METHODS: With representation from Europe (43%; n = 133), North America (17%; n = 53), South America (16%; n = 49), Asia (13%; n = 40), Australasia (5%; n = 16), the Middle East (4%; n = 12), and Africa (2%; n = 6), the combined experience of treating bone sarcomas among attendees totalled approximately 30,000 cases annually, equivalent to 66 years of experience in the UK alone. The meeting's process began with the formation of a local organizing committee, regional leads, and a scientific committee comprising representatives from 150 specialist units across 47 countries. Supported by major orthopaedic oncology organizations, the meeting used a modified Delphi process to develop consensus statements through online questionnaires, thematic groupings, narrative reviews, and anonymous pre-meeting polling.
RESULTS: Strong (> 80%) consensus was achieved on 19 out of 21 statements, reflecting agreement among delegates. Key areas of consensus included the role of radiology in diagnosis and surveillance, the management of locally recurrent disease, and the treatment of dedifferentiated chondrosarcoma. Notably, there was agreement that routine chemotherapy has no role in chondrosarcoma treatment, and radiological surveillance is safe for intraosseous chondrosarcomas. Despite the overall consensus, areas of controversy remain, particularly regarding the treatment of atypical cartilage tumours and surgical margins. These unresolved issues underscore the need for further research and collaboration within the orthopaedic oncology community.
CONCLUSION: BOOM represents the largest global consensus meeting in orthopaedic oncology, providing valuable guidance for clinicians managing chondrosarcoma worldwide. The consensus statements offer a reference for clinical practice, highlight key research priorities, and aim to improve patient outcomes on a global scale.
METHODS: This cross-sectional, online survey-based study involved 15,302 employees from Malaysia, Singapore, Philippines, Thailand, Indonesia, and Vietnam who completed the Depression, Anxiety, Stress Scales (DASS-21), Thriving from Work Questionnaire (TfWQ), and sociodemographic measures. Employee productivity and turnover intention was also measured as a secondary outcome. Hierarchical regression models were conducted to determine the influence of EAP access on employee wellbeing. Subgroup analyses were conducted on employees with access to EAPs to explore how different forms of EAP services contribute to employee wellbeing.
RESULTS: Only 29.04% of employees in the region reported being aware of having access to any forms of EAP services provided by their employers. After controlling for sociodemographic variables, access to EAP was significantly associated with improved mental health, thriving, and productivity, and reduced turnover intention (p
METHODS: The development and validation of the academic writing self-assessment toolkit involved several key steps. First, a thorough review of the literature was conducted to identify the essential criteria for authentic assessment. Next, an analysis of medical students' reflection papers was undertaken to gain insights into their experiences using AI-powered tools for writing feedback. Based on these initial steps, a preliminary version of the self-assessment toolkit was devised. An expert focus group discussion was then convened to refine the questions and content of the toolkit. To assess content validity, the toolkit was evaluated by a panel of 22 medical student participants. They were asked to review each item and provide feedback on the relevance and comprehensiveness of the toolkit for evaluating academic writing skills. Face validity was also examined, with the students assessing the clarity, wording, and appropriateness of the toolkit items.
RESULTS: The content validity evaluation revealed that 95% of the toolkit items were rated as highly relevant, and 88% were deemed comprehensive in assessing key aspects of academic writing. Minor wording changes were suggested by the students to enhance clarity and interpretability. The face validity assessment found that 92% of the items were rated as unambiguous, with 90% considered appropriate and relevant for self-assessment. Feedback from the students led to the refinement of a few items to improve their clarity in the context of the Persian language. The robust reliability testing demonstrated the consistency and stability of the academic writing self-assessment toolkit in measuring students' writing skills over time.
CONCLUSION: The comprehensive evaluation process has established the academic writing self-assessment toolkit as a robust and credible instrument for supporting students' writing improvement. The toolkit's strong psychometric properties and user-centered design make it a valuable resource for enhancing academic writing skills in higher education.
METHODS: We invited 138 potentially eligible participants to take part in the Delphi survey from a representative spread of expertise and geography. We employed a Likert scale with comments for our 32-item proposal in round 1, and a dichotomous scale with comments for our 29-item proposal in round 2. Threshold for agreement was set at ≥ 80% for both rounds.
RESULTS: Forty-seven potentially eligible participants responded to our invitation, 38 completed the first round and 36 completed the second. N = 23 (72%) items achieved ≥ 80% in round 1, and 100% of items in round 2. Three items were dropped or merged following round 1. A third Delphi round was not required to obtain consensus.
CONCLUSIONS: This Delphi expert consensus proposes a 29-item checklist specific to the reporting of nutrition RCTs and will inform further development of guidance through forthcoming consensus meetings.
STUDY DESIGN AND SETTING: We used a descriptive qualitative study design. We employed purposive and snowball sampling techniques to recruit guideline developers from LMICs and World Health Organization offices to participate in online, semistructured interviews. Data were analysed using a thematic approach with NVivo 20 software. Ethics approval was granted by Monash University.
RESULTS: We interviewed 18 participants from LMICs (Colombia, India, Iran, Indonesia, Argentina, and Malaysia) and WHO offices (including headquarters, regional offices, and country offices). Two main themes emerged, along with six associated subthemes. The main themes were as follows: (1) People in LMICs want living guidelines and (2) Resource limitations and their implications for living guidelines in LMICs.
CONCLUSION: Our research identified that guideline developers in LMICs have a strong desire to both develop and use living guidelines, but are currently limited by important barriers. Initiatives to support development, adaptation, and use of living guidelines in LMICs may help overcome barriers and meet the need for living guidelines in LMICs. It is also essential to design strategies that overcome identified barriers to developing, adapting, and implementing living guidelines, such as a lack of resources, delays in updates, and limited accessibility.
PLAIN LANGUAGE SUMMARY: This study looked at how living (continuously updated) approaches can be used to develop, adapt, and use clinical guidelines in settings with limited resources, and explored the pros and cons of each. The findings revealed a strong need to develop and use living guidelines in low-resource settings despite challenges, such as resource scarcity, delays in updating, and limited access to these guidelines. Overall, the findings revealed that living guidelines were worthwhile in LMICs despite all of the related challenges.
METHODS: A systematic literature search was conducted across major databases, including PubMed, EMBASE, and the Cochrane Library, to identify relevant randomized controlled trials (RCTs) evaluating the efficacy and safety of ibrexafungerp in the treatment of VVC. Following rigorous methodology, data extraction, risk of bias assessment using Cochrane's RoB 2 tool, and meta-analysis were conducted.
RESULTS: Four RCTs were included in the analyses. The ibrexafungerp regimen utilized across the studies were 300 mg administered twice daily for one day. Meta-analysis revealed that ibrexafungerp was associated with significantly higher clinical cure rates compared to placebo in patients with VVC (pooled odds ratio (OR) 2.32; 95 % confidence interval (CI) 1.80 to 2.98). Complete symptom resolution was achieved in a greater proportion of participants receiving ibrexafungerp (pooled OR 2.76; 95 % CI 1.62 to 4.71). Analysis of treatment-emergent adverse events revealed a significant higher incidence of at least one treatment-emergent adverse event with ibrexafungerp compared to placebo (pooled OR 2.83; 95 % CI 2.06 to 3.88).
CONCLUSION: This study provides robust support for the efficacy of ibrexafungerp in the treatment of VVC. While the safety profile of ibrexafungerp appears favorable with mostly mild adverse events reported, decision-making in the clinical context should be guided by individual patient factors.
METHODS: A cross-sectional study involving 421 participants was conducted in Iraq from November 2023 to March 2024 across various cancer centers and oncology hospitals. A 41-item questionnaire covering eight domains-Risk Factors, Infections and Antibiotic Use, Mechanisms of Resistance, Impact on Drug Efficacy and Toxicity, Genetic Factors, Microbial Adaptation, Impact of Gut Microbiota, and Antimicrobial Stewardship-was developed. Content validity was evaluated by five experts. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were used to assess construct validity, while Item Response Theory (IRT) evaluated item performance. Reliability was measured using Cronbach's Alpha and Composite Reliability (CR).
KEY FINDINGS: The questionnaire showed strong content validity, with most items achieving a Content Validity Index (CVI) of ≥0.8. EFA identified eight factors, confirmed by CFA with acceptable model fit (CFI = 0.96, TLI = 0.95, RMSEA = 0.05). IRT indicated strong item discrimination and acceptable difficulty. Cronbach's Alpha was 0.88, with CR at 0.89.
CONCLUSION: This validated 41-item questionnaire provides a reliable tool for assessing oncologists' knowledge of bacterial resistance among cancer patients. It helps identify knowledge gaps and guide interventions to improve oncology practice outcomes.