bluuebunny/crossref_metadata_2025_split huggingface dataset:
A survey on the effects of patient safety training programs based on SBAR and FMEA techniques on the level of self-efficacy and observance of patient safety culture in Iran hospital, Shiraz in 2022–2023
Authors: Abrishami Ramin , Golestani Kambiz , Ranjbar Mehri Farhang , Abarghouie Mohammad Hassan Ghasemie , Ghadami Ahmad 
Published: February 2024

BACKGROUND AND OBJECTIVE:
Patient safety and medical personnel self-efficacy are among the main factors involved in providing quality health services. Moreover, safety culture in an organization is considered one of the most critical factors regarding patients’ safety. Therefore, the present study aimed to determine the effects of patient safety programs based on Situation, Background, Assessment, Recommendation (SBAR) and Failure Model Effects Analysis (FMEA) techniques on self-efficacy and patient safety culture in Iran Hospital of Shiraz in 2022–2023.

MATERIALS AND METHODS:
This two-stage quasi-experimental study was conducted in 2022–2033. Considering inclusion criteria, the present study included 80 nurses working in Iran Hospital. The participants were divided into groups of SBAR (40 participants) and FMEA (40 participants). All the data were collected using a Hospital Survey on Patient Safety Culture questionnaire and Sherer General Self-Efficacy Scale. Then, the collected data were analyzed using SPSS 13, Fisher’s exact test, paired t-test, and independent t-test with a significant level of P < 0.05.

RESULTS:
The mean score of total patient safety culture between the two groups was insignificant before the intervention (P = 0.58). However, it was more significant in the FMEA group than the SBAR group after the intervention (P < 0/05). In addition, the mean self-efficacy score between the two groups was insignificant before the intervention (P = 0.80). However, after the intervention, the mean score of the FMEA group was significantly higher than the SBAR group (P < 0.05).

CONCLUSION:
According to the findings of this study, there is a meaningful relationship between patient safety training programs based on SBAR and FMEA techniques on patient safety and self-efficacy of nurses; however, FMEA training has more positive effects on self-efficacy and patient safety compared to other techniques. As a result, these techniques, along with other plans, are recommended to authorities in order to help improve patient safety.
Effectiveness of comprehensive nursing intervention program (CNIP) on knowledge and practice regarding the prevention of non-insulin-dependent diabetes mellitus (NIDDM) among adults
Authors: Koirala Bhumika , Balu Venkatesan , Kamei Sonia , Devi Yumnam Sushma , Sapkota Pratima 
Published: February 2024

BACKGROUND:
There are estimated 72.96 million cases of diabetes in the adult population of India. The prevalence in urban areas ranges between 10.9% and 14.2%, and the prevalence in rural India ranges between 3.0% and 7.8% among the population aged 20 years and above with a much higher prevalence among individuals aged over 50 years. This study aimed to determine the effectiveness of comprehensive nursing intervention program (CNIP) on knowledge and practice regarding the prevention of non-insulin-dependent diabetes mellitus (NIDDM) among adults.

MATERIALS AND METHODS:
A quasi-experimental one-group pretest–posttest design was chosen for the study. Adults were selected using a simple random sampling technique by the lottery method; of 120 eligible adults, 60 were selected to participate in the study. The study was conducted in an urban community, Bangalore, and data were collected from March 25, 2022, to April 23, 2022. CNIP consisted of education, demonstration of exercise, and information booklet. The pretest and posttest were collected using the structured knowledge questionnaire for assessing the level of knowledge and non-observational checklist for assessing the level of practice among adults. Data were analyzed by descriptive and inferential statistics.

RESULTS:
There was significant improvement in the mean scores of knowledge from 52.3 to 82.2 and practice mean score from 45.5 to 68.4. The paired t-test value of knowledge was 3.88, and practice was 2.97, which was significant at P < 0.05 level.

CONCLUSIONS:
The study concluded that CNIP had a great role in increasing the level of knowledge and practice among adults in the prevention of NIDDM.
Critical thinking in nursing and midwifery learning: Quantitative and qualitative review
Authors: Atif Ibtissam , Elamri Nabila , Gantare Abdellah 
Published: February 2024

BACKGROUND:
This study tried to make a quantitative and qualitative review of the scientific production of the mobilization of critical thinking in nursing and midwifery learning.

MATERIALS AND METHODS:
The search was carried out in the “Web of Science” and “PubMed” databases between 2001 and 2021, resulting in 43 articles using several keywords “critical thinking,” “learning”, “nursing,” “midwifery”. The study will be split into two parts: A quantitative review in the form of a bibliometric analysis and a qualitative one in the form of a literature review. The quality of the articles has been verified by assessing the risk of bias (selection bias, detection bias, and interpretation bias) and using the Standards for Quality Improvement Reporting Excellence method.

RESULTS AND OBSERVATIONS:
The selected articles were the subject of a quantitative study leading to several results: chronology of publications, types of publications, number of publications, top journals of publications, etc. The same articles have been processed to produce a full qualitative review of the experimental studies.

CONCLUSION:
The results showed that the total and annual articles need to be higher. Experimental studies, especially quasi-experimental, are far higher than reviews or descriptive studies. The qualitative research showed a controversial relationship between critical thinking and learning improvement.
Validation of intercultural competence scale in the Ethiopian context: Exploring the factor structure and psychometric properties among university students
Authors: Bekere Tessema A. , Teketel Seleshi Z. 
Published: February 2024

BACKGROUND:
Although intercultural competence is a crucial factor for university students’ academic achievement and inter-ethnic conflict resolution, psychometrically sound intercultural competence scale is not available in the Ethiopian context. The aim of the present study was to translate the original English version of intercultural competence into Amharic language and validate the scale in the Ethiopian context.

MATERIALS AND METHODS:
In the processes of retaining culturally equivalent translated measure symmetrical approach was used. Data were collected from 476 (Male = 244 and Female = 232) arbitrarily selected university students with an age mean of 22.35 enrolled in undergraduate degree programs at Ambo University. The total sample was randomly split into two equal-sized group to execute exploratory factor analysis (EFA, N = 238) and confirmatory factor analysis (CFA, N = 238).

RESULT:
The result of the study showed that both EFA and CFA supported a significantly correlated four-factor model of intercultural competence (Attitude, Awareness, Knowledge, and Skills). Moreover, the Amharic version of the intercultural competence scale showed good psychometric properties in terms of content validity, construct validity, internal consistency, and good fit indices to the data.

CONCLUSION:
This generally justifies the use of the Amharic version intercultural competence scale in the Ethiopian context. To satisfy the needs of the labor market, universities in Ethiopia should promote intercultural dialogues that improve the intercultural competence of university students.
Effect of vaccine dose on severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) antibody levels in a vaccinated community in Gowa Regency, Indonesia
Authors: Hamsi Andi Magfirah , Amiruddin Ridwan , Arsin A. Arsunan , Abdullah Andi Zulkifli , Amqam Hasnawati , Riskiyani Shanti 
Published: February 2024

BACKGROUND:
The administration of the coronavirus disease 2019 (COVID-19) vaccine aims to stimulate the production of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) antibodies. This leads to an enhanced production of neutralizing antibodies (Nabs), which naturally neutralize the virus within the body, thereby reducing the risk of COVID-19 infection. This study determined the analysis of factors affecting SARS-CoV-2 antibody levels in vaccinated individuals using data from the COVID-19 Seroepidemiological Survey of Gowa Regency.

METHODS AND MATERIAL:
This was an analytic observational study with a cross-sectional design. The COVID-19 Seroepidemiology Survey data as a whole were 851 individuals, and in this study, the number of samples was 804 individuals from all COVID-19 Seroepidemiology Survey samples who had performed the COVID-19 vaccine in Gowa Regency, selected through purposive sampling.

STATISTICAL ANALYSIS USED:
Data analysis was conducted using various statistical tests, including the independent-samples t-test, Mann–Whitney test, Kruskal–Wallis test, and multiple logistic regression. Furthermore, the analysis was performed through the STATA program version 14.0.

RESULTS:
There was a significant influence between the history of COVID-19 infection (P = 0.0006) and dose of vaccine (P = 0.0001) with SARS-CoV-2 antibody levels in vaccinated individuals. Meanwhile, vitamin consumption and comorbid history did not affect SARS-CoV-2 antibody levels. Multivariate analysis showed that vaccine dose was the most influential variable on antibody levels (P = 0.046; Odds Ratio (OR) 0.19; 95% Confidence Interval (CI): 0.036–0.968).

CONCLUSIONS:
The most influential factor was the vaccine dose on SARS-CoV-2 antibody levels in community in Gowa Regency.
Investigating the relationship between organizational health and burnout and job stress among midwives working in hospitals in 2020
Authors: Vardanjani Maryam Ghazali , Montazeri Simin , Veshare Effat Jahanbani , Ghanbari Saeed 
Published: February 2024

BACKGROUND:
Despite the prominent role of midwives in improving the health of women and families, limited studies have been conducted in the occupational and organizational field and their role on the performance of this group. The purpose of this research is to investigate the relationship between organizational health, burnout, and job stress among midwives working in hospitals affiliated to Shahrekord University of Medical Sciences.

MATERIALS AND METHODS:
The present study is a cross-sectional descriptive–analytical study, which was conducted with available sampling method on 159 midwives working in hospitals affiliated to Shahrekord University of Medical Sciences in 2020. Data collection tools were: Demographic Questionnaire, Modified Hoy and Feldman Organizational Health Questionnaire, Job Stress Questionnaire, Maslach Questionnaire to measure job burnout. Finally, the obtained data were analyzed with descriptive and analytical statistical tests (Pearson).

RESULTS:
The findings of the study showed that 70.4% of the participants had moderate to severe job stress and 70.4% of the participants had moderate level of organizational health and 79.9% suffered from job burnout. The results of structural equations showed that organizational health has an inverse and significant relationship with job stress (P < 0.001, β = −0.45) and job burnout (P = 0.002, β = −0.33).

CONCLUSION:
Organizational health has an inverse and significant relationship with job stress and job burnout. The findings of this study can be useful in planning and organizational policies for midwifery professionals. It also conveys the importance of extensive studies and planning to reduce stress and burnout and then improve organizational health. As a result, it can improve the performance and productivity, and as a result, improve the health of midwives and patients under their care and, consequently, the health of the society.
The Level of Knowledge of Decompression Sickness among Divers in Saudi Arabia – A Cross-sectional Study
Authors: Jamjoom Maan , Altirkistani Bsaim , Al-Jadani Faisal , Mirza Hashem , Alhijjy Majed , Alharthi Reem Abdullah , Hakeem Iliana , Madani Anass 
Published: February 2024

Abstract

Introduction:
Decompression sickness (DCS) is a clinical syndrome, i.e. commonly seen in divers. The global prevalence of DCS among professional dive instructors is approximately 3.4%. This study aimed to assess the level of knowledge concerning DCS among divers in Saudi Arabia.

Materials and Methods:
This is a cross-sectional study conducted among divers in Saudi Arabia. The research team visited several diving resorts to distribute the questionnaires. Furthermore, diving instructors from different cities across the nation were requested to distribute the questionnaire to their colleagues and diving communities.

Results:
A total of 262 divers participated in the study, of which 252 (96.18%) had a scuba-certified license. The majority of divers (94.27%) reported that they were aware of DCS. Furthermore, 27.48% of the participants reported that they had experienced clinical symptoms of DCS. Only 14 (19.44%) received first aid care, and 17 (6.489%) needed a deco dive/decompression dive. Females demonstrated a higher risk of developing DCS-related symptoms than males (odds ratio = 2.57; 95% confidence interval = 5.44–1.21; P = 0.0135).

Conclusion:
Majority of the participants were familiar with the nature of the disease and were found to have practiced safe diving. Practically, one-quarter of the participants experienced DCS-related symptoms, and only very few of them received first aid and/or a deco dive. Despite the nature of the study and its small sample size, this study adds to the growing nature of published literature in giving a better understanding of the disease by divers.
Impact of Smoking in Postoperative Outcomes after Elective Surgery
Authors: Goyal Vishal , Varma Chaitanya K , Behera Mahesh , Reddy G Parmeswar , Shankar Mamadur M. Ram 
Published: February 2024

Abstract

Introduction:
The hazard of smoking is not only limited to the general health risks but also makes the smokers more vulnerable to various perioperative complications ranging from pulmonary complications to delayed wound healing to cardiovascular events.

Methodology:
This is an observational study in the department of general surgery of a tertiary care teaching hospital over a period of 24 months (May 2019–April 2021). Patients between 18- and 60-year age undergoing noncardiac elective surgical procedures were included in the study.

Results:
A total of 240 patients, meeting the inclusion criteria, posted for elective, noncardiac surgery were enrolled in this prospective observational study. In smoker patients’ group (n = 138) undergoing surgery, 42 (30.4%) patients developed postoperative complications as compared to 12 (11.8%) patients in nonsmoker group (n = 102). The risk of postoperative complications among smokers was 3.2 times (odds ratio [OR], 95% confidence interval [CI]: 1.62–6.63) (P ≤ 0.0009). Smokers with pack-years > 11 had 3.8 times increased risk of postoperative complications as compared to nonsmokers (OR, 95% CI: 1.85–8.098) (P ≤ 0.0003).

Conclusion:
Our study aims to add to existing evidence and improve our understanding of delayed wound healing and major complications in smoker patients as surgical cases. Nonsmokers are at a lesser risk than smokers in postoperative complications. Awareness regarding the harmful effects of smoking and its influence on postoperative wound healing, motivation for quitting, and abstinence from smoking will help in reducing postoperative complications and better treatment outcomes.
A Medical Record-based Pilot Study on the Diffusing Capacity of the Lungs for Carbon Monoxide versus Nailfold Capillaroscopy as an Early Marker for Lung Involvement in Connective Tissue Disease-related Interstitial Lung Diseases
Authors: Chopra Manu , Pandey Indramani , Vasdev Vivek , Shrinath V. , Yadav Aseem 
Published: February 2024

Abstract

Background:
Connective tissue disease (CTD)-related interstitial lung diseases (ILDs) are one of the most common ILDs which affect relatively younger populations and can lead to extensive lung damage and fibrosis. Early detection and initiation of anti-inflammatory therapy can curtail the extent of lung damage. The diffusing capacity of the lungs for carbon monoxide (DLCO) is a well-established early marker of ILD. While most of the studies have shown specific nailfold capillaroscopy (NFC) findings in patients with CTD-ILD, none of them has evaluated the relation between diffusion impairment and nailfold capillary changes. The present study was carried out to evaluate the relationship between DLCO and NFC as markers for lung involvement in CTD-ILDs.

Materials and Methods:
This was a medical record-based observational study wherein the medical records of 100 diagnosed patients of CTD-ILD attending the pulmonology and rheumatology outpatient department were screened. Data concerning NFC, spirometry, and DLCO were collected and analyzed.

Results:
In our study of 100 patients, the minimum age was 29 years, and the maximum age was 78 years. A majority of patients in the study were found to be males (58%) and were suffering from CTD-ILD for a duration ranging from 2 to 5 years (58%). Eighty-nine percentage had a functional impairment on spirometry in the form of reduced forced vital capacity, and 61% had impaired DLCO. Nailfold capillary abnormalities were observed in all but one patient. The most common abnormal finding was a loss of capillary density (95% of patients) and a decrease in the intercapillary distance (94% of patients). A significant correlation was seen between diffusion impairment and abnormal nailfold capillary length. However, there was no significant correlation between DLCO and overall nailfold capillary abnormalities.

Conclusion:
The study concludes that NFC cannot be used as a tool to monitor diffusion impairment of the lungs in CTD-ILD. DLCO is a better assessment method compared to NFC changes as an indicator of lung involvement in CTD-ILD.
Microsurgical Training: A Review of Existing Methods and an Innovative Practice Model
Authors: Vishwanath G. , Patil Bhushan Ramesh , Goel Sankalp 
Published: February 2024

Abstract
Surgery under magnification with the use of the operating microscope has seen great advances, and numerous surgical procedures today depend on optical magnification. Training (to impart basic skills) in microsurgery is particularly essential to enable surgeons to take their place in the surgical team and learn further as they progressively observe, assist, and in time, perform microsurgical procedures. Various materials and models are used and have been objectively assessed and validated for simulation in microsurgical training. One such model, the live animal model (with all its disadvantages), has been the “gold standard” for simulation in microsurgical training. We have identified and put into use a new tissue model for training in microvascular surgery – the chicken mesentery, which will offer a good practical solution where the live animal model is unavailable. Further studies using this model for training at various centers will be required for validation and comparison of this tool against existing methods.
Use of Aztreonam Plus Ceftazidime/Avibactam Combination for In vitro Susceptibility Testing of CRO Isolates in a Tertiary Care Hospital – Our experience
Authors: Patel Ankita , Kompella Kiran Kumar , Bahal Ashish , Bhatt Puneet , Mathew Ann , Mahajan Pooja , Sharma Alisha , Ninawe SM , Grover Naveen , Chawla Naveen 
Published: February 2024

Abstract

Background:
Infections caused by metallo-beta-lactamases (MBLs) producing Gram-negative bacteria (mainly Enterobacterales) pose a great challenge for clinicians in treating these multidrug-resistant infections. In recent times, combination antibiotic therapy with ceftazidime–avibactam (CAZ-AVI) with aztreonam (ATM) has been researched by a number of laboratories worldwide and has gained much clinical attention. This study evaluated a practical laboratory method of testing for clinically significant in vitro synergy between CAZ/AVI + ATM in New Delhi MBLs (NDM) producing Gram-negative organisms.

Materials and Methods:
A total of 100 isolates of carbapenem-resistant Enterobacteriaceae (Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, and Enterobacter cloacae) were tested for synergy between CAZ/AVI + ATM using E-strip of CAZ/AVI and disc of ATM. The minimum inhibitory concentration value of CAZ/AVI was measured and the zone of inhibition was observed when ATM was placed parallel to the E-strip on a lawn culture of an isolate. Simultaneously, all isolates were tested for NDM and OXA-48 by Xpert Carba-R.

Results:
Of 100 isolates, 63/100 (63%) were harboring OXA-48 beta-lactamase, 54/100 (54%) were harboring NDM beta-lactamase and 18/100 (18%) were harboring both (OXA-48 and NDM). In vitro synergy between CAZ/AVI + ATM was noted in 99 isolates (99%).

Conclusion:
A significant synergy was demonstrated in vitro with CAZ/AVI + ATM combination therapy and seems to be a promising treatment strategy for infections caused by Enterobacterales harboring NDM and OXA-48 beta-lactamases.
Holmium Laser Lithotripsy in the Management of Difficult Biliary and Cystic Ductal Stones – A Case Series
Authors: Kumar Amit , Goje Harindra Kumar , Tarway Nimesh Kumar , Hande Vivek 
Published: February 2024

Abstract
Choledocholithiasis or common bile duct stone (CBDS) presents a unique challenge in the management of biliary stones. The clinical presentation of CBDS varies from asymptomatic CBDS, detected during the evaluation of gallstone disease to sinister presentation, like severe biliary pancreatitis. Asymptomatic liver function test abnormality, biliary colic, dilated common bile duct (CBD) on sonography for pain abdomen, and cholangitis are the part of the spectrum. Based on clinical suspicion and aided by laboratory parameters, the diagnosis is confirmed by modalities such as ultrasonography or magnetic resonance cholangiopancreatography or by endoscopic ultrasound. Endoscopic radiological cholangiopancreatography (ERCP) has evolved as a standard of care over the decades for the management of CBDS and surgical exploration of CBD is rarely resorted. ERCP is followed by laparoscopic cholecystectomy as a definitive treatment to prevent recurrence of CBDS. Multiple factors play a role in the successful extraction of CBDS. Two broad considerations are the size of stone and bilio-duodenal anatomy. Multiple studies have noted that stone size larger than 15 mm requires fragmentation for successful extraction. Mechanical lithotripsy has been cornerstone for the management of such cases. Besides size of stone, morphology and number of stones, narrow CBD (distal to stone), duodenal diverticulum and altered anatomy due to gastroduodenal surgeries pose a challenge in stone extraction and are collectively called difficult CBDS. Multiple modalities notably extracorporeal shortwave lithotripsy, holmium laser (Ho laser) lithotripsy, and electrohydraulic lithotripsy (EHL) have been studied for the fragmentation of large CBDS. Innovation in cholangioscopy and wider availability of peroral single-operator cholangioscope has brought EHL and Ho laser lithotripsy (LL) at forefront of management of difficult CBD stones. We share the experience of Ho LL for CBDS at a tertiary care hospital in Western India. The data of four patients, successfully managed with single-operator cholangioscopy (SoC)-guided Ho LL for indications ranging from large CBDS to residual large cystic duct stump stone has been discussed. These cases emphasize wider clinical application of SoC-guided Ho-LL beyond the size of the stone. Ho LL has revolutionized the management of difficult biliary stone. The major limitation is cost of care and availability of expertise.