bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring Primary Care Physicians’ Experiences of Language and Cultural Discordant Care for Linguistic Minority Patients at the End-of-Life: A Study Protocol
Authors: Lee Seung Heyck , Gibb Maya , Karunananthan Sathya , Cody Margaret , Tanuseputro Peter , Johnston Sharon , Kendall Claire , Bedard Daniel , Collin Stéphanie , Kehoe MacLeod Krystal
Published: December 2023

Health disparities exist across different linguistic groups. Language barriers in primary care can negatively affect access to healthcare services and the quality and safety of care at the end-of-life. This study will take a novel, in-depth look at the experience of language- and/or cultural-discordant care for adults from linguistic minority groups through the eyes of primary care physicians providing palliative and/or end-of-life care. Language and cultural discordance means that the physician and patient do not speak the same language or are not from the same cultural background. Qualitative data from primary care physicians ( n = 12–24) providing language-discordant end-of-life care to Francophone and/or Allophone older adults across different care models and diverse geographies in Ontario will be collected through semi-structured interviews. Reflexive thematic analysis will be used to report themes within the data and consider the influence of the social locations of the researcher and research participants, geographic considerations impacting service provision, and barriers imposed by differing primary care funding structures on the provision of palliative and end-of-life care for linguistic and cultural minority groups in Ontario. Findings from this study will identify the interconnections among language and cultural discordance, care model, geographic region, and physician perceptions of their combined effects on access to, and quality of, palliative and end-of-life care. This evidence will be key to informing clinical practice guidelines and mobilizing change to improve primary care access and quality for adults at the end-of-life from linguistic and cultural minority populations across Ontario.
Plateauing atrial fibrillation burden in acute ischemic stroke admissions in the United States from 2010 to 2020
Authors: Otite Fadar Oliver , Patel Smit D , Aneni Ehimen , Lamikanra Oluwatomi , Wee Claribel , Albright Karen C , Burke Devin , Latorre Julius Gene , Morris Nicholas Allen , Anikpezie Nnabuchi , Singla Amit , Sonig Ashish , Kamel Hooman , Khandelwal Priyank , Chaturvedi Seemant
Published: December 2023

Background:

Utilization of oral anticoagulants for acute ischemic stroke (AIS) prevention in patients with atrial fibrillation (AF) increased in the United States over the last decade. Whether this increase has been accompanied by any change in AF prevalence in AIS at the population level remains unknown. The aim of this study is to evaluate trends in AF prevalence in AIS hospitalizations in various age, sex, and racial subgroups over the last decade.

Methods:

We used data contained in the 2010–2020 National Inpatient Sample to conduct a serial cross-sectional study. Primary AIS hospitalizations with and without comorbid AF were identified using International Classification of Diseases Codes. Joinpoint regression was used to compute annualized percentage change (APC) in prevalence and to identify points of change in prevalence over time.

Results:

Of 5,190,148 weighted primary AIS hospitalizations over the study period, 25.1% had comorbid AF. The age- and sex-standardized prevalence of AF in AIS hospitalizations increased across the entire study period 2010–2020 (average APC: 1.3%, 95% confidence interval (CI): 0.8–1.7%). Joinpoint regression showed that prevalence increased in the period 2010–2015 (APC: 2.8%, 95% CI: 1.9–3.9%) but remained stable in the period 2015–2020 (APC: –0.3%, 95% CI: –1.0 to 1.9%). Upon stratification by age and sex, prevalence increased in all age/sex groups from 2010 to 2015 and continued to increase throughout the entire study period in hospitalizations in men 18–39 years (APC: 4.0%, 95% CI: 0.2–7.9%), men 40–59 years (APC: 3.4%, 95% CI: 1.9–4.9%) and women 40–59 years (APC: 4.4%, 95% CI: 2.0–6.8%). In contrast, prevalence declined in hospitalizations in women 60–79 (APC: –1.0%, 95% CI: –0.5 to –1.5%) and women ⩾ 80 years over the period 2015–2020 but plateaued in hospitalizations in similar-aged men over the same period.

Conclusion:

AF prevalence in AIS hospitalizations in the United States increased over the period 2010–2015, then plateaued over the period 2015–2020 due to declining prevalence in hospitalizations in women ⩾ 60 years and plateauing prevalence in hospitalizations in men ⩾ 60 years.
Relational assurance in higher education in the knowledge technology era: The case of postgraduate program of educational leadership
Authors: Arar Khalid , Guajardo Miguel , Saiti Anna , Abo-Zaed Arar Eman
Published: December 2023

There are many studies on the role of technology in facilitating equality, quality, and effectiveness in higher learning in the last decade. This study aims at exploring the sustainability of a postgraduate program in a USA context following the COVID surge. Relational assurance is employed through qualitative methods, and frameworks to make sense of higher learning systems, and curricula through the authors’ ontological, epistemological, and place-based contributions following the move to online delivery in 2021. A qualitative case study approach was employed combining semi-structured interviews with faculty and focus-group interviews with graduate students for gaining a deeper understanding of the observables documenting one postgraduate program of educational leadership in Central Texas. The primary expectation of postgraduate students and faculty members is a sense of community. The program reflects a sense of belonging and reality present in local schools, communities, and policy/practice. The meaning of community also includes a common purpose, members committed to a common good, a sense of belonging, and emotional interaction following the COVID surge, the shift to digital technology, and alternative modality of content delivery. This article contributes to the international literature by redefining the quality, value-based, and relational assurance of higher education postgraduate programs. In responding to current conditions and needs while aiming to build sustainable and responsive communities by inviting community members for the assets they bring, their commitment to the region’s development, and further deepen their sense of diversity, inclusion, and collective action for the public good.
Chemical Constituents, Cytotoxicity, and Molecular Docking Studies of Tetragonula iridipennis Propolis
Authors: Phuong Diep Thi Lan , Cong Nguyen Thanh , Phuong Nguyen Van , Hue Nguyen Thi , Vuong Nguyen Quoc , Lien Nguyen Thi Phuong , Ho Duc Viet , Tuan Nguyen Le , Nghia Nguyen Thị , Tuyen Vo Thi Thanh , Hang Nguyen Thu , Thanh Le
Published: December 2023

Objective: Propolis of Tetragonula iridipennis, which is one of the most popular stingless bees found in Vietnam, has been used to promote health and prevent disease. This study aims to identify the chemical constituents of T iridipennis propolis and their cytotoxic activity. Methods: The propolis sample was extracted with ethanol. The crude extract was isolated by combined chromatographic methods. The structures of isolated compounds were determined by electrospray ionization mass spectrometry and nuclear magnetic resonance spectra. The cytotoxicity was evaluated by 3-(4,5-dimethylthiazolyl-2)-2,5-diphenyltetrazolium bromide method. The protein interactions of active compounds were explored by molecular docking study. Results: Sixteen known compounds, including 11 triterpenes, 3 xanthones, a sterol, and a flavonoid were isolated and identified. The propolis ethanol extract displayed good cytotoxicity against A-549 and KB cancer cell lines. 24 S,25-Dihydroxytirucall-7-en-3-one was the most active compound with IC50 values ranging from 18.75  ±  0.21 to 19.62  ±  0.36 µg/mL. Conclusions: Sixteen known constituents were identified from T. iridipennis propolis, of which 8 compounds were discovered for the first time. The propolis of T iridipennis has multiple sources of plant resin, among that Ailanthus triphysa (Simaroubaceae) was identified as a new plant source. A molecular docking study revealed that cytotoxic effects of 24 S,25-dihydroxytirucall-7-en-3-one, α-mangostin, 6-methoxy–bispyrano xanthone, and 3-isomangostin related to the inhibition of all 3 targets epidermal growth factor receptor, human epidermal growth factor receptor 2, and mammalian target of rapamycin (mTOR), while other isolated triterpenes exert their cytotoxicity by the inhibition of mTOR protein activity.
Differences in Nurses’ Satisfaction and Demand for Spatial Design Among Different Departments of Nursing Units: A Case Study in China
Authors: Xuan Xiaodong , Duan Xiaoxia , Feng Zihao , Zheng Yihe
Published: December 2023

Objectives:

The study aimed to extend original research and identify operational and space-related requirements for specialization from the perspectives of nursing behavior and process.

Background:

Studies related to the specialty of different nursing units have been widely conducted in nursing science, while few studies have explored the specialized requirements for the physical environments of nursing units in different departments.

Method:

Questionnaire survey data were collected from 125 nurses in 11 clinical departments, and nurse shadowing (approximately 68 hr) was conducted in four clinical departments.

Results:

The questionnaire survey showed that satisfaction with care activity, visibility, and physical environment within the existing nursing unit environment was rated differently among different departments of nursing units. However, nurses in different groups of age, education, work experience, and position indicated no statistically significant difference. Behavioral observations demonstrated that the spatial and temporal distributions of activities, spatial linkages, and communication patterns varied in distinct departments.

Conclusion:

This research found that nurses in different departments had different evaluations of satisfaction and environmental characteristics. It also explains the differences in nursing work behaviors and processes found in various departments and sheds light on specialized requirements from the behavior perspective. The findings could help optimize the design of efficient and satisfactory nursing units in different departments.
Effects of Delayed-Onset Muscle Pain on Respiratory Muscle Function
Authors: Ozden Sema , Ozalp Ozge , Kilic Rabia Tugba , Yosmaoglu Hayri Baran
Published: December 2023

Background:

Delayed-onset muscle soreness (DOMS) has been widely examined in the peripheral muscles; however, studies showing the potential effects of DOMS on respiratory function are limited.

Hypothesis:

DOMS in trunk muscles has a negative effect on respiratory function parameters, respiratory muscle strength, respiratory muscle endurance, and exercise capacity.

Study Design:

Prospective cohort study.

Level of Evidence:

Level 2.

Methods:

In 24 healthy participants with a mean age of 21 ± 2 years, DOMS was induced for the trunk muscles with a load equal to 80% of the maximum repetitive voluntary contraction. Pulmonary function parameters, respiratory muscle strength and endurance, exercise capacity, pain, fatigue, and dyspnea perception severity were recorded before DOMS and at 24 and 48 hours after DOMS.

Results:

After DOMS, decreases were observed in respiratory function parameters, namely, forced vital capacity, forced expiratory volume in the first second, vital capacity, and 25% to 75% flow rate value of forced expiratory volume (25% to 75%) ( P = 0.02, P = 0.02, P < 0.01, P = 0.01, respectively). Maximal inspiratory pressure and exercise capacity also decreased ( P = 0.02, P < 0.01, respectively). No difference was observed between all 3 measurements of maximal expiratory pressure (MEP) and MEP% values ( P1 = P2 = P3 ≥ 0.99). The results of the respiratory muscle endurance tests did not reveal a significant difference in terms of load and time in all 3 conditions ( P > 0.05).

Conclusion:

After DOMS, there was a 4% to 7.5% decrease in respiratory function parameters, and a 6.6% decrease in respiratory muscle strength.

Clinical Relevance:

The occurrence of DOMS before a competition can have a detrimental impact on pulmonary performance. Hence, it is imperative to consider this factor when devising training and exercise programs. In addition, the development of treatment protocols becomes crucial if DOMS arises.
Association between high-sensitive cardiac troponin level and coronary artery disease: A systematic review and meta-analysis
Authors: Fatemi Alireza , Zahedi Mahdi , Yazdooei Yasmin , Daei Maryam , Ansari Mohammad Mostafa , Sohrabi Ahmad , Azizinejad Arash , Hssanpour Mohammad Reza , Behrouzifar Marzieh , Babapour Hanieh
Published: December 2023

Background and objectives

Previous studies suggest a link between high-sensitive cardiac troponin (hs-cTn) levels and coronary artery disease (CAD). However, the nature of this relationship is disputed. To address this, we conducted a study to gather and assess evidence on the association between hs-cTn and CAD prediction.

Data sources

Studies were systematically searched and collected from four databases and different types of gray literature to cover all available evidence. After the screening, the selected articles’ quality and risk of bias assessment were evaluated.

Synthesis method

Meta-analysis calculated std. mean difference on the extracted data. Furthermore, heterogeneity, sensitivity, subgroups, and publication bias analyses were assessed.

Results

Twenty-two studies were included in this systematic review, with a total of 844 cases and 2101 control people. The results of the meta-analysis on nine studies showed a significant and positive association between hs-cTn levels and CAD (pooled std. mean difference = 0.44; 95% confidence interval = 0.14–0.73; p < 0.003), with no publication bias ( p = 0.9170). Among subgroups, std. mean differences were notably different only when the data were stratified by region or risk of bias; however, subgroup analysis could not determine the source of heterogeneity.

Conclusions

Available prospective studies indicate a strong association of hs-cTn with the risk of CAD and significant improvements in CAD prediction. Further investigations in both molecular and clinical fields with proper methodology and more detailed information are needed to discover more evidence and underlying mechanisms to clear the interactive aspects of hs-cTn level in CAD patients.
Exploratory Factor Analysis of Congolese Information Technology Graduates’ Employability: Towards Sustainable Employment
Authors: Héritier Nsenge Mpia , Lucy Waruguru Mburu , Simon Nyaga Mwendia
Published: December 2023

High unemployment rates in many developing countries have prompted research to focus on sustainability and inclusiveness of employment in line with the sustainable development goal target 8.6. The democratic republic of Congo (DRC) in sub-Saharan Africa experiences one of the highest youth unemployment rates owing to its long-term socio-political and economic instability. Qualitative and quantitative research studies have linked low employability of university-educated youth in the DRC to tribalism, corruption, and insecurity. The current study sought to identify contextual factors that predict employability of information technology (IT) graduates in the DRC. The study surveyed 355 graduates (274 male, 81 female) using 43 questionnaire. Bartlett test was 3,930.05 for Chi2 ( p-value = .000) and KMO test scored 0.68. McDonald’s Omega test of reliability of the instrument scored 0.77 with a total cumulative variance of 72.02%. Results of this study advance the conflict theory by pinpointing the true factors which influence the employability of IT graduates in unstable developing countries. This study has discovered that socio-political background of graduates, graduate academic competencies, graduate-employer relationship, and university employability strategies are the contextual factors that predict the employability of IT graduates in the DRC. The Cronbach’s Alpha test of reliability for the retained contextual factors scored .78, .75, .63, and .53, respectively.
The Effects of Information Technology in Retailer Performance and Survival: The Case of Store-Based Retailers
Authors: Wang Hui-Ming Deanna , Ho Foo Nin
Published: December 2023

This research aims to empirically examine the effects of Information Technology (IT) in the performance and survival of store-based retailers. In particular, we investigate how two types of IT resources—Overall IT investment and Human IT resources—respectively influence retailer performance and survival. We draw on the resource-based view, dynamic capabilities, and IT business value research to develop the hypotheses. Our study employs a longitudinal panel dataset at the firm level obtained from secondary sources from 2010 to 2021. Our sample includes 95 store-based public retailers in the U.S. and has 654 firm-year observations in total. We employ the dynamic panel model and binary logistic regression method to investigate the effects of IT resources on retailer performance and survival, respectively. Our empirical results indicate that while overall IT investment has a positive effect on a retailer’s survival, human IT resources positively influence performance. In addition, stronger performance leads to greater survival likelihood. The findings provide important theoretical, managerial and policy implications concerning the business value of IT in the retailing context.
The Conundrum of Identity in the Omani Higher Education: A Case Study of an English Language Teaching (ELT) Context
Authors: Al Muqarshi Amal S. , Kaparou Maria
Published: December 2023

The developing status of the Omani higher education has made this sector subject to both national and global influences. Such influences created inconsistencies between the demands of the local context and those of the increasingly globalizing context, which resulted in a nationally diverse faculty body. This paper draws on the Social Identity Approach (SIA) and the intersectionality theory to argue that identity in the workplace could be understood better through focusing on processes rather than individual narratives since processes reveal much of the complexity of prototypes especially when applied to workgroups. The paper reports the findings of a qualitative case study conducted in an English language-teaching department in Oman. The study explored identity intersectionalities within a workgroup by analyzing the data generated through 16 interviews, eight meeting observations and document analysis. The thematic analysis reveals that identities are constructed based on intersections of language, nationality, contract and professional identity. Such intersections were evident in relation to the process of recruitment, employment security and retention, staff inclusion, and professional identity enactment. These findings demonstrate that analyzing identity at the intra-categorical level sheds light on its effects at the individual level. The paper concludes by highlighting theoretical and practical implications that are relevant to ELT contexts internationally.
Adverse Childhood Experiences and Resilience Among Cis-gendered Heterosexual and LGBTQIA+ Individuals in India
Authors: Srivastava Lipika , Advani Purvi , Kaur Harsimran , Khattar Shivangi , Saxena Akash , Kumar Shraddha
Published: December 2023

Background:

In 2018, India decriminalized same-sex relationships, marking a major victory for the LGBTQIA+ community. However, it’s well known that only policy reforms are not enough for revolutionary changes. One starting point is the exploration of the quality of life, health, and wellness of these populations through careful research and examining the threats they are facing today so that early interventions can be initiated to improve the conditions and reduce the pain.

Objective:

To assess whether a relationship exists between adverse childhood experiences (ACE) and resilience in cis- gender heterosexual and LGBTQIA+ individuals in India and whether a significant difference exists between the two samples in their measures of the same.

Method:

Online forms were circulated through various social media platforms, the sample consisted of 81 participants (48 cis-gender heterosexual individuals, 33 LGBTQIA+ individuals) within the age range of 18-25 years residing in Urban areas of India. The forms consisted of two questionnaires: The ACEs Questionnaire, and Brief Resilience Scale (BRS). For Data analysis, the Pearson Product moment correlation, and the Non-parametric Kruskal-Wallis H test were carried out.

Results & Conclusion:

Findings reveal a negative correlation between ACE and resilience amongst cis-gender heterosexuals r(46) = 0.47, p < .01, a negative correlation between ACE and resilience amongst the LGBTQIA+, r(31) = 0.13, p = .47, a significant difference between cis-gender heterosexual individuals and LGBTQIA+ individuals in the ACE scores, H (1) = 16.65, p < .01, a significant difference between cis-gender heterosexuals and LGBTQIA+ in the Resilience scores, H (1) = 5.35, p < .05. The results indicate that the LGBTQIA+ individuals did experience more adverse experiences in their childhood as compared to cis-gender heterosexual counterparts, one of the many reasons could be homonegative and trans negative attitudes towards this population. Limitations of the study are that it was only a quantitative study, with a small sample size, and not all communities were equally represented, that is, more data is required from people who identify as pansexual and transgenders. Future directives for researchers are to become gender and culture-informed and conduct deeper research using narrative analysis approaches.
Food Insecurity and Social Policy: A Comparative Analysis of Welfare State Regimes in 19 Countries
Authors: Berkowitz Seth A. , Drake Connor , Byhoff Elena
Published: December 2023

We sought to determine whether a country's social policy configuration—its welfare state regime—is associated with food insecurity risk. We conducted a cross-sectional study of 2017 U.N. Food and Agriculture Organization individual-level food insecurity survey data from 19 countries (the most recent data available prior to COVID-19). Countries were categorized into three welfare state regimes: liberal (e.g., the United States), corporatist (e.g., Germany), or social democratic (e.g., Norway). Food insecurity probability, calibrated to an international reference standard, was calculated using a Rasch model. We used linear regression to compare food insecurity probability across regime types, adjusting for per-capita gross domestic product, age, gender, education, and household composition. There were 19,008 participants. The mean food insecurity probability was 0.067 (SD: 0.217). In adjusted analyses and compared with liberal regimes, food insecurity probability was lower in corporatist (risk difference: −0.039, 95% CI −0.066 to −0.011, p  =  .006) and social democratic regimes (risk difference: −0.037, 95% CI −0.062 to −0.012, p  =  .004). Social policy configuration is strongly associated with food insecurity risk. Social policy changes may help lower food insecurity risk in countries with high risk.
Fintechs Reshaping the Financial Ecology: The Growing Trends and Regulatory Framework
Authors: Mishra Arjyalopa , Vangaveti Aadhruti , Majoo Sidhanth M. K.
Published: December 2023

The concept of financial ecology encompasses the intricate interplay of financial systems, institutions, and technologies within the economic ecosystem. It emphasizes the symbiotic relationships and dependencies that shape the modern financial world. Development of Fintech has the potential to significantly enhance and reshape the dynamics of the financial ecology, introducing new players and altering established relationships within the ecosystem. In today’s digital realm, the financial landscape has gained significant steam in its adoption of technology tools to dispense its services. The ‘internet economy’ is relied upon to produce new market development opportunities and occupations and become the greatest business opportunity for organisations in the future. India has come up significantly in the global discussion on financial technologies over the last two decades. Through a systematic review of the literature on this area, this article identifies that the regulatory framework requires provisions to support greater fintech inclusion. Moreover, several issues still lie deficiently addressed, such as user privacy and cybersecurity. This article attempts to review the opportunities, scope and risks for the implementation of financial innovation in India.
Telehealth serious illness care program for older adults with hematologic malignancies: a single-arm pilot study
Authors: LoCastro Marissa , Mortaz-Hedjri Soroush , Wang Ying , Mendler Jason H. , Norton Sally , Bernacki Rachelle , Carroll Thomas , Klepin Heidi , Liesveld Jane , Huselton Eric , Kluger Benzi , Loh Kah Poh
Published: December 2023

Older patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) feel shocked and bewildered when diagnosed. Serious illness conversations (SICs) may increase disease understanding and preparations for the future. However, SICs often happen late, in part because of clinician-perceived patient discomfort. Telehealth may promote patient comfort by allowing SICs to take place at home. This study assesses the feasibility and usability of a telehealth-delivered Serious Illness Care Program (SICP) for older adults with AML and MDS. We conducted a single-arm pilot study including 20 older adults with AML and MDS. Feasibility was measured using retention rate, with >80% considered feasible. Usability was measured using telehealth usability questionnaire (TUQ; range, 1-7): >5 considered usable. We collected other outcomes including acceptability and disease understanding and conducted post-visit qualitative interviews to elicit feedback. Hypothesis testing was performed at α = 0.10 owing to the pilot nature and small sample size. Retention rate was 95% (19/20); mean TUQ scores were 5.9 (standard deviation [SD], 0.9) and 5.9 (SD, 1.1) for patients and caregivers, respectively. We found the SICP to be acceptable. The majority of patients found the SICP to be very or extremely worthwhile (88.2%; 15/17), and reported it increased closeness with their clinician (75.0%; 12/16). After their visit, patient estimates of curability, and overall life expectancy aligned more closely with those of their clinicians. In qualitative interviews, most patients said that they would recommend this program to others (89.5%, 17/19). This study demonstrated that delivery of the telehealth SICP to older patients with AML and MDS is feasible, usable, and acceptable. This trial is registered at www.clinicaltrials.gov as #NCT04745676.
Efficacy and mechanism of Shenqi Compound in inhibiting diabetic vascular calcification
Authors: Yang Chan , Xie Ziyan , Liu Hanyu , Wang Xueru , Zhang Zehua , Du Lian , Xie Chunguang
Published: December 2023

Background

Shenqi Compound (SQC) has been used in clinic for several decades in the prevention and treatment of diabetes and its complications. But this is merely a heritage of experience. The primary aim of this study is to scientifically validate the therapeutic effects of SQC on diabetic vascular calcification (DVC) in an animal model and, simultaneously, uncover its potential underlying mechanisms.

Method

Spontaneous diabetic rat- Goto Kakizaki (GK) rats were selected for rat modeling. We meticulously designed three distinct groups: a control group, a model group, and an SQC treatment group to rigorously evaluate the influence of SQC. Utilizing a comprehensive approach that encompassed methods such as pathological staining, western blot analysis, qRT-PCR, and RNA sequencing, we thoroughly investigated the therapeutic advantages and the underlying mechanistic pathways associated with SQC in the treatment of DVC.

Result

The findings from this investigation have unveiled the extraordinary efficacy of SQC treatment in significantly mitigating DVC. The underlying mechanisms driving this effect encompass multifaceted facets, including the restoration of aberrant glucose and lipid metabolism, the prevention of phenotypic transformation of vascular smooth muscle cells (VSMCs) into osteogenic-like states, the subsequent inhibition of cell apoptosis, the modulation of inflammation responses, the remodeling of the extracellular matrix (ECM), and the activation of the Hippo-YAP signaling pathway. Collectively, these mechanisms lead to the dissolution of deposited calcium salts, ultimately achieving the desired inhibition of DVC.

Conclusion

Our study has provided compelling and robust evidence of the remarkable efficacy of SQC treatment in significantly reducing DVC. This reduction is attributed to a multifaceted interplay of mechanisms, each playing a crucial role in the observed therapeutic effects. Notably, our findings illuminate prospective directions for further research and potential clinical applications in the field of cardiovascular health.

Graphical Abstract
Healthcare providers’ knowledge and clinical practice surrounding shigellosis — DocStyles Survey, 2020
Authors: Haston Julia C. , Ford Laura , Vanden Esschert Kayla L. , Plumb Ian D. , Logan Naeemah , Francois Watkins Louise K. , Garcia-Williams Amanda G.
Published: December 2023

Background

Shigellosis is an acute diarrheal disease transmitted through contaminated food, water, objects, poor hand hygiene, or sexual activity. Healthcare providers (HCP) may not be aware of the multiple routes of Shigella transmission, populations at increased risk, or importance of antibiotic susceptibility testing (AST). This study assessed HCP knowledge and clinical practices regarding shigellosis and antibiotic resistance.

Methods

Porter Novelli Public Services administered a web-based survey (Fall DocStyles 2020) to HCP in the United States. Pediatricians, primary care physicians, nurse practitioners, and physician assistants completed questions about knowledge and clinical practice of acute diarrhea and shigellosis.

Results

Of 2196 HCP contacted, 1503 responded (68% response rate). Most identified contaminated food (85%) and water (79%) as routes of Shigella transmission; fewer recognized person-to-person contact (40%) and sexual activity (18%). Men who have sex with men (MSM) were identified as being at risk for shigellosis by 35% of respondents. Most reported counseling patients to wash hands (86%) and avoid food preparation (77%) when ill with shigellosis; 29% reported recommending avoiding sex. Many HCP reported treating shigellosis empirically with ciprofloxacin (62%) and azithromycin (32%), and 29% reported using AST to guide treatment.

Conclusions

We identified several gaps in shigellosis knowledge among HCP including MSM as a risk group, person-to-person transmission, and appropriate antibiotic use. Improving HCP education could prevent the spread of shigellosis, including drug-resistant infections, among vulnerable populations.
Making prediabetes visible in primary health care: a qualitative study of health care professionals’ perspectives
Authors: Harcke Katri , Graue Marit , Skinner Timothy Charles , Olsson Christina B. , Saleh-Stattin Nouha
Published: December 2023

Background

People with prediabetes are at high risk of developing type 2 diabetes and its complications, such as cardiovascular diseases and premature mortality. Primary prevention and health maintenance are therefore imperative. Evidence has shown that prediabetes can be prevented or delayed with behavioural change, mainly in eating habits and physical activity. Interventions that use a person-centered approach can lead to improvements in self-management, quality of life, and health outcomes. Nevertheless, there is a need for further research that engages healthcare professionals and people with prediabetes in constructing and implementing preventive programs. The purpose of this study is to explore and describe how healthcare professionals perceive prediabetes, the current challenges in its detection and treatment, and what is needed to improve quality of care.

Methods

This qualitative study was conducted in Region Stockholm. A total of 26 primary health care professionals participated in individual interviews: 15 diabetes nurses and/or district nurses, five general practitioners, five dietitians, and one physiotherapist. Interview transcripts were analyzed with qualitative content analysis.

Results

The analysis revealed two main themes that emphasize the need to make prediabetes more visible in primary health care. Despite the healthcare professionals’ engagement and their motivation to improve prediabetes care, ad hoc practices and the absence of clear screening guidelines and referral pathways made it harder to focus on primary prevention. Supporting professionals in implementing structured care for people with prediabetes might encourage more efficient interprofessional collaboration and contribute to better strategies for promoting behavioural change.

Conclusions

Establishing prediabetes care guidelines, supporting health care professionals´ knowledge and skills in prediabetes care, and implementing interprofessional referral pathways are some steps to enhance prediabetes detection and care precedence in primary health care. These steps could lead to more preventive care and ensure patient safety and health care equity.
Drug-related problems in hospitalized patients with chronic kidney diseases and clinical pharmacist interventions
Authors: Zhang Su , Zhang Guo-bing , Huang Ping , Ren Yan , Lin Bo , Shao Yan-fei , Ye Xiao-lan
Published: December 2023

Background

Patients with chronic kidney disease (CKD) are at high risk of drug-related problems (DRPs) because of extensive comorbidities and pharmacokinetic changes. This study aimed to identify DRPs and possible contributing factors in hospitalized patients with CKD, and evaluate the efficacy of the clinical pharmacist services in detection and intervention of DRPs in a large general hospital in Zhejiang Province, eastern China.

Methods

With the approval of the Ethics Committee, patients with CKD admitted to the nephrology ward from January to December 2020 were enrolled in this prospective study. The clinical pharmacist identified and intervened the DRPs during hospitalization. The DRPs were classified using the Pharmaceutical Care Network Europe (PCNE) DRP classification system, and all data were statistically analyzed using Statistical Package for Social Science (SPSS) version 26.0.

Results

A total of 914 patients with CKD were included, with 463 DRPs observed among 420 (45.95%) participants; the average DRP per patient was 0.51 (standard deviation [SD], 0.60) before pharmacist intervention. Treatment safety accounted for the highest proportion of problems (43.84%), followed by treatment efficacy, accounting for 43.20%. Drug selection was the most common cause of DRPs (60.26%), and antibiotics and cardiovascular agents were the most common drugs associated with DRPs (32.84% and 28.66%, respectively). A total of 85.53% of pharmaceutical intervention recommendations were followed, and 84.23% of DRPs were completely resolved after intervention by the clinical pharmacist. The proportion of patients who experienced DRPs decreased to 7.77%, with an average of 0.08 (SD 0.28) DRPs during hospitalization after pharmacist’s intervention. Significant contributing factors for DRPs were CKD stage 4, number of comorbid diseases, number of prescribed medications, and hospitalization days in both the univariate and multivariate logistic regression models.

Conclusion

DRPs are common among hospitalized patients with CKD in China. CKD stage 4, the number of comorbidities, use of multiple prescription drugs, and extended length of hospital stay are contributing factors for DRPs. Even only one clinical nephrology pharmacist in the nephrology ward, clinical pharmacist can play an important role in facilitating the identification of DRPs in patients with CKD and assisting physicians resolve DRPs in this single center study in China.
Comparing the influence of big data resources on medical knowledge recall for staff with and without medical collaboration platform
Authors: Yuan JunYi , Mi Linhui , Wang SuFen , Cheng Yuejia , Hou Xumin
Published: December 2023

Background

This study aims to examine how big data resources affect the recall of prior medical knowledge by healthcare professionals, and how this differs in environments with and without remote consultation platforms.

Method

This study investigated two distinct categories of medical institutions, namely 132 medical institutions with platforms, and 176 medical institutions without the platforms. Big data resources are categorized into two levels—medical institutional level and public level—and three types, namely data, technology, and services. The data are analyzed using SmartPLS2.

Results

(1) In both scenarios, shared big data resources at the public level have a significant direct impact on the recall of prior medical knowledge. However, there is a significant difference in the direct impact of big data resources at the institutional level in both scenarios. (2) In institutions with platforms, for the three big data resources (the medical big data assets and big data deployment technical capacity at the medical institutional level, and policies of medical big data at the public level) without direct impacts, there exist three indirect pathways. (3) In institutions without platforms, for the two big data resources (the service capability and big data technical capacity at the medical institutional level) without direct impacts, there exist three indirect pathways.

Conclusions

The different interactions between big data, technology, and services, as well as between different levels of big data resources, affect the way clinical doctors recall relevant medical knowledge. These interaction patterns vary between institutions with and without platforms. This study provides a reference for governments and institutions to design big data environments for improving clinical capabilities.
The effect of scenario-based training on the Core competencies of nursing students: a semi-experimental study
Authors: Sadeghi Mohammad , Nematollahi Monirsadat , Farokhzadian Jamileh , Khoshnood Zohreh , Eghbalian Mostafa
Published: December 2023

Introduction

Competency is defined as the variety of skills and knowledge required to perform a specific task. Due to the specificity of pediatric nursing, students face some challenges in acquiring core competencies. Therefore, the use of new training methods in pediatric nursing is necessary. One of the modern learning methods is learning based on clinical scenarios. Thus, this study aimed to investigate the effect of scenario-based education on the core competencies of nursing students.

Method

This quasi-experimental study employed a pre-test and post-test design. All participants (n = 72) were selected via the census method and randomly divided into intervention (N = 33) and control groups (N = 40). The data were collected using a demographic information questionnaire and the Nursing Students’ Clinical Competencies Questionnaire. Before the intervention, both groups completed the pre-tests. After one month, the students in both groups completed post-tests.

Results

The average score of core competencies for the students in the intervention group after the training (247.05, SD = 36.48) increased compared to before the intervention (229.05, SD = 36.58) (P > 0.05). The average score of the core competencies for the students in the control group after the training was 240.76 (SD = 35.36) compared to 235.56 (SD = 27.94) before the intervention, with no significant difference (P < 0.05). The independent t-test did not show a significant difference between the control and intervention groups before and after the intervention (P > 0.05).

Conclusion

The results indicated the effectiveness of scenario-based training on the core competencies of students in the intervention group. Accordingly, nursing administrators and professors are recommended to incorporate new scenario-based teaching and learning methods in educational programs of universities. It is also necessary to conduct more research into the effectiveness of this method in combination with other training methods like team-based and problem-based training.
Professional identity and sense of coherence affect the between compassion fatigue and work engagement among Chinese hospital nurses
Authors: Zhang Yiming , Peng Qianwen , Dong Wanglin , Hou Cui , Chen Chaoran
Published: December 2023

Background

With the continuous improvement of people’s health needs, the public’s requirements for medical care are also getting higher and higher. Work engagement is a positive psychological state related to the work. It is very important to maintain nurses’ work engagement, however, due to many factors, the level of nurses’ work engagement is not high and nursing managers should identify the influencing factors of work engagement, and take positive measures to fully improve nurses’ work engagement.

Objectives

To explore the influence of compassion fatigue, professional identity and sense of coherence on nurses’ work engagement.

Methods

From January 2022 to June 2022, convenience sampling was used to select clinical nurses from 9 tertiary hospitals in Henan Province of China as the research objects for a questionnaire survey. Statistical methods included descriptive statistical analysis, Pearson correlation analysis and the PROCESS Macro Model 4 and 7 in regression analysis.

Results

The results showed that compassion fatigue was significantly negatively correlated with sense of coherence, professional identity and work engagement (P<0.01), professional identity was significantly positively correlated with sense of coherence and work engagement (P<0.01), and there was a significant positive correlation between sense of coherence and work engagement (P<0.01). Professional identity played a partial mediating role between compassion fatigue and work engagement, accounting for 46.40% of the total effect; meanwhile, sense of coherence moderated the effect of compassion fatigue on professional identity and formed a moderated mediation model.

Conclusions

Compassion fatigue has a negative predictive effect on nurses’ work engagement. Professional identity and sense of coherence further explained the relationship of compassion fatigue on compassion fatigue and work engagement through mediating and moderating effects.
Association of metabolic dysfunction-associated fatty liver disease with systemic atherosclerosis: a community-based cross-sectional study
Authors: Zhang Yanli , Xia Zhang , Cai Xueli , Su Xin , Jin Aoming , Mei Lerong , Jing Jing , Wang Suying , Meng Xia , Li Shan , Wang Mengxing , Wei Tiemin , Wang Yongjun , He Yan , Pan Yuesong
Published: December 2023

Background

Data are limited on the association of metabolic dysfunction-associated fatty liver disease (MAFLD) with systemic atherosclerosis. This study aimed to examine the relationship between MAFLD and the extent of atherosclerotic plaques and stenosis, and presence of polyvascular disease (PolyVD).

Methods

In this cross-sectional study, MAFLD was diagnosed based on the presence of metabolic dysfunction (MD) and fatty liver disease (FLD). MAFLD was divided into three subtypes: MAFLD with diabetes mellitus (DM), MAFLD with overweight or obesity (OW), as well as MAFLD with lean/normal weight and at least two metabolic abnormalities. Atherosclerosis was evaluated, with vascular magnetic resonance imaging for intracranial and extracranial arteries, thoracoabdominal computed tomography angiography for coronary, subclavian, aorta, renal, iliofemoral arteries, and ankle-brachial index for peripheral arteries. The extent of plaques and stenosis was defined according to the number of these eight vascular sites affected. PolyVD was defined as the presence of stenosis in at least two vascular sites.

Results

This study included 3047 participants, with the mean age of 61.2 ± 6.7 years and 46.6% of male (n = 1420). After adjusting for potential confounders, MAFLD was associated with higher extent of plaques (cOR, 2.14, 95% CI 1.85–2.48) and stenosis (cOR, 1.47, 95% CI 1.26–1.71), and higher odds of presence of PolyVD (OR, 1.55, 95% CI 1.24–1.94) as compared with Non-MAFLD. In addition, DM-MAFLD and OW-MAFLD were associated with the extent of atherosclerotic plaques and stenosis, and presence of PolyVD (All P < 0.05). However, lean-MAFLD was only associated with the extent of atherosclerotic plaques (cOR, 1.63, 95% CI 1.14–2.34). As one component of MAFLD, FLD per se was associated with the extent of plaques and stenosis in participants with MAFLD. Furthermore, FLD interacted with MD to increase the odds of presence of systemic atherosclerosis (P for interaction ≤ 0.055).

Conclusions

MAFLD and its subtypes of DM-MAFLD and OW-MAFLD were associated with the extent of atherosclerotic plaques and stenosis, and presence of PolyVD. This study implicated that FLD might be a potential target of intervention for reducing the deleterious effects of MAFLD on systemic atherosclerosis.
Impact of population based indoor residual spraying in combination with mass drug administration on malaria incidence and test positivity in a high transmission setting in north eastern Uganda
Authors: Ronald Mulebeke , Humphrey Wanzira , Adoke Yeka , Jean-Pierre Van Geertruyden
Published: December 2023

Background

Mass drug administration (MDA) and indoor residual spraying (IRS) are potent malaria burden reduction tools. The impact of combining MDA and IRS is not well documented. We evaluated the impact of MDA + IRS compared to IRS alone at a high transmission site in Eastern Uganda.

Methods

A quasi-experimental study was implemented in Toroma and Kapujan subcounties in north eastern Uganda. Both subcounties received four rounds of IRS using primiphos-methyl (Acttellic SC300) 6–8 months apart from December 2016 to December 2018. Eligible residents of Kapujan simultaneously received MDA using dihydroartemesinin-piperaquine (DHA-PQ). Health facility data was used to monitor malaria case incidence rate and test positivity rates.

Results

In the MDA + IRS arm, malaria incidence dropped by 83% (IRR: 0·17 (0.16–0.18); p < 0.001) in children under 5 year and by 78% (IRR: 0·22 (0.22–0.23); p < 0.001) in persons aged ≥ 5 years from the pre-intervention to the intervention period. In the IRS arm malaria incidence dropped by 47% (IRR: 0.53 (0.51, 0.56); p < 0.001) in children under 5 years and by 71% 0.29 (0.28, 0.30); p < 0.001) in persons aged ≥ 5 years. A drastic drop occurred immediately after the intervention after which cases slowly increased in both arms. Malaria test positivity rate (TPR) dropped at a rate of 21 (p = 0.003) percentage points per 1000 persons in the MDA + IRS arm compared to the IRS arm. There was a mean decrease of 60 (p-value, 0.040) malaria cases among children under five years and a mean decrease in TPR of 16·16 (p-value, 0.001) in the MDA + IRS arm compared to IRS arm.

Interpretation

MDA significantly reduced malaria burden among children < 5 years however the duration of this impact needs to be further investigated.