bluuebunny/crossref_metadata_2025 huggingface dataset:
Doc’s Kingdom (1989), Route One/USA (1989), Dear Doc (1990) : la trilogie de Doc
Authors: Singer Isabelle
Published: July 2024

Avec Route One USA (1989), Robert Kramer revient aux États-Unis faire le bilan de ce que le pays est devenu après huit ans de reaganisme : pauvreté, violence, discriminations, montée des intégrismes. C’est aussi le retour du personnage de Doc qui apparaît dans Ice (1970), Doc’s Kingdom, Route One USA en enfin Dear Doc, et avec lui vingt ans d’engagement. Ce personnage de fiction est au cœur du dispositif de Route One USA, nous faisant mettre en doute ce que nous estimons documentaire. Dans la structure rhizomatique des films, s’élabore la dimension critique de l’œuvre : rejet d'un état social injuste et violent, rejet aussi du cinéma dominant, cette « monoforme » dirait Peter Watkins, aliénante et simplificatrice.
Learning Strategies among Medical Students in a selected University in Sri Lanka
Authors: Edirisinghe S. , De Silva D. , Dissanayake H. , Yasawardane S.
Published: July 2024

Introduction: The discipline of medicine is continually changing and evolving, and with it, medical education. It is difficult to develop the attitudes, knowledge, and abilities needed to become a competent physician within a short amount of time. The purpose of this study is to identify and compare the practice of surface, strategic, and deep learning strategies by third-year medical students and students who have passed the final MBBS examination.Methods: The Approaches and Study Skills Inventory for Students (ASSIST) – a 52-item questionnaire was given to 138 medical undergraduates at the Faculty of Medical Sciences, University of Sri Jayewardenepura. The ethics review committee of the Faculty of Medical Sciences, University of Sri Jayewardenepura granted ethical clearance for this study (Ref. no. 45/17).Results: The strategic approach was shown to be the most common strategy [78.3%(108/138)] practiced by medical students [Students who completed their final MBBS exams [80.6% (25/31)] and third-year medical students (77.6% (83/107)]. The deep approach was used by 21 (15.2%) individuals and the surface apathetic approach by 9 (6.5%) participants, respectively. Percentage 82.6 (76/92) of females and 69.6% (32/46) of males reported adhering to a strategic approach. A statistically significant difference was not observed in the learning strategies used between the two study populations.Conclusions: The strategic approach was commonly practiced by the study population. The results indicate that deep learning strategies were not utilized among medical undergraduates in their curriculum. Future medical curriculum revisions need to take these findings seriously and develop an instructional design to promote a deep learning approach.
Assessment of Anxiety Levels in Patients Scheduled to Undergo Magnetic Resonance Imaging
Authors: Chail Amit , Muthanna B. A. , Soneji Dharmesh , Singh Harpreet , Lahel Ranjit Singh
Published: July 2024

Introduction:

Magnetic resonance imaging (MRI) has been known to induce elevated levels of anxiety in patients due to multiple factors such as fear of closed spaces when they are scanned in a confined tube for a long duration and loud noise during scans. This study aims to objectively assess anxiety levels in patients scheduled to undergo MRI, using a psychometric scale known as Hospital Anxiety and Depression Scale (HADS).

Methods:

The study was conducted involving 2413 patients who presented to the MRI Centre of a tertiary care hospital for 1 year. All patients scheduled to undergo MRI were explained the objective of the study and those willing to participate were given a self-administered set of questionnaires of Hospital Anxiety and Depression Score – Anxiety subset. Out of 2413 eligible patients, 2027 completed the questionnaires and were included in the study.

Results:

The prevalence of anxiety among the prescan sample group was detected to be 52.5% and in the postscan group 66.5%. There was a greater proportion of females detected with anxiety at 60.3%. The most common age group involved was in the range of 41–50 years (37.7%). The fear of confinement in closed spaces and apprehension of high noise levels was detected to be the most common cause of anxiety at 44%.

Conclusion:

Anxiety among patients scheduled to undergo MRI scans is a major issue that though known has not been given due importance in terms of actions instituted by the hospitals to assess the anxiety and stress levels of these patients. Physicians and hospital administration must make dedicated efforts to put in place psychological support measures to generate the best results out of the scheduled MRI exams, both in terms of clinical outcomes in the form of good quality scans to enable definitive diagnosis, and in financial terms to make the best use of time, workforce and commercial resources available and avoid loss in form of cost increments due to delay/cancellation of scans owing to patient anxiety.
Reactive Infectious Mucocutaneous Eruption with Extensive Cutaneous Involvement
Authors: Anderson Zeynoire , Fotouhi Audrey , Tolliver Starling , Mehregan Darius
Published: July 2024

Recently, there has been discussion to reclassify pediatric Stevens–Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) as drug-induced epidermal necrolysis (DEN), separating it from infectious etiologies and redefining pediatric mucocutaneous eruptions as either reactive infectious mucocutaneous eruption (RIME) or DEN. In this report, we describe a previously healthy 4-year-old girl with rapidly progressive mucocutaneous blistering involving four mucosal membranes and 37.5% of total body surface area (BSA) following a prodromal rhinovirus and enterovirus infection. The symptoms occurred in the absence of an inciting medication and improved with only supportive care. This case illustrates a rare occurrence of RIME with TEN-like BSA involvement, prompting a review of the literature exploring the relationship between BSA involvement in RIME and its influence on patient outcomes. Findings support the proposed reclassification of SJS/TEN as DEN and postinfectious mucocutaneous eruptions as RIME.
Coronavirus Disease 2019 and Skin: A Retrospective Analysis
Authors: Supekar Bhagyashree Babanrao , Wankhade Vaishali Hainath , Kote Shraddha P , Gawali Shirin Sunil , Chopkar Apoorva Dhananjay , Singh Rajesh P , Dhakate Arpit Govinda
Published: July 2024

Introduction:

Coronavirus disease 2019 (COVID-19), a unique viral infection causing multiorgan failure, can lead to diverse dermatological manifestations, unlike other viral exanthems. There is a scarcity of Indian literature describing these manifestations.

Aims and Objectives:

To study the dermatological manifestations due to COVID-19 infection.

Materials and Methods:

It was a retrospective analysis (6 month) of patients with dermatological manifestations related to COVID-19 infection. Medical records were evaluated with respect to demography, detailed clinical presentations, real-time reverse transcription–polymerase chain reaction/rapid antigen test positivity, and related investigations.

Statistical Analysis:

It was done using proportion, mean, and percentages.

Results:

A total of 76 cases were recruited. Out of the 76 COVID-19-related cases, there were 67 diagnosed and 9 suspected cases (later came positive). The overall female predominance (n = 69) was observed. The most common age affected was 31-40 years. The most common presentation during prodromal, acute, and postacute phases was urticaria. Other manifestations were chilblain-like, varicella-like, pityriasis rosea-like, erythema multiforme-like, petechial rash, multisystemic inflammatory syndrome in children and confirmed cases of mucormycosis seen with cutaneous manifestation.

Conclusion:

Our study highlights the need for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing in patients presenting with rash in otherwise asymptomatic individuals having contact with confirmed case and when associated with systemic symptoms. Dermatological manifestations may play an important role in identifying cases early and serve as an important proxy in managing further spread of this disease in the midst of the global pandemic. Urticaria with fever has diagnostic significance since this combination can be a symptom of an otherwise not confirmed SARS-CoV-2 infection.
Curious Case of Swelling over the Back: A Case Report of Sebaceous Cell Carcinoma in a Patient of Airborne Contact Dermatitis
Authors: Jain Sonia , Galui Sangeeta , Sonkusale Pratiksha
Published: July 2024

Sebaceous carcinoma is a rare variety of malignant tumor involving sebaceous glands. Compared to its ocular counterpart, the extraocular variant is even more rare, accounting for only one-fourth of all cases. It is a great mimicker of a plethora of benign and malignant tumors, hence often misdiagnosed. Surgical excision is the preferred mode of treatment in most cases. Here, we present the case of a 72-year-old male with airborne-contact dermatitis who was initially misdiagnosed with acrochordon, which was later found to be a case of sebaceous carcinoma on histopathology. There is a paucity of literature regarding sebaceous gland carcinomas located outside the head-and-neck region, which makes this case even more interesting.
A Cross-sectional Observational Study of Noninfectious Dermatoses in Geriatric Population
Authors: Rajpoot Prachi Singh , Poojary Sheetal , Pathave Hari
Published: July 2024

Introduction:

The geriatric population is expected to constitute 21.1% of total population in India by 2051. Geriatric population is associated with increased prevalence of various chronic diseases, physical disabilities, mental illness, and comorbidities. The trend is changing towards dermatoses of noninfective etiology owing to factors such as increased literacy rates and hygienic practices. Thus, our study is to focus on pattern of dermatoses of noninfective etiology in the most neglected yet important section of our population, that is, geriatric population.

Objective:

The objective of this study was to measure the prevalence of various noninfectious dermatoses among geriatric patients attending the skin outpatient department (OPD) at a tertiary care center.

Methods:

Two hundred and seventy-seven geriatric patients visiting skin OPD at a tertiary care center presenting with various noninfectious dermatoses were included, and the prevalence of various noninfectious dermatoses in this section of population was studied.

Results:

Eczemas were the most common group of noninfectious dermatoses (29.6%), followed by papulosquamous disorders (20.6%). Simultaneously associated systemic diseases and physiological changes were studied. Out of 277 patients, 156 (56.3%) had associated systemic illness. Eighty-seven (31.4%) patients were hypertensive, followed by diabetes mellitus (18.4%). The most common physiological change observed was wrinkling (47.6%), followed by seborrheic keratosis (46.2%). The Dermatology Life Quality Index (DLQI) score between 2 and 5, i.e., small effect on a patient’s life, was significant in 100 (36.1%) patients, followed by moderate (DLQI 6–10 score), no effect (DLQI 0–1), very large (DLQI 11–20 score), and extremely large (DLQI 21–30) in 70 (25.3%), 57 (20.6%), 30 (10.8%), and 20 (7.2%) patients, respectively.

Conclusion:

In our study, eczemas were the most common group of noninfectious dermatoses in the elderly. So, simple measures such as diligent use of moisturizers, avoidance of harsh soaps and detergents along with adequate bathing time can decrease its prevalence.
Role of Serum IFN-γ and IL-10 as Predictive Biomarkers of Vitiligo Disease Activity: A Case-Control Study
Authors: Desai Karishma , Yadalla Hari Kishan Kumar
Published: July 2024

Background and Objectives:

IFNγ is a pleiotropic cytokine and through the regulation of immunologically relevant genes, they coordinate a wide range of cellular programs.[1] As a potent pro-inflammatory cytokine, it plays a pivotal role to induce depigmentation in vitiligo. In this study, we aim to assess the role of IFNγ in the activity, duration and extent of the disease and the antagonistic action of IL-10 is also assessed in vitiligo.

Materials and Methods:

A case-control study was conducted with 100 study participants with 50 cases clinically diagnosed as Vitiligo and 50 controls. All patients underwent complete evaluation with detailed demographic parameters, history and physical examination. The severity of the disease was assessed clinically by Vitiligo Area Scoring Index (VASI) and Vitiligo Disease Activity Score (VIDA). And blood investigations done were IFN-γ and IL-10.

Results:

We observed significantly higher levels of serum IFNγ levels in the patient group when compared with those of the normal controls (p=0.002) and showed a positive correlation with the activity and severity of the disease with a significant VASI (p=0.05) and VIDA score (p=<0.001). The mean serum IL-10 (p<0.001) in patients with vitiligo was significantly lower than that in the control group.

Conclusion:

This study showed significantly high serum levels of IFN-γ and correspondingly low levels of IL-10. New strategies, such as the combination of IFNγ blockade with inhibition of other signalling pathways, may further improve IFNγ targeted immunotherapy of the disease.
Mucocutaneous Manifestations among Patients with Malignancies at a Tertiary Care Center in Maharashtra: A Cross-Sectional Study
Authors: Kachare Supriya Ashok , Belgaumkar Vasudha A , Pradhan Shekhar N.
Published: July 2024

Background:

Malignant disorders are a leading cause of mortality and morbidity. Cutaneous manifestations may be presenting features of internal malignancies, leading to diagnosis of occult tumors, while others may occur as adverse reactions to therapeutic modalities.

Aims and Objectives:

To classify cutaneous manifestations among patients with malignant disorders, document their clinical profile, and analyze them with respect to age, gender, type of malignancy, and treatment.

Materials and Methods:

One hundred twenty patients with proven malignancy presenting with mucocutaneous lesions were enrolled in the cross-sectional study. On the basis of history, clinical examination, investigations and skin biopsy, the lesions were classified as (1) Primary cutaneous malignancy, (2) Cutaneous metastasis, (3) Paraneoplastic syndromes, (4) Mucocutaneous manifestations not related to malignancies, (5) Adverse effects secondary to treatment modalities.

Results:

One hundred twenty patients comprised 70 females (58.3%) and 50 males (41.7%). They were categorized as primary cutaneous malignancy (20.2%), hematological malignancies (15%), solid organ malignancy (50.9%), and gastrointestinal malignancies (5%). HIV seropositivity was seen in two patients (1.6%). Maximum belonged to Category 5 (60, 50%), of which 52 (86.7%) were adverse effects of chemotherapy with single patient showing radiation dermatitis and one patient in Category 3 (0.8%). Eleven patients showed cutaneous metastasis (9.1%), predominantly carcinoma breast. Clinically, primary cutaneous malignancies often presented as ulceronodular growths with squamous cell carcinoma being the most common histopathological type (30%). Anagen effluvium was the most common (35%) manifestation overall and in solid organ malignancies followed by melanonychia (16, 13.33%), cutaneous xerosis (9, 7.5%), and mucocutaneous hyperpigmentation (23, 19.16%).

Conclusions:

Mucocutaneous manifestations need prompt attention to facilitate timely diagnosis and improved outcomes.
Acitretin induced primary hypothyroidism in Darier’s disease: A rare case report
Authors: Babu Betsy Susan , Fernandes Carol Z. , Bhat Balachandra
Published: July 2024

Acitretin is a synthetic, second-generation retinoid mainly used for the treatment of Darier’s disease (DD), which impacts biological processes by binding to a nuclear receptor from the corticosteroid/thyroid receptor superfamily, thereby altering gene expression. Our report outlines the case of a 41-year-old male patient who has received a clinical diagnosis of DD and does not exhibit any other coexisting comorbidities, who developed hypothyroidism posttreatment with acitretin, an unusual and rare side effect of the drug. His baseline routine investigations fell within normal limits before the initiation of acitretin. Acitretin-induced hypothyroidism was treated with thyroxine. Although a good therapeutic response was seen with acitretin, it could not be continued due to the development of side effects and was continued on topical therapy. This case emphasizes the likelihood of adverse effects linked to therapeutic levels of acitretin in patients without any prior history and signifies the critical importance of consistent blood monitoring throughout drug therapy.
Thermoresponsive gel containing bilirubin nanoparticles exerts anti-inflammatory effects by inhibiting neutrophil infiltration and augmenting interleukin-10 levels in carrageenan-induced rat paw edema
Authors: Kamothi Dhaval J. , Kant Vinay , Jangir Babu Lal , Ahuja Munish , Joshi Vinay G. , Kumar Vinod
Published: July 2024

BACKGROUND:

Topical corticosteroids treat cutaneous inflammation but have side effects. In earlier studies, bilirubin exhibited anti-inflammatory effect, but its hydrophobicity and poor absorption limit its potential.

AIM:

Synthesis of bilirubin nanoparticles (BNP) and bilirubin nanoparticles gels (BNP gel) to study the anti-inflammatory effect of topical BNP gel against carrageenan-induced rat paw edema in Wistar rats.

MATERIALS AND METHODS:

BNP were synthesized, and BNP gels were prepared by mixing BNP of different concentrations with pluronic F-127 (PF-127). A different group for each formulation was assigned with five rats in each group. After 1 h of carrageenan (1% [w/v]) injection in each group, different gels were applied topically to their respective groups. Paw edema size, percent inflammation, percent edema inhibition, and inhibition time50 were evaluated. Interleukin-10 (IL-10) levels and neutrophil infiltration in rat paw tissue were evaluated by enzyme-linked immunosorbent assay and hematoxylin and eosin, respectively.

RESULTS:

Synthesized spherical-shaped BNP had negative zeta potential. BNP gels markedly reduced paw edema size and % inflammation as compared to carrageenan and bulk bilirubin gel (Bulk B gel) treated group and significantly increased IL-10 levels and inhibited neutrophil infiltration.

CONCLUSION:

BNP gels exhibited a better anti-inflammatory effect than bulk B gel and comparable anti-inflammatory potential with clobetasol.
The effect of chlorpyrifos oral exposure on the histomorphometric and kidney function in Wistar rat
Authors: Sakinah Elly Nurus , Wisudanti Desie Dwi , Abrori Cholis , Supangat Supangat , Ramadhani Laily Rahmah , Putri Indis Suyanto , Pamungkas Galang Cahyo , Arrobani Muhammad Hanif , Rahmadina Risa , Dirgantara Pandego Wahyu
Published: July 2024

BACKGROUND:

Chlorpyrifos belongs to a broad-spectrum organophosphate insecticide that has high toxicity, is metabolized in the liver by the oxidation reaction, and can inhibit acetylcholinesterase activity. Acetylcholinesterase inhibition generates the reactive oxygen species and induces oxidative stress, which ultimately results in cellular damage like in the kidney. Examining blood urea nitrogen (BUN) levels, creatinine, and kidney histopathology is an appropriate indicator to assess the toxicity of chlorpyrifos to the degree of damage to cells and kidney tissue.

MATERIALS AND METHODS:

This research used to determine the effect of duration of exposure to chlorpyrifos and dose–response relationships is important for early detection of the effects of chlorpyrifos toxicity on health. The research study was a true experimental (completely randomized design) consisting of 30 subjects divided into 5 groups. Controlled Group (K1) given 1 mg/kg BW Tween 20 and NaCl 0, 9% until the 56th day. The chlorpyrifos exposed group (P1, P2, P3, and P4) was given chlorpyrifos 5 mg/kg BW for 7, 14, 28, and 56 days. After the treatment, BUN and creatinine levels were measured, and microscopic changes in the kidney were analyzed. The results of BUN, creatinine, and kidney histopathologic were analyzed using the analysis of variance statistical test.

RESULTS:

The data result showed that compared to the control group, there were significant increases of BUN and creatinine (P = 0.013 and P = 0.003). Histopathological examinations of kidney glomerulus diameter were also smaller compared to the control group (P = 0.00). All the data measurement indicates significant differences compared to the control group.

CONCLUSIONS:

We concluded that sub-chronic oral exposure to chlorpyrifos at low doses can damage the kidneys and cause kidney failure.
Out-of-pocket expenses and healthcare service utilisation among maintenance haemodialysis patients: A study at a tertiary care hospital in Udupi, Karnataka
Authors: Ramesan Anandhu K. , D’Souza Brayal , Sekaran Varalakshmi Chandra
Published: July 2024

Background:

Financial burdens faced by patients in India suffering from chronic kidney disease (CKD) are linked to healthcare access and inadequate insurance coverage. This study analyses out-of-pocket expenses and explores their healthcare utilisation patterns.

Materials and Method:

This time-bound hospital-based cross-sectional study was conducted in a tertiary care hospital in Udupi district, Karnataka, among patients who have undergone haemodialysis (HD) treatment for at least a year. Following ethics approval and CTRI registration, informed consent was obtained from all the patients prior to data collection.

Result:

The study involved 109 HD patients. The direct medical and non-medical costs incurred by HD patients were Rs 9,400 (IQR = 13,700) and Rs 3,200 (IQR = 2,000), respectively. The monthly health-related OOPE was Rs 16672.0 (IQR = 14,630.0). Overall, 103 (94.5%) individuals had been hospitalised since they began HD, and 50.5% of patients were hospitalised within the past year. On linear regression analysis, it was observed that the joint monthly income (β 0.134, 95% CI 0.007 - 0.182, P value = 0.048), number of dialyses per week (β 1.14, 95% CI 7541.5 - 16551.07, P value < 0.001), and social security (β −1.02, 95% CI −13463.0 - 7982.56, P value < 0.001) exhibited significant correlations and served as predictors for household out-of-pocket expenditure (HROOPE) experienced by the patients.

Conclusion:

The study concludes that people receiving HD incur a considerable financial cost. Additionally, the CKD population uses healthcare services at a notable rate, including frequent hospital stays, visits to outpatient departments (OPDs), and emergency treatment, underscoring the pressing need for an increase in insurance coverage.
Nomophobia and its impact on mindfulness and self-efficacy among nurses: An analytical cross-sectional study in the institution of national importance, Western India
Authors: Sharma Karitika , Parihar Aashish , Sharma Suresh K. , Nebhinani Naresh , Mudakavi Irasangappa B.
Published: July 2024

BACKGROUND:

The interaction between people and advanced information and communication technologies results in behavioral addictions, one of them is nomophobia. In a health care setting, nurses constitute a significant proportion of healthcare workers. Therefore, discovering the level of nomophobia and its impact on constructs such as mindfulness and self-efficacy is very important as this might affect the psychological and physical well-being of nurses, which can impact the quality of patient care. The study aimed to assess the level of nomophobia and its relationship with mindfulness and self-efficacy of nurses.

METHODS AND MATERIAL:

An analytical cross-sectional study was carried out in a tertiary care hospital. A total of 420 nurses were selected using a convenience sampling technique. Self-structured questionnaire was used to assess socio-demographic characteristics and mobile phone use. Standardized questionnaires were administered in pen and paper format for measuring nomophobia, mindfulness, and self-efficacy. Statistical Package for Social Sciences (SPSS) version 20.0 was used. Karl Pearson’s correlation coefficient and Chi-square test were employed to analyze the data.

RESULTS:

The majority of nurses (99.5%) had nomophobia. About half of them (53.3%) had a moderate level of nomophobia. Nearly half of nurses had high level of mindfulness (52.6%) and self-efficacy (53.3%) respectively. Further, nomophobia was found to be negatively correlated with mindfulness (r = -0.289) and self-efficacy (r = -0.278).

CONCLUSION:

Nomophobia poses a risk to the mindfulness and self-efficacy of nurses. Continuing education should focus on awareness programs emphasizing good practices in the use of current technologies.
Assessing the impact of a respiratory care bundle on health status and quality of life of chronic obstructive pulmonary disease patients in Jordan: A quasi-experimental study
Authors: Saifan Ahmad R. , Elshatarat Rami A. , Sawalha Murad A. , Khraim Fadi , Ibrahim Ateya M. , Zaghamir Donia E. , Saleh Zyad T. , Hamdan Khaldoun M. , AbuRuz Mohannad E. , Al-Bashaireh Ahmad M.
Published: July 2024

BACKGROUND:

This study aimed to evaluate the effectiveness of a respiratory care bundle, including deep breathing exercises, incentive spirometry, and airway clearance techniques, on the quality of life (QoL) of chronic obstructive pulmonary disease (COPD) patients in Jordan.

MATERIALS AND METHODS:

A quasi-experimental study design and convenience sampling method was used to recruit 120 COPD patients, with 54 in the intervention group and 66 in the control group. The intervention group received additional respiratory care bundle training, while the control group received only discharge instructions and an education program. The St. George’s Respiratory Questionnaire (SGRQ-C) was used to assess participants’ QoL before and after the intervention. Independent t-tests, paired t-tests, and analysis of covariance (ANCOVA) analysis were used to analyze the data.

RESULTS:

The study found no significant differences between patients’ characteristics, health status, and SGRQ-C scores between the two groups at baseline. After the intervention, there were statistically significant differences in all SGRQ-C subscales, which were lower in the intervention group compared to the control group. The paired t-test showed significant reductions in all SGRQ-C symptoms components (t = 7.62, P < .001), activity component (t = 7.58, P < .001), impact component (t = 7.56, P < .001), and total scores post-intervention (t = 7.52, P < .001) for the intervention group. The ANCOVA analysis showed significant differences in scores of SGRQ-C components and total scores (f = 11.3, P < .001) post-intervention between the two groups.

CONCLUSION:

The study’s findings suggest that providing additional respiratory care bundle training for COPD patients can significantly improve their QoL, as measured by the SGRQ-C scores. The respiratory care bundle intervention was effective in reducing COPD symptoms and improving the QoL of COPD patients. Healthcare providers should consider implementing respiratory care bundles as part of COPD management to improve patients’ outcomes.
Evaluation of Emergency Severity Index (ESI) triage quality by nurses and associated factors in Iran
Authors: Razavian Ali , Mohamadirizi Shahla , Heydari Farhad , Nasr-Esfahani Mohammad
Published: July 2024

INTRODUCTION:

The triage process of patients in emergency departments is done by nurses in Iran. it is necessary to pay attention to the ability of nurses in patients’ triage in order to have a correct picture of the status of the emergency department, so the aims of this study is to investigate the quality of nurses’ triage using the Emergency Severity Index (ESI) method and related factors.

MATERIALS AND METHODS:

This is a descriptive study which was performed on all 900 patients referring to the emergency department during 12 months from 2019 to 2020 in the Triage unit of two trauma center hospitals affiliated to Isfahan university of medical sciences. Data collection tools included patients’ demographic, nurses’ demographic and occupational checklist, and ESI Triage Form. To analyze the data, SPSS software was used, descriptive and analytic statistics were used, P < 0.05 was considered statistically significant.

RESULTS:

No significant difference was observed between the quality level of triage by nurses and physicians (P > 0.05), the results of independent t-test showed that nurses in the over triage group have a higher average age and work experience. In the under triage level, the frequency of female nurses was significantly higher than male nurses (P < 0/05).

CONCLUSION:

Accurate and fast triage of patients is the key to successful performance in the emergency department. Therefore correct implementation of triage and identifying the need for nurses for training and identifying existing deficiencies are of utmost importance.
Internalization of multicultural education in improving students’ multicultural competence
Authors: Mardhiah Mardhiah , Ginting Dafid , Mumfangati Titi , Meisuri Meisuri , Fatmawati Endang , Jannah Misbahul , Siyono Siyono , Haris Muhammad , Saputra Nanda
Published: July 2024

BACKGROUND:

This article aims to describe multicultural education in improving students’ multicultural competence. It is very important to teach multicultural values in the school environment to help students understand the importance of mutual respect. Multicultural education is very significant for its application in Indonesia, in the midst of racial, religious, cultural, and customs diversity.

MATERIALS AND METHODS:

This study uses a qualitative research approach with the Meta-Synthesis method to map research results from several kinds of literatures. The number of articles studied in this research was 27 articles. School is the most effective place in developing students’ multicultural competence; therefore, schools must implement learning that prioritizes multicultural principles without discriminating against cultural, racial, linguistic, and cultural backgrounds of students.

RESULT:

The results of this study indicate that 1). The concept of multicultural education applied in schools is able to increase students’ multicultural competence and 2). Students are more open to dealing with existing differences. As for the results of research in an elementary school education environment which is the object of research, this is based on the importance of multicultural education being implemented from an early age.

CONCLUSION:

Multicultural education is very important to increase awareness and tolerance among students. By internalizing multicultural education, students can interpret differences as a matter of course and make students more open to others both in the school environment and in the community environment.
Effectiveness of “Rule of Seven” intervention in improving control status in diabetes mellitus protocol of a randomized controlled trial
Authors: Singhal Kritika , Taywade Manish , Patro Binod K. , Pal Debkumar , Behera Priyamadhaba , Mishra Abhisek K.
Published: July 2024

BACKGROUND:

We developed the “rule of seven” intervention because different targets related to diabetes control can somehow be calculated by multiplication of seven. This study aimed to evaluate the effectiveness of the “rule of seven” in improving glycemic control in patients diagnosed with diabetes by measuring fasting plasma glucose and 2 hours postprandial plasma glucose.

MATERIALS AND METHODS:

This two-arm randomized controlled trial will compare the effectiveness of the “rule of seven” intervention in achieving glycemic control in diabetes mellitus patients. The patients in the control arm will receive routine patient counseling related to diabetes mellitus. Patients registered with the noncommunicable disease (NCD) clinics of All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Community Health Center (CHC) Tangi, and CHC Mendhasala will be recruited consecutively during clinic hours after fulfilling eligibility criteria and obtaining written informed consent. The sample size was estimated as 426 in each group. The ethical permission was obtained from the Institutional Ethics Committee (IEC) and prospectively registered in the Clinical Trial Registry of India (CTRI/2023/07/055522).

DISCUSSION:

After the intervention, we will find out the change in knowledge regarding parameters related to glycemic status; discover the change in biochemical parameters after 1, 3, and 6 months; and conclude whether those changes are statistically significant or not.
Mind mapping to enhance critical thinking skills in respiratory therapy education
Authors: Turkestani Faisal A. , Zipp Genevieve P. , Nufaiei Ziyad Al , Zhranei Raid Al , Alhadian Fahad , Hakeem Jameel , Ismaeil Taha , Algarni Saleh S. , Al-Ahmari Ayedh D. , Homoud Mazen
Published: July 2024

BACKGROUND:

The objective of this study was to investigate the use of mind maps as an active teaching strategy to enhance critical thinking skills (CTSs) among respiratory therapy (RT) students in Saudi Arabia.

MATERIALS AND METHODS:

A total of 86 participants from two RT programs in Saudi Arabian Universities, King Saud bin Abdulaziz University for Health Sciences and The Batterjie Medical College, were randomly assigned to either the mind map group (MMG) or the standard note-taking group (SNTG). With the quasi-experimental design and quantitative method, mean comparisons were made between the groups using an independent t-test.

RESULTS:

There was no significant change between the pre-SNTG and post-SNTG as measured by the health sciences reasoning test (HSRT) after 15 weeks of standard note-taking (SNT). However, it showed the difference between the pre-MMG and post-MMG (P = .02) as measured by the HSRT after 15 weeks of intervention. There was also a significant change between the post-MMG and SNTG (P = .04) as measured by the HSRT, where the MMG had higher scores. However, the study had limitations, which conceded to the failure of participants in the test and the subjectivity of respondents where they were excluded from the study; also, for generalizability of the result, the study should have been taken beyond Riyadh and Jeddah.

CONCLUSION:

Prior to this study, the effectiveness of mind mapping (MM) in the respiratory discipline has not yet been explored. It found that mind mapping was effective at improving CTS, while SNT was not, as measured by pre- and post-test HSRT scores. This was the first investigation into MM’s impact on CTS within respiratory therapy education.
The effect of family-centered education on posttraumatic stress symptoms in mothers of premature infants hospitalized in the NICU
Authors: Rajabzadeh Zahra , Yoosefi Naser , Navidian Ali , Kordsalarzehi Fatemeh
Published: July 2024

BACKGROUND:

Premature infant hospitalization in the neonatal intensive care unit (NICU) is considered a traumatic event for mothers. It is critical to provide instructions and support to couples to help them emotionally adapt and reduce posttraumatic stress. The aim of the present study was to determine the effect of family-centered education on posttraumatic stress in mothers of premature infants hospitalized in the NICU.

MATERIALS AND METHODS:

The present study was a quasiexperimental study. The parents of 80 premature infants admitted to the NICU ward of a hospital in southeastern of Iran in 2020 were divided into two groups of 40 intervention and control. The intervention group received five sessions of family-centered program on daily basis with an average of 60 minutes per session; sessions were held in the presence of both couples and for each couple separately. The control group received only training and usual care. Six weeks after intervention, information was collected using the posttraumatic stress disorder checklist. Data were analyzed using the paired t-test, independent t-test, Chi-square test, and covariance analysis.

RESULTS:

The intervention and control groups’ mean posttraumatic stress scores before family-centered care were 49.65 ± 8.73 and 55.45 ± 10.39, respectively. Six weeks after the intervention the score decreased significantly to 32.75 ± 6.05 and 44.82 ± 6.53. Also, the mean score changes in the intervention group (-16.90 ± 7.69) were significantly higher than those in the control group (-10.63 ± 6.12).

CONCLUSIONS:

Family-centered education has a positive effect on reducing the severity of posttraumatic stress in mothers of premature infants admitted to NICU.
A comprehensive interventional program for promoting sexual function in postmenopausal women: Protocol for a mixed methods study
Authors: Moradi Maryam , Noroozi Mahnaz , Mostafavi Firoozeh , Beigi Marjan
Published: July 2024

BACKGROUND:

Menopause is a natural event in women’s life that leads to physical, psychological, and social consequences. A fundamental health concern in postmenopausal women is problems with their sexual function. This study aims to design an interventional program to promote sexual function in postmenopausal women.

MATERIALS AND METHODS:

This sequential exploratory mixed methods study will be conducted in three phases. The first phase will be a qualitative study with a content analysis approach. The participants will be selected using a purposive sampling in Isfahan, Iran. The data will be collected through in-depth interviews and field notes and analyzed using conventional content analysis. In the second phase, the intervention will be designed and finalized to promote sexual function in postmenopausal women using the results of qualitative study and literature review, asking experts’ opinions, and holding specialized panels. In the third phase, the intervention will be implemented (in the form of a quasi-experimental study) and the effect of the intervention will be determined. In this phase, the data will be collected using the female sexual function index. Finally, an appropriate interventional program will be presented.

CONCLUSION:

It is hoped to promote sexual function in postmenopausal women by conducting this study and implementing an appropriate interventional program that is culturally sensitive. If it is proved that the intervention is effective, a basis for health policy–making to promote sexual health in postmenopausal women can be provided by presenting evidence and increasing the knowledge in this field of health.
Do patients need additional coverage for chronic ailments? Insights from hospital data
Authors: Sugunan Aswin , Pillai K Rajasekharan , D’souza Brayal , George Anice
Published: July 2024

BACKGROUND:

Eliminating financial barriers and improving healthcare accessibility pertain to be key elements of the United Nation’s sustainable development goals. These have directed health policymakers to advocate private health insurance as a health promotion strategy to enable patients to obtain absolute and affordable medical care when needed. Against this backdrop, the current study investigates the coverage trend and financial risk-protective nature of private health insurance plans.

MATERIALS AND METHOD:

We examined 12 months’ hospital billing data of private health insurance holders with cancer, cardiac, neurological, and renal diseases. The billing and insurance claim data of 5002 patients were extracted from the billing section of a tertiary care teaching hospital located in southern India from April 2022 through March 2023. Five per cent of patients from each disease condition were selected through proportionate random sampling for analysis (n= 250). The cost incurred and reimbursement trend under various cost heads were investigated by examining the cost incurred by the patient during the hospitalization and comparing it with the amount reimbursed by the insurance company.

RESULTS:

The scrutiny exhibits that private health insurance fails to provide comprehensive coverage, resulting in under-insurance among subscribers. Reimbursement received for each cost category is also discussed. To the best of our knowledge, this is the first study that has used institutional data instead of large survey data or patient data.

CONCLUSION:

The research concludes by soliciting policymakers, healthcare providers, and insurers to develop strategies to enhance the affordability and accessibility of healthcare to promote health and wellness.
Investigating the depression, anxiety, and stress-related factors in near-miss mothers
Authors: Amiri Marjan , Kohan Shahnaz , Heidari Zeinab
Published: July 2024

BACKGROUND:

Life-threatening complications during pregnancy and childbirth could have an impact on the physical and mental health of mothers. The present research aimed to investigate the factors related to depression, anxiety, and stress among mothers who have survived maternal near-miss situations.

MATERIALS AND METHODS:

This is a descriptive-analytical study, and the data have been collected cross-sectionally. Near-miss mothers who had given birth within the past year were selected through the census method (having at least one criterion of the clinical, laboratory, and management standard of the World Health Organization). The Depression, Anxiety, and Stress Scale (DASS-21) and a demographic questionnaire on personal, family, fertility, and care information were filled out by these mothers.

RESULTS:

One hundred fifty-four near-miss mothers were investigated. The findings indicated that lack of social support, domestic violence, and marital dissatisfaction leads to a significant increase in the mean score of depression among near-miss mothers. In addition, according to the findings, an unemployed spouse, low level of education, lack of social support, recent unintended pregnancy, high blood pressure, and bleeding during pregnancy result in a significant increase in the mean score of stress among near-miss mothers. The findings also showed that domestic violence, a history of infertility, heart disease, and bleeding complications significantly increase anxiety in near-miss mothers.

CONCLUSION:

Considering the high levels of depression, anxiety, and stress in near-miss mothers, it is of utmost importance to pursue and check up on their mental health, as they are one of the most vulnerable groups in society. It is crucial to provide them support long after discharge to reintegrate these mothers into normal living as per the present study’s findings.
The effectiveness of acceptance and commitment therapy on identity crisis and distress tolerance in mothers of children with cancer
Authors: Golestan Kalateh Seyedeh Narges , Rajaei Alireza , Farhangi Hamid , Bayazi Mohammad Hossein
Published: July 2024

BACKGROUND:

Examining the psychological factors related to the disease and their treatment can be important. The present study was carried out with the aim of the effectiveness of acceptance and commitment therapy (ACT) on identity crisis and distress tolerance in the mothers of children with cancer.

MATERIALS AND METHODS:

This research method was semi-experimental with a pre-test and post-test design. The statistical population included all mothers of children with cancer who were referred to Sheikh Mashhad Hospital in 2021. The sample consisted of 30 people who were selected by purposive sampling and were randomly replaced in two groups of experimental and control (equally 15 people in each group). The experimental group underwent ACT, and the control group did not receive any therapy. The identity crisis questionnaire of Rajaei et al. and the distress tolerance scale of Sevens and Gaher were used. Data were analyzed through SPSS 21 software and the analysis of covariance.

RESULTS:

The results revealed that the effect of therapeutic intervention on identity crisis (F = 53.601, P < 0.05) as well as distress tolerance is significant (F = 181.34, P < 0.05). In addition, the effect was stable in the follow-up period (P < 0.05).

CONCLUSION:

According to the results, it can be stated that ACT can reduce the identity crisis and increase the level of distress tolerance in the mothers of children with cancer.
Physical, psychological, and social experiences of women recovered from COVID-19 in Iran: A qualitative study
Authors: Aghamohammadi Vahideh , Rabiee-Khan Fatemeh , Nasiri Khadijeh , Habibi Soola Aghil , Mousazadeh Yalda , Rezakhani Moghaddam Hamed
Published: July 2024

BACKGROUND:

This paper aims to examine the impact of COVID-19 on various health aspects of women recovered from this disease in Ardabil province, Iran.

MATERIALS AND METHODS:

This qualitative study using a content analysis approach was carried out through in-depth individual and focus group discussion using semi-structured interviews schedule in 26 women during June and August 2021. Interviews were recorded, transcribed, and MAXQDA six-stage analysis framework.

RESULTS:

Negative consequences of COVID-19 were generally categorized into five main themes (including increased self-conscious excitement, perceived social stigma, depression, changes in behavioral patterns, and reduced level of quality of life) and 13 subthemes. The positive consequences were the following five themes (including the development of the spiritual attitude, increasing the importance of personal health, the rise of perceived support, increased sense of altruism, and increased financial management) and four subthemes.

CONCLUSION:

Based on the findings, it is concluded that effective support by the government, society, and the medical staff could help to relieve people’s psychological and social stress through providing financial aid, the right information, and training.
Comparative study of the undergraduate community-based nursing curriculum in Shahid Beheshti university of medical sciences, school of nursing and linfield school of nursing
Authors: Zeydani Arezoo , Atashzadeh-Shoorideh Foroozan , Hosseini Meimanat , Zohari-Anboohi Sima
Published: July 2024

BACKGROUND:

Revising UCBNC using successful education systems in the world to guarantee the quality of the curriculum is necessary. This study aimed to compare the undergraduate community-based nursing curriculum at Shahid Beheshti University of Medical Sciences, School of Nursing, and Linfield School of Nursing.

MATERIALS AND METHODS:

The present comparative descriptive study was conducted using Beredy’s four-step approach (description, interpretation, juxtaposition, and comparison) in 2022 and searched the required data using keywords. The fundamental elements of the community-based nursing curriculum were collected and analyzed from the website and internal and external databases.

RESULTS:

The findings of this study showed that there are main differences in the curriculum of the two schools. All dimensions of the Linfield School of Nursing curriculum are designed based on the community-based nursing education model focusing on communication, community, cultural diversity, health, social justice, stakeholder engagement, evidence-based practice, and responding to community needs. Still, the attention and emphasis on the mentioned items in Iran’s curriculum are fragile.

CONCLUSIONS:

The nursing curriculum in Iran should be revised based on the community-based nursing education model, and according to the local conditions, background, and community needs so that can be achieved to the maximum productivity and efficiency of nurses using meet the community needs.