bluuebunny/crossref_metadata_2025 huggingface dataset:
Definitions of Sustainable Leadership in Education: A Systematic Review and Analysis
Authors: Ali Mohammad Al-khamaiseh Ra’ed , Bailey Richard Peter , Jarvis Adrian
Published: October 2024

Sustainable leadership has become a significant focus in educational leadership. Still, concerns persist regarding the clarity of its definitions and their impact addressing critical educational needs. This study employs a systematic review to address these definitional challenges. Seven themes emerge, categorized into three meta-themes: effectiveness and impact, sustainability systems thinking, and collaborative responsibility and future orientation. These findings reveal the diversity of sustainable leadership themes and challenge the assumption that achieving a universal definition is the key to collaborative progress. This methodologically rigorous study enhances our understanding of sustainable leadership in education, offering valuable insights for further research.
Climate Change and Environmentally Sustainable Kidney Care in Canada: A Knowledge, Attitudes, and Practices Survey of Kidney Care Providers
Authors: Ethier Isabelle , Sandal Shaifali , Tarakji Ahmad Raed , Finkle S. Neil , Kahlon Bhavneet , Pederson Kristen , Samanta Ratna , Stigant Caroline
Published: October 2024

Background:

Climate change impacts health and threatens the stability of care delivery systems, while healthcare is mobilizing to reduce its significant environmental impact.

Objective:

This study aimed to assess knowledge, attitudes, and practices (KAP) about climate change among Canadian kidney care providers.

Design, setting, participants, measurements, and methods:

An electronic KAP survey, created by the Canadian Society of Nephrology-Sustainable Nephrology Action Planning committee, was distributed to kidney care providers across Canada, from March to April 2023.

Results:

A total of 516 people responded to the survey. Most respondents (79%) identified as women; 83% were aged 30 to 59 years. Nurses and nephrologists made up 44% and 23% of respondents, respectively. About half of the participants felt informed about climate change to an average degree. Most respondents (71%; 349/495 and 62%; 300/489) were either extremely or very concerned about climate change and waste generated in their kidney care program, respectively. The vast majority of respondents (89%; 441/495) reported taking steps to lower their personal carbon footprint. People who felt more informed about climate change presented higher degrees of concern. Similarly, both those who felt more informed and those who reported higher degrees of concern about climate change were more likely to take steps to reduce their carbon footprint. Over 80% of respondents (314/386) were at least moderately interested in learning sessions about environmentally sustainable initiatives in care.

Limitations:

This survey is at risk of social acceptability, representative, and subjective bias. Overrepresentation from Quebec and British Columbia, as well as the majority of respondents identifying as women and working in academic centers, may affect generalizability of the findings.

Conclusions:

Most kidney care providers who responded to this survey are informed and concerned about climate change, and their knowledge is directly associated with attitude and practices. This indicates that educational initiatives to increase awareness and knowledge on climate change will likely lead to practice changes.
Machine learning in female urinary incontinence: A scoping review
Authors: Wang Qi , Wang Xiaoxiao , Jiang Xiaoxiang , Lin Chaoqin
Published: October 2024

Introduction and Hypothesis

The aim was to conduct a scoping review of the literature on the use of machine learning (ML) in female urinary incontinence (UI) over the last decade.

Methods

A systematic search was performed among the Medline, Google Scholar, PubMed, and Web of Science databases using the following keywords: [Urinary incontinence] and [(Machine learning) or (Predict) or (Prediction model)]. Eligible studies were considered to have applied ML model to explore different management processes of female UI. Data analyzed included the field of application, type of ML, input variables, and results of model validation.

Results

A total of 798 papers were identified while 23 finally met the inclusion criteria. The vast majority of studies applied logistic regression to establish models (91.3%, 21/23). Most frequently ML was applied to predict postpartum UI (39.1%, 9/23), followed by de novo incontinence after pelvic floor surgery (34.8%, 8/23).There are also three papers using ML models to predict treatment outcomes and three papers using ML models to assist in diagnosis. Variables for modeling included demographic characteristics, clinical data, pelvic floor ultrasound, and urodynamic parameters. The area under receiver operating characteristic curve of these models fluctuated from 0.56 to 0.95, and only 11 studies reported sensitivity and specificity, with sensitivity ranging from 20% to 96.2% and specificity from 59.8% to 94.5%.

Conclusion

Machine learning modeling demonstrated good predictive and diagnostic abilities in some aspects of female UI, showing its promising prospects in near future. However, the lack of standardization and transparency in the validation and evaluation of the models, and the insufficient external validation greatly diminished the applicability and reproducibility, thus a focus on filling this gap is strongly recommended for future research.
Designing machine learning for big data: A study to identify factors that increase the risk of ischemic stroke and prognosis in hypertensive patients
Authors: Gong Lingmin , Chen Shiyu , Yang Yuhui , Hu Weiwei , Cai Jiaxin , Liu Sitong , Zhao Yaling , Pei Leilei , Ma Jiaojiao , Chen Fangyao
Published: October 2024

Background

Ischemic stroke (IS) accounts large amount of stroke incidence. The aim of this study was to discover the risk and prognostic factors that affecting the occurrence of IS in hypertensive patients.

Method

Study data were obtained from the Medical Information Mart for Intensive Care (MIMIC)-IV database. To avoid biased factors selection process, several approaches were studied including logistic regression, elastic net regression, random forest, correlation analysis, and multifactor logistic regression methods. And seven different machine-learning methods are used to construct predictive models. The performance of the developed models was evaluated using AUC (Area Under the Curve), prediction accuracy, precision, recall, F1 score, PPV (Positive Predictive Value) and NPV (Negative Predictive Value). Interaction analysis was conducted to explore potential relationships between influential factors.

Results

The study included 92,514 hypertensive patients, of which 1746 hypertensive patients experienced IS. The Gradient Boosted Decision Tree (GBDT) model outperformed the other prediction model terms of prediction accuracy and AUC values in both ischemic and prognosis cases. By using the SHapley Additive exPlanations (SHAP), we found that a range of factors and corresponding interactions between factors are important risk factors for IS and its prognosis in hypertensive patients.

Conclusion

The study identified factors that increase the risk of IS and poor prognosis in hypertensive patients, which may provide guidance for clinical diagnosis and treatment.
The Influence of BookTok on Literary Criticisms and Diversity
Authors: De Melo Alysia
Published: October 2024

BookTok, a TikTok community where creators discuss and review books, influences the publishing industry as books that gain popularity on TikTok have seen mainstream success. BookTok is believed to be a diverse space where stories about marginalized identities are celebrated. This is in opposition to the traditional publishing world that is dominated by White, heterosexual, cis-gendered men. However, despite misconceptions, online spaces are notably homogeneous, and TikTok does not appear to diverge from these patterns. By analyzing 55 TikTok videos collected from the BookTok community, this study analyzes the race, gender, and sexual orientation of TikTok creators, authors, and main characters of BookTok books. This article aims to understand the effects social media applications such as TikTok have on the publishing world and to understand BookTok’s relation to diversity. While there is more gender equity among the authors of BookTok than in the traditional publishing world, there continues to be a deficiency in the prevalence of marginalized authors on the platform. Although women creators and women authors are popular on the app, most of these women are White. In addition, the authors who are most discussed on BookTok do not typically include persons of color or members of the LGBTQ+ community. The tendency for authors to write about their own experiences results in there being few characters of color and few books about members of the LGBTQ+ community. Publishing houses should prioritize increased collaboration with authors of color and LGBTQ+ authors, while also using BookTok to promote and advertise their work.
Visualizing Authority: Rise of the Religious Influencers on the Instagram
Authors: Febrian Harry
Published: October 2024

Roles of various social media influencers—ranging from health and beauty to security—in our society have increasingly become essential topics in the study of social media. However, little is known about the rise of religious influencers in the Global South and the way they negotiate the idea of religious authority in today’s society. To address this gap, this study investigates the way in which religious influencers project their authority through the visual means of Instagram. This study collects Instagram posts ( n = 9,801) from three Islamic religious influencers in Indonesia—the largest Muslim-populated country and the third largest democracy in the world—with a combined follower count of 30 million people. Content analysis is then used to uncover the main strategies in which a sense of authority is visualized in their posts. The findings demonstrate that Indonesian religious influencers mainly used a close-up approach—friendly and informal appearance—to negotiate their visual authority as opposed to the rigid, more distant approach of traditional religious figures. However, to mitigate the risk of becoming too close and losing the respect and veneration of their followers, they adopt strategic distancing through the use of visual versus textual contrast, setting, and focus. The results extend scholarly discussion on religious influencers in the Islamic faith and their visual authority enactment on social media.
Christian perspectives on music education: A framework for teaching to reach heads, hearts, and hands
Authors: Blake Jody N
Published: October 2024

The purpose of this article is to present a Christian perspective on teaching music. Throughout history, Christianity has pervaded the field of music education, impacting the way and the reasons music is taught. This article presents a brief review of historical and theological concepts relating to the philosophy of music education, with specific attention given to orthodoxy, orthopathos, and orthopraxis (or in simpler terms, head, heart, and hands). A preliminary philosophical framework is presented for incorporating the concept of teaching music to educate heads, hearts, and hands.
Structural and Functional Alterations of the Deltoid Muscle After Arthroscopic Rotator Cuff Repair: A 2-Year Longitudinal Observation Study
Authors: Seto Tetsuya , Yukata Kiminori , Fujii Kenzo , Uehara Kazuya , Yamagata Hiroki , Mihara Atsushi , Iwanaga Ryuta , Funaba Masahiro , Imajo Yasuaki , Fujii Hiroshi , Doi Kazuteru , Sakai Takashi
Published: October 2024

Background:

Deltoid muscle detachment and atrophy have been reported to occur after shoulder surgery.

Purpose:

To investigate the 2-year changes in deltoid muscle structure and function after arthroscopic rotator cuff repair (ARCR) using magnetic resonance imaging (MRI) and electrophysical examination.

Study Design:

Case series; Level of evidence, 4.

Methods:

A total of 72 patients (72 shoulders) who underwent ARCR between 2015 and 2020 were enrolled. Whole deltoid muscle volume and regional (anterior, lateral, and posterior) muscle thicknesses were determined on T2-weighted MRI scans of both shoulders taken preoperatively and at 1, 3, 6, 12, and 24 months postoperatively, and their correlations with compound muscle action potentials (CMAPs), shoulder abduction muscle strength, and Constant scores were investigated. Comparison between groups was performed using paired or Student t tests, and the relationship between deltoid muscle volume and various factors was determined using Pearson correlation analysis.

Results:

The volume of the deltoid muscle on the affected side decreased from 44,369 ± 12,371 mm3 preoperatively to 38,139 ± 10,615 mm3 at 1 month postoperatively ( P < .05), representing a 14% decrease. The deltoid muscle volume of the contralateral side also significantly decreased during the same time frame, from 43,278 ± 12,248 to 40,273 ± 11,464 mm3 ( P < .05), representing a 7% decrease at 1 month postoperatively. Subsequently, the deltoid muscle volume on both sides recovered to preoperative levels at 12 months and was maintained at 24 months. Only the thickness of the anterior part of the deltoid was markedly decreased, from 13.9 ± 3.7 mm preoperatively to 12.0 ± 3.2 mm at 1 month postoperatively ( P < .05), representing a 14% reduction. The CMAP amplitude showed a significant decrease at 1 month postoperatively; however, no significant difference was observed after 12 months when compared with the preoperative values or the values on the contralateral side. Positive correlations were found between deltoid muscle volume and CMAP amplitude at 24 months as well as between deltoid muscle volume and shoulder abduction muscle strength ( R2 = 0.698; P < .05) and Constant score ( R2 = 0.133; P < .05).

Conclusion:

Our study demonstrated that the early structural and functional decline of the deltoid muscle after ARCR was fully recovered within 1 year, confirming that this procedure does not negatively affect the deltoid muscle.
The Usefulness of Peer Tutoring and its Impact on Nursing Students’ Academic Performance, Psychological Empowerment, and Satisfaction: Pre-Post Design
Authors: Al Yahyaei Asma , Natarajan Jansi Rani , Seshan Vidya , Joseph Mickael Antoine , Valsaraj Blessy Prabha , Hamed Al Abri Fatema
Published: October 2024

Introduction

The entry to a professional course such as nursing is challenging for the students, due to its multifaceted curriculum and learning expectations.

Objectives

This study investigates the impact of peer tutoring on academic performance, psychological empowerment, and satisfaction among first-year nursing students.

Methods

A quantitative approach with one-group pre-test post-test design was utilized. The study participants were 104 students, with 98 completing both pre- and post-test assessments.

Results

Findings revealed a significant increase in academic performance following peer tutoring (t = 8.97, p < .001), particularly among female participants (t = 4.14, p < .001). Analysis of perceived usefulness showed higher ratings among peer tutors compared to tutees (t = 4.380, p =< .000). Additionally, students with lower GPAs (Grade Point Average) demonstrated significant improvement in academic performance post-tutoring in the ANOVA (F = 6.214, p < .001). A positive correlation was found between psychological empowerment and the perceived usefulness of peer tutoring. Peer tutors reported high levels of satisfaction and positive experiences (r = 0.639, p = 0.001).

Conclusion

This study emphasises the value of peer tutoring in enhancing academic outcomes and highlights the significance of demographic variables in educational interventions. The need for widespread implementation of peer tutoring programs, personalized approaches addressing gender biases, and comprehensive support for students with diverse academic backgrounds would enhance academic outcomes. The correlation between psychological empowerment and the perceived usefulness of peer tutoring climaxes the importance of addressing students’ psychological needs in educational interventions.
Secondary Chondrosarcoma of the Rib in a Case of Diaphyseal Aclasis: A Rare Case Report
Authors: Mohammed Abin , Nair Hari S , Rahman Ebin
Published: October 2024

Hereditary multiple exostosis has a 3%–5% chance of converting into chondrosarcoma. It is a rare case report of a 32-year-old female with hereditary multiple exostosis who presented with pain and progressive swelling over her right chest wall for 3 months. A clinical examination revealed a large globular swelling over her right chest. Imaging revealed a large, ill-defined, aggressive, and exophytic lesion with a thick cartilage cap arising from the 8th rib. The lesion was hypermetabolic and avid on PET CT scan. She underwent a core needle biopsy which showed features of malignant transformation. En-bloc resection of the tumor with 7, 8, and 9 ribs followed by plate and mesh reconstruction was carried out.
Gender and couple status differences in advance care planning: a cross-sectional study
Authors: Baughman Kristin R. , Ludwick Ruth , Audi Ashley , Harlan Laura
Published: October 2024

Background:

Past studies have shown mixed results on how gender and living with a spouse or partner impact advance care planning (ACP). Few if any have tested for the interaction between these two variables.

Objective:

We examined how gender and couple status interact to impact the use of ACP practices including written instructions, designating a durable power of attorney for healthcare (DPOAHC), and discussing one’s decisions with others.

Design:

We used cross-sectional data taken from the Health and Retirement Study, a longitudinal study of adults over the age of 50 in the United States.

Methods:

Data are from 632 respondents who died between the 2016 core survey and the 2018 exit survey. Participants had completed the 2016 survey and had a proxy informant complete the 2018 exit survey after their death. Generalized linear mixed models were used to test for main effects and interactions.

Results:

Women were more likely than men to designate a DPOAHC and to discuss their wishes with others. Women living without a partner were more likely than men living without a partner and coupled households to discuss their wishes with family or others.

Conclusion:

Both gender and couple status are important variables associated with ACP practices. Healthcare providers may want to reach out to women living within a coupled household and men living without a partner to ensure that they know the benefits of ACP.
Utility of smart watch in expediting diagnosis of cold drink-triggered atrial fibrillation: a case report
Authors: Heringer Grace V. , Vinson David R.
Published: October 2024

Background

Patients presenting to the emergency department with recent palpitations are a diagnostic challenge when the arrhythmia and its symptoms have resolved prior to arrival. Newer smart watch technology, adept at detecting atrial fibrillation, can assist in the diagnostic evaluation of transitory palpitations. We report a case of cold drink-triggered atrial fibrillation whose diagnosis would not have been possible without the assistance of the patient’s smart watch.

Case presentation

A middle-aged man without cardiac history developed sudden rapid, irregular palpitations with shortness of breath while drinking a glass of cold juice. He activated his smart watch with 1-lead electrocardiography technology which detected rapid atrial fibrillation. He sought medical care, but while waiting, his symptoms—then 90 min in duration—spontaneously resolved. His initial diagnostic evaluation documented only sinus rhythm, as did several follow-up evaluations with cardiology the next several weeks. Had it not been for his smart watch, the etiology of his transitory palpitations would have remained undiagnosed. His physicians encouraged trigger avoidance. In the following months, he avoided rapid ingestion of cold drink, taking instead small sips. The atrial fibrillation has not recurred.

Conclusions

The case illustrates the valuable contribution of smart watch technology in the diagnostic evaluation of patients with short-lived palpitations. The case also educates clinicians about cold drink and food as a trigger of paroxysmal atrial fibrillation. This trigger, like alcohol, can be modified. Cold drink trigger avoidance has been reported by patients to reduce atrial fibrillation recurrence and is a low-risk, cost-effective strategy that is often successful.
Cytomegalovirus chronic retinal necrosis with ganciclovir resistance: a case report
Authors: Xia Julia , Kantipudi Sanjana , Striebich Christopher C. , Henao-Martinez Andrés F. , Manoharan Niranjan , Palestine Alan G. , Reddy Amit K.
Published: October 2024

Background

Cytomegalovirus (CMV) chronic retinal necrosis (CRN) is a rare viral retinal infection that occurs in mildly immunocompromised people. It shares some features with both acute retinal necrosis and CMV retinitis. It is typically treated with combination intravitreal and systemic ganciclovir. We discuss the management of a case of CMV CRN with ganciclovir resistance.

Case presentation

An 80-year-old female presented with one month of blurry vision in the left eye. She was being treated with abatacept, methotrexate, and prednisone for rheumatoid arthritis. Examination revealed anterior chamber and vitreous cell along with peripheral retinal whitening. Fluorescein angiogram showed diffuse retinal non-perfusion. Aqueous fluid PCR testing returned positive for CMV. The retinitis was initially controlled with oral and intravitreal ganciclovir, but then recurred and progressed despite these therapies. Ganciclovir resistance was suspected and the patient was switched to intravitreal foscarnet injections, along with oral letermovir and leflunomide, which lead to resolution of the retinitis. The patient has now continued with letermovir and leflunomide for approximately 2.5 years without reactivation of the retinitis or need for further intravitreal anti-viral injections and with adequate control of her rheumatoid arthritis.

Conclusion

The incidence of CMV CRN may increase in the future as the use of non-cytotoxic immunosuppressive therapies that result in relatively mild immunosuppression also increases. Treatment with ganciclovir is effective but frequently leads to resistance, as in our case. In this situation, combination therapy with letermovir and leflunomide, particularly in the setting of rheumatoid arthritis where leflunomide can also have an anti-inflammatory effect, can be considered.
NeuroimaGene: an R package for assessing the neurological correlates of genetically regulated gene expression
Authors: Bledsoe Xavier , Gamazon Eric R.
Published: October 2024

Background

We present the NeuroimaGene resource as an R package designed to assist researchers in identifying genes and neurologic features relevant to psychiatric and neurological health. While recent studies have identified hundreds of genes as potential components of pathophysiology in neurologic and psychiatric disease, interpreting the physiological consequences of this variation is challenging. The integration of neuroimaging data with molecular findings is a step toward addressing this challenge. In addition to sharing associations with both molecular variation and clinical phenotypes, neuroimaging features are intrinsically informative of cognitive processes. NeuroimaGene provides a tool to understand how disease-associated genes relate to the intermediate structure of the brain.

Results

We created NeuroimaGene, a user-friendly, open access R package now available for public use. Its primary function is to identify neuroimaging derived brain features that are impacted by genetically regulated expression of user-provided genes or gene sets. This resource can be used to (1) characterize individual genes or gene sets as relevant to the structure and function of the brain, (2) identify the region(s) of the brain or body in which expression of target gene(s) is neurologically relevant, (3) impute the brain features most impacted by user-defined gene sets such as those produced by cohort level gene association studies, and (4) generate publication level, modifiable visual plots of significant findings. We demonstrate the utility of the resource by identifying neurologic correlates of stroke-associated genes derived from pre-existing analyses.

Conclusions

Integrating neurologic data as an intermediate phenotype in the pathway from genes to brain-based diagnostic phenotypes increases the interpretability of molecular studies and enriches our understanding of disease pathophysiology. The NeuroimaGene R package is designed to assist in this process and is publicly available for use.
Global burden of atrial fibrillation attributable to high body mass index from 1990 to 2021: findings from the Global Burden of Disease Study 2021
Authors: Kong Xiangmeng , Wang Mingliang , Jiang Yumei
Published: October 2024

Objectives

To assess the global burden of atrial fibrillation (AF) attributable to high body mass index (BMI) from 1990 to 2021 and analyze its spatiotemporal distribution characteristics.

Study design

An observational study based on GBD 2021 data.

Methods

Data on AF burden due to high BMI were obtained from the Global Burden of Disease Study (GBD) 2021. Estimated annual percentage change (EAPC) was calculated to evaluate temporal trends in age-standardized rates of deaths and disability-adjusted life years (DALYs) over 30 years.

Results

In 2021, high BMI-related AF caused 27,000 deaths and 725,000 DALYs globally, a 376% increase since 1990. Females and the elderly (aged 70+) bore a higher burden. Upper-middle-income regions surpassed high-income regions in AF burden. Australasia had the highest age-standardized rates, while High-income Asia Pacific and South Asia had the lowest. South Asia showed rapid growth in age-standardized death rates.

Conclusion

The global burden of high BMI-related AF varies across regions and time, threatening global health, especially for females and the elderly. Targeted strategies are needed to reduce AF and obesity.
The performance of screening tools and use of blood analyses in prehospital identification of sepsis patients and patients suitable for non-conveyance - an observational study
Authors: Olander Agnes , Frick Lina , Johansson Jennifer , Wibring Kristoffer
Published: October 2024

Background

Early recognition of sepsis by the EMS (Emergency Medical Services), along with communicating this concern to the emergency department, could improve patient prognosis and outcome. Knowledge is limited about the performance of sepsis identification screening tools in the EMS setting. Research is also limited on the effectiveness of prehospital use of blood tests for sepsis identification. Integrating blood analyses with screening tools could improve sepsis identification, leading to prompt interventions and improved patient outcomes.

Aim

The aim of the present study is firstly to evaluate the performance of various screening tools for sepsis identification in the EMS setting and secondly to assess the potential improvement in accuracy by incorporating blood analyses.

Methods

This is a retrospective observational cohort study. The data were collected from prehospital and hospital medical records in Region Halland. Data on demographics, vital signs, blood tests, treatment, and outcomes were collected from patients suspected by EMS personnel of having infection. The data were analysed using Student’s t-test. Sensitivity, specificity, positive predictive value, negative predictive value and odds ratio were used to indicate accuracy and predictive value.

Results

In total, 5,405 EMS missions concerning 3,225 unique patients were included. The incidence of sepsis was 9.8%. None of the eleven tools included had both high sensitivity and specificity for sepsis identification. White blood cell (WBC) count was the blood analysis with the highest sensitivity but the lowest specificity for identifying sepsis. Adding WBC, C-reactive protein (CRP) or lactate to the National Early Warning Score (NEWS) increased the specificity to > 80% but substantially lowered the sensitivity.

Conclusions

Identifying sepsis in EMS settings remains challenging, with existing screening tools offering limited accuracy. CRP, WBC, and lactate blood tests add minimal predictive value in distinguishing sepsis or determining non-conveyance eligibility.
Do authors of systematic reviews of epidemiological observational studies assess the methodologies of the included primary studies? An empirical examination of methodological tool use in the literature
Authors: Kemper Fabian , Faggion Clovis Mariano
Published: October 2024

Background

The procedures used to assess the methodological quality and risk of bias (RoB) of systematic reviews of observational dental studies have not been investigated. The purpose of this research was to examine the way that authors of systematic reviews of epidemiological observational studies published in dentistry conducted the methodological assessment of those primary studies. In the present article, we aimed to assess the characteristics and the level of reporting of tools used to assess the methodologies of these reviews.

Methods

We searched Scopus and the Web of Science from their inceptions to June 2023 for systematic reviews with meta-analyses of observational studies published in dentistry. Document selection and data extraction were performed in duplicate and independently by two authors. In a random sample of 10% of the systematic reviews, there was an agreement of more than 80% between the reviewers; data selection and extraction were conducted in the remaining 90% of the sample by one author. Data on the article and systematic review characteristics were extracted and recorded for descriptive reporting.

Results

The search in the two databases resulted in the inclusion of 3,214 potential documents. After the elimination of duplicates and the application of the eligibility criteria, a total of 399 systematic reviews were identified and included. A total of 368 systematic reviews reported a methodological tool, of which 102 used the Newcastle–Ottawa scale. Additionally, 76 systematic reviews stated the use of a modified methodological tool. Information about the approach of assessing the methodological quality or RoB of primary studies but reporting no tool or tool name occurred in 25 reviews.

Conclusions

The majority of authors of systematic reviews of epidemiological observational studies published in dentistry reported the tools used to assess the methodological quality or RoB of the included primary studies. Modifying existing tools to meet the individual characteristics of various studies should be considered.
Heterogeneity in the association between social support and mental distress in old-age retirees – a computational approach using longitudinal cohort data
Authors: Lahelma Jere , Lahelma Eero , Laaksonen Mikko , Kuivalainen Susan , Koivisto Mikko , Lallukka Tea
Published: October 2024

Background

Mental distress among retirees and older people is a severe public health challenge, and information on new risk groups is needed. This study aims to identify subgroups of old-age retirees with varying associations between low social support and mental distress by applying model-based recursive partitioning (MOB).

Methods

We used the Helsinki Health Study follow-up survey data of old-age retired former municipal sector employees of the City of Helsinki, Finland. Phase 1 data were collected in 2000–2002, when all participants were employed, Phase 2 in 2007, Phase 3 in 2012, Phase 4 in 2017, and Phase 5 in 2022 (n = 4,466, 81% women). Social support and covariates were measured at each Phase 1–5 and the outcome, mental distress (Depression Anxiety Stress Scales [DASS-21]) was measured at a single occasion, during Phase 5. The three subscales and the common factor of general distress were analysed separately. An approach rooted in computational statistics was used to investigate risk factor heterogeneity in the association of low social support and mental distress. MOB combines decision trees with regression analysis to identify subgroups with the most significant heterogeneity among risk factors.

Results

Median (IQR) general distress score from DASS-21 was 5.7 (3.0, 9.0), while Social Support Questionnaire number-score (SSQN) was 1.5 (1.15, 2.05). The primary effect modifier for the association between social support and general distress was education (p < 0.001). Those with high education had a different association of low social support and general distress than those with low or medium education. Additionally, the subgroup with low and medium education had a significant effect modification for age (p = 0.01). For the association between low social support and depressive symptoms, the moderating effect of education was dependent on gender, as men with medium–high education had the weakest association, while for women with medium–high education the association was strongest.

Conclusions

Our results suggest that stratification by sociodemographic variables is justifiable when investigating risk factors of mental distress in old-age retirees. The incongruent association of low social support and depressive symptoms in men with medium–high education compared to women with medium–high education is a promising target for confirmatory research.
Impact of bacterial co-isolation on treatment initiation and long-term prognosis of patients with nontuberculous mycobacterial pulmonary disease: analysis of a prospective cohort study
Authors: Kim Joong-Yub , Kim Sung A , Hyung Kwonhyung , Yim Jae-Joon , Kwak Nakwon
Published: October 2024

Background

Nontuberculous mycobacterial pulmonary disease (NTM-PD), a chronic respiratory condition, presents a growing challenge globally. Uncertainties exist regarding the impact of concurrent bacterial co-isolation on treatment initiation and long-term prognosis.

Methods

This study analysed data from participants enrolled in an ongoing prospective observational cohort study on NTM-PD (NCT01616745) between 1 July 2011, and 31 December 2022, who provided sputum samples for bacterial culture at enrolment. Identification of potential pathogenic microorganisms (PPMs) was defined as a positive bacterial culture. Clinical characteristics were compared between NTM-PD patients with Pseudomonas, non-pseudomonal PPMs, and those without PPM co-isolation. Cox proportional hazard regression models were employed to assess the association of bacterial co-isolation with rates of NTM-PD treatment initiation and all-cause mortality.

Results

Overall, 453 patients (median age, 62 years; 30% male) were included in the analysis. PPMs were co-isolated in 77 patients (17%), including 13 with Pseudomonas species. Co-isolation of Pseudomonas was associated with a significantly higher erythrocyte sedimentation rate (P = 0.02) and St. George’s Respiratory Questionnaire score (P = 0.01). Non-pseudomonal PPM co-isolation was significantly associated with a higher likelihood of NTM-PD treatment initiation (adjusted hazards ratio [aHR], 1.56, 95% confidence interval [CI], 1.03–2.36, P = 0.036), whereas co-isolation of Pseudomonas was independently correlated with increased all-cause mortality (aHR, 3.25, 95% CI, 1.08–9.84, P = 0.037).

Conclusions

Our findings emphasize the importance of microbial surveillance, as bacterial co-isolation affects treatment initiation and prognosis in patients with NTM-PD.
Decoding oxygen prescriptions: electronic health record documentation versus patient-reported use
Authors: Tang Wilson , Smith J. , Dakkak J. , Balasubramanian A. , Seth B. , Leotta C. , Mathai S. C. , McCormack M. C. , Acharya S. , Calypso A. , Danoff S. K.
Published: October 2024

Background

Long term oxygen therapy (LTOT) is prescribed for hypoxemia in pulmonary disease. Like other medical therapies, LTOT requires a prescription documenting the dosage (flow rate) and directions (at rest, with activity) which goes to a supplier. Communication with patients regarding oxygen prescription (flow rate, frequency, directions), monitoring (pulse oximetry) and dosage adjustment (oxygen titration) differs in comparison with medication prescriptions. We examined the communication of oxygen management plans in the electronic health record (EHR), and their consistency with patient-reported LTOT use.

Study design and methods

A cross-sectional study was conducted in 71 adults with chronic lung disease on LTOT. Physician communication regarding oxygen management was obtained from the EHR. Participants were interviewed on their LTOT management plan. The information from each source was compared.

Results

The study population was, on average, 64 years, two-thirds women, and most used oxygen for over 3 years. Only 45% of both at-rest and with-activity oxygen prescriptions were documented in the Electronic Health Record (EHR). Less than 20% of prescriptions were relayed to the patient in the after-visit summary. Of those with EHR-documented oxygen prescriptions, 44% of patients adhered to prescribed oxygen flow rates. Nearly all patients used a pulse oximeter (96%).

Interpretation

We identified significant gaps in communication of oxygen management plans from provider to patient. Even when the oxygen prescription was clearly documented, there were differences in patient-reported oxygen management. Critical gaps in oxygen therapy result from the lack of consistent documentation of oxygen prescriptions in the EHR and patient-facing documents. Addressing these issues systematically may improve home oxygen management.
The hidden link: dysmenorrhea, emotion regulation, and attitudes toward marriage in female nursing students
Authors: Amin Shaimaa Mohamed , El-Sayed Mona Metwally , El-Monshed Ahmed Hashem , Khedr Mahmoud Abdelwahab , Atta Mohamed Hussein Ramadan
Published: October 2024

Background

Menstrual pain, or dysmenorrhea, can cause physical discomfort and mood swings, potentially impacting the attitudes of female nursing students toward marriage. Effective emotion regulation strategies are essential for managing stress and shaping their perspectives on marriage. This study sought to investigate the relationship between dysmenorrhea, emotional regulation skills, and attitudes toward marriage among female nursing students.

Methods

A cross-sectional survey was conducted using a stratified sample of 504 female nursing students from four academic years. The study used a combination of the Working Ability, Location, Intensity, Days of Pain, Dysmenorrhea (WaLIDD) Questionnaire, the Marital Attitude Scale, and the Emotion Regulation Questionnaire to assess various factors among the participants. The Pearson correlation coefficient was utilized to examine the relationships among the three primary variables. Additionally, linear regression analysis was employed to forecast attitudes toward marriage based on factors such as dysmenorrhea, residence, family type, regularity of the menstrual cycle, and age at menarche.

Results

The findings of the study are significant, revealing a negative correlation between dysmenorrhea and marital attitudes (r = -0.105, p = 0.019). Dysmenorrhea exhibited minimal and non-significant correlations with emotion regulation strategies, including cognitive reappraisal (r = -0.006, p = 0.898) and expressive suppression (r = 0.013, p = 0.774). In contrast, marital attitudes significantly influenced emotion regulation (β = -0.169, p < 0.001). Moderation analyses indicated significant effects of various factors on marital attitudes, including residence (β = -0.5136, p = 0.0478), family type (β = 5.9923, p = 0.0060), regularity of the menstrual cycle (β = 6.1262, p = 0.0014), and age at menarche (β = 1.5521, p = 0.0491).

Conclusion

A significant negative correlation between dysmenorrhea and certain attitudes, specifically optimistic and realistic marital attitudes, was found. This indicates that higher levels of dysmenorrhea are associated with less favorable perspectives in these domains. Additionally, the study demonstrates that negative marital attitudes were linked to poorer emotional regulation. This suggests that individuals with more pessimistic views about marriage may face challenges in effectively managing their emotions. These results underscore the intricate connections between physical health, attitudes, and emotional well-being. They highlight the need to address dysmenorrhea within nursing education and practice, considering its broader psychological impact.
Navigating transitions: a qualitative study of nursing teams’ experiences of educational and cultural transitions in Germany
Authors: Schumann Marwa , Peppler Lisa , Beck Patricia , Schenk Liane
Published: October 2024

Background

The global migration of health professionals in general and nurses in particular, has led to nursing shortages and socioeconomic impacts on health systems in both source and destination countries. Adding to the complexity of the situation is the fact that the nursing profession itself is evolving from a vocational to an academic one. Although nursing migration and academization have been studied from either an institutional or an individual perspective, there is a gap in the literature regarding how nursing teams experience these transitions. This study aims to explore how nursing teams navigate through the transitions of academization and internationalization of the current dynamic nursing landscape in Germany.

Methods

Based on social constructivism epistemology this qualitative study involved face-to-face focus group discussions conducted at several hospital sites in Germany from September 2021 to May 2023. The focus group discussions were audio-recorded, transcribed, and analysed using content analysis; the four dimensions of transition theory according to Schlossberg’s Four S (4 S) framework (self, situation, support, and strategy) were used as a priori items to construct the coding framework.

Results

Nine focus group discussions were conducted with a total of 40 nurses from different educational and migrant backgrounds. The analysis showed that the transition experiences of the nursing teams were heterogeneous, with educational and national backgrounds playing an important role in how realistic their expectations of their professional roles and identities were. The dynamic situation characterized by a shortage of qualified nursing staff, increases the pressure on nursing teams and underscores the importance of employer-provided and peer support. Onboarding and communication are key strategies used depending on the duration of the employee turnover.

Conclusion

This study provides insights into the challenges and coping strategies of nursing teams in the current dynamic scene of migration, academicization and professional socialisation in Germany. Extending the Schlossberg 4 S framework from the individual to the team perspective provides a comprehensive view of the transitional experiences of nursing teams. Within each domain of the framework, the experiences of nursing teams are remarkably diverse. Educational background (vocational or academic) and origin (German or foreign trained) play an important role in shaping the transitional experiences of nursing teams.
Effective prevention of early resignation of newly graduated nurses: a transactional analysis
Authors: Ogawa Masanori , Ae Ryusuke , Sasahara Teppei , Omi Keiko
Published: October 2024

Background

New employees often exhibit stress reactions to changes in their environment and some of these may result in resignations. Employees in medical institutions are no exceptions. Considering the shortage of nurses in Japan, countermeasures are needed against the resignation of newly graduated nurses. Many studies have indicated that multifaced factors affect the resignation of newly graduated nurses. Even though individual characteristics are important factors in this regard, training and support for newly graduated nurses do not focus on the nurses’ characteristics. The purpose of this study is to examine the characteristics influencing the early resignation of newly graduated nurses and suggest ways to support them and prevent their early resignation based on their characteristics.

Methods

With the approval of the Ethics Committee, various characteristics of 353 newly graduated nurses (personality, interpersonal relationships, trait anxiety, nurse orientation, desire to be a nurse, and self-proclaimed academic ability) were assessed using a transactional analysis, the State-Trait Anxiety Inventory, and self-reporting numerical rating scales. The characteristics of those who resigned within 1 year (case group) and those who did not (control group) were compared using chi-square test and logistic regression analysis.

Results

Our sample of 353 participants included 32 nurses from the case group and 304 nurses from the control group. Most participants showed similar personality traits. However, the control group had a significantly lower percentage with negative self, strong trait anxiety, negative self and strong trait anxiety, and low orientation compared to the case group. Our logistic regression analysis showed that strong trait anxiety and low nurse orientation are significantly related with the early resignation of nurses.

Conclusions

The early resignation of newly graduated nurses may be prevented by understanding their characteristics at the time of gaining employment and implementing early intervention programs, such as education programs to reduce anxiety, and helping those with strong trait anxiety and low nurse orientation to find meaning in work.
Patients’ knowledge of the indications for their medications – a scoping review
Authors: Bülow Cille , Clausen Stine Søndersted , Thøgersen Patrick Lundholm , Dalin Dagmar Abelone , Hansen Johanne Mølby , Johansson Karl Sebastian , Lundh Andreas , Christensen Mikkel Bring
Published: October 2024

Background

Inadequate medication knowledge may contribute to inappropriate medication use and treatment harms. We aimed to map and synthesise the existing evidence on patients’ knowledge of the indications for their medications.

Method

We searched MEDLINE, Embase, CINAHL, PsychInfo and the Cochrane Library for studies that assessed patients’ knowledge of the indications for their medications from inception to June 16, 2022. A pair of reviewers independently screened and extracted data on study characteristics, aims, and methods used to assess and report patients’ knowledge of the indications for their medications.

Results

We included 99 studies conducted in 33 countries, published between 1979 and 2021, with 42,377 participants in total (median 126 participants [Interquartile range: 63–338]). Studies were observational (n = 77), experimental (n = 18), or qualitative interviews (n = 4). The exact question used to assess knowledge of the indications was reported in 27 studies and was phrased in 25 different ways. Knowledge of the indications was reported as a proportion of either 1) all participants (n = 65) or 2) the total number of medications used by all patients (n = 13). Sixteen studies used both reporting methods, while five only reported a proportion without specifying the denominator. Fourteen studies in various populations reported the number of participants with correct knowledge of all their medications, ranging from 19% (long-term psychiatric in-patients) to 87% (general practice patients).

Conclusion

We did not identify any established scientific standard for assessing patients’ knowledge of the indications for their medications. The wide range of study methodologies and reporting styles observed call for a methodological consensus in this research field. Estimates of correct knowledge varied widely between studies, but whether this was due to differences in study populations or study methodology could not be determined. Furthermore, we did not identify any study investigating whether participants’ knowledge of the indications for their medications was associated with the quality, e.g. appropriateness, of their treatment.