The Impact of Secure Messaging in the Treatment of Patients With Diabetes Within a Primary Care Setting: Protocol for a Scoping Review.

BACKGROUND: Diabetes-a high-burden chronic disease-requires lifetime active management involving the use of different tools and health care resources to improve patient health outcomes. Recent studies have demonstrated promising results regarding the impact of the use of virtual care technology on the treatment of chronic diseases, such as diabetes. However, it is unclear whether the use of technologies, such as secure messaging, improves the quality of care and reduces diabetes-related costs to the health care system. OBJECTIVE: The purpose of our scoping review is to explore what is known about the use of secure messaging in the treatment of diabetes within the primary care setting and how its impact has been assessed from the patient and health system perspectives. Our review aims to understand to what extent secure messaging improves the quality of diabetes care. METHODS: Our scoping review will follow the 6-step Arksey and O'Malley methodological framework, as well as the Joanna Briggs Institute methodology for scoping reviews and their recommended tools. The tools to guide the development and reporting of the review in a structured way will include the Population, Concept, and Context framework and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines and checklist. The search strategy was developed iteratively in collaboration with a professional information specialist. Furthermore, a peer review of electronic search strategies was also conducted by an independent, third-party, professional information specialist. A systematic literature search will be conducted against databases, including Ovid MEDLINE ALL, Embase, APA PsycINFO, Cochrane Library on Wiley, CINAHL on EBSCO, and PubMed. Grey literature sources will also be searched for relevant literature. Literature on the use of secure messaging in the treatment of diabetes (types 1 and 2) within a primary care setting will be included. Two reviewers will review the literature based on the inclusion criteria in the following two steps: (1) title and abstract review and (2) full-text review. Discrepancies will be discussed to reach consensus where possible; otherwise, a third reviewer will resolve the dispute. RESULTS: The results and a final report are expected to be completed and submitted to a peer-reviewed journal in 6 months. CONCLUSIONS: The review will examine existing literature to identify the impact of secure messaging in diabetes treatment within primary care settings. Research gaps will also be identified to determine if there is a need for further studies. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/42339.

Dataset on effect of sand grain size and water salinity on oil recovery.

This research investigates the combined effect of grain size and water salinity on oil recovery. Water flooding experiment was carried out using unconsolidated formation from Niger Delta. Five groups consisting of five samples, were tested for the effective interaction of two factors (grain size and salinity) and how they affect oil recovery. Each group was assigned a particular grain size while the prepared brine concentration was varied within a specified range. The selected grain sizes were obtained from laboratory sieve analyses. For each sand sample, the same concentration of brine used in saturating it was poured into the accumulator and connected to the flooding tube to displace a column of crude oil. The control valve was opened to cause oil displacement. The amount of brine used to displace the crude oil was ten times the pore volume and all the oil in each sample was recovered by the saturated brine solution. Laboratory investigations show that oil recovery was highest for brine concentration of 15,000 ppm; this was also the case in relation to oil recovery and sand grain sizes.

Survey of medical specialists on their attitudes to and resources for health research in Nigeria.

AIM: To study the views of medical specialists on their attitude to and the resources for health research in Nigeria and draw appropriate policy implications. MATERIALS AND METHODS: Structured questionnaires were distributed to consenting 90 randomly selected medical specialists practising in six Nigerian tertiary health institutions. Participants' background information, importance attached to research, motivations for conducting research, funding, ethical oversight, literature search, and statistical support were probed. The coded responses were stored and analyzed using the statistical SPSS software. RESULTS: Fifty-one out of the 90 questionnaires distributed were returned, giving a response rate of 63.3%. Research function was rated third by 64.7% of the respondents after hospital service (72.5%) and teaching (66.0%). Advancement of knowledge was the strongest motivating factor for conducting research (78.4%). Securing funding (94%) and finding time (80%) were their major constraints. Only a minority of the respondents, 20% and 14%, respectfully, positively rated the quality and promptness of the decisions of their institutions' ethical organs in the highest category. Most of their literature search was conducted on the internet (96.1%) and they stored and analyzed their research data with commonly available statistical software. CONCLUSION: Our study respondents regarded research highly but were severely constrained in conducting research by lack of access to sources of funding from within and outside Nigeria and finding time from core hospital functions. We recommend periodic (re)training in research particularly on how to apply for research grants and giving some protected research time for Nigerian medical specialists in order to boost their research function.

Perceptions of Nigerian medical specialists on research.

The current research aimed at collating the views of medical specialists on disease priorities, class and outcomes of health research in Nigeria, and draw appropriate policy implications. Structured questionnaires were distributed to consent 90 randomly selected medical specialists practising in six Nigerian tertiary health institutions. Participants' background information, relative disease priority, research types and class, type and class of publication media, frequency of publications, challenges faced in publishing research, impact of their research on health practice or policy, and inventions made were probed. Fifty-one out of the 90 questionnaires distributed were returned giving a response rate of 63.3%. Sixty-four point six percent indicated that the highest priority should be given to non communicable diseases while still recognizing that considerations should be giving to the others. They were largely "always" involved in simple low budget retrospective studies or cross-sectional and medical education studies (67.8%) and over a third (37.5%) had never been involved in clinical trials. They largely preferred to "always" publish in PubMed indexed journals that are foreign-based (65.0%). They also indicated that their research works very rarely resulted in inventions (4%) and change (4%) in clinical practice or health policy. Our study respondents indicated that they were largely involved in simple low budget research works that rarely had significant impacts and outcomes. We recommend that adequate resources and research infrastructures particularly funding be made available to medical specialists in Nigeria. Both undergraduate and postgraduate medical education in Nigeria should emphasize research training in their curricula.

Perceptions of Nigerian Medical Specialists on Research

"The current research aimed at collating the views of medical specialists on disease priorities; class and outcomes of health research in Nigeria; and draw appropriate policy implications. Structured questionnaires were distributed to consent 90 randomly selected medical specialists practising in six Nigerian tertiary health institutions. Participants' background information; relative disease priority; research types and class; type and class of publication media; frequency of publications; challenges faced in publishing research; impact of their research on health practice or policy; and inventions made were probed. Fifty-one out of the 90 questionnaires distributed were returned giving a response rate of 63.3. Sixty-four point six percent indicated that the highest priority should be given to non communicable diseases while still recognizing that considerations should be giving to the others. They were largely ""always"" involved in simple low budget retrospective studies or cross-sectional and medical education studies (67.8) and over a third (37.5) had never been involved in clinical trials. They largely preferred to ""always"" publish in PubMed indexed journals that are foreign-based (65.0). They also indicated that their research works very rarely resulted in inventions (4) and change (4) in clinical practice or health policy. Our study respondents indicated that they were largely involved in simple low budget research works that rarely had significant impacts and outcomes. We recommend that adequate resources and research infrastructures particularly funding be made available to medical specialists in Nigeria. Both undergraduate and postgraduate medical education in Nigeria should emphasize research training in their curricula."

Caudate lobe resection: an Egyptian center experience.

BACKGROUND DATA: Hepatectomy is a technically challenging surgery, and of all aspects of hepatic resection, caudate lobe resection is the most difficult. Knowledge of the anatomy of the caudate lobe is necessary to achieve safe caudate lobe resection. METHODOLOGY: Hospital records of 54 patients, who had caudate lobe resection in our center from January 2000 to August 2007, were retrieved. The demographic data, clinicopathological features, and perioperative events were extracted and analyzed. RESULTS: Out of a total of 500 patients who had various forms of hepatic resection during the period in question, only 54 had caudate lobe resection (10.8%). Isolated caudate lobe resection (ICLR) was performed in 16 (29.6%) patients while the remainder had caudate lobe resection as a part of a major hepatectomy. Indications for hepatectomy in patients with ICLR include hepatocellular carcinoma, primary hepatic carcinoid tumor, cavernous hemangioma, and adenoma. Mean operative time for ICLR was 230 +/- 50 min while it was 240 +/- 50 min for right hepatectomy and 245 +/- 55 min for left hepatectomy. The associated mean blood loss was 1200 +/- 200, 1300 +/- 350, and 1350 +/- 350 ml, respectively. None of these were statistically significant. In patients who had ICLR, there was no mortality while three patients developed postoperative complications (bile leak in two patients and one patient with wound infection). Various forms of perioperative complications were noticed in six patients. All these patients, who also showed 7.8% mortality, had major hepatectomy. CONCLUSIONS: Caudate lobe resection is a technically challenging procedure. Isolated caudate lobe resection is a safe procedure with good outcome in well selected patients. It is, however, associated with increased perioperative risks when associated with major hepatectomy.