bluuebunny/crossref_metadata_2025_split huggingface dataset:
Causes of hospitalization and predictors of HIV-associated mortality at the main referral hospital in Sierra Leone: a prospective study
Authors: Lakoh Sulaiman , Jiba Darlinda F. , Kanu Joseph E. , Poveda Eva , Salgado-Barreira Angel , Sahr Foday , Sesay Momodu , Deen Gibrilla F. , Sesay Tom , Gashau Wadzani , Salata Robert A. , Yendewa George A. 
Published: October 2019

Abstract

Background
HIV infection is a growing public health problem in Sierra Leone and the wider West Africa region. The countrywide HIV prevalence was estimated at 1.7% (67,000 people), with less than 30% receiving life-saving ART in 2016. Thus, HIV-infected patients tend to present to health facilities late, with high mortality risk.

Methods
We conducted a prospective study of HIV inpatients aged ≥15 years at Connaught Hospital in Freetown—the main referral hospital in Sierra Leone—from July through September 2017, to assess associated factors and predictors of HIV-related mortality.

Results
One hundred seventy-three HIV inpatients were included, accounting for 14.2% (173/1221) of all hospital admissions during the study period. The majority were female (59.5%, 70/173), median age was 34 years, with 51.4% (89/173) of them diagnosed with HIV infection for the first time during the current hospitalization. The most common admitting diagnoses were anemia (48%, 84/173), tuberculosis (24.3%, 42/173), pneumonia (17.3%, 30/173) and diarrheal illness (15.0%, 26/173). CD4 count was obtained in 64.7% (112/173) of patients, with median value of 87 cells/μL (IQR 25–266), and was further staged as severe immunosuppression: CD4 < 100 cells/μL (50%, 56/112); AIDS: CD4 < 200 cells/μL (69.6%, 78/112); and late-stage HIV disease: CD4 < 350 cells/μL (83%, 93/112). Fifty-two patients (30.1%, 52/173) died during hospitalization, 23% (12/52) of them within the first week. The leading causes of death were anemia (23.1%, 12/52), pneumonia (19.2%, 10/52), diarrheal illness (15.4%, 8/52) and tuberculosis (13.6%, 7/52). Neurological symptoms, i.e., loss of consciousness (p = 0.04) and focal limb weakness (p = 0.04); alcohol use (p = 0.01); jaundice (p = 0.02); cerebral toxoplasmosis (p = 0.01); and tuberculosis (p = 0.04) were significantly associated with mortality; however, only jaundice (AOR 0.11, 95% CI [0.02–0.65]; p = 0.01) emerged as an independent predictor of mortality.

Conclusion
HIV-infected patients account for a substantial proportion of admissions at Connaught Hospital, with a high morbidity and in-hospital mortality burden. These findings necessitate the implementation of specific measures to enhance early HIV diagnosis and expand treatment access to all HIV-infected patients in Sierra Leone.
Ethanol extract of Chrysanthemum zawadskii Herbich induces autophagy and apoptosis in mouse colon cancer cells through the regulation of reactive oxygen species
Authors: Kim Kwang-Youn , Oh Tae-Woo , Yang Hye-Jin , Kim Young-Woo , Ma Jin-Yeul , Park Kwang-Il 
Published: October 2019

AbstractBackgroundRecent research has suggested that autophagy can provide a better mechanism for inducing cell death than current therapeutic strategies. This study investigated the effects of using an ethanol extract of Chrysanthemum zawadskii Herbich (ECZ) to induce apoptosis and autophagy associated with reliable signal pathways in mouse colon cancer CT-26 cells.MethodsUsing ECZ on mouse colon cancer CT-26 cells, cell viability, annexin V/propidium iodide staining, acridine orange staining, reactive oxygen species (ROS) and western blotting were assayed.ResultsECZ exhibited cytotoxicity in CT-26 cells in a dose-dependent manner. ECZ induced apoptosis was confirmed by caspase-3 activation, poly (ADP-ribose) polymerase cleavage, and increased production of reactive oxygen species (ROS). Furthermore, it was shown that ECZ induced autophagy via the increased conversion of microtubule-associated protein 1 light chain 3II, the degradation of p62, and the formation of acidic vesicular organelles. The inhibition of ROS production by N-Acetyl-L-cysteine resulted in reduced ECZ-induced apoptosis and autophagy. Furthermore, the inhibition of autophagy by 3-methyladenine resulted in enhanced ECZ-induced apoptosis via increased ROS generation.ConclusionThese findings confirmed that ECZ induced ROS-mediated autophagy and apoptosis in colon cancer cells. Therefore, ECZ may serve as a novel potential chemotherapeutic candidate for colon cancer.
The protective effect of Phellinus linteus decoction on podocyte injury in the kidney of FSGS rats
Authors: Wan Feng , Yang Ru-chun , Shi Yan-peng , Tang Yue-Wen , Tang Xuan-li , Zhu Xiao-ling , Li You-gui , Wang Yong-jun 
Published: October 2019

Abstract

Background
This study aimed to investigate the effect of the Phellinus linteus (Mesima) decoction on podocyte injury in a rat model of focal and segmental glomerulosclerosis (FSGS) and evaluate the potential mechanisms.

Methods
FSGS resembling primary FSGS in humans was established in rats by uninephrectomy and the repeated injection of doxorubicin. The FSGS rats were randomly divided into the model group, low-dose group of P. linteus decoction (PLD-LD), medium-dose group of P. linteus decoction (PLD-MD), and high-dose group of P. linteus decoction (PLD-HD). Blood and urine analysis were performed after 12 weeks and the molecular indicators of renal function and the renal pathological changes were examined.

Results
FSGS developed within 12 weeks in the test group and showed progressive proteinuria and segmental glomerular scarring. Urinary protein, serum creatinine, urea nitrogen, triglycerides and cholesterol were significantly reduced following the 12-week intervention with P.linteus decoction, especially in the PLD-LD group. Renal nephrin and podocin were markedly increased. Moreover, the pathological damage in the renal tissue was alleviated by the PLD-LD intervention.

Conclusion
The P. linteus decoction alleviated the podocyte injury in the FSGS rat model, thus minimizing the progression of glomerular sclerosis and improving renal function.
Constructing an experiential education model in undergraduate radiology education by the utilization of the picture archiving and communication system (PACS)
Authors: Chen Yingqian , Zheng Keguo , Ye Shanshan , Wang Jifei , Xu Ling , Li Ziping , Meng Quanfei , Yang Jianyong , Feng Shi-Ting 
Published: October 2019

Abstract

Background
Medical education in China is in a transitional period, from passive learning models to experiential education. We modified an experiential education method for radiology education. The aim of this study is to evaluate the effect of this method on undergraduate radiology education.

Method
With the help of the picture archiving and communication system (PACS) and RadiAnt DICOM Viewer, we modified an experiential education method that simulates similar working conditions for undergraduate medical students to formulate radiology diagnosis similar to clinical radiologists. A total of 101 students were allocated into either the experiential education group or the control group. The final examination scores and a 5-point Likert scale self-assessment questionnaire of radiologic skills were collected from all the students as an objective assessment and a subjective assessment respectively. A questionnaire was also used to assess the satisfaction with the experiential model in the experiential education group. Mann-Whitney U test was used to compare the ranked data, and t-tests were used to compare the numeric data.

Results
The experiential education group demonstrated significantly higher scores (7.4 ± 1.3) compared to the control group (6.7 ± 1.5, p < 0.05) in the question type “description and diagnosis”. The self-assessment questionnaire indicated that the experiential education was related to increased familiarity with the diagnosis thinking principle and the sequences and reconstruction methods of computer tomography (CT) imaging, which also strengthen participants’ self-confidence to perform future clinical work (p < 0.05). The self-assessment questionnaire in the experiential education group showed that the majority of students were satisfied with the organization (82.5%), interactivity (85%) and quality (85%) of the learning activity. Most students found this model of learning to be helpful for studying radiology (85%) and for understanding anatomy (90%).

Conclusion
Compared with the traditional radiology education approach, the experiential education method showed greater efficacy in improving students’ analysis and diagnostic skills and their self-confidence.
Investigating factors affecting on medical sciences students’ intention to adopt mobile learning
Authors: Azizi Seyyed Mohsen , Khatony Alireza 
Published: October 2019

AbstractBackgroundMobile learning (m-learning) provides a good opportunity for students’ lifelong learning. The design and implementation of effective and successful mobile learning requires identification of factors that affect m-learning. The aim of this study was to investigate the factors that affect the intention of students of medical sciences to adopt mobile learning based on theory of planned behavior (TPB).MethodsIn this cross-sectional study, 332 students of medical sciences were randomly selected. The study tool was a based a questionnaire that had been designed based on TPB model. Descriptive statistics (mean, standard deviation, frequency and percentage) were calculated. In order to determine the standardized factor loading and assess the study hypotheses, structural equation modeling was used. Composite reliability, average variance extracted, and standardized factor loading were used to determine the convergent validity.ResultsThe mean of mobile learning readiness was 3.59 ± 0.83. Among the TPB structures, the structures of attitude (β = 0.525) and behavioral control (β = 0.318) had positive and significant effect on the intention to adopt m-learning (P ≤ 0.01). However, the structure of subject norm did not have a significant effect on the intention to adopt m-learning. In general, attitude, behavioral control and subject norm structures were 0.675 determinants of the intention to adopt m-learning (r2 = 0.675).ConclusionsIn this study Mobile learning readiness of the students was at moderate level. Also the results indicated Positive and significant effect of attitude and behavioral control on the intention of students to accept m-learning. The TPB-based model was a suitable model for identifying psychological factors that affect the intention of students of medical sciences to adopt m-leaning. In order to increase the students’ acceptance of mobile learning, we suggest that, other psychological, behavioral, social, and cultural factors that affect the acceptance of m-learning should be identified. Educational programs are also suggested to be introduced to students to familiarize them with the m-learning and its application in learning process.
A personalized, web-based breast cancer decision making application: a pre-post survey
Authors: Wyatt Kirk D. , Jenkins Sarah M. , Plevak Matthew F. , Venegas Pont Marcia R. , Pruthi Sandhya 
Published: October 2019

Abstract

Background
Every case of breast cancer is unique, and treatment must be personalized to incorporate a woman’s values and preferences. We developed an individually-tailored mobile patient education application for women with breast cancer.

Methods
Pre-post surveys were completed by 255 women who used the tool.

Results
Patients thought the application included helpful information (N = 184, 72%) and was easy to navigate (N = 156, 61%). Most patients thought the amount of information in the tool was “about right” (N = 193, 87%). Decision making confidence increased by an average of 0.8 points (10-point scale) following a consultation and use of the tool (p < 0.001).

Conclusions
Tailored mobile applications may optimize care by facilitating shared decision making and knowledge transfer, and they may also enhance the experience of patients as they navigate through their breast cancer journey.
“I prefer a male nurse to a female nurse”: patients’ preference for, and satisfaction with nursing care provided by male nurses at the Komfo Anokye teaching hospital
Authors: Budu Hayford Isaac , Abalo Emmanuel Mawuli , Bam Victoria Bubunyo , Agyemang Deus Osei , Noi Shirley , Budu Florence A. , Peprah Prince 
Published: October 2019

Abstract

Background
Although most male nurses join the profession for self-actualisation, the cultural and societal stereotyping of male nurses as “He-Man”, “gay” and “troublemakers”, and their marginalisation at the hospital during certain personal and intimate care procedures, tend to deepen the existing gender discrimination prevalent within the nursing profession. This study therefore assessed patients’ preference for, and satisfaction with nursing care provided by male nurses at the medical and surgical wards of Komfo Anokye Teaching Hospital [KATH].

Methods
An inferential cross-sectional study design, in which the prevalence of a condition among an identified population is determined, was used. Using convenience sampling, 150 respondents who meet certain practical criteria and are available and willing to participate were sampled. Data from a context-based research instrument on the opinion, preference and satisfaction of patients with male nursing were analysed using χ2 test, Mann Whitney U test, ordinal logistic regression and logistic regression.

Results
The study indicates that more females than males had ever been attended to by a male nurse for the period considered by the study, and females described male nurses as polite and courteous and were comfortable with their treatment. Being single [OR = 0.111, 95% CI (0.013–0.928)] and professing Islamic faiths [OR = 36.533, 95% CI (2.116–630.597)] were functions of respondents’ preference for a male nurse. Significantly too, affiliating to a religious sect (OR = 2.347, 95% CI [0.076–1.630]) and being educated (OR = 1.387, 95% CI [0.040–0.615]), were associated with higher odds of falling in one of the higher categories of satisfaction with nursing care provided by male nurses as against the lower categories.

Conclusion
Although marital status, religious affiliation and educational level were the significant predictors of patients’ preference for, and satisfaction with care provided by male nurses, the effect of the other variables should not be overlooked. The finding disproves assertions on the negative effect of religion on male nurses. It is recommended that public awareness be created on the role of male nurses in the healthcare delivery system to promote acceptance of gender diversity in the nursing profession.
An audit of dementia education and training in UK health and social care: a comparison with national benchmark standards
Authors: Smith S. J. , Parveen S. , Sass C. , Drury M. , Oyebode J. R. , Surr C. A. 
Published: October 2019

Abstract

Background
Despite people living with dementia representing a significant proportion of health and social care users, until recently in the United Kingdom (UK) there were no prescribed standards for dementia education and training. This audit sought to review the extent and nature of dementia education and training offered to health and social care staff in the UK against the standards described in the 2015 Dementia Training Standards Framework, which describes the knowledge and skills required of the UK dementia workforce.

Methods
This audit presents national data concerning the design, delivery, target audience, length, level, content, format of training, number of staff trained and frequency of delivery within existing dementia training programmes offered to health and social care staff. The Dementia Training Standards Framework was used as a reference for respondents to describe the subjects and learning outcomes associated with their training.

Results
The findings are presented from 614 respondents offering 386 training packages, which indicated variations in the extent and quality of training. Many training packages addressed the subjects of ‘person-centred care’, ‘communication’, ‘interaction and behaviour in dementia care’, and ‘dementia awareness’. Few training packages addressed subjects concerning ‘pharmacological interventions in dementia care’, ‘leadership’ and ‘end of life care’. Fewer than 40% of The Dementia Training Standards Framework learning outcomes targeted to staff with regular contact with people with dementia or in leadership roles were covered by the reported packages. However, for training targeted at increasing dementia awareness more than 70% of the learning outcomes identified in The Dementia Training Standards Framework were addressed. Many training packages are not of sufficient duration to derive impact; although the majority employed delivery methods likely to be effective.

Conclusions
The development of new and existing training and education should take account of subjects that are currently underrepresented and ensure that training reflects the Training Standard Framework and evidence regarding best practice for delivery. Lessons regarding the limitations of training in the UK serve as a useful illustration of the challenge of implementing national dementia training standards; particularly for countries who are developing or have recently implemented national dementia strategies.
Health seeking behaviour, delayed presentation and its impact among oral cancer patients in Pakistan: a retrospective qualitative study
Authors: Basharat Sarah , Shaikh Babar Tasneem , Rashid Haroon Ur , Rashid Mamoon 
Published: October 2019

Abstract

Background
Delayed diagnosis of Oral Cancer (OC) can mean a difference in quality and expectancy of life for the patient. This delay could be from the healthcare side, or more importantly from the patient’s side. Globally, there are studies enumerating the causes for delays from the patients’ side in seeking healthcare for Oral Cancer; however, no similar research is found in the context of Pakistan. This study endeavoured to understand the health seeking behaviour, reasons for delay in consultation and the impact on OC patients’ lives.

Methods
In-depth interviews were conducted with randomly selected OC patients at a private sector tertiary care facility in Islamabad (who met the inclusion criteria of having successfully been treated for Oral Cancer) which caters to the most diverse population for the treatment of Oral Cancer. Theoretical saturation was achieved at 14 interviews. All participants gave verbal consent for participation, which was recorded prior to the interviews.

Results
Patients (age range 43–68 years) had received the surgical treatment and radiation. The reported delay before seeking a proper medical advice ranged from 1 month to 2 years. Lack of awareness about OC risk factors, symptoms, and whom to approach for treatment were the main reasons. Most respondents relied on self-treatment considering the non-healing wound/ulcer to be a minor issue until they were advised a consultation with a specialist. Treatment started within 1–3 months after a confirmed diagnosis on biopsy. The reported average expenditure on treatment was US$5000-10,000, mostly covered through a private health insurance and others borrowed the money.

Conclusion
A socio-behavioural change campaign for the general population can result in earlier presentation of the OC, minimizing the financial burden on the patient as well as the health system, and improving the quality of life of the patients.
Accessing public healthcare in Oslo, Norway: the experiences of Thai immigrant masseuses
Authors: Tschirhart Naomi , Diaz Esperanza , Ottersen Trygve 
Published: October 2019

Abstract

Background
Thai massage is a highly gendered and culturally specific occupation. Many female Thai masseuses migrate to Norway as marriage migrants and as such are entitled to the same public healthcare as Norwegian citizens. Additionally, anyone who is not fluent in Norwegian is entitled to have an interpreter provided by the public healthcare system. Norway and most other countries aspire to universal health coverage, but certain immigrant populations continue to experience difficulties accessing appropriate healthcare. This study examined healthcare access among Thai migrant masseuses in Oslo.

Methods
Guided by access to healthcare theory, we conducted a qualitative exploratory study in 2018 with Thai women working as masseuses in Oslo, Norway. Through semi-structured in-depth interviews with 14 Thai women, we explored access to healthcare, health system navigation and care experiences. We analyzed the data using thematic analysis and grouped the information into themes relevant to healthcare access.

Results
Participants did not perceive that their occupation limited their access to healthcare. Most of the barriers participants experienced when accessing care were related to persistent language challenges. Women who presented at healthcare facilities with their Norwegian spouse were rarely offered interpreters, despite their husband’s limited capacity to translate effectively. Cultural values inhibit women from demanding the interpretation services to which they are entitled. In seeking healthcare, women sought information about health services from their Thai network and relied on family members, friends and contacts to act as informal interpreters. Some addressed their healthcare needs through self-treatment using imported medication or sought healthcare abroad.

Conclusions
Despite having the same entitlements to public healthcare as Norwegian citizens, Thai migrants experience difficulties accessing healthcare due to pervasive language barriers. A significant gap exists between the official policy that professional interpreters should be provided and the reality experienced by study participants. To improve communication and equitable access to healthcare for Thai immigrant women in Norway, health personnel should offer professional interpreters and not rely on Norwegian spouses to translate. Use of community health workers and outreach through Thai networks, may also improve Thai immigrants’ knowledge and ability to navigate the Norwegian healthcare system.