Comparison of the clinical performance of i-gel and Ambu laryngeal masks in anaesthetised paediatric patients:A meta-analysis

BACKGROUND Paediatric supraglottic airway devices(SGAs)are widely used in routine anaesthesia and serve as primary or back-up devices for difficult airway management.The inflatable Ambu laryngeal masks and non-inflatable i-gel are two improvements of SGAs based on classic laryngeal masks.The clinical performance and safety of these two devices in paediatric patients are still unclear and warrant further investigation.AIM To perform a systematic review and meta-analysis on the clinical performance and safety of Ambu laryngeal masks and i-gel in anaesthetised paediatric patients.METHODS MEDLINE,Embase,Web of Science and Cochrane Central Register of Controlled Trials were searched from inception dates to April 2020.We identified published randomised controlled trials(RCTs)in which the intervention involved the use of Ambu laryngeal masks and i-gel in anaesthetised paediatric patients(age<18 years).We assessed the oropharyngeal leak pressure(OLP)as the primary outcome.The secondary outcomes were insertion time,success rate of insertion on the first attempt,and incidence of adverse events.RESULTS After searching for all relevant trials published up to April 2020,data from seven RCTs with a total of 667 paediatric patients(323 and 344 participants in the i-gel and Ambu groups,respectively)were evaluated.The mean OLP in anaesthetised paediatric patients was lower in the Ambu group[21.82 cmH2O for Ambu vs 23.98 cmH2O for i-gel,P=0.003,95%confidence interval(CI):-3.58 to-0.75,I2=68%,Mantel-Haenszel random model].We did not find any clear evidence of differences between the devices in terms of insertion time,success rate of insertion,and incidence of adverse events except for blood staining(risk ratio 5.86,95%CI:1.76 to 19.46,P=0.004,I2=0,fixed-effect model).CONCLUSION The i-gel airway may provide a better seal and is therefore probably more suitable than the Ambu laryngeal mask airway in anaesthetised paediatric patients.However,the evidence is insufficient to allow making firm conclusions or to guide clinical practice,owing to the small number of relevant published studies.

Relationship between clinical performance and professional self-concept in critical care nurses

Objective:To determine the relationship between clinical performance and professional self-concept in critical care nurses.Methods:This study was conducted on 308 critical care nurses.Data gathering instruments were nurses’clinical performance questionnaire(NCPQ)and nursing professional self-concept measure(NPSCM).Independent sample t-test,one-way analysis of variance(ANOVA),and Pearson correlation coefficient were used for data analyses.Results:The average age of the nurses was 33.74±7.01 years.The clinical performance score of female nurses was significantly higher than male nurses.In the domain of clinical performance,clinical judgment and clinical inquiry had the highest and lowest scores,respectively.In the nurses’professional self-concept,the highest and lowest scores were awarded to the subscales of self-confidence and staff relations,respectively.In addition,there was a significant positive correlation between self-concept and clinical performance of nurses.Conclusions:Increasing professional self-concept improves the clinical performance of critical care nurses.Professional self-concept enhancement measures are recommended to improve the clinical performance of nurses in critical care units.

Emotional intelligence and its impacts on the clinical performance of nurses in general public hospitals

Objectives:The nursing profession is considered to be at a high risk of workplace stress,workload,and burnout due to the high job demands.The nurses require the appropriate and prompt coping mechanisms to relieve the effects of stress.The nurses have to be emotionally intelligent to overcome the work-related stress to meet the clinical-based duties.But there is a paucity of the effect of emotional intelligence(EI)on the clinical performance of nurses in the literature.Therefore,the role of dimensions of EI in the improvement of clinical performance of nurses was explored in this study.Methods:A total of 194 nurses with different education levels and experiences were included from various clinical departments and shifts of public hospitals in Iraqi Kurdistan.Results:The mean age of the nurses was 29.44 years,with ages ranging from 23 years to 36 years.The nurses were men(56.70%),married(53.10%),non-smokers(86.10%),physically active(55.70%),and irregular physically active(63.90%).Nurses were able to appraise their own emotions but not the emotions of other nurses.They regulated their own emotions but were weak in regulating the emotions of other nurses.They did not utilize emotions in coming up with new ideas and facing obstacles in clinical settings.Generally,the nurses reported that a little clinical performance is required in medical settings.The levels of interpersonal communication and problem solving were improved with an increasing appraisal and regulating own emotions.The level of problem solving was improved with appraising own emotions and utilizing emotions in facing obstacles.Conclusions:Nurses need to know how to regulate others’emotions and utilize these emotions in coming up with new ideas and facing the obstacles positively in medical settings.

A Novel Open C-shaped Molar Band for Orthodontic Applications： Mechanical Characterizations and Clinical Trials

To evaluate the retention properties of the novel ‘C＇-shaped molar bands at a laboratory level. Resin-modified glass ionomer cement（RMGIC） was used as a luting agent for the novel C-shaped molar band. The mechanical properties of the band were examined and the retention performance was characterized in the mesial, distal and vertical directions. A clinical trial was conducted using a spilt-mouth design on 50 patients. The novel C-shaped molar bands fit most molars without a repeated try-in process.The use of both nanoHA coating and RMGIC enhanced the tensile（8.00 ± 1.8 MPa） and shear strengths（27.17 ± 8.6 MPa） of the molar bands, leading to high retention in vertical, mesial and distal directions（ p 〈 0.001）. In clinical trials, the C-shaped molar bands had a failure rate（15%） comparable to that of traditional bands, and 93% of the failed bands demonstrated an adhesive remnant index score of 0, corroborating the observation that no luting agent residue remained on the tooth surface in most cases. The novel C-shaped molar bands appear to be a promising appliance that requires further clinical investigations, and may be used effectively in orthodontics.