bluuebunny/crossref_metadata_2025_split huggingface dataset:
Developing online communication training to request donation for vascularized composite allotransplantation (VCA): improving performance to match new US organ donation targets
Authors: Siminoff Laura A. , Alolod Gerard P. , McGregor Hayley , Hasz Richard D. , Mulvania Patricia A. , Barker Laura K. , Gardiner Heather M. 
Published: January 2024

Abstract
Background
Approaching families of dying or newly deceased patients to donate organs requires specialized knowledge and a mastery of relational communication. As the transplantation field has progressed, Donation Professionals (DPs) are also leading conversations with family decision makers (FDMs) about the donation of uncommon anatomical gifts, such as face, hands, genitalia, referred to as Vascularized Composite Allotransplants (VCA) without much training or experience. To address the need for training, we adapted and beta tested an evidenced-based communication training program for donation discussions to VCA requests. The overarching goal of Communicating Effectively about Donation for Vascularized Composite Allotransplantation (CEaD-VCA) is to increase the number of VCA authorizations and to improve the socioemotional outcomes of FDMs.

Methods
We developed CEaD-VCA, an online, on-demand training program based on the previously tested, evidenced-based communication skills training program designed to train DPs to have conversations about solid organ donation. The training was modified utilizing data from a national telephone survey with DPs and results of 6 focus groups conducted with members of the general public. The survey and focus groups assessed knowledge, attitudes, and barriers to VCA donation. The training was shaped by a partnership with a leading industry partner, the Gift of Life Institute.™

Results
Using the results as a guide, the existing CEaD training program, consisting of interactive eLearning modules, was adapted to include technical information about VCA, foundational communication skills, and two interactive example VCA donation request scenarios to facilitate active learning. Forty-two DPs from two partner Organ Procurement Organizations (OPOs) participated in the beta test of CEaD-VCA. Pre- and post-test surveys assessed the impact of the training.

Conclusions
The training was scored highly by DPs in effectiveness and ease of use. This project created a standardized, accessible, and comprehensive training for DPs to communicate about VCA donation. CEaD-VCA is an example of how to develop a communication skills training for difficult conversations utilizing input from stakeholders, guided by communication theory. It also demonstrates how gaps in communication skills during medical education can be filled utilizing advanced online Learning Management Systems. The training specifically addresses new CMS rules concerning OPO performance metrics.
Implementation of a coaching training for enhancing empathy and emotional intelligence skills in health science students: a prospective study
Authors: Aguilar-Ferrándiz María Encarnación , Toledano-Moreno Sonia , Casas-Barragán Antonio , Albornoz-Cabello Manuel , Tapia-Haro Rosa María , Correa-Rodríguez María 
Published: January 2024

Abstract
Background
Empathy and emotional intelligence are core competencies in the educational curriculum of health science students, both play a significant role in teamwork relationships and in attention patient’s cares; so innovative strategies to enhance these emotional skills are required. We prospectively tested an academic coaching program for improving empathy and emotional intelligence in students of health sciences degrees.

Methods
A prospectively single arm intervention study was performed in undergraduate students of nursing, physiotherapy and occupational therapy of the Faculty of Health Sciences from the University of Granada (Spain). The three groups of students participated in nine sessions of coaching, which included a training program to manage patient’s priorities and communication, adherence to treatment, motivation and satisfaction. Survey data included the Cognitive and Affective Empathy Test (TECA), the Trait Meta-Mood Scale (TMMS-24) and the Interpersonal Reactivity Index (IRI) which were assessed at baseline and post-intervention.

Results
A total of 93 students of 259 (mean age of 21.6 ± 3.2 years) participated in the study and completed the sessions of coaching/surveys. After the intervention, we observed an improvement in the cognitive dimension of empathy among nursing students (p = 0.035) and in the affective dimension of empathy in physiotherapy students (p = 0.044). In addition, an increase on perceived emotional intelligence among students was achieved only in nursing/physiotherapy groups (p ≤ 0.048). Finally, slight improvements were founded in the dimensions “Perspective-Taking” and “Personal Distress” of the occupational therapy group (p ≤ 0.031). No significant differences were found for the rest of variables of TECA (p ≥ 0.052), TMMS-24 (p ≥ 0.06) and IRI (p ≥ 0.12).

Conclusions
This study shows that an academic coaching intervention with students from health sciences degrees improves their empathy skills and self-perceived emotional intelligence. The current findings can be used to determine more effective approaches to implementing academic coaching interventions based in better designs as clinical trial studies.
What about the fundamentals of nursing—its interventions and its continuity among older people in need of home- or facility-based care: a scoping review
Authors: Nordaunet O. M. , Gjevjon E. R. , Olsson C. , Aagaard H. , Borglin G. 
Published: January 2024

AbstractAimThis scoping review investigated and descriptively summarised previous research about fundamental nursing, its focus (what care needs are described, how is it described and by whom is it described), continuity of care (is it described in relation to fundamental nursing) and possible nursing interventions or activities targeting older people’s fundamentals of care needs in home- or facility-based care.MethodsThis scoping review was carried out following the steps of Arksey and O’Malley’s methodology and PRISMA-ScR reporting guidelines. Searches were conducted in PubMed via NIH, CINAHL via EBSCO and PsycInfo via ProQuest for the time period between January 2002 and May 2023.ResultsForty-two studies were included where the majority had been conducted in a facility-based care context. Nutrition—or rather nutritional care activities targeting eating and drinking—was the most frequently described fundamental care needs addressed. After this came personal care such as cleansing, dressing, oral care, skin, and foot care. Few studies addressed more than one fundamental care need at the time. The nursing staff described fundamental nursing as complex, comprehensive, and demanding. Older people and relatives described a gap between the fundamental nursing provided and their perceived need for support. Less attention was given to older peoples relational and psychosocial needs. Identified nursing interventions mainly targeted physical care needs. Our findings also implied that interventions focusing on fundamental nursing were described as feasible in practice with favourable or moderate results, while long-term effects were difficult to detect. No studies were identified focusing on fundamental nursing in relation to outcomes such as continuity of care.ConclusionFundamental nursing was mainly described in relation to physical care needs, which were essentially conducted within facility-based care contexts. Interventions and activities primarily focused on one fundamental need at the time, mainly within the physical domain. No nursing interventions were identified focusing on relational and psychosocial needs where continuity of care can be viewed as a relevant outcome. Such limited focus are especially concerning as research has highlighted the importance of that older people with complex care needs can benefit from a holistic and person-centred approach i.e. fundamental nursing.Trial registrationOpen Science Frameworkhttps://doi.org/10.17605/OSF.IO/XJ39EProtocol:http://dx.doi.org/10.1136/bmjopen-2022-069798
Climates and associated factors for evidence-based practice implementation among nurses: a cross-sectional study
Authors: Zhang Xinyue , Peng Mengting , He Mei , Du Meijie , Jiang Mengyao , Cui Mengying , Cai Yue , Yan Qi , Wang Ying 
Published: January 2024

Abstract
Background
The organizational climate that fosters and supports the implementation of evidence is a key factor influencing the effective implementation of evidence-based practice (EBP). Nurses, being the largest group of medical staff, play a crucial role in EBP implementation. The perception of the climate for EBP implementation among nurses in their organizations is unknown, especially among Chinese nurses.

Aims
To clarify the implementation climate of EBP among Chinese nurses and identify the factors associated with the implementation and development of evidence-based nursing practices.

Methods
This study employed a descriptive cross-sectional study design. From March 2023 to April 2023, a sample of nurses (n = 1260) from two Tertiary care hospitals in central China were selected and surveyed by self-designed social-demographic questionnaire and Implementation Climate Scale. Multiple linear stepwise regression analysis was conducted to determine the predictors of implementation climate.

Results
The nurses achieved a mean ICS score of 59.10 ± 11.22, with mean scores exceeding 3 points for each sub-dimension and item. In the results of multiple linear regression, income satisfaction, implementation of evidence-based nursing practice project(s) within the unit, experience of evidence-based nursing practice during working life, and specific training or courses in evidence-based nursing practice were predictors of ICS. Of these, income satisfaction was the most significant predictor. These factors could explain 17.5% of the total variance in implementation climate.

Conclusion
The climate for implementing EBP in Chinese nursing organizations was relatively strong. Nursing managers can enhance the climate for implementing EBP in their organizations by actively improving salary and enhancing EBP-related trainings and practices.

Relevance to clinical practice
Understanding nurses’ perceptions of the EBP implementation climate in their organizations can help to identify specific barriers and facilitators to the development of EBP and facilitate its successful implementation.

Patient or public contribution
Clinical nurses were involved in data collection and completed the questionnaires on EBP implementation climate.
Cost of implementing CAR-T activity and managing CAR-T patients: an exploratory study
Authors: Cavallo Maria Caterina , Cavazza Marianna , Bonifazi Francesca , Casadei Beatrice , Cutini Ilaria , Tonietti Barbara , Saccardi Riccardo , Zinzani PierLuigi , Jommi Claudio 
Published: January 2024

Abstract
Background
Chimeric antigen receptor T cells (CAR-T) represent an innovation but raise issues for healthcare payers because of the uncertainty on impact at market launch, high cost and important organisational impact. The literature has focused on their assessment, appraisal and market access solutions. No evidence on the costs sustained to implement CAR-T is available and a few studies reported the cost of the CAR-T clinical pathway, including the activities that are remunerated through inpatient or outpatient fee-for-service/episode. This paper aims at filling the information gap, assessing the cost of implementing CAR-T activity and the full cost of managing the CAR-T clinical pathway.

Methods
Cost analysis relied on the Activity Based Costing approach, which was applied to two Italian healthcare organisations, both CAR-T Centres authorized by the regional governments with a minimum of 20 patients treated with the first two CAR-T therapies launched on the market.

Results
The cost of implementing CAR-T was estimated at €1.31 million (calculated for one of the organizations with complete data). Most of these costs (77%) were generated by quality assurance activity. The mean cost per patient entering the CAR-T pathway (59 and 27) and surviving at follow-up (21 and 5) ranges from €48K to €57K and from €96K to €106K, respectively. Fees for hospitalization and infusion of gene therapy accounts for more than 70% of these costs. The actual hospitalisation cost varies greatly across patients and is in general lower than the fee-for-episode paid by the region to the hospital.

Conclusions
Despite its limitations (exploratory nature; the time spent by staff on activities which are not remunerated through fees was estimated through interviews with the CAR-T coordinators; cost items are not fully comparable), this research highlighted the relevant organisational and economic impact of CAR-T and provided important insights for policy makers and healthcare managers: the necessity to invest resources in CAR-T implementation; the need for assessing activities which are not remunerated through fees for service / episode; the opportunity to shift from fee-for-episode / service to bundled payments for CAR-T clinical pathway.
Costs and scale-up costs of community-based Oral HIV Self-Testing for female sex workers and men who have sex with men in Jakarta and Bali, Indonesia
Authors: Putri Wayan Citra Wulan Sucipta , Ulandari Luh Putu Sinthya , Valerie Ivy Cerelia , Prabowo Bagus Rahmat , Hardiawan Donny , Sihaloho Estro Dariatno , Relaksana Riki , Wardhani Brigitta Dhyah Kunthi , Harjana Ngakan Putu Anom , Nugrahani Nur Wulan , Siregar Adiatma Yudistira Manogar , Januraga Pande Putu 
Published: January 2024

Abstract
Background
The proportion of individuals who know their HIV status in Indonesia (66% in 2021) still remains far below the first 95% of UNAIDS 2030 target and were much lower in certain Key Populations (KPs) particularly Female Sex Workers (FSW) and Male having Sex with Male (MSM). Indonesia has implemented Oral HIV Self-testing (oral HIVST) through Community-based screening (HIV CBS) in addition to other testing modalities aimed at hard-to-reach KPs, but the implementation cost is still not analysed. This study provides the cost and scale up cost estimation of HIV CBS in Jakarta and Bali, Indonesia.

Methods
We estimated the societal cost of HIV CBS that was implemented through NGOs. The HIV CBS’s total and unit cost were estimated from HIV CBS outcome, health care system cost and client costs. Cost data were presented by input, KPs and areas. Health care system cost inputs were categorized into capital and recurrent cost both in start-up and implementation phases. Client costs were categorized as direct medical, direct non-medical cost and indirect costs. Sensitivity and scenario analyses for scale up were performed.

Results
In total, 5350 and 1401 oral HIVST test kits were distributed for HIV CBS in Jakarta and Bali, respectively. Average total client cost for HIV CBS Self testing process ranged from US$1.9 to US$12.2 for 1 day and US$2.02 to US$33.61 for 2 days process. Average total client cost for HIV CBS confirmation test ranged from US$2.83 to US$18.01. From Societal Perspective, the cost per HIVST kit distributed were US$98.59 and US$40.37 for FSW and MSM in Jakarta andUS$35.26 and US$43.31 for FSW and MSM in Bali.

Conclusions
CBS using oral HIVST approach varied widely along with characteristics of HIV CBS volume and cost. HIV CBS was most costly among FSW in Jakarta, attributed to the low HIV CBS volume, high personnel salary cost and client cost. Future approaches to minimize cost and/or maximize testing coverage could include unpaid community led distribution to reach end-users, integrating HIVST into routine clinical services via direct or secondary distribution and using social media network.
Feasibility of early digital health rehabilitation after cardiac surgery in the elderly: a qualitative study
Authors: Toft Bente Skovsby , Rodkjær Lotte Ørneborg , Sørensen Lotte , Saugbjerg Marianne Rørbæk , Bekker Hilary Louise , Modrau Ivy Susanne 
Published: January 2024

Abstract
Background
Increasing numbers of elderly patients experience prolonged decreased functional capacity and impaired quality of life after seemingly successful cardiac surgery. After discharge from hospital, these patients experience a substantial gap in care until centre-based cardiac rehabilitation commences. They may benefit from immediate coaching by means of mobile health technology to overcome psychological and physiological barriers to physical activity. The aim of this study was to explore the usability, acceptability, and relevance of a mobile health application designed to support remote exercise-based cardiac rehabilitation of elderly patients early after cardiac surgery from the perspective of patients, their relatives, and physiotherapists.

Methods
We adapted a home-based mobile health application for use by elderly patients early after cardiac surgery. Semi-structured dyadic interviews were conducted with a purposive sample of patients (n = 9), their spouses (n = 5), and physiotherapists (n = 2) following two weeks of the intervention. The transcribed interviews were analysed thematically.

Results
Three themes were identified: 1) creating an individual fit by tailoring the intervention; 2) prioritizing communication and collaboration; and 3) interacting with the mobile health application. Overall, the findings indicate that the mobile health intervention has the potential to promote engagement, responsibility, and motivation among elderly patients to exercise early after surgery. However, the intervention can also be a burden on patients and their relatives when roles and responsibilities are unclear.

Conclusion
The mobile health intervention showed potential to bridge the intervention gap after cardiac surgery, as well as in fostering engagement, responsibility, and motivation for physical activity among elderly individuals. Nevertheless, our findings emphasize the necessity of tailoring the intervention to accommodate individual vulnerabilities and capabilities. The intervention may be improved by addressing a number of organizational and communicational issues. Adaptions should be made according to the barriers and facilitators identified in this study prior to testing the effectiveness of the intervention on a larger scale. Future research should focus on the implementation of a hybrid design that supplements or complements face-to-face and centre-based cardiac rehabilitation.

Trial registration
Danish Data Protection Agency, Central Denmark Region (1–16-02–193-22, 11 August 2022).
Blood glucose and lipids are associated with sarcoidosis: findings from observational and mendelian randomization studies
Authors: Zhan Yuan , Zhang Jiaheng , Yang Ruonan , Deng Zhesong , Chen Shanshan , Feng Jie , Wu Jixing , Huang Qian , Gu Yiya , Xie Jungang 
Published: January 2024

Abstract
Background
Several researches have demonstrated that patients with sarcoidosis accompanied with the abnormality in blood glucose and/or lipids, however, the causal relationship between them remains uncertain. To elucidate the potential association and causality of blood glucose and lipids with sarcoidosis, we conducted a propensity score matching (PSM)-based observational study combined with mendelian randomization (MR) analysis.

Methods
All subjects in this study were retrospectively collected from Tongji Hospital during 2010 and 2023. 1:1 PSM was employed to control the potential confounders as appropriate. Univariable and multivariable logistic regression analyses were performed to estimate the associations of sarcoidosis with fasting glucose, high density lipoprotein cholesterol (HDLC), low density lipoprotein cholesterol (LDLC), total cholesterol (TC), and total triglyceride (TG). The further subtype analysis was also conducted. Afterwards, a bidirectional MR analysis based on public data deeply explored the causality among the 5 candidate traits and sarcoidosis, for which the inverse-variance weighted (IVW) method was utilized as the main inferring approach.

Results
In the observational study, a total number of 756 subjects were enrolled, with 162 sarcoidosis patients and 594 non-sarcoidosis participants, while 160 pairs of subjects were matched after PSM. Multivariable logistic regression analysis indicated that HDLC (OR: 0.151; 95% CI: 0.056–0.408; P < 0.001) and TC (OR: 3.942; 95% CI: 2.644–5.877; P < 0.001) were strongly associated with sarcoidosis. Subtype analysis showed that low HDLC was independently correlated to risk of lesions in bronchus and lungs, and mediastinal lymph nodes, while high TC was to cervical lymph nodes. In MR analysis, high fasting glucose, low HDLC, and high TC were identified as the causal factors of sarcoidosis.

Conclusion
HDLC and TC had the potential to influence the risk of sarcoidosis, which could be regarded as predictors and may provide new diagnostic and therapeutic targets for sarcoidosis.
Prognostic implications of systemic immune-inflammation index in myocardial infarction patients with and without diabetes: insights from the NOAFCAMI-SH registry
Authors: Luo Jiachen , Qin Xiaoming , Zhang Xingxu , Zhang Yiwei , Yuan Fang , Shi Wentao , Liu Baoxin , Wei Yidong ,   the NOAFCAMI-SH Registry Investigators
Published: January 2024

Abstract
Background
It is well-known that systemic inflammation plays a crucial role in the pathogenesis and prognosis of acute myocardial infarction (AMI). The systemic immune-inflammation index (SII, platelet × neutrophil/lymphocyte ratio) is a novel index that is used for the characterization of the severity of systemic inflammation. Recent studies have identified the high SII level as an independent predictor of poor outcomes in patients with AMI. We aimed to investigate the prognostic implications of SII in AMI patients with and without diabetes mellitus (DM).

Methods
We included 2111 patients with AMI from February 2014 to March 2018. Multivariable Cox regression analyses were performed to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of all-cause death and cardiovascular (CV) death. Multiple imputation was used for missing covariates.

Results
Of 2111 patients (mean age: 65.2 ± 12.2 years, 77.5% were males) analyzed, 789 (37.4%) had DM. Generalized additive model analyses showed that as the SII increased, the C-reactive protein and peak TnT elevated while the LVEF declined, and these associations were similar in patients with and without DM. During a median of 2.5 years of follow-up, 210 all-cause deaths and 154 CV deaths occurred. When treating the SII as a continuous variable, a higher log-transformed SII was significantly associated with increased all-cause mortality (HR: 1.57, 95%CI: 1.02–2.43) and CV mortality (HR: 1.85, 95%CI 1.12–3.05), and such an association was also significant in the diabetics (HRs and 95%CIs for all-cause death and CV death were 2.90 [1.40–6.01] and 3.28 [1.43–7.57], respectively) while not significant in the nondiabetics (Pinteraction for all-cause death and CV death were 0.019 and 0.049, respectively). Additionally, compared to patients with the lowest tertiles of SII, those with the highest tertiles of SII possessed significantly higher all-cause mortality (HR: 1.82, 95%CI 1.19–2.79) and CV mortality (HR: 1.82, 95%CI 1.19–2.79) after multivariable adjustment, and this relationship remained pronounced in the diabetics (HRs and 95%CIs for all-cause death and CV death were 2.00 [1.13–3.55] and 2.09 [1.10–3.98], respectively) but was not observed in the nondiabetics (HRs and 95%CIs for all-cause death and CV death were 1.21 [0.75–1.97] and 1.60 [0.89–2.90], respectively). Our restricted cubic splines analyses indicated a pronounced linear association between SII and mortality only in diabetics.

Conclusions
In AMI patients with DM, high SII is an independent predictor of poor survival and may be helpful for patient’s risk stratification.