bluuebunny/crossref_metadata_2025 huggingface dataset:
Nationwide consensus on quality indicators to assess glaucoma care: A modified Delphi approach
Authors: Iorio-Aranha Flavio , de Freitas Cláudia , Rocha-Sousa Amândio , Azevedo Ana , Barbosa-Breda João
Published: April 2023

Purpose

Performance assessments are essential to tracking and improving quality in health care systems. Key aspects of the care process that act as indicators must be measured in order to gain an in-depth understanding of a care unit's operation. Without standardized quality indicators (QIs), it is difficult to characterize and compare the abilities of institutions to achieve excellence. The aim of this study is to reach a consensus among glaucoma specialists concerning the development of a set of QIs to assess the performance of glaucoma care units.

Methods

A two-round Delphi technique was performed among glaucoma specialists in Portugal, using a 7-point Likert scale. Fifty-three initial statements (comprising process, structure, and outcome indicators) were evaluated and participants had to agree on which ones would be part of the final set of QIs.

Results

By the end of both rounds, 28 glaucoma specialists reached consensus on 30/53 (57%) statements, including 19 (63%) process indicators (mainly relating to the proper implementation of complementary exams and the setting of follow-up intervals), 6 (20%) structure indicators, and 5 (17%) outcome indicators. Of the indicators that were part of the final list, functional and structural aspects of glaucoma progression and the availability of surgical/laser procedures were the most prevalent.

Conclusions

A set of 30 QIs for measuring the performance of glaucoma units was developed using a consensus methodology involving experts in the field. Their use as measurement standards would provide important information about unit operations and allow further implementation of quality improvements.
Prescription trends for preservative free glaucoma medication in a public health system
Authors: Pérez-García Pilar , Burgos-Blasco Bárbara , Morales-Fernández Laura , Fernández-Ruiz-Morón Ana , Gómez-Calleja Verónica , Oribio-Quinto Carlos , Collado-Vincueria Isabel , Garcia-Feijoo Julian , Martinez-de-la-Casa Jose María
Published: April 2023

Purpose

To analyze the prescribing trends over a 7-years period, between 2013 and 2020, in a tertiary hospital (Hospital Clinico San Carlos, Madrid, Spain) and its health area.

Material and methods

A retrospective study on the data collected from the information systems, “farm@web” and “Farmadrid”, of glaucoma prescriptions in the framework of a public health system (Spanish National Health System) during the last seven years.

Results

Prostaglandin analogues were the most commonly used drugs in monotherapy during the study period (range: 36.82% − 47.07%). Fixed combinations of topical hypotensives had an upward trend since 2013 (range: 39.99% − 54.21%), becoming the most dispensed drugs in 2020 (48.99%). Preservative-free eye drops (lacking benzalkonium chloride, BAK) have displaced preservative containing topical treatments in all pharmacological groups. In 2013, BAK-preserved eye drops accounted for 91.1% of the total prescriptions, however in 2020 they only accounted for 34.2% of total prescriptions.

Conclusions

The results of the present study highlight the current trend to avoid BAK-preserved eye drops for the treatment of glaucoma.
Porous organizational boundaries and associated states: introducing memberness in international organizations
Authors: Hofmann Stephanie C. , Andreska Anamarija , Burai Erna , Uribe Juanita
Published: April 2023

The current binary understanding of membership in international organizations (IOs), especially regional organizations (ROs), creates blind spots and biases in our understanding of who matters in IOs, as well as why and how they matter. Existing scholarship primarily looks at full member-states or non-state actors to capture who influences such organizations. Associated states are often portrayed as passive receivers of IO rules instead of active contributors. We address this blind spot and resulting analytical bias by exploring what types of association relationships exist and how they impact IOs. We propose a novel conceptualization of membership that we call member ness. On the level of IOs, memberness is based on the relative openness of organizational boundaries and stratified access via material and ideational contributions. On the level of states, memberness captures associated states’ individual choices to contribute materially and/or ideationally to an IO. Memberness moves away from a purely rights-based understanding of membership (or who you are in an IO) to include a capacity-based understanding (or what you do in an IO). This shift in focus uncovers new channels of influence on IOs. Associated states’ material and ideational contributions to IOs constitute three memberness types: payroller, sponsor, and advisor. We argue that these memberness types impact IOs’ vitality, design, and performance in previously unrecognized ways. We illustrate these types with empirical examples from ROs across the globe and discuss the implications of memberness for IO research programs.
Political groups over national parties: Measuring the Europeanization of the political arena through MEPs’ Twitter interactions
Authors: van Vliet Livia , Chueri Juliana , Törnberg Petter , Uitermark Justus
Published: April 2023

The question of the democratic character of the European Union (EU) has been a center-point of decades of political research. An important critique suggests that the development of the European political arena is still incomplete, with European parliamentarians primarily orienting themselves to national issues and politicians, implying a problematic mismatch between the political arena and their policy jurisdiction. Research has however been limited by methodological difficulties of capturing the level of Europeanization of the political arena. This paper contributes a novel method for measuring Europeanization by studying interactions between the European Parliament to their national parliamentarians on Twitter in 15 EU countries. Contrary to expectations in the literature, we find substantial Europeanization of the political arena. The level of Europeanization furthermore varies greatly across countries and political groups. This has important implications on the debate on EU’s democratic deficit, as communication across different levels of parliament indicates democratic debate.
Look me in the eyes: How direct address affects viewers’ experience of parasocial interaction and credibility?
Authors: Atad Erga , Cohen Jonathan
Published: April 2023

This study examines whether viewers’ parasocial interaction with a journalist affects the credibility of the journalist and the credibility of the news message, as well as whether the journalist’s direct or indirect address triggers this effect. In a between-subjects experiment ( N = 255), viewers had a more intense parasocial experience when the journalist addressed them directly rather than indirectly. Furthermore, viewers’ intense parasocial experiences contributed to their perceptions of source credibility, message credibility, and news enjoyment. Additionally, as predicted, a more vital parasocial experience indirectly affected credibility through enjoyment. The results concern journalist and news message credibility and the importance of audience engagement in the news is discussed.
Thermo-mechanical behavior of 3D multi-directional braided composites based on a two-scale method
Authors: Dong Jiwei , Luo Ning , Kuai Chengyu , Zuo Hong , Wang Meng
Published: April 2023

Two-scale modeling is adopted to investigate the thermo-mechanical behavior of 3D four-directional (3D4D), 3D five-directional (3D5D), and 3D full five-directional (3DF5D) braided composites. Based on the stress-strain relationship considering thermal expansion and the periodic boundary conditions, the elastic constants and the coefficients of thermal expansion (CTE) of the three types of braided composites are predicted by a two-scale homogenization method. The micro stress under free expansion and thermo-mechanical coupling is also simulated. The calculated results are in good agreement with experimental results from relevant references. The numerical results show that the longitudinal elastic and thermal expansion properties are gradually improved with the increase of axial yarn content from 3D4D to 3D5D and then to 3DF5D braided composites. The braiding angle corresponding to the zero longitudinal CTE of each braided structure is basically about 40°. Furthermore, with the increase of temperature, the longitudinal micro-stress in yarns increases gradually, but that in matrix drops. These conclusions will provide a reliable basis for the structural optimization design and safety evaluation of 3D multi-directional braided composites in a thermal environment.
Endovascular thrombectomy of large ischemic strokes: Reimagining the boundaries of reperfusion
Authors: Ballout Ahmad A
Published: April 2023

The cumulative results of the SELECT-2, ANGEL-ASPECTS, and RESCUE-JAPAN LIMIT clinical trials suggest that endovascular thrombectomy performed within 24 h of symptom onset, in patients presenting with large ischemic strokes, defined by parenchymal and/or perfusion imaging, is safe and is associated with better functional outcomes with a treatment effect that persisted across all subgroups of patients. Our aim was to review these studies and to discuss the implications that these studies may have on patient selection, systems of care, and the utility of our imaging modalities.
Elite athletes’ and support staffs’ experiences and perceptions of long-haul travel, and the self-management strategies they use
Authors: Rossiter Antonia , Comyns Thomas M. , Sherwin Ian , Nevill Alan M. , Warrington Giles D.
Published: April 2023

Elite athletes and their support staff are often required to travel for international competitions all over the globe, however little is known about their experiences of long-haul (LH) travel and its perceived effects on performance. The aim of this study was to explore elite athletes’ and support staffs’ perception of symptoms experienced following LH travel and the self-management strategies they used to mitigate these symptoms. Elite athletes and support staff ( n = 88), who had embarked on an LH flight (> 8 hours) in the previous 2 years for training or competition, completed a survey examining their perceptions of LH travel, symptoms experienced following the flight(s) and strategies they implemented to minimise the symptoms. Associations between symptoms experienced and travel strategies used with participant and journey characteristics were examined by Chi-squared tests. LH travel was widely perceived by participants to be disruptive to physical (86.4%) and mental performance (72.7%) and to increase the risk of illness and injury (86.4%). The most common symptoms experienced were related to fatigue and disruption to sleep. All participants implemented strategies to help mitigate the negative consequences of LH travel. Moving and stretching regularly in-flight and simple strategies for aligning the body clock to destination time were most prevalent. The study findings will allow the translation of research to better inform future guidelines that address the unique needs and priorities of elite athletes and support staff as they embark on LH travel for training and competition with a view to optimising performance outcomes.
Criminal records and post-prison employment in Ghana: Formal and informal means of performing criminal background checks
Authors: Baffour Frank Darkwa , Francis Abraham P , Chong Mark David , Harris Nonie
Published: April 2023

This article contributes to the discussion on criminal record-keeping and post-prison employment from the perspective of a developing country. We present and discuss the results of a qualitative research based on interviews with 13 employers in Ghana about the use of criminal background checks in the hiring process. Data suggest a perceived lack of trust towards formerly incarcerated individuals primarily rooted in traditional cultural and moral values. Participants perceived that being associated with people with a criminal record is largely disapproved at the societal level. As a result, formerly incarcerated individuals are discriminated against in the employment setting. We also found that community dynamics and relations manage to overcome the lack of accuracy and reliability of state-provided criminal history information. Due to the absence of reliable access to criminal records through official channels, employers resort to informal means relying on community ties to get access to information about the past and character of job applicants. We conclude by discussing the implications of our findings for research, policy and practice.
Collateral consequences of criminal records from the other side of the pond: How exceptional is American penal exceptionalism?
Authors: Corda Alessandro , Rovira Marti , Henley Andrew
Published: April 2023

In this article, we highlight the existence and expansion of so-called ‘collateral consequences’ (CCs) of criminal records in Europe to challenge the prevalent view that these are features of the claimed ‘American exceptionalism’ within the penal field. First, we consider how CCs have been widely presented as a quintessential example of American penal exceptionalism within extant scholarship before problematising the adoption of such a framework from a European perspective. Second, we demystify the issue of CCs within Europe by highlighting the deleterious effects which CCs have on the lives of European people with a criminal record. Third, we consider precisely what can be regarded as ‘exceptional’ about CCs in the United States as compared to Europe by analysing key areas of possible differentiation. We conclude by cautioning against the view that European penality is necessarily – and always homogeneously and consistently – ‘progressive’ in relation to its treatment of criminal records and criminal record subjects. We also suggest that far greater attention and vigilance is required from criminologists and criminal justice scholars regarding the expansion and operation of CCs in Europe.
Private View? The Organisational Performance of ‘Privateness’ and ‘Publicness’ at an Art Gallery
Authors: Harris Laura
Published: April 2023

This article takes a cultural approach to analysing the profound privatisation of the public in one of the many places in which it manifests: an art gallery. I argue that, as well as categories of political and economic bearing, ‘privateness’ and ‘publicness’ are cultural categories through which lived experiences are made meaningful. They are therefore performable by organisations that have dual public and private accountabilities. I draw on the cultural pragmatics understanding of ‘performance’ as well as a mesosociological attention to groups to study a private view as one example of such a performance. Through the manipulation of arenas, relations and histories I show how the art gallery staff managed to uphold the meanings of both privateness and publicness at this occasion, and manipulate them according to the different desired outcomes of social contexts. In conclusion, I argue that organisational performances of privateness and publicness are in a dynamic tension with one another; that the performative balancing act is a central part of the day-to-day work of such organisations; and that the cultural approach can help us unravel organisational strategies to paper over the social exclusions that characterise their ‘publics’.
Intensive care nurses’ experiences of caring for isolated COVID-positive patients during first wave of COVID-19
Authors: Køster Allan , Fernandez Anthony Vincent , Meyhoff Christian Sylvest , Andersen Lars Peter Kloster
Published: April 2023

Background:

COVID-19 has fundamentally changed all fields of health care. Intensive care nurses have been at the forefront of the pandemic facing the massive impact of the disease, both professionally and personally. This study investigated nurses’ experiences of caring for isolated COVID-19 positive patients in the intensive care department during the first wave of the COVID-19 pandemic. The study investigated how isolation affected the nurses themselves, how they related with their patients, and how isolation affected patient care in general.

Methods:

The study was performed at a 20-bed university hospital intensive care department in Copenhagen, Denmark. COVID-19 positive patients were isolated or cohort isolated. A dedicated nurse cared for each isolated patient and wore full personal protective equipment. The study is based on in-depth phenomenological interviews with intensive care nurses conducted in summer 2020. The interviews were structured according to the principles of “Phenomenologically Grounded Qualitative Research.” The data included observations from within the isolated patient rooms.

Findings:

Six intensive care nurses participated in the study. The analysis documented following themes consistently reported by all nurses: (1) a general sense of uncanniness, (2) intense feelings of confinement and co-isolation, and (3) heightened senses of bodily objectification, including how nurses’ experienced their patients and also themselves.

Conclusion:

This is the first Scandinavian phenomenological study to focus on mapping the experiences of intensive care nurses during the extreme circumstances of the first wave of the COVID-19 pandemic. Further studies may explore long-term effects, such as psychiatric morbidity or psychological functioning in these individuals.
The impact of disease-modifying therapies on immunoglobulin blood levels in patients with multiple sclerosis: a retrospective cross-sectional study
Authors: Klein Ana , Flaskamp Martina , Berthele Achim , Held Friederike , Muratovic Harisa , Hemmer Bernhard
Published: April 2023

Background:

Although disease-modifying therapies (DMTs) in multiple sclerosis (MS) are known to target the immune system, mechanisms of action, efficacy, safety, and tolerability profiles differ. The long-term impact of DMTs on the immune system and its relation to infectious complications is still poorly understood.

Objectives:

To analyze the effect of DMTs on serum immunoglobulin (Ig) levels under consideration of patient demographics and therapy duration.

Design:

We included 483 patients on DMTs, 69 patients without DMTs, and 51 controls in this retrospective cross-sectional study.

Methods:

IgG, IgM, and IgG subclass 1–4 levels of patients with MS under treatment with DMTs were compared with treatment naive MS patients and controls by multivariate linear regression. Further, Ig levels stratified by DMTs were analyzed regarding therapy duration.

Results:

MS patients treated with fingolimod (FG), natalizumab, and B-cell depleting therapies (BCDT) demonstrated significantly lower IgG and IgM levels than healthy controls after a median treatment of 37, 31, and 23 months, respectively (p < 0.05). Treatment with dimethyl fumarate (DMF) and teriflunomide was associated with lower IgG, but not IgM levels. DMF and BCDT were also associated with lower IgG1 levels, while FG led to a reduction of IgG2. Treatment with interferon-beta (IFN) and glatiramer acetate (GA) had no impact on Ig levels. Analysis of subgroups by linear regression also showed a time-dependent decrease of Igs levels in patients treated with BCDT with a median annual reduction of IgG of 3.2% and IgM of 6.2%.

Conclusion:

Treatment with DMTs, except GA and IFN, was associated with a decrease in Ig levels. DMTs differed in the extent of decreasing Ig levels but also in their differential effects on Ig subclasses. Monitoring of Ig levels should be considered in patients on long-term treatment with DMTs, particularly those on BCDT, to identify patients at risk of low immunoglobulin levels.
Artificial intelligence and radiomics in evaluation of kidney lesions: a comprehensive literature review
Authors: Ferro Matteo , Crocetto Felice , Barone Biagio , del Giudice Francesco , Maggi Martina , Lucarelli Giuseppe , Busetto Gian Maria , Autorino Riccardo , Marchioni Michele , Cantiello Francesco , Crocerossa Fabio , Luzzago Stefano , Piccinelli Mattia , Mistretta Francesco Alessandro , Tozzi Marco , Schips Luigi , Falagario Ugo Giovanni , Veccia Alessandro , Vartolomei Mihai Dorin , Musi Gennaro , de Cobelli Ottavio , Montanari Emanuele , Tătaru Octavian Sabin
Published: April 2023

Radiomics and artificial intelligence (AI) may increase the differentiation of benign from malignant kidney lesions, differentiation of angiomyolipoma (AML) from renal cell carcinoma (RCC), differentiation of oncocytoma from RCC, differentiation of different subtypes of RCC, to predict Fuhrman grade, to predict gene mutation through molecular biomarkers and to predict treatment response in metastatic RCC undergoing immunotherapy. Neural networks analyze imaging data. Statistical, geometrical, textural features derived are giving quantitative data of contour, internal heterogeneity and gray zone features of lesions. A comprehensive literature review was performed, until July 2022. Studies investigating the diagnostic value of radiomics in differentiation of renal lesions, grade prediction, gene alterations, molecular biomarkers and ongoing clinical trials have been analyzed. The application of AI and radiomics could lead to improved sensitivity, specificity, accuracy in detecting and differentiating between renal lesions. Standardization of scanner protocols will improve preoperative differentiation between benign, low-risk cancers and clinically significant renal cancers and holds the premises to enhance the diagnostic ability of imaging tools to characterize renal lesions.
Peripherally Inserted Central Catheters-associated blood stream infections—occurrence, risk factors, and pathogens, a single center study
Authors: Arjun Rajalakshmi , Niyas Vettakkara Kandy Muhammed , Sasidharan Aswathy , Jomes Jeffery , Yadav Manish Kumar , Kesavan Suresh
Published: April 2023

Background

Peripherally inserted central catheters (PICCs) are central venous catheters inserted peripherally but terminate in great vessels. PICCs are widely used for patients requiring long-term intravenous therapy in both in-patient and out-patient settings.

Aim

This study was carried out to understand PICC-related complications, specifically infections and causal pathogens, in a tertiary care hospital in Kerala, South India.

Methods

A retrospective analysis of PICC insertions and follow-up during a 9 years period to look at patient demographics and infections related to PICC was carried out.

Results

The overall PICC-related complication rate is 28.1% (4.98 per 1000 PICC days). Commonest complication was thrombosis followed by infection, either PICC-associated bloodstream infection (PABSI) or local infection (LI). PABSI noted in this study was 1.34 per 1000 catheter days. The majority (85%) of PABSI were due to Gram-negative rods. The average duration of PICC days for occurrence of PABSI was 14 days and the majority occurred in in-patients.

Conclusion

Thrombosis and infection were the commonest PICC-related complications. PABSI rate was comparable to that of previous studies.
A critical analysis of education policy in turbulent times: A comparative study
Authors: Arar Khalid , Zohri Abdel-Aziz , Zohri Abdel-Aziz , Alhouti Ibrahim , Chaaban Youmen , Sawalhi Rania , Salha Soheil
Published: April 2023

This study is a qualitative investigation of education policies and decision making during COVID-19 pandemic in five Middle East and North Africa Region (MENA) countries: Kuwait, Lebanon, Morocco, Palestine, and Qatar. It aims at scrutinizing how these countries responded to the education disruption caused by the pandemic between February 2020 and July 2021 and how they managed the resulting turbulence. We also investigate the extent to which these decisions were equitable and innovative. Data were collected from Ministerial notes, media content, and international organizations reports about the situation of education in the region. Walt and Gilson’s (1994) policy analysis triangle and the Cynefin framework ( Kurtz & Snowden, 2003 ) guided the objectives and the analysis of the data. Findings revealed that these countries muddled through the education policy at the beginning of the pandemic, centralized decision making, and faced difficulties to implement online and distance learning. In the second phase, most of these countries tried to save education, but were halted by structural challenges. Some differences were witnessed among these countries in how they have dealt with the evolving crisis. However, some similarities have also been noticed at the levels of context, process and actors. The decisions taken often lacked innovation and led to less equitable outcomes. The discussion of the findings has some implications for education policy and education management in turbulent times in the MENA region.
The supine moving apprehension test—Reliability and validity among healthy individuals and patients with anterior shoulder instability
Authors: Rabin Alon , Chechik Ofir , Olds Margie K , Uhl Timothy L , Kazum Efi , Deutsch Adin , Citron Eran , Cohen Tal , Dolkart Oleg , Bibas Assaf , Maman Eran
Published: April 2023

Background

Performance-based tests for patients with anterior shoulder dislocation are lacking. This study determined the reliability and validity of the supine moving apprehension test designed to assess the ability to control anterior instability loads.

Methods

Thirty-six participants were recruited (18 healthy individuals, and 18 patients following anterior shoulder dislocation). Healthy participants performed the supine moving apprehension test on 2 separate occasions to determine test-retest reliability. Patients completed the supine moving apprehension test and the Western Ontario Shoulder Instability index before and 6 months after surgical stabilization of their shoulder. The presence of anterior apprehension was also documented post-operatively.

Results

The supine moving apprehension test demonstrated good test-retest reliability (intraclass correlation coefficient = 0.74−0.84). Patients performed 18−30 repetitions less than healthy individuals during the supine moving apprehension test ( P < 0.01). A strong correlation was found between supine moving apprehension test scores and Western Ontario Shoulder Instability post-operatively ( r = −0.74, P ≤ 0.01). Supine moving apprehension test scores significantly improved among patients following surgery ( P < 0.01). Patients with a negative apprehension test post-operatively performed the supine moving apprehension test significantly better than patients with a positive apprehension test ( P < 0.01).

Conclusions

The supine moving apprehension test is reliable and valid among patients with anterior shoulder dislocation and may serve to assess patients’ ability to control shoulder anterior instability loads.
Guest Editorial: Regulating algorithmic management
Authors: Adams-Prassl Jeremias , Abraha Halefom , Kelly-Lyth Aislinn , Rakshita Sangh , Silberman Michael ‘Six’
Published: April 2023

This special issue of the European Labour Law Journal, edited by Jeremias Adams-Prassl, Halefom Abraha, Aislinn Kelly-Lyth, Sangh Rakshita and Michael ‘Six’ Silberman, explores the regulation of Algorithmic Management in the European Union and beyond. In our guest editorial, we set out the background to the project, introduce the reader to the key themes and highlights of the papers to follow, and acknowledge the support that the project has enjoyed.
Study of the importance of protein needs for catch-up growth in Indonesian stunted children: a narrative review
Authors: Endrinikapoulos Ariana , Afifah Diana Nur , Mexitalia Maria , Andoyo Robi , Hatimah Ihat , Nuryanto Nuryanto
Published: April 2023

Stunting is a chronic nutritional deficiency due to various adverse cross-sectoral environmental conditions, including food intake. This influences the linear growth and development of children’s brains and their cognitive function. Providing interventions to meet stunted children’s protein needs tends to prevent the further abnormal development of cognitive functions. High-protein foods are supplied from various edible local commodities in Indonesia. Therefore, this study aims to demonstrate the importance of feeding stunted children with high-protein diets and provide insight that local food ingredients in the country have growth-promoting potential. Through Google Scholar, PubMed, Science Direct, and Nature, 107 articles were obtained with keywords related to stunting, such as protein intake, catch-up growth + stunting, and adverse effect + catch-up growth. The preferred citations randomized-controlled trials and systematic reviews relevant to the study question were compiled using Mendeley version 1.19.8. Based on the literature review results, stunting is hereditary and affects the quality of generations. The adequacy of protein needs is closely related to growth and development, hence, foods containing a high amount of the nutrient facilitate catch-up growth in stunted children. This conclusion is expected to provide information to policymakers and health agencies in the country concerning the education related to high nutritional local food, which can be reached by the community. Interventions with high-protein-containing local foods ought to be tailored to dietary needs and accompanied by monitoring for the presence or absence of unreasonable weight gain to prevent overweight or obesity.
COVID-19 vaccination knowledge, attitudes and practices among the general population of Romania during the third wave of COVID-19 pandemic
Authors: Šljivo Armin , Abdulkhaliq Arian , Granov Nermir , Reiter Leopold , Mahendran Eljakim , Zeglis Ioannis , Mohammed Mohammed Abdulkadir , Yousef Assy , Dadić Ilma , Ivanović Katarina , Selimović Amina , Mujičić Ermina , Gabor-Harosa Florina Maria
Published: April 2023

Objective:

Romania began its COVID-19 immunization programme with approved vaccinations in three stages, as follows: The first step of vaccination is for health and social professionals, the second stage is for high-risk persons and the third stage is for the remainder of the general public. This study aims at assessment of knowledge, attitude and practice towards COVID-19 and vaccination against COVID-19 in the Romanian population during the third wave of the pandemic.

Methods:

This cross-sectional study was based on a Bosnian and Herzegovinian study on COVID-19 vaccination during the country’s third wave of COVID-19 pandemic.

Results:

Our study sample, dominantly female (629; 61.0%), with a bachelor’s degree (734; 71.2%), either single (539; 52.3%) or in a relationship (363; 35.2%), engaged in intellectual labour (910; 88.3%) and living in an urban environment (874; 84.8%) with a mean age of 25.07 ± 8.21 years, 294 (28.5%) people with COVID-19 symptoms and 86 (8.3%) were tested COVID-19 positive, had a mean knowledge score of 16.38 ± 4.0 with correct answer rates on questions ranging from 30.1% to 88.2%. Being single (odds ratio = 3.92, p = 0.029) or in a relationship (odds ratio = 3.79, p = 0.034), having a bachelor’s degree and higher (odds ratio = 1.61, p = 0.006) and being COVID-19 tested (odds ratio = 1.82, p < 0.001) were associated with higher knowledge test scores. Our sample had relatively optimistic attitudes towards final COVID-19 disease containment (712; 69.1%) and vaccination programmes (679; 65.9%). The majority of the sample followed socio-epidemiological measures and did not visit places of mass social gatherings (666; 64.1%) and wore masks (992; 95.7%) while being outside their home. In terms of vaccination rates, 382 (37.0%) of the individuals were presently immunized against COVID-19. Higher knowledge test scores (>15 points) (odds ratio = 1.66, p = 0.002) and positive attitudes of this study (odds ratio = 1.59, p = 0.001, odds ratio = 4.16, p < 0.001) were identified as independent predictors for vaccinating against COVID-19.

Conclusion:

Romanian citizens have had good knowledge, optimistic attitudes and appropriate practices towards COVID-19 vaccination during the third wave of COVID-19 outbreak in the country. Higher knowledge regarding the disease and vaccination against it not only increased attitudes towards the end of the pandemic, but also increased the willingness to be vaccinated and to avoid infection risk factors.
Diagnosis and management of thoracic endometriosis syndrome: Case report
Authors: Murphy Shaw Ashley , Demarco Kara , Belovs Laura , Strange Robert , Spitzer Trimble
Published: April 2023

Introduction:

While the diagnosis of endometriosis is relatively common, thoracic endometriosis is a rare manifestation. Thoracic Endometriosis Syndrome (TES) most commonly presents with pneumothorax, 3% which are bilateral, making this case unique in the already limited breadth of TES with catamenial hemopneumothorax. Additionally, this patient had laboratory values constant with ovarian suppression yet continued menses and recurrent hemopneumothorax, necessitating surgical intervention. We propose that with this severity of disease a combination of surgical intervention and hormonal therapy is the ideal approach, providing the lowest rate of recurrence.

Case description:

A 33 year old woman with 2-day history of chest pain and shortness of breath with heavy menstrual cycles and significant dysmenorrhea. A chest radiograph and computed tomography scan revealed right-sided pneumothorax and bilateral hemothoraces with left-sided diaphragmatic hernia. Video-assisted thoracoscopic surgery confirmed sanguinous pleural effusions and biopsy proven endometriotic lesions. The patient was started on a gonadotropin-releasing hormone agonist and experienced short-interval recurrence of her symptoms. An aromatase inhibitor was added to her regimen and she underwent a left diaphragmatic hernia repair.

Conclusions:

The recurrence of symptoms despite complete hypothalamic-pituitary-ovarian axis suppression, in addition to the surgical requirements and findings make this case unique in the already limited breadth of thoracic endometriosis syndrome with catamenial hemopneumothorax.
Effectiveness of Metaphorical Communication in Government Campaign on Digitization
Authors: Antil Anjuman , Saini Neha , Sehgal Sanjeewani , Aggarwal Shalini , Shahzad Umer
Published: April 2023

The study aims to investigate the influence of persuasive metaphorical communication on citizens’ attitude, attachment and adoption of digital services based on the government’s logo and tag line in a campaign to promote digitization. The hierarchy of effects model is used to determine the effectiveness of metaphorical communication for the digitization campaign. Structural equation modelling is used on a sample of 301 Indian citizens. The results show that the hierarchy of effects approach is supported by the data. Emotional attachment has a mediating effect on citizens’ attitude towards the campaign and their intention to adopt the services. The moderating effect of gender is also found to be significant. Further, it is seen that professionals are more involved with the metaphorical campaign than students. Therefore, policymakers may consider the greater use of metaphors in their strategy for publicity of welfare schemes and as a tool for propagating socially and economically relevant messages. The paper contributes to the effectiveness of persuasive communication in emerging economies’ government campaigns.
Effects of Ultrasonic Instrumentation on the Shear Bond Strength of Ceramic Brackets: An In Vitro Study
Authors: Rajamanickam Preethi , Ramasamy Navaneethan
Published: April 2023

Aim:

Accumulation of plaque during orthodontic treatment makes oral prophylaxis a regular necessity. The use of esthetic brackets has gained popularity, it becomes necessary to assess the consequences of ultrasonic instrumentation during oral prophylaxis on ceramic bracket’s shear bond strength (SBS).

Materials and Methods:

Fifty-four premolar teeth which were extracted due to therapeutic reasons were divided into six groups with each group containing nine teeth each. Ceramic brackets were bonded onto the labial surfaces using two different adhesive systems (Ormco Enlight and Transbond) and were subjected to ultrasonic scaling at different scaler tip angulations. The samples were then rendered a debonding force in a Universal testing machine and the bond strengths were assessed.

Results:

In terms of angulation of ultrasonic instrumentation, among the groups bonded with the Ormco Enlight, the 45° angulation group had statistically significant higher bond strength values compared to the 0° angulation group. Among the transbond groups, there was no statistically significant difference in the bond strengths even though the 45° angulation group had slightly higher bond strength value than the 0° angulation group.

Conclusion:

Supragingival scaling around the bracket base at 0° around the ceramic brackets for 1 min resulted in the reduction of SBS. Therefore, the clinicians should be cautious during plaque removal, avoid performing extended ultrasonic instrumentation at the bracket base, especially at 0° angulation.
Supervisor Communication Competence and Employee Outcomes: Predictive Effects in Remote, Hybrid, and In-Person Workplaces
Authors: Mikkelson Alan , Sloan David , Walter Rylee , Hinnenkamp Craig
Published: April 2023

Supervisor communication competence was used to predict both beneficial (Study 1) and detrimental (Study 2) employee outcomes across remote, hybrid, and in-person work experiences. In both studies, there were no differences in perceived supervisor communication competence based on remote, hybrid, and in-person work experiences. As predicted, effective and appropriate supervisor communication were related to employee outcomes across work experiences. In Study 1, regression analyses indicated that effective communication was the best predictor of beneficial employee outcomes (engagement, empowerment, and accomplishment), whereas appropriate communication was the best predictor of detrimental employee outcomes (burnout, stress, alienation, and turnover intentions) in Study 2.
A Development Approach to a Protracted IDP Situation: Lessons from Azerbaijan
Authors: Wistrand Jennifer S.
Published: April 2023

This article highlights the realities facing Azerbaijan’s internally displaced persons (IDPs), living in a state of protracted displacement. It argues that the World Bank’s development approach to the IDP population in Azerbaijan and to IDP populations elsewhere has likely done more for these populations’ long-term welfare and prospects than exclusively humanitarian approaches could have accomplished, even though displaced peoples have traditionally been presumed to be the responsibility of the humanitarian community.

The article begins with a brief discussion of the differences between refugees and IDPs and between humanitarian and development approaches. It then outlines a history of the conflict between Azerbaijan and Armenia over the contested region of Nagorno-Karabakh which, in the early 1990s, produced upward of a half-million Azerbaijani IDPs. Next, the article discusses some of the realities (economic, social, and mental health, among others) that confronted Azerbaijan’s IDPs 15 years into their displacement. It focuses on a community of IDPs who lived in a temporary-turned-long-term “collective center” on the outskirts of Azerbaijan’s capital of Baku. Finally, the article discusses one of the World Bank’s projects in Azerbaijan with IDPs.

The article concludes with policy recommendations on the way future scholars, practitioners, and policymakers should be trained to understand and approach IDPs. More broadly, it recommends that combined humanitarian and development approaches to IDP situations should become the norm. This seems imperative given that the number of IDPs displaced by conflict and violence world-wide has increased each year for more than a decade, while the ability of IDPs to avail themselves of traditional durable solutions has not kept pace.
Five Years Lost: Youth Inclusion in the Rohingya Response
Authors: Islam Imrul , Naing Zia
Published: April 2023

While youth are routinely lauded as “change-makers,” they are often underserved and unsupported in refugee responses. As the Rohingya face protracted displacement in Bangladesh, what is the state of youth inclusion in the response? Do youth and adolescents feel supported, or are they ignored and left behind?

To answer these questions, the paper uses:

Literature on youth participation and inclusion in humanitarian programming; Key informant interviews with practitioners from national and international non-governmental organizations (NGOs) and UN agencies; Focus group discussions and key informant interviews with refugee individuals and groups across nine camps for Rohingya refugees in Bangladesh.

It finds that:

Refugee Rohingya youth and adolescents remain firmly on the margins of humanitarian programming, and are largely excluded from decision-making processes; Approximately 96 percent of surveyed youth between 18 and 24 years of age report being unemployed; For surveyed women aged 18–24 years, unemployment rates bordered on 99 percent; and Stress and anxiety are omnipresent amongst the community: an overwhelming majority of respondents reported experiencing disturbing thoughts and resorting to negative coping mechanisms.

The paper ends with a series of recommendations to the Strategic Executive Group (SEG) and the Inter-Sector Coordination Group (ISCG), to donors, the international community, and the government of Bangladesh. 1
Integration Through Health During Protracted Displacement: Case Studies From Colombia and Jordan
Authors: McCann Katherine , Fouad Fouad M. , Harker Roa Arturo , Zard Monette
Published: April 2023

As the global rate of displacement reaches new highs and the average length of displacement extends from years to decades, integration is an increasingly crucial lifeline for refugees and displaced communities seeking to rebuild their lives. Health systems serve as an ideal conduit for integration due to universal need, system complexity, and the interplay of political, social, and economic factors on health outcomes. Using lessons learned from case studies in Colombia and Jordan, this paper will explore different strategies for integration of refugee health services with host population health systems. It will highlight successful policy implementation and innovative approaches as well as predict potential barriers to success via a population-centered approach that emphasizes the importance of supporting host communities concurrently with displaced populations. It offers the following findings and recommendations for governmental and humanitarian actors.

Effective integration requires a “whole of person” approach which acknowledges and responds to the linkages between legal status, economic needs, and mental and physical health and wellbeing. Addressing the health needs of populations experiencing protracted displacement must go hand-in-hand with, and cannot be decoupled from, addressing the needs of host communities. Demographic and epidemiologic data inclusive of both host and displaced populations enables governments and service providers to better plan for and respond to key health and non-health needs. Donors and financing structures can play a critical role in facilitating greater integration of health and other services.
Strategies for the Facilitation of Self-Leadership Among Ward Nurses in a Nurse-Led Critical Care Outreach Service
Authors: Prinsloo Carine
Published: April 2023

Introduction

Nurses are responsible for monitoring and providing nursing care to patients. The early detection of a patient who is starting to deteriorate – and the activation of critical care outreach services (CCOS) – can improve patient outcomes. However, the literature indicates that CCOS are underutilised. Self-leadership is a process whereby persons influence their own behaviour.

Objective

The purpose of this study was to develop strategies for the facilitation of self-leadership in ward nurses that will enable them to act proactively and promptly in utilising CCOS at a private hospital group in South Africa.

Methods

A sequential exploratory mixed-method research approach was followed to develop strategies for the facilitation of self-leadership in nurses that will enable them to utilise CCOS proactively when a patient starts to deteriorate. An adapted version of Neck and Milliman's self-leadership strategic framework was used as the methodological steps of the study.

Results

The quantitative analysis extracted eight factors, which were used as the departure point to develop strategies for the facilitation of self-leadership among nurses in a CCOS. Five strategies were developed that related to self-motivation, role models, patient outcome, assistance and guidance from CCOS, and the power of self-confirmation; these strategies aligned with the themes and categories extracted from the qualitative data analysis.

Conclusion

There is a need for self-leadership among nurses in a CCOS.
Understanding the Sex, Racial, and Ethnic Disparities in Eosinophilic Esophagitis
Authors: El Halabi Maan , Malik Zubair
Published: April 2023

The incidence of eosinophilic esophagitis (EoE) has been rapidly increasing. EoE affects both children and adults and can present with a variety of symptoms depending on age. Multiple studies have found that EoE is more common in Caucasian men compared with other genders or racial or ethnic groups; however, the basis for that predominance is still unknown. The varied clinical illness presentation and persistence in various ethnic groups begs the question of whether genetic or environmental factors might be contributors behind EoE. This paper will review the literature regarding epidemiology, risk factors, and genetic and ethnic differences in EoE.
Rotator Cuff Repair With Bone Grafting of Greater Tuberosity Cyst: A Technique Video
Authors: Forsythe Brian , Gamsarian Vahram , Ward Caitlin , Mirle Vikranth , Brusalis Christopher M.
Published: April 2023

Background:

Nearly 500,000 rotator cuff repairs are performed annually in the United States. Cysts within the humeral head have been reported to occur in more than half of patients diagnosed with a rotator cuff tear. They are related to age-related degeneration and rotator cuff dysfunction, and may arise from congenital abnormalities.

Indications:

Humeral head cysts may pose technical challenges during rotator cuff repair. Cysts located at the footprint of a planned rotator cuff repair can decrease biological healing capacity and reduce the fixation strength of suture anchors. One treatment strategy to address bone loss secondary to humeral head cysts is to incorporate cancellous allograft bone chips, which provide an osteoconductive scaffold for bone formation.

Technique Description:

Standard arthroscopic portals were established and during arthroscopy, the rotator cuff tear was identified, and tissue was mobilized. The cyst was debrided to healthy, bleeding bone using curettes and an arthroscopic shaver. A 2.5 mL sterile syringe was packed with crushed, cancellous allograft bone chips. The tip of the syringe was removed to allow for a wider aperture to facilitate injection of bone chips. Through an accessory, percutaneous portal just lateral to the acromion, the syringe was inserted into the cyst site, and bone graft contents were injected into the cyst. Pressure was applied to the syringe to impact the bone graft material. The bone chips were impacted with the syringe plunger. Following rotator cuff repair, the patient underwent subacromial decompression, distal clavicle excision, and open sub-pectoral biceps tenodesis with suture anchor fixation.

Discussion/Conclusion:

Greater tuberosity cysts can impose a technical challenge during arthroscopic rotator cuff repair. Incorporation of impacted cancellous allograft bone chips is an efficient, reproducible method to enhance healing of the RTC tendon enthesis.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.