bluuebunny/crossref_metadata_2025 huggingface dataset:
Gossypiboma: A case of retained intra-luminal surgical sponge leading to delayed diagnosis and treatment in a Nigerian patient
Authors: Ukweh Ofonime Nkechinyere , Akpan Samuel Okokon , Ntamu Cyprian Ochiche , Enang Mbang Egbe , Ekpo Kyrian Onyo , Nwagbara Victor Ikechukwu
Published: September 2024

Gossypiboma, a term used to describe a retained foreign body mass of cotton (sponge, abdominal mop or gauze) within the body after a surgical procedure, is an uncommon but serious surgical complication. It can manifest with various clinical presentations and often leads to delayed diagnosis and significant morbidity. This report highlights the need for a repeat exploration at the end of open abdominal surgeries as routine. The case presented is that of a young female who underwent open myomectomy in an outreach setting, and subsequently developed symptoms of an acute abdomen due to a retained abdominal mop seen at surgery. The abdominal mop seen at laparotomy had migrated transmurally and became trapped within the ileum and ileocecal junction. After removal of the intra-luminal abdominal mop and abdominal closure, she had post-operative malnutrition and anaemia that were corrected as she regained full recovery. The incidence of gossypiboma is believed to be underestimated in developing countries, and surgical sponges are the most frequently retained foreign bodies. Accurate estimates of the incidence are challenging due to socio-cultural impediments and fear of litigation. Prompt recognition and prevention of gossypiboma are crucial to avoid associated complications and improve patient outcomes.
Utilization and engagement with an employer-provided digital mental health platform: An international perspective
Authors: Maistrello Giulia , Phillips William , Lee Daniel Steven , Romanelli Robert J.
Published: September 2024

Objective

This retrospective study (2020–2022) compared the usage patterns across international regions of an employer-provided digital mental health platform, which is available in native languages and offers both self-guided digital activities and one-on-one sessions.

Methods

Routine data from the platform were analyzed by describing the demographic profile of 178,119 users from different geographical regions, their baseline mental health status and burnout levels, as well as patterns of engagement. Statistical analyses were conducted using logistic and ordered logit models to examine the association between cumulative engagement with the platform over time and baseline characteristics.

Results

The platform had high engagement and satisfaction levels across regions and age groups. Female users were more engaged than males in both self-guided digital activities and one-on-one sessions. Older users and those from non-US regions were more engaged in self-guided digital activities, while younger users and those from the US were more engaged in one-on-one sessions. Symptoms of anxiety were also associated with engagement with one-on-one sessions.

Conclusions

The study's findings provide valuable insights into the benefits of digital platforms in addressing mental health needs of employers from different regions. Future research should focus on exploring the specific factors that influence engagement with digital mental health platforms and how these platforms can be optimized and tailored to better serve diverse populations.
Artificial intelligence applications in bone fractures: A bibliometric and science mapping analysis
Authors: Zhong Sen , Yin Xiaobing , Li Xiaolan , Feng Chaobo , Gao Zhiqiang , Liao Xiang , Yang Sheng , He Shisheng
Published: September 2024

Background

Bone fractures are a common medical issue worldwide, causing a serious economic burden on society. In recent years, the application of artificial intelligence (AI) in the field of fracture has developed rapidly, especially in fracture diagnosis, where AI has shown significant capabilities comparable to those of professional orthopedic surgeons. This study aimed to review the development process and applications of AI in the field of fracture using bibliometric analysis, while analyzing the research hotspots and future trends in the field.

Materials and methods

Studies on AI and fracture were retrieved from the Web of Science Core Collections since 1990, a retrospective bibliometric and visualized study of the filtered data was conducted through CiteSpace and Bibliometrix R package.

Results

A total of 1063 publications were included in the analysis, with the annual publication rapidly growing since 2017. China had the most publications, and the United States had the most citations. Technical University of Munich, Germany, had the most publications. Doornberg JN was the most productive author. Most research in this field was published in Scientific Reports. Doi K's 2007 review in Computerized Medical Imaging and Graphics was the most influential paper.

Conclusion

AI application in fracture has achieved outstanding results and will continue to progress. In this study, we used a bibliometric analysis to assist researchers in understanding the basic knowledge structure, research hotspots, and future trends in this field, to further promote the development of AI applications in fracture.
Invasive trigeminal ganglioneuroma: A case report and review of the literature
Authors: Narra Rama Krishna , Are Kavya , Nuzhat Parveen
Published: September 2024

Ganglioneuromas are rare tumors arising from retroperitoneal and posterior mediastinal sympathetic nerves. Intracranial trigeminal nerve ganglioneuromas are even more rare, with only seven cases reported to date. We present a case of a 65-year-old male with a right-sided throbbing headache type and blindness in his right eye. Magnetic resonance imaging revealed an ill-defined mass lesion in the middle-cranial fossa, with a few areas having a reduced apparent diffusion coefficient and multiple microhemorrhages. Piecemeal debulking of the tumor was achieved by performing a right-middle craniotomy via the pterionic and sub-temporal approach. The detected histological features matched those of a ganglioneuroma (maturing type) of the trigeminal nerve.
Researching hate speech online: Exploring the potential and limitations of Facebook as a survey tool in Africa
Authors: McGeer Caitlyn , Stremlau Nicole
Published: September 2024

As part of a broader research program, we sought to conduct surveys with social media users in several African countries to gauge their definitional understandings of online hate and mis/disinformation; awareness of content moderation processes; and flagging/reporting. The challenge, however, was how to conduct survey research in difficult-to-reach places, some of which are affected by violent conflict, and within a limited budget. Social media platforms present unique opportunities for researchers to recruit participants in these contexts. These platforms show promise in reaching participants who would otherwise be unreachable, but they pose significant limitations as well. Given that our aim was to reach social media users, we used Facebook to advertise our survey, drawing on the breadth of research on using the platform as a research tool and the fact it has a large user base in the targeted countries. In this article, we explore the practicalities, challenges, and limitations of Facebook as a tool for survey research in African countries.
Are Primary Health Care Visits Associated With Reduced Risk of Hospital Readmissions After Discharge From Geriatric Inpatient Departments? Evidence From Stockholm County
Authors: Naseer Mahwish , Willers Carl , Boström Anne-Marie , Lindh Mazya Amelie , Nilsson Gunnar H , Fors Stefan , Rydwik Elisabeth
Published: September 2024

Introduction/objectives:

Primary health care visits post-discharge could potentially play an important role in efforts of reducing hospital readmission. Focusing on a single or a particular type of visit obscures nuances in types of primary care contacts over time and fails to quantify the intensity of primary health care visits during the follow-up period. The aim of this study was to explore associations between the number and type of primary health care visits post-discharge and the risk of hospital readmission within 30 days.

Methods:

A register-based closed cohort study. The study population of 6135 individuals were residents of Stockholm who were discharged home from any of the 3 geriatric inpatient departments, excluding those who were readmitted within the next 24 h. The dependent variable was hospital readmission within 30 days of discharge. The key independent variable was the number and type of primary health care visits in 30 days post-discharge. Cox-regression with time-varying covariates was employed for data analyses.

Results:

Approximately, 12% of the participants were readmitted to hospital within 30 days. There was no statistically significant association between number of primary care visits post-discharge and readmission (HR 1.00; 95% CI 1.00-1.01). Compared to no primary health care visit, no statistically significant association were found for administrative care related visits (HR 0.33, 95%CI 0.08-1.33), clinic visits (HR 0.93, 95%CI 0.71-1.21), home visits (HR 1.03, 95%CI 0.84-1.27), or team visits (HR 0.76, 95%CI 0.54-1.07).

Conclusions:

There were no associations between primary health care visits post-discharge and hospital readmission after geriatric inpatient care. Further studies using survey or qualitative approaches can provide insights into the factors that are relevant to post-discharge care but are unavailable in this type of register data studies.
“An Act of Complete Care”: Provider Perspectives on Linking Maternal Contraceptive Care With Well-Baby Visits in Community Health Centers
Authors: Knepper Amanda , Zocchi Alejandra , Haider Sadia , Caskey Rachel
Published: September 2024

Background:

Short inter-pregnancy interval (IPI) is associated with adverse health outcomes for women and infants, and low-income women experience disproportionate rates of short IPI. An essential solution is providing postpartum (PP) women with timely contraceptive care. However, patient-centered approaches for facilitating care access are needed.

Objective:

To explore Community Health Center (CHC) staff and provider perspectives on the implementation of a clinical trial offering co-scheduled well-infant/maternal contraceptive care for women with infants 0 to 6 months at the Well-Baby Visit (WBV).

Method:

Eighteen participants (providers, staff, and administrators) representing 7 diverse CHC sites in 2 U.S. states completed semi-structured telephone interviews. Audio-recordings were transcribed and analyzed using hybrid thematic analysis.

Results:

Offering co-scheduled visits was perceived as beneficial for facilitating timely PP contraception, convenient care access, and encouraging family planning considerations during the PP period. However, provider and staff discomfort with initiating family planning and contraceptive care conversations at the WBV emerged as a salient barrier.

Conclusion:

Paired approaches to well-infant/maternal contraceptive care may promote increased access to timely contraception for PP women, possibly reducing unintended short IPI. Comprehensive training, ongoing support, and patient-centered implementation strategies tailored to context and developed with care team input are needed to ensure competency and comfortability with facilitating contraceptive care conversations at the WBV.
Rethinking the Role of the Principal in the Strategic Management of Human Capital in Public Secondary Schools in Zimbabwe
Authors: Mugwaze Fortunate , Smith Clive
Published: September 2024

Effective leadership and management are at the centre of the strategic management of human capital in education. Principals in schools as organizations promote the effective execution of strategies by coordinating staff members toward accomplishing school goals and objectives to improve student outcomes. Principals are critical in implementing strategic plans and providing a conducive setting for teaching and learning that allows human capital to grow and perform better. Principals must be strategic and forward-thinking by aligning school systems, culture, and processes to achieve all goals. Principals in public secondary schools in Zimbabwe face challenges in strategically managing human capital. Evidence mainly points to the teachers’ low motivation levels and lack of training and coherence in support mechanisms that would enable principals to strategically manage human capital in Zimbabwean schools. Thus, this necessitates the need to rethink the role of the principal. The study aimed to explore ways to rethink and redefine the principal’s role in Zimbabwean schools where education is in crisis. Following an interpretivist paradigm, a qualitative approach using a case study design was employed to gather data. The study found a need for policy change to strengthen the principal’s management and instructional leadership role when managing human capital effectively in schools. Such a bold move would pave the way for an upgrade in principals’ leadership and management capacities so they can effectively manage teacher performance and thereby improve academic performance.
Research on the Effect of Low-Carbon Education on Residents by the Chinese Government
Authors: Tian Ze , Si Hongcheng , Guo Canyu , Zhang Jun , Zhang Hanqi , Zhang Quanwang
Published: September 2024

The low carbon living of residents is important for China to achieve the “double carbon goal.” This paper uses the natural language processing technique in machine learning to collect data from 2005 to 2020, constructs the government’s “green will” index and residents’ low-carbon life index, and conducts an empirical study through a static panel model and a dynamic panel model. The study shows that: (a) all cities in the Yangtze River Delta pay more and more attention to low-carbon publicity, but there are individual differences in the degree of attention; (b) in general, the government’s willingness to go green does drive residents to develop a low-carbon life; (c) affluence and human capital growth are positively related to the effect of government low-carbon publicity. Accordingly, the following measures are proposed: increase the government’s low-carbon publicity efforts, deepen education reform, attract high-end talents, strengthen scientific and technological innovation, promote new urbanization, and reduce the marginal cost of carbon emissions.
Leader Member Exchange as a Mediator of the Relationship Between Schools’ Openness to Change and Political Skills of School Principals
Authors: Bilge Bekir , Konaklı Tuğba
Published: September 2024

In today’s competitive and complex environment, school leaders require social influencing skills to mobilize schools to enable them to adapt to change. The schools’ openness to change (SOC) is affected by the direction and strength of relationships between teachers and principals in the school. In particular, the political skills of school principals can play a prominent role in mobilizing employees for change. This research investigates the impact of school principals’ political skills on schools’ openness to change, with a focus on the mediating role of leader member exchange (LMX) quality. The sample group was obtained by simple random sampling from 613 state teachers working in the Kocaeli province in Turkey in the 2019 to 2020 academic year. This study is based on quantitative data collected through the “Leader-Member Exchange Scale,”“Schools’ Openness to Change Scale,” and “Political Skill Inventory.” The measurement models of the latent variables (political skill, LMX, and SOC) were confirmed via running Confirmatory Factor Analysis (CFA). Afterward, Structural Equation Modeling (SEM) was used to test the structural model. The results reveal that the political skills of school principals significantly predict the SOC and the LMX. Political skills of school principals affect schools’ openness to change positively, and leader-member exchange positively effects the relationship between political skills and openness to change. It’s recommended that activities supporting the quality of leader member interactions in schools be carried out.
How Does University-Industry Collaboration Drives the Green Innovation?
Authors: Jing Li Chao
Published: September 2024

Breaking through the company’s own green knowledge barriers through school-enterprise cooperation has become an important means for companies to expand market competitive advantages and environmental governance. This article uses China’s non-financial listed company data from 2010 to 2021 to study the causal effect of school-enterprise cooperation on corporate green innovation. The results passed a series of robustness tests and confirmed that school enterprise cooperation can improve the level of green innovation of enterprises. This paper also uses the instrumental variable method to mitigate the causal relationship between the two. The results show that school-enterprise cooperation can still significantly improve corporate green innovation. The results of the mechanism test confirm that school-enterprise cooperation will promote corporate green innovation by reducing corporate green innovation risks and easing corporate financing constraints. At the same time, the heterogeneity analysis results show that school-enterprise cooperation has a better effect on improving green innovation for enterprises in heavily polluting industries, enterprises in years with low economic policy uncertainty, and enterprises with a high degree of government-enterprise connection. The findings of this article help to understand the intrinsic mechanism between school-enterprise cooperation and corporate green innovation, and confirm that school-enterprise cooperation can improve the climate and environmental innovation system, which has important practical significance for the construction of the industry-university-research system.
Mind the Gap: How Teachers’ Professional Development Preferences Relate to Scientific Recommendations
Authors: Ehlert Mareike , Souvignier Elmar
Published: September 2024

There is extensive empirical research on principles of effective teacher professional development (PD). However, teachers’ expectations of PD and how well these align with scientific recommendations are only rarely addressed. N = 125 teachers were presented with video vignettes on two evidence-based interventions of varying complexity for which they indicated their own PD preferences. Teachers’ preferences were then compared to scientific recommendations for effective PD. In line with scientific recommendations, teachers generally preferred coherent PD with a clear content focus and collective participation. However, there were large differences between individual teachers’ preferences as well as between PD features. A striking discrepancy between research and practice was found for PD duration: Most teachers preferred one-shot workshops (six contact hours at most). Surprisingly, teachers barely differed in their PD preferences for interventions of varying complexity, indicating that teachers have clearly defined notions of PD. Regression analyses on individual and contextual factors did not yield systematic results to explain teachers’ PD preferences. In sum, teachers’ desired short duration, their lacking awareness of adjusting PD for interventions of varying complexity, and individually significant deviations from scientific recommendations for PD make it necessary to clearly communicate evidence-based standards to teachers—and policymakers.
Auditory Risk Factors at Birth and Language Development at 2 Years of Age: A Longitudinal Analysis
Authors: Ramirez Yaser , Castillo Yuleidys , Acea Shuyeng , Pagani Linda S.
Published: September 2024

Aim. To analyze the relationship between auditory risk factors at birth and subsequent language development in toddlerhood. Methods. Participants are 136 children from a longitudinal birth cohort follow-up at age 2 years. They were divided into 2 groups: One comprising 105 children without hearing risk factors at birth and another comprising 31 children with auditory risk factors at birth but normal hearing. Results. In children with and without risk factors, the combination of socio-emotional, socio-economic, and auditory risk factors at birth significantly predicted language development at age 2 years. Family socio-economic status had a significant impact on overall child development, even after controlling for socio-emotional development and the presence of risk factors. Conclusions. The study was conducted in an upper-middle income country with a socialized health care system. It underscores the importance of a holistic approach to early childhood language development, taking into account biological, socioeconomic, and emotional factors.
Onwards and ...eastwards? EU-Azerbaijan relations as an example of crisis-driven agenda-setting within the framework of the European neighbourhood policy
Authors: Meyer Julia K , Bayramov Agha
Published: September 2024

This paper uses qualitative discourse analysis to investigate how the Second Nagorno-Karabakh war in 2020 and Russian invasion of Ukraine in 2022 have impacted bilateral relations between the European Union and Azerbaijan in the realm of security and energy policy? The study takes into account geo-political developments in the aftermath of the 2018 Agreement on New Partnership Priorities, as well as contemplates the future of the European Neighbourhood Policy. In this context, the paper illuminates the interplay of EU external governance, agenda-setting, and crisis concepts. In essence, the paper asserts that the EU responds swiftly to crises, such as the Ukraine and Karabakh conflicts, through actions like mediation, investments, and deepening bilateral relations, while often overlooking the root causes. Additionally, the EU consistently emphasizes long-term strategies and energy policies, with security concerns becoming more prominent during crisis periods.
Crowdsourced Data Collection Opens New Avenues for the Behavioral Sciences to Impact Real-World Applications
Authors: Kravitz Dwight J. , Mitroff Stephen R. , Callahan-Flintoft Chloe , Oie Kelvin S.
Published: September 2024

The behavioral sciences have had great success in their study of the mechanisms that drive behavior. However, they have had less impact on applied settings or policy. This gap results from the very adaptability that makes human behavior useful. Adaptability implies that behavior will be highly specific to the context in which it occurs. Thus, building a bridge between the lab and application requires testing in the specific applied setting, which runs afoul of the high cost of data collection. This cost has also led to a focus on simple paradigms that poorly match applied settings. However, crowdsourcing enables data collection at vastly reduced budgets and schedules. This new cost regime also enables paradigms better suited to applied settings. Behavioral science should now be used throughout applied- and policy-focused projects.
Postgraduate Operating Room Nursing Students’ Experiences with Blended Learning Combining Digital Learning Paths and Basic Skills Training as Preparation for Internship: A Qualitative Study
Authors: Kolstad Lena Rengård , Tjugum Vibeke , Rød Irene , Skedsmo Karoline , Stenseth Hege Vistven , Reime Marit Hegg
Published: September 2024

Introduction

Numerous pedagogical practices ought to be contemplated for the acquisition of practical aptitudes imperative to postgraduate operating room nursing education. The employment of digital technologies has emerged as a strategic focus in higher education and learning paths exhibit potential as a digital approach in nursing education.

Objective

This study aimed to investigate the experiences of postgraduate OR nursing students who underwent a blended learning approach, which combines digital learning paths with skills training, and to explore how this approach prepares students to attain specific learning outcomes during their internship period.

Methods

This qualitative study employed a descriptive, exploratory design and utilized focus group interviews facilitated by an interview guide to gather qualitative data. A purposive sampling strategy was employed, and the collected data were analyzed using a systematic text condensation approach.

Results

The analysis of the data revealed two main categories and five subgroups. The first category, “Blended learning serves as adequate preparation for internship,” includes subgroups that highlight the advantages of diverse learning activities that aid in the development of a strong foundation in practical skills. The positive influence of peer collaboration fosters improved learning through social interaction, while the organization of the curriculum has a significant impact on students’ learning experiences. The second category, “The importance of skills training and behaving in an operating theater context,” consists of subgroups that emphasize the necessity of progressing from basic technical skills training to simulation pedagogy to ensure appropriate behavior in the operating room. Small group sizes, close monitoring, and assessment by educators contribute to effective learning.

Conclusion

The integration of digital learning paths with skills training fosters a problem-solving approach and encourages active and collaborative learning. Skills training in small groups, timely feedback, and coordination among subject managers to handle the students’ workload can create an optimal learning environment.
Dietary Practices and Associated Factors Among Adult Diabetic Patients at Academic Tertiary-Level Hospitals in Central Ethiopia: Convergent Mixed Study
Authors: Saliya Sentayehu Admasu , Ashine Taye Mezgebu , Heliso Asnakech Zekiwos , Babore Getachew Ossabo , Birhanu Bethelhem , Hailu Awoke Girma , Sebro Sisay Foga , Ezo Elias , Begizew Selamawit Wondale
Published: September 2024

Background

Diabetes mellitus (DM) is one of the most common chronic diseases globally. Despite the presence of national strategies to prevent potential sequelae DM has been associated with increased morbidities and mortality in Ethiopia, and the prevalence appears to be on the rise. Although studies have been conducted among DM patients in the country, there is a lack of information that could allow an in-depth understanding of the situation.

Objective

To assess dietary practices and associated factors among adult DM patients at academic tertiary-level hospitals in central Ethiopia.

Methods

The institution-based concurrent mixed-methods study was conducted from January 01 to 30 2024 involving 420 adult DM patients. Participants were selected using a simple random sampling technique for quantitative study. A purposive sampling technique was used to select 16 participants for qualitative analysis. For the quantitative study, a self-administered structured questionnaire was used to collect data, and an in-depth interview for the qualitative part. Multivariate binary logistic regressions were used to assess the explanatory variables associated with dietary practice. A thematic analysis was performed for qualitative data.

Result

Of 420 eligible participants, 406 (96.7%) participated in the study. The overall proportion of good dietary practices among participants was 172 (44.2%). The being female, urban residence a family history of DM, and good dietary were significantly associated with the dietary practice. From qualitative analysis, two themes have emerged; Living as before and not adhering to diabetic dietary recommendations and barriers to adherence to effective eating practice.

Conclusions and recommendations

Less than half of adult DM patients had good dietary practices. Sex, geographic location, family history of DM, and level of knowledge of diabetic diet were associated with dietary practice. Intervention programs on awareness creation and training to improve the dietary practice by stakeholders were recommended.
Endovascular treatment in patients with acute ischemic stroke presenting beyond 6 h after symptom onset: An international multicenter cohort study of the EVA-TRISP collaboration
Authors: Wali Nabila , Stolze Lotte J , Rinkel Leon A. , Heldner Mirjam R , Müller Madlaine , Arnold Marcel , Mordasini Pasquale , Gralla Jan , Baumgartner Philipp , Inauen Corinne , Westphal Laura P , Wegener Susanne , Michel Patrik , Trüssel Simon , Mannismäki Laura , Martinez-Majander Nicolas , Curtze Sami , Kägi Georg , Picchetto Livio , Dell’Acqua Maria Luisa , Bigliardi Guido , Riegler Christoph , Nolte Christian H , Serôdio Miguel , Miranda Miguel , Marto João Pedro , Zini Andrea , Forlivesi Stefano , Gentile Luana , Cereda Carlo W , Pezzini Alessandro , Leker Ronen R , Honig Asaf , Berisavac Ivana , Padjen Visnja , Zedde Marialuisa , Kuhrij Laurien S , Van den Berg-Vos Renske M , Engelter Stefan T , Gensicke Henrik , Nederkoorn Paul J
Published: September 2024

Introduction:

After positive findings in clinical trials the time window for endovascular thrombectomy (EVT) for patients with an acute ischemic stroke has been expanded up to 24 h from symptom onset or last seen well (LSW). We aimed to compare EVT patients’ characteristics and outcomes in the early versus extended time window and to compare outcomes with the DAWN and DEFUSE 3 trial results.

Patients and methods:

Consecutive EVT patients from 16 mostly European comprehensive stroke centers from the EVA-TRISP cohort were included. We compared rates of 90-day good functional outcomes (Modified Rankin Scale 0–2), symptomatic intracranial hemorrhage (sICH), and 90-day mortality between patients treated in the early (<6 h after onset or LSW) versus extended (6–24 h after onset or LSW) time windows.

Results:

We included 9313 patients, of which 6876 were treated in the early and 2437 in the extended time window. National Institutes of Health Stroke Scale (NIHSS) score at presentation was lower in patients treated in the extended time window (median 13 [IQR 7–18] vs 15 [IQR 9–19], p < 0.001). The percentage of patients with good functional outcome was slightly lower in the extended time window (37.4% vs 42.2%, p < 0.001). However, rates of successful recanalization, sICH, and mortality were similar. Good functional outcome rates after EVT were slightly lower for patients in the extended window in the EVA-TRISP cohort as compared to DAWN and DEFUSE 3.

Discussion and conclusion:

According to this large multicenter cohort study reflecting daily clinical practice, EVT use in the extended time window appears safe and effective.
Malpractice rates are lower for women physicians compared to men physicians
Authors: Gupta Kiran , Romero Vincent , Grenon Véronique , Sarkar Urmimala
Published: September 2024

Background

Previous literature has shown that women physicians are less likely to be involved in medical malpractice litigation than male physicians.

Methods

This study sought to examine the differences in malpractice experience by provider gender by using closed medical malpractice claims from 2011 through 2020.

Results

We found that after adjusting for the number of claims and dollar losses per full time equivalents worked, female physicians experienced fewer and less costly claims than male physicians ( p < .001). Specific specialties had a significant relationship between claim frequency and provider gender, which included general surgery ( p = .01), obstetrics ( p = .001), gynecology ( p = .04), internal medicine and family general practice ( p < .001).

Conclusion

The results from this analysis support the prior findings that male physicians experience a higher rate of malpractice claims. Therefore, there is an opportunity to learn how women providers achieve lower malpractice risk to inform clinical practice recommendations.
Understanding the needs for support and coping strategies in grief following the loss of a significant other: insights from a cross-sectional survey in Sweden
Authors: Benkel Inger , Skoglund Johanna , Enstedt Daniel , Hård af Segerstad Ylva , Öhlén Joakim , Nyblom Stina
Published: September 2024

Background:

Grief has previously been described in pathological terms, characterized by several stages. In the past three decades, new perspectives on grief as a reaction to the loss of a significant other have emerged. It shows that grief is an individual process based on circumstances surrounding the death and the bereaved person’s life situation, rather than being predetermined.

Objective:

The aim of the study was to show how grief is perceived by people who have lost a significant other, and it focuses on bereavement support, how the death affects the bereaved person’s living conditions, how the bereaved person deals with grief, and if grief is expressed differently depending on whether it was an expected death (ED) or an unexpected death (UED).

Design:

A cross-sectional design was used with data collected anonymously using an online survey with semi-structured answers and options for participants to add their own comments, and it was analyzed descriptively.

Result:

Support in grief was mainly given by family and friends, and the perceived need was primarily for emotional support or emotional support combined with practical support, and to a greater extent for UEDs and women. For some bereaved persons, health caregivers and religious institutions provided support outside their own network. Grief can affect how people socialize with others and change social relationships. People can deal with grief in social as well as religious ways in the company of friends, through everyday conversations, spending time in nature, and having a spiritual outlook on life, and with the help of pets.

Conclusion:

The results can contribute to an increased understanding of grief after the loss of a significant other and how grief affects the bereaved person’s life depending on whether it is an ED or a UED. There was a difference between the genders, with women perceiving a need for and receiving different forms of support and to a greater extent than men.
Preparation for implementation of evidence-based practices in urban schools: A shared process with implementing partners
Authors: Eiraldi Ricardo , Comly Rachel , Wolk Courtney Benjamin , Rabenau-McDonnell Quinn , McCurdy Barry L. , Khanna Muniya S. , Jawad Abbas F. , Banks Jayme , Clark Stacina , Popkin Kristina M. , Wilson Tara , Henson Kathryn
Published: September 2024

Background

Shifting organizational priorities can negatively affect the sustainment of innovations in community settings. Shifting priorities can present barriers to conducting clinical research in schools if a misalignment occurs between school district priorities and the aims of the study. Often this misalignment occurs due to a shift during the period between when the study is submitted for funding and when research activities begin. Participatory research approaches can be employed to restore alignment between study processes and school district priorities. The purpose of the study is to describe data from a shared process with district partners. The shared process resulted in modifications to the main study's implementation processes and strategies in order to restore alignment with evolving school priorities while remaining faithful to the aims of the study.

Method

Data originated from qualitative interviews conducted with 20 school district and school personnel in a large urban school district. Qualitative themes were organized into categories based on a social-ecological school implementation framework. Data from team meetings, meetings with school district administrators, and emails served to supplement and verify findings from interview analyses.

Results

Themes included barriers and facilitators at the macro-, school-, individual-, team-, and implementation quality levels. Adaptations were made to address barriers and facilitators and restore alignment with school district priorities. Most adaptations to study processes and implementation strategies focused on re-training and providing more information to school district coaches and school-based staff. New procedures were created, and resources were re-allocated for the larger study.

Conclusions

Findings were discussed in relation to the implementation literature in schools. Recommendations for sustaining strong collaboration among researchers and school partners are provided.
On the use of selective Z-pinning in stiffened composite panels to prevent skin/stringer debonding
Authors: Yan Bin , Zhu ShengWei , Zhang YunKe , Shen LiangJi , Li Yuan , Jiang WenTao , Kang WenLi , Dou Hu
Published: September 2024

Carbon fiber reinforced plastic (CFRP) composites have been widely used in engineering. This paper investigates the effect of composite z-pin (polyimide fiber/epoxy resin) on flexural properties of skin/stringer composite structure with different z-pin densities and diameters. Compared with unpinned specimens, the peak loading and energy absorption of z-pinned specimens are increased by 98% and 9 times, respectively. Parameterized research indicates that the optimal z-pin density is 1.35%. And thin z-pins are beneficial to improve the peak loading and energy absorption, which attributes to more total contact area of z-pins. The statistical results present that z-pin pre-hole inserted (ZPI) process can significantly reduce initial damages of z-pinned specimens compared with Ultrasonically Assisted Z-fiber (UAZ) process. Specifically, the z-pin inclination angle is decreased by 60%, and the initial damages in eye-like zone are prominently reduced. The z-pin makes the specimen exhibit the quasi-brittle behavior under flexural loading by playing a bridging role, which makes the flexural properties of specimens prominently increased. In addition, the “snubbing effect” will enhance the bridging effect of z-pins, but it will lead to inter-fibers debonding, splitting, and shear failure of z-pins.
The prioritisation of climate security: A content analysis of national security agendas
Authors: Wik Trine Marielle , Neal Andrew W.
Published: September 2024

Climate change is leading to severe environmental degradation and ecological breakdown. We are on a path towards 2°C to 3°C warming above pre-industrial levels, yet at the current 1°C warming, we already see drastic and irreversible changes. Arguably, this represents an existential threat to humanity, and by extension, a national security threat to every country in the world. Nevertheless, the securitisation of climate remains contested, and research on states’ approaches to climate securitisation remains limited despite them being the most important actors in climate change policy. In this article, we perform a content analysis on a large corpus of current national security and defence documents from 94 countries to determine: Is climate on national security agendas? To what extent is it prioritised? What are the main ways in which national security agendas handle climate security? We find that although most states in our sample (84%) mention climate in their national security documents (NSDs), they still treat it as a low priority in most cases. All states devote less than a quarter of their NSDs to climate change. Only five states dedicate 10% or more, whilst the majority of states dedicate 3% or less.
The Patient Perspective of an Inpatient Addiction Medicine Unit Implemented in an Urban Northern Acute Care Hospital in Ontario, Canada
Authors: Morin Kristen A , Bodson Adele , Ghartey Karla , Patrick Krysten A , Knowlan Shannon , Marsh David C , Aubin Natalie , Leary Tara
Published: September 2024

Background:

An Addiction Medicine Unit (AMU) represents a promising approach to enhancing hospital care for individuals who use substances, but there is limited research to understand patients’ perspectives on AMUs. Therefore, the study objectives involved exploring patients’ experiences with the AMU.

Methods:

Qualitative semi-structured interviews were conducted with 17 patients to gather their perspectives about the AMU. The AMU offers specialized inpatient addiction support, integrating medical and psychosocial interventions while facilitating connections to community supports to stabilize patients and manage addiction-related issues using a harm reduction philosophy.

Results:

Factors identified by patients that lead to positive experiences with the AMU included: efficient access to high-quality acute medical care, specialized addiction care, and additional support for non-medical needs. Patients emphasized the benefits of having peer support workers on staff, the overall positive interactions with staff, and how different these experiences were from their hospital admissions outside of the AMU. Factors identified by patients that should be considered in an AMU included: the ease of access to substances, negative interactions with other patients, and self-stigma/internalized discrimination. Also, the patient perspective reflected varied views on harm reduction. Patients’ perception of the impact of an AMU overall reflected that the AMU is an effective way to deliver comprehensive treatment, to address the needs of PWUS, both medical and substance-use-related issues. They identified that the unit’s intentional harm reduction philosophy facilitated access to care and positive patient-staff interactions, emphasizing the unit’s progress in reducing fear and judgment and rebuilding trust in the healthcare system.

Conclusion:

The introduction of a new AMU in a Northern urban acute care hospital in Ontario has yielded positive patient experiences. The AMU model shows potential to re-establish trust between patients and providers, but ongoing efforts are needed to address underlying stigma to be more effective.
N-formylmethionine-leucyl-phenylalanine protects against irradiation-induced damage to hematopoiesis and intestines
Authors: Li Zhihua , Wu Yatong , Du Jicong , Qian Wen , Wang Sinian , Li Fengsheng , Dong Suhe , Jiao Shunchang
Published: September 2024

Background

Ionizing radiation (IR), including radiotherapy, can exert lasting harm on living organisms. While liposaccharide (LPS) offers resistance to radiation damage, it also induces toxic responses. Thankfully, an LPS analogue called N-formylmethionine-leucyl-phenylalanine (fMLP) holds the potential to mitigate this toxicity, offering hope for radiation protection.

Methods

Survival of C57BL/6 mice exposed to IR after administration with fMLP/LPS/WR-2721 or saline was recorded. Cell viability and apoptosis assay of bone marrow (BMC), spleen and small intestinal epithelial (HIECs) cells were tested by Cell Counting Kit-8 (CCK-8) and flow cytometry assay. Tissue damage was evaluated by Hematoxilin and Eosin (H&E), Ki-67, and TUNEL staining. RNA sequencing was performed to reveal potential mechanisms of fMLP-mediated radiation protection. Flow cytometry and western blot were performed to verify the radiation protection mechanism of fMLP on the cell cycle.

Results

The survival rates of C57BL/6 mice exposed to ionizing radiation after administering fMLP increased. fMLP demonstrated low toxicity in vitro and in vivo, maintaining cell viability and mitigating radiation-induced apoptosis. Moreover, it protected against tissue damage in the hematopoietic and intestinal system. RNA sequencing shed light on fMLP’s potential mechanism, suggesting its role in modulating innate immunity and cell cycling. This was evidenced by its ability to reverse radiation-induced G2/M phase arrests in HIECs.

Conclusion

fMLP serves as a promising radioprotective agent, preserving cells and radiosensitive tissues from IR. Through its influence on the cell cycle, particularly reversing radiation-induced arrest in G2/M phases, fMLP offers protection against IR’s detrimental effects.
Demographic and temporal trends in mental health and substance use services provided by primary care physicians in British Columbia, Canada
Authors: Jamieson Margaret , Juda Myriam , Lavergne M. Ruth , Kurdyak Paul , Laporte Audrey , Rudoler David
Published: September 2024

Background

As the demand for mental health and substance use (MHSU) services increases, there will be an even greater need for health human resources to deliver this care. This study investigates how family physicians’ (FP) contact volume, and more specifically, MHSU contact volume, is shaped by demographic trends among FPs in British Columbia, Canada.

Methods

We used annual physician-level administrative billing data and demographic information on FPs in British Columbia between 1996 and 2017. This study analyzes trends in primary care service provision among graduating cohorts of FPs, FPs of different ages (as measured by years since graduation), and FPs practicing during different time periods. Additionally, analyses are stratified by FP sex to account for potential differences in labour supply patterns between male and female FPs.

Results

Our results show that while FPs’ overall contacts with patients decreased between 1996 and 2017, their annual number of MHSU contacts increased, which was largely driven by an increase in substance use visits. Demographically, the proportion of female FPs in the labour force rose over time. Observed trends were similar, though not identical in male and female FPs, as males tended to have higher overall contact volume (both total contacts and MHSU), but also steeper declines in contact volume in later careers. The number of contacts (both total and MHSU) changed across career stage - rising steadily from start to mid-career, peaking at 20–30 years in practice, and decreasing steadily thereafter. This was evident for all cohorts and consistent over the 21-year study period but flattened in amplitude over time. Our findings also point to potential cohort effects on labour supply. The inverse U-shaped career trend extended to MHSU contacts, but its peak seems to have shifted to a later career stage (peaking at 30–40 years of practice) over time.

Conclusions

Our study shows changing dynamics in MHSU service delivery among FPs over time, across the life span and between FP sexes that are likely to influence access to care beyond simply the number of FPs. Given the healthcare needs of the population, these findings point to potential future changes in provision of MHSU services.
Association of electronic cigarette use and suicidal behaviors: a systematic review and meta-analysis
Authors: Awad Abdelaziz A. , Itumalla Ramaiah , Gaidhane Abhay M. , Khatib Mahalaqua Nazli , Ballal Suhas , Bansal Pooja , Srivastava Manish , Arora Isha , Kumar MRavi , Sinha Aashna , Pant Kumud , Serhan Hashem Abu , Shabil Muhammed
Published: September 2024

Background

The proliferation of electronic cigarettes (e-cigarettes) has presented new challenges in public health, particularly among adolescents and young adults. While marketed as safer than tobacco and as cessation aids, e-cigarettes have raised concerns about their long-term health and psychosocial impacts, including potential links to increased suicidal behaviors. This study aims to evaluate the relationship between e-cigarette use and suicidal behaviors by conducting a systematic review of the current literature.

Methods

We searched PubMed, Web of Science, and EMBASE for studies up to March 10, 2024, examining the relationship between e-cigarette use and suicidal behaviors. Eligible studies included cross-sectional, longitudinal, retrospective, prospective, and case–control designs. Meta-analysis was performed to calculate pooled odds ratios (ORs). Newcastle Ottawa scale was used to assess the quality of studies. R software (V 4.3) was used to perform the meta-analysis.

Results

Our analysis included fourteen studies, predominantly from the US and Korea, with participants ranging from 1,151 to 255,887. The meta-analysis identified a significant association between e-cigarette use and an increased risk of suicidal ideation (OR = 1.489, 95% CI: 1.357 to 1.621), suicide attempts (OR = 2.497, 95% CI: 1.999 to 3.996), and suicidal planning (OR = 2.310, 95% CI: 1.810 to 2.810). Heterogeneity was noted among the studies.

Conclusion

E-cigarette use is significantly associated with the risk of suicidal behaviors, particularly among adolescents. The findings underscore the necessity for caution in endorsing e-cigarettes as a safer smoking alternative and call for more extensive research to understand the underlying mechanisms. Public health strategies should be developed to address and mitigate the risks of suicidal behaviors among e-cigarette users.