Sedoanalgesia Administration with Propofol and Ketamine for Minor Urologic Interventions

Aim: In this study we aimed to administer sedoanalgesia with propofol and ketamine combination in patients undergoing planned minor urologic interventions with limited anesthesia. By combining these two medications, lower doses may be used, and we aimed to provide sufficient sedation, analgesia and amnesia without disrupting hemodynamic and respiratory stability and to increase patient and surgeon satisfaction. Material-Method: The study included 53 patients with planned minor urologic interventions aged from 19 to 85 years and physical situation ASA I-III. After six hours starvation, patients were taken to the surgery. Patients were monitored for electrocardiography (ECG), oxygen saturation (SPO2 ) and non-invasive blood pressure. For use if necessary a nasal O2 cannula was inserted. A vein in the back of the left hand was opened and 5 ml/min isotonic sodium chloride infusion was begun. Patient heart rate (HR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP) and oxygen saturation (SpO2 ) values were measured and a 5 point sedation scale (Table 1) was used to measure sedation scores. Basal values were recorded (0 min). Later patients were randomly divided into two groups with Group I administered intraurethral lidocaine gel for local anesthesia by the surgeon, while Group II were administered intravenous 0.015 mg/kg midazolam, 0.5 mg/kg 1% ketamine and 0.5 mg/kg 1% propofol by the authors for sedoanalgesia. At five minute intervals the HR, SAP, DAP, MAP, SpO2 values and sedation scores were measured and recorded. Results: Statistical evaluation found a statistically significant increase in SAP, DAP and MAP values measured at the 5th minute in Group I patients compared to preoperative values. In Group I patients, when the heart rate measured in the 1st and 5th minutes are compared with preoperative values there was a statistically significant increase identified. In Group II patients, there was a statistically significant fall in SpO2 values in the 1st and 5th minutes compared with preoperative values. When patient and surgeon satisfaction are compared with Group I, Group II was found to be statistically significantly higher. Though the blood pressure and heart rate increases in Group I patients were statistically significant, they were not at levels that required clinical intervention and/or treatment. Similarly the SpO2 decrease observed in Group II patients did not fall below 90% in any patient in spite of being statistically significant and rose again without clinical intervention and/or treatment. Conclusion: In this study we showed that sedoanalgesia administration with propofol and ketamine may be an alternative method for patients undergoing minor urology interventions that does not disrupt hemodynamic and respiratory stability, does not delay patient discharge, has low side effect incidence and has high patient and surgeon satisfaction

Assessing the feasibility of measuring residents\u27 quality of life in English care homes and the construct validity and internal consistency of measures completed by staff proxy: a cross-sectional study

\ua9 Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ Group.Objectives To assess the feasibility of capturing older care home residents\u27 quality of life (QoL) in digital social care records and the construct validity (hypothesis testing) and internal consistency (Cronbach\u27s alpha) of four QoL measures. Design Cross-sectional data collected in wave 1 of the DACHA (Developing resources And minimum dataset for Care Homes\u27 Adoption) study, a mixed-methods pilot of a prototype minimum dataset (MDS). Setting Care homes (with or without nursing) registered to provide care for older adults (>65 years) and/or those living with dementia. All homes used a digital record system from one of two suppliers. Participants Data were extracted from 748 residents. All permanent residents, aged 65 years or older, were eligible to participate, including those lacking capacity to consent. Temporary residents and residents in their last weeks of life were excluded. Outcome measures and analysis The English language versions of Adult Social Care Outcomes Toolkit (ASCOT)-Proxy-Resident, ICEpop CAPability measure for Older people (ICECAP-O), EQ-5D-5L proxy and the QUALIDEM were added to the digital record. As there have not been any previous studies of the structural validity of the English language version of the QUALIDEM, ordinal exploratory factor analysis (EFA) was applied for this measure only. Feasibility (% missing by software provider and measure), % floor/ceiling effects (>15% at lower/upper end of the scales), convergent or divergent construct validity (criterion of >75% of hypotheses accepted) and internal consistency (Cronbach\u27s alpha ≥0.7) were assessed for all four measures. Results The ordinal EFA of QUALIDEM did not replicate the findings of previous research. A six-factor (36 item) solution was proposed and used in all subsequent analyses. There were low rates of missing data (<5%) for all items, except ASCOT-Proxy-Resident Control (5.1%) and Dignity (6.2%) and QUALIDEM item 35 (5.1%). Ceiling effects were observed for the ASCOT-Proxy-Resident and two of the QUALIDEM subscales. None of the scales had floor effects. Cronbach\u27s alpha indicated adequate internal consistency (α ≥0.70) for the ASCOT-Proxy-Resident, ICECAP-O and EQ-5D-5L proxy. There were issues with two QUALIDEM subscales. Construct validity for all measures was adequate. Conclusions The findings support the use of EQ-5D-5L, ASCOT-Proxy-Resident and the ICECAP-O in care homes for older people. The choice of measure will depend on the construct(s) of interest. More research is needed to establish the psychometric properties of the QUALIDEM in an English care home setting

Cross-sectional study assessing the feasibility of measuring residents’ Quality of Life in English care homes and assessing the construct validity and internal consistency of measures completed by staff-proxy.

Objectives To assess the feasibility of capturing older care home residents’ quality of life (QoL) in digital social care records and the construct validity (hypothesis testing) and internal consistency (Cronbach’s alpha) of four QoL measures. Design Cross-sectional data collected in wave 1 of the DACHA (Developing resources And minimum dataset for Care Homes’ Adoption) study, a mixed-methods pilot of a prototype minimum dataset (MDS). Setting Care homes (with or without nursing) registered to provide care for older adults (>65 years) and/or those living with dementia. All homes used a digital record system from one of two suppliers. Participants Data were extracted from 748 residents. All permanent residents, aged 65 years or older, were eligible to participate, including those lacking capacity to consent. Temporary residents and residents in their last weeks of life were excluded. Outcome measures and analysis The English language versions of Adult Social Care Outcomes Toolkit (ASCOT)-Proxy-Resident, ICEpop CAPability measure for Older people (ICECAP-O), EQ-5D-5L proxy and the QUALIDEM were added to the digital record. As there have not been any previous studies of the structural validity of the English language version of the QUALIDEM, ordinal exploratory factor analysis (EFA) was applied for this measure only. Feasibility (% missing by software provider and measure), % floor/ceiling effects (>15% at lower/upper end of the scales), convergent or divergent construct validity (criterion of >75% of hypotheses accepted) and internal consistency (Cronbach’s alpha ≥0.7) were assessed for all four measures. Results The ordinal EFA of QUALIDEM did not replicate the findings of previous research. A six-factor (36 item) solution was proposed and used in all subsequent analyses. There were low rates of missing data (<5%) for all items, except ASCOT-Proxy-Resident Control (5.1%) and Dignity (6.2%) and QUALIDEM item 35 (5.1%). Ceiling effects were observed for the ASCOT-Proxy-Resident and two of the QUALIDEM subscales. None of the scales had floor effects. Cronbach’s alpha indicated adequate internal consistency (α ≥0.70) for the ASCOT-Proxy-Resident, ICECAP-O and EQ-5D-5L proxy. There were issues with two QUALIDEM subscales. Construct validity for all measures was adequate. Conclusions The findings support the use of EQ-5D-5L, ASCOT-Proxy-Resident and the ICECAP-O in care homes for older people. The choice of measure will depend on the construct(s) of interest. More research is needed to establish the psychometric properties of the QUALIDEM in an English care home setting

Piloting a minimum data set (MDS) in english care homes: a qualitative study of professional perspectives on implementation and data use

\ua9 The Author(s) 2025.Background: Digitalisation within English care homes offers potential to make more effective use of substantial data collected by staff during care planning and recording. A pilot minimum data set was co-designed with stakeholders based on two digital care records with additional structured measures. Our objectives were to explore (1) care home staff opinions and experiences of collecting structured measures of quality of life, cognition and function for residents and (2) how a minimum data set data might be used by staff and other professionals interested in care homes. Methods: Between June and October 2023 focus groups and interviews involving care home staff and Integrated Care System participants from three regions of England were undertaken. Integrated Care System staff work externally from care homes and support commissioning of services for care homes and reviewing data. We used a semi-structured topic guide. Two waves of care home focus groups were conducted after each wave of minimum data set data capture. A single wave of focus groups/interviews were undertaken with Integrated Care System participants. Reflexive thematic analysis was used to develop themes. Results: Twenty-four staff from 22 care homes and 16 staff from 15 care homes participated in five wave one and four wave two focus groups respectively. Ten Integrated Care System participants from two of three study regions participated in one focus group (seven participants) and three individual interviews. Three themes were developed: the care home context and the importance of a minimum data set for care, appropriateness and relevance of quality of life measures to resident care, and data quality and purpose. Conclusions: Care home staff can collect structured measures on resident quality of life, function and cognition using digital care records to contribute to a minimum data set. The data generated can inform and enhance resident care. However, implementation is an evolving process requiring support, trust-building and confidence among those collecting and interpreting data and incorporation as part of routine care

Understanding Virtual Onboarding Dynamics and Developer Turnover Intention in the Era of Pandemic

Akdur, Gorkem/0000-0001-7879-3109; Aydin, Mehmet/0000-0002-3995-6566; Akdur, Gizdem/0000-0001-7326-4750This study examines the dynamics of virtual onboarding (VO) for Salesforce Commerce Cloud developers during the COVID-19 pandemic in a multinational software company. The newly developed Virtual Integration and Retention Framework (VIRF), which provides an improved understanding of VO, customized to the opportunities and challenges presented by the pandemic, is the fundamental concept of this study. A two-staged, higher-order constructed (HOC) quantitative research approach was used for the study, revealing a negative relationship between VO success and the challenges brought on by the pandemic. This emphasizes how difficult it can be to transition to remote work settings, especially regarding how operational effectiveness and employee well-being interact. Furthermore, the study demonstrates the positive connection between VO success and the delivery of technology and equipment during the pandemic. This result emphasizes how important logistical support is to the effectiveness of remote work arrangements. The study's key findings show positive impact of successful VO on developers' job satisfaction and workplace relationship quality (WRQ). Strong VO practices are essential to improve employee retention, as evidenced by the inverse correlation between these factors and turnover intentions. The study uses mediation analysis, with job satisfaction and WRQ acting as mediators, to further clarify how VO success influences turnover intentions. This study offers an in-depth understanding of VO practices during the pandemic. It discusses the future of remote work and onboarding procedures while navigating the immediate difficulties caused by the outbreak. The study emphasizes how important VO is for improving WRQ, decreasing turnover intentions of developers within the software company, and improving job satisfaction. These insights benefit organizations trying to improve developer integration and retention in changing work environments and improve their remote work strategies.This research did not receive grants from public, commercial, or non- profit funding agencies. The corresponding author is an employee at the case company. No funds, grants, or other support was received.Science Citation Index Expande

Correlation of p16 expression with clinicopathologic features in oropharyngeal carcinoma

WOS: 000344386800280