bluuebunny/crossref_metadata_2025 huggingface dataset:
The influence of caring-based character learning interventions on the practical competencies among nursing students
Authors: Permana Bhakti , Yusuf Ah , Bakar Abu , Iswanti Dwi Indah , Saifudin I Made Moh. Yanuar
Published: September 2024

This study aimed to assess the impact of an educational intervention centered on fostering a caring-based character on the practical nursing competency related to ethics, law, and cultural sensitivity. The research employed a quasi-experimental approach with a pre-post design, incorporating a control group. Purposive sampling was used to select 33 respondents for both the intervention and control groups (n=66). The competency measurement instrument was validated and deemed reliable. The intervention, carried out over 12 weeks, utilized a module. Data analysis involved the Wilcoxon match pairs test and Mann-Whitney U-test. The intervention group exhibited a significant improvement in practical nursing competency concerning ethics, law, and cultural sensitivity before and after the caring-based character learning intervention (p<0.001), whereas the control group showed no notable difference (p=0.065). Significant competency differences were observed between the intervention and control groups (p=0.023). The implementation of a caring-based character learning module has the potential to enhance nursing students' competency, particularly in practical aspects related to ethics, law, and cultural sensitivity. It is suggested that nursing education incorporates character learning modules into the curriculum, training programs, or extracurricular activities.
A bibliometric study on the adoption of mobile health: trends and future directions
Authors: Sakarji Siti Rosnita , Othman Abdul Kadir , Mohd Beta Raja Mayang Delima , Narmaditya Bagus Shandy
Published: September 2024

This study presents a comprehensive overview of research on mobile health applications (mHealth apps) from 2013 to 2023. A total of 207 research papers from the Scopus database were analyzed. Based on keyword co-occurrences and co-authorship mapping, the paper identifies emerging trends and research patterns by using the VOSviewer software. Over the past ten years, there has been a discernible increase in the number of mHealth publications. However, a lack of attention has been given to the Asian context. It is anticipated that applications of mHealth will be observed in numerous health services given the high volume of citations obtained in this subject. The present review paper is assisted by the bibliometric approach and offers a rigorous analysis of journal papers on mHealth that have been published. The findings of the current work may serve as a foundation for further research in this discipline that focuses on bringing attention to the nature of the subject matter. This overview could be a central resource for researchers and practitioners looking for information that can help with cross-disciplinary projects by directing them to recognized peer-reviewed publications, journals, and networks.
Modeling determinants of stunting among children under five years in Urban Areas
Authors: Fibrianti Fibrianti , Palupi Fitria Hayu , Mentari Witri Dewi , Setiyadi Agung , Sutriyawan Agung
Published: September 2024

Child stunting remains a global public health problem. Compared to other middle-income countries, Indonesia is one of the countries with a high prevalence of stunting. This study aims to identify predictive indices and analyse the determinants of stunting in children under five in urban areas. Case control design was conducted on 420 (210 cases and 210 controls). Simple random sampling and side proportional techniques were used for sampling. Structured questionnaires were used to collect data through interviews and anthropometric measurements. Multivariable binary logistic regression analysis and statistical significance expressed at 95% CI, as well as receiver operating characteristic analysis were used. Mothers with low education (OR=1.6, 95% CI=1.0-2.6), fathers with no permanent job (OR=1.5, 95% CI=1.0-2.4), pregnancy interval less than 24 months (OR=1.6, 95% CI=1.0- 2.6), family size of five or more (OR=2.1, 95% CI=1.3-3.3), income below minimum household income (OR=1. 7, 95% CI=1.0-2.8), not exclusively breastfed (OR=2.1, 95% CI=1.1-3.7), not fully immunised (OR=2.1, 95% CI=1.0-4.4), low birth weight (OR=2.3, 95% CI=1.2-4.5), and a history of disease (OR=2.0, 95% CI=1.0-3.8) were determinants of stunting. The most dominant determinant of stunting in children under five years old is low birth weight. Therefore, strategies and programmes are aimed at early prevention efforts, by increasing awareness to change community behaviour regarding improving maternal nutrition since pregnancy.
Community participation in COVID-19 prevention and control
Authors: Santos Jonalyn P. , Turingan Rosalie A. , Mapanao Nicole P. , Agustin Angelica B. , Mallo Colin Joy C. , Palino Justin Adrian A.
Published: September 2024

Community-based health protocols are essential strategies for prevention and control of COVID-19 and community participation is an essential contribution of communities during the pandemic. This study assessed community participation to COVID-19 prevention and control activities among barangays in a component city in northern Philippines. This descriptive-quantitative research was conducted in six barangays with the least and most COVID-19 cases in 2021. Barangay residents, officials and health workers were surveyed about community participation using five process indicators namely needs assessment, leadership, organization, resource mobilization and management. A high level of community participation towards COVID-19 prevention and control activities was seen in the barangays with leadership having the highest mean (4.23) and resource mobilization having the lowest mean (3.44). Leadership was significantly the same among all barangays while organization, management, needs assessment and resource mobilization significantly differed according to type of barangay, COVID-19 prevalence and population size. The researchers conclude that there is strong community participation of barangays towards COVID-19 prevention and control activities especially along leadership. However, the capacity of barangays to contribute, mobilize and distribute resources must be improved to maximize community prevention and control of COVID-19.
The synergy of digital knowledge and skills in forming digital citizenship: a comprehensive assessment on nursing students
Authors: Purnama Sari Ni Putu Wulan , Artsanthia Jintana , Suvaree Sudarat , Prachyakoon Numpueng
Published: September 2024

Nurses play a pivotal role in improving the quality of healthcare services through innovation in the nursing care delivery system by using technological advancement. Digital knowledge and mindset are useful for further developing digital skills and literacy among future nurses to form digital citizenship. This study aimed to analyze the correlation between digital knowledge and mindset with digital skills, literacy, and citizenship among nursing students. The mind sponge theory was used in study conceptualization and results interpretation. This quantitative study utilized a cross-sectional design. The population was all nursing students in two private nursing institutions located in Bangkok, Thailand (n=476) and Surabaya, Indonesia (n=179). Samples were the total population. Self-developed, valid, and reliable instrument was used in data collection. Descriptive statistics and correlation test were used in data analysis (α<.05). Findings showed that digital knowledge did not correlate with digital mindset (p=.94), but it was weakly correlated with digital skills, literacy, and citizenship (ρ=.12-.16; p<.05). Digital mindset was strongly correlated with digital skills, literacy, and citizenship (ρ=.56-.60; p<.05). Digital skills had a strong correlation with digital literacy and citizenship (ρ=.58-.67; p<.05), while digital literacy was strongly correlated with digital citizenship (ρ=.59; p=<.05). The synergy of digital mindset, skills, and literacy are recommended to support the digital citizenship formation. We strongly recommend the implementation of collaborative learning method in nursing education. This method promotes the information filtering and exchanging behaviors among students important for digital nursing.
The role of social-psychological support in breastfeeding promotion among young mothers: literature review
Authors: Handayani Lina , Prihadi Kussusanto Ditto , Vergawita Tania , Fitriani Isah , Hafidz Beddu , Aisyahrani Asa Ismia Bunga
Published: September 2024

Breastfeeding promotion is vital for improving neonatal health and reducing mortality rates, particularly in developing countries. The World Health Organization advocates for exclusive breastfeeding during the first six months of life due to its substantial benefits for infant growth, development, and immunity. Understanding the determinants of exclusive breastfeeding, such as maternal knowledge and practices, is crucial for devising effective interventions to enhance breastfeeding rates among mothers. Social-psychological interventions, including family and peer support, have demonstrated efficacy in increasing breastfeeding frequency by addressing behavioral changes in new parents. Psychological factors such as self-efficacy, postnatal depression, and stress significantly influence breastfeeding decisions. Additionally, cultural norms, social media, and healthcare professionals are critical in shaping breastfeeding practices. This literature review examines the influence of these factors and interventions, underscoring the need for comprehensive strategies to promote breastfeeding, especially among novice and young mothers. Peer support programs, education-based initiatives, and postnatal support are highlighted as effective approaches. The study emphasizes the importance of tailored socio-psychological interventions and calls for further research to address existing gaps and strengthen the validity of findings, ultimately aiming to enhance breastfeeding outcomes and the overall well-being of mothers and infants.
Periprocedural Assessment of Paravalvular Regurgitation After Transcatheter Aortic Valve Replacement Using Diastolic Delta and Videodensitometry
Authors: Rooijakkers Maxim J. P. , Elkoumy Ahmed , Stens Niels A. , van Wely Marleen H. , Versteeg Geert A. A. , Tsai Tsung‐Ying , Rodwell Laura , Heijmen Robin H. , Serruys Patrick W. , Soliman Osama , van Royen Niels
Published: September 2024

Background

Paravalvular regurgitation (PVR) is a common complication after transcatheter aortic valve replacement, posing an increased risk of heart failure and mortality. Accurate intraprocedural quantification of PVR is challenging. Both hemodynamic indices and videodensitometry can be used for intraprocedural assessment of PVR. We compared the predictive value of the isolated versus combined use of the hemodynamic index diastolic delta (DD) and videodensitometry for the incidence of relevant PVR 1 month after transcatheter aortic valve replacement.

Methods and Results

In this prospective cohort study, patients underwent periprocedural PVR assessment by DD and videodensitometry (using left ventricular outflow tract—aortic regurgitation [LVOT‐AR]). Cardiac magnetic resonance served as reference modality for PVR assessment. Relevant PVR was defined as cardiac magnetic resonance–regurgitant fraction >20%. Fifty‐one patients were enrolled in this study. Mean age was 80.6±5.2 years and 45.1% of patients were men. Mean LVOT‐AR and cardiac magnetic resonance–regurgitant fraction were 8.2%±7.8% and 11.7%±9.6%, respectively. The correlation between DD and LVOT‐AR was weak (
r
=−0.36). DD and LVOT‐AR showed a comparable accuracy to predict relevant PVR (area under the curve 0.82, 95% CI: 0.69–0.95 versus area area under the time–density curve 0.80, 95% CI: 0.62–0.99). The combination of DD and LVOT‐AR improved the prediction of relevant PVR (area under the time–density curve, 0.90, 95% CI: 0.81–0.99), and resulted in an increased concordance (86.3%) and positive predictive value (75%) compared with DD alone (76.5% and 40%, respectively), or LVOT‐AR alone (82.3% and 50%, respectively).

Conclusions

DD and videodensitometry are both accurate and feasible modalities for the assessment of PVR after transcatheter aortic valve replacement. The synergistic use of both techniques increases the predictive value for relevant PVR after transcatheter aortic valve replacement.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT04281771.
Make or Break: The Influence of Expected Challenges and Rewards on the Motivation and Experience Associated with Cognitive Effort Exertion
Authors: Zhang Yue , Leng Xiamin , Shenhav Amitai
Published: September 2024

Challenging goals can induce harder work but also greater stress, in turn potentially undermining goal achievement. We sought to examine how mental effort and subjective experiences thereof interact as a function of the challenge level and the size of the incentives at stake. Participants performed a task that rewarded individual units of effort investment (correctly performed Stroop trials) but only if they met a threshold number of correct trials within a fixed time interval (challenge level). We varied this challenge level (Study 1, n = 40) and the rewards at stake (Study 2, n = 79) and measured variability in task performance and self-reported affect across task intervals. Greater challenge and higher rewards facilitated greater effort investment but also induced greater stress, whereas higher rewards (and lower challenge) simultaneously induced greater positive affect. Within intervals, we observed an initial speed up then slowdown in performance, which could reflect dynamic reconfiguration of control. Collectively, these findings further our understanding of the influence of task demands and incentives on mental effort exertion and well-being.
Rooted in Society?
Authors: Makulilo Alexander , Mehler Andreas , Haji Mohamed
Published: September 2024

In 2010, Zanzibar, a sub-state within the United Republic of Tanzania, became a unique case of power sharing in Africa. The country conducted a referendum before establishing a government of national unity and entrenched it in Zanzibar’s Constitution of 1984. The aim was to make the power-sharing system durable and rooted in society to achieve peace and development. Nevertheless, a political system must be accepted, practised and routinised to be rooted in society. Usually, peace settlements involve elites, who negotiate, sign and occasionally benefit from the pact—and Zanzibar is not an exception. What is missing in peace negotiations is the broad-based participation of the citizens. Based on a survey and expert interviews, this article examines how power sharing in Zanzibar has nevertheless become rooted in society over time.
Political Socialization of Igorot Millennials and Zoomers and Their Views about the Marcoses
Authors: Tatcho Orville B.
Published: September 2024

This qualitative study seeks to understand the political views of select Igorot millennials and Generation Z participants (zoomers) about the Marcoses, the dominant political family in Philippine politics today. Through eighteen (18) purposively sampled interviews with Igorot millennials and zoomers, and political socialization as a framework, this article (1) explains the factors that shape and influence the political socialization of the participants, (2) discusses the role of social media as an agent of political socialization, and (3) examines the political views of the participants about the Marcoses, particularly the reasons they cited for the perceived popularity of the political family. This article concludes with recommendations to enhance the political learning of Igorot millennials and zoomers, as well as some conceptual and practical implications for political socialization as a process.
Metaphysical Desire
Authors: Evink Eddo , Kruiter Kevin
Published: September 2024

This article revisits the debate on the ‘religious and ethical readings’ of Derrida that was instigated by Martin Hägglund’s Radical Atheism. The impasse in this debate can be overcome in a new reading of Derrida’s work that combines the strong elements of the opposing interpretations. At the same time, this new and critical reading exposes an implicit metaphysical desire, a desire without desire, in Derrida’s work, the presuppositions and consequences of which are not well understood in all the other interpretations. This desire turns out to be an excessive desire, which should be balanced with a more contextual approach.
A Review of Methods to Assess Groundwater Vulnerability to Pollution
Authors: Aduck Jovens , Mufur Alice , Fonteh Mathias
Published: September 2024

Groundwater resources that are increasingly being cherished for most socioeconomic development are exposed to varied pollutant sources. Studies have shown that they are vulnerable to various impacts such as climatic change, human impacts and also pollution from seawater intrusion in coastal areas. The susceptibility of a groundwater body to pollution indicates extent to which its quality is at risk of being compromised by contaminants. Assessments of this vulnerability are classified based on scale (site, local, regional) or objective (such as risk management or protection zoning) and also distinguish between source and resource vulnerability maps, as well as specific and intrinsic vulnerability maps. Groundwater vulnerability assessment methods differ based on several factors, including the availability and spatial distribution of quantitative and qualitative data, the objectives and scale of the mapping, the costs of model development, and the particular hydrogeological characteristics of the aquifer under investigation. The National Research Council has classified these methods into three primary categories: process-based methods, statistical methods, and overlay/index methods. Among these, the overlay/index method is widely employed for conducting large-scale assessments of aquifer sensitivity and groundwater vulnerability. It is especially advantageous in developing countries due to the easily accessible data required for its implementation.
Water Requirement and Irrigation Scheduling of Potato (Solanum tuberosum L.) by Using CROPWAT 8.0 at Welmera District, Central Highland of Ethiopia
Authors: Abebe Nigusie , Temam Mohammed
Published: September 2024

In Welmera district, due to poor management of irrigation water, determination of crop water requirements and appropriate irrigation scheduling is important to prevent over or under-irrigation. The 30-year climatic data (1993- 2023) collected from Holeta Agricultural Research Center were used to estimate potato water requirements and irrigation scheduling using CROPWAT 8.0 model. The results shows that, the CWR, NIR and GIR for potato crop was 444.9 mm, 371.7 mm and 619.5 mm respectively. For the early January planted potato, irrigation should be given fourteen times (1-Jan, 9-Jan, 19-Jan, 29-Jan, 5-Feb, 12-Feb, 19-Feb, 26-Feb, 5-Mar, 11-Mar, 19- Mar, 26-Mar, 31-Mar and last irrigation on 10-Apr) with a gross irrigation water amount of 24.2 mm, 19.9 mm, 23.3 mm, 24.2 mm, 26.9 mm, 35.5mm, 38 mm, 43.5 mm, 43.4 mm, 40.8 mm, 41.9 mm, 39.5 mm, 40.2 mm and 42.9 mm depth respectively. The results obtained from this study can be useful in preventing over or under-irrigation and for future planning of water resource, thereby helping to save water in meeting the CWRs, and can be used as a guide for farmers to select the amount and frequency of irrigation for the crop being studied.
Socio-Economic Perspectives of Household Water Treatment for Safe Drinking in Nigeria
Authors: Onyechi Tochukwu , Obodoechi Divine , Ameh Chika , Amuka Joseph , Hauwa Victoria
Published: September 2024

Access to safe drinking water remains a huge challenge to households in developing countries of which Nigeria is one. This is evident from the numerous cases of water related diseases ravaging the country. The United Nations Children Emergency Fund reports that over 150,000 Nigerians and about 117, 000 under five children, die of water borne diseases annually. Since safe water is gotten from water treatment, the challenges associated with ensuring that water is adequately treated for the households are enormous. Considering that the household is generally the primary source of drinking water for the populace, the socio-economic characteristics of a household plays a key role in determining their access to quality water for drinking. It is based on this that this study seeks to evaluate how household socio-economic characteristics influences a household’s decision to treat its drinking water. The study uses the Binary Logistic regression model to test for the correlates of household water treatment decisions. The data employed in this study is sourced from the Multiple Indicator Cluster survey conducted by UNICEF. A total of 26359 households were selected for the study. The study shows that about 23,495 of the selected households do not treat their water for safe drinking in Nigeria. The result also shows that source of drinking water is a key determining factor in the water treatment decisions of households, as different sources of water were found to have varying degrees of effects on water treatment decisions by households. Some ethnic groups were also observed to have a poor water treatment culture. Also, education of household head and high wealth status increases water treatment.
The Role of School Leaders on Students’ Academic Achievement in Secondary Schools of Wolisso Town
Authors: Shibiru Tesfaye , Regassa Tadesse
Published: September 2024

School leaders are the primary figures in school settings. And, the success of schools is largely ascertained by the efforts of their school leaders. Therefore, the main objective is to reveal the role of school leaders in students’ academic achievements in secondary schools of Woliso town. A mixed approach and descriptive design that was accompanied by survey method has been utilized. Three primary schools in the town were selected using purposive sampling. From a total of 200 staff in the designated primary schools, 142 participants were recruited using a proportional simple random sampling and availability method in 2023. Data was collected using questionnaires and interviews. The numerical statistics were examined using expressive statistical methods. Mean, ratio and standard deviation are supported by SPSS version 26. The findings show that school leaders’ roles should be considered and taken into account. Developing parents' participation and community involvement, communicating with parents about students' result, facilitating communication between the school and parents regarding academic matters, assigning properties on behalf of appropriate operation and success of school visualization and aims, fulfilling facilities like text books, table, chairs, black boards and other materials to improve academic achievement of students’, facilitate teachers’ adequate workspace for preparation such as library and staff. The government and other interested parties should set priority to work strongly toward improving school leaders’ role and other aforementioned factors sequentially for the success of the students’ academic achievement.
Investigation of Malaria Outbreak in Sagambe Area, Mutasa District, Zimbabwe
Authors: Moyoweshumba Maxwell , Mhlanga Maxwell
Published: September 2024

The burden of Malaria remains a global concern, killing millions of people annually, yet it is a preventable and curable disease.. Malaria, a mosquito-borne disease caused by a parasite, leads to fever, chills, and flu-like symptoms, and can be fatal if untreated. In Zimbabwe, the malaria incidence rate decreased from 39 cases per 1,000 people in 2014 to 25 per 1,000 in 2015, a 36% reduction. A study in Sagambe, Mutasa District aimed to identify risk factors for contracting malaria. Using a 1:1 unmatched case-control study, 88 cases and 88 controls were examined. Data were collected via interviewer-administered questionnaires for cases and controls, and self-administered questionnaires for key informants. Evening outdoor activity significantly increased the risk of malaria (AOR = 9.71, 95% CI 1.97-47.85). Other risk factors included sex (p = 0.023), not owning a mosquito net (OR = 0.26, 95% CI 0.14-0.49), not sleeping under a net the previous night (OR = 0.14, 95% CI 0.07-0.35), not closing windows after sunset (OR = 4.39, 95% CI 1.79-11.11), and not wearing long sleeves outdoors (OR = 0.08, 95% CI 0.01-0.56). The outbreak was linked to evening outdoor activities. Participants had high knowledge of malaria transmission but limited awareness of symptoms beyond headache and general body weakness. The study suggests enhancing health education campaigns in Sagambe.
Estimation of Urban Greenhouse Gas Fluxes from Mole Fraction Measurements Using Monin–Obukhov Similarity Theory
Authors: Kenion Helen C. , Davis Kenneth J. , Miles Natasha L. , Monteiro Vanessa C. , Richardson Scott J. , Horne Jason P.
Published: September 2024

The purpose of this study is to determine whether urban greenhouse gas (GHG) fluxes can be quantified from tower-based mole fraction measurements using Monin–Obukhov similarity theory (MOST). Tower-based GHG mole fraction networks are used in many cities to quantify whole-city GHG emissions. Local-scale, micrometeorological flux estimates would complement whole-city estimates from atmospheric inversions. CO2 mole fraction and eddy-covariance flux data at an urban site in Indianapolis, Indiana, from October 2020 through January 2022 are analyzed. Using MOST flux–variance and flux–gradient relationships, CO2 fluxes were calculated using these mole fraction data and compared to the eddy-covariance fluxes. MOST-based fluxes were calculated using varying measurement heights and methods of estimating stability. The MOST flux–variance relationship method showed good temporal correlation with eddy-covariance fluxes at this site but overestimated flux magnitudes. Fluxes calculated using flux–gradient relationships showed lower temporal correlation with eddy-covariance fluxes but closer magnitudes to eddy-covariance fluxes. Measurement heights closer to ground level produce more precise flux estimates for both MOST-based methods. For flux–gradient methods, flux estimates are more accurate and precise when low-altitude measurements are combined with a large vertical separation between measurement heights. When stability estimates based on eddy-covariance flux measurements are replaced with stability estimates based on the weather station or net radiation data, the MOST-based fluxes still capture the temporal patterns measured via eddy covariance. Based on these results, MOST can be used to estimate the temporal patterns in local GHG fluxes at mole fraction tower sites, complementing the small number of eddy-covariance flux measurements available in urban settings.
PEG treatment is unsuitable to study root related traits as it alters root anatomy in barley (Hordeum vulgare L.)
Authors: Töpfer Veronic , Melzer Michael , Snowdon Rod J. , Stahl Andreas , Matros Andrea , Wehner Gwendolin
Published: September 2024

Background

The frequency and severity of abiotic stress events, especially drought, are increasing due to climate change. The plant root is the most important organ for water uptake and the first to be affected by water limitation. It is therefore becoming increasingly important to include root traits in studies on drought stress tolerance. However, phenotyping under field conditions remains a challenging task. In this study, plants were grown in a hydroponic system with polyethylene glycol as an osmotic stressor and in sand pots to examine the root system of eleven spring barley genotypes. The root anatomy of two genotypes with different response to drought was investigated microscopically.

Results

Root diameter increased significantly (p < 0.05) under polyethylene glycol treatment by 54% but decreased significantly (p < 0.05) by 12% under drought stress in sand pots. Polyethylene glycol treatment increased root tip diameter (51%) and reduced diameter of the elongation zone (14%) compared to the control. Under drought stress, shoot mass of plants grown in sand pots showed a higher correlation (r = 0.30) with the shoot mass under field condition than polyethylene glycol treated plants (r = -0.22).

Conclusion

These results indicate that barley roots take up polyethylene glycol by the root tip and polyethylene glycol prevents further water uptake. Polyethylene glycol-triggered osmotic stress is therefore unsuitable for investigating root morphology traits in barley. Root architecture of roots grown in sand pots is more comparable to roots grown under field conditions.
Is this really Empowerment? Enhancing our understanding of empowerment in patient and public involvement within clinical research
Authors: Schilling Imke , Gerhardus Ansgar
Published: September 2024

Background

There has been a growing push to involve patients in clinical research, shifting from conducting research on, about, or for them to conducting it with them. Two arguments advocate for this approach, known as Patient and Public Involvement (PPI): to improve research quality, appropriateness, relevance, and credibility by including patients’ diverse perspectives, and to use PPI to empower patients and democratize research for more equity in research and healthcare. However, while empowerment is a core objective, it is often not clear what is meant by empowerment in the context of PPI in clinical research. This vacancy can lead to insecurities for both patients and researchers and a disconnect between the rhetoric of empowerment in PPI and the reality of its practice in clinical trials. Thus, clarifying the understanding of empowerment within PPI in clinical research is essential to ensure that involvement does not become tokenistic and depletes patients’ capacity to advocate for their rights and needs.

Methods

We explored the historical roots of empowerment, primarily emerging from mid-20th century social movements like feminism and civil rights and reflected the conceptual roots of empowerment from diverse fields to better understand the (potential) role of empowerment in PPI in clinical research including its possibilities and limitations.

Results

Common themes of empowerment in PPI and other fields are participation, challenging power structures, valuing diverse perspectives, and promoting collaboration. On the other hand, themes such as contextual differences in the empowerment objectives, the relationship between empowerment and scientific demands, research expertise, and power asymmetries mark a clear distinction from empowerment in other fields.

Conclusion

PPI offers potential for patient empowerment in clinical trials, even when its primary goal may be research quality. Elements like participation, sharing opinions, and active engagement can contribute to patient empowerment. Nonetheless, some expectations tied to empowerment might not be met within the constraints of clinical research. To empower patients, stakeholders must be explicit about what empowerment means in their research, engage in transparent communication about its realistic scope, and continuously reflect on how empowerment can be fostered and sustained within the research process.
The relationship between HbA1c and the activities of daily living in complex chronic patients with and without intracerebral hemorrhage
Authors: Zheng Ying , Zhan Chenju , Liu Qixi , Chen Chengsheng
Published: September 2024

Background

Associations between HbA1c and adverse outcomes in ischemic and hemorrhagic stroke have been confirmed. It is still unclear whether HbA1c is related to the activities of daily living (ADL) score in complex chronic patients (CCP) with and without intracerebral hemorrhage (ICH).

Aim

The associations between HbA1c and ADL (Barthel score) in CCP with ICH and without ICH were evaluated, respectively.

Methods

We have analyzed data from a previous cohort study involving in 3594 CCPs without a ICH history at baseline, who were followed up for 5 years to assess ICH episode.

Results

One hundred sixty-one ICH case were detected in a total of 3594 patients during the period of follow up for 5 years. Our nonlinear analysis suggested positive trends on the association between HBA1c and Barthel score in ICH and non-ICH patients, respectively. The multivariate linear regression analysis showed that elevated HbA1c was positively associated with a higher Barthel score among all study population (β = 1.25, 95% CI: 0.92, 1.59; P < 0.0001) with adjusted age and sex. Among non-ICH patients, increased HbA1c was still positively associated with an increased Barthel score (β = 1.24, 95% CI: 0.90, 1.58; P < 0.001). However, HbA1c appeared to have no any relationship with Barthel score in ICH patients (β = 1.87, 95% CI: -0.07, 3.82; P = 0.0613) after adjustment for age and sex. By additionally using sensitivity analysis, we still observed that the strong relationship was still existed in non-ICH patients (β = 0.90, 95% CI: 0.56, 1.24; P < 0.001) but not in ICH patients (β = 1.88, 95% CI: -0.10, 3.86; P = 0.0649).

Conclusion

We observed for the first time that elevated HbA1c is associated with better ADL in CCPs without ICH but not in those with ICH. This interesting discovery contradicts the traditional adverse effects of elevated HbA1c.
Cascade testing in mitochondrial diseases: a cross-sectional retrospective study
Authors: Haque Sameen , Crawley Karen , Schofield Deborah , Shrestha Rupendra , Sue Carolyn M.
Published: September 2024

Background

Cascade testing can offer improved surveillance and timely introduction of clinical management for the at-risk biological relatives. Data on cascade testing and costs in mitochondrial diseases are lacking. To address this gap, we performed a cross-sectional retrospective study to provide a framework for cascade testing in mitochondrial diseases, to estimate the eligibility versus real-time uptake of cascade testing and to evaluate the cost of the genetic diagnosis of index cases and the cost of predictive cascade testing.

Methods

Data was collected through retrospective chart review. The variant inheritance pattern guided the identification of eligible first-degree relatives: (i) Males with mitochondrial DNA (mtDNA) single nucleotide variants (SNVs) – siblings and mothers. (ii) Females with mtDNA SNVs – siblings, mothers and offspring. (iii) Autosomal Dominant (AD) nuclear DNA (nDNA) variants – siblings, offspring and both parents. (iv) Autosomal Recessive (AR) nDNA variants – siblings.

Results

We recruited 99 participants from the Adult Mitochondrial Disease Clinic in Sydney. The uptake of cascade testing was 55.2% in the mtDNA group, 55.8% in the AD nDNA group and 0% in AR nDNA group. Of the relatives in mtDNA group who underwent cascade testing, 65.4% were symptomatic, 20.5% were oligosymptomatic and 14.1% were asymptomatic. The mean cost of cascade testing for eligible first-degree relatives (mtDNA group: $694.7; AD nDNA group: $899.1) was lower than the corresponding index case (mtDNA group: $4578.4; AD nDNA group: $5715.1) (p < 0.001).

Conclusion

The demand for cascade testing in mitochondrial diseases varies according to the genotype and inheritance pattern. The real-time uptake of cascade testing can be influenced by multiple factors. Early diagnosis of at-risk biological relatives of index cases through cascade testing, confirms the diagnosis in those who are symptomatic and facilitates implementation of surveillance strategies and clinical care at an early stage of the disease.
Relationship between physical exercise, bullying, and being bullied among junior high school students: the multiple mediating effects of emotional management and interpersonal relationship distress
Authors: Zhang Qiang , Deng Wenjing
Published: September 2024

Objective

This paper investigates the relationships between physical activity (PA), school bullying, emotion regulation self-efficacy (ERS), and interpersonal relationship distress (IRD) among junior high school students. It also examines the underlying mechanisms of school bullying to provide insights into reducing adolescent bullying and to lay the groundwork for preventing and controlling aggressive behaviors.

Methods

A survey was conducted on 484 students (240 males, 12.18 ± 0.8 years) from 4 secondary schools using the Physical Activity Rating Scale (PARS), Emotional Management Self-Efficacy Scale (EMSS), Interpersonal Relationship Distress Scale (IRDS), and Campus Bullying Scale (CBS) to examine the effects among the variables. A stratified random sampling method was used to select the sample, and data were collected with a structured questionnaire. The data were analyzed using SPSS 24.0 and AMOS 24.0 statistical software. The analysis included Pearson correlation analysis, structural equation modeling, and bias-corrected percentile Bootstrap methods.

Results

(1) PA negatively predicts IRD, which in turn has an indirect effect on bullying (PA → IRD → Bullying), ES = -0.063. Additionally, EM and IRD act as mediators between PA and school bullying (PA → EM → IRD → Bullying), ES = 0.025. (2) PA negatively predicts IRD, which has an indirect effect on being bullied (PA → IRD → Being bullied), ES = -0.044. EM and IRD serve as chain mediators between PA and being bullied (PA → EM → IRD → Being bullied), ES = -0.071.

Conclusion

PA can positively predict bullying, but it can be mitigated through EM to reduce IRD, thereby decreasing the occurrence of campus bullying and being bullied.
Assessing health-related quality of life in patients with interstitial lung diseases
Authors: Stoltefuß S. , Leuschner G. , Milger K. , Kauke T. , Götschke J. , Veit T. , Lenoir A. , Kneidinger N. , Behr Jürgen
Published: September 2024

Background

The R-Scale-PF was proposed to evaluate the health-related quality of life (HRQoL) in patients with idiopathic pulmonary fibrosis (IPF). We generated a German version of the R-Scale-PF (GR-Scale), representing the first translation of the questionnaire into another language and assessed HRQoL longitudinally in various interstitial lung diseases (ILDs) using the R-Scale-PF scoring system at a specialized ILD centre.

Methods

We have translated the questionnaire in accordance with the WHO translation guidelines and applied it to 80 ILD patients of our department, with follow-ups after 3–6 months, assessing its internal consistency, floor and ceiling effects, concurrent validity, known-groups validity, and its responsiveness to changes over time.

Results

At baseline, all 80 patients completed the GR-Scale. In 70 patients (87.5%), follow-up data could be obtained after 4.43 ± 1.2 months. The GR-Scale demonstrated acceptable internal consistency (Cronbach’s α 0.749) and slight floor effects. Concurrent validity analysis showed weak but significant correlations with forced vital capacity (FVC; r=-0.282 p = 0.011) and diffusion capacity for carbon monoxide (DLco; r=-0.254 p = 0.025). In the follow-up analysis, moderate correlations were found with FVC (r=-0.41 p < 0.001) and DLco (r=-0.445 p < 0.001). No significant difference in the total score was found between patients with IPF (n = 10) and with non-IPF ILDs (n = 70). The GR-Scale successfully discriminated between groups of varying disease severity based on lung function parameters and the need for long-term oxygen therapy (LTOT). Furthermore, it was able to distinguish between patients showing improvement, stability or decline of lung function parameters.

Conclusion

Our prospective observational pilot study suggests that the GR-Scales is a simple and quick tool to measure HRQoL in patients with ILDs, thus providing an important additional information for the clinical assessment of ILD patients.

Trial registration

Our study was retrospectively registered in the German Clinical Trial Register (DRKS) on 02.11.2022 (DRKS-ID: DRKS00030599).
Assessing emergency room leadership of ObGyn residents in a public university teaching hospital of Sindh, Pakistan: a cross-sectional survey
Authors: Shah Nusrat , Shah Nighat , Rabab Umm-e , Tariq Hira , Ayaz Samina , Fahim Tanzila
Published: September 2024

Background

Leadership is a critical competency for medical professionals, yet it is often neglected in medical training. For ObGyn residents, leadership training is particularly crucial as it significantly impacts both maternal and newborn outcomes, as well as the operational efficiency of healthcare teams. The main objective of this study was to assess the perceptions of obstetrics and gynecology residents who served as group leaders in the emergency team at the Department of Gynecology, Ward 3, Dr. Ruth K.M. Pfau Civil Hospital Karachi.

Methods

A Cross-sectional survey was conducted with purposively sampled 28 year-4 residents who worked as group leaders during last 3 years (from 2018 to 2020) of their residency program at the emergency team in the department of Gynecology Ward 3 Dr Ruth KM Pfau Civil Hospital Karachi. The perceptions on leadership were assessed on 25 items scale sent through a questionnaire on email. Grading of responses was done using a 4-point ordinal scale where 1 meant little importance and 4 was regarded as having great importance. Data was summarized with relevant descriptive statistics and was analyzed on SPSS version 22.

Results

The mean age of residents was 30.36. The mean leadership scores of the group of residents were calculated to be 77.50 (SD ± 9.57) while 14(50%) residents showed good and 14 (50%) showed excellent leadership skills based on cumulative scores. Of the 25 traits examined in this study, the highest reported trait was humility 3.82 (± 0.39) followed by empowerment 3.68 (± 0.77) and effective communication 3.68 (± 0.77). While responding about learning experiences, 89.3% of participants felt that the experience enhanced their decision-making skills and boosted their confidence in dealing with emergencies.

Conclusion

Our study highlights the critical importance of leadership development in the training of ObGyn residents, particularly in high-pressure emergency settings. The findings reveal that residents value leadership traits such as humility, empowerment, and effective communication, which are essential for building teamwork and ensuring optimal patient outcomes and patient satisfaction.
KC-like chemokine as a biomarker of sepsis in dogs with pyometra
Authors: Hagman Ragnvi , Klemming Caroline , Bengtsdotter Emma , Södersten Fredrik , Wang Liya , Wernersson Sara
Published: September 2024

Background

Sepsis, defined as a dysregulated inflammatory response to infection inducing organ dysfunction, is a common cause of mortality in both humans and animals. Early detection and treatment is essential for survival, but accurate diagnosis is challenging due to the lack of specific biomarkers for sepsis. This study explored the potential of the keratinocyte-derived chemokine (KC)-like protein in dogs as a biomarker of sepsis in dogs with bacterial uterine infection (pyometra). The aim was to compare KC-like concentrations in dogs with pyometra with or without sepsis and to assess associations between KC-like and clinical variables, including days of hospitalization as an outcome.

Results

A mouse KC ELISA was validated and used to determine the concentrations of KC-like in serum from 34 dogs with pyometra and 18 healthy controls. Dogs with pyometra were classified as having sepsis based on two different criteria for systemic inflammatory response syndrome (SIRS), resulting in 74% and 30% sepsis-positive, respectively. The concentration of KC-like protein was higher in pyometra dogs with sepsis than in pyometra dogs without sepsis (p < 0.05) and in healthy controls (p < 0.0001) when using either of the two SIRS criteria. Moreover, KC-like was slightly increased in dogs with pyometra without sepsis compared with healthy controls when using the more stringent SIRS criteria (p < 0.05). Analyses of all dogs showed that KC-like concentrations correlated positively with hospitalization days, C-reactive protein (CRP) concentrations, white blood cells, and percentage of band neutrophils; however, KC-like correlated negatively with hemoglobin and did not correlate with circulating creatinine.

Conclusions

Our results suggest that circulating KC-like protein increases in dogs with sepsis in pyometra and that KC-like is associated with more severe clinical illness. These findings support a potential role of KC-like as a biomarker of sepsis; however, the true identity of KC-like in dogs has yet to be uncovered.
Repeated prefrontal tDCS for improving mental health and cognitive deficits in multiple sclerosis: a randomized, double-blind, parallel-group study
Authors: Zakibakhsh Nasim , Basharpoor Sajjad , Ghalyanchi Langroodi Hamidreza , Narimani Mohammad , Nitsche Michael A , Salehinejad Mohammad Ali
Published: September 2024

Background

Multiple Sclerosis (MS) is an autoimmune disease associated with physical disability, psychological impairment, and cognitive dysfunctions. Consequently, the disease burden is substantial, and treatment choices are limited. In this randomized, double-blind study, we conducted repeated prefrontal electrical stimulation in 40 patients with MS to evaluate mental health variables (quality of life, sleep difficulties, psychological distress) and cognitive dysfunctions (psychomotor speed, working memory, attention/vigilance), marking it as the third largest sample size tDCS research conducted in MS to date.

Methods

The patients were randomly assigned (block randomization method) to two groups of sham (n = 20), or 1.5-mA (n = 20) transcranial direct current stimulation (tDCS) targeting the left dorsolateral prefrontal cortex (F3) and right frontopolar cortex (Fp2) with anodal and cathodal stimulation respectively (electrode size: 25 cm2). The treatment included 10 sessions of 20 min of stimulation delivered every other day. Outcome measures were MS quality of life, sleep quality, psychological distress, and performance on a neuropsychological test battery dedicated to cognitive dysfunctions in MS (psychomotor speed, working memory, and attention). All outcome measures were evaluated at the pre-intervention and post-intervention assessments. Both patients and technicians delivering the stimulation were unaware of the type of stimulation being used.

Results

Repeated prefrontal real tDCS significantly improved quality of life and reduced sleep difficulties and psychological distress compared to the sham group. It, furthermore, improved psychomotor speed, attention, and vigilance compared to the sham protocol. Improvement in mental health outcome variables and cognitive outperformance were interrelated and could predict each other.

Conclusions

Repeated prefrontal and frontopolar tDCS ameliorates secondary clinical symptoms related to mental health and results in beneficial cognitive effects in patients with MS. These results support applying prefrontal tDCS in larger trials for improving mental health and cognitive dysfunctions in MS.

Trial registration

ClinicalTrials.gov Identifier: NCT06401928.