bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nursing care in early extubation of cardiosurgical patient: a literature review
Authors: Soave G , Monaco E , Monte G , Gregori D , Martinato M 
Published: October 2020

Abstract

Introduction
Recent studies show that mechanical ventilation (MV) is necessary in only 5-10% of cardiosurgical patients. Thus, this finding denies the theory arguing that a prolonged period of MV (24 hours to 7 days) reduces the risk of complications. Based on these considerations, strategies have developed, i.e. the Fast Track (FT), with the aim of encouraging early extubation (1 to 8 hours after surgery). The objectives of this review are: to verify the effectiveness of FT in terms of reducing post-operative complications, mortality and costs, to analyse the operating procedures and inclusion criteria of each protocol and to outline nursing care in the whole process.

Methods
Literature search was performed in Cochrane, PubMed, and CINAHL databases. No limits have been applied on study design and publication timespan. Population included adult patients who underwent cardiac surgery with admission to an intensive care unit and were mechanically ventilated.

Results
16 articles (including 8 RCT) have been selected. The protocols require that nurses, based on specific parameters, assess the possibility of weaning from sedation and early extubation according to standardised practices. Early extubation decreases the risk of MV-related complications by decreasing hospitalization lenght and thus total costs by at least 3%. No significant differences have been found between FT and standard of care regarding postoperative complications and mortality.

Conclusions
Taking into account both the proven applicability, safety and efficacy of FT protocols and their high heterogeneity in published studies, that prevent their comparison, further research is needed to identify a reliable algorithm for early extubation based on pre-operative, intraoperative and postoperative data.

Key messages
Early extubation decreases the risk of MV-related complications by decreasing hospitalization lenght and thus total costs by at least 3%. Recent studies show that mechanical ventilation (MV) is necessary in only 5-10% of cardiosurgical patients.
Review of Philippine Health Laws and its Implication to HTA Institutionalization
Authors: Uezono D , Fajardo M , Zuniga Y M , Briones J , Genuino A J , Guerrero A M , Castro B 
Published: October 2020

Abstract

Objective
To identify the implications of health legislations on the direction of health technology assessment (HTA) institutionalization in the Philippines.

Methods
We reviewed 15 health laws and extracted information using a preset data extraction tool. The collected data was then subjected to the KJ (Kawakita Jiro) method to group similar provisions, taking into account their respective implications to the HTA direction. Once grouped, a core concept was identified that captured the underlying provisions within the group. After which, the core concepts were tabulated and matched with the core components of HTA institutionalization to identify specific policy implication to HTA.

Results
Three major paradigms emerged that are considered important in the institutionalization of HTA. First, common among the health laws are the need for the provision or expansion of benefit packages through the Philippine Health Insurance Corporation. Aside from the benefit packages, the reviewed laws also require delivery of new health services that entail the use of specific health technologies. Lastly, as a consequence of the need for new health services, equity concerns became evident in relation to the identified health services specifically in terms of socioeconomic divide, geographical location and disease status.

Discussion and Conclusions
The three paradigms identified from the review of health laws indicate synergism and antagonism to the HTA-related policy content of the Philippines' UHC Law. Some identify the need for HTA before being funded by the government while others do not explicitly state this. Despite the health laws requiring expansion or creation of benefit packages and delivery of new health services, there is still a need to undergo HTA in order to ensure efficient use of resources. The presence of these laws should not be tantamount to exception of undergoing HTA process but rather should be taken as a guide for priority-setting of topics for assessment.

Key messages
In the process of institutionalizing HTA, existing legislations on health can help map out areas of priority for assessment. Many health policies preceded the signing of the Universal Health Care Law, thus it is important to review them to determine provisions that are synergistic or antagonistic to the content of UHC Law.
Stress perception and associated factors among healthcare students
Authors: Dardouri M , Mallouli M , Chelbi S , Ben Rejeb M 
Published: October 2020

Abstract

Introduction
Stress and its deleterious effects are currently a major topic in public health. Health care studies can be very stressful as they pose a challenge for students around the world. The aim of this study was to assess stress perception among healthcare students and to identify its associated factors.

Methods
A descriptive cross-sectional study was carried out over a five-month period (January-May 2017) among healthcare students at the Higher School of Health Sciences, University of Sousse (Tunisia), during the 2016/2017 academic year. The socio-demographic and health status data have been collected using a pre-established data collection sheet. Stress perception was assessed by the French version of the Perceived Stress Scale with 10 items (PSS-10). Factors associated with stress were examined using ANOVA and T-student tests.

Results
A total of 237 students participated in the study with a response rate of 64.40%. The average age was 20.57±1.05 with a female predominance of 90.7%. The mean of the PSS-10 total score was 31.37±4.406. A rate of 89% of cases had a perceived high-stress score. Factors associated with stress were social status (p = 0.005), housing (p = 0.01), hometown (p = 0.03), presence of a diagnosed health condition (p = 0.02), presence of eating disorder (p = 0.04), presence of sleeping disorder (p = 0.004).

Conclusions
This study reported that healthcare students had a high level of stress associated with endogenous and exogenous factors. Stress management strategies must be included in the educational curriculum in healthcare schools.

Key messages
Health care studies pose a challenge for students around the world. Healthcare students had a high level of stress associated with endogenous and exogenous factors.
Rapid response platform to manufacture human immunoglobulins
Authors: Van der Hart E , Wall A , Pronyk R , Buhay S , Wiebe P 
Published: October 2020

Abstract
A rapidly deployable drug product for use in the early stages of a disease outbreak could prevent further spread of the pathogen. Emergent BioSolutions is developing a rapid response platform (RRP) to manufacture human immunoglobulins (HIG) for use as a passive immunotherapy during public health emergencies. Passive immunotherapies derived from either convalescent plasma or purified immunoglobulins (Ig) have a long history of success in treating a range of viral, bacterial and toxin diseases, as they provide the immediate benefit of a protective response. Emergent's RRP is being developed to address the need for front-line therapy/prophylaxis with immediate benefit with the potential to overcome the current limitations of convalescent plasma.
Emergent's proposed RRP begins with identification of plasma donors with measurable levels of pathogen-specific antibodies using a field deployable real-time donor screening assay. Plasma collected from eligible donors is treated using the Mirasol® Pathogen Reduction Technology, pooled, purified and concentrated into HIG using Emergent's rapid HIG manufacturing process to produce product formulated for intramuscular administration.
Our rapid HIG process is chromatography based and each 30 L run aims to purify, formulate, and fill ∼65 doses (1 g of total IgG) with testing and release onsite for immediate use. Multiple innovations to streamline operations, including single-use technologies and minimal human interfaces, allow for the manufacture of HIG product in ∼30 hours.
To house the process, Emergent has designed and constructed a working modular manufacturing unit (MMU) prototype. The MMU consists of a modified 53-foot shipping container designed for multiple modes of transport, to meet ISO 8 environment requirements with self-contained utilities, including HVAC, and can run off a diesel generator or local power.
Product from multiple development runs within the MMU have been characterized and validation work is ongoing.

Key messages
A modular manufacturing unit is being developed with the potential to provide a local capability to produce health solutions for endemic diseases. A modular manufacturing unit is being developed with the potential to rapidly manufacture human immunoglobulins during public health emergencies and pandemics.
Multidrug-resistant Klebsiella pneumoniae: risks to food safety and public health
Authors: Cornacchia A , Di Marzio V , Ciarrocchi A , Saletti M A , Marfoglia C , Ancora M , Cammà C , Di Pasquale A , Blasi G , Centorotola G 
Published: October 2020

Abstract

Background
Klebsiella pneumoniae (Kp) is a Gram-negative hospital-acquired pathogen. Kp also poses a potential food safety hazard, since a significant increase of multidrug-resistant (MDR) Kp was observed in foods. The purpose of this study was to characterize MDR Kp strains in order to evaluate the presence of beta-lactams, quinolones and aminoglycosides resistance genes.

Methods
A total of 13 Kp strains, isolated from chicken (n.8), raw milk (n.2), waste water (n.2), human faeces (n.1), and identified as MDR by microdilution test, were selected to evaluate antimicrobial resistance profiles, focusing on beta-lactams, quinolones and aminoglycosides. Next Generation Sequencing (NGS), with NextSeq 500 Illumina platform, was performed to acquire genome sequences. The antimicrobial resistance profiles were obtained using ResFinder (https://cge.cbs.dtu.dk/services/ResFinder/).

Results
From the 13 Kp considered, 6 strains (46.2 %) showed the presence of several beta-lactam genes. The blaSHV gene was carried by 12 Kp (92.3%); of these strains, 5 also carried blaTEM (41.7%) and 3 also blaCTX-M (25.0%) genes. Only 1 Kp strain showed the presence of blaOKP-A gene. All the 13 Kp carried the oqxA and oqxB genes. Of these strains, 4 also highlighted the presence of qnrB or qnrS plasmid-mediated gene for quinolone resistance. Regarding aminoglycoside resistance, 6 Kp strains (46.2%) carried aph, aadA and aaC genes, linked to gentamicin and streptomycin resistance protein.

Conclusions
These preliminary results emphasize the need of further studies on more several samples, to better understand the antimicrobial resistance of Kp strains, the hypothetical transmission of MDR Kp from foods to consumers and the potential risk posed to food safety, environmental and public health.

Key messages
The increasing prevalence of multidrug-resistant Klebsiella pneumoniae requires the need to investigate more foods and environmental samples to ensure consumer safety and public health. Public health safety requires a major knowledge of the hypothetical mechanisms and routes of transmission of multidrug-resistant Klebsiella pneumoniae.
Risk perception, knowledge, prevention, information sources and efficacy beliefs related to Covid-19
Authors: Genovese C , Signorelli C , Pavia M , Icardi G , Mistretta A , Casuccio A , Villari P , Pellissero G , Siliquini R , Squeri R 
Published: October 2020

Abstract

Background
Sars-Cov-2 is one of the latest examples of an emerging infectious disease challenging the world and it is the third case, in just two decades, of “spillover”. In light of the recent outbreak (Italy is in 2nd position), it is important to evaluate people risk perception and to support the Health Authority with effective communicative actions to avoid the spread of “infodemia”/alarmism. The aim of this study is a) to study levels of perceived threat, risk perception, severity and comparative vulnerability b) to compare risk perception with other communicable/not communicable diseases; c) provide information to increase awareness/ knowledge of the disease.

Methods
We performed an Italian multicentre study from 11 February 2020 and it is still in progress. The subjects in study (general population, HCWs and university students) were enrolled through the administration of a standardized questionnaire based on Health Belief Model through CAPI and CAWI methods. The summary and inferential statistical analyses will be carried out using the R software.

Results
We enrolled 2495 people from 11 February until 4 March 2020. All the respondents had heard of COVID19. Only 2% didn't know any symptoms and 3% answered to all the questions correctly (mean knowledge score of 13). 48% thought that he/she could acquired COVID 19 in the next 12 months and 70% stated that their concern of the disease was high(score5). Perceived capability to avoid it was rated as good/very good by 62%. The correct mask use (WHO) was reported by 64% of the sample and 47% stated all preventive actions (2% no one). Only 22% of the sample stated all actions to be taken in case of suspected acquisition of COVID19.

Conclusions
Italy is facing an epidemic that could have the potential to affect the entire national health system. It's so important to implement public health activities and surveillance systems in order to limit the spread of the disease and bad/disinformation.

Key messages
This study is the first to report on public perception of Sars-Cov-2 in all the Italy. The results indicated that the Italian population is aware of the outbreak and it is concerned about their risk. On the other hand, only half of the sample is aware about all preventive actions and not everybody knows all procedures to be taken in case of COVID 19 suspect.
Organizational Commitment Of Afad Istanbul Search And Rescue Unit
Authors: Karakoç M , Erdoğan Ö , Demirbaş E 
Published: October 2020

Abstract

Background
Our study is intended to evaluate the Organizational Commitment of the Istanbul AFAD Search and Rescue Unit (AKB) employees operating at national and international level during disasters and to serve as a model for the other organizations that conduct national and international operations in the area of search and rescue.

Methods
This research was carried out with a total of 75 employees from Istanbul AFAD AKB from 02.11.18 to 01.01.2019. Introductory Information Form and Organizational Commitment Scale were used for data collection. Findings of the study were evaluated via IBM SPSS Statistics 22.

Results
Among 71 persons who participated in the study, it was determined that 91.5% were male, 50.7% were at the age of 40 or older, 81.7% were married, 67.6% had bachelor's degree, 63.4% were search and rescue technicians, and 50.7% were employed by their current organization for 10 years or less. Regarding the employees, it was found that 25.4% had very good organizational commitment while 54.9% faced issues in relation to the organizational commitment. OCS point average of the employees was 3.07±0.20 and the obtained Cronbach Alfa internal consistency coefficient of the scale was 0.678. OCS points of those employed for 12 years or longer in total were determined to be high at statistically significant level. Also, OCS points of those who did not face any issue in relation to the Organizational Commitment were found to be high at a statistically significant level against those who faced issues.

Conclusions
It is important to ensure work satisfaction, provide harmonization, and avert chaos and stress for boosting the organizational commitment. Therefore, the managers should conduct activities intended to boost the employee commitment levels within the organization.

Key messages
Disaster is a significant public health issue and disaster employees are special. The issues faced by the employees that perform search and rescue operations must be considered important and resolved.
Challenges and innovations in the use of active methodologies in undergraduate medical courses
Authors: Hermes E , Montenegro I , Lazorek J , Sarubbi V 
Published: October 2020

Abstract

Background
Conscious perception of oneself and others in their complexity and subjectivity allows the approach of trying to understand the human being to overcome the labeling stigma of the disease. For the educator, it is unique to guide the way that can transform a gap in the undergraduate medical education into a possibility of positive action. It was in this sense that the perception workshop was developed based on the concept of Integrated Gestalt Therapy. Teachers of the Communication, Leadership, and Management Skills discipline invited undergraduate medical students to stimulate the five senses. For sensory experiments, 6 stations were used in the classroom. Season 1 - View: Photos from the 'More Medical Programs' and deductive interpretation were posted on the board for observation. Season 2 - Tact: Blindfolded they handled four types of objects with different textures. Season 3 - Movement: two photos of yoga position (medium and high complexity) for imitation. Station 4 - hearing: auditory processing through binaural stimulation with computer-attached headset. Season 5 - nose and taste memory: through spices, leaves and dried fruits, the nostrils were stimulated for identification and recognition. Station 6 - Speech: Voice Lab through Voice Spectrogram Analysis (Praat).

Results
Faced with activities like this, we can see that students go through a process of breaking paradigms, which significantly influences their way of thinking. This training is part of continuing education through the perspective of the knowledge spiral. With the evolution of the undergraduate years, the student will be able to refine and deepen their reflections in a continuous process.

Conclusions
This work represents a breakthrough in the field of health education. Humanized professionals, aware of their skills and abilities, with actions aimed at the well-being of the population, in a generalist, critical and reflective manner.

Key messages
The impact generated on the assisted population have been observed when this new professional profile is inserted in health services. This workshop represents a breakthrough in the field of training health professionals with actions focused on the welfare of the population in a generalist, critical and reflexive manner.
Formulating a structured description of the levels of qualifications recognized in the health system
Authors: Koikov V , Baigozhina Z , Bekbergenova Z , Umbetzhanova A , Derbissalina G , Mergentai A 
Published: October 2020

Abstract

Issue
Constantly emerging new challenges for national health systems (HS) and new technologies require the creation of conditions for the continuous provision of the HS with the necessary number of health workers (HW) with the appropriate level of qualifications. In this regard, the high relevance acquires the formulation of a structured description of levels of qualifications in the HS, the requirements for the future and existing qualifications, taking into account the priorities of the HS development, as well as mapping of occupations by the qualification level.

Description of the Problem
The main problems in regulating the sectoral qualifications system (SQS) in Kazakhstan is the lack of a sectoral framework of qualifications (SQF) and professional standards governing the requirements for specialists in the HS, and the lack of a clear distinction of competencies by the qualification level. Accordingly, there is a discrepancy between educational programs and practical health care needs, and an imperfection of the HWs certification system.
Changes: We have incorporated into the National Code 'On the health of the people and the HS' points that define the SQS basic principles and regulation. As SQS has been defined set of legal and institutional mechanisms to control demand of HWs from the labor market and the qualifications offer from the health education system. SQS includes SQF; professional standards; state compulsory health education standards; system for assessing the professional preparedness and certification of specialists; system of continuing professional development of HWs. For a structured description of the levels of qualifications recognized in the HS we developed SQF. In SQF all HWs were divided into sub-sectors: medicine, pharmacy, public health and intersubsectoral processes.

Lessons
The presence of an effective SQS will create the conditions for providing the HS with human resources that meet the needs of the state, business and society.

Key messages
We have analyzed the existing system for regulating the qualifications of health professionals and have proposed legislative mechanisms for regulating the SQS in the field of healthcare. This made it possible to ensure conditions for effective legal regulation of the HWs qualification demands from the labor market and the supply of qualifications from the health education system.
Students’ knowledge and attitude towards scientific research at Tbilisi State Medical University
Authors: Gabunia L , Khetsuriani S , Gamkreldze N , Antia N 
Published: October 2020

Abstract

Background
Since 2012, Scientific-Research Skills Center (SRSC) of Tbilisi State Medical University (TSMU) conducts “Basic of scientific research skills” course for the students of TSMU. The activities and functions of the center are derived from the competence of basic medical education in the Bologna Process. The center is continuously developing Research-Skills teaching in both, theoretical and practical terms.

Objectives
We conducted a survey among medical students of TSMU to assess students' knowledge about research and attitudes towards the scientific research prior and after completing “Basics of Scientific Research skills”course; to evaluate the importance of the course and reveal students' possible motivation changes towards becoming future researchers.

Results
To accomplish this aim, we conducted survey in two phases, before and after completion of the module. 177 students of faculty of Medicine completed the self-administered pre- and post-test anonymously. The possible answers to the questions were graded by 1-5 points (5- maximum). According to the results, 58% of students graded the question about “importance of research” by maximum points in post-tests, as opposed to pre-test (42%). Before undertaking the course, 82% of surveyed students considered research as an integral part of medical science. while, this indicator increased till 92% after the course completion. The survey results also showed that the majority of students (60% pre-test; 74% post-test) are willing to participate in scientific research in future.

Conclusions
scientific research skills course has a positive impact on the development and advancing scientific research skills among medical students. The course helps students to understand the importance of scientific research in health care. The course needs further development and more emphasis on practical research skills such as fieldwork, students' involvement in ongoing research projects etc.

Key messages
Our study showed that Tbilisi State Medical University students consider scientific research as an extremely important course in their curricula. Based on our survey findings, SRSC will further improve the course and will strengthen scientific research approaches.