Journal of evaluation in clinical practice
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The article aims to describe the establishment and development of the Vascular Access Unit in a major hospital in Southern Europe during the SARS-COV2 pandemic and to evaluate the benefits brought by the Unit. ⋯ Establishing Vascular Access Teams should be a priority in large hospitals, as they can positively impact ward organization and significantly enhance patient satisfaction.
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Individuals experiencing homelessness (IEH) tend to have increased length of stay (LOS) in acute care settings, which negatively impacts health care costs and resource utilisation. It is unclear however, what specific factors account for this increased LOS. This study attempts to define which diagnoses most impact LOS for IEH and if there are differences based on their demographics. ⋯ Homelessness significantly increases the LOS of individuals within both ED and inpatient settings. We have identified several diagnoses that are associated with increased LOS in IE; these should inform the prioritisation and development of targeted interventions to improve the health of IEH.
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Observational Study
Implementation of an Early Referral Programme for Patients With Hand Arthralgia.
Rheumatoid arthritis (RA) is a progressive autoimmune inflammatory disease. According to the European League Against Rheumatism (EULAR), the stages of RA progression include pre-RA, preclinical RA, inflammatory arthralgia, arthralgia with positive antibodies, arthralgia suspected of progressing to RA, undifferentiated arthritis and finally established RA. According to the Community Oriented Program for Control of Rheumatic Diseases (COPCORD), the prevalence of RA in Mexico is 1.6% [2], with approximately 10% of health problems addressed at the primary care level. ⋯ The implementation of this early referral programme significantly reduced the time in months for patients to access rheumatologic care.
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To determine the effect of the health literacy levels of caregivers of individuals with T2DM on caregiving activities and supportive behaviours. ⋯ In the research, it was determined that care activities and supportive behaviours were higher in those with higher levels of HL, higher levels of education, those who were not employed, those with higher income levels, and those who received education about diabetes. Nurses should develop training programmes to increase the HL levels of caregivers.
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Zero-event counts are common in clinical studies, particularly when assessing rare adverse events. These occurrences can result from low event rates, short follow-up periods, and small sample sizes. When both intervention and control groups report zero events in a clinical trial, the study is referred to as a double-zero-event study, which presents methodological challenges for evidence synthesis. There has been ongoing debate about whether these studies should be excluded from evidence synthesis, as traditional two-stage meta-analysis methods may not estimate an effect size for them. Recent research suggests that these studies may still contain valuable clinical and statistical information. ⋯ We advocate for retaining double-zero-event studies in meta-analyses and emphasise the importance of carefully considering their role in FI assessments. Including these studies ensures a more accurate evaluation of the robustness of clinical results in evidence synthesis.