bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of long-acting buprenorphine – A systematic review
Authors: McMaster John , Abeysundera Hesitha 
Published: October 2024

Objective To analyse the evidence of the effectiveness of long-acting injection buprenorphine (LAI-B) in the management of opioid use disorder (OUD). Method Databases were searched for studies reporting on the effectiveness of LAI-B for the treatment of OUD. Risk of bias was assessed, and a narrative synthesis of data was presented. The study adhered to PRISMA guidelines and was registered with PROSPERO (CRD42023396033). Results Eighteen studies were included in the final review: two double-blind randomised control trials, two open-label randomised control trials, two retrospective cohort studies, one non-controlled pilot study, and eleven observational studies. In comparative trials, LAI-B was superior to placebo and superior or non-inferior to treatment as usual. LAI-B was positively associated with improvements in abstinence rates and patient-centred outcomes. There was limited data on the long-term effects of continuous LAI-B prescription. Conclusion LAI-B is an effective treatment for OUD with advantages over existing forms of treatment. Patients reported high levels of medication satisfaction and there were no significant safety concerns. This review highlights the need for future research on long-term effectiveness outcomes, with participants of more varied demographics and psychiatric comorbidity, which is more reflective of the OUD population seen in community clinical settings.
Trends in glaucoma surgery in a tertiary hospital in Spain: 2010–2022
Authors: Morales-Fernandez Laura , Garcia-Bardera Javier , Pérez-García Pilar , Saenz-Frances Federico , Garcia-Saenz Sofia , Martinez-de-la-Casa Jose M , Garcia-Feijoo Julian 
Published: October 2024

Objective This study aims to conduct an analysis glaucoma surgeries performed over a 13-year period at a tertiary hospital affiliated with the Spanish National Health System, with the goal of assessing temporal trends. Methods This retrospective observational study scrutinized surgeries undertaken in the glaucoma unit of a tertiary center in Spain between 2010 and 2022. Data collected included surgical dates, procedure performed, whether it was standalone or combined, as well as patient demographics including age, sex, and type of underlying glaucoma. Surgeries on individuals under 18 years of age were excluded. An annual comparative analysis was performed to ascertain the evolving trends in glaucoma surgical interventions. Results A total of 12,944 surgeries were included in the analysis, comprising 9428 isolated cataract surgeries and 2975 glaucoma procedures. Trabeculectomy, glaucoma drainage devices (GDD), and cyclodestruction, collectively referred to as traditional surgery, demonstrated a decline from 93.2% to 23.6% over the study duration. Minimally invasive glaucoma surgery (MIGS) and minimally invasive bleb surgery (MIBS) demonstrated a significant increase from 3.8% in 2010 to 74.7% in 2022, relative to the total glaucoma surgeries. Furthermore, combined surgeries manifested a noteworthy increase from 39.0% in 2010 to 44.2% in 2022, with 86.4% of combined procedures in 2022 being MIGS or MIBS. Conclusion In recent years, there has been a noticeable change in the trend of glaucoma surgeries, with MIGS and MIBS procedures experiencing a significant increase and becoming the most commonly performed glaucoma procedures. Consequently, traditional glaucoma surgeries have decreased in frequency.
The to be, or not to be, of acting autistic
Authors: Dean Michelle , Nordahl-Hansen Anders 
Published: October 2024

There are an increasing number of autistic characters seen in film and television, and an increasing number of autistic individuals entering the workforce. At the intersection of media and employment, only a small proportion of autistic characters are played by autistic actors. This study examines the experiences of professional autistic actors who have played autistic characters in film and television. Secondary aims examine autistic actors’ impressions of autistic representations. Using thematic analysis grounded in transformative and postpositivist frameworks, nine autistic actors participated in interviews and discussed their experiences as professional actors, and their reactions to autism portrayals. Qualitative analysis of interview transcripts revealed three salient themes: (1) advantages and disadvantages of disclosing autism, (2) professional networks, and (3) windows and mirrors. Actors described trying to balance a desire to distance themselves from their diagnosis with a desire to build their resume and take advantage of opportunities specifically available for autistic actors. Actors benefited from professional support networks who were knowledgeable about autism and who advocated their inclusion and employment. They appreciated seeing autistic characters on the screen, but also expressed concerns with inauthentic casting and overrepresentations of stereotypical and misleading portrayals. Actors’ recommendations for future autistic characterizations are described. Lay abstract Autistic characters are becoming more common in film and television, and a growing number of production companies are making efforts to hire autistic actors to play autistic characters. The purpose of this study is to learn about the experiences of professional autistic actors who have played autistic characters in professional media productions. We also explored autistic actors’ impressions of the autistic characters they have seen on screen. We interviewed nine professional autistic actors, who discussed their experiences as professional actors playing autistic characters. Interviews revealed the following themes, including (1) the advantages and disadvantages of disclosing autism, (2) professional networks, and (3) windows and mirrors. Throughout the interviews, the actors discussed instances when they needed to identify as being autistic to take advantage of autism-focused employment opportunities, and other instances when they felt more comfortable not identifying as autistic. Actors’ professional support networks were knowledgeable about autism and advocated for the inclusion and employment of autistic actors. They appreciated the growing number of autistic characters on screen but hoped more production companies invest in authentic casting initiatives. Actors compel production companies to move away from overplayed stereotypical and misleading portrayals. The actors’ recommendations for future autistic characterizations are described.
Effect of resilience training in improving the ability to cope with stress and hope of mothers with cancer children
Authors: Khalili Arash , Khatiban Mahnaz , Ebrahimi Sajjad , Oshvandi Khodayar 
Published: October 2024

Background: The present study investigates the effect of resilience training in improving the ability to cope with stress and hope of mothers with cancer children. Methods: In this interventional study, 70 mothers parenting children with cancer were selected as available and randomly classified into the control and experimental groups. The mothers of the two groups completed the parenting stress and hope questionnaire. In the test group, nine sessions of resilience training were held by the researcher for 60 min. One month after the intervention, they were again asked to complete the parenting stress and hope questionnaires. Moreover, in the control group, the mothers completed the parenting stress and hope questionnaires again 2 months later without any intervention. Result: The difference between the average scores of hope and parental stress showed that the mean score of hope in the intervention and control groups increased by about 5.45 and 2.74 units, and the hope variable was improved in both groups. The mean score of parental stress in the intervention group decreased by 39.62 units. However, in the control group, it increased by 2.45 units, and parental stress in this group declined. Conclusion: Resilience training significantly reduced the level of parental stress and increased the level of hope in the mothers of the test group. Therefore, it is recommended to use resilience in reducing the level of parental stress and increasing the hope level of mothers with children with cancer.
Holmium versus thulium fibre laser for ureteroscopy and lithotripsy: When, why and how?
Authors: Fernandez Moncaleano Golena , Higgins Andrew M , Ghani Khurshid R 
Published: October 2024

Background: The holmium: yttrium-aluminum-garnet (Ho:YAG) laser, which has been the gold standard for lithotripsy, has evolved to high frequency systems with pulse modulation. However, there is now an alternative laser for lithotripsy - the thulium fiber laser (TFL). Purpose: While bench testing has shown superior fragmentation performance of the TFL compared to Ho:YAG, initial clinical results for ureteroscopy have not been as dramatic. We therefore analyze laboratory and clinical studies comparing these two laser platforms. Our goal is to offer insights into when and why to choose one laser over the other for ureteroscopy, along with strategies for optimal use. Methods: In this narrative review we describe the characteristics of each laser and provide an overview of the in vitro studies comparing Ho:YAG and TFL for fragmentation, retropulsion and heat generation. We also review evidence from prospective comparative effectiveness clinical trials for ureteroscopy and lithotripsy. We provide our schema for when we use each laser for ureteroscopy, the rationale and our approach with laser settings. Conclusions: Ho:YAG and TFL have distinct wavelengths, pulse duration, peak power, and water absorption parameters that make them suitable for different scenarios. The decision between which laser to choose rests upon individual preferences and confidence levels of use, with the ultimate priority for safe patient use.
Patient Perspectives of Telemedicine in Outpatient Nephrology Clinics During COVID-19: A Qualitative Study
Authors: Osman Abdelhady , Lee Seung Heyck , Noori Mateen , Al-Jaishi Melissa , Gallo Kerri , Harwood Lori , Moist Louise 
Published: October 2024

Background: The COVID-19 pandemic notably disrupted care for patients with chronic kidney disease (CKD) care, necessitating a rapid shift to telemedicine. Despite the growing use of telemedicine, the impact of this transition on patients’ experiences, particularly in Canada and considering sociocultural factors, remains underexplored. This study aims to investigate patients with CKD perspectives on telemedicine versus in-person care and to offer recommendations for enhancing telemedicine services. Objective: The objective was to understand patients with CKD views on telemedicine clinics during the pandemic compared to traditional in-person clinics. Design: This was a qualitative descriptive study employing semi-structured interviews. Setting: This study was conducted in general nephrology and multidisciplinary kidney care clinics in London, Canada. Population: The study population was English-speaking patients with CKD with at least one in-person nephrology visit before March 15, 2020, and one telemedicine appointment after March 30, 2020. Methods: Interviews were conducted using a structured guide, with transcripts analyzed line-by-line by 3 independent reviewers through directed content analysis. Themes were identified and agreed upon through group consensus. Results: Interviews with 12 participants revealed 5 key themes: (1) convenience; (2) building connection and trust; (3) necessity of in-person care; (4) role of family or caregivers; and (5) preferences for clinic types. Most participants (11/12) valued the convenience of telemedicine, noting similar levels of care compared to in-person visits. However, they found it easier to establish personal connections in face-to-face appointments. Most (8/12) preferred in-person visits if their condition worsened. Overall, a combination of in-person and telemedicine was favored, with a preference for video over telephone. Limitations: The study’s focus on one academic nephrology center in Ontario and predominantly white participants limits broader applicability. Additionally, recall bias may affect the findings due to the interview-based design. Conclusions: Telemedicine will remain integral to CKD care, with a hybrid model combining in-person and telemedicine preferred. Integrating patient feedback into future telemedicine practices is essential to enhance flexibility, access, and patient satisfaction.
Enhancing exercise intervention for patients with post-acute COVID-19 syndrome using mobile health technology: The COVIDReApp randomised controlled trial protocol
Authors: Salvador-Ruiz Andres J , Moral-Munoz Jose A , Salazar Alejandro , Lucena-Anton David , De Sola Helena , Failde Inmaculada , Dueñas María 
Published: October 2024

Objectives To analyse the effectiveness of a physical exercise programme guided by a mobile health technology system (COVIDReApp) for patients with post-acute COVID-19 syndrome. This syndrome is a multisystem disease that occurs in people with a history of COVID-19 between 1 and 3 months after the onset of the disease. This study will assess the impact of the intervention on fatigue, post-exertional dyspnoea, quality of life, pain severity, physical fitness, anxiety, depression and cognitive function. We also aim to analyse whether there are associations between the variables studied and the evolution of these associations during follow-up. Design A single-blind randomised controlled trial. Methods One hundred patients diagnosed with post-acute COVID-19 will be enrolled and randomly assigned to two groups. The experimental group will perform the intervention through a physical exercise programme guided by the COVIDReApp system, whereas the control group will perform the programme in paper format. Study outcomes will be collected at baseline and at 4, 12 and 24 weeks. Student's t-tests or Mann–Whitney U-tests will be used to analyse differences between groups, mixed ANOVA for differences over time and longitudinal structural equations for associations between variables at follow-up. Discussion This study is based on current evidence regarding exercise prescription recommendations for patients with post-acute COVID-19 syndrome. Our intervention is supported by a solid theoretical framework; however, challenges include tailoring the physical exercise programme to everyone's predominant symptoms and ensuring adherence to the programme. Trial registration number NCT05725538.
The use of smart technologies for enhancing palliative care: A systematic review
Authors: Maguraushe Kudakwashe , Ndlovu Belinda Mutunhu 
Published: October 2024

Introduction With the rapid advancement of technology, smart technologies have permeated various sectors, including palliative care in healthcare. Based on the available literature, similar studies have elucidated the application of individual and isolated smart technologies in palliative care, with their benefits, and limitations. This research, therefore, focuses on the conceptualisation of various smart technologies and makes holistic recommendations on the effective and efficient use of smart technologies in healthcare to enhance palliative care. Purpose The purpose of this study is to systematically review the existing literature to conceptualise the role of various key smart technologies in palliative care, and their benefits and make recommendations on how smart technologies can enhance healthcare in palliative care. Methodology The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were adopted in this study. Using the keywords: ‘smart technologies’, ‘healthcare’ and ‘palliative care’ (using Booleans AND/OR in different ways, including their synonyms), an exhaustive search was done on four major databases: MEDLINE, PubMed, Scopus and CINAHL. Resultantly, 19 articles met the inclusion criteria and were analysed. Findings The main results reveal that smart technologies enhance the quality of life and efficiency of palliative care, notably telemedicine, wearable devices, and mobile health apps. They reduce hospital visits and carer stress by improving patient-doctor communication, enabling remote monitoring, and forecasting health outcomes. However, there are challenges such as the digital divide, privacy issues, and the need for comprehensive integration and training into the current frameworks. Conclusion and implications The study emphasises the significant impact of smart technologies in improving palliative care. It emphasises the importance of considering technological, ethical, and practical factors to ensure that these advancements truly enhance palliative care. This research has important implications for healthcare professionals and policymakers, indicating a need for a patient-centred palliative care model that integrates technology more effectively.
Effectiveness of tele-rehabilitation in patients with knee osteoarthritis: A randomized controlled trial
Authors: Tedeschi Roberto , Platano Daniela , Pillastrini Paolo , Berti Lisa , Benedetti Maria Grazia 
Published: October 2024

Objective The primary objective of this randomized controlled trial was to evaluate the effectiveness of tele-rehabilitation (TR) compared to conventional rehabilitation (CT) in reducing pain (as measured by the Numeric Pain Rating Scale [NPRS]) in patients with knee osteoarthritis (OA). Secondary objectives included assessing changes in physical function and quality of life, as measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Short Form-36 (SF-36) health survey, respectively. Methods Fifty-five patients diagnosed with knee OA were randomly allocated to either the TR group ( n = 29), receiving remote physiotherapy sessions three times a week for four weeks, or the CT group ( n = 26), undergoing traditional outpatient rehabilitation with the same exercise regimen. Outcomes were measured at baseline and after a three-month follow-up period. Results At baseline, there were no significant differences between groups in terms of NPRS and WOMAC scores. After three months, both the CT and the TR groups showed significant improvements in pain reduction (NPRS, p < 0.001), WOMAC score ( p < 0.001), and in some subscales of the SF-36 (i.e., physical functioning, role limitation attributable to physical problems, energy, and pain). Conclusion Tele-rehabilitation is an effective alternative to CT for reducing pain and improving quality of life in patients with knee OA. These findings suggest that TR can be incorporated alongside conventional approaches to provide a comprehensive treatment strategy for managing knee OA, enhancing patient outcomes in various dimensions of well-being. Trial registration NCT05719350; Telerehabilitation in Patients With Osteoarthritis (TABLET).
Needs and Opportunities for Anal Cancer Prevention in Patients Engaged With PrEP Care: Development of Conceptual Model
Authors: Wheldon Christopher W. , Flores Cristian L. , Wilson-Shabazz Imani , Luck Caseem C. , Singley Katie , Bass Sarah B. 
Published: October 2024

Introduction: Populations at risk for HIV infection—including gay, bisexual, and other men who have sex with men (GBM) and transgender/gender diverse people (TGD)—are at disproportionate risk for anal cancer. Most anal cancers are caused by human papillomavirus (HPV) and are preventable with HPV vaccination and screening. Engaging at-risk populations who are already receiving HIV preventive care (eg, pre-exposure prophylaxis [PrEP]) may be an effective implementation strategy. The purpose of this study was to (1) identify the information, motivation, and behavioral skills that influence decisions about anal cancer prevention and to (2) describe the healthcare utilization patterns among PrEP users that impact their engagement in anal cancer prevention. Methods: Using purposive sampling in the United States, we ensured diverse representation among PrEP users aged 18 to 45 across gender and ethnoracial identities. Recruitment sources included primary healthcare clinics, social media, and community venues. Semi-structured interviews were recorded, transcribed, and coded using structural, pattern, and theoretical approaches. Results: Participants (N = 36) were mostly cisgender gay ethnoracial minority men. We identified 29 unique codes that were nested within 3 categories: individual decision-making, healthcare utilization patterns, and healthcare system influences. Participants commonly lacked essential information about HPV and anal cancer, often holding misconceptions about risks and prevention. Motivation for anal cancer prevention was driven by healthcare interactions and perceived risks, while fragmented healthcare and reliance on telemedicine were potential barriers. Many participants used telehealth services to access PrEP, described it as convenience, cost-effective, and liked the lack of provider interaction. Some participants used telehealth for PrEP and did not have a primary care provider. The importance of access to LGBTQ+-affirmative healthcare services was highlighted. Conclusions: Integrating patient education and prevention services into ongoing PrEP management can enhance the reach and equity of anal cancer prevention. Our model underscores critical areas of misinformation, necessary systems-level changes, and unmet needs.
Prophylactic Negative Pressure Wound Therapy in Reducing Surgical Site Infections: An Evidence-Based Literature Review
Authors: Formosa Marika , Ebejer Stephen J. 
Published: October 2024

Background Surgical site infections (SSIs) are a frequent postoperative complication that nurses commonly need to provide asepsis-specific meticulous care for. The application of a closed-incisional negative pressure wound therapy (iNPWT) device is regarded as a novel technique that aims to lower the risk of external wound contamination. Aim The purpose of this review was to evaluate the effectiveness of iNPWT on high-risk closed laparotomy incisions with the aim to inform nursing practitioners and physicians engaged in multieffort wound care practices. Nursing professionals play a crucial role in mitigating the incidence of SSIs, from the time of application, through ongoing assessment tissue condition, and ensuring asepsis, thereby enhancing patient care and safety. The Research Question Is prophylactic negative pressure wound therapy effective in reducing the incidence of (closed) surgical site wound infections postlaparotomy? PICO Elements The population studied included patients undergoing laparotomy surgery. The intervention under review included the application of iNPWT, compared to the use of standard gauze dressing. The expected outcome was SSI reduction. Methods and Results A systematized literature search was conducted using various databases to identify published studies that address the PICO question. The PRISMA checklist and Critical Appraisal Skills Programme tools allowed to exclude irrelevant articles and to critically appraise the evidence, respectively. Eleven key articles were retrieved including four RCTs and seven systematic reviews and meta-analysis. The results indicated an overall positive association between iNPWT and a reduction in SSI in laparotomy surgeries when compared to standard dressings. Linking Evidence to Action Data across most studies reviewed support the benefits with the use of iNPWT as a preventive strategy to lower the rates of SSI, with some claiming no difference. Although heterogeneity in the studies precludes a definite conclusion, nurses may make a more informed decision when navigating the demands of SSI prevention targeted nursing care.