bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prediction of Early Postoperative Pain in Infants Undergoing Primary Cleft Palate Repair
Authors: Frawley Geoff , Wilkes Courtney , Hallett Ben , Chong David 
Published: April 2023

Objective Identification of at risk patients before surgery could facilitate improved clinical communication, care pathways and postoperative pain management Design A retrospective cohort study was performed in all infants who had undergone cleft palate repair. Setting Tertiary Institutional Participants Infants < 36 months of age who underwent primary repair of cleft palate between March 2016 and July 2022 Intervention Requirement for analgesic intervention in the post operative care unit Main outcome measure Adverse perioperative event defined as pain or distress. Secondary outcomes were the incidence of airway obstruction, hypoxemia or unplanned intensive care admission. Results Two hundred and ninety one patients (14.6 months,10.1 kg weight) were included. Cleft distribution included submucous (5.2%), Veau I (23.4%), Veau 2 (38.1%), Veau 3 (24.4%), and Veau 4 (8.9%). Overall 35% of 291 infants undergoing cleft palate repair experienced pain or distress requiring opiate intervention in the first hour after surgery. Infants with a Veau 4 cleft palate had 1.8 times and Veau 2 cleft palate had 1.5 times the risk of postoperative pain compared to infants with Veau 1 cleft palate (relative risk 1.82, 95%CI 1.04−3.18 and 1.49, 95%CI 0.96−2.32 respectively). The use of bilateral above elbow arm splints was significantly associated with postoperative pain or distress (odds ratio 2.23, 95%CI 1.01−5.16). Conclusions Post operative pain requiring intervention in PACU is common despite adequate intraoperative multimodal analgesia, local anaesthesia infiltration and postoperative opiate infusions. Infants undergoing soft palate alone or submucous palate repair may require less perioperative opiates.
The outcomes of postoperative eye patching after cataract surgery in patients with Fuchs’ endothelial corneal dystrophy
Authors: Gazit Inbal , Dubinsky-Pertzov Biana , Or Lior , Pras Eran , Einan-Lifshitz Adi 
Published: April 2023

Purpose To investigate the influence of post-operative eye patching on corneal thickness, endothelial cells’ loss and visual acuity in patients diagnosed Fuchs’ endothelial corneal dystrophy (FECD). Setting Public healthcare centre, Shamir Medical Centre, Israel. Methods This randomized controlled trial included patients with FECD undergoing routine cataract surgery in a public medical centre. Patients were randomly assigned to 2 groups: the eye undergoing surgery was covered with a patch for 24 h in the first group (patched group), and a plastic shield was used in the second (non-patched group). Both groups received a unique dose of a local steroid and antibiotic post-operatively. The eyes were examined pre-operatively, and on days 1, 7 and 30 post-surgery . Examination included: best corrected visual acuity (BCVA), comeplete slit lamp examination, intra ocular pressure (IOP), anterior chamber depth (ACD), central corneal thickness (CCT) using the IOL Master 700 (Zeiss, Germany) and endothelial cell density (ECD) using Specular microscopy. Cumulative dissipated energy (CDE) and operation time were recorded for all cases. Results The study included 46 eyes of 46 patients diagnosed with FECD. Twenty-three eyes in the patched group, and 23 eyes in the non-patched group . Thirty days post-operatively the CCT in the patched group decreased by 60 ± 38 mµ (9%) compared to 92 ± 80 mµ (13.5%) in the non- patched group (p = 0.04). Seven days post-operatively the CCT in the patched group decreased by 31 ± 35 mµ (5%) compared to 58 ± 76 (8%) in the non-patched group, but this difference did not reach statistical significance (p = 0.081). There was no statistically significant difference in endothelial cells loss as well as BCVA at 1, 7 and 30 days post-operatively between the study groups. Conclusions Avoiding eye patch post-operatively after cataract surgery in patients with FECD results in better corneal clarity recovery and reduced corneal edema one month post-operatively. Visual acuity and endothelial cell's loss were not influenced by patching.
Parent reported barriers and facilitators to support services for autistic children in Aotearoa New Zealand
Authors: Wallace-Watkin Carla , Sigafoos Jeff , Woods Lisa , Waddington Hannah 
Published: April 2023

We surveyed New Zealand parents of autistic children to identify their perceived barriers and facilitators to accessing support services, including the influence of a family’s level of financial resourcing. A total of 173 completed surveys were analysed. Service pathway factors were the greatest barrier experienced by participants, whereas facilitators related to providers tended to be most helpful. Lower family income was associated with a higher number of reported barriers. Both lower family income and having a child who identified their gender as non-binary were predictive of rating the extent of barriers higher. Parents of younger or of non-speaking autistic children on average reported a greater number of facilitators. Implications of these results for support service delivery and potential areas for future research are discussed.Lay abstractParents might have problems in getting support services for their autistic child due to certain barriers. However, there might also be things that can ease or facilitate parents’ access to support services. In this study, New Zealand parents were asked about their experiences in getting support services for their autistic child. We also looked at differences in reported barriers and facilitators based on several demographic factors with a focus on family level of financial resourcing. A total of 173 parents completed a survey. The results suggested that parents experienced several barriers, particularly related to service pathways. Facilitators were also experienced, predominantly related to providers. Financial resourcing predicted the number of parent-reported barriers. Both lower level of family financial resourcing and having a non-binary child predicted parents’ rating of the extent of barriers. Child age and level of speech were predictors for reports of experiencing a higher number of facilitators, with parents of younger children or of non-speaking autistic children reporting a greater number of facilitators. We discuss how these results may be useful to support service delivery and identify areas for future research.
Outreach to farmworkers before and during the COVID-19 pandemic
Authors: Saldanha Kennedy 
Published: April 2023

Summary Outreach is an important element of social care. It is an informal but planned form of on-site service delivery to vulnerable populations. Outreach affects some target populations, such as migrant farmworkers, immensely. Outreach staff demonstrate a unique capacity to navigate remote and hard to -to-reach areas, making contact with farmworkers who would otherwise not receive essential services. This ethnographic study describes how organizations make first contact with farmworkers in normal times, and the changes to outreach observed during the COVID-19 pandemic. Findings Outreach workers connect, interact, and provide services to farmworkers in unique settings and situations. The general components of farmworker outreach are planning, engaging, improvising, and initiating services. During the pandemic, the changes observed were a sense of urgency to serve farmworkers, and adaptations in the modality of outreach to include a focus on health, collaboration with health clinicians, and the use of social media to contact farmworkers. Applications Outreach matters to farmworkers and other groups that are secluded, isolated, and vulnerable to abuse. In crisis times, such as the pandemic, outreach is even more vital. Hence, outreach, including the skills required t o conduct outreach, should form part of social work curriculum. Different models and outreach components should be evaluated to assess whether organizations providing outreach services to target populations deliver results beyond immediate benefits and contribute to structural change and advocacy on behalf of them.
Are Perceived Benefits of Heated Tobacco Products Consumption Aiding Smoking Cessation?
Authors: Martinho Mafalda , Silva Susana C. , Duarte Paulo , Ferreira Marisa R. 
Published: April 2023

Background The tobacco industry has been facing several transformations, considering that technology has evolved and health concerns have increased. One way for this industry to meet the growing social and health concerns is to provide alternative solutions. Heated tobacco products (HTPs) were the solution found, but they nevertheless pose several challenges to regulators, companies, and consumers, since HTPs are advertised as a less harmful alternative to conventional cigarettes. Focus of the Article This study aims to analyze smokers' perception of HTPs to provide insights for social marketing campaigns targeting behavioral change. Research questions The main objectives of this research are: (1) to assess whether smokers and ex-smokers view HTPs as less harmful to health than traditional cigarettes; and (2) to determine to what extent HTPs can help increase the intention to quit smoking. Methods This study explores smokers’ perception of HTPs consumption using a modified version of the Health Belief Model (HBM). A survey study involving 250 smokers and ex-smokers was conducted to test the conceptual model using PLS-Path modeling to validate the research hypotheses. The data were analyzed using the SPSS 27 and SmartPLS 3.3 programs. Results The results suggest that the perceived benefits of heated tobacco consumption negatively influence the likelihood of quitting smoking. Therefore, HTPs do not work as auxiliary products with regard to the intention to quit smoking. In some cases, the effect is quite the opposite, as HTPs use increases tobacco consumption and dependence. Perceived susceptibility and perceived severity are not significant predictors of the decision to quit smoking. Research limitations Future research could use a sample that includes only HTPs smokers and ex-smokers, analyze HTPs benefits and understand the primary motivation behind replacing conventional cigarettes with HTPs. Practical implications Entities attempting to promote the reduction of tobacco consumption should equate HTPs to conventional tobacco and focus on campaigns targeting only HTPs smokers. Whenever studying perceptions on HTPs, it is important to consider smokers’ dependence on nicotine and the particularities of the devices used to consume HTPs. Importance to the Social Marketing Field Considering the social relevance and growth of heated tobacco consumption, as well as the increase of the tobacco industry’s economic power, this research offers relevant insights into consumers’ perceptions toward HTPs.
The perspectives of homeless people using the services of a mobile health clinic in relation to their health needs: a qualitative study on community-based outreach nursing
Authors: Paradis-Gagné Etienne , Jacques Marie-Claude , Pariseau-Legault Pierre , Ben Ahmed Houssem Eddine , Stroe Ioana Ruxandra 
Published: April 2023

Background: Significant social and health issues are associated with homelessness. Negative experiences with the healthcare system are also frequent and cause people experiencing homelessness to avoid health services. Aims: The purpose of this study was to (1) explore participants’ health needs concerning outreach nursing services and (2) describe the perceptions and preferences of people who access this form of community-based intervention. Methods: We conducted a critical ethnography with semi-structured interviews of 12 people experiencing homelessness who receive the services of a nurse-led mobile clinic, and 60 hours of observation during the provision of these services. Results: Our results describe the perspectives of people experiencing homelessness in three main categories: (1) worrisome health and social needs, (2) non-use of healthcare and (3) what connects us to health services. Conclusions: Timely access to healthcare is an important issue for people experiencing homelessness. Nurse-led clinics meet needs that go far beyond health issues.
Global Nurse Involvement in ethical decision-making during pandemics: a concept analysis
Authors: Alshawish Eman , Benbenishty Julie 
Published: April 2023

Background: During pandemics, there are considerable ethical dilemmas. It is imperative that nurses are involved in ethical decision-making bringing nursing theory, practice and perspectives to better advocate for patients. In order to prepare nurses to be partners in ethical dilemma decision-making during pandemics, it is vital to understand the extent that nurses are involved in such decision-making during the COVID-19 pandemic. Aim: The purpose of this concept analysis is to identify nurse involvement in ethical decision-making during pandemics. Method: Concept analysis methodology based on literature searches used bibliographic databases: PubMed – 20 papers; Google Scholar – 8120 papers; EMBASE – 25 papers; Science Direct – 246 papers and hand searches. Results: Nurse involvement in ethical decision-making during pandemics focused on nurses’ physical and emotional stress, communication challenges, saturation and collapse of limited resources and allocation of scarce resources. Additional dilemmas included, changing nature of nurses’ relationships with patients and families, questionable ethical equipoise preforming COVID-19 research, triage patient decisions receiving scarce resources, partner participation during labour and delivery and end-of-life decisions. Conclusion: In order to protect and sustain nurses’ well-being and competency, nurses should establish a framework for nurses’ involvement in ethical policy development in emergencies, pandemics, education and preparedness and decision-making to be able to deal with public health emergencies.
Supporting children’s drama in the on demand age: Assessing the efficacy of forty years of Australian policy frameworks and funding schemes
Authors: Potter Anna 
Published: April 2023

This is a case study of 40 years of policy approaches in Australian children’s television during which the children’s television production ecology was profoundly altered by new distribution technologies. For decades Australia used quotas, subsidies and screen organisation The Australian Children’s Television Foundation to safeguard supplies of children’s television including drama. Digitisation has caused enormous industrial disruption while delivering abundant children’s content on demand. The article calls for new approaches to supporting local children’s screen content through increased funding of public service media rather than the ad hoc distribution of resources to an organisation without direct pathways to audiences.
Systematic review and meta-analysis of mesenchymal stromal/stem cells as strategical means for the treatment of COVID-19
Authors: Taufiq Hannah , Shaik Fakiruddin Kamal , Muzaffar Umaiya , Lim Moon Nian , Rusli Syahnaz , Kamaluddin Nor Rizan , Esa Ezalia , Abdullah Syahril 
Published: April 2023

Background: In coronavirus disease 2019 (COVID-19) patients, elevated levels of inflammatory cytokines from over stimulation of immune cells have become a concern due to the potential outburst of cytokine storm that damages the tissues and organs, especially the lungs. This leads to the manifestation of COVID-19 symptoms, such as pneumonia, acute respiratory distress syndrome (ARDS), multiple organ failure, and eventually death. Mesenchymal stromal/stem cells (MSCs) are currently one of hopeful approaches in treating COVID-19 considering its anti-inflammatory and immunomodulatory functions. On that account, the number of clinical trials concerning the use of MSCs for COVID-19 has been increasing. However, the number of systematic reviews and meta-analysis that specifically discuss its potential as treatment for the disease is still lacking. Therefore, this review will assess the safety and efficacy of MSC administration in COVID-19 patients. Objectives: To pool evidence on the safety and efficacy of MSCs in treating COVID-19 by observing MSC-related adverse effects as well as evaluating its effects in reducing inflammatory response and improving pulmonary function. Data Sources and Methods: Following literature search across six databases and one trial register, full-text retrieval, and screening against eligibility criteria, only eight studies were included for data extraction. All eight studies evaluated the use of umbilical cord-derived mesenchymal stromal/stem cell (UC-MSC), infused intravenously. Of these eight studies, six studies were included in meta-analysis on the incidence of mortality, adverse events (AEs), and serious adverse events (SAEs), and the levels of C-reactive protein (CRP) and interleukin (IL)-6. Meta-analysis on pulmonary function was not performed due to insufficient data. Results: MSC-treated group showed significantly lower risk of mortality than the control group ( p = 0.03). No statistical significance was observed on the incidence of AEs ( p = 0.78) and SAEs ( p = 0.44), and the levels of CRP ( p = 0.06) and IL-6 ( p = 0.09). Conclusion: MSCs were safe for use, with lower risk of mortality and no association with AEs. Regarding efficacy, descriptive analysis showed indications of improvement on the inflammatory reaction, lung clearance, and oxygenation status despite the lack of statistical significance in meta-analysis of CRP and IL-6. Nevertheless, more studies are needed for affirmation. Registration: This systematic review and meta-analysis was registered on the PROSPERO database (no. CRD42022307730).
Noninvasive Continuous Glucose Monitoring With a Novel Wearable Dial Resonating Sensor: A Clinical Proof-of-Concept Study
Authors: Handy Consuelo , Chaudhry Mohamed Sabih , Qureshi Muhammad Rafaqat Ali , Love Bradley , Shillingford John , Plum-Mörschel Leona , Zijlstra Eric 
Published: April 2023

Background: A noninvasive, wearable continuous glucose monitor would be a major advancement in diabetes therapy. This trial investigated a novel noninvasive glucose monitor which analyzes spectral variations in radio frequency/microwave signals reflected from the wrist. Methods: A single-arm, open-label, experimental study compared glucose values from a prototype investigational device with laboratory glucose measurements from venous blood samples (Super GL Glucose Analyzer, Dr. Müller Gerätebau GmbH) at varying levels of glycemia. The study included 29 male participants with type 1 diabetes (age range = 19-56 years). The study comprised three stages with the following aims: (1) demonstrate initial proof-of-principle, (2) test an improved device design, and (3) test performance on two consecutive days without device recalibration. The co-primary endpoints in all trial stages were median and mean absolute relative difference (ARD) calculated across all data points. Results: In stage 1, the median and mean ARDs were 30% and 46%, respectively. Stage 2 produced marked performance improvements with a median and mean ARD of 22% and 28%, respectively. Stage 3 showed that, without recalibration, the device performed as well as the initial prototype (stage 1) with a median and mean ARD of 35% and 44%, respectively. Conclusion: This proof-of-concept study shows that a novel noninvasive continuous glucose monitor was capable of detecting glucose levels. Furthermore, the ARD results are comparable to first models of commercially available minimally invasive products without the need to insert a needle. The prototype has been further developed and is being tested in subsequent studies. Trial registration number: NCT05023798.
Malpractice Lawsuits Relating to Mechanical Thrombectomy for Acute Ischemic Stroke: A Systematic Review
Authors: Qureshi Kasim , Farooq Muhammad U. , Gorelick Philip B. 
Published: April 2023

Background and Purpose Medical-legal claims for malpractice relating to the use of alteplase for acute ischemic stroke (AIS) are usually for failure to treat rather than for complications. The advent of mechanical thrombectomy (MT) as a standard of AIS treatment has added a new dimension to the medical-legal landscape as there is a need for the delivery of a higher level of care creating the potential for delays and errors associated with such treatment. Information on causes of malpractice related to mechanical thrombectomy (MT) is currently lacking. Methods We conducted a systematic review of legal databases (Westlaw, LexisNexis, Google Scholar Case Law, and VerdictSearch) to identify medical malpractice cases with and without verdicts filed in the United States up to March 31, 2021 which pertained to performance or non-performance of MT for AIS. We collected various case characteristics, case outcomes, and root causes for malpractice claims. Results We found 25 cases, 16 of which alleged failure to treat with MT, 8 for harm due to delay in treatment and 1 case that alleged complications. Root causes included delay in vascular imaging, communication breakdowns, and transportation delays. Eight cases had an outcome in favor of the defendant, 9 in favor of the plaintiff, and 8 remained to be determined. Conclusions As with alteplase, malpractice allegations regarding MT for AIS are largely for failure to treat or delay in treatment as opposed to complications. Addressing root causes of diagnostic delay, communication breakdowns, and transportation delays may reduce subsequent malpractice risk.
Incremental diagnostic yield and clinical outcomes of lateral decubitus CT myelogram immediately following negative lateral decubitus digital subtraction myelogram
Authors: Shlapak Darya P , Mark Ian T , Kim Dong Kun , Benson John C , Diehn Felix E , Kissoon Narayan R , Liebo Greta B , Madhavan Ajay A , Morris Jonathan M , Morris Pearse P , Oien Michael P , Verdoorn Jared T , Carr Carrie M 
Published: April 2023

Introduction Spontaneous intracranial hypotension (SIH) caused by a spinal cerebrospinal fluid (CSF) leak classically presents with orthostatic headache. Digital subtraction myelography (DSM) has a well-established diagnostic yield in the absence of extradural spinal collection. At our institution, DSM is followed by lateral decubitus CT myelogram (LDCTM) in the same decubitus position to increase diagnostic yield of the combined study. We evaluated the incremental diagnostic yield of LDCTM following negative DSM and reviewed patient outcomes. Methods Retrospective review of consecutive DSMs with subsequent LDCTM from April 2019 to March 2021 was performed. Combined reports were reviewed, and studies with positive DSMs were excluded. Of the exams with negative DSM, only studies with LDCTM reports identifying potential leak site were included. Interventions and follow-up clinical notes were reviewed to assess symptoms improvement following treatment. Results Of the 83 patients with negative DSMs, 11 (13.2%) had positive leak findings on LDCTMs, and 21 (25.3%) were equivocal. Of 11 positive LDCTMs, 6 leaks were nerve sheath tears (NSTs) and 5 were CSF-venous fistulas (CVFs). 10/11 (90.9%) had intervention and follow-up, with 9/10 (90%) having positive clinical outcome. Of the 21 equivocal LDCTM patients (19 CVFs and 2 NSTs), 15 (71.4%) had interventions and follow-up, with 3/15 (20.0%) with positive clinical outcomes. Conclusion LDCTM following negative DSM has an incremental diagnostic yield up to 38.6%, with up to 14.5% of positive patient outcomes following treatment. LDCTM should be considered after DSM to maximize diagnostic yield of the combined exam.