Natural orifice versus transabdominal specimen extraction in laparoscopic surgery for colorectal cancer: meta-analysis.

BACKGROUND: Natural orifice specimen extraction (NOSE) is a technique that involves collecting a specimen for extraction through a natural opening avoiding a mini-laparotomy incision. The aim of this study was to compare NOSE and transabdominal specimen extraction in laparoscopic (LAP) colorectal cancer surgery for postoperative outcomes and oncological safety. METHOD: A systematic search was conducted in five electronic databases from inception till October 2020. Articles were selected based on the inclusion criteria (studies comparing LAP and NOSE colorectal surgeries reporting at least one of the outcomes) and analysed. Primary outcomes included postoperative complications, pathological results (resection margins and lymph node collection), and oncological outcomes. Secondary outcomes included operating time, blood losses, use of analgesics, functional recovery, duration of hospital stay, and cosmetic results. Fixed and random-effect models were used to measure the pooled estimates. RESULTS: Nineteen studies involving a total of 3432 participants were analysed (3 randomized clinical trials (RCTs) and 16 retrospective non-randomized studies). Pooled results showed significantly reduced postoperative complications (OR 0.54; 95 per cent c.i. 0.44 to 0.67; P < 0.00001). Pathological outcomes of NOSE were comparable to LAP with no significant difference noted in terms of resection margins (P > 0.05) and lymph node collection (weighted mean difference (WMD) -0.47; 95 per cent c.i. -0.94 to 0; P = 0.05). Pooled analysis demonstrated comparable long-term outcomes in terms of cancer recurrence (OR 0.94; 95 per cent c.i. 0.63 to 1.39; P = 0.75), 5-year disease-free survival (HR 0.97; 95 per cent c.i. 0.73 to 1.29; P = 0.83), and overall survival (HR 0.93, 95 per cent c.i. 0.58 to -1.51; P = 0.78). Finally, the NOSE group had decreased use of additional analgesia after surgery and earlier resumption of oral intake when compared with LAP (respectively OR 0.28; 95 per cent c.i. 0.20 to 0.37; P < 0.00001 and WMD -0.35; 95 per cent c.i. -0.54 to -0.15; P = 0.0005). CONCLUSION: This meta-analysis showed that in comparison with LAP, NOSE decreases severe postoperative morbidity while improving postoperative recovery without compromising oncological safety, but it is limited by the small number of RCTs performed in this field.

Attitudes towards COVID-19 vaccination, vaccine hesitancy and intention to take the vaccine.

BACKGROUND: The pandemic is at a paradoxical stage, with vaccine roll out initiated but a significantly elevated level of infection and death. Hope for recovery lies in high equitable vaccine uptake. OBJECTIVE: The study aimed to: i) explore attitudes and factors influencing attitudes, towards the COVID-19 vaccine amongst people living in Malta, ii) identify the reasons as to why individuals are unsure or unwilling to take the vaccine. METHODS: Two consecutive, short, anonymous online surveys using social media platforms were used to gather data from adult individuals. The first study was open to residents in Malta, while the second study invited international participation. Study 1 consisted of 17 questions inspired by the Theories of Planned Behaviour and Reasoned Action. Study 2 asked participates whether they were willing, unwilling or unsure of taking the vaccine and their reasons for being unsure or unwilling. RESULTS: A total of 2,529 individuals participated in Study 1 and 834 in Study 2. In both studies respondents were predominantly female having a tertiary education. Over 50% declared that they were willing to take the vaccine, with males being more willing (t=5.83, df=1164.2, p<0.00005). Opinions of significant others- family and friends (r=0.22, p<0.005) and health professionals (r=0.74, p<0.005) were associated with willingness to take the vaccine. Vaccine hesitancy was present in the study population with 32.6% being unsure and 15.6% declaring that they were not willing to take the vaccine. Females were more likely to be unsure (Chi-squared=14.63, df=4, p=0.006). Lack of vaccine safety was the main reason cited for unwillingness to take the vaccine. Predictors for willingness to take the vaccine were: i) The belief that the COVID-19 vaccine will protect the health of the people who take it; ii) Valuing the advice of health professionals regarding the effectiveness of COVID-19 vaccine; iii) Having taken the influenza vaccine last year and; iv) Encouraging their elderly parents to take the vaccine. CONCLUSIONS: COVID-19 vaccination information campaigns should promote group strategies, focusing on emphasising the safety of the vaccine and offer reassurance, especially to women.

Attitudes towards COVID-19 vaccination, vaccine hesitancy and intention to take the vaccine

BACKGROUND: The pandemic is at a paradoxical stage, with vaccine roll out initiated but a significantly elevated level of infection and death. Hope for recovery lies in high equitable vaccine uptake. OBJECTIVE: The study aimed to: i) explore attitudes and factors influencing attitudes, towards the COVID-19 vaccine amongst people living in Malta, ii) identify the reasons as to why individuals are unsure or unwilling to take the vaccine. METHODS: Two consecutive, short, anonymous online surveys using social media platforms were used to gather data from adult individuals. The first study was open to residents in Malta, while the second study invited international participation. Study 1 consisted of 17 questions inspired by the Theories of Planned Behaviour and Reasoned Action. Study 2 asked participates whether they were willing, unwilling or unsure of taking the vaccine and their reasons for being unsure or unwilling. RESULTS: A total of 2,529 individuals participated in Study 1 and 834 in Study 2. In both studies respondents were predominantly female having a tertiary education. Over 50% declared that they were willing to take the vaccine, with males being more willing (t=5.83, df=1164.2, p < 0.00005). Opinions of significant others- family and friends (r=0.22, p < 0.005) and health professionals (r=0.74, p < 0.005) were associated with willingness to take the vaccine. Vaccine hesitancy was present in the study population with 32.6% being unsure and 15.6% declaring that they were not willing to take the vaccine. Females were more likely to be unsure (Chi-squared=14.63, df=4, p = 0.006). Lack of vaccine safety was the main reason cited for unwillingness to take the vaccine. Predictors for willingness to take the vaccine were: i) The belief that the COVID-19 vaccine will protect the health of the people who take it; ii) Valuing the advice of health professionals regarding the effectiveness of COVID-19 vaccine; iii) Having taken the influenza vaccine last year and; iv) Encouraging their elderly parents to take the vaccine. CONCLUSIONS: COVID-19 vaccination information campaigns should promote group strategies, focusing on emphasising the safety of the vaccine and offer reassurance, especially to women

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WASP (Write a Scientific Paper): Using correspondence analysis to investigate qualitative data elicited through photographs.

Images can be helpful for eliciting data in the form of responses from participants. Sometimes photographs can help participants speak about issues, events, thoughts and emotions which they find difficult to talk about. This paper discusses how photos can be used and how the data collected through their use in a discussion can be analysed using Correspondence Analysis (CA). Although CA is considered a quantitative tool for analysing data, this paper describes how it can be used with qualitative data.

On stopping rules and the sex ratio at birth.

One popular stopping rule intended to increase the rate of male births is to keep having babies until the first male is born. We show that such a stopping rule does not change the sex ratio at birth when the probability p that a birth produces a male is constant across a population. We show, however, that when p varies across couples, as evidence suggests that it does in the human population, with mean around 0.515 and standard deviation 0.05, then such a stopping rule tends to favour female births and the correct rule should be to stop procreating until the first female is born. But we also show that it does not seem that such stopping rules, even if favouring male births, can account for the dramatic increase in the rate of male births registered in some countries. Most of these conclusions have appeared in some form or other in various studies, but they are scattered across the literature and are very often presented using some heavy mathematical techniques. In this paper, we try to bring together these ideas and make them more accessible by analysing these stopping rules using the simplest mathematical tools possible.

Personality traits of pharmacy and medical students throughout their course of studies / Rasgos de personalidad de estudiantes de Farmacia y Medicina a lo largo de los años de estudio

Background: Pharmacists and medical doctors are two professional groups that very often receive their education and practice in the same environment. However, their approach to patient care and collaboration tends to be different and this may lead to both frustration and conflict which may adversely affect patient care. Personality has been identified as a psychological issue that could contribute to conflict in a work situation. Objective: To study the personality traits of a cohort of students studying pharmacy and medicine at the University of Malta in their first and final year. Methods: The Gordon Personal Profile - Inventory was administered to a cohort of pharmacy and medical students in their first year and once again administered to the same cohort who completed their course of study in their final year. Basic demographic data was also collected. Results: In first year the most pronounced traits for both student groups were those of Emotional Stability and Personal Relations. Over a period of five years, there were shifts in personality traits. In their final year pharmacy students were characterized by high scores for Cautiousness and Personal Relations while medical students exhibited medium scores in Cautiousness and Emotional Stability. Conclusion: The changes in personality traits over the duration of the course were not radical changes but rather that of traits becoming more pronounced (AU)

Antecedentes: Farmacéuticos y médicos son dos grupos profesionales que frecuentemente reciben su educación y práctica en el mismo entorno. Sin embargo, su abordaje de la atención al paciente y la colaboración tiende a ser diferente, y esto puede llevar tanto a frustración como a conflictos que pueden afectar negativamente la atención al paciente. Se ha definido la personalidad como un aspecto psicológico que podría contribuir a crear conflictos en una situación laboral. Objetivo: Estudiar los rasgos de personalidad de una cohorte de estudiantes de farmacia y medicina en la Universidad de Malta en su primer y último año. Métodos: Se administró el Gordon Personal Profile -Inventory a una cohorte de estudiantes de farmacia y medicina en su primer año, y de nuevo se administró a la misma cohorte que completó los estudios en el último año. También se recogieron los datos demográficos básicos. Resultados: En el primer año, los rasgos más pronunciados para ambos estudiantes eran los de Estabilidad Emocional y Relaciones Personales. Durante el periodo de cinco años hubo cambios en los rasgos de personalidad. En su año final, los estudiantes de farmacia se caracterizaron por alta puntuación de Precaución y de Relaciones Personales, mientras que los estudiantes de medicina presentaron puntuaciones medias en Precaución y en Estabilidad Emocional. Conclusión: Los cambios en los rasgos de personalidad mientras a lo largo de la duración de la carrera no fueron radicales, pero determinados rasgos se convirtieron en más pronunciados (AU)

Personality traits of pharmacy and medical students throughout their course of studies.

BACKGROUND: Pharmacists and medical doctors are two professional groups that very often receive their education and practice in the same environment. However, their approach to patient care and collaboration tends to be different and this may lead to both frustration and conflict which may adversely affect patient care. Personality has been identified as a psychological issue that could contribute to conflict in a work situation. OBJECTIVE: To study the personality traits of a cohort of students studying pharmacy and medicine at the University of Malta in their first and final year. METHODS: The Gordon Personal Profile - Inventory was administered to a cohort of pharmacy and medical students in their first year and once again administered to the same cohort who completed their course of study in their final year. Basic demographic data was also collected. RESULTS: In first year the most pronounced traits for both student groups were those of Emotional Stability and Personal Relations. Over a period of five years, there were shifts in personality traits. In their final year pharmacy students were characterized by high scores for Cautiousness and Personal Relations while medical students exhibited medium scores in Cautiousness and Emotional Stability. CONCLUSION: The changes in personality traits over the duration of the course were not radical changes but rather that of traits becoming more pronounced.

Balanced Centrality of Networks.

There is an age-old question in all branches of network analysis. What makes an actor in a network important, courted, or sought? Both Crossley and Bonacich contend that rather than its intrinsic wealth or value, an actor's status lies in the structures of its interactions with other actors. Since pairwise relation data in a network can be stored in a two-dimensional array or matrix, graph theory and linear algebra lend themselves as great tools to gauge the centrality (interpreted as importance, power, or popularity, depending on the purpose of the network) of each actor. We express known and new centralities in terms of only two matrices associated with the network. We show that derivations of these expressions can be handled exclusively through the main eigenvectors (not orthogonal to the all-one vector) associated with the adjacency matrix. We also propose a centrality vector (SWIPD) which is a linear combination of the square, walk, power, and degree centrality vectors with weightings of the various centralities depending on the purpose of the network. By comparing actors' scores for various weightings, a clear understanding of which actors are most central is obtained. Moreover, for threshold networks, the (SWIPD) measure turns out to be independent of the weightings.

Career paths and personality in pharmacy.

BACKGROUND: Pharmacists choose different career paths which may have different requirements in terms of demands and environments, irrespective of knowledge and intellectual capability. A contributing factor could be personality whereby pharmacists seek to work in an environment which is compatible with their personality. OBJECTIVE: To explore the relationship between personality and career paths taken by pharmacists. METHODS: Data regarding pharmacists' personality profile as determined by The Gordon Personal Profile Inventory (GPPI) were gathered using an anonymous survey. The inventory booklet was mailed to all pharmacists registered to practice in Malta who were at the time residing in the country. Demographic data and information regarding areas of practice was also gathered. Analysis was carried out using variety of statistical tests including t-test, Manova and Multiple Correspondence Analysis. RESULTS: Most of the types of pharmacists considered, lie somewhat close to the average categories of the GPPI attributes, with those who work in importation and wholesale being the ones who stand out most from the rest by scoring high on self esteem, ascendency, original thinking, vigour, sociability. Those who work in industry and, especially, in hospitals are the two categories of pharmacists who seem to score low on the GPPI traits in general, while those who work in the Community scored high in personal relations and are a little more likely to score higher in cautiousness and responsibility. CONCLUSION: Pharmacists are not a homogeneous group of individuals. It is evident that their personality is a significant factor in the career path that they have chosen. Not all pharmacists possess personalities that are conducive to patient-oriented practice. Those that do not primarily possess the latter personality traits, appear to have chosen to practice in non-traditional areas where, possibly, they have found a good fit with their personality and other factors.

Patient-oriented personality traits of first-year pharmacy students.

OBJECTIVE: To determine, using the Gordon Personal Profile-Inventory (GPP-I), if the personality traits of first-year pharmacy students match the traits required for patient-centered practice. METHODS: The GPP-I, which measures the personality traits of ascendency, responsibility, emotional stability, sociability, cautiousness, original thinking, personal relations, and vigor, was administered to incoming pharmacy students at the beginning of their first semester. RESULTS: The pharmacy school had attracted students with strong traits of original thinking, followed by personal relations, and vigor. The students, however, were limited in emotional stability and ascendency. CONCLUSION: The pharmacy profession needs to be more proactive in projecting the desired image and communicate its increasingly challenging and patient-oriented practice to attract individuals whose personalities are conducive to current practice models.