bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors influencing the reporting of medication errors and near misses among nurses: A systematic mixed methods review
Authors: Braiki Raouaa , Douville Frédéric , Gagnon Marie‐Pierre 
Published: September 2024

AbstractAimThis study aimed to systematically review empirical evidence on factors influencing nurses to report medication errors and near misses.BackgroundThere is underreporting of medication errors among nurses, in particular among novice and beginner nurses. To improve quality of care, factors influencing the reporting of medication errors and near misses should be documented.MethodA systematic mixed methods review was conducted. CINAHL, Cochrane Collaboration, Embase, Medline, PsycINFO and Web of Science databases were explored and analysed from December 1990 to December 2023. Two reviewers independently selected and extracted data using a standardized data extraction grid. Data were analysed using thematic analysis based on the adapted theory of planned behaviour.ResultsForty‐two studies met the eligibility criteria. Principal factors influencing the reporting of medication errors and near misses among nurses were associated with perceived behavioural control, subjective norm and attitude. Few studies examined factors influencing reporting medication errors and near misses among novice and beginner nurses, and sociodemographic and professional factors.ConclusionTo understand factors influencing reporting of medication errors and near misses, further studies should be conducted to investigate sociodemographic and professional factors.
Effect of Indo‐Mediterranean diet versus calorie‐restricted diet in children with non‐alcoholic fatty liver disease: A pilot randomized control trial
Authors: Deshmukh Aniket , Sood Vikrant , Lal Bikrant Bihari , Khanna Rajeev , Alam Seema , Sarin Shiv Kumar 
Published: September 2024

SummaryBackgroundDietary interventions and increased physical activity are the cornerstones for management of the paediatric non‐alcoholic fatty liver disease (NAFLD). Though, no specific diet has been proven superior, Indo‐Mediterranean diet (IMD) has shown promise in adult literature. Thus, we aimed to compare the effect of IMD and a standard calorie‐restricted diet (CRD) in Indian overweight children and adolescents with biopsy‐proven NAFLD.MethodsThirty‐nine consecutive biopsy‐proven NAFLD children between the ages of 8 and 18 years were randomized into either IMD or CRD for 180 days, and various parameters were evaluated at baseline and then after 180 days (NCT05073588).ResultsA total of 34 subjects (18 in IMD and 16 in CRD group) completed the study. There was a significantly higher decrease in controlled attenuation parameter (CAP) values (as a marker of hepatic steatosis; on transient elastography) (95% CI: 4.2–73.4, p = 0.042), weight (95% CI: 0.75–5.5, p = 0.046) and body mass index (BMI) (95% CI: 0.21–2.05, p = 0.014) (but not in Pediatric NAFLD Fibrosis Index or PNFI; as a marker of hepatic fibrosis) in IMD group compared to the CRD group. Liver stiffness measurement, serum cholesterol and low‐density lipoprotein levels and HOMA‐IR decreased only in the IMD group (p < 0.001). Our statistical model showed that delta‐Weight was the only independent variable associated with delta‐CAP.ConclusionBoth IMD and CRD can improve the various anthropometric, clinical, imaging and biochemical parameters but IMD was superior to CRD in terms of reducing CAP values and weight/BMI over 180 days in overweight/obese NAFLD children.
Exploring the Pathways to Diagnosis for Men With Borderline Personality Disorder: A Qualitative Study
Authors: Broadbear J. H. , Bhagwandas M. G. , Crowley S. , Cheney L. , Rao S. 
Published: September 2024

ABSTRACTBorderline personality disorder (BPD) is often perceived as being more common in females, since women are more likely to seek help and be diagnosed. However, epidemiological studies have reported no sex differences in community prevalence. The purpose of this study was to learn from the narrative journeys of men who have received a diagnosis of BPD. Eight men participated, mean age 45.9 years (range 27–73 years). Recruitment was through clinician referrals at the study site and via social media and website advertising. Participants consented to a 60–90‐min semi‐structured interview via an audio‐visual digital platform. Audio recordings were transcribed and analysed using Interpretative Phenomenological Analysis (IPA). Three themes were identified: (i) The Emergence of Symptoms, (ii) Reaching Crisis Point and (iii) Receiving a Diagnosis. Participants reported many adverse experiences during childhood and adolescence. Early symptoms were often exacerbated by emotionally invalidating caregiving. Participants reported seeking mental health support only after reaching a crisis point, which often arose following an employment‐related stressor. Participants typically initiated help‐seeking by consulting a General Practitioner. Long delays were reported from initial help‐seeking to being diagnosed with BPD; all expressed relief upon diagnosis. The findings highlight the deleterious consequences of emotional invalidation in participants' mental health and their capacity to access timely support. General Practitioners play a critical role in identifying probable symptoms of BPD in men and are the gateway to referral to psychiatrists and psychologists. It is vital that education is provided to assist their important work.
Evaluating Saudi Arabian nurses’ willingness to respond to nuclear and radiological disasters
Authors: Shubayr Nasser 
Published: September 2024

AbstractAimWe evaluated Saudi Arabian nurses’ willingness to engage in nuclear and radiological disaster response.BackgroundIn the face of rising nuclear and radiological threats, it is essential that nurses are fully prepared to handle the health consequences of such emergencies. As frontline responders, nurses play a critical role in managing high‐stakes situations, making their readiness a key factor in ensuring public safety during these crises.MethodsA cross‐sectional survey was conducted among 612 registered nurses in Saudi Arabia. The survey used a structured questionnaire based on the theory of planned behavior, identifying behavioral intentions as the primary outcome and attitudes toward these behaviors, subjective norms, and perceived behavioral control as influencing factors. The data were analyzed using descriptive and inferential statistics.ResultsMost respondents lacked specialized training and reported strong behavioral intentions. Attitude and perceived behavioral control were key drivers of these behavioral intentions, with less impact from subjective norms. Behavioral intentions were also shaped by education, the perceived likelihood of nuclear and radiological emergencies in their region, peer influence, perceived self‐efficacy, and family concerns. Younger and married nurses showed significantly stronger behavioral intentions.DiscussionAlthough most nurses lacked specialized training, their strong engagement intentions and positive responses to active learning and training indicate a desire to close this gap through further education. However, inadequate institutional support, trouble communicating with family, and concerns about personal radiation exposure emerged as potential barriers.ConclusionTargeted educational initiatives and support systems are needed to enhance nurses’ confidence, competence, and willingness to engage in radiological and nuclear emergency scenarios.Implications for nursing and health policyPolicymakers should prioritize the development of specialized training programs and support mechanisms for nurses, ensuring they are adequately prepared to respond effectively to increasing radiological and nuclear threats.
Continuous muscle pump activation by neuromuscular electrical stimulation of the common peroneal nerve in the treatment of patients with venous leg ulcers: A position paper
Authors: Stacey Michael C. , Sibbald R. Gary , Evans Robyn 
Published: September 2024

AbstractThe standard treatment for patients with confirmed Venous Leg Ulcers (VLUs) is compression therapy to improve the function of the calf muscle pump. There is a significant cohort of patients who are unable to tolerate optimal compression therapy or indeed any level of compression therapy. In addition, there is a cohort of patients who can tolerate compression whose ulcers show little or no evidence of healing. There is a need for ways to further improve calf muscle pump function and to improve venous ulcer healing in these patients. Published data were reviewed on the use of Muscle Pump Activation (MPA) using common peroneal nerve neuromuscular electrical stimulation (NMES) to improve calf muscle pump function. There is physiological evidence that MPA can improve calf muscle pump function and venous return in both control subjects and in patients with venous disease. The use of MPA has also been shown to improve venous flow volume and venous flow velocity on ultrasound scanning in patients with venous disease. MPA has been shown to improve microcirculation in the skin using Laser Doppler and laser Doppler Speckle Contrast Imaging, in both normal subjects as well as in patients with venous disease and VLU. A recent randomized controlled trial of MPA plus compression therapy compared with compression therapy alone, found significantly faster rates of healing with the use of MPA in addition to compression therapy. There are indications for the use of MPA as an adjunctive treatment to enhance calf muscle pump function in patients with VLU:
who cannot tolerate compression therapy
who can only tolerate suboptimal, low‐level compression
whose ulcer healing remains slow or stalled with optimal compression.
Association of alcohol consumption with hypertension or prehypertension in Chinese adolescent: A cohort study of the China Health and Nutrition Survey
Authors: Chen Meiqi , Liu Juan , Fan Menglin , Li Bin , Ren Yong , Xu Shaoyong 
Published: September 2024

AbstractThis study was conducted to investigate the association between alcohol consumption in adolescence and the risk of hypertension or prehypertension development in early adulthood. This cohort study included adolescent participants aged 12–18 years from the 2000–2011 China Health and Nutrition Survey. Cox proportional risk regression models were used to analyze the associations of the frequency of alcohol consumption, alcohol intake, and type of alcohol with the risk of developing hypertension or prehypertension. Restricted cubic spline analysis was used to assess the dose–response relationships for alcohol intake and their hazard ratios (HRs). A total of 1556 participants were included in the final analysis. Among the overall population, 448 (30.81%) and 35 (34.31%) participants developed hypertension or prehypertension, respectively. Compared with no alcohol consumption, alcohol consumption ≥ 2 times/week and consumption of ≥2 types of alcohol were associated with an increased risk of hypertension and prehypertension, with HRs of 1.97 (95% confidence interval [CI] 1.17–3.34; p = 0.011) and 1.77 (95% CI 1.01–3.09; p = 0.046), respectively. Alcohol intake of > 96 mL/week was associated with an increased risk of hypertension and prehypertension, with HRs of 2.09 (95% CI 1.12–3.90; p = 0.020) and 2.07 (95% CI 1.11–3.84; p = 0.021), respectively. The restricted cubic spline analysis showed that the risk of developing high blood pressure or prehypertension tends to increase with increasing alcohol consumption. Heavy alcohol consumption in adolescence increased the risk of developing hypertension and prehypertension in early adulthood.
Gandouling ameliorates liver injury in Wilson's disease through the inhibition of ferroptosis by regulating the HSF1/HSPB1 pathway
Authors: Zhao Chenling , Chen Jie , Tian Liwei , Wen Yuya , Wu Mingcai , Tang Lulu , Zhou An , Xie Wenting , Dong Ting 
Published: September 2024

AbstractFerroptosis, an iron‐dependent form of cell death, plays a crucial role in the progression of liver injury in Wilson's disease (WD). Gandouling (GDL) has emerged as a potential therapeutic agent for preventing and treating liver injury in WD. However, the precise mechanisms by which GDL mitigates ferroptosis in WD liver injury remain unclear. In this study, we discovered that treating Toxic Milk (TX) mice with GDL effectively decreased liver copper content, corrected iron homeostasis imbalances, and lowered lipid peroxidation levels, thereby preventing ferroptosis and improving liver injury. Bioinformatics analysis and machine learning algorithms identified Hspb1 as a pivotal regulator of ferroptosis. GDL treatment significantly upregulated the expression of HSPB1 and its upstream regulatory factor HSF1, thereby activating the HSF1/HSPB1 pathway. Importantly, inhibition of this pathway by NXP800 reversed the protective effects of GDL on ferroptosis in the liver of TX mice. In conclusion, GDL shows promise in alleviating liver injury in WD by inhibiting ferroptosis through modulation of the HSF1/HSPB1 pathway, suggesting its potential as a novel therapeutic agent for treating liver ferroptosis in WD.
Behavioral characteristics of toddlers later identified with an autism diagnosis, ADHD symptoms, or combined autism and ADHD symptoms
Authors: Davis Naomi O. , Lerebours Reginald , Aiello Rachel E. , Carpenter Kimberly L.H. , Compton Scott , Franz Lauren , Kollins Scott H. , Sabatos‐DeVito Maura , Spanos Marina , Dawson Geraldine 
Published: September 2024

BackgroundAutism commonly co‐occurs with attention‐deficit/hyperactivity disorder (ADHD), but less is known regarding how ADHD symptoms impact the early presentation of autism. This study examined early behavioral characteristics of a community sample of toddlers later identified with autism diagnosis, ADHD symptoms, combined autism and ADHD symptoms, or neither condition.MethodsParticipants were 506 toddlers who were part of a longitudinal study of children's behavioral development. Parents completed questionnaires about their children's behavior at two time points. Four groups were identified based on study measures or medical record: autism diagnosis (n = 45), elevated ADHD symptoms (n = 70), autism and ADHD symptoms (n = 30), or neurotypical development (n = 361). Relationships between early parent report of autism‐ and ADHD‐related behaviors, social–emotional and behavioral functioning, and caregiver experience and subsequent group designation were evaluated with adjusted linear regression models controlling for sex.ResultsSignificant group differences were found in measures of autism‐related behaviors, ADHD‐related behaviors, externalizing and internalizing behaviors, and parent support needs (p < .0001). Pairwise comparisons indicated toddlers later identified with combined autism diagnosis and ADHD symptoms had higher levels of autism‐related behaviors, externalizing and internalizing behaviors, and autism‐related parent support needs compared to the other groups. Toddlers with subsequent elevated ADHD symptoms or combined autism diagnosis and ADHD symptoms exhibited similar levels of ADHD‐related behaviors, while both groups displayed more ADHD‐related behaviors than toddlers subsequently identified with autism or those with neither condition.ConclusionsIn this community sample, toddlers for whom combined autism diagnosis and ADHD symptoms were subsequently identified showed a distinct presentation characterized by higher early autism‐related behaviors, broader behavioral concerns, and higher parent support needs. Presence of ADHD symptoms (alone or in combination with autism) was associated with higher parent‐reported ADHD‐related behaviors during toddlerhood. Results indicate that ADHD‐related behaviors are manifest by toddlerhood, supporting screening for both autism and ADHD during early childhood.
Medical director presence and time in U.S. nursing homes, 2017–2023
Authors: Goldwein Eric L. , Mollot Richard J. , Dellefield Mary Ellen , Wasserman Michael R. , Harrington Charlene A. 
Published: September 2024

AbstractBackgroundFederal regulations require all nursing homes to have a medical director, where medical directors oversee resident medical care and develop, implement, and evaluate resident care policies and procedures that reflect current standards of practice.MethodsThis descriptive study examined medical director: (1) presence or absence and the amount of time spent from 2017 to 2023; (2) presence and time by ownership type; (3) variations in presence and time across states; and (4) overall CMS deficiencies for violations of medical director regulations. This study used federal Payroll‐Based Journal (PBJ) data on staffing positions for the period of 2017–2023, along with federal nursing home ownership data and deficiencies data for 2023.ResultsMore than a third of U.S. nursing homes (36.1%) reported zero medical director presence in Quarter 1, 2023. Medical director presence fluctuated between 2017 and 2023 with a decline over the past 4 years. Among nursing homes reporting a medical director, the medical director was on payroll for an average 36 min per day or 4.2 h per week per facility, and less than 1 min per resident day. Medical director presence and time varied significantly by ownership type and state. For‐profit nursing homes reported a lower rate of medical director presence (61.4%) compared to non‐profit (71.3%) and government (66.5%) nursing homes and reported that medical directors spent less time in the facilities. Facilities seldom (0.2%) receive regulatory deficiencies for medical director requirements.ConclusionsThough medical directors have a critical role in overseeing clinical care, some nursing homes report no medical director time and those that do report about 4 h per week. Together, these findings may indicate the need for improvement. More research is needed to understand these variations and the extent to which medical director regulations are being followed by nursing homes and enforced by regulators.
Is There an Increase in Possible Sleep Bruxism in Children Over Time? A Longitudinal Study
Authors: Soares Josiane Pezzini , Serra‐Negra Júnia Maria , da Silva Moro Juliana , Santos Pablo Silveira , Brancher Giana , Evangelista Maria Eduarda , Cardoso Mariane , Santana Carla Miranda , Bolan Michele 
Published: September 2024

ABSTRACTBackgroundBruxism is a behaviour that has several consequences in an individual's life, especially when it starts in childhood. However, bruxism can be a potential protective factor, which is an attribute that reduces the chance of a negative health outcome.ObjectivesTo evaluate the incidence of sleep bruxism (SB) and dental wear in children and adolescents.Materials and MethodsThis longitudinal study began in 2014 and 2016 (baseline) with initial 1816 children followed for 5 and 3 years, respectively. The follow‐up data collection started in 2019. The diagnosis of SB was parents report (baseline) and self‐report (follow‐up) due to age groups of each phase, and questions related to symptoms of SB were collected. Five calibrated examiners (kappa >0.7) collected the clinical data. The clinical variables were dental erosion and dental wear. Contextual, individual, behaviour and clinical characteristics were collected. A multilevel logistic regression model was used to investigate the association of contextual, individual, behaviour and clinical characteristics with SB. Poisson regression for repeated measures was performed to evaluate the incidence of SB and dental wear (incidence rate ratio—IRR and confidence interval—95% CI).ResultsTwo hundred and fifty‐three children and adolescents answered questionnaires and were clinically examined. The mean age of the follow‐up in 2019 was 11.25 years old (±2.19). There was no increase in the incidence of SB (95% CI: 0.74–1.35). Children/adolescents had a 2.2 higher risk to present dental wear (95% CI: 1.89–2.60). SB at the follow‐up was associated with the contextual variable, earache, erosion and awake bruxism.ConclusionsIn this population, children with SB remained with this behaviour and showed higher dental wear over the years.
Bridging oral health and nutrition: Assessing produce prescription programs in pediatric dental clinics serving low‐income communities
Authors: Houser Zachary L. , Lyden Elizabeth , Koukol Claire C. , Parks Courtney A. 
Published: September 2024

AbstractObjectivesThis study assesses the needs and feasibility of conducting a produce prescription (produce Rx) program in a pediatric dental clinic setting serving low‐income patients.MethodsWe conducted a cross‐sectional quantitative survey examining several household characteristics including demographics, benefits received, fruit and vegetable intake patterns, food security, feasibility of a produce Rx program, and respondents' answers to questions based on social cognitive theory constructs. The survey was administered at the University of Nebraska Medical Center (UNMC) pediatric dental clinic, a pediatric dental residency clinical training site. One hundred adult respondents with low income completed a 36‐item questionnaire during their child's dental appointment.ResultsAlmost half of respondents reported experiencing food insecurity (45%). Respondents who were food insecure experienced higher levels of nutrition insecurity (p = 0.012), less confidence in choosing fruits and vegetables (FVs) (p = 0.026), difficulty in purchasing FVs in their neighborhood (p = 0.012), and more concern that FVs cost too much (p < 0.001) when compared to respondents who were food secure. Notwithstanding the barriers they face, almost all respondents reported that they eat FVs because of health benefits (95%) and to set a good example for their family (91%). Additionally, most respondents expressed an interest in produce Rx programs (80%) and nutrition education activities (81%).ConclusionsThis study demonstrated the potential for produce Rx program uptake in a pediatric dental clinic setting through positive caregiver‐reported need and interest. Future studies should explore how produce Rx programs can be adapted most effectively in this novel setting.
Sleep and cardiac autonomic modulation in older adults: Insights from an at‐home study with auditory deep sleep stimulation
Authors: Huwiler Stephanie , Ferster M. Laura , Brogli Luzius , Huber Reto , Karlen Walter , Lustenberger Caroline 
Published: September 2024

SummaryThe autonomic nervous system regulates cardiovascular activity during sleep, likely impacting cardiovascular health. Aging, a primary cardiovascular risk factor, is associated with cardiac autonomic disbalance and diminished sleep slow waves. Therefore, slow waves may be linked to aging, autonomic activity and cardiovascular health. However, it is unclear how sleep and slow waves are linked to cardiac autonomic profiles across multiple nights in older adults. We conducted a randomized, crossover trial involving healthy adults aged 62–78 years. Across 2 weeks, we applied auditory stimulation to enhance slow waves and compared it with a SHAM period. We measured sleep parameters using polysomnography and derived heart rate, heart rate variability approximating parasympathetic activity, and blood pulse wave approximating sympathetic activity from a wearable. Here, we report the results of 14 out of 33 enrolled participants, and show that heart rate, heart rate variability and blood pulse wave within sleep stages differ between the first and second half of sleep. Furthermore, baseline slow‐wave activity was related to cardiac autonomic activity profiles during sleep. Moreover, we found auditory stimulation to reduce heart rate variability, while heart rate and blood pulse wave remained unchanged. Lastly, within subjects, higher heart rate coincided with increased slow‐wave activity, indicating enhanced autonomic activation when slow waves are pronounced. Our study shows the potential of cardiac autonomic markers to offer insights into participants' baseline slow‐wave activity when recorded over multiple nights. Furthermore, we highlight that averaging cardiac autonomic parameters across a night may potentially mask dynamic effects of auditory stimulation, potentially playing a role in maintaining a healthy cardiovascular system.