Miracle-dz/UniFAR-FTUs huggingface dataset:
Standardized referral form: Restricting client-centered practice?

Abstract Background: To increase homecare efficiency, the Ministry of Health and Social Services in Québec, Canada, encourages standardization of practices, including those of community occupational therapists (COTs). The impact of standardization is not known and might reduce client-centeredness. Aim/objectives. To explore the content and use of a referral form to standardize COTs’ practice. Material/methods. An institutional ethnography inquiry was conducted through observations of work and interviews with 10 COTs working in three homecare programs. Secondary informants were also interviewed and documents collected. Data were analyzed using institutional ethnography procedures. Findings. The referral form, completed by the COTs’ colleagues, includes categories primarily related to safety or autonomy in personal care and mobility. The form organizes COTs’ work, including information collection and interactions with clients and caregivers. Seen as consultants, COTs assess needs and make recommendations to keep clients at home safely for as long as possible, an important element of the homecare discourse. Conclusion/significance. The impact on COTs’ potential to be truly client-centered revealed by these findings merits serious consideration by other health professionals. Concerted efforts by professionals to question and act upon contextual barriers to client-centeredness are needed.
Anatomic Repair of Recurrent Aortic Arch Obstruction

Children undergoing repair of aortic coarctation are at lifelong risk of developing recurrent aortic obstruction. Several surgical techniques have been described to address this challenging problem. Some centers have used extraanatomic aortic bypass techniques to avoid dissection on the previously operated field. We have favored a technique that relies on anatomic reconstruction. Although a repeat end-to-
Leisure-activity participation to prevent later-life cognitive decline: a systematic review

Abstract Objective: A systematic literature review was conducted to characterise the current state of knowledge concerning the definition, categorisation, and operationalisation of leisure activity in studies examining its possible role in preventing later-life cognitive decline. Following PRISMA guidelines for a systematic review, the study examined peer-reviewed empirical research publications focused on leisure activity, cognitive decline, and prevention. Methods: Searches in the PubMed/Medline reSEARCH, CINHAL, Ovid MEDLINE, Embase, Web of Science, PsychoINFO, ERIC Proquest, the Cochrane library, and PsycARTICLES databases for the years 2000 to 2011 identified 52 publications for inclusion. Results: The results are discussed and based on these findings are further interpreted using the Model of Human Occupation, which focuses on key factors identified in the review that are salient to associations between participation in leisure activities and prevention of dementia. Conclusions: While the findings support a growing consensus that participation in leisure activities might significantly contribute to prevention of dementia, it also identifies major hindrances to progress. Important limitations detected include a lack of theoretical underpinnings, and little consensus and standardisation in the measured key variables. The study reinforces the critical need to overcome these limitations to enable health care professionals (e.g. occupational therapists) to make evidence-based recommendations for increased participation in activities as a means of promoting health and preventing cognitive decline.
Infant feeding practices in home countries and Australia: Perth Chinese mothers survey

Objective: This study aimed to document the infant feeding practices of Chinese-Australian mothers in their home countries and following migration to Australia. The factors that influenced infant feeding practices are also described. Design: A cross-sectional survey. Subjects: A sample of 506 Mandarin-speaking mothers with at least one child, who were born outside of Australia, resident in the Perth area and aged between 23 and 59 years. Setting: Community-based household telephone interviews in Perth, Western Australia. Statistical analysis: χ2-statistics was used to test the differences in the rates and factors influencing infant feeding practices between mothers’ home countries and Australia. Results: There were no significant differences between any breastfeeding rates among Chinese women delivering in either their home countries where breastfeeding initiation was 86.6% or in Australia. Full breastfeeding rates at three and six months for Chinese women were lower than recent Australian rates. Chinese women delivering in Australia received more breastfeeding support and assistance from health professionals. In Australia, 78% stated that they received support form their doctors and nurses for breastfeeding compared with 37.6% in their home countries (P < 0.001). In particular, they were more likely to have put their infant to the breast immediately after birth (47.9%) compared with women delivering in their home countries (4.1%) (P < 0.001). Solid foods were introduced earlier in their home countries. Conclusion: The Chinese-Australian mothers’ infant feeding practices in Australia reflected both Western and Eastern influences. The Chinese mothers introduced complementary foods earlier than in other Australian studies, suggesting that culturally specific programs will be needed to encourage exclusive breastfeeding to six months.
Ferret islet amyloid polypeptide (IAPP): characterization of in vitro and in vivo amyloidogenicity

Diabetes in the domestic ferret (Mustela putorius furo) has previously been described and the purpose of this study was to evaluate if the ferret could serve as a model for the study of β-cell degeneration associated with formation of islet amyloid. The nucleotide and amino acid sequence of ferret islet amyloid polypeptide (IAPP) 1–37 was identified and the synthesized peptide was studied with regards to in vitro amyloidogenicity and potential cellular toxicity in a comparative approach to human, cat and the non-amyloidogenic rat IAPP. Ferret IAPP forms amyloid-like fibrils, but with a longer lag phase than human and cat IAPP and the aggregation process was shown to reduce cell viability of cultured β-cells, but with less potency than these two amyloidogenic counterparts. Immunohistochemistry of ferret pancreas confirmed IAPP expression in the islets of Langerhans, but no islet amyloid was found in a very limited sample size of one diabetic and five healthy ferrets. Islet amyloid has never been described in ferrets, and it is not possible to determine if it is due to lack of studies/material or to the fact that the ferret’s life span is too short to present with such pathology.
Association of chemerin levels in synovial fluid with the severity of knee osteoarthritis

Context: Chemerin has been implicated to be correlated with inflammation. Objective: This study aims to determine the association of chemerin levels in serum and synovial fluid (SF) with the disease severity of patients with knee Osteoarthritis (OA). Methods: 124 patients with knee OA and 76 healthy controls were enrolled in this study. Results: Chemerin levels in serum were significant higher with regard to paired SF. Chemerin levles in SF of knee OA patients were correlated with disease severity evaluated by KL grading criteria. Conclusion: Chemerin levels may be involved in the pathophysiology of the development and progression of OA.
Characterisation and genetic polymorphism of metallothionein gene CgMT4 in experimental families of Pacific oyster Crassostrea gigas displaying summer mortality

Summer mortality events have been observed in Pacific oyster Crassostrea gigas for several decades. This paper examines the selective pressure exerted by summer mortality on the polymorphism of a newly identified oyster metallothionein gene. CgMT4 cDNA and genomic sequences were obtained. CgMT4 was studied in two generations of oysters reared in three sites on the French Atlantic coast, using single strand conformation polymorphism analysis. Four alleles were detected. Individuals carrying genotype MT4-CD seem to have higher susceptibility to summer risk conditions. The MT4 gene could be a potential new genetic marker for susceptibility; further validation studies are recommended.
Urinary neutrophil gelatinase-associated lipocalin and L-type fatty acid binding protein as diagnostic markers of early acute kidney injury after liver transplantation

Objective: We examined the value of two potential novel urinary biomarkers, neutrophil gelatinase-associated lipocalin (NGAL) and L-type fatty acid binding protein (L-FABP), in diagnosing acute kidney injury (AKI) in liver transplant recipients. Methods: NGAL and L-FABP in urinary sample from Twenty-five patients before surgery and at 2, 4, 6, 12, 24, 48, 72 and 120 h after the anhepatic phase were tested. Standard statistics were used along with receiver-operating characteristic (ROC) analysis to evaluate the diagnostic value of selected markers. Results: Urinary NGAL was only slightly elevated at 2 h in the non-AKI group while rose and stayed high from 2–6 h in the AKI group. However, urinary L-FABP rose transiently in both groups 2–120 h following surgery. The level of urinary NGAL presented differences at 2–6 h (p < 0.05) and urinary L-FABP at 4 h (p < 0.05) between AKI and non-AKI groups. ROC analysis showed that area under the curves (AUCs) of NGAL were 0.766, 0.773, and 0.773 at 2, 4 and 6 h respectively while 0.760 of L-FABP at 4 h. Conclusion: Urinary NGAL rather than L-FABP appeared to be a sensitive and specific marker of AKI in liver transplant recipients.
The biological effects upon the cardiovascular system consequent to exposure to particulates of less than 500 nm in size

Abstract Context: Ultrafine particulate matter contribution to cardiovascular disease is not known and not regulated. PM up to 500 nm are abundant in urban air and alveolar deposition is significant. Objective: Effects beyond the alveolar barrier within the body or in vitro tissues exposed to particles <500 nm. Methods and results: Databases: MEDLINE; Ovid-MEDLINE PREM; Web of Science; PubMed (SciGlobe). 127 articles. Results in tables: “subject type exposed”, “exposure type”, “technique”. Conclusion: Heart rate, vasoactivity, atherosclerotic advancement, oxidative stress, coagulability, inflammatory changes are affected. Production of reactive oxygen species is a useful target to limit outcomes associated with UFP exposure.
Matrix metalloproteinases as candidate biomarkers in adults with congenital heart disease

Abstract Context Matrix metalloproteinases (MMPs) are associated with diastolic dysfunction and heart failure in acquired heart disease. Objective To investigate the role of MMPs as novel biomarkers in clinically stable adults with congenital heart disease. Methods We measured serum MMP-2, -3, -9 and tissue inhibitor of matrix metalloproteinase-1 in 425 patients and analysed the association with cardiac function and exercise capacity. Results MMP-2 was significantly associated with exercise capacity, ventilatory efficiency and left ventricular deceleration time, independently of age, sex, body surface area and NT-proBNP. Conclusion MMP-2 may provide new information in the clinical evaluation of adults with congenital heart disease.
Outreach: ‘the past, present, and future’

The term Outreach is used to define the process of extending critical care services beyond the current or usual limits. Its purpose is to ‘break down the walls’ of critical care, by extending intensive care to sick patients outside of intensive care boundaries so preventing unnecessary morbidity and mortality in ward patients. The objectives were outlined by the Department of Health in their 2000 publication ‘Comprehensive Critical Care’:
Cultural adaptation and validating a Japanese version of the readiness for interprofessional learning scale (RIPLS)

Readiness for interprofessional education (IPE) can be an important factor to evaluate because of the influences of attitudes toward the outcomes of interprofessional learning activities. However, a dearth of Japanese evaluation tools hinders its evaluation. The readiness for interprofessional learning scale (RIPLS) was selected, because it has been validated in different countries and its items reflected our local situation best. This research aimed to develop and validate a Japanese version of the original 19-item RIPLS. We developed a Japanese RIPLS employing forward/backward translation. Reliability of the Japanese version was studied using classical test theory and structural equation modeling to construct a model to inform curriculum development. We obtained a 0.74 Cronbach's α, which indicates adequacy. Subscales of “interprofessional education opportunities” (α = 0.90) and “uniqueness of profession” (α = 0.60) have relatively little weight compared to “teamwork and collaboration” (α = 0.92). A one-way structure suggests that readiness for interprofessional learning starts with “teamwork & collaboration” followed by changes in “learning opportunities” and subsequently “uniqueness of profession” (root mean square error of approximation = 0.06, comparative fit index = 0.93). This Japanese RIPLS can be used in undergraduate health sciences students with appropriate caution. Further development of the subscales and a client-centered subscale would be beneficial to fully achieve its potential. The need for further research into its reliability and validity is identified. Recommendations are provided for cross-cultural adaptation and for establishing validity across different contexts.
Immunogenetic studies of juvenile dermatomyositis

Typing for HLA-A and -B antigens was performed on 87 children with definite juvenile dermatomyositis (JDMS). A significantly increased frequency of HLA-B8 (estimated relative risk = 2.8, Pc less than 0.01) was observed among White patients, but not among Blacks or Latin Americans with JDMS. No abnormality of HLA haplotype segregation was observed among 38 healthy siblings of the JDMS probands.
Is social capital as perceived by the medical director associated with coordination among hospital staff? A nationwide survey in German hospitals

Effective coordination among all members of hospital staff has been shown to be associated with better quality of care. The literature indicates that social capital, a form of organizational resource, may facilitate the task of coordination. However, to the best of our knowledge, no study has yet examined this link within a healthcare setting. Thus, the objective of this study was to analyze the relationship between social capital and coordination among hospital staff, as perceived by the medical director being a key informant of the hospital. In 2008, we surveyed the medical directors of 1224 German hospitals by the use of a standardized questionnaire. We conducted stepwise multivariate linear regression and controlled for hospital size, ownership and teaching status. In total, 551 medical directors (45%) responded to the survey. We found social capital to be a significant predictor of coordination (β = 0.444, p < 0.001). The regression model explained 28% of the variance in coordination. Higher levels of social capital can be associated with better coordination among members of hospital staff, as perceived by the medical director. Therefore, investment in social capital may facilitate better organization of work processes in hospitals and may therefore help to improve patient outcomes. However, longitudinal studies are needed in order to explain the causal relationship between social capital and coordination among hospital staff.
Shared decision-making and interprofessional collaboration in mental healthcare: a qualitative study exploring perceptions of barriers and facilitators

Abstract Shared decision-making and interprofessional collaboration are important approaches to achieving consumer-centered care. The concept of shared decision-making has been expanded recently to include the interprofessional healthcare team. This study explored healthcare providers’ perceptions of barriers and facilitators to both shared decision-making and interprofessional collaboration in mental healthcare. Semi-structured interviews were conducted with 31 healthcare providers, including medical practitioners (psychiatrists, general practitioners), pharmacists, nurses, occupational therapists, psychologists and social workers. Healthcare providers identified several factors as barriers to, and facilitators of shared decision-making that could be categorized into three major themes: factors associated with mental health consumers, factors associated with healthcare providers and factors associated with healthcare service delivery. Consumers’ lack of competence to participate was frequently perceived by mental health specialty providers to be a primary barrier to shared decision-making, while information provision on illness and treatment to consumers was cited by healthcare providers from all professions to be an important facilitator of shared decision-making. Whilst healthcare providers perceived interprofessional collaboration to be influenced by healthcare provider, environmental and systemic factors, emphasis of the factors differed among healthcare providers. To facilitate interprofessional collaboration, mental health specialty providers emphasized the importance of improving mental health expertise among general practitioners and community pharmacists, whereas general health providers were of the opinion that information sharing between providers and healthcare settings was the key. The findings of this study suggest that changes may be necessary at several levels (i.e. consumer, provider and environment) to implement effective shared decision-making and interprofessional collaboration in mental healthcare.
Interprofessional learning at work: what spatial theory can tell us about workplace learning in an acute care ward

Abstract It is widely recognized that every workplace potentially provides a rich source of learning. Studies focusing on health care contexts have shown that social interaction within and between professions is crucial in enabling professionals to learn through work, address problems and cope with challenges of clinical practice. While hospital environments are beginning to be understood in spatial terms, the links between space and interprofessional learning at work have not been explored. This paper draws on Lefebvre’s tri-partite theoretical framework of perceived, conceived and lived space to enrich understandings of interprofessional learning on an acute care ward in an Australian teaching hospital. Qualitative analysis was undertaken using data from observations of Registered Nurses at work and semi-structured interviews linked to observed events. The paper focuses on a ward round, the medical workroom and the Registrar’s room, comparing and contrasting the intended (conceived), practiced (perceived) and pedagogically experienced (lived) spatial dimensions. The paper concludes that spatial theory has much to offer understandings of interprofessional learning in work, and the features of work environments and daily practices that produce spaces that enable or constrain learning.
Developing a comprehensive faculty development program to promote interprofessional education, practice and research at a free-standing academic health science center

Abstract There is an on-going transformation in health professions education to prepare students to function as competent members of an interprofessional team in order to increase patient safety and improve patient care. Various methods of health education and practice directed toward students have been implemented, yet descriptions of faculty development initiatives designed to advance interprofessional education and practice are scarce. This article describes a faculty development program at the Medical University of South Carolina, USA, based on the conceptual framework of adult transformational learning theory. Three components comprise the faculty development program: an institute, fellowship and teaching series. Evaluations of the three components indicate that the faculty development program aided in the sustainability of the university’s interprofessional program, and built capacity for improvement and growth in interprofessional endeavors.
Making international links to further interprofessional learning: a student-led initiative for the homeless population

Abstract Supporting homeless people to recovery requires interprofessional collaborative responses. In North America interprofessional student groups have supported traditional services to address the needs of homeless populations. We report on the first two years of designing and developing an interprofessional student-led response to support homeless people in the UK. The project began with working in partnership with local statutory and voluntary services; and was affirmed through interviews with local homeless people. The findings identified that many avoided going to the services provided and 90% would welcome clinical services from interprofessional groups of students. The results have led to the launch of project LIGHT (Leicester Initiative Good Health Team) and today interprofessional student groups run health promotion activities for this population.