bluuebunny/crossref_metadata_2025_split huggingface dataset:
Undergraduate Senior Nursing Students' Perceptions of Beneficial Prebriefing Practices
Authors: Lebo Chelsea R. 
Published: October 2024

Background
Examining nursing students' perceptions of prebriefing and what components are most effective in preparation for simulation may help standardize prebriefing and enhance learning experiences.

Method
This qualitative descriptive study explored the perceptions of prebriefing, prework assignments, and what methods of prebriefing increased self-confidence when undergraduate nursing students participated in simulation. An inductive approach to content analysis was used to interpret the data.

Results
Two themes that emerged from the data were preparation is essential to simulation success and preparation is essential to future success. Additionally, five subthemes were identified: understanding content in advance, logistical clarity, well-prepared students are invested, increased self-confidence, and pride in education and learning.

Conclusion

Prebriefing is essential to simulation and undergraduate nursing student success. Although prebriefing practices vary between educators, undergraduate nursing students valued prework and expressed a preference for written assignments. Overall, students perceived prework as increasing their self-confidence during simulation.

[
J Nurs Educ
. 2024;63(10):693–697.]
Experiences of nurses studying towards post-basic qualifications during COVID-19 in KwaZulu-Natal
Authors: Sokhela Dudu G. , Nokes Kathleen , Orton Penelope M. 
Published: October 2024

Background: The COVID-19 pandemic caused abrupt closure of schools including higher education institutions. The transition from in-person to virtual teaching platforms caused challenges for frontline nurses in post-basic programmes. Nurses were forced to divide their efforts between responding to the pandemic and their studies.Aim: The study aims to describe the experiences of nurses studying post-basic qualifications during COVID-19 in KwaZulu-Natal.Setting: The setting comprised virtual platforms such as closed social media groups (nursing colleagues and South African Society of Occupational Health Nurses Facebook) and Microsoft Teams or WhatsApp calls.Methods: A qualitative descriptive design using individual virtual interviews with eight nurses working in healthcare settings while studying post-basic qualifications. The framework was Fullan’s Change Theory in educational settings. Data were analysed using applied thematic analysis.Results: Four themes were identified; transitioning from in-person to online teaching and learning, challenges in clinical placements, support to achieve educational goals, and unique aspects of studying and caring for infected patients and 10 sub-themes emerged.Conclusion: Participants found benefits of online learning despite challenges with the Internet network. There was a shortage of mentors, and personal protective equipment in clinical settings; however, participants were cognisant of the duty to care for infected patients notwithstanding personal risk of infection.Contribution: Nurses were at the frontline of the pandemic yet facing challenges in clinical facilities and their studies. The study could contribute to understanding participants’ experiences, which might help with response planning in future pandemics.
Ideal Clinic Realisation and Maintenance programme implementation in rural KwaZulu-Natal
Authors: Mhlungu Donald T. , Boersema Geertien C. , Ramukumba Mokholelana M. 
Published: October 2024

Background: The delivery of quality primary healthcare (PHC) services is vital for enhancing the health status of rural communities, yet persistent barriers exist in resource-constrained rural settings.Aim: The study explored perspectives on the barriers to and facilitators of implementing the Ideal Clinic Realisation and Maintenance (ICRM) programme as a quality assurance initiative in a rural KwaZulu-Natal subdistrict.Setting: Professional nurses and healthcare managers from seven PHC clinics in a rural subdistrict of KwaZulu-Natal and supervising managers from a district hospital participated in this study.Methods: Telephonic semi-structured interviews were conducted using a qualitative case study approach with the purposively selected sample. Data were inductively and thematically analysed.Results: Themes included ICRM programme organisation, barriers and facilitators for implementing the ICRM programme. Barriers in rural PHC settings included overburdened clinics, suboptimal infrastructure, staff burnout, poor communication and non-adherence to clinical guidelines. Despite obstacles, programme implementation was facilitated through stakeholder support and teamwork. Participants emphasised the need for infrastructure upgrades, more human and physical resources, and maintenance of stakeholder support.Conclusion: If challenges are mitigated and supportive factors are leveraged, the potential for successful programme implementation and improved healthcare delivery can benefit both healthcare providers and recipients.Contribution: Through providing insight into the perspectives of both implementers and supervisors, the study informs stakeholders and policymakers about difficulties encountered and potential improvements to be made in the implementation of the ICRM programme in rural PHC.
The Impacts of Cardiac Rehabilitation Exercise Therapy in Patients Following Percutaneous Coronary Intervention: Systematic Review
Authors: Amanda Rana Zhafira , Adwiarto Sarah Khairunnisa , Purwowiyoto Sidhi Laksono 
Published: October 2024

Abstract

Background:
Cardiac rehabilitation (CR) is a vital evidence-based intervention for improving quality of life and reducing adverse outcomes in patients with coronary artery disease (CAD) post-percutaneous coronary intervention (PCI), addressing persistent risks such as high mortality and recurrent angina despite advancements in PCI.

Objective:
This study focused on establishing the impact of cardiac rehabilitation (CR) exercise therapy following percutaneous coronary intervention (PCI) with multiple vital outcomes.

Methods:
A comprehensive search was performed across databases, including ScienceDirect, PubMed, PMC, and Cochrane, with a restriction to the English-language articles. The focus was on randomized controlled trials (RCTs) that evaluated the effects of CR exercise therapy in patients who underwent PCI – comparing the group that participated in CR exercise therapy with those that received routine care. Key outcomes evaluated included laboratory values, left ventricular ejection fraction, 6-min walk test, quality of life (QoL), cardiopulmonary function, exercise capacity, and cardiovascular events. The Cochrane RoB 2 was utilized to evaluate the quality of the study. Outcomes were synthesized qualitatively to summarize the effects of CR on the estimated parameters.

Results:
This review included 12 RCTs from several countries involving 1215 patients – 605 in control groups and 610 in intervention groups. Nine studies categorized some concerns in the overall assessment, and three RCTs were classified as low risk of bias. Results showed that patients with CR intervention effectively experience positive impacts across all key outcomes.

Conclusion:
CR benefits coronary artery disease patients post-PCI by managing cardiovascular risk factors, improving heart function, reducing cardiovascular events, and enhancing QoL.
The Role of Psychological Flexibility in the Treatment of Anxiety Disorders: A Systematic Review
Authors: Bijulakshmi P. , Kumar V. Veera Balaji 
Published: October 2024

Abstract
Anxiety disorders are the most prevalent among psychiatric disorders, and adequate knowledge about the development and treatment of anxiety disorders is essential. Psychological flexibility (PF) is the dynamic process wherein an individual can adapt to situational demands while handling stressful situations and has been postulated to be related to the development of anxiety disorders. This systematic review analyzed the concept of PF in relation to the development and treatment of anxiety disorders. The keywords “psychological flexibility in the treatment of anxiety disorders” were used to search the databases PubMed and Google Scholar. Articles from 2012 to 2022 were included. Results were categorized into two groups, Group 1 consisted of articles that studied the relationship of PF to anxiety disorders in a clinical perspective and Group 2 consisted of articles that explained the role of PF in anxiety in a theoretical perspective. Group 1 consisted of 53 articles that included studies on the role of PF in anxiety disorders; out of which 31 were randomized clinical trials on the efficacy of increasing PF in the treatment of anxiety disorders. Group 2 consisted of 39 articles that explained the role of PF in the formation of anxiety and in maintaining mental health. Research findings have shown that PF is a process wherein individuals can learn to navigate negative emotions and strive to achieve valued goals in the face of adversities by regulating behavioral patterns. Thus, PF plays an important role in psychological well-being and hence has a therapeutic role in the treatment of anxiety disorders.
Value of implementing a care bundle approach to improve outcome of pediatric ventilator − associated events (PedVAE) in pediatric intensive care unit (PICU)
Authors: Mahmoud Nagwa Mohamed Sabry , Hammad Ahmed Roshdy Mahmoud , Okaily Nagwa Ismail , Afify Mohamed Farouk 
Published: October 2024

Background
Pediatric ventilator-associated events (PedVAEs) refer to a persistent deterioration in oxygenation following a period of stability, and these are valuable for monitoring and detecting issues arising from mechanical ventilation in children. However, the effectiveness of measures to reduce PedVAEs rates is still being determined.

Objectives
We aimed to evaluate the incidence of PedVAEs before and after implementation of a ventilator care bundle (VCB) in the pediatric intensive care unit (PICU).

Methods
We conducted a single-centre prospective comparative analysis on 323 mechanically ventilated patients admitted to the PICU from January 2022 to June 2023 (after the implementation of the VCB). From these patients, we selected those who met the CDC protocol diagnosis for PedVAEs (Group II). Prior to the implementation of the VCB, we retrospectively analysed the records of 108 patients from January 2021 to December 2021. We noted the complete blood count, C-reactive protein, procalcitonin, arterial blood gases, and endotracheal aspirate cultures of the patients.

Results
There was a significant decrease in the length of stay following a bundle implementation (P value < 0.05), with a mean of 10.9 (4.9) days before bundle and 8 (2.7) days after bundle. Following the bundle implementation, group II had 24% lower PedVAEs than group I (33%). In group II, mechanical ventilation complications were 25%, compared to 49% in group I.

Conclusion
Ventilator-associated event (VAE) is a consequence of mechanical ventilation that greatly lengthens the duration of stay in the PICU and increases the risk of mortality. The introduction of a bundle was found to be successful in reducing the rate of VAEs in patients in PICU.
Emergency admission preceding malignancy diagnosis: Insights from a study at a tertiary care hospital
Authors: Redha Hussain A. , Al Hatmi Kawther S. , Al-Ghaithi Safa K. , Al Zeedy Khalfan B. , Al Alawi Abdullah M. 
Published: October 2024

BACKGROUND:
A considerable number of cancer patients are diagnosed following presentation at emergency department with symptoms related to their condition, yet research in this area remains scarce. This study aimed to identify the clinical characteristics and evaluate the health outcomes of patients who presented to the emergency department with symptoms of cancer.

MATERIALS AND METHODS:
We analyzed data for patients diagnosed with cancer postemergency department presentation at a tertiary care hospital between 2015 to 2021. Data on patient characteristics, clinical features, and health outcomes was abstracted through meticulous review of the patients’ medical record. SPPS was used for data analysis. Wilcoxon rank-sum test and Chi-square or Fisher’s exact test as appropriate, were used to determine statistical significance for continuous and categorical variables, respectively. Regression analysis determined factors associated with treatment and mortality. Kaplein-Meier analysis was performed to determine survival time.

RESULTS:
During the study period, 108 patients were diagnosed with new malignancies following acute medical admission. The median age of these patients was 67 years (interquartile range [IQR]: 56–75), and 58 (53.7%) of these patients were men. The most common presenting complaints were pain (55.6%), weight loss (44.4%), and poor appetite (36.1%). The median time from the onset of symptoms to hospital presentation was 30 days (IQR 8–62). The most common types of malignancies diagnosed in the study were hepatobiliary (18.5%), gastroesophageal (15.7%), and lung cancer (14.8%). Two-thirds of patients had Stage IV malignancy, and 64.81% presented with distant metastatic disease at the time of diagnosis. Older age (69 vs. 61.5 years; P = 0.04), lower level of general education and higher attainment (11.4% vs. 44.4%; P < 0.01), advanced malignancy stages (P < 0.01), and metastatic disease at diagnosis (75.4% vs. 44.4%; P = 0.01) were associated with higher mortality.

CONCLUSION:
Emergency presentations for newly diagnosed cancer, often seen in older patients with lower education and multiple comorbidities, were generally associated with poor survival rates owing to advanced disease with distant metastasis. Enhancing awareness of critical symptoms could improve early detection rates.
The therapeutic potential of hemp seed oil as Nasya in the management of insomnia: a literature review
Authors: Bohra Mohita , Shukla Gyanendra Datta 
Published: October 2024

Abstract
The significance of getting sufficient sleep for maintaining good health and wellbeing is widely known. The American Psychiatric Association classifies insomnia as the most common sleep–wake disorder characterized by difficulty with sleep quality, timing, and quantity. The residual effects and the social stigma associated with the use of sedative drugs incline patients toward seeking alternative therapy. Ayurveda presents an exhaustive elucidation of the etiology, manifestations, and therapeutic modalities concerning insomnia. Among the extensively prescribed Panchakarma (the five-fold bio-purification process) interventions for insomnia management, Nasya (instillation of oils, powders, or juices through the nasal route) holds a significant position. Nasya is considered an effective way to directly deliver medicines to the brain by bypassing the blood–brain barrier through olfactory and trigeminal nerve pathways. Anandkand, an important book on Indian alchemy, mentions various formulations of hemp, including the use of hemp seed oil (Vijaya Beej Tail) for Nasya. A narrative analysis of hemp seed oil Nasya for insomnia was conducted using Ayurvedic texts and electronic databases. Although valued for its nutraceutical properties, there is limited clinical data on its effectiveness in treating insomnia. No relevant clinical studies were found for its use in treatment of insomnia, but some preclinical and clinical studies exist for other conditions. The presence of a perfect proportion of omega-3 to omega-6 fatty acids, coupled with its antioxidant properties and the existence of preclinical findings suggesting the sedative and anti-anxiety effects of hemp seed extracts by influencing the benzodiazepine receivers linked to gamma-aminobutyric acid, makes it a choice for Nasya therapy in clinically managing insomnia. A significant enhancement in scientific research efforts is imperative to maximize its potential utilization.
An optimistic review of modernization versus noise-induced hearing loss with the scope of Ayurveda management: a hope or a hype
Authors: Satyavati  , Fiaz Shamsa , Hanifa Nasreen , Sharma Navneet 
Published: October 2024

Abstract

Background:
In today’s fast-paced world of technology, where progress brings many benefits, we sometimes overlook the downsides, and one major issue is noise pollution. Noise pollution acts as a “sneaky killer” and manifests in various noncommunicable diseases, which hampers our lifestyle. One such issue is hearing loss (HL) due to over or continuous exposure to noise also known as “noise-induced HL (NIHL)” and is gaining popularity due to its increasing prevalence. While the cause is simply the overuse of noise, the way it has developed with modernization is not known.

Aims and Objectives:
This work aims to provide a comprehensive understanding of the pathophysiology of “NIHL” and how the modern environment, characterized by increased noise levels, affects the auditory health of individuals along with the scope of Ayurveda in its management.

Materials and Methods:
A sincere attempt is made by reviewing a wide range of works of literature and scientific studies from the past 10 years.

Result and Conclusion:
Avoidance of etiological factors is primarily necessary for the anticipation of hearing impairment and Ayurveda does have scope for its treatment but there is absolute lacunae of quality data with very few large randomized controlled trials. Thus, a hope for further research in this area remains the need of the hour.
Abdominal wall failure
Authors: Sharma Ekta , Goyal Shirish , Gupta Sanjay , Kaushik Robin , Attri Ashok K. 
Published: October 2024

Abstract
Generalised weakness of the abdominal wall can lead to its failure to contain the abdominal viscera within the confines of the abdominal cavity, resulting in simultaneous hernias at different sites. We propose that this entity should be termed ‘abdominal wall failure’, and the laparoscopic approach is ideal for the management of such a condition. This report presents the case of a patient with concurrent hiatal hernia, bilateral direct inguinal hernias, bilateral femoral hernias and recurrent paraumbilical hernia, managed laparoscopically.
Enhancing Gingival Aesthetics: A Case Report on Gingival Depigmentation
Authors: Nair Deepthy B. , Jose Paul , Prakash D’lima Johnson , Reshma T. S. 
Published: October 2024

Abstract
The beauty of a smile is not solely defined by the teeth’s shape, position and colour, but also by the condition of the gingival tissues. While melanin pigmentation of the gingiva poses no medical risk, complaints about ‘black gums’ are common, particularly amongst individuals with a high smile line. Consequently, treatment approaches in periodontal aesthetics aim to establish a harmonious balance between the pink hues of the gums and the white of the teeth, a crucial aspect of all dental procedures. Various methods for gingival depigmentation have been documented, including bur abrasion, scraping, partial thickness flap surgery, cryotherapy, electrosurgery and laser treatment. In this case report, scraping, electrosurgery and diode laser techniques were employed for depigmentation, chosen for their simplicity, effectiveness and ability to deliver satisfactory results, thereby ensuring patient contentment.
Assessment of Calcium Concentration and pH at the Periapical Environment on Placing Calcium Hydroxide with Different Natural Vehicles – An In vitro Study
Authors: Kannan Nithya , Peedikayil Faizal C. , Kottayi Soni , Aravind Athira , Sreedharan Aswathi , Ramesh Athul 
Published: October 2024

Abstract

Background:
In root canal therapy, the number of microorganisms in canals can be controlled by giving proper intracanal medication dressing. Calcium concentration and changes in pH at the periapical region denote the effect of antibacterial action in the periapical region.

Aim:
The aim is to determine a suitable natural vehicle for calcium hydroxide (Ca(OH)2) as an intracanal medicament by assessing the calcium concentration and changes in pH at the periapical region.

Materials and Methods:
A total of 60 extracted single-rooted permanent teeth were equally allotted into four groups – Group I: Ca(OH)2 with distilled water, Group II: Ca(OH)2 with aloe vera, Group III: Ca(OH)2 with coconut water, and Group IV: Ca(OH)2 with neem extract. pH was determined by pH meter and calcium by chromatography. The values were taken on days 1, 2, 3, 7 and 14.

Results:
All the materials showed alkaline pH and release of calcium ion throughout the study. For day 1, the mean pH value was highest for distilled water (10.06) and lowest for aloe vera extract (9.42). The highest calcium release during day 1 was by coconut water (67.85) and the least calcium release was by aloe vera (42.01). On day 14, the highest calcium release was by distilled water (89.98) followed by coconut water (67.24) and least by neem extract (61.13). pH values and calcium release in four different natural vehicles were significant (P < 0.05).

Conclusion:
All natural materials used in this study showed good Ca(OH)2 diffusion when used as a vehicle with Ca(OH)2 in root canals.
Clinical dilemma in managing deep venous embolism with hemorrhagic stroke
Authors: Chima Emmanuel , Iheanacho Joseph , Elendu Kelechi Collins , Uwanuruochi Kelechukwu 
Published: October 2024

Abstract
Recent stroke is a recognized contraindication to anticoagulation. However, some patients with a recent hemorrhagic stroke develop deep venous thrombosis. This creates a dilemma whereby the physicians have to navigate the best in the risky line of management. We report a 65-year-old man with pulmonary embolism 3 weeks after hemorrhagic stroke. He was given conventional anticoagulant treatment and was discharged with clinical improvement 2 weeks later.
Elevated mean pulmonary artery pressure and right ventricular dysfunction in children with obstructive sleep apnea
Authors: Ahmadu Ibrahim , Aliyu Ibrahim , Ahmed Abdulazeez , Asani Mustafa O. 
Published: October 2024

Abstract

Background:
Obstructive sleep apnea (OSA), characterized by cessation of ventilation or occurrence of significant hypoventilation during sleep, is associated with several complications, including cardiovascular dysfunction. This study aims to determine the prevalence and determinants of elevated mean pulmonary artery pressure (mPAP) and right ventricular (RV) dysfunction in children with OSA.

Materials and Methods:
A cross-sectional comparative study was conducted on 75 eligible children with OSA aged 2–14 years and compared with 75 age- and sex-matched apparently healthy children. Trans-thoracic echocardiography was used to assess the pulmonary artery pressure as well as RV systolic and global function.

Results:
The mean mPAP was significantly higher in the children with OSA (20.41 ± 8.5) as compared to the controls (11.35 ± 2.8) (P < 0.001). Elevated mPAP was found in 29.3% of the children with OSA, while 33.3% and 34.7% had RV systolic and global dysfunction, respectively. Children with a duration of OSA ≥2 years were more likely to have elevated mPAP than those with a duration of illness <2 years (P = 0.046). RV systolic and global dysfunctions were significantly more common in the cases with elevated mPAP compared with those with normal mPAP (P < 0.001).

Conclusion:
Elevated mPAP and RV dysfunction are common in children with OSA, especially those with a duration of illness ≥2 years. Children with OSA and elevated mPAP are more likely to have impaired RV systolic and global function.