Miracle-dz/UniFAR-FTUs huggingface dataset:
Stressors and Coping Patterns of Newly Versus Old Diagnosed Children with Type1 DiabetesMellitus: An Assessment Study

Background: Children with type1 diabetes are at a greater risk for emotional and behavioral problems. Children with poorly controlled diabetes are at risk of negative effects on the child's personality, schooling, participation in activities, finally leading to stressors uprising. Research Design: A descriptive comparative design was utilized in this study. Aim: This study aimed to assess the stressors and coping patterns of newly versus old diagnosed children with type1 diabetes and to assess factors affecting stressors and coping of newly and old diagnosed children with type1 diabetes. Setting: This study was conducted at Diabetes Outpatient Clinics of Children's Hospitals affiliated to Ain Shams and Tanta universities. Subjects: The study involved 200 children aged from birth to 18 years old diagnosed with type1 diabetes, (57) of them were newly diagnosed since less than 6 months and (143) were old diagnosed children with type1 diabetes since more than 6 months period. Tools of data collection: 1-A questionnaire sheet to assess children‟s characteristics, factors affecting stressors, coping patterns and physical, psychological and social stressors affecting the newly and old diagnosed children with type1 diabetes. 2-Stress scale to assess the behavior of the diabetic children towards type1 diabetes. 3Coping patterns scale to assess the diabetic children coping patterns towards type1 diabetes. Results: Old diagnosed children had more physical (37.1%), psychological (70.6%) and social stressors (71.3%) compared with newly diagnosed children with type1 diabetes. Stress level was mild (33.3% and 37.1%) and moderate (22.8% and 24.5%) in both newly and old diagnosed children and both of them were sometimes (42.1% and 43.4%) able to cope with type1 diabetes. Factors affecting stressors and coping patterns were children age and ranking. There was a significant difference between newly and old diagnosed children related to stressors, stress, coping patterns and their age, ranking and parental discovery of diabetes. Conclusion: Old diagnosed children with type1 diabetes had physical, psychological and social stressors more than newly diagnosed children and both of them were sometimes able to cope with type1 diabetes. Factors affecting stressors and coping patterns of newly and old diagnosed children with type1 diabetes were child‟s age, ranking and parental discovery of type1 diabetes. Recommendations: Designing and carrying out programs to support newly, old diagnosed children and their parents to cope with type1 diabetes and minimize their physical, psychological and social stressors.
Prevalence of sensorineural hearing loss in type 2 diabetes mellitus

Background: The association of sensorineural hearing loss (SNHL) in diabetes mellitus patients is known since decades, yet there is no clear consensus among previous studies, with respect to the prevalence of SNHL in type 2 diabetes patients and the effect of duration and control of diabetes on hearing acuity. Hence the objectives of this study are to find the prevalence of SNHL in type 2 diabetes patients and to find the effect of duration and control of diabetes on hearing loss.Methods: The present study was conducted on 86 type 2 diabetes patients attending Navodaya Medical College Hospital, Raichur and age and gender matched 86 non- diabetic controls in the age group of 30-65 years, selected based on inclusion and exclusion criteria. After detailed history taking and clinical examination, all subjects underwent FBS, PPBS estimation and HbA1c evaluation was done for diabetic patients. All underwent pure tone audiometry and the findings were recorded and analyzed. Results: Diabetes patients had insidious onset, gradually progressive, bilaterally symmetrical SNHL. SNHL is prevalent in 67.44% of type 2 diabetes patients compared to 23.26% of controls. It is aggravated with the increasing age and duration of diabetes. Poor control of diabetes showed increased prevalence of SNHL compared to good control of diabetes.Conclusions: There is increased prevalence of SNHL in type 2 diabetes patients and it is more evident in patients with long duration of diabetes and more pronounced in patients with poor diabetic control.
On the Design and Evaluation of an eHealth System for Management of Patients in Out-of-Hospital Care

This thesis covers the design and evaluation of a generic web-based eHealth system into real clinical settings. Moreover, the use of an off-the-shelf video communication system for out-of-hospital care is tested and evaluated. A large part of the thesis will cover the design process of the web-based system (WBS) for out-of- hospital long term disease management. The systems were implemented in two very different settings: heart failure care and neonatal home healthcare. The methods of evaluation are questionnaires, including both patients and nurses. Also, data extracted from a blood pressure monitor, and data extracted from the prototype system database are used in the evaluation. The first study, performed in 2008, indicated that the prototype developed was applicable in the patient group (heart failure). However, several issues concerning the system were found, resulting in the development of a new prototype system. The two subsequent studies, heart failure care and neonatal home healthcare, were performed using the new system. Results from these two studies indicate that the WBS is usable for two very different applications. In heart failure care compliance with the system is very good, however in neonatal care the results are ambiguous. The neonatal evaluations show that even though the patients may be positive towards eHealth systems, the necessity of care personnel participation is vital. If there is no feedback, the patients lose interest and find the system useless. A questionnaire survey studying attitudes towards information and communication technology (ICT) as a tool in health care, and also studying the attitudes towards home follow up, was also performed. The target group was healthcare personnel in heart care, and the questionnaire was sent out to 84 cardiology and medicine clinics in Sweden. All 21 counties and regions in Sweden were included in the dispatch, and of these responses were collected from 17. The results indicate a large interest and confidence in healthcare ICT, and well as in home follow-up and monitoring of patients. A comparison between nurses and physicians indicate a slight difference where nurses in general are more positive than physicians.
The Association of Climatic Factors with Rates of Surgical Site Infections.

BACKGROUND Surgical site infections (SSI) are among the most common healthcare- associated infections. The aim of our explorative study was to determine how selected climatic factors are associated with SSI rates. METHODS SSI rates were calculated for operative procedures included in the surgi- cal site infection surveillance component (OP-KISS) of the German Nosocomial Infection Surveillance System (Krankenhaus-Infektions-Surveillance-System, KISS) during the years from 2000 to 2016. The surgeries were associated with department-related and patient-related data. Data of the German Meteorological Service (Deutscher Wetterdienst, DWD), including outdoor temperature and rainfall, were used to analyze the association between climatic factors and rates of SSI. Analyses focused on temperature which showed strong correlations with other climatic parameters. A descriptive analysis was performed, using the chi-squared test. Adjusted odds ratios (AORs) were calculated for SSI rates in relation to tem- perature, using a multivariable logistic regression model. RESULTS For the altogether 2 004 793 included operative procedures, 32 118 SSIs were documented. Temperatures ≥ 20 °C were associated with a significantly higher occurrence of SSI compared to temperatures <5 °C (AOR: 1.13; 95% confi- dence intervals [1.06; 1.20]). This increase was found for gram-positive pathogens (AOR: 1.13 [1.03; 1.23]) and, even more pronounced, for gram-negative pathogens (AOR: 1.20 [1.07; 1.35]). The association was strongest for superficial SSI caused by gram-negative pathogens (AOR: 1.38 [1.16; 1.64]). CONCLUSION An association between climatic factors and SSI rates was demon- strated. The predicted rise in global temperatures by up to 4 °C by the end of this century compared to preindustrial levels may increase the likelihood of SSI and should be taken into consideration in future preventive strategies.
Incidence of Anemia Among Pregnant Females of Rural Areas of Punjab

| Background: Anemia is a clinical condition characterized by decrease in hemoglobin concentration of blood and according to World Health Organization (WHO) anemia is the major public health problem, so it is important to find the prevalence of anemia in pregnant females. The aim of this study is to determine the prevalence of anemia in pregnant females of rural areas of Punjab. Methodology and materials: This cross sectional study was conducted from January 2016 to June 2016. The locations of the subjects (n=600) were asked verbally. Blood sample of subjects (n=600) were collected andrun on hematological analyzer (Model ‘KX-21 Sysmex”, Germany) to asses various parameters of blood. Statistical analysis was done using SPSS (version 13). The patients with low hemoglobin level (≥10.9g/dl) were considered as anemic. result: The mean hemoglobin level in anemic subjects was 8.8±0.04 (g/dl) and the total prevalence was 89%. The mean value of red blood cell (RBC’s), white blood cell (WBC’s) platelets and hematocrits in anemic subjects were 4.1±0.02 (106/μl), 10±0.06 (103/μl), 350±3.35 (103/μ) and 33.6±0.28 (%) respectively. The subjects were also divided into three trimesters to determine the prevalence of anemia in different trimesters. The mean values of hemoglobin level in three trimesters were 9.2±0.07 (g/dl), 9.1±0.08 (g/dl) and 7.8±0.07 (g/dl) respectively. conclusion: The prevalence of anemia among pregnant female of rural area was 89% and it was observed that in the 3rd trimester hemoglobin level was low as compared to the 1st and 2nd trimester.
The busy teacher educator’s guide to assessment

This document is part of the ESCalate Help Directory for Teacher Educators and the principal author is Sue Bloxham of the University of Cumbria. This guide is designed to provide a short summary of issues to be considered in developing, implementing and managing assessment in teacher education programmes. The guide highlights the important matters that need to be taken into account and provides links to relevant sources of help and suggestions for further reading. There are explorations of assessment for, assessment of, and assessment as, and links to the evidence provided in research. Professor Bloxham considers how we influence student learning and discusses feedback and diversification of assessment, as well as presenting a critique of Anderson and Krathwohl's taxonomy. There are plenty of useful references to follow up the ideas presented hereIt is presented as an online article and a Word document of some 14 pages
Detection of Medication Errors in Primary Care Units through Passive Voluntary Reporting Forms

The lack of a universally accepted terminology of what constitutes a Medication Error (ME), makes it difficult to report, detect, categorize and prevent MEs. Methodologically, there isn't a complete picture of the incidence and prevalence of MEs. The broad range of ME rates in literature reflects heterogeneity in the study designs and detection methods used. The current study aimed to detect MEs in reports received from Primary Care Units. A retrospective analysis was applied on such reports dated from March to November 2013 and some fatal cases are taken from 2014. All voluntary reports were included, excluded were errors not associated with drug use and pharmaceutical company reports. Eligible reports underwent assessment using predetermined criteria to pick up MEs. The criteria were applicable on 115 reports, in which MEs were detected. 60% (69/ 115) of ME cases were error cluster while 40% (46/115) were unknown due to either underreporting, lack of data or poor observation and correlation (p< 0.05). Only 7% (8/115) p<0.001 of the reports were pregnancy cases. Moreover, errors associated with vaccine use accounted for 7% (8/115) of the cases while 93% accounted for errors from other drug use at p<0.001. Long-term follow-up was needed but not done by the assessors in 41% (47 of 115) of ME cases at p-value=0.05. Attachments were provided with the reports in 9% (10 /115) of the cases while the majority 91% (105/115) were not (p<0.001). In conclusion, voluntary reporting is a major strategy to prevent MEs by learning from errors reported.
Assessment of Serum Levels of Growth Factors IGF1 and IGFBP3 in Children with Cystic Fibrosis

Background: Cystic fibrosis (CF) is a multi-systemic disorder with an autosomal recessive inheritance. It is characterized by recurrent pulmonary infections and gastrointestinal problems, particularly pancreas insufficiency. Objectives: The aim of this study was to evaluate growth peptides in CF patients. Methods: This cross sectional study was approved by Mashhad University of Medical Sciences ethical committee. Patients were between six months to 18 years old, who were referred to Dr. Sheikh Hospital subspecialty clinic. They were enrolled for the study after obtaining a written constant. Demographic data was recorded. Of all cases, 10-cc blood sample was obtained and growth peptide levels were determined and measured. Data were analyzed by SPSS version 16 and Mann Whitney and χ tests were used. Results: Patients’ mean age at onset was 3.4 ± 1.1 months. Overall, 36 (60%) children were male and 24 (40%) were female. Mean body mass index (BMI) was 15.9 ± 3.2 kg/m. Mean levels of growth hormone was 1.9 ± 0.37 (ng/mL), insulin-like growth factor 1 (IGF1) was 85.8 ± 9.6 microg/L and insulin-like growth factor binding protein 3 (IGFBP3) level was 18538 ± 10643 pg/mL. Conclusions: The mean serum levels of GH, IGF1, and IGFBP3 in CF children with growth failure was lower than children without growth failure. Regarding the relatively high prevalence of growth disorders in children with cystic fibrosis, selected, appropriate, and standard medical treatments could improve the outcome for these children.
The Effect of Yoga Exercise on Selective Attention of Collegiate Athletes Following Short-Term Sleep Deprivation

Objectives: As negative consequences of sleep disturbances on cognitive performance in all age groups are well documented the study was aimed at identifying the eﬀect of Yoga practices on selective attention of collegiate athletes following short-term sleep deprivation. Methods: Nineteencollegiateathleteswererecruitedinacross-overdesignintwophases. Inthecontrolcondition, theirattention was measured after short-term sleep deprivation (6 hours), then, they were given Yoga exercises within a one week washout phase. The posttest was performed following a one week Yoga intervention (experimental condition). The quality of sleep was measured by Actiwatch Sleep Analysis in the washout phase (a 7-day period), and the total score was obtained based on their performance in the last three days. The subjects wore an Actiwatch-7 on their non-dominant wrist for seven consecutive days. In the experimental condition, they attended exercise physiology and were tested. Dependent t -tests was used to analyze the data. Results: The results indicated that Yoga protocol improved both subtests of selective attention signiﬁcantly, including the mean time for correct responses ( t = 4.98; P = 0.001) and the mean time for correct rejections ( t = 3.73; P = 0.001). Furthermore, the total scoreof sleepqualitywithinthelastthreedaysof thewashoutphaseimprovedsigniﬁcantlyintheYogacondition( t =2.68;P=0.01). Conclusions: As known, sleep deprivation could result in poor psychomotor performance; hence, the Yoga exercise would attenuate the devastating consequences of sleep disorder in tasks needing decisions in individuals with such a problem. The results suggest that performing a Yoga exercise may play a major role in improving psychomotor performance in collegiate athletes who are vulnerable for sleep disturbances.
Diagnosis of Carnitine Deficiency in Extremely Preterm Neonates Related to Parenteral Nutrition: Two Step Newborn Screening Approach

Currently, there is no evidence in the literature to support the routine supplementation of all parenterally fed premature infants with l-carnitine. In our study, we found that about 8.56% of extremely preterm neonates are diagnosed with carnitine deficiency secondary to malnutrition, either due to reduced stores at birth or related to total parenteral nutrition (TPN). Our two step approach of performing newborn screening (NBS) again at 32 weeks gestational age (GA) equivalent helps to diagnose 81.4% more preterm babies with carnitine deficiency—who would otherwise be missed—and supplement them with l-carnitine for optimal growth. We performed a retrospective cohort study to diagnose carnitine deficiency related to malnutrition in two groups: those presenting at birth and those presenting later in life. We found that there was a statistically significant difference in the median GA and birth weight (BW) between the two groups, but there was no difference in the free carnitine levels.
The effect of red blood cell transfusion on plasma hepcidin and growth differentiation factor 15 in gastric cancer patients: a prospective study.

Background Hepcidin and growth differentiation factor 15 (GDF-15) have been reported to be highly expressed in various cancers. Serum hepcidin and GDF-15 levels were demonstrated to be potential prognostic markers in cancers. This study aims to evaluate the effect of red blood cell (RBC) transfusion on plasma hepcidin and GDF-15 in gastric cancer patients. Methods In this prospective study, 40 patients with gastric cancer were eligible for this study. Peripheral blood samples were obtained before and within 24 h after RBC transfusion. A routine blood test was performed before transfusion and within 24 h post-transfusion. Plasma hepcidin, GDF-15, interleukin 6 (IL-6) and erythropoietin were determined by ELISA. Results In patients with metastasis, plasma hepcidin (P=0.02), and GDF-15 (P=0.01) levels were higher than without metastasis. Plasma hepcidin was increased after RBC transfusion (P=0.001), while plasma erythropoietin was decreased after transfusion (P=0.03). However, RBC transfusion did not affect plasma GDF-15 (P=0.32) and IL-6 (P=0.12). The effect of RBC transfusion on variables did not differ between metastatic and non-metastatic patients. The mean percentage change of hepcidin in transfusion volume 4 unit (U) was more than 2 U. Conclusions RBC transfusion could increase plasma hepcidin and have no effect on plasma GDF-15 in gastric patients.
The Association of Atrial Fibrillation and Ischemic Stroke in Patients on Hemodialysis: A Competing Risk Analysis

Background: Stroke is common in patients with end-stage renal disease (ESRD) treated with hemodialysis (HD) and associated with high mortality rate. In the general population, atrial fibrillation (AF) is a major risk factor for stroke and therapeutic anticoagulation is associated with risk reduction, whereas in ESRD the relationship is less clear. Objective: The purpose of this study is to demonstrate the influence of AF on stroke rates and probability in those on HD following competing risk analyses. Design: A national record linkage cohort study. Setting: All renal and stroke units in Scotland, UK. Patients: All patients with ESRD receiving HD within Scotland from 2005 to 2013 (follow-up to 2015). Measurements: Demographic, clinical, and laboratory data were linked between the Scottish Renal Registry, Scottish Stroke Care Audit, and hospital discharge data. Stroke was defined as a fatal or nonfatal event and mortality derived from national records. Methods: Associations for stroke were determined using competing risk models: the cause-specific hazards model and the Fine and Gray subdistribution hazards model accounting for the competing risk of death in models of all stroke, ischemic stroke, and first-ever stroke. Results: Of 5502 patients treated with HD with 12 348.6-year follow-up, 363 (6.6%) experienced stroke. The stroke incidence rate was 26.7 per 1000 patient-years. Multivariable regression on the cause-specific hazard for stroke demonstrated age, hazard ratio (HR) (95% confidence interval [CI]) = 1.04 (1.03-1.05); AF, HR (95% CI) = 1.88 (1.25-2.83); prior stroke, HR (95% CI) = 2.29 (1.48-3.54), and diabetes, HR (95% CI) = 1.92 (1.45-2.53); serum phosphate, HR (95% CI) = 2.15 (1.56-2.99); lower body weight, HR (95% CI) = 0.99 (0.98-1.00); lower hemoglobin, HR (95% CI) = 0.88 (0.77-0.99); and systolic blood pressure (BP), HR (95% CI) = 1.01 (1.00-1.02), to be associated with an increased stroke rate. In contrast, the subdistribution HRs obtained following Fine and Gray regression demonstrated that AF, weight, and hemoglobin were not associated with stroke risk. In both models, AF was significantly associated with nonstroke death. Limitations: Our analyses derive from retrospective data sets and thus can only describe association not causation. Data on anticoagulant use are not available. Conclusions: The incidence of stroke in HD patients is high. The competing risk of “prestroke” mortality affects the relationship between AF and risk of future stroke. Trial designs for interventions to reduce stroke risk in HD patients, such as anticoagulation for AF, should take account of competing risks affecting associations between risk factors and outcomes.
Assessment of Quality of Pediatric Emergency Triage and Its Associated Factors in Wolaita Zone, Ethiopia

Background: Most deaths of children in hospital frequently occur within the first 24 hours of admission. Immediate triage on arrival may prevent many of these deaths. Pediatric emergency triage assessment and treatment was introduced in 2014 in Ethiopia, however, there is no evidence which shows its quality and associated factors in the country. Objective:-This study aimed to assess the quality of pediatric emergency triage and its associated factors in selected hospitals of Wolaita zone 2017. Methods: A facility-based cross-sectional study design was used March to April 2017. A total of 178 health care workers (HCWs) were included in this study. The data was collected by using a self-administered questionnaire on the HCWs, and an observation checklist for hospitals assessment. We performed descriptive and multivariable logistic regression analyses; adjusted odds ratio and 95% CI were used to determine statistically significant associations. Results: This study indicated that 41.7% of HCWs did not correctly define triage, 81% did not know triage duration, 85.7% did not identify all triage categories and 64% did not categorize child with urgent signs. Conclusion: The overall quality of pediatric emergency triage service was poor.