Yoxas/statistical_literacy huggingface dataset:
Despite a growing body of research into end-of-life care (EOLC) in intensive care units (ICUs), few studies have concurrently explored the perspectives of families and clinicians. The objective of this study was to identify the characteristics of high-quality EOLC in the ICU from family and clinician perspectives and by examining the care documented in medical records. A convergent mixed-methods study incorporating electronic health record audits (n = 20), structured interview surveys with families (n = 20), clinician surveys (n = 189), and focus groups (n = 10) was undertaken at a 30-bed, level 3 ICU at a metropolitan public adult teaching hospital in Australia. Descriptive statistics were calculated from quantitative data, and inductive thematic analysis was used to analyse qualitative data. Overall, families were very satisfied with EOLC and the quality of communication yet, felt that earlier, clearer communication that the patient was dying was required. Families spoke of the attentiveness, or lack thereof, by ICU clinicians and the opportunity to be present for the patient's death. The majority of ICU clinicians felt EOLC could be improved. Nurses highlighted communication challenges when family meetings were delayed. Some nurses expressed a lack of clarity of how to withdraw care, resulting in hesitancy to cease potentially inappropriate care, and to provide EOLC outside ICU practice norms. In many instances, observations, invasive monitoring, and interventions were documented after EOLC commenced. A lack of documented personal cares was also noted. This study provides new insights into EOLC from the dual perspectives of families and clinicians. There is a need for institutional guidelines to support ICU clinicians' EOLC practices and education to improve clinician confidence with communication.
Despite a growing imperative for graduates to possess STEM skills, both to boost their employability prospects and their perceived economic value, it is critical to also consider the professional or 'soft skills' that will enable these graduates to thrive in their careers. Ironically, gender differences in personality and occupational choice are larger, not smaller, in more gender-equal countries. This is known as the gender equality paradox and in STEM it highlights the importance of purposeful initiatives throughout the educational trajectory, even in countries with higher levels of gender equality. This study employed an online self-assessment of perceived employability (PE) using a validated instrument and analyzed the data from 2493 STEM students studying at multiple Australian universities. The findings, underpinned by Social Cognitive Careers Theory, indicate that female report greater confidence than their male peers in ethical literacy and in some emotional literacy skills; these are understood to be critical soft skills for STEM graduates. This distinction is more pronounced in the natural and physical sciences and within information technology fields. Theoretical contributions and practical implications are discussed.
Despite a temporary decrease in the number of newly HIV infections in Poland in 2020, a return to the growing number of new infections was observed in 2021 in the surveillance. The aim of the study was to assess the epidemiological situation of newly HIV infections and AIDS cases and death among AIDS cases in Poland in 2021 in comparison to the changes in preceding years. Analysis of the epidemiological situation was based on reports of newly detected HIV cases and AIDS cases received from doctors and laboratories and the results of the annual survey of HIV testing conducted by laboratories throughout the country. A dataset on clients from Voluntary Testing and Counselling, coordinated by the National AIDS Center, which anonymously collects epidemiological and behaviour data on tested people was used. In 2021 there were 1 367 HIV cases newly diagnosed in Poland (diagnosis rate 3.58 per 100,000), including 236 among non-Polish citizens. The number of HIV infections increased by 43.3% compared to the previous year and was higher by 3.8% compared to the median in 2015-2019 years. Similarly, among VCT clients, number of HIV increased by 45%, from 309 in 2020 to 448 in 2021 year. The total number of AIDS cases reported to surveillance was 62 (incidence 0.16 per 100,000). The HIV infection was most often detected in the age group 30-39 year (35.8%) and among men (82.1%). Among cases with known transmission route, 68.7% concerned among MSM. The percentage of AIDS cases diagnosed at the same time with HIV increased by more than 30 percent points (from 63.5% to 95.1% of all AIDS cases). In 2021 the number of newly detected HIV infections increased compared to the previous year, probably due to a reduction in restrictions related to the COVID-19 pandemic and increased in HIV testing rate.
Despite advances in non-invasive and minimally invasive techniques, some proximal ureteral stones with impaction require open or laparoscopic surgery. No systematic reviews or meta-analyses have compared the efficacy and safety of open proximal ureterolithotomy and laparoscopic approaches. The aim of this study was to compare the efficacy and safety between open and laparoscopic proximal ureterolithotomy for ureteral stone management. Following the PRISMA guidelines, systematic searches were conducted in five databases (PubMed, Scopus, ScienceDirect, Web of Science, and ProQuest) to identify articles comparing those two surgical approaches. Operative time, blood loss, pain score, hospital stay, recovery time, and complications were collected and compared. Heterogeneity-based meta-analysis with random-effects or fixed-effects models were conducted. Two randomized controlled trials and four observational cohort studies with 386 participants met the criteria. Open surgery had significantly less time than laparoscopic ureterolithotomy (mean difference (MD): 26.63 minutes, 95%CI: 14.32, 38.94; p<0.0001). Intraoperative blood loss (MD: -1.27 ml; 95%CI: -6.64, 4.09; p=0.64) and overall complications (OR: 0.68; 95%CI: 0.41, 1.15; p=0.16) were not significantly different between two approaches. Laparoscopic ureterolithotomy reduced visual analogue scale (VAS) pain scores (MD: -2.53; 95%CI: -3.47, -2.03; p<0.00001), hospital stays (MD: -2.40 days; 95%CI: -3.42 to -1.38 days; p=0.03), and recovery time (MD: -9.67 days; 95%CI: -10.81 to -8.53 days; p<0.00001). In conclusion, open proximal ureterolithotomy had less time, but laparoscopic surgery reduced postoperative pain, hospital stay, and recovery time. Both methods had comparable intraoperative bleeding and complications.
Despite an increased recognition of the right of adolescents to be involved in decisions that affect them, young people continue to be under-involved in health research. One of the reasons is a lack of awareness among researchers on the current evidence base around the benefits of involving adolescents. To address this, we conducted an umbrella review to synthesize the evidence on the positive impacts of adolescent involvement in health research. This umbrella review was preregistered with PROSPERO (CRD42021287467). We searched 11 databases, Google Scholar, PROSPERO, reference lists, 10 journals, websites of 472 organizations, and sought input from experts. Ultimately, we included 99 review articles. We found that adolescent involvement has many positive impacts on young people, including increased knowledge and skills; personal development; financial benefits; career and academic growth; enhanced relationships; and valuing their experience. The positive impacts of adolescent involvement on the research itself include increased relevance of the study to adolescents, improved recruitment, development of more adolescent-friendly materials, enhanced data collection and analysis, and more effective dissemination. Researchers also benefited from adolescents' involvement through increased knowledge, skills, and a shift in their attitudes. The evidence supporting the positive impacts of adolescent involvement in research is substantial but limited by a lack of rigorous evaluation, inconsistent reporting, and unclear evaluation methods.
Despite an increasing focus on gender diversity in radiology the underrepresentation of women in radiology has not significantly improved over the last two decades, with women continuing to representing just a quarter of the radiology workforce since 2007 (AAMC, 20191). Although multifactorial, lack of perceived patient interaction in the field has been reported to be one of the main deterring factors in why women chose not to pursue radiology (Arleo et al., 2016; Fielding et al., 20072,3). With increasing advances and integration of medical imaging into medical care (Brink and Hricak, 20234), Radiology's impact on daily patient care will continue to increase and with it, the need for an expert and diverse radiologist workforce. Thus, exposure to the field and its patient-centered focus to younger women, especially those students who are already interested in STEM, presently is ever more important. Such early exposure can provide for longitudinal engagement with the field and its numerous career opportunities, dispel the many myths of the specialty as one of isolation and lack of patient contact, and popularize the field among young adults. Current investment in mentoring young women, prior to the cementing of rather pervasive misconceptions about Radiology during their undergraduate and medical education, can help support a more diverse future for our field. Below is one rising high-school freshman's reflection on the field of breast imaging after a 10-day summer shadowing experience with Department of Radiology.
Despite being an important determinant of health outcomes, measures of structural racism are lacking in studies examining the relationship between the social determinants of health (SDOH) and overdose deaths. The aim of this study is to examine the association between per capita revenue generated from fines and forfeitures, a novel measure of structural racism, and other SDOH with county-level overdose deaths from 2017-2020. This longitudinal analysis of 2,846 counties from 2017-2020 used bivariate and multivariate Generalized Estimating Equations models to estimate associations between county overdose mortality rates and SDOH characteristics, including the fines and forfeitures measure. In our multivariate model, higher per capita fine and forfeiture revenue (5.76; CI: 4.76, 6.78), households receiving food stamps (1.15; CI: 0.77, 1.53), residents that are veterans (1.07; CI: 0.52, 1.63), substance use treatment availability (4.69; CI: 3.03, 6.33) and lower population density (-0.002; CI: -0.004, -0.001) and percent of Black residents (-0.7`; CI: -1.01, -0.42) were significantly associated with higher overdose death rates. There was a significant additive interaction between the fines and forfeitures measure (0.10; CI: 0.03, 0.17) and the percent of Black residents. Our findings suggest that structural racism, along with other SDOH, is associated with overdose deaths. Future research should focus on connecting individual-level data on fines and forfeitures to overdose deaths and other health outcomes, include measures of justice-related fines, such as court fees, and assess whether interventions aimed at increasing economic vitality in disadvantaged communities impact overdose deaths in a meaningful way.
Despite being easily corrected with eyeglasses, over two-thirds of the world's child population presents with vision impairment (VI) due to uncorrected refractive errors. While systematic reviews have shown that VI can significantly impact children's depression and anxiety, none have reviewed the existing literature on the association between spectacle correction and well-being. This review aims to address this knowledge gap. The main outcome measures were i) cognitive and education well-being which included mathematics and english literacy, reading fluency, school function, academic performance and grades; ii) psychological and mental health well-being which included physical anxiety, learning anxiety and mental health test scores and iii) quality of life. We searched eight databases for articles published between 1999 to 2021 that assessed the associations between spectacle correction and children's (0 to 18 years) well-being. There were no restrictions on language or geographic location. Two reviewers independently screened all publications using validated quality checklists. The findings of the review were analysed using narrative synthesis. [PROSPERO CRD42020196847]. Of 692 records found in the databases, six randomised control trials, one cohort, one cross-sectional and one qualitative study (N = 9, 1.3%) were eligible for analysis. Data were collected from 25 522 children, 20 parents and 25 teachers across the nine studies. Seven were rated as good quality (67 to 100% of quality criteria fulfilled), and two were satisfactory (33 to 66% of quality criteria fulfilled). Spectacle correction was found to improve children's educational well-being (n = 4 very strong evidence; n = 2 strong evidence), quality of life (n = 1, very strong evidence) and decrease anxiety and increase mental health scores (n = 1, strong evidence). Evidence suggests that spectacle correction improves children's cognitive and educational well-being, psychological well-being, mental health, and quality of life. More research is needed, given the paucity of published literature and the focus on only three aspects of well-being.
Despite being preventable, healthcare-associated infections are known primary causes of patient mortality and morbidity, threatening global public health. Though it is believed that one competent and dedicated cleaning staff member given the right tools and enough time can prevent more health-care-associated infectious diseases than a room full of doctors and nurses can cure, it was discovered in Letaba Hospital of the Limpopo Province, South Africa, that knowledge and practices of infection control among cleaning staff were not optimal. The proposed study aims to evaluate the impact of training interventions on cleaners' knowledge levels and practices. In Phase 1, cleaners' pre-training knowledge level, practices, and perceptions regarding correct cleaning techniques will be assessed through qualitative, individual, in-depth interviews. The initial question will read, "Describe the steps you follow when cleaning at this health facility and why?" In Phase 2a, a cleaning training program will be developed based on the South African Qualification Authority ID 118730 Healthcare Cleaner: Occupational Certificate Curriculum and the Center for Diseases Control and ICAN's Best Practices for Environmental Cleaning in Healthcare Facilities in Resource-Limited Settings. In Phase 2b, a cleaning training intervention will be implemented. In Phase 3, cleaners' post-training knowledge level, practices, and perceptions will be reassessed and compared to pre-training findings. The Standard Protocol Items: Recommendations for an Interventional Trial, commonly known as SPIRIT, guided the development of this protocol. This protocol received ethical clearance number FHS/22/PH/04/3005 in August 2023 from the University of Venda Human and Clinical Trials Research Ethics Committee. The protocol approval was granted by the Limpopo Provincial Department of Health (LP_2022-05-028) in October 2023. This protocol is registered with the South African National Clinical Trial Registry. The findings of this study may provide baseline data upon which healthcare facilities' cleaner training qualification curriculum may be developed. In addition, this protocol contributes to the application of qualitative methodology in an intervention trial.
Despite changing clinical care dynamics, health professions education has been slow in addressing gaps in leadership development as teaching and assessment of clinical care-related knowledge, skills, and attitudes remain central across curricula. While accreditation standards across health professions programs acknowledge the importance of leadership development within curricula, it remains an underrepresented aspect of health professions training. Given the varied approach to leadership training, we set out to develop a tailored approach to leadership development that integrated the Center for the Advancement of Pharmacy Education (CAPE) outcomes and was based on self-awareness, skill-building, and application. This pilot included three cohorts of doctor of pharmacy students and measured their knowledge, skills, and self-awareness as they progressed through this year-long program. It also measured leadership competency attainment using a pre- and post-assessment in one cohort. Participant satisfaction was assessed using session and program evaluations, while self-perception of growth and leadership competency attainment was assessed using a survey that was administered before and after program participation. Participants found the program to be beneficial in meeting stated objectives and in creating a conducive learning environment. Results of the pre- and post-assessment indicated growth in all dimensions of self-perception of knowledge, skills, and self-awareness, as well as attainment of leadership competency personal leadership commitment and leadership knowledge. Offering co-curricular leadership development programs based on CAPE outcomes and leadership competencies provided students with the opportunity to develop leadership skills and acquire knowledge needed to be effective healthcare leaders.
Despite continued critique of the idea of clear boundaries between scientific and lay knowledge, the 'deficit-model' of public understanding of ecological issues still seems prevalent in discourses of biodiversity management. Prominent invasion biologists, for example, still argue that citizens need to be educated so that they accept scientists' views on the management of non-native invasive species. We conducted a questionnaire-based survey with members of the public and professionals in invasive species management (n = 732) in Canada and the UK to investigate commonalities and differences in their perceptions of species and, more importantly, how these perceptions were connected to attitudes towards species management. Both native and non-native mammal and tree species were included. Professionals tended to have more extreme views than the public, especially in relation to nativeness and abundance of a species. In both groups, species that were perceived to be more abundant, non-native, unattractive or harmful to nature and the economy were more likely to be regarded as in need of management. While perceptions of species and attitudes towards management thus often differed between public and professionals, these perceptions were linked to attitudes in very similar ways across the two groups. This suggests that ways of reasoning about invasive species employed by professionals and the public might be more compatible with each other than commonly thought. We recommend that managers and local people engage in open discussion about each other's beliefs and attitudes prior to an invasive species control programme. This could ultimately reduce conflict over invasive species control.
Despite continuous improvements in anti-rheumatic pharmacological treatment, people with chronic inflammatory arthritis still report substantial disease impact. Based on the framework for complex interventions, we thus developed INSELMA, a novel nurse-coordinated multidisciplinary self-management intervention for patients with rheumatoid arthritis, psoriatic arthritis or axial spondyloarthritis. Based on individual biopsychosocial assessments, a rheumatology nurse facilitated goal setting and coordinated interdisciplinary support. The aim of this study was to explore the patients' experience of participating in the six-months INSELMA intervention. Individual semi-structured interviews were conducted with 15 of the participants after their final follow-up. Thematic analysis was applied. The analysis derived four overall themes. (1) A new opportunity at the right time. The participants' disease impacted all areas of daily life. Participation in INSELMA was experienced as an opportunity to improve symptoms and together reduce long-held challenges they had fought alone, until now. (2) The importance of person-centred goals. The participants found it meaningful to work with their individual goals, which encompassed physical, psychological, and social factors. Having time between consultations to work with goals at home was important. (3) Empathy, partnership and a little nudging from health professionals are essential. The empathic nurses' continuous support and coaching helped participants become aware of their own resources. The participants highlighted having access to support from a physiotherapist and occupational therapist with rheumatology experience as important. (4) I got more than I could have hoped for. Most of the participants experienced decreased symptom load and improvement in physical strength, mobility, sleep, and mood as well as increased energy, knowledge, and self-management ability. The participants expressed new hope for the future with an improved ability to manage their symptoms and work towards new goals. The participants found the INSELMA intervention meaningful and feasible. They experienced decreased disease impact and increased activity levels, facilitated by empathy and self-management support from health professionals.
Despite decades of calls for increased diversity in the health research workforce, disparities exist for many populations, including Black, Indigenous, and People of Color individuals, those from low-income families, and first-generation college students. To increase representation of historically marginalized populations, there is a critical need to develop programs that strengthen their path toward health research careers. High school is a critically important time to catalyze interest and rebuild engagement among youth who may have previously felt excluded from science, technology, engineering, and mathematics (STEM) and health research careers. The overall objective of the MYHealth program is to engage high school students in a community-based participatory research program focused on adolescent health. Investigators will work alongside community partners to recruit 9th through 12th graders who self-identify as a member of a group underrepresented in STEM or health research careers (e.g., based on race and ethnicity, socioeconomic status, first generation college student, disability, etc.). MYHealth students are trained to be co-researchers who work alongside academic researchers, which will help them to envision themselves as scientists capable of positively impacting their communities through research. Implemented in three phases, the MYHealth program aims to foster a continuing interest in health research careers by developing: 1) researcher identities, 2) scientific literacy, 3) scientific self-efficacy, and 4) teamwork and leadership self-efficacy. In each phase, students will build knowledge and skills in research, ethics, data collection, data analysis, and dissemination. Students will directly collaborate with and be mentored by a team that includes investigators, community advisors, scientific advisors, and youth peers. Each year, a new cohort of up to 70 high school students will be enrolled in MYHealth. We anticipate the MYHealth program will increase interest and persistence in STEM and health research among groups that have been historically excluded in health research careers.