bluuebunny/crossref_metadata_2025_split huggingface dataset:
The outcomes of cardiopulmonary resuscitation and their predictors during the coronavirus 2019 pandemic in Iran
Authors: Goodarzi Afshin , Abdi Alireza , Ghasemi Hooman , Darvishi Niloofar , Jalali Rostam 
Published: August 2023

Abstract
Background
Coronavirus disease 2019 (COVID-19) can negatively affect different healthcare-related outcomes. Nonetheless, there is limited information about its effects on different healthcare-related outcomes. This study aimed at evaluating the outcomes of cardiopulmonary resuscitation (CPR) and their predictors during the COVID-19 pandemic in Iran.

Methods
This cross-sectional study was conducted on 1253 patients who had undergone CPR in the emergency wards of teaching hospitals in the west of Iran from the beginning of the first wave to the end of the third epidemic wave of COVID-19 in Iran, between February 20, 2020, and January 20, 2021. Data were collected using the National CPR Documentation Forms developed based on the Utstein Style and routinely used for all patients with cardiac arrest (CA). The SPSS (v. 20.0) program was used to analyze the data through the Chi-square, Fisher’s exact, and Mann-Whitney U tests and logistic regression analysis.

Results
Participants’ age mean was 64.62 ± 17.54 years. Age mean among participants with COVID-19 was eight years more than other participants. Most participants were male (64.09%) and had at least one underlying disease (64.99%). The total rates of the return of spontaneous circulation (ROSC) and CPR–discharge survival were respectively 15.3% and 3.8% among all participants, 20.25% and 5.17% among participants without COVID-19, and 8.96% and 2.04% among participants with COVID-19. The significant predictors of ROSC were age, affliction by COVID-19, affliction by underlying diseases, baseline rhythm, delay in epinephrine administration, and epinephrine administration time interval, while the significant predictors of CPR–discharge survival were age and baseline rhythm.

Conclusions
The total rates of ROSC and CPR–discharge survival were respectively 15.3% and 3.8% among all participants. The rates of ROSC and CPR to discharge survival among patients without COVID-19 are respectively 2.26 and 2.53 times more than the rates among patients with COVID-19.
Telephone outreach by volunteer navigators: a theory-based evaluation of an intervention to improve access to appropriate primary care
Authors: Haggerty Jeannie , Smithman Mélanie-Ann , Beaulieu Christine , Breton Mylaine , Dionne Émilie , Lewis Virginia 
Published: August 2023

Abstract
Background
A pilot intervention in a participatory research programme in Québec, Canada, used telephone outreach by volunteer patient navigators to help unattached persons from deprived neighbourhoods attach successfully to a family doctor newly-assigned to them from a centralized waiting list. According to our theory-based program logic model we evaluated the extent to which the volunteer navigator outreach helped patients reach and engage with their newly-assigned primary care team, have a positive healthcare experience, develop an enduring doctor-patient relationship, and reduce forgone care and emergency room use.

Method
For the mixed-method evaluation, indicators were developed for all domains in the logic model and measured in a telephone-administered patient survey at baseline and three months later to determine if there was a significant difference. Interviews with a subsample of 13 survey respondents explored the mechanisms and nuances of intended effects.

Results
Five active volunteers provided the service to 108 persons, of whom 60 agreed to participate in the evaluation. All surveyed participants attended the first visit, where 90% attached successfully to the new doctor. Indicators of abilities to access healthcare increased statistically significantly as did ability to explain health needs to professionals. The telephone outreach predisposed patients to have a positive first visit and have trust in their new care team, establishing a basis for an enduring relationship. Patient-reported access difficulties, forgone care and use of hospital emergency rooms decreased dramatically after patients attached to their new doctors.

Conclusions
As per the logic model, telephone outreach by volunteer navigators significantly increased patients’ abilities to seek, reach and engage with care and helped them attach successfully to newly-assigned family doctors. This light-touch intervention may have promise to achieve of the intended policy goals for the centralized waiting list to increase population access to appropriate primary care and reduce forgone care.
Newly diagnosed type 2 diabetes – does New Zealand General Practice adequately prepare patients to self-manage their Condition?
Authors: Chepulis Lynne , Mellsop-Kupe Jessie , Moorhouse Suzanne , Keenan Rawiri , Norman Kimberley , Paul Ryan 
Published: August 2023

Abstract
Background
Type 2 diabetes mellitus (T2D) is predominantly managed in primary care, and patients need to be provided with appropriate knowledge and education to understand how to best self-manage their condition. For optimal T2D self-management, primary care teams should share this information from the time of diagnosis. Little is currently known about how and when these resources are being provided to patients with T2D in New Zealand.

Methods
An online survey was carried out between Oct 2022 and Feb 2023. Patients diagnosed with T2D after Jan 2020 were invited to participate, with recruitment occurring via primary care and social media. Questions included information about demographics, diagnosis, provision of education resources and/or referral services as well as about current diabetes management. All responses were analysed with chi square tests. Free-text comments were summarised only.

Results
A total of 203 participants from across New Zealand completed the survey, but 18 were excluded due to being diagnosed more than 3 years ago, or self-reporting with type 1 diabetes rather than T2D. Nearly three quarters (70.7%) of participants reported that they were given appropriate resources to understand and manage their T2D, though half of these would have like more information. Overall, family and friends, self-led research and healthcare-provided education were equally useful, though this differed by ethnic groups. Similarly, approx. 70% of patients thought that medications had been well explained. Free text comments suggested a need for more targeted information around food choice and insulin use as well as a need for empathy and appropriate language from healthcare providers.

Conclusions
Primary care appears to be providing most newly diagnosed patients with appropriate resources to understand and manage their T2D, but there is room for improvement with up to a third of participants not understanding how to manage foods, medication and lifestyle choices to optimise health outcomes. Further work is required to address this gap and should include the use of culturally-appropriate materials to meet the multi-ethnic population needs.
Health literate-sensitive shared decision-making in maternity care: needs for support among maternity care professionals in the Netherlands
Authors: Murugesu Laxsini , Damman Olga C. , Timmermans Danielle R. M. , de Wit Sanne , Nieuwenhuijze Marianne , Smets Ellen M. A. , Fransen Mirjam P. 
Published: August 2023

Abstract
Background
Shared decision-making (SDM) in maternity care is challenging when clients have insufficient health literacy (HL) skills. This study gained insight in how professionals apply HL-sensitive SDM in Dutch maternity care and their needs for support therein.

Methods
Maternity care professionals (n = 30) completed a survey on SDM and the role of HL. Midwives (n = 13) were observed during simulated conversations discussing pain relief options and interviewed afterwards. The client-actors were instructed to portrait specific inadequate HL skills. Observation items focused on adapting communication to HL, and SDM (OPTION-5).

Results
In the survey, professionals indicated experiencing most challenges when estimating clients’ information comprehension. Observations showed that most midwives created choice awareness and informed clients about options, whereas exploring preferences and actual decision-making together with clients were observed less frequently. Their perceived HL-related obstacles and needs for support related to clients’ information comprehension. In the interviews, midwives reported putting much effort into explaining available options in maternity care, but also that decisions about pain relief are often postponed until the moment of labour.

Conclusion
Professionals’ self-reported needs focus on clients’ information comprehension. However, observations indicate that it is not the stage of informing, but rather value clarification and actual decision-making that need improvement in HL-sensitive SDM.
Risk factors of suicidal spectrum behaviors in adults and adolescents with attention-deficit / hyperactivity disorder – a systematic review
Authors: Austgulen Amalie , Skram Nanna Karen Gilberg , Haavik Jan , Lundervold Astri J. 
Published: August 2023

Abstract
Introduction
Adolescents and adults with attention-deficit/hyperactivity disorder (ADHD) are at increased risk of suicidal spectrum behaviors (SSBs). However, there is limited knowledge about risk factors triggering SSBs in this group of people.

Objective
To explore published literature concerning factors that may increase the risk of SSBs in adults and adolescents with ADHD.

Methods
A systematic literature search following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted on 22nd of February 2022 using the Ovid MEDLINE and Web of Science databases. Three categories of search terms were used: (1) self-harm, self-injury, self-mutilation, suicide, self-poisoning; (2) adults, adolescents; and (3) attention-deficit hyperactivity disorder/ADHD. Studies with data concerning mediating factors of SSBs in relation to a clinical diagnosis of ADHD in participants above 16 years of age were included.

Results
The literature search identified 604 articles, of which 40 were included in the final study selection. Factors found to increase the likelihood of SSBs included ADHD symptom severity and persistence, female gender, family history of ADHD, childhood and parental influences, and social functioning. Even when adjusting for psychiatric comorbidities, most studies showed that adults and adolescents with ADHD have an elevated risk of SSBs.

Conclusion
This systematic review has documented that several demographic and clinical features are associated with an increased risk of SSBs in adolescents and adults with ADHD. Notably, ADHD emerges as an independent risk factor for SSBs. This information ought to have clinical implications in terms of screening and suicide prevention strategies. Further longitudinal studies are needed to investigate the outcome of preventive strategies in individuals along the full spectrum of ADHD symptom severity.
Long-term health consequences among individuals with SARS-CoV-2 infection compared to individuals without infection: results of the population-based cohort study CoMoLo Follow-up
Authors: Heidemann Christin , Sarganas Giselle , Du Yong , Gaertner Beate , Poethko-Müller Christina , Cohrdes Caroline , Schmidt Sein , Schlaud Martin , Scheidt-Nave Christa 
Published: August 2023

Abstract
Background
Most of the previous studies on health sequelae of COVID-19 are uncontrolled cohorts and include a relatively short follow-up. This population-based multi-center cohort study examined health consequences among individuals about 1 to 1.5 years after SARS-CoV-2 infection compared with non-infected.

Methods
The study population consisted of adults (≥ 18 years) from four municipalities particularly affected by the COVID-19 pandemic in the year 2020 who completed a detailed follow-up questionnaire on health-related topics. Exposure was the SARS-CoV-2 infection status (based on IgG antibodies, PCR test, or physician-diagnosis of COVID-19) at baseline (May to December 2020). Outcomes assessed at follow-up (October 2021 to January 2022; mean: 452 days) included recurrent or persistent health complaints, incident diseases, health-related quality of life (PROMIS-29), subjective health, and subjective memory impairment. Logistic and linear regression models were adjusted for baseline sociodemographic and lifestyle characteristics (age, sex, municipality, education, smoking, body mass index), pre-existing health conditions (chronic disease/health problem, health-related activity limitation, depressive/anxiety disorder), and follow-up time.

Results
Among 4817 participants, 350 had a SARS-CoV-2 infection at baseline and 4467 had no infection at baseline or during follow-up. Those with an infection statistically significantly more often reported 7 out of 18 recurrent or persistent health complaints at follow-up: smell/taste disorders (12.8% vs. 3.4%, OR 4.11), shortness of breath (23.0% vs. 9.5%, 3.46), pain when breathing (4.7% vs. 1.9%, 2.36), fatigue (36.9% vs. 26.1%, 1.76), weakness in legs (12.8% vs. 7.8%, 1.93), myalgia/joint pain (21.9% vs. 15.1%, 1.53) and cough (30.8% vs. 24.8%, 1.34) and 3 out of 6 groups of incident diseases: liver/kidney (2.7% vs. 0.9%, 3.70), lung (3.2% vs. 1.1%, 3.50) and cardiovascular/metabolic (6.5% vs. 4.0%, 1.68) diseases. Those with an infection were significantly more likely to report poor subjective health (19.3% vs. 13.0%, 1.91), memory impairment (25.7% vs. 14.3%, 2.27), and worse mean scores on fatigue and physical function domains of PROMIS-29 than non-infected.

Conclusion
Even after more than one year, individuals with SARS-CoV-2 infection showed an increased risk of various health complaints, functional limitations, and worse subjective well-being, pointing toward profound health consequences of SARS-CoV-2 infection relevant for public health.
Effect of the number of negative lymph nodes removed on the survival and recurrence rate after gastrectomy in patients with gastric cancer: a multicenter retrospective cohort study
Authors: Bahardoust Mansour , Kheirabadi Mahdieh , Donyadideh Ghazaleh , Khaleghian Mohsen , Haghmoradi Meisam , Tizmaghz Adnan 
Published: August 2023

Abstract
Background
Various factors affect the survival rate of Gastric cancer (GC) patients after gastrectomy. This study aimed to investigate the effect of the number of negative lymph nodes (NLNs) removed on GC patients’ survival and recurrence rate after gastrectomy.

Methods
In this retrospective, multicenter cohort study, we reviewed the medical profile of 639 patients with a definite diagnosis of GC who underwent gastrectomy from 2010 to 2022 in one of the medical centers affiliated with the Iran University of Medical Sciences. Based on the number of NLNs removed, patients were divided into three groups, including (0–9NLNs), (10–15 NLNs), and (≥ 16 NLNs), including 155, 231, and 253 GC patients, respectively. Demographic characteristics, tumor characteristics, and pathological findings of the patients were extracted by referring to the patient’s files.

Results
The 5-year survival rate of patients was estimated at 48.2%. The 5-year tumor recurrence rate in patients with the number of NLNs 1–9, NLNs 10–15, and ≥ 16 NLNs were 79.4%, 51.1%, and 30.8%, respectively. (Log-rank = 9.24, P 0.001) The multivariate analysis showed that the 5-year survival rate in patients with fewer NLNs removed ≥ 16 was significantly higher than in the other two groups. In addition, age, BMI, tumor size, tumor stage, metastasis, and tumor differentiation were significantly related to the survival of GC patients after gastrectomy. (p < 0.05)

Conclusion
Paying attention to the number of NLNs removed during gastrectomy can be a key factor in improving the survival prediction of GC patients.
A scoping review of remote facilitation during simulation-based healthcare education
Authors: Park Ju Ok , Lee-Jayaram Jannet , Sato Eri , Eto Yuka , Kahili-Heede Melissa , Hirayama Krystal , Berg Benjamin W 
Published: August 2023

Abstract
Background
Remote facilitation is a synchronous distance education method where instructors facilitate a lesson, in real-time, in physically separate conditions. In this scoping review, we aimed to describe types of remote facilitation used in a healthcare simulation, the influences on learner outcomes, and related factors.

Methods
We accessed PubMed, EMBASE, CINAHL, ERIC, and Web of Science using our search strategies. Five reviewers performed the review using the Preferred Reporting Items for Systematic Reviews and Meta Analysis extension for Scoping Reviews (PRISMA-ScR) framework, and the Johanna Briggs Institute (JBI) guidelines.

Results
We included a total of 29 articles presenting 28 simulation studies. The most common tool was videoconferencing (n = 26, 89.7%). Knowledge improvement was the most frequently measured outcome. There was no significant difference in learning outcomes between the two teaching modes. There were differences in learners’ preferences and satisfaction with remote facilitators before and after COVID-19.

Conclusions
Our scoping review indicates that remote facilitation has been widely accepted in many healthcare professions using various types of simulation modalities. Remote facilitation can be used to overcome logistical problems of synchronous multi-location education, and to improve learner knowledge, skills, and confidence measured by instructor evaluation or self-assessment.
Hybridizing video-based learning with simulation for flipping the clinical skills learning at a university hospital in Pakistan
Authors: Saeed Sana , Khan Maryam Hameed , Siddiqui Muhammad Muneeb Ullah , Dhanwani Anny , Hussain Areeba , Ali Muhammad Maisam 
Published: August 2023

Abstract
Background
While learning and practicing on actual patients is a major mode of teaching clinical skills, concerns about patient safety, unavailability, and lack of standardization have led to the development of simulation for medical education. Simulation-based teaching is affected by challenges such as lack of protected time for faculty, inexperienced learners, and the number of students per group. These have led to the integration of various eLearning formats in the curriculum. The hybridized format changes the traditional clinical skills teaching into the flipped classroom. This study aims to measure the effectiveness of hybridizing video-based learning with simulation for flipping the clinical skills teaching of fourth-year medical students at the Department of Paediatrics and Child Health at Aga Khan University, Pakistan.

Methods
The study employed a mixed-methods design. Fourth-year medical students of the batch 2020-21 (n = 100) consented to participate in the study. The quantitative component focuses on identifying the effect of the intervention on the perceived self-efficacy of medical students (batch 2020-21) relevant to the clinical skill. Along with this, the performance of the intervention batch of 2020-21 on the end of clerkship objective structured clinical exam (OSCE) was compared with the previous batch of 2019-20, taught using simulation alone. Focused group discussions (FGDs) were used to explore the experiences of medical students (batch 2020-21) about the intervention. Quantitative data underwent descriptive and inferential analysis using Stata v16 while qualitative data underwent content analysis using NVivo software.

Results
Hybridization of video-based learning with simulation significantly improved self-efficacy scores for all examinations (cardiovascular, respiratory, neurological, and abdomen) with p-value < 0.05. OSCE scores of the intervention group were significantly higher on the neurological and abdominal stations as compared to the previous batch (p-value < 0.05). In addition, the overall structure of the intervention was appreciated by all the students, who stated it allowed reinforcement of basic concepts, retention, and further insight into clinical applications.

Conclusion
The hybridization of video-based learning with simulation facilitated in creation of better opportunities for medical students to revive their prior knowledge, apply core concepts for the problem and engage in clinical reasoning.
Family members’ perception of their needs in critical care units at a tertiary hospital in Malawi: A qualitative study
Authors: Kalolo Angellina Mankhamba , Mula Chimwemwe , Gundo Rodwell 
Published: August 2023

Abstract
Background
Family members experience an emotional crisis when their loved one is critically ill and admitted to a critical care unit (CCU). An extensive literature has explored optimal ways to interact with families in the critical care setting, including intervention studies. What is less explored are perceptions of family members in low-income settings including Malawi. In such settings, perceptions may differ as a consequence of different cultural practices and resource limitations (personnel and technology). Therefore, this study explored family members’ perceptions of their needs in CCUs at a tertiary hospital in Malawi.

Study designs and methods
The study used a qualitative descriptive design. Data were gathered through interviews with 12 participants who were purposively selected from immediate family members of patients hospitalized for 48 h or more in adult intensive care unit (ICU) and high dependency unit (HDU). The interviews were audio recorded and transcribed verbatim. Data analysis followed the steps of content analysis.

Findings
The following four themes were identified: perceived information, physical, and psychosocial needs, and coping mechanisms of the family members. The family members needed information about their patient’s progress frequently and viewed this as a priority compared to other needs such as comfort and food.

Conclusion
This study suggests that there should be a collaborative relationship between the CCU team and family members in order to meet their needs. Findings affirm the need for health professionals to develop guidelines or standards that promote frequent discussions with CCU family members as a means to provide support and lessen anxiety.