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Delineate the scope of teleconsultation services that can be effectively performed to provide women with comprehensive gynaecological and obstetrical care.
Based on the literature and experts’ insights, we identified a list of gynaecological and obstetrical care practices suitable for teleconsultation. A three-round Delphi consensus survey was then conducted online among a panel of French experts. Experts using a 9-point Likert scale assessed the relevance of each teleconsultation practice in four key domains: prevention, gynaecology and antenatal and postnatal care. Consensus was determined by applying a dual-criteria approach: the median score on a 9-point Likert scale and the percentage of votes either below 5 or 5 and higher.
The study was conducted at a national level in France and involved multiple healthcare centres and professionals from various geographical locations.
The panel comprised 22 French experts with 19 healthcare professionals, including 12 midwives, 3 obstetricians-gynaecologists, 4 general practitioners and 3 healthcare system users. Participants were selected to include diverse practice settings encompassing hospital and private practices in both rural and urban areas.
The study’s primary outcome was the identification of gynaecological and obstetrical care practices suitable for teleconsultation. Secondary outcomes included the level of professional consensus on these practices.
In total, 71 practices were included in the Delphi survey. The practices approved for teleconsultation were distributed as follows: 92% in prevention (n=12/13), 55% in gynaecology (n=18/33), 31% in prenatal care (n=5/16) and 12% in postnatal care (n=1/9). Lastly, 10 practices remained under discussion: 7 in gynaecology, 2 in prenatal care and 1 in postnatal care.
Our consensus survey highlights both the advantages and limitations of teleconsultations for women’s gynaecological and obstetrical care, emphasising the need for careful consideration and tailored implementation.
Introducción: Las enfermeras han brindado cuidados a los pacientes con COVID-19, y muchas tuvieron que lidiar con este virus al ser infectadas. Objetivo: Describir las experiencias de las enfermeras en primera línea contagiadas con COVID-19 que recibieron atención domiciliaria. Método: Investigación cualitativa descriptiva, el tamaño de la muestra fue con 12 enfermeras infectadas con COVID-19 que recibieron tratamiento domiciliario en Chiclayo, Perú. El muestreo fue por la técnica de bola de nieve. Para recolectar los datos se utilizó la entrevista semiestructurada a través de los medios virtuales previo consentimiento informado. Resultados: Surgieron tres categorías: a) Incertidumbre ante modo de contagio, medios de diagnóstico, sintomatología y evolución por la COVID-19, b) Cuidados recuperativos en el hogar: tratamiento médico, uso de medicina tradicional y medidas de bioseguridad, y c) Impacto en la vida familiar, laboral, social, emocional y espiritual al sufrir de la COVID-19. Conclusiones: Las enfermeras presentaron síntomas leves de la COVID-19 y se recuperaron en su domicilio, cumplieron con el tratamiento médico, algunas usaron remedios caseros. Practicaron estrictamente las medidas de bioseguridad para evitar que su familia se contagie. Utilizaron la tecnología digital y reforzaron su fe para afrontar el impacto familiar, emocional y social.
by Patricia Escobedo, Daniel Garcia, Liam Cascelli, Gabriela Chavira, Gilberto E. Flores, Jodi L. Constantine Brown, David Boyns, Andrew T. Ainsworth
In March 2020, the COVID-19 pandemic forced many in person undergraduate research experiences (UREs) to pivot to remote online training. To investigate how the COVID-19 quarantine disrupted student URE outcomes over time, the current study examines Building Infrastructure Leading to Diversity (BUILD) Promoting Opportunities for Diversity in Education and Research (PODER) URE outcomes across different platforms (in-person, remote, and hybrid models) by comparing student survey data from 2019 to 2021. Participants consisted of three cohorts: 2019 (n = 26 students), 2020 (n = 33), 2021 (n = 34). The BUILD PODER Summer JumpStart program (SJS), which aims to increase diversity in Science, Technology, Engineering, and Mathematics (STEM) by recruiting mostly underrepresented students, was conducted in person in 2019, remotely in 2020 and using a hybrid model in 2021. All students completed an online survey on the first and last day of the four-week SJS program. We used one-way and mixed ANOVA models to analyze Cohort, Time (pre-test vs. post-test scores), and interaction of Cohort and Time for Research Self-Efficacy, Sense of Belonging, Mentor Relationship, Mentee Knowledge, Health, Stress, and Student Program Satisfaction measures. Despite the platform changes, student scores increased significantly over time for all measures. There was a significant main effect of Time for Research Self-Efficacy, Sense of Belonging, Mentor Relationship, Mentee Knowledge, Health Assessment, and Stress Management. Findings indicate that URE programs that are implemented remotely and using a hybrid format can provide students with experiences similar to in-person URE programs. In addition, remote UREs may provide added benefits compared to in-person programs. For instance, remote UREs could engage more historically minoritized students, who may experience barriers to access, such as work/family commitments, financial constraints, and geographic limitations.by Matthias Bosman, Dustin N. Krüger, Kasper Favere, Guido R. Y. De Meyer, Constantijn Franssen, Emeline M. Van Craenenbroeck, Pieter-Jan Guns
Apart from cardiotoxicity, the chemotherapeutic agent doxorubicin (DOX) provokes acute and long-term vascular toxicity. Dexrazoxane (DEXRA) is an effective drug for treatment of DOX-induced cardiotoxicity, yet it remains currently unknown whether DEXRA prevents vascular toxicity associated with DOX. Accordingly, the present study aimed to evaluate the protective potential of DEXRA against DOX-related vascular toxicity in a previously-established in vivo and ex vivo model of vascular dysfunction induced by 16 hour (h) DOX exposure. Vascular function was evaluated in the thoracic aorta in organ baths, 16h after administration of DOX (4 mg/kg) or DOX with DEXRA (40 mg/kg) to male C57BL6/J mice. In parallel, vascular reactivity was evaluated after ex vivo incubation (16h) of murine aortic segments with DOX (1 μM) or DOX with DEXRA (10 μM). In both in vivo and ex vivo experiments, DOX impaired acetylcholine-stimulated endothelium-dependent vasodilation. In the ex vivo setting, DOX additionally attenuated phenylephrine-elicited vascular smooth muscle cell (VSMC) contraction. Importantly, DEXRA failed to prevent DOX-induced endothelial dysfunction and hypocontraction. Furthermore, RT-qPCR and Western blotting showed that DOX decreased the protein levels of topoisomerase-IIβ (TOP-IIβ), a key target of DEXRA, in the heart, but not in the aorta. Additionally, the effect of N-acetylcysteine (NAC, 10 μM), a reactive oxygen species (ROS) scavenger, was evaluated ex vivo. NAC did not prevent DOX-induced impairment of acetylcholine-stimulated vasodilation. In conclusion, our results show that DEXRA fails to prevent vascular toxicity resulting from 16h DOX treatment. This may relate to DOX provoking vascular toxicity in a ROS- and TOP-IIβ-independent way, at least in the evaluated acute setting. However, it is important to mention that these findings only apply to the acute (16h) treatment period, and further research is warranted to delineate the therapeutic potential of DEXRA against vascular toxicity associated with longer-term repetitive DOX dosing.
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