bluuebunny/crossref_metadata_2025_split huggingface dataset:
Learning and Study Strategies of Students in the First Year of an Entry-Level Physical Therapist Program
Authors: Scales Melissa H. , Vallabhajosula Srikant 
Published: February 2023

Introduction.
The learning and study strategies of entry-level physical therapist (PT) students may not be as effective as those needed for success in an entry-level PT education program. The Learning and Study Strategies Inventory, third edition (LASSI) is a reliable tool to assess learning and study strategies. The purpose of this study was to assess the learning and study strategies of first-year PT students and if the strategies change over the first year.

Review of Literature.
There is little research on using the LASSI with PT students; however, the LASSI has been used with other health care professional students.

Subjects.
The participants (n = 211) were from 5 cohorts of PT students in their first year of an entry-level PT education program.

Methods.
In the first week of the curriculum the students took the LASSI in class. The results were released individually to each student. No intervention was provided. At the end of the first year, the students retook the LASSI. Paired samples t-tests were run to determine whether the 10 subtest mean percentile scores changed significantly from baseline to follow-up and how they compared to established LASSI benchmarks.

Results.
Six subtest scores, Anxiety, Attitude, Concentration, Information Processing, Selecting Main Ideas, and Test Strategies, showed significant changes (P ≤ .005) from baseline to follow-up. However, all subtest averages fell below the 75th percentile mark, which is reported as the threshold requiring reflection to improve skills for learning and study strategies.

Discussion and Conclusion.
Students, on average, may not have adequate learning and study strategies when they start an entry-level PT education program. The LASSI may be an effective tool to focus resources in a timely and proactive manner for those students who may need them. Determining the resources needed earlier may decrease the need for later remediation, attrition, or licensure examination failures.
Professional Experience Related to Self-Assessed Teaching Effectiveness Among Physical Therapist Clinical Instructors
Authors: Carmel Stacy , Kupczynski Lori , Groff Shannon , Bannon William 
Published: February 2023

Introduction.
Physical therapist (PT) students learn through clinical practice with the supervision of a clinical instructor (CI). Clinical instructors have teaching, education, and practice experiences that can positively affect their self-assessed clinical teaching effectiveness (CTE), which may improve learning outcomes for students.

Review of Literature.
Identifying CI experiences, such as specific teaching, education, or practice expertise, as they relate to effective clinical teaching may be beneficial in the selection of PT CIs and allow instructors to focus on professional experiences that will elevate their self-assessed teaching abilities.

Subjects.
The study included 851 PTs from a large geographical area. The participants had varying educational, clinical, and professional experiences and each had been a CI for at least 1 student clinical education experience.

Methods.
Specific PT CI professional experiences associated with CTE were determined through a correlation study using quantitative data collected online through a validated survey instrument, the Clinical Teaching Effectiveness Questionnaire. This study examined degree earned, PT residency and PT fellowship training, the American Board of Physical Therapy Specialties (ABPTS), American Physical Therapy Association (APTA) Credentialed Clinical Instructor Program (CCIP) level 1 and level 2, years of clinical experience, number of students taught, and number of years of clinical teaching.

Results.
Results indicated that a higher level of self-assessed CTE was associated with ABPTS certification, CCIP level 1 and level 2, and a higher number of students mentored by a CI. Physical therapist residency training, PT fellowship training, years of clinical experience, and number of years of clinical teaching were not related to self-assessed CTE.

Discussion and Conclusion.
Specific teaching, clinical, and practice experiences were related to CTE. To increase PT CI CTE, CIs are encouraged to consider ABPTS certification, CCIP level 1 and level 2, and mentoring students regularly. The PT profession, APTA, and Doctor of Physical Therapy programs should support these endeavors.
A Thematic Survey on the Reporting Quality of Randomized Controlled Trials in Rehabilitation: The Case of Multiple Sclerosis
Authors: Ventura Lucia , Moreno-Navarro Pedro , Martinez Gianluca , Cugusi Lucia , Barbado David , Vera-Garcia Francisco Jose , Kalron Alon , Dvir Zeevi , Deriu Franca , Manca Andrea 
Published: February 2023

Background and Purpose:
Optimal reporting is a critical element of scholarly communications. Several initiatives, such as the EQUATOR checklists, have raised authors' awareness about the importance of adequate research reports. On these premises, we aimed at appraising the reporting quality of published randomized controlled trials (RCTs) dealing with rehabilitation interventions. Given the breadth of such literature, we focused on rehabilitation for multiple sclerosis (MS), which was taken as a model of a challenging condition for all the rehabilitation professionals.
A thematic methodological survey was performed to critically examine rehabilitative RCTs published in the last 2 decades in MS populations according to 3 main reporting themes: (1) basic methodological and statistical aspects; (2) reproducibility and responsiveness of measurements; and (3) clinical meaningfulness of the change.

Summary of Key Points:
Of the initial 526 RCTs retrieved, 370 satisfied the inclusion criteria and were included in the analysis. The survey revealed several sources of weakness affecting all the predefined themes: among these, 25.7% of the studies complemented the P values with the confidence interval of the change; 46.8% reported the effect size of the observed differences; 40.0% conducted power analyses to establish the sample size; 4.3% performed retest procedures to determine the outcomes' reproducibility and responsiveness; and 5.9% appraised the observed differences against thresholds for clinically meaningful change, for example, the minimal important change.

Recommendations for Clinical Practice:
The RCTs dealing with MS rehabilitation still suffer from incomplete reporting. Adherence to evidence-based checklists and attention to measurement issues and their impact on data interpretation can improve study design and reporting in order to truly advance the field of rehabilitation in people with MS.

Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1 available at: http://links.lww.com/JNPT/A424).
Landscape Review of Mail-in Self-Collection, Programs for Sexually Transmitted Infections
Authors: Pontes Miya F. , Armington Gretchen , Fink Rachel , Gaydos Charlotte A. , Manabe Yukari C. 
Published: February 2023

Background
Mail-in self-collection of samples with centralized reference laboratory sexually transmitted infection (STI) testing has been shown to be feasible with equivalent performance. Commercial, fee-for-service mail-in testing Web sites seem to be popular. These sites are currently unregulated by the US Food and Drug Administration.

Methods
To compile a list of US organizations offering mail-in testing for STIs/HIV, the phrases “mail-in STI testing” and “home STI testing” were entered into search engines. Supplementary information was collected by organization email or “Contact Us” submission.

Results
Information was collected from 20 programs in the United States offering STI mail-in, self-collection testing services. Five programs (25%) were free to consumers. Six organizations (30%) only offered prefixed kits (STIs tested could not be selected). Half of the organizations provided extragenital testing, 2 (10%) did not provide extragenital testing, and the 8 others (40%) did not clarify. Three organizations (15%) used their own laboratory, 11 (55%) did not provide laboratory information. One commercial laboratory provided services to 5 organizations.

Conclusions
Mail-in self-collection services are ubiquitous and exist in all states except 2; STI testing public health programs that offer testing at no cost to the consumer are only in 46% of states. Mail-in testing is likely a permanent fixture in sexual health services and will be an important component of a hybrid approach that complements that of static clinic services.
A Quality Improvement Initiative to Decrease Central Line–Associated Bloodstream Infections During the COVID-19 Pandemic: A “Zero Harm” Approach
Authors: Redstone Carol S. , Zadeh Maryam , Wilson Mary-Agnes , McLachlan Samantha , Chen Danny , Sinno Maya , Khamis Safiyya , Malis Kassia , Lui Flavia , Forani Steven , Scerbo Christina , Hutton Yuka , Jacob Latha , Taher Ahmed 
Published: February 2023

Introduction
Central line–associated bloodstream infections (CLABSIs) are associated with significant patient harm and health care costs. Central line–associated bloodstream infections are preventable through quality improvement initiatives. The COVID-19 pandemic has caused many challenges to these initiatives. Our community health system in Ontario, Canada, had a baseline rate of 4.62 per 1000 line days during the baseline period.

Objectives
Our aim was to reduce CLABSIs by 25% by 2023.

Methods
An interprofessional quality aim committee performed a root cause analysis to identify areas for improvement. Change ideas included improving governance and accountability, education and training, standardizing insertion and maintenance processes, updating equipment, improving data and reporting, and creating a culture of safety. Interventions occurred over 4 Plan-Do-Study-Act cycles. The outcome was CLABSI rate per 1000 central lines: process measures were rate of central line insertion checklists used and central line capped lumens used, and balancing measure was the number of CLABSI readmissions to the critical care unit within 30 days.

Results
Central line–associated bloodstream infections decreased over 4 Plan-Do-Study-Act cycles from a baseline rate of 4.62 (July 2019–February 2020) to 2.34 (December 2021–May 2022) per 1000 line days (51%). The rate of central line insertion checklists used increased from 22.8% to 56.9%, and central line capped lumens used increased from 72% to 94.3%. Mean CLABSI readmissions within 30 days decreased from 1.49 to 0.1798.

Conclusions
Our multidisciplinary quality improvement interventions reduced CLABSIs by 51% across a health system during the COVID-19 pandemic.
Evaluation of National Patient Safety Implementation Framework in Selected Public Healthcare Facilities of Tamil Nadu: An Operational Research
Authors: Krishnamoorthy Yuvaraj , Govindan Dhanajayan , Rajaa Sathish , Sinha Isha , Kanth Krishna , Krishnan Murali , Samuel Gerald 
Published: February 2023

Background
The Ministry of Health and Family Welfare has introduced the “National Patient Safety Implementation Framework” to ensure the patient safety at different levels of healthcare delivery system. However, there is limited effort made in evaluating the implementation status of this framework. Hence, we have performed the process evaluation of National Patient Safety Implementation Framework across the public healthcare facilities in Tamil Nadu.

Methods
This was a facility-level survey conducted by research assistants who visited 18 public health facilities across 6 districts of Tamil Nadu, India, for the purpose of documenting the presence of structural support systems and strategies to promote patient safety. We developed a tool for data collection based on the framework. It comprised a total of 100 indicators under the following domains and subdomains: structural support, systems for reporting, workforce, infection prevention and control, biomedical waste management, sterile supplies, blood safety, injection safety, surgical safety, antimicrobial safety, and COVID-19 safety.

Results
Only one facility (subdistrict hospital) belonged to the high-performing category with a score of 79.5 on the implementation of patient safety practices. About 11 facilities (4 medical colleges and 7 Government Hospitals) belonging to medium-performing category. The best-performing medical college had a score of 61.5 for patient safety practices. Six facilities (2 medical colleges, 4 Government Hospitals) belonged to low-performing category in terms of patient safety. The least-performing facilities (both subdistrict hospitals) had scores of 29.5 and 26 for patient safety practices, respectively. Because of COVID-19, there was a positive effect on biomedical waste management and infectious disease safety across all facilities. Most performed poor in the domain with structural systems to support quality and efficiency of healthcare and patient safety.

Conclusions
The study concludes that based on the current situation of patient safety practices in public health facilities, it will be difficult to perform full-fledged implementation of patient safety framework by the year 2025.
Respiratory metagenomics: route to routine service
Authors: Edgeworth Jonathan D. 
Published: February 2023

Purpose of review
The coronavirus disease 2019 pandemic demonstrated broad utility of pathogen sequencing with rapid methodological progress alongside global distribution of sequencing infrastructure. This review considers implications for now moving clinical metagenomics into routine service, with respiratory metagenomics as the exemplar use-case.

Recent findings
Respiratory metagenomic workflows have completed proof-of-concept, providing organism identification and many genotypic antimicrobial resistance determinants from clinical samples in <6 h. This enables rapid escalation or de-escalation of empiric therapy for patient benefit and reducing selection of antimicrobial resistance, with genomic-typing available in the same time-frame. Attention is now focussed on demonstrating clinical, health-economic, accreditation, and regulatory requirements. More fundamentally, pathogen sequencing challenges the traditional culture-orientated time frame of microbiology laboratories, which through automation and centralisation risks becoming increasingly separated from the clinical setting. It presents an alternative future where infection experts are brought together around a single genetic output in an acute timeframe, aligning the microbiology target operating model with the wider human genomic and digital strategy.

Summary
Pathogen sequencing is a transformational proposition for microbiology laboratories and their infectious diseases, infection control, and public health partners. Healthcare systems that link output from routine clinical metagenomic sequencing, with pandemic and antimicrobial resistance surveillance, will create valuable tools for protecting their population against future infectious diseases threats.
Emergency department versus operating room intubation of patients undergoing immediate hemorrhage control surgery
Authors: Dunton Zachary , Seamon Mark J. , Subramanian Madhu , Jopling Jeffery , Manukyan Mariuxi , Kent Alistair , Sakran Joseph V. , Stevens Kent , Haut Elliott , Byrne James P. 
Published: February 2023

BACKGROUND
Hemorrhage control surgery is an essential trauma center function. Airway management of the unstable bleeding patient in the emergency department (ED) presents a challenge. Premature intubation in the ED can exacerbate shock and precipitate extremis. We hypothesized that ED versus operating room intubation of patients requiring urgent hemorrhage control surgery is associated with adverse outcomes at the patient and hospital-levels.

METHODS
Patients who underwent hemorrhage control within 60 minutes of arrival at level 1 or 2 trauma centers were identified (National Trauma Data Bank 2017–2019). To minimize confounding, patients dead on arrival, undergoing ED thoracotomy, or with clinical indications for intubation (severe head/neck/face injury or Glasgow Coma Scale score of ≤8) were excluded. Two analytic approaches were used. First, hierarchical logistic regression measured the risk-adjusted association between ED intubation and mortality. Secondary outcomes included ED dwell time, units of blood transfused, and major complications (cardiac arrest, acute respiratory distress syndrome, acute kidney injury, sepsis). Second, a hospital-level analysis determined whether hospital tendency ED intubation was associated with adverse outcomes.

RESULTS
We identified 9,667 patients who underwent hemorrhage control surgery at 253 trauma centers. Patients were predominantly young men (median age, 33 years) who suffered penetrating injuries (71%). The median initial Glasgow Coma Scale and systolic blood pressure were 15 and 108 mm Hg, respectively. One in five (20%) of patients underwent ED intubation. After risk-adjustment, ED intubation was associated with significantly increased odds of mortality, longer ED dwell time, greater blood transfusion, and major complications. Hospital-level analysis identified significant variation in use of ED intubation between hospitals not explained by patient case mix. After risk adjustment, patients treated at hospitals with high tendency for ED intubation (compared with those with low tendency) were significantly more likely to suffer in-hospital cardiac arrest (6% vs. 4%; adjusted odds ratio, 1.46; 95% confidence interval, 1.04–2.03).

CONCLUSION
Emergency department intubation of patients who require urgent hemorrhage control surgery is associated with adverse outcomes. Significant variation in ED intubation exists between trauma centers not explained by patient characteristics. Where feasible, intubation should be deferred in favor of rapid resuscitation and transport to the operating room.

LEVEL OF EVIDENCE
Therapeutic/Care Management; Level III.
The impact of lidocaine plaster prescribing reduction strategies: a comparison of two national health services in Europe
Authors: Mattsson Molly , Boland Fiona , Kirke Ciara , Flood Michelle , Wallace Emma , Walsh Mary E , Corrigan Derek , Fahey Tom , Croker Richard , Bacon Sebastian C J , Inglesby Peter , Evans David , Goldacre Ben , MacKenna Brian , Moriarty Frank 
Published: February 2023

AbstractIntroductionIn 2017, two distinct interventions were implemented in Ireland and England to reduce prescribing of lidocaine medicated plasters. In Ireland, restrictions on reimbursement were introduced. In England, updated guidance on items not to routinely prescribe in primary care, including lidocaine plasters, was published. This study aims to compare how the interventions impacted prescribing of lidocaine plasters in these countries.MethodsWe conducted an interrupted time series study using general practice data. For Ireland, monthly dispensing data (2015-2019) from the means-tested General Medical Services scheme was used. For England, data covered all patients. Outcomes were the rate of dispensings, quantity and costs of lidocaine plasters, and we modelled level and trend changes from the first full month of the policy/guidance change.FindingsIreland had higher rates of lidocaine dispensings compared to England throughout the study period; this was 15.22/1,000 population immediately pre-intervention, and there was equivalent to a 97.2% immediate reduction following the intervention. In England, the immediate pre-intervention dispensing rate was 0.36/1,000, with an immediate reduction of 0.0251/1,000 (a 5.8% decrease), followed by a small but significant decrease in the monthly trend relative to the pre-intervention trend of 0.0057 per month.InterpretationAmong two different interventions aiming to decrease low-value lidocaine plaster prescribing, there was a substantially larger impact in Ireland of reimbursement restriction compared to issuing guidance in England. However, this is in the context of much higher baseline rates of use in Ireland compared to England.FundingThis study was funded by the Health Research Board (SDAP-2019-023).
Coping with drug resistant tuberculosis alongside COVID-19 and other stressors in Zimbabwe: a qualitative study
Authors: Timire Collins , Kranzer Katharina , Pedrazzoli Debora , Kavenga Fungai , Kasozi Samuel , Mbiba Fredrick , Bond Virginia 
Published: February 2023

AbstractBackgroundHouseholds in low-resource settings are more vulnerable to events which adversely affect their livelihoods, including shocks such as the death of a family member, inflation, droughts and more recently COVID-19. Drug Resistant Tuberculosis (DR-TB) is also another shock that inflicts physical, psychological and socioeconomic burden on individuals and households. We describe experiences and coping strategies among people affected by DR-TB and their households in Zimbabwe during the COVID-19 pandemic, 2020 to 2021.MethodsWe conducted 16 in-depth interviews with adults who had just completed or were completing treatment. Interview themes included health seeking behaviour, impact of DR-TB on livelihoods and coping strategies adopted during treatment. We analysed data using thematic analyses.ResultsHealth seeking from providers outside the public sector, extra-pulmonary TB and health system factors resulted in delayed DR-TB diagnosis and treatment and increased financial drain on households. DR-TB reduced productive capacity and narrowed job opportunities leading to income loss that continued even after completion of treatment. Household livelihood was further adversely affected by lockdowns due to COVID-19, outbreaks of bird flu and cattle disease. Stockouts of DR-TB medicines, common during COVID-19, exacerbated loss of productive time and transport costs as medication had to be accessed from other clinics that were further away. Reversible coping strategies included: reducing number of meals; relocating in search of caregivers and/or family support; spending savings; negotiating with school authorities to keep children in school. Some households had to adopt irreversible coping strategies such as selling productive assets and withdrawing children from school.ConclusionDR-TB combined with COVID-19 and other stressors pushed households into deeper poverty, and vulnerability. Multi-sectoral approaches that combine health systems, psychosocial and economic interventions are crucial to mitigate diagnostic delays and suffering, and meaningfully support people with DR-TB and their households to compensate the loss of livelihoods during and post DR-TB treatment.