Miracle-dz/UniFAR-FTUs huggingface dataset:
Reducing medication errors by engaging nurses in medication safety research

Background: Medication error is the most common adverse event for hospitalised children and can lead to significant harm. Despite decades of research and implementation of a number of initiatives, the error rates continue to rise, particularly those associated with administration. Objectives: The objective of this literature review is to explore the factors involving nurses, families and healthcare systems that impact on medication administration errors in paediatric patients. Design: A review was undertaken of studies that reported on factors that contribute to a rise or fall in medication administration errors, from family, nurse and organisational perspectives. The following databases were searched: Medline, Embase, CINAHL and the Cochrane library. The title, abstract and full article were reviewed for relevance. Articles were excluded if they were not research studies, they related to medications and not medication administration errors or they referred to medical errors rather than medication errors. Results: A total of 15 studies met the inclusion criteria. The factors contributing to medication administration errors are communication failure between the parents and healthcare professionals, nurse workload, failure to adhere to policy and guidelines, interruptions, inexperience and insufficient nurse education from organisations. Strategies that were reported to reduce errors were double-checking by two nurses, implementing educational sessions, use of computerised prescribing and barcoding administration systems. Yet despite such interventions, errors persist. The review highlighted families that have a central role in caring for the child and therefore are key to the administration process, but have largely been ignored in research studies relating to medication administration. Conclusions: While there is a consensus about the factors that contribute to errors, sustainable and effective solutions remain elusive. To date, families have not been included as key stakeholders in researching or developing effective interventions to reduce medication administration errors.
PTSD relapse in Veterans of Iraq and Afghanistan: A systematic review

ABSTRACT This systematic review examines studies published between 2003, the initial invasion of Iraq, and 2018 related to the long-term treatment outcomes for Veterans of Iraq and Afghanistan suffering from combat-related posttraumatic stress disorder (PTSD). More specifically this review attempts to estimate the rate at which Veterans experience the return of symptoms after completing treatment. The review was conducted by the authors in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. The literature search identified eight eligible studies, which met the predefined inclusion criteria. Of the included studies a majority were deemed to be at a high risk of attrition bias. In addition, few studies comprehensively reported relevant relapse or recurrence related outcome statistics. The implications of the available evidence base on long-term treatment outcomes are discussed. Recommendations for future studies on relapse and recurrence of PTSD symptoms among Veterans of Iraq and Afghanistan are also presented.
Comparação de parâmetros e protocolos de aquisição e reconstrução de imagens de microtomografia para o diagnóstico de lesões de cárie incipientes : Comparison of acquisition and reconstruction parameters and protocols of microtomography images for the diagnosis of incipient caries lesions

The objectives in the present study were: to evaluate the accuracy of Micro Computed Tomography (Micro-CT) in the identification of incipient caries lesions in posterior teeth; and to evaluate the influence of acquisition and reconstruction parameters and protocols in the diagnosis of the lesions. Six posterior teeth resulting in 12 proximal, 6 sound and 6 incipient caries lesions were used. The scans were done in two equipment, SkyScan 1172 and 1174 (Bruker, Kontich, Belgium), which differ in power, having 100kVp and 100μA and 50kVp and 800μA, respectively. Acquisition parameters such as: rotation step, frame, filters, partial and total rotation were varied resulting in 16 scans per tooth and each scan was reconstructed using 0,15 and 30% of Beam Hardening Correction (BHC). At the end, 576 groups of images were evaluated by three examiners using a 5-point scale for the presence/absence of caries lesion on the proximal faces. The histological preparation of the samples was performed and the analysis of the sections under polarized light was the gold standard of this study. No statistically significant difference was observed between the devices, although both had excellent results in terms of accuracy. Equipment 1174 reached 70% and 1172 reached 60% of protocols with perfect accuracy. The parameters of rotation step, frame, filters, partial and total rotation isolated did not significantly influence the results. When significant differences, however punctual in the results of 1174, were identified, the parameter of better quality resulted in greater accuracy. For the 1174 protocols, only the protocols that grouped the worst acquisition parameters and without BHC application differed from the others, presenting satisfactory/regular accuracy results, 0.881 and 0.653. The protocols of 1172 device did not differ from each other. When the BHC tool was tested, it proved to be effective in increasing the accuracy to 81.25% of perfect accuracy protocols and correcting the two worst protocols cited, both of which reached perfect accuracy. No statistical difference was observed regarding the application or correction levels for the other protocols. In conclusion, Micro-CT presented an excellent performance in the identification of incipient caries lesions. The isolated acquisition parameters had no decisive influence on the diagnosis, but when the worst parameters were grouped, a significant decrease in the accuracy of the method was observed. Although it did not show statistical difference in most comparisons (0,15,30%), the BHC tool increased the overall accuracy of the protocols and corrected protocols of unsatisfactory accuracy.
Applied clinimetrics in critical care

Introduction The Behavioral Pain Scale (BPS) and Critical-Care Pain Observation Tool (CPOT) are behavioral pain assessment tools for uncommunicative and sedated ICU patients. This study compares the discriminant validation and reliability of the CPOT and the BPS simultaneously, in mechanically ventilated patients on a mixed adult ICU. Materials and Methods This is a prospective observational cohort study in 68 mechanically ventilated medical ICU patients who were unable to report pain. Results The BPS and CPOT scores showed a significant increase of two points between rest and the painful procedure (turning). The median BPS scores between rest and the non-painful procedure (oral care) showed a significant increase of one point, whereas the median CPOT score remained unchanged. The inter-rater reliability of the BPS and CPOT scores during turning was 0.60 and 0.62, respectively. The overall inter-rater reliability was 0.74 and 0.75 respectively. Conclusions The present study showed that the BPS and CPOT are reliable and valid for use in a daily clinical setting. Although both scores increased with a presumed painful stimulus, the discriminant validation of the BPS use was less supported as it increased during a non-painful stimulus. The CPOT appears preferable in this particular group of patients, especially with regard to its discriminant validation.
Inpatient treatment for patients with substance use disorders: outcomes at 6 months follow-up for both voluntarily and compulsorily admitted patients

Background: Treatment services to patients with substance use disorders (SUDs), including those mandated to treatment, needs to be evaluated and evidence based. The Norwegian Municipal Health Care Act calls for mandated treatment for persons with “severe and life-threatening substance use disorder” if these individuals are not otherwise willing to be voluntarily treated and consequently risk their lives over drug use. This study aims to examine substance use–related outcomes at 6 months following inpatient treatment and to analyse factors associated with improved outcomes and abstinence. Method: This prospective study followed 202 hospitalized patients with SUD who were admitted voluntarily (VA; n= 137) or compulsorily (CA; n = 65). The European Addiction Severity Index was used at baseline and at follow-up to assess socio-demographic and substance use variables. Regression analysis was conducted to investigate factors associated with abstinence at 6 months of follow-up. Results: The frequency of use of a preferred substance showed marked improvement for both VA and CA patients (61 and 37 %, respectively) at follow-up. Seventy-five percent of VA patients using amphetamine reported improvement compared to 53 % of CA patients. At follow-up, the CA group continued to have a higher rate of injection use. The CA group had experienced higher rates of overdose in the past 6 months and lower abstinence rates (24 % versus 50 %) at follow-up. A lower severity of drug use at intake (non–injection drug use), voluntary treatment modality, and higher treatment involvement during follow-up all were significant factors associated with abstinence at 6 months after treatment. Conclusion: Voluntary treatment for SUD generally yielded better outcomes; nevertheless, we also found improved outcomes for CA patients. It is important to keep in mind that in reality, the alternative to CA treatment is no treatment at all and instead a continuation of life-threatening drug use behaviours. Our observed outcomes for CA patients support the continuation of CA treatment.
Health systems strengthening for prevention of rheumatic heart disease in Zambia: a novel clinic-based curriculum to help advance knowledge and skills of health workers

Program/Project Purpose: Rheumatic heart disease (RHD) is a major public health problem in sub-Saharan Africa affecting up to 1-3% of school-aged children. Health care workers (HCWs) are essential to implementing national strategies to control RHD in countries such as Zambia. A key practice is proper diagnosis of streptococcal sore throat since it can lead to acute rheumatic fever (ARF) and RHD if untreated. One output of a public-private partnership to combat RHD in Zambia has been a novel training curriculum to prevent and treat RHD. We sought to determine the program’s short term …
Effect of ionizing radiation on the female reproductive system.

INTRODUCTION AND OBJECTIVE The tendency towards postponement of maternity implies a greater exposure of female germ cells to damaging environmental effects, including ionizing radiation (IR). Progress in paediatric oncology, based on the use of radiotherapy, also implies the occurrence of gonadal dysfunctions and subsequent female fertility disorders. Therefore, it seems justifiable to systematize the state of knowledge concerning the effect of IR on the female reproductive system. BRIEF DESCRIPTION OF THE STATE OF KNOWLEDGE A considerable part of studies concerning the effect of IR on female germ cells have been conducted on animals. Their extrapolation to humans is hindered because in animal studies high acute exposures are applied, which do not reflect human environmental exposures characterized by chronic low dose exposure. Studies on animals provide a heterogenous image, which hinders the formulation of unequivocal conclusions and indicates that radiosensitivity depends, i.a. on IR dose, stage of development of oocytes, the applied marker of the effects of IR, or on the species. LD50 of human oocytes is estimated to be below 2 Gy. The effect of IR depends, i.a. on the dose fractionation and the age (older women are more radiosensitive). In females, the effective sterilizing dose is: at birth 20.3 Gy, at 10 years 18.4 Gy, at 20 years 16.5 Gy, whereas at 30 years 14.3 Gy, which is associated with the available pool of ovarian follicles. CONCLUSIONS Within the range of low doses received as a result of environmental exposure to IR, there is no evidence for the occurrence of either adverse pregnancy outcomes, nor fertility disorders in females. These effects may be related to the cancer radiotherapy, or exposure to high IR doses during nuclear accidents.
The Significant Risk Factors of Intra-Operative Hemorrhage during Laparoscopic Myomectomy: A Systematic Review

Laparoscopic myomectomy (LM) is becoming increasingly common in the management of uterine myomas and is usually offered regardless of the number, location, and size of the myomas. It has a generally low rate of periprocedural complications and is preferred to laparotomy for several reasons that are not limited to decreased length of hospital stay, number of sutures, smaller incisions, and decreased pain. However, blood loss during LM remains a challenge. To be able to stratify patients and provide better management after LM, it is crucial to identify these predictors of blood loss. Therefore, the aim of this review was to identify the risk factors for periprocedural blood loss after laparoscopic uterine myomectomy. According to our data synthesis, age, body mass index, and phase of the menstrual cycle do not seem to affect the blood loss during LM. Conversely, size and number of myomas, as well as operative time, was directly related to the increase of blood loss.
Association between Lifestyle and Gastroesophageal Reflux Disease Questionnaire Scores: A Cross-Sectional Study of 37 442 Chinese Adults

The aim of this study was to investigate the distribution characteristics of GerdQ results in a Chinese population and the association between lifestyle and GerdQ scores. Among the 37 442 individuals enrolled from September 2009 to March 2016, 7 449 (19.89%) had a GerdQ score of ≥8 points and 29 993 (80.11%) had a GerdQ score of <8 points. The percentage of men with suspected GERD was significantly higher than the percentage of women with suspected GERD (χ2 = 111.571, P ≤ 0.001), and the prevalence of GERD was higher in the young and middle-aged populations than in the elderly population. The prevalence of GERD increased gradually with weight gain (χ2 = 145.227, P ≤ 0.001). With regard to lifestyle, the prevalence of GERD in the subjects who smoked (χ2 = 119.361, P ≤ 0.001), consumed alcohol excessively, lacked physical activity (χ2 = 86.916, P ≤ 0.001), and had an excessive intake of oil, meat, fish, and eggs showed an ascending trend (χ2 = 105.388, P ≤ 0.001). In contrast, an adequate intake of vegetables (≥300 g/d) and fruit (≥200 g/d) was associated with a significantly lower incidence of GERD. Suspected GERD is very common in individuals undergoing health examinations. Unhealthy lifestyles are closely related to the high incidence of suspected GERD. GerdQ scores can play a role in screening for GERD.
Second Autologous Stem Cell Transplant (ASCT) as Salvage Therapy in Patients with Relapsed Multiple Myeloma: Improved Outcomes in Patients with Longer Disease Free Interval after First ASCT.

Background: Single autologous stem cell transplant (ASCT) is considered the standard of care for younger multiple myeloma (MM) patients (pts). However, it is not curative and virtually all patients will ultimately relapse. As more options, such as biological therapy, are available to treat relapsed disease, the role of a second ASCT as salvage therapy is unclear. Method: Retrospective review of all MM pts who received a 2 nd ASCT as salvage therapy at Princess Margaret Hospital. Results: Between February 1997 and June 2007, 61 MM pts received a second ASCT for relapsed MM at our institution. Median age was 56 yrs (range 35–71) at second transplant. 37 pts (61%) were male. Immunoglobulin subtype included IgG (36), IgA (14), light chain (6), nonsecretory (3), IgM(1) and IgD (1). Transplant conditioning regimen for first transplant was high dose melphalan (MEL) 140–200 mg/m2 in 51, MEL/etoposide(E)/TBI in 4, and MELl/TBI in 2. 2 nd ASCT conditioning consisted of MEL + TBI +/− E in 2, MEL alone in 58 and Busulfan/Cyclophosphomide in 1. The median time from diagnosis to first transplant was 9.7 months (2.0–74.2). The median time to relapse after the first transplant was 32.6 months (9.7–85.6), with a median interval between transplants of 45.1 months (19.7– 115). Two transplant-related deaths occurred (3%). Response to first transplant was 4 CR (8%), 34 PR (68%), 2 MR (4%) and 10 SD (20%). Nineteen pts went on to maintenance therapy between transplants. Response to second transplant was 4 CR (8%), 41 PR (80%), 5 SD (10%) and 1 PD (2%). Median progression-free survival (PFS) was 15.8 months (0–63.8) while median overall survival (OS) was 4.2 years (0–7.0) after 2 nd ASCT. The relationship between progression-free interval after 1 st ASCT and the outcome of the 2nd ASCT is summarized Table 1. Patients can be stratified into two groups, those with a disease free interval of less than or greater than 24 months. The use of maintenance therapy did not differ between the two groups, 6 (40%) in patients with PFS ≤24 months and 13 (28%) in patients with PFS >24 months. Conclusions: 2 nd ASCT is a feasible and safe salvage therapy in patients with relapsed MM. 2nd ASCT is effective in providing a median progression free survival of 1.25 years and median overall survival of 4.2 years after 2 nd ASCT - results that compare favourably with other salvage approaches. Patients with a longer disease free interval after 1 st ASCT experience a better progression free survival and overall survival after 2nd ASCT. It is reasonable, therefore, to consider a 2 nd ASCT if the time to progression is greater than 2 years after first ASCT.
Stigma Among Patients with HIV/AIDS: A Cross Sectional Study in Malaysia

Introduction:HIV stigma refers to negative beliefs, feelings and attitudes towards people living with HIV (PLWH), groups associated with PLWH and other key populations at higher risk of HIV infection, such as people who inject drugs, sex workers, men who have sex with men and transgender people. Despite the advancement made in the knowledge and treatment of HIV, PLWH continues to be stigmatized.Objective: To determine the level of HIV stigma and its predictors among people living with HIV/AIDS in a tertiary hospital in Malaysia.Methods: A cross sectional study was conducted among HIV/AIDS patients aged 18 and above at infectious disease clinic in Hospital Sungai Buloh, Gombak, Malaysia. HIV stigma was assessed using Berger’s HIV stigma scale, which is available in Bahasa Malaysia and English.A self-administered questionnaire was used to determine their demographic and clinical characteristics. Multiple linear regression analysis was used to identify the predictors.Results: 526 subjects participated in this study. The mean age of the study population was 33.5± 8.4 years. The majority of the participants were male (90.9%) and contracted HIV through sexual activities (87.8%). The mean score of HIV stigma was 104.7 ± 19.5. Based on multiple linear regression analysis, patients who were unemployed (B = -8.00, 95% confidence interval (CI) = -12.12,-3.88, p = < 0.001) and being on antiretroviral treatment (B = 4.95, 95% (CI) = 0.30, 9.60, p = < 0.037) had higher level of HIV stigma.Conclusions: The level of HIV stigma was high (mean score =104.7 ± 19.5). HIV/AIDS patients who are unemployed and on antiretroviral agents were at risks of having higher level of HIV stigma. Future study is needed urgently to implement intervention that can minimize the stigmatization among patients with HIV/AIDS.International Journal of Human and Health Sciences Vol. 04 No. 01 January’20 Page : 26-35
Analysis of the Factors Contributing to the High Rates of Care in Wales: Briefing Paper (Revised)

On 31st March 2018, there were 6,405 children looked after in Wales, almost 1,900 more children than were looked after in 2006. Over that time Wales has consistently had more children looked after per 10,000 of the population than the rest of the UK, and that gap has widened. Within Wales, while most Local Authorities have seen a rise in both the number and rate of children looked after, there is significant variation; and some have seen the rate of children looked after fall since 2014. Using published data, this report explores what we can say about the factors that are driving these trends. The following infographics drawing on our data analysis show the kinds of placements children in Wales are in and where they’re placed.
Prevalence of Candida albicans in patients using fixed orthodontic appliances after the use of peppermint

This study was conducted to evaluate the antifungal effect of peppermint extract as mouth rinse during orthodontic treatment. Thirty patients (11 males and 19 females) who wear orthodontic appliances and instructed to use chlorhexidine as mouth rinse (8 patients); Mentha piperita extract (10 patients) or left to care of their teeth without any mouth rinse (12 patients); mean number of Candida albicans colonies recovered from anterior surface at three intervals (Time 0: Before wearing the appliance; time 1: After 7 days and time 2: After 1 month) was 48.8, 144.3, 158.9 for the control group; 132.9, 125.4, 147.9 for the peppermint group and 72, 105.8 and 130.8 for the chlorhexidine group. The mean number of Candida albicans colonies from the posterior surface at the different intervals was 87.4, 136.8, 159.5; 121.3, 84, 34.6 and 78.5, 91.25, 91 for control, peppermint and chlorhexidine groups respectively. The use of the peppermint extract decreases the number of Candida albicans significantly at the posterior surfaces.
Overweight May Have Some Positive Reproductive Benefits as Compared to Obese Represented by Higher Sperm Progressive Motility in Infertile Men

1,6 have (BMI) between 25 and 30 classified as overweight, and a BMI classified as to as a leading or indirect of and driven by an increase in related life-threatening disorders, including dyslipidemia, hypertension, cancer, type 2 diabetes, metabolic disorders, reproductive and sexual health impairment [5]. Although both males and females are affected by this lifestyle disorder in Abstract Objective: The purpose of this study is to unfold the
Comparison of dental health, treatment needs in visually impaired and normal healthy school-going children of 6–14-year age group

Introduction: This research aimed to evaluate and compare the oral health status and treatment required for visually impaired children and normal healthy school-going children in New Delhi and to investigate the factors that influence oral health. Subjects and Methods: The study was conducted in 420 children who were equally divided into visually impaired children and normal healthy children. Oral health status was recorded, which includes dental caries, plaque, debris, and gingival status in both groups. The Chi-square test was used, and statistical significance was fixed at (P < 0.05). Results: The total caries experience (Decayed, Missing, and Filled Surface + decayed, missing, filled surface) was found to be more in normal healthy children 2.72 than the visually impaired children 2.22 and it was found to be statistically significant (P < 0.05). Oral hygiene simplified index of normal healthy children and visually impaired children were 0.74 and 1.33, respectively, and found to be statistically significant (P < 0.05). The gingival index of normal healthy children was 0.10 found to be greater than visually impaired children 0.08. Visually impaired children required more treatment needs than normal healthy children. Conclusions: Visual impairment can actively limit these children maintaining good oral hygiene, and hence, it is important to create awareness, proper oral health guidance, and periodically screening to avoid complicated treatment needs in these children.