A Systematic Review of the Reliability and Validity of the Patient Activation Measure Tool.

Patient activation, broadly defined as the ability of individuals to manage their health and navigate the healthcare system effectively, is crucial for achieving positive health outcomes. The Patient Activation Measure (PAM), a popularly used tool, was developed to assess this vital component of health care. This review is the first to systematically examine the validity of the PAM, as well as study its reliability, factor structure, and validity across various populations. Following the PRISMA and COSMIN guidelines, a search was conducted in MEDLINE, EMBASE, and Cochrane Library, from inception to 1 October 2023, using combinations of keywords related to patient activation and the PAM. The inclusion criteria were original quantitative or mixed methods studies focusing on PAM-13 or its translated versions and containing data on psychometric properties. Out of 3007 abstracts retrieved, 39 studies were included in the final review. The PAM has been extensively studied across diverse populations and geographical regions, including the United States, Europe, Asia, and Australia. Most studies looked at populations with chronic conditions. Only two studies applied the PAM to community-dwelling individuals and found support for its use. Studies predominantly showed a high internal consistency (Cronbach's alpha > 0.80) for the PAM. Most studies supported a unidimensional construct of patient activation, although cultural differences influenced the factor structure in some cases. Construct validity was established through correlations with health behaviors and outcomes. Despite its strengths, there is a need for further research, particularly in exploring content validity and differential item functioning. Expanding the PAM's application to more diverse demographic groups and community-dwelling individuals could enhance our understanding of patient activation and its impact on health outcomes.

Risk of wound infection with use of sterile versus clean gloves in wound repair at the Emergency Department: A systematic review and meta-analysis.

STUDY OBJECTIVE: Sterile gloves are widely used during wound repair procedures in Emergency Departments (ED) worldwide. It is unclear whether sterile gloves protect against postoperative wound infections. We conducted a systematic review and meta-analysis to determine if sterile gloves offer significant protection against wound infections compared to clean gloves for wound repair in the ED. METHODS: Ovid MEDLINE, Ovid Embase, Cochrane Library and Web Of Science were searched for randomised controlled trials (RCTs) or non-randomized studies of intervention (NRSIs) from their dates of inception to January 2023. RCTs or NRSIs comparing sterile (control) vs. clean/no (intervention) glove use for wound repair procedures in the ED and reporting postoperative wound infections were included. Two investigators independently extracted data and assessed risk-of-bias of each report on a standardised form. Wound infection incidence was pooled using a random effects model. Subgroup analysis was performed to explore heterogeneity. RESULTS: 7 studies were included in the review, with 6 included in the meta-analysis. Of 3227 patients, 115/1608 (7.2%) patients in the intervention group and 135/1619 (8.3%) patients in the control group had postoperative wound infections. Overall RR was 0.86 (95% CI,0.67-1.10, I2=3.6%), and of high evidence certainty (GRADE). Absence of a protective effect was invariant in sensitivity analyses, leave-one-out analysis and subgroup analyses. CONCLUSION: No evidence of additional protection against wound infections with the use of sterile gloves for wound repair in the ED compared to clean gloves was found. However, the review was limited by nonreporting of antibiotic history and time between wound repair and follow-up amongst included studies. Considering the ergonomics, potential cost-savings and environmental impact, clean gloves are a viable alternative to sterile gloves, without compromising wound infection risk in this setting.

Two-layered metallic film-induced surface plasmon polariton for fluorescence emission enhancement in on-chip waveguide.

We demonstrate an enhancement of fluorescence emission due to bimetallic silver-gold film-induced surface plasmon wave extension. Rhodamine B (RhB) dyes were excited by the evanescent wave field produced from surface plasmon polaritons excited on metal-deposited sections along an embedded strip waveguide. Various silver-gold combinations were used to quantify for the evanescent field enhancement. The underlying silver yields better evanescent field enhancement, while the overlying gold ensures that the stability of the sensing surface is not compromised. In comparison to the conventional single gold film surface plasmon resonance (SPR) configuration, the two-layered metallic structure is capable of enhancing the surface plasmon polariton (SPP) evanescent field considerably, as verified experimentally by the ca. 4.0 times improvement in the RhB fluorescence emission. The compact waveguide structure and improved electric field probing depth can potentially be exploited for on-chip SPR--fluorescence excitation of less concentrated fluorophore-labelled biological and chemical analytes, with a capability of massively parallel processing for high throughput screening.