Stay (2023)

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Type of publication:
Service improvement case study

Author(s):
*Madeleine Oliver, *Kirstie Sloan, *Shelby Fenton-Cook, *Karen Evans (SRO)

Citation:
SaTH Improvement Hub, June 2023

Abstract:
To Reduce the number of patients residing over 14 days by 25% by 26th May 2023 as part of the 6 week ‘new way of working trial’.

Link to PDF poster

Professional Education Facilitators introduction into the AHP Workforce (2023)

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Type of publication:
Service improvement case study

Author(s):
*Tony Davies

Citation:
SaTH Improvement Hub, July 2023

Abstract:
To introduce effective Professional Education Facilitators into the AHP workforce by August 2023 as evidenced by the increase in student numbers, staff questionnaires and an increase in tariff funding (which ultimately increases spending on education within the trust).

Link to PDF poster

Data Management in the Learning from Death Process (2023)

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Type of publication:
Service improvement case study

Author(s):
*Fiona McAREE

Citation:
SaTH Improvement Hub, June 2023

Abstract:
The aim is to streamline the data source and improve reporting compliancy to Board by the end of March 2023 as evidenced by:
• MTG workbook
• SJR tracker
• Master divisional list of SJRs

Link to PDF poster

Sharing policies between divisions (2023)

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Type of publication:
Service improvement case study

Author(s):
*Helen Ford, *Rachel North, *Tina Dodd, *Nina Sinclair and *Gemma Styles

Citation:
SaTH Improvement Hub, July 2023

Abstract:
To improve the communication of polices that need to be shared between divisions as evidence by a written and agreed process by June 2023.

Link to PDF poster