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ay. Whether this is considered clinically significant enough to rule out eligibility will differ from practice-to-practice and will depend on surgical volume, resources available and financial interests.

To describe and compare patient blood management (PBM) practices in cardiac surgery in nine European countries and identify the main risk factors for bleeding or transfusion according to the surveyed centres.

We set up an online survey to evaluate PBM practices in two clinical scenarios, risk factors for bleeding or transfusion, and previous experience with antifibrinolytics.

This survey was completed by European anesthesiologists in 2019.

No patients were included in the survey.

None.

We evaluated the degree of implementation of PBM practices in patients undergoing cardiac surgery.

Ninety-eight of 177 responses (38%) were complete with variable response rates by country. In a non-emergent situation, no respondents would transfuse red cells preoperatively in an anaemic patient, while cell salvage (89%) and antifibrinolytics (82%) would almost always be used. Optimization of Hemoglobin level (36%) and use of off-pump techniques (34%), minimally invasive surgery (25%) and relatively recently-developed CPB technologies such as mini-bypass (32%) and autologous priming (38%), varied greatly across countries. In an emergent clinical situation, topical haemostatic agents would frequently be used (61%). Tranexamic acid (72%) and aprotinin (20%) were the main antifibrinolytics used, with method of administration and dose varying markedly across countries. Five factors were considered to increase risk of bleeding or transfusion by at least 90% of respondents pre-operative anaemia, prior cardiac surgery, clopidogrel 5days or less before surgery, use of other P2Y12 inhibitors at any point, and thrombocytopenia <100.10

platelets/mm

.

PBM guidelines are not universally implemented in European cardiac surgery centres or countries, resulting in discrepancies in techniques and products used for a given clinical situation.

PBM guidelines are not universally implemented in European cardiac surgery centres or countries, resulting in discrepancies in techniques and products used for a given clinical situation.

Co-producing aspects of nursing and midwifery education is increasingly being used in higher education to try to improve student learning and meet standards set by some professional accreditation bodies. This review aims to identify and synthesise evidence on this pedagogical approach.

Systematic review.

Searches were conducted in CINAHL, ERIC, MEDLINE, and PubMed.

Four bibliographical databases were searched using relevant search terms between 2009 and 2019. Titles, abstracts, and full text papers were screened. Pertinent data were extracted and critical appraisal undertaken. Data were analysed using the framework approach and findings presented in a narrative summary.

Twenty-three studies were included. Two overarching themes emerged. The first focused on the impact of co-production on nursing and midwifery students, service users, and carers which had five subthemes; 1) acquiring new knowledge and skills, 2) gaining confidence and awareness, 3) building better relationships, 4) feeling vulnerablets that participatory approaches could improve learning and positively impact on nursing and midwifery students, service users, and carers. Educators should consider adopting co-production and including students, service users, carers, practice staff, and other relevant stakeholders in this pedagogical process. see more However, more rigorous research examining how effective co-production is in improving learning over traditional methods is warranted given the additional resources required to deliver it.

Undergraduate nursing students may experience high levels of stress, anxiety or depression. This can not only influence their personal wellbeing and academic performance, but also communication with patients during clinical placement and the quality and safety of the healthcare delivered. The objective of the review was to identify interventions that target stress, anxiety or depressed mood in undergraduate nursing students during their undergraduate course.

A quantitative systematic review, guided by the Joanna Briggs Institute methodology, was conducted. The review considered studies that included undergraduate nurses, and which evaluated interventions targeting stress, anxiety and depressed mood. The review included experimental studies published in English from 2008 to 2018. A tabulated and narrative summary was utilised to present the results.

A total of 1579 studies were identified following a systematic search and 931 studies were screened by title and abstract. A total of 44 studies were criticay of evidence.

There are a range of effective interventions that target stress, anxiety or depressed mood among nursing students. The quality of the studies reporting these interventions was found to be variable and generally samples were small with limited follow-up. Studies of mindfulness interventions comprised the largest sample sizes, displayed the highest levels of evidence, and transcended stress, anxiety and depressed mood. Future research would benefit from a co-ordinated approach to build the strength of the body of evidence.

A histologic grading system for invasive lung adenocarcinoma (ADC) has been proposed by the International Association for the Study of Lung Cancer (IASLC) Pathology Committee in June 2020. This study evaluated the prognostic value of the IASLC histologic grading system (the IASLC system) in a large Japanese cohort.

We performed comprehensive histologic subtyping using the semiquantitative estimation of five major patterns and complex glandular patterns in patients with a completely resected lung ADC and determined the histologic grade using the IASLC system. Concordance index and receiver-operating characteristic curves were used to evaluate the clinical utility of the IASLC system for recurrence and death; the comparison was performed with the architectural-pattern system (the Arch system) and the grading system on the basis of the two most predominant patterns (the Sica’s system).

Of 1002 patients with invasive ADC, 235 had recurrent disease and 166 died of lung cancer. The concordance index and area under the curve of the IASLC system were 0.