Miracle-dz/UniFAR-FTUs huggingface dataset:
Are consultants in Colombo, Sri Lanka satisfied with their job?

Introduction: Job stress and job satisfaction play a key role in the work environment of an organization. These influence the behaviour of a doctor towards his or her co-workers, administration and, most importantly towards the patients. Objective: To assess job stress among consultants working in Colombo group of hospitals and to identify the factors that affect job satisfaction. Methods: A descriptive cross sectional study was conducted by using postal questionnaire on 262 consultants working in Colombo group of hospitals. Hospital consultants job stress and job satisfaction questionnaire developed by Amanda Ramirez et al. was used with their permission. Results: Of the 262 questionnaires mailed 171 were returned. Of total responded 84.6% reported extremely satisfied or satisfied with their work. Nearly 92% agreed intellectual stimulation by teaching contributed to their job satisfaction. Nearly 80% reported having a high level of responsibility, being perceived to do the job well by the colleagues, being able to bring about positive changes to the unit, having a high level of autonomy contributed to their job satisfaction. Poor administration and lack of facilities e.g. computers, filing procedures caused job stress in 73%. Threat of being sued for malpractice or having to deal with distressed relatives did not contribute to stress in nearly 80%. Conclusion: In Sri Lanka nearly 85% consultants reported they were satisfied with their job and teaching medical undergraduates and post graduates was one of the major contributory factors. However 73% indicated factors such as lack of resources, and poor administration cause stress at work. Providing computers and basic stationery for patient documentation and efficient and effective administration will improve the work output of consultants by reducing their stress levels.
Yükseköğrenim Gören Yabancı Uyruklu Öğrencilerin Sosyal Uyumlarını Etkileyen Etmenler

Bu arastirmanin amaci Turkiye’de yuksekogrenim goren yabanci uyruklu ogrencilerin yasadiklari sorunlar ve sosyal uyumlarini etkileyen etmenlerin incelenmesidir.Bu calisma,niteligi ve gerceklestirme bicimi itibariyle niceliksel ve iliskisel tarama yontemiyle yapilmistir. Ayrica mevcut durumundabelirlenmesineve aciklamasinacalisilmaktadir. Arastirma, yuksekogrenim goren yabanci uyruklu ogrencilerin yasadiklari uyum sorunlarini belirlemekte, sosyal uyumlarini etkiledigi dusunulen yas, cinsiyet, ekonomik durum,barinma yerleri,yasanilan kent, arkadaslik iliskileri, sosyal-kulturel ve sportif etkinliklere katilimlari ile ogrenimlerinden memnun olma gibi durumlariniincelemektedir.Bu amacla Bursa ilinde,2011-2012 ogretim yilinda yuksekogrenim goren, cesitli universite ve bolumlere devam etmekte olan 221yabanci uyruklu ogrenciye arastirmaci tarafindan gelistirilen anketuygulanarak calisma yapilmis ve veriler toplanmistir.
Outcomes of critically ill adult patients with continuous renal replacement therapy-requiring acute kidney injury in the Free State province of South Africa: the impact of HIV

Background: Continuous renal replacement therapy (CRRT)-requiring acute kidney injury (AKI) in critically ill adult patients frequently occurs in the intensive care unit and is associated with high morbidity and mortality. There is a paucity of epidemiological data regarding CRRT-requiring AKI in sub-Saharan Africa. Methods: We conducted a retrospective cohort study of all critically ill adult patients with CRRT-requiring AKI at Universitas Academic Hospital, Bloemfontein, during the period 1 July 2010 to 30 June 2014. The primary purpose was to determine the incidence of CRRT-requiring AKI. Secondary objectives were to record mortality, renal recovery and duration of CRRT. Results: The number of patients with CRRT-requiring AKI was 87 (1.1%) of the 7 709 patients admitted to the ICU over this 4-year period. Of these, 37 (43%) were HIV infected. The median age was 56 years (43 years in the HIV-infected versus 64 years in the HIV-uninfected group (P < 0.01). The majority of the HIV-infected patients were Black (89%). Metabolic acidosis together with pulmonary oedema and oliguria were the main indications for dialysis. The overall mortality was 31% with most of the deaths (82%) occurring in the HIV-positive patients. These patients had a mortality rate of 60% versus 10% among the uninfected (P < 0.01. Multivariate logistic regression identified female sex and HIV infection as independent predictors of mortality. The median duration of CRRT was 3 days and renal recovery occurred in 26% of patients. Conclusions: The incidence of CRRT-requiring AKI in critically ill adult patients at Universitas Academic Hospital was low. The overall mortality was relatively low when compared to that reported by others; however, it was relatively very high in the HIV-infected group.
More Benefits Than Problems

Chemotherapy often requires a central venous access such as a peripherally inserted central catheter (PICC-line). The purpose of this study is to describe patients’ experiences with the PICC-line during curative oncological treatment. A quantitative cross-sectional study including 36 questionnaires (response rate 97%) comprising 14 questions was used. The results are presented in four dimensions: information, discomfort, anxiety, and restrictions in daily life. Patients are generally satisfied with their PICC-lines compared with peripheral pinpricks; however, some restrictions regarding dressings, movement, and hygiene routines were reported. Moreover, patients described anxiety using the PICC-line regarding lack of functionality and risk of infection. Therefore, patients need information based on everyday life situations, and nurses’ information skills may significantly increase patient safety and patient satisfaction during curative oncological treatment.
An Overview of Point-of-Care Testing Service

Point-of-Care Testing (POCT) has become extremely important in diagnostic laboratory services confirming a clinical suspicion, i.e. including (ruling in) or excluding (ruling out) a clinical diagnosis. This is particularly true in setting such as emergency room, intensive care unit, casualty room, etc. The Royal college of Pathologists, UK and The institute of Biomedical Science, UK produced some POCT guidelines so that internal quality control (IQC) and external quality assessment (EQA) have been maintained ensuring the accuracy of results and therefore, avoiding and reducing in patients misdiagnosis. New emerging devices utilizing molecular techniques based on polymerase chain reaction (PCR) to provide POCT service for infectious diseases are likely to reach the commercial market in the next few years. The various facets of POCT i.e. technological requirements, POCT service implementation and management, POCT devices availability, IQC and EQA performance were discussed.
Dietary intervention reduces self-reported symptoms in patients with Crohn's disease in remission

Objectives: Patients with Crohn’s disease (CD) often (42-57 %) report food hypersensitivities with symptoms like bloating and abnormal feces, similar to symptoms in patients with irritable bowel syndrome (IBS), despite being in remission. One pilot study found that a dietary intervention low in fermentable carbohydrates (FODMAPs) decreased symptoms in CD patients. Dietary interventions carried out on patients with IBS may be transferable to CD patients in remission with self-reported hypersensitivities. Furthermore, patients with CD often experience extraintestinal symptoms like fatigue and musculoskeletal pain, however investigation on the efficacy of dietary interventions on these symptoms are lacking. This study was set out to explore the efficacy of a dietary intervention, based on symptom triggers in IBS, on patients with CD in remission with self-reported food hypersensitivities. Methods: An open prospective study was undertaken in patients with CD in clinical remission (defined as calprotectin < 250 μg/g in feces) with self-reported reactions to food intake. The patients followed their habitual diet including foods with wheat and cow’s milk for two weeks. This was followed by a two-week strict elimination diet and a gradual reintroduction of individual food-items for 4 to 9 weeks. If a reaction occurred, the suspected food-item was excluded. Symptom severities of total symptoms, abdominal pain, bloating, abnormal feces, wind, fatigue and musculoskeletal pain were evaluated using a visual analogue scale (VAS, 0-10 cm) and foodand symptom diary. The food symptom triggers identified during the reintroduction period were compared to the self-reported symptoms and the symptom triggers collected at the introduction meeting. Main results: A total of 12 patients (aged 23-66 years, four men) completed the intervention. Whereas all symptoms decreased (P < 0.05) from baseline to the elimination period, they did not increase (P > 0.05) from the elimination period to the last week of the reintroduction period (endpoint). The most frequent symptom triggers were cow’s milk products and wheat products. Conclusion: Dietary interventions may reduce self-reported symptoms in patients with CD in remission. Still, the underlying mechanism causing the food hypersensitivity reported by the CD patients in this study remains unknown. Table of contents Preface . 1
Common Findings and Predictive Measures of Opioid Overdoses

Purpose This research examines autopsy findings from fatal opiate/opioid intoxications in New Hampshire for cerebral edema, pulmonary edema, and urinary bladder distension in the interest of finding predictability of such cases. Methods Autopsy reports of 150 decedents, between 20 and 40 years old, were reviewed. Subjects were divided into three groups as follows: 50 whose cause of death was opioid intoxication excluding fentanyl, 50 who died from fentanyl, and 50 who, lacking intoxication, died from cardiac issues, seizure disorders, or positional asphyxia as the control group. Autopsy reports were reviewed for cerebral edema, pulmonary edema, and urinary bladder distension. Results Pulmonary edema was present in 96% of those who died of fentanyl alone and in 94% of those who died of opioids excluding fentanyl. Cerebral edema occurred in 54% of decedents who died of opiates/opioids excluding fentanyl and 8% in those who died solely of fentanyl. Thirty-four percent of the fatal intoxications excluding fentanyl had bladder distension while only 16% of those who died of fentanyl intoxication. The control group found 30% had pulmonary edema, 2% had cerebral edema, and none had bladder distension. The triad occurred in 8% of intoxications and never in the control group. Conclusion The results validated correlation between opioid intoxication and pulmonary edema, cerebral edema, and bladder distension. Cerebral edema and bladder distension suggest opioid intoxication, but arise less frequently in fentanyl intoxication. We hypothesize that fentanyl causes death more rapidly than other opioids leading to these results. Given the variations, we do not recommend reliance on postmortem computed tomography in lieu of autopsy to evaluate potential fatal intoxications.
First encounter with robot Alpha: How individual differences interact with vocal and kinetic cues in users’ social responses

The Computers are Social Actors (CASA) paradigm was proposed more than two decades ago to understand humans’ interaction with computer technologies. Today, as emerging technologies like social robots become more personal and persuasive, questions of how users respond to them socially, what individual factors leverage the relationship, and what constitutes the social influence of these technologies need to be addressed. A lab experiment was conducted to examine the interactions between individual differences and social robots’ vocal and kinetic cues. Results suggested that users developed more trust in a social robot with a human voice than with a synthetic voice. Users also developed more intimacy and interest in the social robot when it was paired with humanlike gestures. Moreover, individual differences including users’ gender, attitudes toward robots, and robot exposure affected their psychological responses. The theoretical, practical, and ethical value of the findings was further discussed in the study.
Clinical profile, prognostication and treatment outcomes in non Hodgkins lymphoma

Background: Non Hodgkins lymphoma is the most prevalent hematopoietic neoplasm, representing approximately 4% of all cancer diagnoses and ranking seventh in frequency among all cancers. Most of the data that we have is of west and data pertaining to Indian subcontinent is lacking. The aim of this study was to study clinical profile, prognostication, and assess treatment outcome in DLBCL patients in a tertiary care hospital. Methods: 100 patients of DLBCL reporting to a tertiary care hospital between 2013 to 2016 were chosen for the study. All patients were subjected to routine investigation and specialized investigation including bone marrow examination and Positron emission tomography. Patients were treated with standard treatment protocol and their response to treatment were assessed. Results: Study revealed male predominance with median age of onset was 45.6. Anorexia was the most common symptom. Lymphadenopathy was the most common sign. Bone marrow involvement and anemia commensurate each other. Only16% cases presented in IPI score 4 and 5. Complete remission achieved with treatment in stage l and ll disease were beyond 90% and steep decline in complete remission with treatment was noted in stage lll and lV (~70%). 76% patients with DLBCL showed CR, 12.5% showed PR. Conclusions: The present study revealed male preponderance with relatively early age of onset compared to western population. B- cell lymphoma (DLBCL) constituted maximum number of NHL cases (89%). We have found a higher proportion of B cell subtype as compared to other Indian studies, at the same time it corroborated with the findings of western studies. Complete remission achieved with treatment in stage l and ll disease were beyond 90% and steep decline in complete remission with treatment was noted in stage lll and lV (~70%).
Recommendations for the Public Health Response to Hepatitis C

s of identified published studies were reviewed for relevance, and full reviews were conducted for selected articles. Relevance was based on whether the study addressed the question being considered and whether the sociocultural setting and health care system in relation to the search question was sufficiently similar to Canada’s. Resource limitations did not allow the working group to conduct full systematic reviews. Whenever possible, published systematic reviews or other high-quality reviews were used, instead of undertaking a full separate review of primary literature. Where a systematic or other high-quality review was identified, it was supplemented as necessary with studies done since its publication or studies addressing gaps or limitations. Where no reviews were available, the most relevant studies were considered, summarized in table form, and assessed for individual strength. These studies were assessed for methodological rigour using criteria similar to those published by the National Institute for Health and Clinical Excellence public health guidance methods used in the U.K. Where relevant, the strength of individual studies is presented using the same approach as the National Institute for Health and Clinical Excellence documents for guidance in public health: ++, +, or – ratings of internal validity according to the degree of potential for the results to be affected by biases (with “++” having the lowest potential for bias and “–” having the highest potential for bias), and the same ranking
Nurse AMHPs: an exploratory study of their experiences

Purpose Mental health and learning disability nurses have been eligible to become approved mental health professionals (AMHPs) since 2008, when the Mental Health Act 2007 was implemented. Despite this, there have been proportionally low numbers of these nurses pursuing the AMHP role. The purpose of this paper is to explore the experiences of these nurse AMHPs of training and practice. Design/methodology/approach Ten practicing nurse AMHPs were recruited from across four local authority sites. Using semi-structured interviews, participants were asked to discuss their experiences of being an AMHP. Findings The participants highlighted the need to navigate personal, cultural and structural factors relating to accessing and applying for the training, difficulties with agreeing contracts terms, gaining comparative pay and undertaking the role. Research limitations/implications The limitations of this study are the small number of participants and therefore the generalisability of the findings. Also, respondents were practising AMHPs rather than nurses who considered the role but then rejected it as a career option. Practical implications This study has led to gain a greater understanding of the experiences of nurse AMHPs. Social implications The results from this study will assist employing local authorities, and NHS consider the barriers to mental health and learning disability nurses becoming AMHPs. Originality/value The value of this study is in the insight that provides the experiences of nurse AMHP from applying to training through to being a practising AMHP.
Determinants of newborn care at home among the parents attending maternal and child health clinic in maternity hospital, Thapathali, Kathmandu, Nepal

Maternal and child health reveals the basic status of women and child in Nepal. High Infant Mortality rate and Neonatal Mortality rates reveal the inadequate health care delivery and inadequate knowledge and practice of traditional birthing practice and newborn care at home in rural areas. This study was conducted to identify the various determining factors affecting care of the newborn babies at home. A convenient purposive sampling technique was used for the purpose. The leaflets regarding newborn care and common health problems and their management were also distributed to the parents as they needed. The data were collected from 100 parents attending MCH clinic Maternity Hospital, Thapathali by using the semi structured questionnaire consisting of socio-demographic characteristics, knowledge and practice related to care and common health problems of the newborn baby. The obtained data were analyzed by using frequency, percentage, mean value, standard deviation and calculation of P value. This study revealed that the majority (88%) of the literate respondents were from the urban area. 71.42% of the respondents had knowledge about the management of difficulty breathing at home delivery situation. All the respondents fed colostrum and 86% of them had their baby exposed to sun in the morning for about 1-2 hours and 57% had knowledge of common health problems like poor sucking, eye infection and cord infection. The scoring of the knowledge shows that 33% of respondents had adequate knowledge and only 9% had inadequate knowledge of care of the newborn. On the practice side, 33% of the respondents had inadequate practice and only 15 % had adequate practice. Among the respondents of SLC/campus level 68% had the practice of bath on the 2nd day after birth and 64% of the respondents who were literate/ primary level had practiced of bath to their baby immediately after birth. There is statistically significant association between education level and practice of giving bath, (P Value=0.003). Development of leaflets regarding information of care of the newborn and common heath problems and their management at home situation were necessary to prepare and provide information to the parents.
False-Negative Interpretation of Breast Sentinel Lymph Node Touch Preps: Analysis of the Causes with Suggestions to Improve Diagnostic Accuracy

Sentinel lymph node (SLN) biopsy has become widely accepted as an important procedure in staging breast cancer. False-negative results of touch prep (TP) examination at time of SLN biopsy requires additional surgery, delaying treatment and increasing cost. Therefore, we have analyzed our experience with false-negative interpretation on SLN TP’s. Eight-hundred and three consecutive SLN biopsies from 2003 to 2005 were obtained from the pathology archive of Roswell Park Cancer Institute. The intraoperative consultation results were correlated with the final diagnoses. Twenty-five SLN intraoperative consultations had false-negative TP’s [false-negative rate = 3.1% (25/803), including 9 metastatic lobular carcinomas and 16 metastatic ductal carcinomas]. These cases were re-evaluated by 3 pathologists independently, and the metastases in the SLN sections were confirmed by positive cytokeratin staining. Size of the metastatic focus, nuclear grade and the adequacy of TP’s were analyzed with regard to the cause of false-negative results. On re-screening of TP’s, we found that rare tumor cells of low nuclear grade were identified on 28% (7/25) of the TP’s (3 metastatic lobular carcinomas and 4 metastatic ductal carcinomas). In the remaining 72% (18/25) of TP’s, re-screening revealed no evidence of tumor. Evaluation of these TP’s demonstrated that 50% (9/18) were unsatisfactory for evaluation or limited by scant cellularity. While cases that remained negative on re-screening tended to have smaller measured foci of tumor in the SLN (Average 0.65 mm vs. 0.94 mm from cases that were positive on re-screening), there was considerable overlap between these two groups. In conclusion, TP’s with scant cellularity, unsatisfactory TP’s and failure to identify tumor cells with low nuclear grade were found to significantly contribute to false-negative interpretations. We suggest that an additional TP or frozen section may be necessary if the cellularity of the initial TP is limited. Correlation with the original core biopsy may be of value to help in identifying cancer cells of low nuclear grade.
Gestational age at first antenatal attendance in Kano, northern Nigeria.

Objectives: To determine the gestational age at which women register for antenatal care and the reason why they register at that time. Methods: A structured questionnaire was administered by trained personnel to the women attending the Thursday booking clinic in Aminu Kano Teaching Hospital, Kano. The questionnaire contains the bio-social characteristics of the respondents, gestational age, parity and reason(s) for booking at that time. Results: Majority (62.4%) of the women were aged between 20 and 29 years. The mean gestational age at booking was 24 weeks. Ninety two per cent of the women booked in the second and third trimesters. Fifty-seven per cent had no specific reason for booking at the time they did, while 6% booked late because they just relocated. Conclusion: Majority of our women book late for antenatal care. Health education with emphasis on the benefits of booking in the first trimester of pregnancy is advocated. Service providers should also develop a referral system for those pregnant women relocating to new stations. Keywords : Gestational age, booking, pregnancy, antenatal care, Kano. Highland Medical Research Journal Vol. 5 (1) 2007 pp. 75-78
The Alignment of Innovation Policy and Social Welfare: Evidence from Pharmaceuticals

This chapter provides an overview of different innovation policies and their performance in the pharmaceutical sector. I emphasize three points. First, both push and pull policies have generally promoted pharmaceutical research for diseases with large burdens. Second, imperfections in product and capital markets undermine the efficiency of pull policies. Similarly, the allocation of public funds is not always optimal, which limits the efficacy of push policies. Finally, interactions with other domestic policies and with policies in other countries are often overlooked in both economic studies of pharmaceutical research and development as well as policy choices.