bluuebunny/crossref_metadata_2025_split huggingface dataset:
Simulated Learning Environments as an Interdisciplinary Option for Vocational Training: A Systematic Review
Authors: Navarro-Parra Sandra Liliana , Chiappe Andrés 
Published: December 2023

Background The current scenario of university education calls for training spaces that go beyond direct instruction and knowledge memorization exercises. Such requirement stems from the need to articulate very diverse knowledge and skills that the current professional must develop both in university practice and in their daily work. Given this circumstance, it is imperative to build new teaching experiences that articulate the space of practice and the knowledge that corresponds to it, as scenarios for the interdisciplinary and permanent construction of knowledge. Method To address this issue, a systematic literature review has been conducted to explore research from the last 20 years on the educational implementation of simulations in various professions. After conducting filtering and sampling processes, 101 articles were reviewed, which were read in depth and to which qualitative processes of categorization and frequency analysis were applied. Results The results of the review highlight some advantages and limitations of simulations as learning resources and suggest the importance of their deployment from an interdisciplinary perspective of teaching, especially in health sciences. Conclusion Finally, we reflect on the importance of approaching simulation-based learning from a curricular perspective, which brings learning in higher education closer to the complex realities of the world of work. In addition, the existence of great challenges and transformative effects of its implementation on university educational structures and models is highlighted.
Analysis of Obstructive Sleep Apnoea in Craniofacial Microsomia Based on Polysomnography
Authors: Ma Lun-kun , Zhang Zhi-yong , Tang Xiao-jun , Xu Xi , Feng Shi , Zhao Shan-baga , Liu Bing-yang , Zang Tian-ying , Li Hong-wen , Liu Wei 
Published: December 2023

Objective This study aimed to investigate the prevalence of obstructive sleep apnoea (OSA) in patients with craniofacial microsomia (CFM) through polysomnography (PSG) and the relationship with the severity of CFM. Methods This study reviewed patients of CFM with pre-operative PSG data between January 2005 and September 2023. Patients were grouped according to the Pruzansky-Kaban classification. OSA was diagnosed and severity was assessed by the obstructive apnea-hypopnea index. The Pediatric Sleep Questionnaire was used to investigate OSA-related signs and symptoms. The χ 2 test and Fisher's exact test were used to compare between groups. Univariate logistic regression was used to identify risk factors associated with OSA. A p-value less than 0.05 was considered statistically significant. Results A total of 121 patients with CFM were included in the study with 3 bilateral and 118 unilateral patients. In total, 86 patients (71.07%) were diagnosed with OSA. The prevalence of OSA in type IIa, type IIb and type III was 72.97%, 78.33%, and 47.62%. There was no statistically significant difference in the prevalence of OSA between type IIa and type IIb ( p > .05). The difference in the prevalence of OSA between type III and type II was statistically significant ( p < .05). Snoring was the most common symptom among the patients of CFM with OSA. Conclusions Patients with CFM have a higher incidence of OSA based on PSG in type II and type III patients. The incidence of OSA did not correlate positively with the severity of CFM, with type III patients having certain particularities.
Healthcare Professionals’ Knowledge, Attitude and Practice of Infection Prevention in Southwest Ethiopia
Authors: Yosef Tewodros 
Published: December 2023

Introduction: Infection prevention (IP) is a practical and scientifically supported technique to prevent avoidable infections. The effectiveness of IP techniques applied will depend on the knowledge, attitudes, and behaviors of healthcare professionals. Objective: This study aimed to assess the knowledge, attitude, and practice (KAP) of IP and its associated factors among healthcare professionals at Mizan-Tepi University Teaching Hospital (MTUTH) in southwest Ethiopia. Methods: A cross-sectional survey was conducted from September 1 and 15, 2021 among 196 healthcare professionals at MTUTH in south-west Ethiopia. The knowledge, attitude and practice outcome variables were measured using 13, 13, and 12 questions respectively. A logistic regression analysis was used. The level of significance was declared at a P < .05. Results: The level of good knowledge, favorable attitude, and good practice of IP were 71.9%, 63.8%, and 53.6% respectively. Being a GP/specialist [adjusted odds ratio (aOR) = 10.6, 95% CI (2.13-52.9)] and the presence of an IP manual at work [aOR = 3.43, 95% CI (1.33-8.82)] were factors connected with good IP knowledge. The presence of sufficient PPE in the work area [aOR = 2.73, 95% CI (1.36-5.50)] and IP training [aOR = 3.05, 95% CI (1.28-7.29)] were factors associated with a favorable attitude toward IP. Good IP practice was linked to having enough personal protective equipment (PPE) in the workplace [aOR = 3.63, 95% CI (1.71-7.72)] and having good IP knowledge [aOR = 3.08, 95% CI (1.39-6.86)]. Conclusion: The level of KAP of IP among study participants was poor. The provision of adequate PPE, IP manuals and in-service training will help to improve the KAP of healthcare professionals toward IP. Therefore, the hospital management authority and other concerned stakeholders like local NGOs and regional health bureau should provide consistent support to the health professionals in terms of training, resources, and infrastructure to improve and integrate universal precaution in everyday services.
Setting individualised goals for people living with dementia and their family carers: A systematic review of goal-setting outcome measures and their psychometric properties
Authors: Budgett Jessica , Sommerlad Andrew , Kupeli Nuriye , Zabihi Sedigheh , Olsen Anna , Cooper Claudia 
Published: December 2023

Background Individualised goal-setting outcome measures can be a useful way of reflecting people living with dementia and family carers’ differing priorities regarding quality-of-life domains in the highly heterogeneous symptomatology of the disease. Evaluating goal-setting measures is challenging, and there is limited evidence for their psychometric properties. Aim (1) To describe what goal-setting outcomes have been used in this population; (2) To evaluate their validity, reliability, and feasibility in RCTs. Method We systematically reviewed studies that utilised goal-setting outcome measures for people living dementia or their family carers. We adapted a risk of bias and quality rating system based on the COSMIN guidelines to evaluate the measurement properties of outcomes when used within RCTs. Results Thirty studies meeting inclusion criteria used four different goal-setting outcome measures: Goal Attainment Scaling (GAS), Bangor Goal Setting Interview (BGSI), Canadian Occupational Performance Measure (COPM) and Individually Prioritized Problems Assessment (IPPA); other papers have reported study-specific goal-setting attainment systems. Only GAS has been used as an outcome over periods greater than 9 months (up to a year). Within RCTs there was moderate quality evidence for sufficient content validity and construct validity for GAS, COPM and the BGSI. Reliability was only assessed in one RCT (using BGSI); in which two raters reviewed interview transcripts to rate goals with excellent inter-rater reliability. Feasibility was reported as good across the measures with a low level of missing data. Conclusion We found moderate quality evidence for good content and construct validity and feasibility of GAS, BGSI and COPM. While more evidence of reliability of these measures is needed, we recommend that future trials consider using individualised goal setting measures, to report the effect of interventions on outcomes that are most meaningful to people living with dementia and their families.
Physical activity in idiopathic pulmonary fibrosis: Longitudinal change and minimal clinically important difference
Authors: Shingai Kazuya , Matsuda Toshiaki , Kondoh Yasuhiro , Kimura Tomoki , Kataoka Kensuke , Yokoyama Toshiki , Yamano Yasuhiko , Ogawa Tomoya , Watanabe Fumiko , Hirasawa Jun , Reid W. Darlene , Kozu Ryo 
Published: December 2023

Background and objective Reference values of physical activity to interpret longitudinal changes are not available in patients with idiopathic pulmonary fibrosis (IPF). This study aimed to define the minimal clinical important difference (MCID) of longitudinal changes in physical activity in patients with IPF. Methods Using accelerometry, physical activity (steps per day) was measured and compared at baseline and 6-months follow-up in patients with IPF. We calculated MCID of daily step count using multiple anchor-based and distribution-based methods. Forced vital capacity and 6-minute walk distance were applied as anchors in anchor-based methods. Effect size and standard error of measurement were used to calculate MCID in distribution-based methods. Results One-hundred and five patients were enrolled in the study (mean age: 68.5 ± 7.5 years). Step count significantly decreased from baseline to 6-months follow-up (−461 ± 2402, p = .031). MCID calculated by anchor-based and distribution-based methods ranged from 570-1358 steps. Conclusion Daily step count significantly declined over 6-months in patients with IPF. MCID calculated by multiple anchor-based and distribution-based methods was 570 to 1358 steps/day. These findings contribute to interpretation of the longitudinal changes of physical activity that will assist its use as a clinical and research outcome in patients with IPF.
A Process Evaluation of a Fall Prevention Intervention Using the RE-AIM Framework
Authors: Somerville Emily , Yan Yan , Stark Susan 
Published: December 2023

Background: Home hazard removal programs are effective in reducing falls among older adults, but delivery in the United States is limited. Objectives: We completed a process evaluation of the Home Hazard Removal Program (HARP), an intervention delivered by occupational therapists. Methods: Using the RE-AIM framework (reach, effectiveness, adoption, implementation, maintenance), we examined outcomes using descriptive statistics and frequency distribution. We examined differences between covariates using Pearson correlation coefficients and two-sample t tests. Results: 79.1% of eligible older adults participated (reach); they experienced a 38% reduction in fall rates (effectiveness). Ninety percent of recommended strategies were completed (adoption), 99% of intervention elements were delivered (implementation), and 91% of strategies were still used at 12 months (maintenance). Participants received an average of 258.6 minutes of occupational therapy. An average of US$765.83 was spent per participant to deliver the intervention. Conclusions: HARP has good reach, effectiveness, adherence, implementation, and maintenance and is a low-cost intervention.
Focus Group With Parents of Children With Mental and Behavioral Health Concerns
Authors: Stevenson Brittney , Bolton Tiffany , Dare Nathaniel 
Published: December 2023

Background: Scholars from multiple fields have shown that parents raising a child with mental and behavioral health concerns (MBHC) need additional support. We need parents to self-identify necessary supports as a basis for intervention planning. Objectives: In this study, we examined what parents say they need from professionals to support their families. Methodology: Occupational therapy faculty and students employed a strengths-based coaching approach to conduct a focus group with five parents. We conducted qualitative thematic analysis and used inductive coding to identify themes related to unmet self-identified needs of families. We refined themes through an iterative process and achieved 93% agreement after three rounds of coding. Results: Four themes emerged from the transcript analysis: External Control, Internal Competence, Relating to Others, and Role of Self-Care. Conclusion: Professionals must consider the unique needs identified by parents who have children with MBHC when planning interventions within our education and health care systems.
Endovascular therapy versus medical management for mild strokes due to medium and distal vessel occlusions
Authors: Nedelcu Simona , Gulati Akanksha , Henninger Nils 
Published: December 2023

Background Distal and medium vessel occlusion (DMVO) strokes account for up to 40% of all acute ischemic strokes, many of which have a low initial deficit severity. Increasingly, endovascular treatment (EVT) is considered for these patients. However, there is a paucity of data comparing potential safety and efficacy of EVT versus best medical management (BMT) in these patients, particularly when presenting with mild symptoms. Methods We retrospectively analyzed consecutive DMVO patients with NIHSS ≤6 who presented between January 2018 and December 2021 within 24 h from last seen well. We compared early and late clinical outcomes, as well as safety outcomes using multivariable linear and logistic regression analyses to determine whether EVT was independently associated with the outcomes of interest. Results We included 80 subjects that fulfilled our study criteria (n = 41 BMT and n = 39 EVT). On adjusted analyses, when comparing EVT and BMT groups, there was no statistical difference in the NIHSS at discharge (Coefficient = −0.6, 95%-CI = −3.45–2.26, p = 0.678) or in the modified Rankin scale (mRS) at discharge (Coefficient = 0.37, 95%-CI = −0.52–1.25, p = 0.408). Furthermore, there was no difference in the 3-month mRS defined as good (mRS 0–2) (OR = 0.56, 95%-CI = 0.17–1.83, p = 0.341) or excellent (mRS 0–1) (OR = 0.45, 95%-CI = 0.15–1.34, p = 0.152). Finally, there was no difference in the incidence of all-type parenchymal hemorrhage (OR = 0.9, 95%-CI = 0.22–3.62, p = 0.879). Conclusions We found that among DMVO patients with low admission NIHSS treatment with EVT versus BMT was associated with similar outcomes. Larger prospective studies are required to confirm these findings.
Comparative cost analysis of endovascular and open approaches for elective treatment of middle cerebral artery aneurysms
Authors: Lauzier David C , Cler Samuel J , Srienc Anja I , Patel Bhuvic , Pierce Andrew , Gagne Jason , Vellimana Ananth K , Chatterjee Arindam R , Kansagra Akash P , Moran Christopher J , Zipfel Gregory J , Osbun Joshua W 
Published: December 2023

Background Intracranial aneurysms of the middle cerebral artery can be treated using several open surgical and endovascular approaches. Given the growing evidence of clinical equipoise between these various treatment strategies, there is a need to assess the costs associated with each. Methods Cost of aneurysm treatment was divided into two categories for comparison. “Initial cost” comprised the total in-hospital expenses for initial aneurysm treatment and “total cost” comprised initial aneurysm treatment and all expenses relating to readmission due to treatment-related complications, prescribed catheter angiograms for monitoring of treatment stability, and any retreatments needed for a given aneurysm. The open surgical group was subdivided into a pterional approach group and a lateral supraorbital (LSO) approach group for. Results Median initial cost was $37,152 (IQR $31,318–$44,947) for aneurysms treated with the pterional approach, $29,452 (IQR $27,779–$32,826) for aneurysms treated with the LSO approach, and $19,587 (IQR $14,125–$30,521) for aneurysms treated with endovascular approaches. The median total cost was $39,737 (IQR $33,891–$62,259) for aneurysms treated with the pterional approach, $31,785 (IQR $29,513–$41,099) for aneurysms treated with the LSO approach, and $24,578 (IQR $18,977–$34,547) for aneurysms treated with endovascular approaches. Analysis of variance test demonstrated variance across groups for both initial and total cost ( p = 0.004, p = 0.008, respectively). In our subsequent analysis, initial cost and total cost were higher in the pterional group than the endovascular group ( p = 0.003 and p = 0.006, respectively). Conclusions Endovascular treatment of elective aneurysms has a significantly lower cost than open surgical treatment with the pterional approach, but not with the LSO approach. For aneurysms not amenable to endovascular treatment, a minimally invasive LSO approach carries a lower cost burden than a pterional approach.
Some key questions: Pregnancy intention screening by community health workers
Authors: St Clair Stephanie , Dearden Susan , Clark Lauren , Simonsen Sara E 
Published: December 2023

Background: Unintended pregnancy contributes to a high burden of maternal and fetal morbidity in the United States, and pregnancy intention screening offers a key strategy to improve preconception health and reproductive health equity. The One Key Question© is a pregnancy intention screening tool that asks a single question, “Would you like to become pregnant in the next year?” to all reproductive-age women. This study explored the perspectives of community health workers on using One Key Question in community-based settings. Objectives: This study aimed to identify barriers and facilitators to the use of the One Key Question pregnancy intention screening tool by community health workers who serve reproductive-age women in Salt Lake City, Utah. Design: Using reproductive justice as a guiding conceptual framework, this study employed a qualitative descriptive design. Participants were asked to identify barriers and facilitators to the One Key Question, with open-ended discussion to explore community health workers’ knowledge and perceptions about pregnancy intention screening. Methods: We conducted focus groups with 43 community health workers in Salt Lake City, Utah, from December 2017 through January 2018. Participants were trained on the One Key Question algorithm and asked to identify barriers and facilitators to implementation. All focus groups occurred face-to-face in community settings and used a semi-structured facilitation guide developed by the study Principal Investigator with input from community partners. Results: Pregnancy intention screening is perceived positively by community health workers. Barriers identified include traditional cultural beliefs about modesty and sex, lack of trust in health care providers, and female bias in the One Key Question algorithm. Facilitators include the simplicity of the One Key Question algorithm and the flexibility of One Key Question responses. Conclusion: One Key Question is an effective pregnancy intention screening tool in primary care settings but is limited in its capacity to reach those outside the health system. Community-based pregnancy intention screening offers an alternative avenue for implementation of One Key Question that could address many of these barriers and reduce disparities for underserved populations.
Unveiling the Hungarian landscape of laboratory and clinical management capacities for invasive fungal infections: navigating the frontlines against fungal menaces
Authors: Kovács Renátó , Majoros László , Stemler Jannik , Cornely Oliver Andreas , Salmanton-García Jon 
Published: December 2023

Background: Antifungal diagnostic capacity has been documented in various countries, there is a lack of comprehensive research on clinical mycology diagnostics and treatment in Hungary. Methods: We conducted an online survey encompassing questions that explored various aspects of the mycology diagnostic and antifungal therapy-related information. The survey aimed to gather details about institutional profiles, perceptions of invasive fungal infections (IFIs), and access to microscopy, culture, serology, antigen detection, molecular testing, and therapeutic drug monitoring. Results: As of May 2023, a total of 17 institutions responded to the questionnaire. Seven participants categorized the institutional incidence of IFI as ‘very low’, four as ‘low’, and six as ‘mild’. The majority of centers identified Candida spp. (94%) and Aspergillus spp. (82%) as the most prevalent fungal pathogens. Nearly half of the laboratories (47%) reported using matrix-assisted laser desorption/ionization-time of flight mass spectrometry for identification. All institutions had access to microscopy and culture-based diagnostic approaches. A significant number of centers had access to antigen detection (71%) and various molecular assays (59%). Regarding antifungal agents, all reporting sites used at least one triazole, with voriconazole (77%) being the most common mold-active azole. Furthermore, 71% of the centers applied at least one formulation of amphotericin B, and 65% to one echinocandin. However, only 18% of the centers used 5-flucytosine. Conclusion: Resource availability for diagnosing and treating IFI in Hungary varies across hospitals based on location. Surveys help identify gaps and limitations in this area. To address these challenges, interregional cooperation within Hungary could be a facilitating strategy.
Itaipu Binational Dam: A Quantitative Analysis of the Economic and Social Impacts in Paraguay. Successful or not?
Authors: Fruet Vicente , Campos Daniel , Caridad Lorena 
Published: December 2023

The Itaipu Binational dam is a giant hydroelectric project situated on the Parana River, which began its construction in 1973 and was completed in 1983. It was undertaken by Brazil and Paraguay, two countries with enormous geopolitical and economic differences. With 14,000 MWh of installed power, it is the second largest hydroelectric dam in the world. Both countries are partners in this project, but the socioeconomic results have not been as expected. In this regard, although Paraguay’s GDP per capita, between 1983 and 2020, increased by 341%, Itaipu did not represent a true economic development engine for Paraguay. On the other hand, it had serious negative impacts especially on social, demographic, and environmental aspects. A structural equations model (SEM) was designed, in its Path Analysis modality, which includes 10 variables: 3 exogenous (Royalties from Itaipu, Electric power exports, and External debt) and 7 endogenous (GDP per capita, Proportion of agricultural sector in GDP, Proportion of service sector in GDP, Population with needs unsatisfied, Housing deficit, Changes of land use, and CO2 emissions). The model exposes an adequate simulation range, and the results show a high degree of goodness of fit, using different indices (CMIN, FMIN, CFI, and RMSEA). The corresponding tests upon the model validate the hypotheses raised. JEL Classification: O13, O54, H54, H60, F34, C18