bluuebunny/crossref_metadata_2025 huggingface dataset:
The “ABC SAVES LIVES”: A Schoolteacher-Led Basic Life Support Program in Navarra, Spain
Authors: Louis Clint Jean , Beaumont Carlos , Velilla Nikole , Greif Robert , Fernandez Javier , Reyero Diego
Published: September 2022

To implement a teacher-led basic life education program in schools. Design thinking methodology was used to develop a comprehensive program to make teachers competent and confident in the delivery of Basic Life Support (BLS), and then to independently implement teaching programs in their school’s community. Specific teaching material and training manikins were provided by the “ABC Save Lives association.” Training was open to all but focused on physical education teachers at all schools in the region. Between 2011 and 2019, 1,726 teachers from 208 schools [35% preschool-primary, 28% secondary, 28% private schools partly funded by public funds; 9% vocational] participated in the program. Sixty percent (619) were physical education teachers, who trained 59465 students. All schools have progressively been supplied with at least five BLS manikins each. In 2014, the regional government of Navarra approved mandatory BLS education in physical education in primary and secondary schools. With adequate education and proper support, physical education teachers can independently implement a Basic Life Support program in their schools aiming to increase bystander cardio-pulmonary resuscitation competencies. Furthermore, the Basic Life Support education increases students’ confidence of social responsibilities and awareness of cardiac arrest as a public health problem.
Feedback on Pronunciation: Vietnamese EFL Teachers’ Beliefs and Practice
Authors: Phuong Thi Thanh Huyen
Published: September 2022

In EFL classrooms today, teachers are facing the challenge of helping their students improve their intelligibility in international communication in English. Feedback is one of the main ways through which teachers are performing the task. However, feedback on students’ English pronunciation has not received commensurate attention in EFL contexts. Aiming to shed some light on this essential but neglected aspect of English language teaching (ETL), this study examines the beliefs and practices of ten experienced teachers of English at a non-English-major university in Vietnam. Findings derived from semi-structured interviews and classroom observations show that teachers largely shared a strong belief in the importance of feedback in learners’ pronunciation development. Teachers were found to mainly focus on instant feedback rather than delayed feedback, and on individual errors rather than collective ones. Findings also indicated that teachers’ approaches to feedback provision diverged greatly, which were confined by their varying expectations in pronunciation pedagogy, different knowledge, and beliefs regarding how to correct, what to correct, and who would benefit from error correction. On the basis of the findings, implications for classroom practices and teacher training were discussed.
A Clinically Applicable Predictive Score in Lumbar Disc Disease for Formulating a Surgical Plan
Authors: Subramaniam Macherla Haribabu , Moirangthem Victor , Ramakrishnan Bala subramaniam , Venkatesan Muralidharan
Published: September 2022

Study Design

Case control study

Objective

Micro-lumbar discectomy or Interbody fusion procedure are work-horse surgical procedures in management of lumbar disc disease. Spine surgeon in their early years of practice gets confused in choosing ideal surgical plan when dealing with a complex scenario. A clinical score is needed to guide spine surgeons in choosing an optimal surgical plan.

Materials and methods

Study was done with research grant approval from AO Spine. A predictive score was formulated as per hypothesis following a pilot study. Two fellowship trained spine surgeons-one using the score (Group A) and other not using score (Group B-control) treated 40 patients included in their respective group. All patients were analysed preoperatively, post-surgery at 12 months follow-up with Visual analog scale score for back pain, leg pain, Oswestry disability index score, SF-36 score. Change in parameters at 12 months follow-up were analysed statistically. P ≤ .05 was considered statistically significant. Success rate of individual surgeon who managed respective group of patients and Difficulty index of surgeon who managed without using score was evaluated at 12 months follow-up.

Results

Success rate of Group A-surgeon was higher than Group B-surgeon .15% of Group B patients had poor surgical outcome at follow-up. Statistically significant improvement in Group A patients were seen in all 3 evaluated parameters when compared to Group B patients at 12 months of follow-up ( P ≤ .05). Difficulty index of surgeon who didn’t use the score was 15%.

Conclusion

The proposed predictive score comprising all risk factors, can be used by spine surgeons when they are confronted with difficult scenario in decision-making. Accuracy, reliability and validity of the score needs to be evaluated in a larger scale.

Level of evidence

Ⅲ
Lumbar Decompression versus Decompression and Fusion in Octogenarians: Complications and Clinical Course With 3-Year Follow-Up
Authors: Lenga Pavlina , Gülec Gelo , Bajwa Awais A. , Issa Mohammed , Oskouian Rod J. , Chapman Jens R. , Kiening Karl , Unterberg Andreas W. , Ishak Basem
Published: September 2022

Study Design

Retrospective review.

Objectives

This study aimed to assess and compare the clinical course and complications between surgical decompression and decompression with fusion in lumbar spine patients aged ≥80 years.

Methods

A retrospective review of electronic medical records at a single institution was conducted between September 2005 and December 2021. Logistic regression was used to identify potential risk factors for the occurrence of complications.

Results

Over a 16-year period, 327 patients were allocated to the decompression only group and 89 patients were allocated to the decompression and instrumented fusion group. The study had a mean follow-up duration of 36.7 ± 12.4 months. When assessing the CCI, patients of the instrumentation group had fewer comorbidities (8.9 ± .5 points vs 6.2 ± 1.5 points; P < .001), significantly longer surgical duration (290 ± 106 minutes vs 145 ±50.2 minutes; P < .001), significantly higher volume of intraoperative blood loss (791 ± 319.3 ml vs 336.1 ± 150.8 ml; P < .001), more frequent intraoperative blood transfusion (7 ± 2.1% vs 16± 18.0%; P < .001), and extended stays in the intensive care unit and hospitalization rates. Logistic regression analysis revealed that surgical duration and extent of surgery were unique risk factors for the occurrence of complications.

Conclusions

Lumbar decompression and additional fusion in octogenarians are considerable treatment techniques; albeit associated with increased complication risks. Prolonged operative time and extent of surgery are critical confounding factors associated with higher rates of postoperative complications. Surgery should only be performed after careful outweighing of potential benefits and risks.
A Multi-Disciplinary Review of Time-Driven Activity-Based Costing: Practical Considerations for Spine Surgery
Authors: Ali Daniyal Mansoor , Leibold Adam , Harrop James , Sharan Ashwini , Vaccaro Alexander R. , Sivaganesan Ahilan
Published: September 2022

Study Design

A multi-disciplinary review.

Objectives

To provide a roadmap for implementing time-driven activity-based costing (TDABC) for spine surgery. This is achieved by organizing and scrutinizing publications in the spine, neurosurgical, and orthopedic literature which utilize TDABC and related methodologies.

Methods

PubMed and Google Scholar were searched for relevant articles. The articles were selected by two independent researchers. After article selection, data was extracted and summarized into research domains. Preferred reporting items for systematic reviews and meta-analyses (PRISMA) systematic review process was followed.

Results

Of the 524 articles screened, thirty-five articles met the inclusion criteria. Each included article was examined and reviewed to define the primary research question and objective. Comparing different procedures was the most common primary objective. Direct observation along with one other strategy (surveys, interviews, surgical database, or EMR) was most commonly employed during process map development. Across all surgical subspecialties (spine, neurologic, and orthopedic surgery), costs were divided into direct cost, indirect cost, cost to patient, and total costs. The most commonly calculated direct costs included personnel and supply costs. Facility costs, hospital overhead costs, and utilities were the most commonly calculated indirect costs. Transportation costs and parental lost wages were considered when calculating cost to patient. The total cost was a sum of direct costs, indirect costs, and costs to the patient.

Conclusion

TDABC provides a common platform to accurately estimate costs of care delivery. Institutions embarking on TDABC for spine surgery should consider the breadth of methodologies highlighted in this review to determine which type of calculations are appropriate for their practice.
The perception of professionals and users of the quality of care and respect for human rights in four outpatient care facilities of an Italian hospital during the Covid-19 pandemic
Authors: Carta Mauro G , Sancassiani Federica , Melis Paola , Aviles-Gonzales Cesar I , Urban Antonio , Minerba Luigi , D’Oca Silvia , Atzeni Michela , Velluzzi Fernanda , Ferreli Caterina , Serrentino Roberta , Coghe Ferdinando , Cossu Giulia
Published: September 2022

Background:

During the Covid-19 pandemic, delays in providing medical services, dissatisfaction, criticism toward health workers (HW) and the risk of burnout of HW in Italy have been documented. No studies have contrasted the point of view of HW and users on the quality of care and respect for human rights in health facilities.

Objective:

To compare the perception of users of their satisfaction with the care provided with the perception of HW of their satisfaction with work as well as the perception of the respect of HW “s and users” human rights.

Methods:

The “Well-Being at work and respect for human rights questionnaire” (WWRR) was administered on a sample of users (142) and HW (154) in four outpatient health care facilities of a hospital in Sardinia, Italy.

Results:

Users showed higher scores than HW on their satisfaction with the care received ( p < 0.0001), the perception of respect for their human rights ( p < 0.0001), and availability of resources for care ( p < 0.0001). The HW scores were higher than 50% of the maximum in all items, but a relatively low score was reported on the HW’s satisfaction of the resources and the respect for their rights.

Conclusion:

The satisfaction for care and respect for human rights in the outpatient health services was higher than expected. The relatively low score by the HWs in relation to the satisfaction with the resources and perception of respect for their human rights could be a wake-up call. The study does not involve emergency rooms, wards, or Covid units.
New Medical Device and Therapeutic Approvals in Otolaryngology: State of the Art Review of 2021
Authors: Choi Alexander M. , Brenner Michael J. , Gorelik Daniel , Erbele Isaac D. , Crowson Matthew G. , Kadkade Prajoy , Takashima Masayoshi , Santa Maria Peter L. , Hong Robert S. , Rose Austin S. , Ostrander Benjamin T. , Rabbani Cyrus C. , Morrison Robert J. , Weissbrod Philip A. , Tate Alan D. , Kain Joshua J. , Lina Ioan A. , Shaffer Scott R. , Ahmed Omar G.
Published: September 2022

Objective

To evaluate new medical devices and drugs pertinent to otolaryngology–head and neck surgery that were approved by the Food and Drug Administration (FDA) in 2021.

Data Sources

Publicly available FDA device and drug approvals from ENT (ear, nose, and throat), anesthesia, neurosurgery, plastic surgery, and general surgery FDA committees.

Review Methods

FDA device and therapeutic approvals were identified and reviewed by members of the American Academy of Otolaryngology–Head and Neck Surgery’s Medical Devices and Drugs Committee. Two independent reviewers assessed the relevance of devices and drugs to otolaryngologists. Medical devices and drugs were then allocated to their respective subspecialty fields for critical review based on available scientific literature.

Conclusions

The Medical Devices and Drugs Committee reviewed 1153 devices and 52 novel drugs that received FDA approval in 2021 (67 ENT, 106 anesthesia, 618 general surgery and plastic surgery, 362 neurosurgery). Twenty‐three devices and 1 therapeutic agent relevant to otolaryngology were included in the state of the art review. Advances spanned all subspecialties, including over‐the‐counter hearing aid options in otology, expanding treatment options for rhinitis in rhinology, innovative laser‐safe endotracheal tubes in laryngology, novel facial rejuvenation and implant technology in facial plastic surgery, and advances in noninvasive and surgical treatment options for obstructive sleep apnea.

Implications for Practice

FDA approvals for new technology and pharmaceuticals present new opportunities across subspecialties in otolaryngology. Clinicians’ nuanced understanding of the safety, advantages, and limitations of these innovations ensures ongoing progress in patient care.
Can learnings from the COVID-19 pandemic improve trial conduct post-pandemic? A case study of strategies used by the DISC trial
Authors: Knowlson Catherine , Tharmanathan Puvan , Arundel Catherine , James Sophie , Flett Lydia , Gascoyne Samantha , Welch Charlie , Warwick David , Dias Joseph
Published: September 2022

Background

RCTs often face issues such as slow recruitment, poor intervention adherence and high attrition, however the 2020/2021 COVID-19 pandemic intensified these challenges. Strategies employed by the DISC trial to overcome pandemic-related barriers to recruitment, treatment delivery and retention may be useful to help overcome routine problems.

Methods

A structured survey and teleconference with sites was undertaken. Key performance indicators in relation to recruitment, treatment delivery and retention were compared descriptively before and after the pandemic started. This was situated also in relation to qualitative opinions of research staff.

Results

Prior to the pandemic, retention was 93.6%. Increased support from the central trial management team and remote data collection methods kept retention rates high at 81.2% in the first 6 months of the pandemic, rising to 89.8% in the subsequent 6 months. Advertising the study to patients resulted in 12.8 patients/month enquiring about participation, however only six were referred to recruiting sites. Sites reported increased support from junior doctors resolved research nurse capacity issues. One site avoided long delays by using theatre space in a private hospital.

Conclusions

Recruitment post-pandemic could be improved by identification of barriers, increased support from junior doctors through the NIHR associate PI scheme and advertising. Remote back-up options for data collection can keep retention high while reducing patient and site burden. To future proof studies against similar disruptions and provide more flexibility for participants, we recommend that RCTs have a back-up option of remote recruitment, a back-up location for surgeries and flexible approaches to collecting data.
Network Governance for Interorganizational Temporary Organizations: A Systematic Literature Review and Research Agenda
Authors: Wang Linzhuo , Müller Ralf , Zhu Fangwei
Published: September 2022

Governance of interorganizational networks for joint project execution has become a popular research theme in recent years. However, little is known about how the knowledge in this field is structured and how to further develop it based on the given structure. This systematic literature review identifies three main categories of literature in this field: design of network governance, network performance, and theory in network governance. Each of these categories is further divided into subcategories, which are assessed for the timely development and current state of knowledge. This provides the foundation for the development of a research agenda, which includes configurational understanding of network governance design, governing for temporary organizing particularities, and level-crossing theoretical development.
Theoretical Model of Dynamic Bulk Modulus for Aerated Hydraulic Fluid
Authors: Yuan Xiaoming , Wang Weiqi , Zhu Xuan , Zhang Lijie
Published: September 2022

Existing models of bulk modulus for aerated hydraulic fluids primarily focus on the effects of pressure and air fraction, whereas the effect of temperature on bulk modulus is disregarded. Based on the lumped parameter method and the full cavitation model, combined with the improved Henry’s law and the air polytropic course equation, a theoretical model of dynamic bulk modulus for an aerated hydraulic fluid is derived. The effects of system pressure, air fraction, and temperature on bulk modulus are investigated using the controlled variable method. The results show that the dynamic bulk modulus of the aerated hydraulic fluid is inconsistent during the compression process. At the same pressure point, the dynamic bulk modulus during expansion is higher than that during compression. Under the same initial air faction and pressure changing period, a higher temperature results in a lower dynamic bulk modulus. When the pressure is lower, the dynamic bulk modulus of each temperature point is more similar to each other. By comparing the theoretical results with the actual dynamic bulk modulus of the Shell Tellus S ISO32 standard air-containing oil, the goodness-of-fit between the theoretical model and experimental value at three temperatures is 0.9726, 0.9732, and 0.9675, which validates the theoretical model. In this study, a calculation model of dynamic bulk modulus that considers temperature factors is proposed. It predicts the dynamic bulk modulus of aerated hydraulic fluids at different temperatures and provides a theoretical basis for improving the analytical model of bulk modulus.
A recurrent somatic missense mutation in GNAS gene identified in familial thyroid follicular cell carcinomas in German longhaired pointer dogs
Authors: Yu Yun , Manders Freek , Grinwis Guy C. M. , Groenen Martien A. M. , Crooijmans Richard P. M. A.
Published: September 2022

Background

We previously reported a familial thyroid follicular cell carcinoma (FCC) in a large number of Dutch German longhaired pointers and identified two deleterious germline mutations in the TPO gene associated with disease predisposition. However, the somatic mutation profile of the FCC in dogs has not been investigated at a genome-wide scale.

Results

Herein, we comprehensively investigated the somatic mutations that potentially contribute to the inherited tumor formation and progression using high depth whole-genome sequencing. A GNAS p.A204D missense mutation was identified in 4 out of 7 FCC tumors by whole-genome sequencing and in 20 out of 32 dogs’ tumors by targeted sequencing. In contrast to this, in the human TC, mutations in GNAS gene have lower prevalence. Meanwhile, the homologous somatic mutation in humans has not been reported. These findings suggest a difference in the somatic mutation landscape between TC in these dogs and human TC. Moreover, tumors with the GNAS p.A204D mutation had a significantly lower somatic mutation burden in these dogs. Somatic structural variant and copy number alterations were also investigated, but no potential driver event was identified.

Conclusion

This study provides novel insight in the molecular mechanism of thyroid carcinoma development in dogs. German longhaired pointers carrying GNAS mutations in the tumor may be used as a disease model for the development and testing of novel therapies to kill the tumor with somatic mutations in the GNAS gene.
Iranian midwives’ lived experiences of providing continuous midwife-led intrapartum care: a qualitative study
Authors: Amiri-Farahani Leila , Gharacheh Maryam , Sadeghzadeh Narges , Peyravi Hamid , Pezaro Sally
Published: September 2022

Background & Objective

Continuity of midwifery-led care during labour and birth is considered optimal. To ensure its sustainability in practice where limited evidence is available, the aim of the present study was to explore midwives’ lived experiences of delivering continuous midwife-led intrapartum care.

Methods

This study took a qualitative approach in meeting its aim. Participants were midwives working in the labour wards of private and public hospitals in Iran. The data were purposefully collected in 2019 through in-depth, semi-structured, and face-to-face interviews with midwives (n = 10) aged between 26 and 55 years. A thematic analysis based on descriptive phenomenology was undertaken to make sense of the data collected.

Results

“Wanting to lead continuous woman-centered care but being unable to” was identified as an overarching theme. Three other themes “emphasis on the non-interventional care”, “midwifery-specific focus” and “barriers and challenges of midwifery care” were also identified. Ultimately, midwives described knowing how to and wanting to lead continuous ‘woman’-centered care but being unable to. Perceived barriers included lack of familiarity with and knowledge in relation to childbirth, the insignificant role of midwives in decision making, obstetrician utilitarianism, high workloads along with work-related stress argument-driven communication between midwives and obstetricians and an absence of a ‘triangle of trust’ in care.

Conclusion

Future research strategies could usefully include obstetricians and focus on the upscaling of midwifery in Iran using continuity of care models, highlight the value of midwives, identify why uptake of antenatal education in Iran is poor and develop user friendly, evidence based, midwife-led programs. Initiatives aiming to promote mutual professional respect, trust and collegiality and increased remuneration for midwifery work would be also welcomed in pursuit of reducing maternal and infant mortality in Iran.
Prognostic role of TOPS in ambulance-transferred neonates in a low-resource setting: a retrospective observational study
Authors: Cavallin Francesco , Contin Annaelena , Alfeu Natércia , Macmillian Belinda , Seni Amir Hussein Abubacar , Cebola Bonifacio Rodriguez , Calgaro Serena , Putoto Giovanni , Trevisanuto Daniele
Published: September 2022

Background

Assessing the severity of transferred neonates at admission can improve resource allocation. This study evaluated the role of TOPS (illness severity score including temperature, oxygen saturation, skin perfusion and blood sugar) in predicting mortality in neonates transferred by ambulance in a low-resource setting.

Methods

The study was conducted at Beira Central Hospital (Mozambique). Infants who were transferred by ambulance to the Neonatal Intensive Care Unit between 16th June and 16th October 2021 were included. The association between TOPS and mortality was investigated with a logistic regression model. Receiver-operating characteristics (ROC) curve was derived for TOPS; area under the ROC curve, sensitivity and specificity were calculated.

Results

In-transport mortality was 2/198 (1.0%) and in-hospital mortality was 75/196 (38.3%). Median gestational age and birthweight were 38 weeks and 2600 g. Main causes of admission were asphyxia (29.3%), prematurity (25.3%) and sepsis (22.7%). Hypothermia and oxygen desaturation at admission were 75.8% and 32.3%. TOPS ≥ 1 was associated with increased mortality risk (odds ratio 7.06. 95% confidence interval 1.90 to 45.82), with 0.97 sensitivity and 0.26 specificity.

Conclusions

The high mortality rate calls for interventions and quality initiative studies to improve the transfer process and the conditions at admission. TOPS can be used to identify neonates at risk of mortality and concentrate efforts of health care providers. Interventions preventing hypothermia and oxygen desaturation should be implemented in pre-transport stabilization and care during transport.
Investigation of retinal microvasculature and choriocapillaris in adolescent myopic patients with astigmatism undergoing orthokeratology
Authors: Wang Xiao-qin , Chen Ming , Zeng Liu-zhi , Liu Long-qian
Published: September 2022

Background

To observe alterations of fundus microcirculation and retinal thickness in adolescent myopic patients with astigmatism after toric and spherical orthokeratology using optical coherence tomography angiography (OCTA), to explore the effects of orthokeratology on the retinal thickness and choroidal blood flow.

Methods

A total of 48 patients were enrolled and divided into two group (toric orthokeratology (T) group and spherical orthokeratology (S) group) according to the type of lens design. OCTA was used to measure the superficial and deep retinal vessel densities at the macular region, radial peripapillary capillary (RPC) density, foveal avascular zone (FAZ) area, and choriocapillaris (ChC) perfusion area before and after orthokeratology for 3 months. The data were statistically analyzed by SPSS 19.0 software.

Results

Compared with before orthokeratology, the superficial vessel density in the fovea and parafovea in the T group significantly increased, and the deep vessel density in the whole area and fovea were significantly elevated after 3 months (P < 0.05). The superficial vessel density was significantly higher only in the parafovea in the S group after 3 months than that before orthokeratology (P < 0.05), deep vessel density in the whole area and parafovea after 3 months was significantly higher than that before orthokeratology (P < 0.05). RPC density in the two groups increased after 3 months of orthokeratology in the whole area and inside the disc area (P < 0.05).

Three months after toric orthokeratology, FAZ area in the T group was significantly reduced by 0.05 (− 0.41 to + 0.08) mm2, while ChC perfusion area was enlarged by 0.06 ± 0.12 mm2. FAZ area in the S group significantly decreased by 0.01 (− 0.19 to + 0.01) mm2, whereas ChC perfusion area increased by 0.06 (− 0.07 to + 0.50) mm2. Retinal thickness in the two groups increased after 3 months of orthokeratology in the whole area and parafoveal area (P < 0.05).

Conclusion

Orthokeratology improved retinal blood flow in macular area and RPC while controlling myopia. The changes in FAZ and ChC perfusion areas did not significantly differ between toric and spherical orthokeratology.
Effect of educational intervention based on health belief model on mothers monitoring growth of 6–12 months child with growth disorders
Authors: Khani Jeihooni Ali , Mohammadkhah Fatemeh , Razmjouie Fatemeh , Harsini Pooyan Afzali , Sedghi Jahromi Fariba
Published: September 2022

Background

Maternal education is one of the main ways to improve children's nutritional behaviors and development. The purpose of this study is to investigate the effect of educational intervention based on Health Belief Model (HBM) on mothers monitoring growth of 6–12 months child with growth disorders in Ghirokarzin city, Fars Provonce, Iran.

Methods

This quasi-experimental study was conducted on mothers of 6–12 months children with growth disorders of Ghirokarzin city, Fars province, Iran in 2021–2022. One hundred twenty mothers of 6–12 months child with growth disorders in Ghirokarzin city were selected using random sampling method and were divided into two groups of intervention (60) and control (60). The experimental group received training on the HBM constructs. Both groups completed the questionnaire before and three months after.intervention. A questionnaire beased on Health Belief Model constructs were used to collect information. The data was analyzed with SPSS 22 software using paired t-tests, Chi-square tests, and independent t-tests, with a significance level of 0.05.

Results

Three months after the educational intervention, the experimental group showed a significant increase in terms of knowledge, HBM constructs, weight of the children and feeding behavior.

Conclusion

This study showed the educational intervention based on the HBM improved the knowledge and feeding behavior of mothers and improved Growth Disorders of child. Hence, this model can act as a framework for designing and implementing educational interventions for prevention of growth disorders in children.
Attitudes towards the neurological examination in an unwell neonate: a mixed methods approach
Authors: Fadilah Ala , Clare Quentin , Hart Anthony Richard
Published: September 2022

Background

The neurological examination of an unwell neonate can aid management, such as deciding if hypothermia treatment is warranted in hypoxic ischaemic encephalopathy or directing investigations in hypotonic neonates. Current standardised examinations are not designed for unwell or ventilated neonates, and it is unclear how confident paediatricians feel about the examination or what aspects they perform. 

Aim

This study aimed to review the confidence of UK paediatricians on the neurological examination in unwell neonates, describe their attitudes towards it, and determine what could improve practice.

Methods

An explanatory sequential mixed methods approach (QUAN → QUAL) with equal weighting between stages. A survey on attitudes to the neonatal neurological examination was sent to all UK neonatal units and members of the British Paediatric Neurology Association. Volunteers were sought for semi-structured interviews. Thematic analysis was used to interpret qualitative data, which was triangulated with quantitative questionnaire data.

Results

One hundred ninety-three surveys were returned, 31.0% from neonatologists, 9.3% paediatric neurologist. The median range for confidence was 4 (IQR3-5). Twenty-three interviews occurred. Thematic analysis revealed three themes: “Current culture on neonatal units”, “ Practicalities of the neurological examination in unwell neonates”, and “Changing the culture”. Most interviewees did not feel confident performing or interpreting the neurological examination in unwell neonates. Many units had a culture of seeing it as low priority, did not see its relevance in the acute management of unwell neonates. A few interviewees worked in units with a positive culture towards the neurological examination who used adapted standardised examinations and provided training. 72% of questionnaire responders wanted a new standardised neurological examination designed for the unwell neonate, which should be short, utilise pictures like the Hammersmith Neonatal Neurological Examination, contain an assessment of consciousness, be developmentally appropriate and achievable in unwell, ventilated neonates, be accompanied by a schematic to aid interpretation, and for greater training and assessments of competence.

Conclusions

There are barriers preventing paediatricians being able to perform a neurological examination in unwell neonates, and a culture of neurophobia is common. A new standardised examination is needed, alongside aids to interpretation, training, and assessment.
Reference values for diaphragm electrical activity (Edi) in newborn infants
Authors: Gurumahan Varappriyangga , Thavalingam Sriganesh , Schindler Tim , Smyth John , Lui Kei , Bolisetty Srinivas
Published: September 2022

Background

Neurally adjusted ventilatory assist is an emerging mode of respiratory support that uses the electrical activity of the diaphragm (Edi) to provide synchronised inspiratory pressure support, proportional to an infant’s changing inspiratory effort. Data on Edi reference values for neonates are limited. The objective of this study was to establish reference Edi values for preterm and term neonates who are not receiving respiratory support.

Methods

This was a prospective observational study of newborn infants breathing spontaneously in room air. The Edi waveform was monitored by a specialised naso/orogastric feeding tube with embedded electrodes positioned at the level of the diaphragm. Edi minimums and peaks were recorded continuously for 4 h without changes to routine clinical handling.

Results

Twenty-four newborn infants (16 preterm [< 37 weeks’ gestation]; 8 term) were studied. All infants were breathing comfortably in room air at the time of study. Edi data were successfully captured in all infants. The mean (±SD) Edi minimum was 3.02 (±0.94) μV and the mean Edi peak was 10.13 (±3.50) μV. In preterm infants the mean (±SD) Edi minimum was 3.05 (±0.91) μV and the mean Edi peak was 9.36 (±2.13) μV. In term infants the mean (±SD) Edi minimum was 2.97 (±1.05) μV and the mean Edi peak was 11.66 (±5.14) μV.

Conclusion

Reference Edi values were established for both preterm and term neonates. These values can be used as a guide when monitoring breathing support and when using diaphragm-triggered modes of respiratory support in newborn infants
Patients’ perspectives of the effects of a group-based therapeutic patient education program for bipolar disorder: a qualitative analysis
Authors: Duval Mélanie , Harscoët Yves-Antoine , Jupille Julien , Grall-Bronnec Marie , Moret Leïla , Chirio-Espitalier Marion
Published: September 2022

Background

Few qualitative studies have explored the impact of group-based psychoeducation programs from the perspective of patients with bipolar disorder, and no studies to date have examined the effects of such programs on patients’ personal recovery. The aim of this study was to explore the effects of a group therapeutic education program on the personal recovery of people with bipolar disorder and its determinants.

Methods

Three professionals conducted semistructured interviews with 16 patients who participated in 9 weekly sessions of four separate bipolar therapeutic education programs. The interviews were transcribed verbatim and analyzed inductively by two of the professionals using the thematic analysis method.

Results

Three main themes emerged from the interviews: the elements of therapeutic education, the experience of therapeutic education and the changes facilitated by therapeutic education. The changes reported by the participants included the evolution of the patient’s relationship with the disorder, improvement in the patient’s knowledge of the disorder, improvement in disorder management throughout daily life in general, and development of psycho-social skills and social relationships.

Conclusions

This study provides support for the beneficial impact of group therapeutic education programs on the personal recovery of people with bipolar disorder. These programs improve all dimensions of recovery according to the CHIME model, with connectedness, hope and empowerment being the main dimensions impacted. Our results indicate that therapeutic group education programs can be beneficial for people with bipolar disorder at any point during their experience of the disorder, with the potential exception of periods of thymic decompensation.
Unpacking the impact of chronic pain as measured by the impact stratification score
Authors: Rodriguez Anthony , Edelen Maria Orlando , Herman Patricia M. , Hays Ron D.
Published: September 2022

Background

In 2014, the National Institute of Health Pain Consortium’s research task force on research standards for chronic low back pain (CLBP) proposed a measure that could be used to stratify patients by the impact CLBP has on their lives, namely the Impact Stratification Score (ISS). This study examines the dimensionality of the ISS and support for its single total score, and evaluates its overall psychometric properties.

Methods

The sample included 1677 chiropractic patients being treated for CLBP and chronic neck pain, had an average age of 49, 71% female, and 90% White. Study participants completed the PROMIS-29 v2.1 profile survey that contains the 9 ISS items. The ISS was evaluated using item-total correlations, Cronbach’s alpha, factor analysis (i.e., correlated factors and bifactor models), and item response theory (IRT). Reliability indices and item properties were evaluated from bifactor and IRT models, respectively.

Results

Item-total correlations were high (0.64–0.84) with a Cronbach’s alpha of 0.93. Eigenvalues suggested the possibility of two factors corresponding to physical function and pain interference/intensity. Bifactor model results indicated that data were essentially unidimensional, primarily reflecting one general construct (i.e., impact) and that after accounting for ‘impact’ very little reliable variance remained in the two group factors. General impact scores were reliable (omegaH = .73). IRT models showed that items were strong indicators of impact and provided information across a wide range of the impact continuum and offer the possibility of a shorter 8-item ISS. Finally, it appears that different aspects of pain interference occur prior to losses in physical function.

Conclusions

This study presents evidence that the ISS is sufficiently unidimensional, covers a range of chronic pain impact and is a reliable measure. Insights are obtained into the sequence of chronic pain impacts on patients’ lives.
One-minute sit-to-stand test is practical to assess and follow the muscle weakness in cystic fibrosis
Authors: Hardy Sophie , Berardis Silvia , Aubriot Anne-Sophie , Reychler Gregory , Gohy Sophie
Published: September 2022

Background

Quadriceps muscle weakness and reduced exercise tolerance are prevalent and associated with a worse prognosis in patients with cystic fibrosis (CF). The one-minute sit-to-stand test (1STST) has been proposed to evaluate functional exercise capacity and quadriceps strength.

Research question

The aim of the study was to verify the relationship between the 1STST and the maximal isometric voluntary contraction of the quadriceps (MVCQ) evaluated by the dynamometer in stable patients with CF and to evaluate the impact of intravenous (IV) antibiotherapy.

Methods

Dynamometer and 1STST were performed in stable patients with CF at a routine visit, the admission and the discharge of an IV antibiotherapy. Patients wore an activity monitor during 72 h during IV treatment.

Results and significance

51 stable patients with CF at a routine visit and 30 treated with IV antibiotherapy were recruited. In stable patients, the 1STST was reduced to a mean of 2101 nxkg (657—SD), representing a median of 79% (7; 142—min; max)) of the predicted values (%PV) as well as the MVCQ to 78.64 N-m (23.21; 170.34), representing 57%PV (26). The 1STST was correlated to MVCQ (r = 0.536; p < 0.0001) and lung function (r = 0.508; p = 0.0001). Over the IV antibiotherapy course, the 1STST improves significantly like lung function and body mass index while a positive trend for MVCQ was observed. The gain of 1STST was correlated to the change in MVCQ (r = 0.441; p = 0.02) and was significantly higher in hospitalized patients versus home therapy. The 1STST is a good alternative to the dynamometer to evaluate and assess muscular weakness for the routine visit and IV antibiotherapy.
Women’s participation in the prevention and control of dengue using environmental methods in the global south: a qualitative meta-synthesis
Authors: Mungall-Baldwin Cathy
Published: September 2022

Background

Dengue, a mosquito-borne viral disease, causes significant mortality and morbidity in low- to middle-income countries. A body of research indicates that women can be effective in implementing vector borne disease control, but they still face inequitable opportunities for participation, leadership and decision-making in the execution of dengue prevention and vector control programmes. Yet implementing informal environmental management practices to prevent mosquito vector breeding forms part of their domestic household responsibilities. Understanding the enablers and barriers to women’s equitable roles with men in formal and informal disease prevention, and the benefits of their participation could help to increase their role and may be a contributing factor to reducing disease rates. The objective of this qualitative meta-synthesis was to synthesise evidence about women’s roles in dengue prevention and control in the global south and generate insights around the barriers, enablers, and benefits.

Methods

Eight databases were searched from inception to 7thDecember 2020. One investigator independently reviewed all titles and abstracts for relevant articles. Grey literature was searched using 34 websites of global health and international development organisations.

Results

A total of 18 articles representing qualitative research or the qualitative component of mixed methods studies from Latin American and Caribbean (n = 8), Asia (n = 9), and one international review were included in the meta-synthesis. Relevant scholarship from Africa was lacking. This meta-synthesis revealed five unique themes surrounding women’s participation, seven categories of barriers, six of enablers, four health, well-being and social benefits for individuals, and four for communities .

Conclusion

An analysis of the results confirmed that women’s participation in dengue prevention was not gender equitable, gender sensitive nor transformative although women are the primary human resource for household and community-based prevention. Women demonstrated specific qualities aiding successful implementation. Corrective action is urgently needed to shift unhelpful gender norms, and empower women into leadership and decision-making roles.
Assessing oral comprehension with an eye tracking based innovative device in critically ill patients and healthy volunteers: a cohort study
Authors: Bodet-Contentin Laetitia , Messet-Charrière Hélène , Gissot Valérie , Renault Aurélie , Muller Grégoire , Aubrey Aurélie , Gadrez Pierrick , Tavernier Elsa , Ehrmann Stephan
Published: September 2022

Purpose

Communication of caregivers and relatives to patients is a major difficulty in intensive care units (ICU). Patient’s comprehension capabilities are variable over time and traditional comprehension tests cannot be implemented. Our purpose was to evaluate an oral comprehension test adapted for its automatic implementation using eye-tracking technology among ICU patients.

Methods

Prospective bi-centric cohort study was conducted on 60 healthy volunteers and 53 ICU patients. Subjects underwent an oral comprehension test using an eye-tracking device: Their results and characteristics were collected. The total duration of the test was 2 and a half minutes.

Results

While performing the test, 48 patients (92%) received invasive ventilation. Among healthy volunteers, the median rate of right answers was very high (93% [interquartile range 87, 100]), whereas it was lower (33% [20, 67]) for patients. For both groups, a significantly lower right answers rate was observed with advancing age (67% [27, 80] vs. 27% [20, 38] among patients and 93% [93, 100] vs. 87% [73, 93] among healthy volunteers, below and above 60 years of age, respectively) and in case of lack of a bachelor’s degree (60% [38, 87] vs. 27% [20, 57] among patients and 93% [93, 100] vs. 87% [73, 93] among healthy volunteers). For patients, the higher the severity of disease was, the lower the rate of correct answers was.

Conclusion

The eye-tracking-adapted comprehension test is easy and fast to use among ICU patients, and results seem coherent with various potential levels of comprehension as hypothesized in this study.
Eating disorder risks and awareness among female elite cyclists: an anonymous survey
Authors: Koppenburg C , Saxer F , Vach W , Lüchtenberg D , Goesele A
Published: September 2022

Background

Eating disorders (EDs) are an increasingly recognized concern in professional sports. Previous studies suggests that both female gender and endurance sports put athletes at risk. Female elite cyclists are hence of specific interest. The present study aimed at evaluating the distribution of the individual risk of ED in this group. Further the association between individual risk and both the awareness for the topic ED and the deviation from “normal” weight was depicted.

Methods

Female cyclists registered with the Union Cycliste Internationale were contacted via email or facebook and asked to complete a survey comprising age, weight, the Eating-Attitude-Test (EAT-26), and questions regarding ED awareness. The observed distribution of the EAT-26 score was compared to results from previous studies in normal subjects and athletes. The distribution of the ED awareness was described and ED awareness was correlated with the EAT-26 score. Both the deviation from ideal weight and the body mass index (BMI) were correlated with the EAT-26 score.

Results

Of the 409 registered athletes 386 could be contacted, 122 completed the questionnaire. Age ranged from 20-44yrs, BMI from 17.0 to 24.6 kg/m2. In the EAT-26, 39 cyclists (32.0%) scored above 20 points indicating a potential benefit from clinical evaluation, 34 cyclists (27.9%) scored 10–19 points suggesting disordered eating. Sixteen athletes (13.2%) had been treated for an ED. About 70% of athletes had been pressured to lose weight. The mean EAT-26 score was above the average observed in normal female populations. It was also above the average observed in many female athlete populations, but lower than in other leanness focussed sports. More than 80%of athletes perceived elite cyclists at risk for developing ED. Increased ED awareness and deviation from the ideal weight were associated with higher EAT-26 scores, but not the body mass index.

Conclusion

Female cyclists are at risk of developing ED and they are aware of this risk. To improve their health and well-being, increased efforts to support elite cyclists and their teams in preventive activities and early detection are crucial.
Longitudinal disease-associated gut microbiome differences in infants with food protein-induced allergic proctocolitis
Authors: Martin Victoria M. , Virkud Yamini V. , Dahan Ehud , Seay Hannah L. , Itzkovits Dvir , Vlamakis Hera , Xavier Ramnik , Shreffler Wayne G. , Yuan Qian , Yassour Moran
Published: September 2022

Background

Complex interactions between the gut microbiome and immune cells in infancy are thought to be part of the pathogenesis for the marked rise in pediatric allergic diseases, particularly food allergies. Food protein-induced allergic proctocolitis (FPIAP) is commonly the earliest recognized non-immunoglobulin E (IgE)-mediated food allergy in infancy and is associated with atopic dermatitis and subsequent IgE-mediated food allergy later in childhood. Yet, a large prospective longitudinal study of the microbiome of infants with FPIAP, including samples prior to symptom onset, has not been done.

Results

Here, we analyzed 954 longitudinal samples from 160 infants in a nested case-control study (81 who developed FPIAP and 79 matched controls) from 1 week to 1 year of age by 16S rRNA ribosomal gene sequencing as part of the Gastrointestinal Microbiome and Allergic Proctocolitis (GMAP) study. We found key differences in the microbiome of infants with FPIAP, most strongly a higher abundance of a genus of Enterobacteriaceae and a lower abundance of a family of Clostridiales during the symptomatic period. We saw some of these significant taxonomic differences even prior to symptom onset. There were no consistent longitudinal differences in richness or stability diversity metrics between infants with FPIAP and healthy controls.

Conclusions

This study is the first to identify differences in the infant gut microbiome in children who develop FPIAP, some even before they develop symptoms, and provides a foundation for more mechanistic investigation into the pathogenesis of FPIAP and subsequent food allergic diseases in childhood.