bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient and carer experiences of hospital‐based hybrid virtual medical care: a qualitative study
Authors: Thompson Anna E , Shaw Tim , Nott Shannon , Wilson Andrew , Saurman Emily 
Published: December 2024

AbstractObjectivesTo understand patients’ and carers’ experiences of virtual medical care delivered into rural and remote hospitals.Study designQualitative study using semi‐structured interviews.Setting, participantsInterviews were conducted between 7 June 2022 and 21 February 2023. Participants were people who had received a virtual medical service from the Virtual Rural Generalist Service (VRGS), and their carers, in rural and remote hospitals within the Western NSW Local Health District.Main outcome measuresAcceptability of, access to, quality of and appropriateness of care provided by the VRGS.ResultsWe interviewed 43 patients and carers about their experiences of VRGS services received in an emergency department or inpatient setting. About half of our participants thought that virtual medical care (supported by in‐person nursing staff) was highly acceptable and equivalent to in‐person care. For the remaining participants, virtual care was seen as being an acceptable alternative if in‐person care was not available. Patients reported that the model met their immediate needs, even if the virtual delivery mode was not their preference. VRGS doctors were generally seen as skilled and personable, and acceptability of virtual care increased with more experience of it. A key perceived benefit of virtual care was increased access to medical care without the need to travel long distances. Hospital‐based virtual care was not considered less appropriate for older adults or children.ConclusionsVirtual care in a rural hospital setting, such as that delivered by the VRGS, is broadly acceptable to patients and carers. While most would prefer to have a doctor physically present, patients and carers are accepting of the need for virtual care to supplement in‐person care in rural and remote areas. Patients and carers who experience hospital‐based virtual care perceive that it can provide good quality medical care and meet many of their needs.
Defining a core set of research and development priorities for virtual care in the post‐pandemic environment: a call to action
Authors: Shah Kavisha , Newton Nicki , Charlston Emma , Shaw Miranda , Singh Jagdev , Johnston Adam , Hutchings Owen , Yu Chenyao , Wang Pearl , Jones Aaron , Ritchie Angus , Davis Rebecca , Robinson Fiona , Alison Jennifer A , Baysari Melissa T , Makeham Meredith , Norris Sarah , Laranjo Liliana , Nicholls Emma , Chow Clara K , Shaw Tim 
Published: December 2024

AbstractObjectivesTo identify research and development priorities for virtual care following the coronavirus disease 2019 pandemic from the perspective of key stakeholders (patients, clinicians, informaticians and academics).DesignQualitative study using a modified nominal group technique.SettingOnline semi‐structured interviews and workshops held in November 2022 and February 2023.ParticipantsHealth workers involved in delivering virtual care in two metropolitan local health districts and one specialty statewide network, and people who had received care from these sites, were recruited using passive snowball sampling. Research and academic staff from a tertiary institution were also invited to participate.Main outcome measuresPriorities to support a translational research agenda for virtual care.ResultsTwenty‐five individuals participated including 18 innovation deliverers, two innovation recipients and five implementation facilitators. Stakeholders identified several key priorities for developing virtual care models and for sustaining and scaling virtual care services. These included demonstrating the economic and societal value of virtual care, developing a common framework to support evaluation and comparison of virtual care services, ensuring virtual care services integrate acute and primary care, and defining which models of care are most appropriate for virtual care delivery.ConclusionAs the health system recalibrates with the return of in‐person care, there is a growing need to demonstrate the value of virtual care models to patients, the health system, and society at large. Demonstrating this value while also demonstrating improvements to health outcomes will future‐proof virtual care, enabling it to be used to address broader challenges of health care delivery. In addition, sustaining virtual care will depend on robust operational structures and workforce training and education. As services evolve, research and development priorities must be revisited to ensure that translational research aligns with stakeholder interests.
Этнологический мониторинг – инструмент государственной политики при промышленном освоении территорий традиционного природопользования коренных малочисленных народов Севера
Authors: И.В. Самсонова , М.В. Гренадерова 
Published: December 2024

концепция устойчивого развития повлекла за собой развитие целого ряда важнейших государственных инструментов, среди которых и инструменты этносоциальной политики. Промышленное освоение территорий в местах традиционного проживания и традиционной хозяйственной деятельности коренных малочисленных народов влияет на состояние этноса и окружающую среду. В этих условиях важное значение приобретают действенные инструменты государственной политики, одним из которых является этнологический мониторинг. С учетом концепции устойчивого развития, промышленное освоение территорий должно быть направлено на создание баланса между экономическими интересами компаний и сохранением природных и культурных ценностей. Только такой подход позволит обеспечить устойчивое развитие как для бизнеса, так и для общества в целом. В статье сделана попытка определить роль этнологического мониторинга как инструмента государственной политики в отношении промышленных компаний и коренных малочисленных народов. Для успешной реализации этнологического мониторинга авторами определены направления совершенствования процесса этнологического мониторинга.
the concept of sustainable development has led to the development of a number of important state instruments, including instruments of ethnosocial policy. The industrial development of territories in places of traditional residence and traditional economic activity of indigenous small-numbered peoples affects the state of the ethnic group and the environment. In these conditions, effective public policy instruments are becoming important, one of which is ethnological monitoring. Taking into account the concept of sustainable development, industrial development of territories should be aimed at creating a balance between the economic interests of companies and the preservation of natural and cultural values. Only such an approach will ensure sustainable development for both business and society as a whole. The article attempts to define the role of ethnological monitoring as a tool of state policy in relation to industrial companies and indigenous peoples. For the successful implementation of ethnological monitoring, the authors have identified areas for improving the process of ethnological monitoring.
Conocimiento y aplicación del personal adscrito y residentes de Anestesiología del modelo Vortex para manejo de la vía aérea medido por la encuesta de preparación de NVNIConocimiento y aplicación del personal adscrito y residentes de Anestesiología del modelo Vortex para manejo de la vía aérea medido por la encuesta de preparación de NVNI
Authors:   Critical Care & Emergency Medicine, Morales Luna Diana Teresa , Ramírez Aldama Josué Manuel , Zoquiapa Edwin 
Published: December 2024

Objective: To identify in the Assigned staff and Residents of the Anesthesiology Service of the CMN La Raza Specialty Hospital the knowledge and application of the Vortex tool for airway management through the NVNI preparation survey.

Material and methods: An observational, descriptive, prospective, single-center and cross-sectional study was carried out, applying surveys via anonymous internet to Resident Doctors of the 3 years of the course and Doctors assigned to the Anesthesiology service. Variables were recorded from population characteristics, knowledge and application of the Vortex tool. The training stage was carried out on the Vortex
tool, to repeat the application of the post-training NVNI preparation survey. The information was organized in a database and descriptive statistical analysis was performed by comparing variables.

Results: 102 pre-training and 61 post-training surveys were administered. For the post-training survey, there is an increase in the identification of the term NVNI by 22.5%, CICO is recognized by 57.4% of personnel, an increase of 5.9% in the use of the term Emergency frontal neck access,
identification of equipment location NVNI rescue rate increased 15.9%.

Conclusions: Training personnel in NVNI events is important, since 50.80% of participants know of a case. Knowledge of the Vortex model was increased to 31.10%. There is an area of opportunity for teaching and professional preparation regarding the application of the model.
Epinephrine Versus Dopamine in Children, What Is the Current Evidence and What Do We Need? A Systematic Review and Meta-analysis
Authors: Loomba Rohit S. , Patel Riddhi D. , Villarreal Enrique G. , Farias Juan S. , Flores Saul 
Published: December 2024

INTRODUCTION
Pediatric patients often receive vasoactive agents following cardiothoracic surgery or when in shock. The use of vasoactive agents varies between different settings and has largely changed because of anecdotal observations or small observational studies. Although vasoactive agents are frequently used, there are limited studies in pediatric populations comparing them to one another. The purpose of this systematic review is to quantify the comparative effects of epinephrine and dopamine while identifying gaps in knowledge.

METHODS
A systematic review of published manuscripts was completed to identify full-text manuscripts in English using PubMed, Embase, and Cochrane databases. Studies were included if they included clinical data using dopamine and epinephrine in different patients and included data for the same end points for patients receiving epinephrine or dopamine.

RESULTS
A total of 5 studies with 397 patients were included. Of the included patients, 187 received epinephrine and 210 received dopamine. The mean age for all the patients was 45 months. When all patient data were pooled, a significantly lower mortality was associated with epinephrine compared with dopamine (risk ratio, 0.74; 95% CI, 0.55–0.99). When only neonatal data were pooled, epinephrine was associated with a significantly higher average heart rate (10 bpm; 95% CI, 2.0–18.7) and a significantly lower average mean arterial blood pressure (−2.5 mm Hg; 95% CI, −4.6 to −0.4).

CONCLUSION
Limited data are available comparing dopamine to epinephrine in pediatric patients. The ­available data demonstrate an apparent mortality benefit associated with the use of epinephrine.
Retrospective Comparison of Early Versus Late Initiation of Long-Acting Insulin in Critically Ill Pediatric Patients in Diabetic Ketoacidosis
Authors: Cormack Emily S. , Howard Amber , Eddy Derrick , Schulte Nick 
Published: December 2024

OBJECTIVE
Determine whether early administration (EA) of long-acting insulin in pediatric diabetic ­ketoacidosis (DKA) reduces time to acidosis resolution while maintaining safety when compared with late administration (LA).

METHODS
This retrospective review compared EA (within 4 hours) to LA (4 to 24 hours) of long-acting insulin in DKA management in the pediatric intensive care unit between 2015 and 2022. Admissions were excluded for patients ≥18 years of age, without type 1 diabetes, with insufficient laboratory data, or who did not receive insulin glargine within 24 hours of starting treatment. Primary outcome was resolution of acidosis, measured as time to normalization of serum sodium bicarbonate concentration (&gt;15 mEq/L). Secondary outcomes included hospital and intensive care lengths of stay, and insulin infusion duration. Safety outcomes were hypokalemia, hypoglycemia, and cerebral edema.

RESULTS
Of the 233 admissions evaluated, 51 met inclusion for each group. The median patient age was 11 years, 42% female, and 59% had new-onset diabetes. No difference was found in the median time to acidosis resolution (8.13 hours [EA] and 8.02 hours [LA]; p = 0.4161). Median insulin infusion durations were 16.2 and 17.6 hours for EA and LA, respectively (p = 0.8750). Median hospital stay was 2 days for both groups (p = 0.9068). Hypoglycemia and hypokalemia rates were not significantly different but occurred more often than previously reported.

CONCLUSIONS
Early administration of long-acting insulin in pediatric DKA did not affect acidosis duration or treatment length when compared with late administration. Incidence of hypoglycemia and hypokalemia were similar between groups.
Pediatric Prescribers’ Knowledge of the Ew Meds™ List and Taste Masking
Authors: Peña Dafne Espinal , Morgan Jill A. , Howard Amy Kruger 
Published: December 2024

OBJECTIVE
The primary objective of this study was to determine pediatric prescribers’ knowledge and confidence in identifying bad tasting liquid medications. The secondary objective examined the techniques used to mask the taste of liquid medications and whether any of the masking techniques recommended by prescribers were reported to be effective in children.

METHODS
Nationally, health care prescribers were invited to participate in an online survey about medication tastes and masking practices. Participants included physicians, physician assistants, and nurse practitioners who prescribe oral liquid medications. They were asked to complete a 17-question survey consisting of 4 demographic questions, 6 about their practice; 1 on confidence identifying bad tasting medications; 1 on knowledge of Ew MedsTM; 4 on taste masking; and 1 on potential taste tools.

RESULTS
Seventy-five prescribers completed the survey. Prescribers correctly identified Ew MedsTM 27.9% of the time (median score 3.35/12) and 34.7% (26/75) of prescribers felt confident with their knowledge of bad tasting medications. Thirty percent (21/71) of prescribers reported educating patients about masking bad tasting medications “most of the time” or “always” and 12.7% (9/71) never educate patients. Almost all prescribers who responded about masking indicated they recommend mixing the medication in food or drink (55/58, 95%). In general, taste masking techniques reported by pediatric prescribers had mixed effectiveness.

CONCLUSION
Based on prescribers’ limited confidence and knowledge regarding medication taste, education about bad tasting liquid medications and appropriate taste masking should be readily available, including the dangers of altering medication efficacy when mixing in food and drink.
Evaluation of Stress Ulcer Prophylaxis in Pediatric General Medicine Patients After Transfer From the Intensive Care Unit and at Discharge
Authors: Loubani Lamees , Bartlett Jenna W. , Mothner Brent , Asaithambi Rathi , Lee Surin 
Published: December 2024

OBJECTIVES
The primary aim of this study was to determine continuation rates of stress ulcer prophylaxis (SUP) upon transfer from a pediatric intensive care unit (PICU) to a general medicine unit and upon hospital discharge. The secondary aim was to identify patient characteristics or concomitant medications that were associated with continuation of SUP at transfer from the PICU.

METHODS
This retrospective chart review included patients who were initiated on acid suppression for SUP in the PICU between June 2021 and May 2022 and subsequently transferred to a general medicine unit prior to discharge. Patients were excluded if they were receiving acid suppressant therapy prior to admission or were started on acid suppressants for an indication other than SUP.

RESULTS
Two hundred three patients (median age, 3.3 years) were included. The rates of SUP continuation at the time of transfer from the PICU to a general medicine unit and at hospital discharge were 61.6% and 9.9%, respectively. Patients continued on SUP at the time of transfer from the PICU were more likely to be prescribed concomitant corticosteroids (p &lt; 0.01), anticoagulants or antiplatelet medications (p &lt; 0.01).

CONCLUSIONS
The continuation of SUP from the PICU to the general medicine unit is common at our institution and calls into question the appropriateness of this practice. Future research is warranted to investigate the appropriateness of the continuation of SUP at transitions of care. Additionally, implementation of institutional protocols standardizing review of SUP may help reduce unnecessary prescribing of acid suppressants in general medicine units and at discharge.
Optimal Dosing Recommendations of Clonidine in Pediatrics Using Physiologically Based Pharmacokinetic Modeling
Authors: Yellepeddi Venkata , Bayless Sharlo , Parrot Madison , Sherwin Catherine M. 
Published: December 2024

OBJECTIVE
Clonidine has been widely used in the pediatric population to treat neonatal abstinence syndrome (NAS), attention deficit hyperactivity disorder (ADHD), sedation, and Tourette’s syndrome; however, there is no consensus on dosing. This research aims to recommend optimal dosing of clonidine in the pediatric population using physiologically based pharmacokinetic (PBPK) modeling.

METHODS
The pediatric PBPK model was developed from an adult model by scaling the clearance processes from adults to pediatrics using ontogeny equations. The adult and pediatric models were verified using clinical PK data, and the model performance was evaluated based on visual predictive checks and absolute fold error (AFE). The final pediatric PBPK model was used to simulate clonidine PK in the virtual pediatric population. The optimal dose was recommended based on a target concentration representing clonidine’s α-2 central agonist activity (EC50 = 40.5 nM).

RESULTS
The adult and pediatric models predicted well, with more than 90% of observed data captured within the 95% prediction interval of simulated data. The AFE values were within 2-fold for clonidine plasma concentrations from observed and predicted data. The pediatric simulations showed that 30 µg/kg dose orally for neonates and 0.9 mg/day orally for children (6–17 years) are optimal for achieving target concentrations for maximal α-2 adrenergic activity.

CONCLUSIONS
The pediatric PBPK model of clonidine scaled from the adult PBPK model provided optimal dosing recommendations for clonidine in different pediatric age groups. The pediatric PBPK model described in this study can be extended to other pediatric age groups and routes of administration.
Confiscation as an Essential criminal mechanism for countering Transnational Organized Crime
Authors: Dzneladze Levan 
Published: December 2024

The paper addresses one of the challenging issues of modernity. Although many international and domestic tools[1] have been developed in recent decades, including the fight against transnational organized crime, it is becoming increasingly extensive and global. "According to the International Monetary Fund, revenue from drug trafficking and money laundering accounts for six to eight percent of the global economy.[2] Thus, the fight against this phenomenon necessitates a continually updated approach.
The increased use of digital technologies in the public and private sectors made criminals inclined to commit crimes causing immeasurably great economic harm to society. The leading driving factor for Transnational Organized Crime is to make the maximum profit in a short time. The effective fight against this complex criminal event is about recovering and confiscating assets acquired through committing crimes.[3]
The paper is based on an analysis of doctrine and judicial practice. It also discusses distinct aspects and modern challenges related to the return of criminal assets in the fight against transnational organized crime.
The study aims to identify gaps and measures taken to ensure their solution.
[1] Tumanishvili G., (Samets. Ed.), Jishkariani B., (Samets. ed.), Shrami E., (Ed.), Influence of European and International Law on Georgian Criminal Procedure, Tb. 2019, 800-801.
[2] Shelley, L., Transnational organized crime and seized assets: moral dilemmas concerning the disposition of the fruits of crime, 7 Maastricht J. EUR. & Comp. L.35 (2000), [24.01.2023].
[3] "Crime does not pay", - White paper on best practices in Asset Recovery, 1, https://www.interior.gob.es/opencms/pdf/archivos-y-documentacion/documentacion-y-publicaciones/publicaciones-descargables/seguridad-ciudadana/White-paper-on-best-practices-in-asset-recovery-NIPO-126-12-071-X.pdf [05.08.2024].
Proyectos de Marketing Digital para MIPYMES desde la perspectiva de la Economía Social y Solidaria
Authors: Loza Solache Irma Violeta , Lara Escamilla Samuel 
Published: December 2024

El objetivo del presente articulo es evidenciar el diseño de proyectos de innovación aplicados para el desarrollo de la economía social y solidaria, como parte del proceso de formación educativa en los posgrados para conectar con las necesidades sociales de las comunidades, particularmente si se abordan desde la perspectiva de la economia social y solidaria y y de las ciencias económico administrativas. Por ello es necesario desarrollar proyectos que coadyuven al desarrollo de las denominadas sociedades cooperativas, que requieren entreo otras cosas, de estrategias de marketing digital que les brinden alcance y visibilidad tal como las campañas en redes sociales para llegar a segmentos especificos interesados en productos y servicios éticos y sostenibles. En la presente investigación se exploran y describen los proyectos sociales recopliados, que se generaron a partir de la intervencion-accion docente en un ambiente virtual y que como resultado, fueron parte de la inmersion en MiPYMES de las comunidades de los estudiantes a manera de pilotaje en otra fase de la investigación. La exploración de dichos productos académicos, se llevó acabo a tráves de métodos cualitativos para describir las cualidades y características de dichos proyectos y la interaccion con las comunidades.
Assessment of innovativeness and openness to change among nurses, midwives
and paramedics
Authors: Lemska Magdalena Ewa , Kretowicz Katarzyna , Szymańska Ilona 
Published: December 2024

IntroductionInnovativeness, which is associated with the continuous improvement of the current healthcare system, the implementation of new ideas, the introduction of new products and equipment in the medical environment, and the change that causes the modification of existing habits and procedures, affect the development of the healthcare system and improve the quality of patient care.AimThe aim of the study was to assess the innovativeness and the openness to change of nurses, midwives and paramedics.Material and methodsThe research was conducted from November 2023 to April 2024. The total number of people participating in the survey 123 respondents. The following methods were the survey technique was used, and the method of estimation, using rating scales.Results and discussionThe study shows that nurses, midwives and paramedics have similar values of levels of innovativeness and openness to change. Openness to change is at a high level, while innovativeness, according to the adopted key, is described as above average. In the case of nurses, age, seniority, education and the position held have an impact on the level of openness to change.ConclusionsThe level of innovativeness in this group of respondents is significantly influenced by education and position. The level of openness to changes of midwives is influenced by age, education and position, while their innovativeness is influenced by the place of residence, education and position. Paramedics have a level of openness to change and innovativeness at an equal level regardless of the parameters taken into account, only the position they hold makes a difference in results.