Miracle-dz/UniFAR-FTUs huggingface dataset:
Use of Simulation to Reinforce Evidence-based Collection Processes

Vll Chapter One: Introduction Current Practice 1 Practice Change 2 Implementing the Practice Change 3 Purpose 3 Definition of Terms 4 Chapter Two: Review of the Literature Blood Culture Contamination 5 Evidence-Regarding Blood Culture Contan1ination 6 Detennining Contamination 6 Factors Associated with Contamination 10 Educational Interventions to Decrease Contamination 12 Evidence Regarding Simulation 13 History of Sin1ulation 13 Uses ofSin1ulation 14 Simulation in Healthcare Education 14 Simulation for Vascular Access 16 Summary 17 Chapter Three: Methodology Design 18 Setting 18 Sample 19 Procedures 19 Recruitment and Consent of Nurses 19 Data Collection Instruments 20 Blood Culture Contamination Rates 21 Intervention 21 Protection of Human Subjects 22
The effects of inspiratory muscle training on respiratory muscle strength and pulmonary functions in children with bronchiectasis

Aim: The aim of this study was to examine the effects of inspiratory muscle training on respiratory muscle strength and pulmonary functions in children with bronchiectasis Methods: A randomized, double-blind, prospective study was carried out by comparing two groups of children with stable bronchiectasis. Group A was trained with inspiratory-threshold loading device and cough training. Group B received a single cough teaching session. 16 children were in Group A (mean age:11,81±2,71 years) and 15 children were in Group B (mean age:12,07 ±2,25 years). Patients in Group A trained at inspiratory-threshold loads up to 40% of maximal static inspiratory pressure (PImax) and patients in Group B did not participate in any form of training. Pulmonary functions (VC, FRC, FEV1, PEF, MEF%50, MVV, MMF) and respiratory muscle strength measurements (PImax and PEmax) were performed at the beginning and at the end of the study. For statistical analyses; independent sample t-test, Mann Whitney U test, Wilcoxon Signed-rank test and paired t-test were used. Results: Demographic findings were similar (p>0, 05) in two groups. There were significant improvements in pulmonary functions and respiratory muscle strength measurements (p≤0, 05) in Group A patients, while no significant difference was seen in Group B patients after eight weeks. Conclusion: From these results, we concluded that inspiratory muscle training improves respiratory muscle strength and pulmonary functions in children with bronchiectasis. It is also observed that cough training helped children to expectorate easily. Funding: Istanbul University Research Foundation.
Cardiac magnetic resonance imaging at 1.5 T in patients with cardiac rhythm devices.

AIMS Recent studies suggest that non-cardiac magnetic resonance imaging (MRI) scanning can be performed safely in selected cardiac rhythm device patients. However, little is known about the safety of performing specific cardiac MRI in this setting. We sought to determine the feasibility of cardiac MRI in patients with pacemakers (PMs) or implantable cardioverter-defibrillators (ICDs). METHODS AND RESULTS Thirty-eight patients underwent a total of 39 (8 ICDs and 31 PM) cardiac MRI examinations at 1.5 T using usual protocols without specific absorption rate (SAR) restrictions. Nine PM-dependent patients were included. All devices were interrogated before and immediately after MRI. During the scan, pacing mode was programmed to asynchronous for PM-dependent patients whereas ICDs were programmed to a monitor-only mode. All devices were functioning appropriately after cardiac MRI. Comparison of device parameters obtained before and immediately after MRI revealed no significant changes in pacing threshold, lead impedance, battery status, or sensing signal amplitude. Neither clinical events nor patient complaints were reported. Significant imaging artefacts were present on 11 of 39 scans (28.2%). These artefacts were significantly more frequent in ICDs (8 of 8, 100%) vs. PMs (3 of 31, 9.7%) (P < 0.001). Diagnostic questions were answered in 92.3% of the cases, with just three pronounced artefacts preventing an adequate diagnosis in three ICD patients. CONCLUSIONS Our results suggest that cardiac MRI may be performed safely in appropriately selected patients with close monitoring during the scan without limitation of peak SAR level using several precautionary measures. Image artefacts were more frequent in ICD patients.
Supportive Housing in Foster Care: The Views of Young People

This study investigated Finnish young people's experiences of supportive housing. Supportive housing is an after-care programme that should support the transition from foster care to independent adulthood. It is directed mainly at young people who have been taken into foster care by social workers. The sample consisted of 39 young people (23 males, 16 females) aged 17–26 who had been residents in supportive care in Helsinki for 3–36 months. Their experiences were collected by use of a quantitative questionnaire. The data indicate that most of the participants felt their needs were met in supportive housing. Despite the overall positivity, two important issues should be noted. First, the results reveal some gender differences, indicating that boys had a somewhat more positive experience of supportive housing than girls. The second key issue is that many respondents did not get much support for acquiring hard skills such as managing financial, employment or health care issues, or for planning life after supportive housing.
Mixed treatment comparisons for atrial fibrillation: evidence network or bewildering entanglement?

This editorial refers to ‘Mixed treatment comparison of dronedarone, amiodarone, sotalol, flecainide, and propafenone, for the management of atrial fibrillation’ by N. Freemantle et al. , on page 329. Atrial fibrillation (AF) imparts significant morbidity and mortality, affecting more than 6 million patients in Europe alone. The impairment in quality of life attributable to AF is similar to the deficits associated with myocardial infarction or heart failure.1 Current clinical practice guidelines advocate antiarrhythmic therapy for patients with debilitating symptoms despite adequate rate control.2,3 Although successive generations of antiarrhythmic drugs have broadened the array of therapeutic options, rates of AF recurrence and toxicity remain frustrating.4 In 2009, dronedarone became the first antiarrhythmic drug in nearly 2 decades to be approved in the European Union for the treatment of AF. Direct comparisons between dronedarone and other antiarrhythmic agents are limited, creating uncertainty for clinicians. Given the paucity of direct, head-to-head data comparing dronedarone and other antiarrhythmic agents for AF, Freemantle et al . 5 analysed outcomes from 40 different randomized-controlled trials of currently available guideline recommended class IC and class III agents (amiodarone, dronedarone, flecainide, propafenone, and sotalol). 2 In addition to conventional random-effect meta-analysis models that evaluated only the direct comparisons between drugs, the investigators constructed a model that accommodated both the direct and indirect treatment comparisons within the available data. In direct comparisons, amiodarone had the greatest overall efficacy for the prevention of recurrent AF [odds ratio (OR) 0.15, 95% 0.10–0.22] and was superior to both sotalol and dronedarone. In terms of safety, all of the included …
Management of patients with palpitations: a position paper from the European Heart Rhythm Association.

### Aim of the document Palpitations are among the most common symptoms that prompt patients to consult general practitioners, cardiologists, or emergency healthcare services.1–4 Very often, however, the diagnostic and therapeutic management of this symptom proves to be poorly efficacious and somewhat frustrating for both the patient and the physician. Indeed, in many cases a definitive, or at least probable, diagnosis of the cause of palpitations is not reached and no specific therapy is initiated.5,6 This means that many patients continue to suffer recurrences of their symptoms, which impair their quality of life and mental balance, lead to the potential risk of adverse clinical events, and induce continual recourse to healthcare facilities. These difficulties stem from the fact that palpitations are generally a transitory symptom. Indeed, at the moment of clinical evaluation, the patient is often asymptomatic and the diagnostic evaluation focuses on the search for pathological conditions that may be responsible for the symptom. This gives rise to some uncertainty in establishing a cause–effect relationship between any anomalies that may be detected and the palpitations themselves. Moreover, as palpitations may be caused by a wide range of different physiological and pathological conditions, clinicians tend to apply a number of instrumental investigations, laboratory tests, and specialist examinations, which are both time-consuming and costly. Comparable, for example, to syncope, such an approach is warranted in selected patients, whereas other patients with palpitations may not require such careful follow-up. The initial clinical assessment should, therefore, include an educated estimation of the likelihood of a relevant underlying arrhythmia in a patient with palpitations (‘gatekeeper' function). The current management of patients with palpitations is guided chiefly by the clinical experience of the physician. Indeed, the literature lacks specific policy documents or recommendations regarding the most appropriate diagnostic work-up to be adopted in individual …
Trends in the incidence and prevalence of atrial fibrillation in Iceland and future projections.

AIMS Data are scarce on the epidemiology of atrial fibrillation (AF) in Europe. The aim of this study was to examine recent trends in the incidence and prevalence of AF and project the prevalence to the year 2050. METHODS AND RESULTS From 1991 to 2008 a total of 4905 residents of Reykjavik, Iceland were diagnosed with AF at the city's main health care centre. The age-standardized incidence of AF increased in women (0.9% per year, 95% CI 0.1-1.8) but not in men (0.1% per year, 95% CI -0.6 to 0.9). The age-standardized prevalence increased per year by 1.8% (95% CI 1.3-2.3) in men and 2.3% (95% CI 1.7-2.9) in women from 1998 to 2008. The number of adults with AF in Iceland is projected to increase from 4495 (prevalence 2.0%) in 2008 to 11 088 (prevalence 3.5%) in 2050, if the incidence of AF and mortality remain constant beyond 2008. However, if the incidence continues to increase as it has and mortality decreases according to projections for the general population, the projected number will rise to 13 583 (prevalence 4.3%). CONCLUSION In this study in a northern European population, the incidence of AF increased in women but not men from 1991 to 2008. The prevalence of AF is currently high and the number of patients with AF is expected to triple in the next four decades. AF is already a serious public health problem and the burden of this disease could reach epidemic proportions in the coming years.
Knowledge and practice of condom use among black and white South Africans

The aim of the study was to investigate knowledge and sexual practices with reference to correct use of condoms among 108 Black and 114 White adult South Africans chosen by systematic random sampling. Results indicated that about 25% of the sexually active sample(28,6% Blacks and 18,9% Whites) reported never having used condoms. About 55% of the sample reported never using condoms, 20% always, 12% regularly and 13% irregularly in the preceding three months. The overall knowledge mean score about correct usage was 7,7% (Whites 8,3 and Blacks 7,1) (range0-10). The most common mistakes with the respect to condom use knowledge were ignorance before putting on a condom just before ejaculation (44%), when to take off a condom (41%), unrolling a condom before putting it on the penis (33%), and the use of oil-based lubricant with a condom (31%). Predictors for programmes consider cultural diversity.
Prediction of sinus node dysfunction in patients with persistent atrial flutter using the flutter cycle length.

AIMS Sinus node dysfunction (SND) occasionally coexists with atrial flutter (AFL). However, the identification of SND during AFL is difficult. We investigated whether we could predict underlying SND in patients with persistent AFL using the flutter cycle length (FCL). METHODS AND RESULTS We retrospectively studied 211 successfully ablated patients with persistent cavotricuspid isthmus (CTI)-dependent AFL and measured the FCL before the ablation and corrected sinus node recovery time (CSNRT) after the ablation. Twenty-four patients (11%) required a permanent pacemaker implantation (PMI) for significant SND after AFL termination and had a longer FCL (295 ± 37 vs. 236 ± 34 ms; P< 0.0001) and greater CSNRT (1727 ± 1014 vs. 603 ± 733 ms; P< 0.0001) than those not requiring a PMI. A receiver-operating characteristic curve identified an FCL of >273 ms as the optimal cut-off value for predicting SND requiring a PMI (area under the curve 0.91; sensitivity, 83% and specificity, 89%; P< 0.0001). Multiple linear and logistic regression analyses revealed that the left ventricular ejection fraction (LVEF) (β = -0.2; P= 0.0016) and FCL (β = 0.46; P< 0.0001) were independently associated with the CSNRT, and that females [odds ratio (OR), 2.43; 95% confidence interval (CI), 1.32-4.62; P= 0.0046], an LVEF < 50% (OR, 2.10; 95% CI, 1.20-3.87; P= 0.012), and an FCL of >273 ms (OR, 5.34; 95% CI, 3.08-10.08; P< 0.0001) were independent predictors of SND requiring a PMI. CONCLUSION Although this study was based on a review of a database, the results suggest that assessing the FCL in patients with persistent CTI-dependent AFL could be helpful in the risk stratification of underlying SND.
The impacts of short-term foot massage on mean arterial pressure of neurosurgical patients hospitalized in intensive care units

A B S T R A C T Aims: Short term foot massage helps regulate the vital signs of patients who are hospitalized for long periods of time in intensive care units. The purpose of this study was “to examine the immediate impacts of short-term foot massage on mean arterial pressure among neurosurgical patients hospitalized in intensive care units”. Methods: This quasi-experimental study was conducted in 2013 on 78 patients who had been conveniently recruited from the intensive care units of Imam Reza (PBUH) Hospital, Kermanshah, Iran. Patients were equally and randomly assigned to the experimental and the control groups. Study data were collected by using a demographic questionnaire and a blood pressure data sheet which were completed through observation, interviewing, and physiologic measurement. Mean arterial blood pressure was measured both five and one minutes before the intervention. Then, the feet of each patient in the experimental group were massaged for five minutes and mean arterial pressure was re-measured one and five minutes afterward. The SPSS16 was used for calculating the measures of descriptive statistics and conducting the paired- and the independent-samples t tests. Results: In the experimental group, mean arterial blood pressure decreased significantly both one minute (93.23±14.16; p=0.005) and five minutes (89.76±13.66; p<0.005) after the study intervention. However, within-group comparison revealed that means arterial blood pressure did not change significantly in the control group after the intervention. Conclusions: Foot massage is effective in decreasing mean arterial pressure and giving patients a sense of calmness.
A Study of Complications following Self-administration with Medical Abortion Pills

Aims: The objective of this study was to find out the complications following self-administration with medical abortion pills. Methods: A prospective descriptive study was conducted in Department of Obstetrics and Gynecology,Nepal Medical College over a period of two years from January 2013 to December 2014 among 48 women who were admitted with abortion complications and also gave history of self-administration of abortion pills. Results: During the study period, 48 women with history of self-medication with abortion pills were admitted with various abortion complications. There were 60% of women who had consumed abortion pills within approved nine weeks gestation while 19% had consumed after nine weeks and 21% after twelve weeks. Majority (60%) were admitted with incomplete abortion, 4% with missed abortion, 13% with continued live pregnancy, 6.5% with septic abortion and 6.5% with ectopic pregnancy. Anemia was present in 79% of patient. More than one third of the patient had severe anemia and blood transfusion was needed in 52%. Surgical evacuation was required in 71% of patient; medical abortion with repeat doses of mifepristone and misoprostol was done in was done 13% and 6.5% needed laparotomy for ectopic pregnancy. Conclusions: Though medical abortion is considered to be highly effective and safe procedure, unsupervised selfadministration of medical abortion pills was associated with serious maternal morbidities. There should be some policy to restrict over the counter sale of this medicine.
Wearable devices as facilitators, not drivers, of health behavior change.

Several large technology companies including Apple, Google, and Samsung are entering the expanding market of population health with the introduction of wearable devices. This technology, worn in clothing or accessories, is part of a larger movement often referred to as the “quantified self. ” The notion is that by recording and reporting information about behaviors such as physical activity or sleep patterns, these devices can educate and motivate individuals toward better habits and better health. The gap between recording information and changing behavior is substantial, however, and while these devices are increasing in popularity, little evidence suggests that they are bridging that gap. Only 1% to 2% of individuals in the United States have used a wearable device, but annual sales are projected to increase to more than $50 billion by 2018. 1 Some of these devices aim at individuals already motivated to change their health behaviors. Others are being considered by health care organizations, employers, insurers, and clinicians who see promise in using these devices to better engage less motivated individuals. Some of these devices may justify that promise, but less because of their technology and more because of the behavioral change strat
Use of complementary medicine in metastatic melanoma patients treated with ipilimumab within a clinical trial

In Germany, 40–90 % of all cancer patients use complementary and alternative medicine (CAM). So far, no data are available on the use of CAM by melanoma patients. The objective of our study was to gather data on CAM use, sources of information, and goals of patients with metastatic melanoma.
Persepsi, Peluang Aksi, dan Infomasi serta Perilaku Pencegahan Malaria

Di dunia, malaria masih menjadi masalah kesehatan masyarakat terutama di negara-negara tropis termasuk Indonesia. Di Jawa Tengah, kasus malaria terus memperlihatkan kecenderungan yang meningkat, salah satu daerah endemis malaria di Banyumas adalah Puskesmas II Sumpiuh. Berdasarkan survei pendahuluan masih banyak ditemukan perilaku berisiko yang dapat mengakibatkan terjadi malaria. Penelitian ini bertujuan mengetahui persepsi masyarakat, kemungkinan aksi, dan informasi tentang malaria yang berpengaruh terhadap perilaku pencegahan malaria di Puskesmas Sumpiuh II Banyumas. Penelitian observasional dengan pendekatan cross sectional ini dilakukan pada populasi kepala keluarga di Puskesmas II Sumpiuh. Jumlah sampel sebanyak 95 kepala keluarga ditarik menggunakan metode simple random sampling . Pengumpulan data dilakukan menggunakan kuesioner. Analisis data dilakukan menggunakan metode analisis univariat dengan statistik deskriptif, analisis bivariat dengan kai kuadrat, serta analisis multivariat dengan regresi logistik. Persepsi masyarakat tentang kerentanan, persepsi tentang kegawatan, kemungkinan aksi hambatan dan informasi tidak berhubungan dengan perilaku pencegahan malaria, kecuali kemungkinan aksi manfaat berhubungan dengan perilaku pencegahan malaria. Variabel yang berpengaruh pada perilaku pencegahan malaria adalah manfaat pencegahan malaria. Malaria has still been a threatening of health problem in the world, particularly in tropical countries including Indonesia. The malaria cases in Central Java continued to increase. One of the Malaria endemic areas in Banyumas is Sumpiuh Primary Health Care II. Based on preliminary survey, It was found that there were risky behavior affecting the emerge of malaria. This study aimed to find out the community perception, action probabilility and information about malaria which influenced to preventive behavior in Primary Health Care II Sumpiuh.Cross sectional study was conducted to head of household in primary health care II Sumpiuh. The number of sample that was selected with simple random sampling method was 95 household heads. Data analysis methods used in this study were univariate analysis with descriptive statistic, bivariate with chi square and multivariate with logistic regression. Community perceptions about vulnerability, seriousity of disease, obstruction and perception about information did not relate to preventive behavior of Malaria, except perception about the benefit related to preventive behavior.The influenced variable for malaria preventive behavior was prevention benefit taken by community.
Internet and society: a preliminary report

[Editor's note: This study is based on data on a panel of households recruited as a random telephone sample of the U.S. population. In order to use the Internet for the purpose of efficient multi-channel data collection, each household in the sample--with or without prior Internet connection--was equipped with a WebTV® set-top box, with free Internet access and email accounts. The data for the study were collected in December 1999, from a national random sample of 4,113 individuals in 2,689 panel households. The margin of sampling error is about ±1.5% for results from the complete survey, and about ±2.5% for the subset of Internet users. ]