Multicomponent Deimplementation Strategy to Reduce Low-Value Preoperative Testing.

Importance: Routine preoperative blood tests and electrocardiograms before low-risk surgery do not prevent adverse events or change management but waste resources and can cause patient harm. Given this, multispecialty organizations recommend against routine testing before low-risk surgery.

Objective: To determine whether a multicomponent deimplementation strategy (the intervention) would reduce low-value preoperative testing before low-risk general surgery operations.

Bridging medical expertise in crisis: The development and implementation of a novel mobile application for Ukrainian physicians during wartime.

Background: The full-scale invasion disrupted health care in Ukraine, leading to the displacement of physicians and affecting their access to subspecialist consultations. HealUA, a mobile application, was designed to provide secure and timely remote physician-to-physician consultations. We aimed to assess the implementation of the HealUA mobile application for peer-to-peer physician consultations in Ukraine during the Russian invasion.

Cancer-related Fear and Worry in Patients with Low-Risk Thyroid Cancer: A Longitudinal Cohort Study.

Context: Little is known about how patients' emotions impact the choice between hemi- and total thyroidectomy (TT) for low-risk thyroid cancer (LR-TC) and how these emotions change after treatment.

Objective: To investigate thyroid cancer-specific fear and worry both before and after treatment of LR-TC with hemi- or TT.

Methods: This prospective cohort study enrolled adults with confirmed or likely LR-TC at 15 institutions.

Neuromuscular Load in Professional Women's Handball: Segmentation of the Player Load and the Impacts at Group and Individual Level.

Handball is a team sport characterised by physical interaction with other opponents. This interaction produces a high load on the players that can manifest itself in various ways, from discomfort to prolonged injuries due to tears caused by excessive load. In order to establish correct protocols for application in women's teams, context- and gender-specific reference data must be available.

Thyroid Cancer-Related Fear & Anxiety in Patients With Benign Thyroid Nodules: A Mixed-Methods Study.

Introduction: Thyroid cancer diagnosis often evokes strong negative emotions in patients, yet little is understood about such responses in those with benign thyroid nodules. This study explored the impact of a hypothetical cancer diagnosis, the provision of treatment information, and emotional support from surgeons on patients with benign nodules.

Methods: Patients within 30 d of a thyroid nodule biopsy were asked to imagine their nodule was cancerous and write down their feelings about this diagnosis.

Opportunities to improve the diagnosis and treatment of primary hyperparathyroidism: retrospective cohort study.

Background: Although primary hyperparathyroidism (PHPT) is readily diagnosed biochemically and can be cured with low-risk surgery, it is often underrecognized and undertreated. Our objectives were to characterize, within our health system, how often patients with hypercalcemia were evaluated for PHPT and how often patients with PHPT underwent definitive treatment with parathyroidectomy.

Methods: Ambulatory patients aged 18 years or older seen at our health system between January 2018 and June 2023 with chronic hypercalcemia were identified from the medical record.

Surgeon Preference for Maximizing Medical Care Is Associated with Recommending More Extensive Surgery for Low-Risk Thyroid Cancer.

While patient-level determinants of total thyroidectomy use have been well described, surgeon-level drivers of more extensive surgery are present and less well described. This survey sought to examine the associations between surgeons' operative recommendations, their beliefs about cancer, and their attitudes about medical maximizing-minimizing. A mixed-mode, cross-sectional survey was administered in September 2020 via mail and email to 222 thyroid surgeons identified in the Centers for Medicare & Medicaid Services Provider Utilization and Payment Physician and Other Practitioners dataset.

Understanding and Assisting the Recovery of Non-English-Speaking Trauma Survivors: Assessment of the NESTS Pathway.

Background: Spanish-speaking trauma and burn patients have unique needs in their postdischarge care navigation. The confluence of limited English proficiency, injury recovery, mental health, socioeconomic disadvantages, and acute stressors after hospital admission converge to enhance patients' vulnerability, but their specific needs and means of meeting these needs have not been well described.

Study Design: This prospective, cross-sectional survey study describes the results of a multi-institutional initiative devised to help Spanish-speaking trauma and burn patients in their care navigation after hospitalization.

Behavioral Interventions on Surgeons' Preoperative Decision-Making: A Scoping Review and Critical Analysis.

Introduction: Consensus is lacking regarding the optimal strategy to influence surgeons' behaviors to reduce low-value surgical care. Comprehensively describing the existing body of literature that seeks to intervene on surgeons' preoperative decision-making may aid in structuring future behavior change strategies.

Methods: We performed a scoping review using four databases (Medical Literature Analysis and Retrieval System Online, Embase, Web of Science, and Cumulated Index to Nursing and Allied Health Literature) for articles that tested the effect of behavioral-based interventions on any aspect of surgeons' decision-making in the preoperative setting.

Targets for De-implementation of Unnecessary Testing Before Low-Risk Surgery: A Qualitative Study.

Introduction: Despite multispecialty recommendations to avoid routine preoperative testing before low-risk surgery, the practice remains common and de-implementation has proven difficult. The goal of this study as to elicit determinants of unnecessary testing before low-risk surgery to inform de-implementation efforts.

Methods: We conducted focused ethnography at a large academic institution, including semi-structured interviews and direct observations at two preoperative evaluation clinics and one outpatient surgery center.

Game Space and Game Situation as Mediators of the External Load in the Tasks of School Handball.

The teacher’s didactic intervention also requires knowledge and control of learning tasks’ workloads. The objectives of the study were as follows: (i) to quantify the subjective external load-eTL of tasks framed in didactic units designed by in-service teachers; and (ii) to analyze the differences in the subjective eTL according to the game situation and the game space. A total of 306 learning tasks designed by seven in-service teachers (five men and two women), with more than 10 years of teaching practice, were analyzed.

The Most Common Handball Injuries: A Systematic Review.

Handball is a team sport involving a great physical demand from its practitioners in which a high number of injuries occur, affecting individual and collective performance. Knowledge of the injuries is of great importance for their prevention. The objective of the present study was to identify, locate and compare the most frequent injuries and injury mechanisms in handball practice.

Does the Physiological Response of a Triathlete Change in the Use or Absence of Drafting?

Background: Currently, tactics play an important and decisive role in sprint distance triathlons. One of the most decisive tactical elements is drafting in the cycling sector, depending on whether or not it is allowed by the test regulations. The objective was to analyze the physiological responses in running, in relation to drafting in the cycling sector, according to level and sex.

Predictors and Outcomes of Upstaging in Rectal Cancer Patients Who Did Not Receive Preoperative Therapy.

Background: Preoperative chemoradiation is indicated for clinical stage II and III rectal cancers; however, the accuracy of clinical staging with preoperative imaging is imperfect.

Objective: The study aimed to better characterize the incidence and management of clinical and pathologic stage discordances in patients who did not receive preoperative chemoradiation.

Design: This was a retrospective cohort analysis.

Analysis of the Objective Internal Load in Portuguese Skydivers in the First Jump of the Day.

The general objective of this study was to identify the variation in heart rate (HR) of Portuguese skydivers during 6 moments in their first jump of the day, bearing in mind the variable level of experience. Thirty-one Portuguese skydivers, 28 men and 3 women, aged between 19 and 62, participated in the study, 12 had A and B licenses (less experienced) and 19 had C and D licences (more experienced). The instrument used to record the heart rate of the skydivers at the different moments of their first jump of the day was the WIMU PRO.

External load of the tasks planned by teachers for learning handball.

The load in tasks planned for sports teaching in physical education classes has received little attention. The purpose of this study was therefore to analyze the external load, eTL, in the tasks designed by physical education teachers from the in-service and pre-service stages, for teaching handball in primary education, and to compare them with the tasks included in the lesson plans designed for handball using the tactical games teaching model. An associative, comparative and cross-sectional methodology was used.

On-Match Impact and Outcomes of Scoring First in Professional European Female Football.

Background: Scoring first seems to be a determinant in professional football playing; several factors could influence the development of the match and the outcome. This study aimed to identify which factors could influence scoring first and impact match outcomes in professional European female football.

Methods: There were 504 official matches held on 74 match days during the 2018-2019 professional female European football seasons (, , and ), analysed using a notational and inferential assessment.

Analysis of the Research Methodology in Spanish Doctoral Theses on Handball. A Systematic Review.

The objective of this investigation was to analyze scientific production assessed by indexed doctoral theses in the Ordered Spanish Theses (TESEO) database, on the topic of the sport of handball in Spain. Productivity was analyzed on the basis of variables grouped by contextual information, methodologies and procedures. Seventy-two indexed theses from between 1976 and 2021 were analyzed.

Training and Profile of Special Olympics Portugal Coaches: Influence of Formal and Non-Formal Learning.

Since coaches play an important role in the development of athletes, the process and mechanisms used by Special Olympics Portugal to develop coaches' skills are worthy of research. In this context, the study aims to identify the training paths and profiles of the Special Olympics Portugal coach. It also aims to analyze the relationship between formal and non-formal learning in the profile and training of this type of coach.

Career Development of Adapted Sports Coaches: Systematic Review of Qualitative Evidence Literature.

This study aims to synthesize and understand the qualitative and empirical evidence previously published on adapted sports career development. This systematic literature review also aimed at developing a conceptual model of the training and career path of adapted sports coaches. The research was carried out through the following databases: PubMed, Erid, EBSCO, Web of Science and Scopus.

Citius, Altius, Fortius; Is It Enough to Achieve Success in Basketball?

The NBA Draft Combine includes a series of standardized measurements and drills that provide NBA teams with an opportunity to evaluate players. The purpose of this research was to identify the Combine tests that explain draft position and future performance in the NBA rookie season. Variables were selected from the previous categories of anthropometric measurements and strength and agility tests.

Facilitators and barriers to allyship in academic surgery: A qualitative study.

Background: Academic health centers have promoted initiatives to improve diversity, equity and inclusion in medicine. Despite this emphasis, there has been limited discussion on practical strategies for navigating bias within academic surgery. This study analyzes experiences of confronting bias within the department of surgery at the University of Michigan.

Design and Validation of the Instrument for the Measurement of Learning and Performance in Football.

The assessment of tactical-technical knowledge of football is essential to develop optimal and integral teaching processes for students. Therefore, the aim of this study was to design and validate an instrument so that teachers, coaches, and researchers can observe and codify both the tactical behaviors and technical skills performed by the students in the game of football. The design and validation of the instrument were carried out in four phases: a) review of the literature and previous instruments; b) design of the Instrument for the Measurement of Learning and Performance in Football (IMLPFoot).