bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge, attitude, and perceived practice of sanitary workers on healthcare waste management: A descriptive cross-sectional study in Dodoma region,Tanzania
Authors: Millanzi Walter C , Herman Patricia Z , Mtangi Samweli A 
Published: May 2023

Introduction: Healthcare facilities produce a variety of trash that, if handled improperly, could endanger the environment, the health of patients and clients, healthcare personnel, and the general public. Health staff have been given training on infection control and healthcare waste management. It is not apparent whether similar initiatives are taken for sanitary personnel, though. By evaluating sanitary workers’ knowledge, attitudes, and practices about healthcare waste treatment in the Dodoma region of Tanzania, this study sought to clarify the situation. Methods: From March to August 2022 in Dodoma, Tanzania, a descriptive cross-sectional study using a quantitative methodology was conducted on 156 randomly chosen sanitary workers. The primary data collection instruments were structured questionnaires that were conducted by interviewers and a trash checklist that the research team created. Statistical Package for Social Sciences computer software was used to conduct a descriptive analysis of the data with a 95% confidence level and a 5% level of significance. Results: The average age was 28 ± 6.2 years, and there were 74.4% females. Of all of the health institutions under study, 78.4% of the generated medical waste was non-infectious, whereas 21.6% of it was infectious. The share of non-infectious and infectious healthcare waste created by regional referral hospitals was 43.5% and 13.2%, respectively. While 67.8% of sanitary workers believed that handling healthcare waste was not their problem and 63.6% of sanitary workers actually displayed subpar practices of handling healthcare waste, 74.4% of sanitary workers had low understanding about handling healthcare waste. Their procedures for handling medical waste were substantially influenced by the kind of healthcare facility, sex, education, job experience, knowledge, and attitude ( p < 0.05). Conclusion: Sanitary staff members had limited understanding and thought they were less concerned with gathering, moving, and storing medical waste. To provide the highest level of health safety, national health policy and facility-based interventions must support and fund participatory waste management training that is tailored to the sociodemographic profiles of sanitary employees.
Digital health interventions to support family caregivers: An updated systematic review
Authors: Zhai Shumenghui , Chu Frances , Tan Minghui , Chi Nai-Ching , Ward Teresa , Yuwen Weichao 
Published: May 2023

Objective Chronic diseases are the leading causes of death and disability in the U.S., and disease management largely falls onto patients’ family caregivers. The long-term burden and stress of caregiving negatively impact caregivers’ well-being and ability to provide care. Digital health interventions have the potential to support caregivers. This article aims to provide an updated review of interventions using digital health tools to support family caregivers and the scope of the Human-Centered Design (HCD) approaches. Methods We conducted a systematic search on July 2019 and January 2021 in PubMed, CINAHL, Embase, Cochrane Library, PsycINFO, ERIC, and ACM Digital Library, limiting to 2014–2021 to identify family caregiver interventions assisted by modern technologies. The Mixed Methods Appraisal Tool and the Grading of Recommendations Assessment, Development and Evaluation were used to evaluate the articles. Data were abstracted and evaluated using Rayyan and Research Electronic Data Capture. Results We identified and reviewed 40 studies from 34 journals, 10 fields, and 19 countries. Findings included patients’ conditions and relationships with family caregivers, how the technology is used to deliver the intervention, HCD methods, theoretical frameworks, components of the interventions, and family caregiver health outcomes. Conclusion This updated and expanded review revealed that digitally enhanced health interventions were robust at providing high-quality assistance and support to caregivers by improving caregiver psychological health, self-efficacy, caregiving skills, quality of life, social support, and problem-coping abilities. Health professionals need to include informal caregivers as an essential component when providing care to patients. Future research should include more marginalized caregivers from diverse backgrounds, improve the accessibility and usability of the technology tools, and tailor the intervention to be more culturally and linguistically sensitive.
Kinect-based objective evaluation of bradykinesia in patients with Parkinson's disease
Authors: Wu Zhuang , Gu Hongkai , Hong Ronghua , Xing Ziwen , Zhang Zhuoyu , Peng Kangwen , He Yijing , Xie Ludi , Zhang Jingxing , Gao Yichen , Jin Yue , Su Xiaoyun , Zhi Hongping , Guan Qiang , Pan Lizhen , Jin Lingjing 
Published: May 2023

Objective To quantify bradykinesia in Parkinson's disease (PD) with a Kinect depth camera-based motion analysis system and to compare PD and healthy control (HC) subjects. Methods Fifty PD patients and twenty-five HCs were recruited. The Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale part III (MDS-UPDRS III) was used to evaluate the motor symptoms of PD. Kinematic features of five bradykinesia-related motor tasks were collected using Kinect depth camera. Then, kinematic features were correlated with the clinical scales and compared between groups. Results Significant correlations were found between kinematic features and clinical scales ( P < 0.05). Compared with HCs, PD patients exhibited a significant decrease in the frequency of finger tapping ( P < 0.001), hand movement ( P < 0.001), hand pronation-supination movements ( P = 0.005), and leg agility ( P = 0.003). Meanwhile, PD patients had a significant decrease in the speed of hand movements ( P = 0.003) and toe tapping ( P < 0.001) compared with HCs. Several kinematic features exhibited potential diagnostic value in distinguishing PD from HCs with area under the curve (AUC) ranging from 0.684–0.894 ( P < 0.05). Furthermore, the combination of motor tasks exhibited the best diagnostic value with the highest AUC of 0.955 (95% CI = 0.913–0.997, P < 0.001). Conclusion The Kinect-based motion analysis system can be applied to evaluate bradykinesia in PD. Kinematic features can be used to differentiate PD patients from HCs and combining kinematic features from different motor tasks can significantly improve the diagnostic value.
Magnetic Resonance Imaging-CCCFLS Scoring System: Toward Predicting Clinical Symptoms and C5 Paralysis
Authors: Wang Shunmin , Sun Jingchuan , Han Dan , Fan Jianping , Yu MM Yaping , Yang MM Haiqin , Gao Chunyan , Zhou XiaoNan , Guo Yongfei , Shi Jiangang 
Published: May 2023

Study Design A retrospective study. Objective To develop a new MRI scoring system to assess patients’ clinical characteristics, outcomes and complications. Methods A retrospective 1-year follow-up study of 366 patients with cervical spondylosis from 2017 to 2021. The CCCFLS scores (cervical curvature and balance (CC), spinal cord curvature (SC), spinal cord compression ratio (CR), cerebrospinal fluid space (CFS). Spinal cord and lesion location (SL). Increased Signal Intensity (ISI) were divided into Mild group (0-6), Moderate group (6-12), and Severe group (12-18) for comparison, and the Japanese Orthopaedic Association (JOA) scores, visual analog scale (VAS), numerical rating scale (NRS), Neck Disability Index (NDI) and Nurick scores were evaluated. Correlation and regression analyses were performed between each variable and the total model in relation to clinical symptoms and C5 palsy. Results The CCCFLS scoring system was linearly correlated with JOA, NRS, Nurick and NDI scores, with significant differences in JOA scores among patients with different CC, CR, CFS, ISI scores, with a predictive model (R2 = 69.3%), and significant differences in preoperative and final follow-up clinical scores among the 3 groups, with a higher rate of improvement in JOA in the severe group ( P < .05), while patients with and without C5 paralysis had significant differences in preoperative SC and SL ( P < .05). Conclusion CCCFLS scoring system can be divided into mild (0-6). moderate (6-12), severe (12-18) groups. It can effectively reflect the severity of clinical symptoms, and the improvement rate of JOA is better in the severe group, while the preoperative SC and SL scores are closely related to C5 palsy. Level of Evidence III
Cervical Sagittal Alignment and Balance Associated With Aging Chinese Adults: A Radiographic Analysis
Authors: Jin Linyu , Liang Yan , Guo Chen , Zheng Bin , Liu Haiying , Xu Shuai 
Published: May 2023

Study Design This was a retrospective cohort radiographic study. Objective To determine the age- and gender-related normative values and correlation of cervical sagittal parameters in asymptomatic Chinese adults, and to explore the changes and compensating mechanisms across different age groups. Methods The asymptomatic subjects were divided into 6 groups according to age and then one-way analysis of variance was used to compare the multiple sets of cervical sagittal parameters among the different age groups. Independent t-tests were performed to compare the sagittal parameters among different gender and different cervical spine alignments. Relationships between each parameter were tested by Pearson’s correlation. Linear regression analysis based on T1 slope (T1S) and C2 slope (C2S) was used to provide an equation to predict normal cervical alignment. Results Mean values of each cervical sagittal parameter were presented based on age and gender. There were positive correlations between age and cervical lordosis (CL) (r = -.278, P < .001), T1S (r = .271, P < .001), cervical sagittal vertical axis (cSVA) (r = .218, P < .001), C2-C4 Cobb angle (r = -.283, P < .001), horacic inlet angle (TIA) (r = .443, P < .001), and neck tilt (NT) (r = .354, P < .001). Older groups (aged >50 years) had greater T1 Slope, C2S, and TIA. The C2-C4 Cobb angle maintained a steadily increasing trend and significantly increased in the older adult groups ( P < .05), while the C5-C7 Cobb angle was relatively constant. Mean values of parameters were larger in males ( P > .05). Linear regression analysis indicated a strong association between T1S and CL (R2 = .551, standard error 1.16°), T1S and C5-7 (R2 = .372; P < .001), and C2S and C2-4 (R2 = .309; P < .001). Conclusions Normative values of cervical sagittal parameters vary by age and sex. The CL, cSVA, and T1S, C2-4 Cobb angle changed with increasing age, and it can influence the recruitment of compensation mechanism. Normative CL of Chinese adults was predicted by the equation CL = T1S-14.7° ± 1.2°, which could serve as a reference when planning for cervical surgery.
Quality of Life and Associated Factors Among Adult Cancer Patients Undergoing Chemotherapy Treatment at Amhara National, Regional State, Ethiopia, 2021
Authors: Muhamed Ahmed Nuru , Bogale Sitotaw Kerie , Netere Henok Biresaw 
Published: May 2023

Background In cancer, quality of life (QoL) is an important patient-reported metric; evaluating how patients feel physically and emotionally while fighting the disease could lead to better treatment. Despite its therapeutic effects, chemotherapy treatment causes a plethora of side effects that can affect QoL. Factors affecting the QoL of cancer patients undergoing chemotherapy treatment in Ethiopia have not been thoroughly investigated. As a result, this study assesses QoL and associated characteristics among adult cancer patients receiving chemotherapy at Amhara Region, Ethiopia in 2021. Martials and Methods From February 15 to May 15, 2021, an institutional based cross-sectional study was done in Amhara region. Three hundred fourteen patients were included in the study. The data was gathered using Amharic version of European organization for research and treatment of cancer quality of life questionnaire (EORTC QLQ C-30) through a face-to-face interview. Epi Data 4.6 was used to enter the data, which was then exported to SPSS version 23 for statistical analysis. Multivariable logistic regression analysis was used to determine the relationship between independent and dependent variables. The statistical significance was determined by a p-value of less than .05. Result Cancer patients in Amhara Region had a 44.32 average QoL. Emotional functioning AOR 1.01 (1.0–1.04), social functioning AOR 1.02 (1.01–1.03), nausea and vomiting AOR 0.95 (0.93–0.98), pain AOR 0.95 (0.93–0.98), financial difficulty 0.97 (0.95–0.99), education AOR 4.3 (1.49–12.32), underweight AOR 0.45 (0.24–0.84),  > 5th cycle of chemotherapy AOR 4 (1.78–9.11), stage IV cancer AOR 0.21 (0.06–0.71), comorbidity AOR 0.28 (0.14–0.57), anxiety AOR 0.32 (0.12–0.84), and depression AOR 0.29 (0.13–0.63) were all significantly associated with QoL in multivariable logistic regression. Conclusion Adult cancer patients receiving chemotherapy in the Amhara region had a poor QoL. Emotional functioning, social functioning, nausea and vomiting, pain, financial difficulty, education, body mass index, cancer stage, chemotherapy cycle, comorbidity, anxiety, and depression all had association with QoL. To improve the QoL of cancer patients, QoL assessments, proper symptom management, nutritional support, and integration of psycho-oncology treatment should be considered.
Does Digital Rubbing Massage-Pain Relief (DRM Pain Relief) Affect Breast Cancer Patients’ Pain, Comfort, and Quality of Life?
Authors: Sudirman  , Indriyawati Nina , Dwiningsih Sri Utami 
Published: May 2023

Introduction The incidence of breast cancer in Indonesia is the highest among types of cancer in women, with an estimated pain prevalence of 40%–89%. More than 50% of cancer patients suffer from pain that has not been resolved. Cancer pain's impact will affect the comfort level and quality of life. Objectives The purpose of this study was to analyze the effectiveness of DRM Pain Relief on the degree of pain, comfort, and quality of life among breast cancer patients. Methods The research was a true experimental study with pre-test and post-test designs with a control group. The population was all breast cancer patients attending hospitals in Semarang and Pekalongan Districts. The research subjects were 64 respondents who met the inclusion and exclusion criteria. Respondents were selected randomly and divided into two groups, namely 32 in the treatment group (DRM Pain Relief application) and 32 in the control group (only received drugs as conventional therapy in the hospital). Data were analyzed using a multivariate test. Results The application of DRM Pain Relief was effective in reducing the degree of pain ( p < .001), and effectively increasing comfort ( p < .001), as well as improving the quality of life of breast cancer patients in the components of improvement in symptom status, functional status, and global quality of life with p-value <.001, .003,  < .001, respectively. Conclusion The DRM Pain Relief effectively reduces the degree of pain, increases comfort, and improves the quality of life of breast cancer patients.
Knowledge and Perception of the Employees Towards COVID-19 Vaccination at Palestinian Universities
Authors: Shouli Mustafa Mohammad , Ayed Ahmad , Shouli Khaila Mohammad , Alekel Khalid 
Published: May 2023

Introduction Major efforts are being made to control the spread and impact of the coronavirus pandemic using vaccines. However, willingness to be vaccinated depends largely on factors beyond the availability of vaccines. Objective This study aimed to investigate the knowledge and perception of university employees towards the COVID-19 vaccination. Methods A cross-sectional study was conducted between February and June 2021. A total of 310 university employees from six Palestinian universities participated in the study. A self-reported questionnaire was used for data collection and included the following: personal and medical characteristics of the university employees’ knowledge and perception regarding receiving the COVID-19 vaccination. Results Three hundred and ten out of 336 questionnaires (92.3% response rate) were completed and returned by the participants. The results revealed that 41.9% of university employees had good knowledge of the COVID-19 vaccination. On the other hand, 51.9% of them had a positive perception of the COVID-19 vaccination. Also, there is a significant difference between the level of knowledge and perception of the COVID-19 vaccine ( p < .05). Conclusion Less than half of the university employees had good knowledge, and half of them had a positive attitude towards the COVID-19 vaccination. Also, it has been determined that there is a relationship between the level of knowledge and perception of the COVID-19 vaccine. The study recommended that employees should be involved in educational campaigns to increase their knowledge of the importance of vaccines in COVID-19 prevention.
Effects of Blended Simulation on Nursing Students’ Critical Thinking Skills: A Quantitative Study
Authors: Sterner Anders , Sköld Robert , Andersson Henrik 
Published: May 2023

Introduction Critical thinking is regarded as imperative to healthcare quality and patient outcomes; therefore, effective strategies in nursing education are required to promote students’ critical thinking abilities, leading to their success in clinical work. Accordingly, simulation-based education has been suggested as a measure for achieving this goal. Objective The aim of this study was to explore whether a nursing education course with blended simulation activities (hands-on simulations with high-fidelity manikins and a web-based interactive simulation program) could increase nursing students’ critical thinking skills. Method A quasiexperimental, one-group pretest and post-test design was utilized. Data were collected through premeasurement and postmeasurement using a critical thinking questionnaire and were analyzed using paired sample t-tests, independent sample t-tests, and the nonparametric Wilcoxon signed-rank test. The effect size was calculated using Cohen's d formula. Results Sixty-one nursing students (57 women and four men, mean age 30 years) participated in the study. Findings of the paired sample t-test showed a significantly higher mean score for posteducation than pre-education, indicating a significant change in nurses’ critical thinking capabilities ( p < .001). The results for Cohen's d formula ( − 0.87) of the mean scores between pre-education and posteducation indicated a large effect size. The Wilcoxon signed-rank test also showed a statistically significant increase in the students’ critical thinking abilities between pre-education and posteducation measures ( p < .001). No statistically significant differences were found in the mean score according to age or sex. Conclusion This study concluded that blended simulation-based education can increase nursing students’ critical thinking capabilities. As a result, this study builds on the use of simulation as a measure for developing and promoting critical thinking abilities during nursing education.
Cost-effectiveness of tenecteplase versus alteplase for acute ischemic stroke
Authors: Nguyen Chi Phuong , Lahr Maarten MH , van der Zee Durk-Jouke , van Voorst Henk , Roos Yvo BWEM , Uyttenboogaart Maarten , Buskens Erik 
Published: May 2023

Introduction: Alteplase is widely used as an intravenous thrombolytic drug in acute ischemic stroke (AIS). Recently however, tenecteplase, a modified form of tissue plasminogen activator, has been shown to increase early recanalization rate and has proven to be non-inferior with a similar safety profile compared to alteplase. This study aims to evaluate the cost-effectiveness of 0.25 mg/kg tenecteplase versus 0.9 mg/kg alteplase for intravenous thrombolysis in AIS patients from the Dutch healthcare payer perspective. Methods: A Markov decision-analytic model was constructed to assess total costs, total quality-adjusted life year (QALY), an incremental cost-effectiveness ratio, and incremental net monetary benefit (INMB) of two treatments at willingness-to-pay (WTP) thresholds of €50,000/QALY and €80,000/QALY over a 10-year time horizon. One-way sensitivity analysis, probabilistic sensitivity analysis, and scenario analysis were conducted to test the robustness of results. Clinical data were obtained from large randomized controlled trials and real-world data. Results: Treatment with tenecteplase saved €21 per patient while gaining 0.05 QALYs, resulting in INMB of €2381, clearly rendering tenecteplase cost-effective compared to alteplase. Importantly, tenecteplase remained the cost-effective alternative in all scenarios, including AIS patients due to large vessel occlusion (LVO). Probabilistic sensitivity analysis proved tenecteplase to be cost-effective with a 71.0% probability at a WTP threshold of €50,000/QALY. Conclusions: Tenecteplase treatment was cost-effective for all AIS patients (including AIS patients with LVO) compared to alteplase. The finding supports the broader use of tenecteplase in acute stroke care, as health outcomes improve at acceptable costs while having practical advantages, and a similar safety profile.
The ‘rights of nature’ in an age of white supremacy?
Authors: Fitz-Henry Erin 
Published: May 2023

The past 10 years have witnessed a flourishing of interdisciplinary research across the social sciences that aims to better theorize the relationships between structural racism and the deepening ecological crisis. In this article, I consider how grassroots lawyers and community activists for the ‘rights of nature’ (RoN) in the United States are transforming their discourses, legal tactics, and pedagogical strategies in the face of a national context marked by pervasive anti-Black racism. After considering how racism has historically accompanied efforts to extend moral and legal ‘personhood’ to ecosystems in ways that continue to make solidarity work with racial justice organizations vexed and difficult, I show that, despite these exclusionary legacies, RoN activists are experimenting with municipal law-making in ways that are bringing them into closer conversation with contemporary racial justice struggles. Instead of focusing narrowly on the problem of the denial of ‘rights’ to non-humans, RoN activists are increasingly concerned with the broader structural problem of state pre-emption over local decision-making and the profoundly anti-democratic nature of a state/corporate nexus that is limiting possibilities for progressive action across a wide range of justice issues. Whilst these legal experiments do not resolve enduring tensions between anti-racist and environmental struggles, they suggest important re-directions taking place among historically white environmental activists.