bluuebunny/crossref_metadata_2025_split huggingface dataset:
Priorities to improve woman‐centred gestational diabetes mellitus care: A qualitative study to compare views between clinical and consumer end‐users
Authors: Wan Ching Shan , Nankervis Alison , Teede Helena , Aroni Rosalie 
Published: June 2023

AbstractBackgroundImmigrants worldwide have a two‐fold higher risk of gestational diabetes mellitus (GDM) than women of the host country. Providing culturally appropriate woman‐centred GDM care to attenuate adverse maternal and neonatal health outcomes is a persistent challenge for health services. Underpinned by the Knowledge to Action Framework, understanding and comparing the views of patients from different ethnic backgrounds and healthcare professionals (HCPs) about current and optimal GDM care can highlight priority areas to improve woman‐centred care. This qualitative study aimed to compare the views of ethnic Chinese and Australian‐born Caucasian women and their HCPs, including endocrinologists, obstetricians, midwives, diabetes nurse educators and dietitians, about what constitutes optimal GDM care and how to improve woman‐centred GDM care.MethodsPurposive sampling was used to recruit 42 Chinese and 30 Caucasian women with GDM and 17 HCPs from two large Australian hospital maternity services to complete in‐depth, semi‐structured interviews. Patients’ and HCPs’ views were thematically analysed and compared.ResultsFour out of nine themes showed misalignments between patients’ and HCPs’ views on GDM care, reflecting priority areas to improve woman‐centred care by (i) reaching agreement on the attitudes towards different treatment targets between HCPs; (ii) enhancing inter‐professional communication; (iii) improving GDM care transition to postpartum care; and (iv) providing detailed dietary advice tailored to Chinese patients’ cultural diet.ConclusionsFurther research on reaching consensus on treatment targets, enhancing inter‐professional communication, developing a perinatal care transition model from pregnancy to postpartum, and developing Chinese patient‐oriented educational resources is required to improve woman‐centred care.
Trauma‐Informed Psychosocial Screening and Care Planning: A Patient‐Centered Improvement Project in a Midwife Clinic
Authors: Lefever‐Rhizal Debra , Collins‐Fulea Catherine , Bailey Joanne Motino 
Published: June 2023

IntroductionTraumatic stress is associated with increases in preterm birth, low birth weight, and other perinatal complications. Yet the identification of patients with traumatic stress and intervention for traumatic stress prevention or treatment remain low. Locally in this university hospital‐based midwife clinic, a health records review found that trauma exposure was documented in 5% of patient records, and no records had a diagnosis of posttraumatic stress disorder (PTSD). This is lower than research‐based population estimates of 25% to 50% for trauma exposure and 8% for PTSD during pregnancy. The clinic staff did not screen for posttraumatic stress, and exposure screening was limited to intimate personal violence. Staff had not been trained in trauma‐informed care (TIC) as defined by the Substance Abuse and Mental Health Services Administration. The aim for this improvement project was to provide trauma screening and trauma‐related care planning, collectively referred to as trauma‐informed psychosocial care, to midwifery patients 85% of the time.ProcessInterventions were implemented over 4 plan‐do‐study‐act (PDSA) cycles. These included staff training in TIC; written screening at the new prenatal, third trimester, and postpartum visits; verbal broad inquiry at every visit; and bidirectional trauma‐specific care planning emphasizing patient and provider input into treatment choice. The clinic flow was changed to create privacy for patient‐staff interaction at every visit. Field notes and data were analyzed every 2 weeks and iterative changes applied.OutcomesTrauma disclosure increased from 5% to 30% and identification of PTSD from 0% to 7%. Bidirectional care plan documentation increased from 8% to 67%. Staff rated the workload as reasonable.DiscussionRedesigning psychosocial screening to align with TIC principles increased the discovery of trauma to levels consistent with research‐based population estimates. Gains were made in bidirectional care planning. This project illustrates practical methods of implementing TIC principles.
Retention of newly graduated registered nurses in the hospital setting: A systematic review
Authors: Vázquez‐Calatayud Mónica , Eseverri‐Azcoiti Mari Carmen 
Published: June 2023

AbstractBackgroundThere is a gap in the literature on identifying and describing effective interventions for the retention of newly graduated registered nurses in hospital settings. To the best of our knowledge, no systematic review has been conducted on this issue.AimTo identify effective interventions that promote the retention of newly graduated registered nurses in the hospital setting and their components.DesignA systematic review was conducted according to PRISMA 2020 Statement.MethodsInformation derived from the PubMed, CINAHL, Scopus, PsycINFO and Cochrane Library databases was reviewed, for the period January 2012–October 2022. Screening, data extraction and quality appraisal were conducted independently by two reviewers. The Joanna Briggs Institute Critical Appraisal tools were used for descriptive, quasi‐experimental and cohort studies. Disagreements between the two reviewers were resolved through discussion.ResultsFollowing the critical appraisal, nine studies were included. The evidence reveals the heterogeneity of programmes developed in the hospital context to promote the retention of newly graduated registered nurses, clarifies the three competencies to be addressed (core, cross‐cutting and specific), their components (programme development framework, duration, content and support components), and shows significant improvements after their implementation.ConclusionsThis systematic review identifies that either nurse residency or individualised mentoring programmes, lasting 1 year, and multi‐component, addressing core and specific competencies and including preceptor or mentor components seem to be the most comprehensive and effective in promoting the retention of new nurses in the hospital setting.Relevance to Clinical PracticeThe knowledge provided by this review will contribute to developing and implementing more effective and context‐specific strategies directed at retaining newly graduated registered nurses and subsequently enhancing patient safety and healthcare costs.No Patient or Public ContributionGiven the study design and focus.
The onset of sepsis as experienced by patients and family members: A qualitative interview study
Authors: Olander Agnes , Andersson Henrik , Sundler Annelie J. , Hagiwara Magnus Andersson , Bremer Anders 
Published: June 2023

AbstractAims and ObjectivesTo explore the onset of sepsis based on patients' and family members' experiences.BackgroundKnowledge about the onset of sepsis is limited among patients and their families, which makes early recognition of sepsis difficult. Previous studies argue that their stories are important to recognising sepsis and reduced suffering and mortality.DesignA descriptive design with a qualitative approach was used.MethodsIn total, 29 patients and family members participated in 24 interviews with open‐ended questions, including five dyadic and 19 individual interviews. The interviews were conducted during 2021, and participants were recruited from a sepsis group on social media. A thematic analysis based on descriptive phenomenology was performed. The study followed the COREQ checklist.FindingsTwo themes emerged from the experiences: (1) When health changes into something unknown, including the two subthemes; Bodily symptoms and signs being vague but still tangible and Feelings of uncertainty, and (2) Turning points when warnings signs are deemed as serious, including the two subthemes Passing borders when feeling out of control and Difficulties understanding the seriousness.ConclusionsPatients' and family members' stories of the onset of sepsis indicate that symptoms and signs appeared insidiously and then noticeably worsen. The symptoms and signs seemed not be attributed to sepsis; instead, there was uncertainty about what the symptoms and signs meant. It was mainly family members who possibly understood the seriousness of the disease.Implications for the profession and patient carePatients' experiences of their symptoms and signs and family members' unique knowledge of the patient, indicate that healthcare professionals should listen and try to understand what the patient and family members are telling and take their concerns seriously. How the condition appears, and family members' concerns are important pieces of the assessment to recognise patients with sepsis.Patient or public contributionPatients and family members contributed to the data collected.
Cardiovascular risk in rheumatoid arthritis patients treated with targeted synthetic and biological disease‐modifying antirheumatic drugs: A multi‐centre cohort study
Authors: Tong Xinning , Shen Chin‐Yao , Jeon Ha‐Lim , Li Yihua , Shin Ju‐Young , Chan Shirley CW , Yiu Kai Hang , Pratt Nicole L. , Ward Michael , Lau Chak Sing , Wong Ian CK , Li Xue , Lai Edward Chia‐Cheng 
Published: June 2023

AbstractBackgroundThis study aimed to compare the cardiovascular safety of interleukin‐6 inhibitors (IL‐6i) and Janus Kinase inhibitors (JAKi) to tumour necrosis factor inhibitors (TNFi).MethodsWe conducted a retrospective cohort study using population‐based electronic databases from Hong Kong, Taiwan and Korea. We identified newly diagnosed patients with rheumatoid arthritis (RA) who received b/tsDMARDs first time. We followed patients from b/tsDMARD initiation to the earliest outcome (acute coronary heart disease, stroke, heart failure, venous thromboembolism and systemic embolism) or censoring events (death, transformation of b/tsDMARDs on different targets, discontinuation and study end). Using TNFi as reference, we applied generalized linear regression for the incidence rate ratio estimation adjusted by age, sex, disease duration and comorbidities. Random effects meta‐analysis was used for pooled analysis.ResultsWe identified 8689 participants for this study. Median (interquartile range) follow‐up years were 1.45 (2.77) in Hong Kong, 1.72 (2.39) in Taiwan and 1.45 (2.46) in Korea. Compared to TNFi, the adjusted incidence rate ratios (aIRRs) (95% confidence interval [CI]) of IL‐6i in Hong Kong, Taiwan and Korea are 0.99 (0.25, 3.95), 1.06 (0.57, 1.98) and 1.05 (0.59, 1.86) and corresponding aIRR of JAKi are 1.50 (0.42, 5.41), 0.60 (0.26, 1.41), and 0.81 (0.38, 1.74), respectively. Pooled aIRRs showed no significant risk of cardiovascular events (CVEs) associated with IL‐6i (1.05 [0.70, 1.57]) nor JAKi (0.80 [0.48, 1.35]) compared to TNFi.ConclusionThere was no difference in the risk of CVE among RA patients initiated with IL‐6i, or JAKi compared to TNFi. The finding is consistent in Hong Kong, Taiwan and Korea.
The medical internship as a meaningful transition: A phenomenographic study
Authors: Carlsson Yvonne , Bergman Stefan , Nilsdotter Anna , Liljedahl Matilda 
Published: June 2023

AbstractBackgroundThe transition from student to doctor is often depicted as a struggle in the literature, and previous research has focused on interventions to minimise difficulties in transitioning from undergraduate to postgraduate training. In considering this transition as a potential transformative experience, we intend to produce new insights into how junior doctors experience the transition to clinical work. The aim of this study was to explore medical interns' conceptualisations of the transition from student to doctor through studying the Swedish medical internship, which serves as a bridge between undergraduate and postgraduate studies. The research question was formulated as follows: How do medical interns perceive the meaning of the medical internship?MethodsThe data were collected through in‐depth interviews with 12 senior medical interns in western Sweden. The transcribed interviews were analysed using a phenomenographic approach, which resulted in four qualitatively varying ways of perceiving the meaning of the internship, organised hierarchically in a phenomenographic outcome space.ResultsThe interns perceived the meaning of the internship as an opportunity to work and learn in an authentic setting (internship as in‐service training) and in a protected environment (internship as a space). The internship guaranteed a minimum level of competence (internship as a quality marker) and allowed the interns to gain new insights into themselves and their world (internship as an eye‐opener).DiscussionBeing allowed to be learners in a protected space seemed pivotal for the interns to develop into competent, confident and independent practitioners. The medical internship studied here could be viewed as a meaningful transition into new ways of experiencing, allowing for an increased understanding of oneself and the world. This study adds to the scientific literature on what constitutes a transformative transition.
Sex differences in paroxysmal atrial fibrillation catheter ablation: A difference‐in‐difference propensity score matched analysis
Authors: Ma Yibo , Guo Lanyan , Liu Cheng , Xu Jian , Wang Yi , Yi Fu 
Published: June 2023

AbstractBackgroundWhether male and female patients with atrial fibrillation (AF) differ in their risk of recurrence after catheter ablation remains controversial. Large differences in baseline characteristics between males and females often affect study results.MethodsPatients with drug‐refractory paroxysmal AF who received their first catheter ablation procedure between January 2018 and December 2020 were retrospectively enrolled. Propensity score matching was used to adjust for age, body mass index, and AF duration. Our main concerns were sex differences in comorbidities, procedures, arrhythmia recurrences, and procedure‐related complications.ResultsFor this study, 352 patients (176 pairs) were matched, and baseline characteristics were comparable between the two groups. Intraprocedural sex differences were apparent as more male patients received cavotricuspid isthmus ablation (55.00% vs. 31.43%, p = .005). Full follow‐up, 1‐year, 2‐year, and 3‐year AF recurrence rates were comparable between male and female groups. Multivariable Cox regression showed that the recurrence risk of paroxysmal AF was similar between male and female patients. AF duration was the only potential risk factor and occurred for only male patients. There were no significant differences in the subgroup analyses. Procedure‐related complications were comparable between the male and female groups.ConclusionWe did not observe differences in baseline characteristics, arrhythmia recurrences, or procedure‐related complications between male and female patients. Sex differences were reflected mainly in the finding that male patients received more cavotricuspid isthmus ablations, and atrial fibrillation duration was the only potential risk factor for recurrence and only for male patients.
Childhood granulomatous periorificial dermatitis in 31 Chinese children successfully treated with oral roxithromycin
Authors: Wang Senfen , Li Ping , Li Jianhong , Zhang Huan 
Published: June 2023

AbstractData regarding the treatment of childhood granulomatous periorificial dermatitis (CGPD) using oral therapies are limited. This study included 31 Chinese children with CGPD treated with oral roxithromycin. After 12 weeks of treatment, 90.3% of the patients recovered, and there were no severe adverse effects. Our results suggest that oral roxithromycin is an effective and safe treatment for CGPD.
An Aesthetics of Chinese Calligraphy
Authors: Shi Xiongbo 
Published: June 2023

AbstractThis article introduces the aesthetic significance of Chinese calligraphy, one of the highest art forms in China. It focuses on three major aesthetic concerns manifested in classical texts on this art. First, Chinese art theory stresses that the forms (xing) of successful calligraphic works are never static; rather, they should be filled with internal force (shi). Second, calligraphic creation can be understood as a psychosomatic process, that is, involving coordination between the mind and the hand. Third, appreciation of Chinese calligraphy is identified with the process of reconstructing the calligrapher's creation of the work, which is analogous to Richard Wollheim's identifying criticism as retrieval. The last section examines the concept of qi and discusses what kind of aesthetic considerations encourage us to make a connection between Chinese calligraphy and abstract art.
Evolving Concepts of Functional Localization
Authors: McCaffrey Joseph B. 
Published: June 2023

AbstractFunctional localization is a central aim of cognitive neuroscience. But the nature and extent of functional localization in the human brain have been subjects of fierce theoretical debate since the 19thCentury. In this essay, I first examine how concepts of functional localization have changed over time. I then analyze contemporary challenges to functional localization drawing from research on neural reuse, neural degeneracy, and the context‐dependence of neural functions. I explore the consequences of these challenges for topics in philosophy of science and philosophy of mind including localizationist versus anti‐localizationist approaches to cognitive neuroscience, multiple realizability, reverse inference in functional neuroimaging, and the modularity of mind.
The Beginning of Hegel'sLogic
Authors: Dunphy Robb 
Published: June 2023

AbstractThis article discusses two topics, both commonly referred to using the label “the beginning of Hegel'sLogic”: (1) Hegel's justification for the claim that a science of logic must begin by considering the concept of “pure being”. (2) Hegel's discussion of the concepts “being”, “nothing”, and “becoming” in the first chapter of hisLogic. Discussing recent work on both of these topics, two primary claims are defended: Regarding (1): the strongest interpretations of Hegel's case for beginning a science of logic with the concept of pure being are those which take him to argue that this concept must be necessarily both “immediate” and “mediated” at the same time. Regarding (2): The widespread tendency to take Hegel's treatment of the concepts of being, nothing, and becoming as an example with which to illustrate his “dialectical method” should be replaced with an interpretation of that chapter which understands it to rather make possible the kind of dialectical transitions which make up the rest of Hegel'sScience of Logic.
Reducing the Price of Naïveté in return‐to‐play from sports‐related concussion
Authors: Garcia Gian‐Gabriel P. , Lavieri Mariel S. , McAllister Thomas W. , McCrea Michael A. , Broglio Steven P. , CARE Consortium Investigators  
Published: June 2023

Patient‐reported outcomes (PROs) play an increasingly important role in medical decision making. Yet, patients whose objectives differ from their physician's may strategically report symptoms to alter treatment decisions. For example, athletes may underreport symptoms to expedite return‐to‐play (RTP) from sports‐related concussion (SRC). Thus, clinicians must implement treatment policies that mitigate the Price of Naïveté, that is, the reduction in health outcomes due to naïvely believing strategically reported symptoms. In this study, we analyze dynamic treatment cessation decisions with strategic patients. Specifically, we formulate the Behavior‐Aware Partially Observable Markov Decision Process (BA‐POMDP), which optimizes the timing of treatment cessation decisions while accounting for known symptom‐reporting behaviors. We then analytically characterize the BA‐POMDP's optimal policy, leading to several practical insights. Next, we formulate the Behavior‐Learning Partially Observable Markov Decision Process (BL‐POMDP), which extends the BA‐POMDP by learning a patient's symptom‐reporting behavior over time. We show that the BL‐POMDP is decomposable into several BA‐POMDPs, allowing us to leverage the BA‐POMDP's structural properties for solving the BL‐POMDP. Then, we apply the BL‐POMDP to RTP from SRC using data from 29 institutions across the United States. We estimate the Price of Naïveté by comparing the BL‐POMDP to naïve benchmark policies. Accordingly, the BL‐POMDP reduces premature RTP by over 44% and provides up to 3.63 additional health‐adjusted athletic exposures per athlete compared to current practice. Overall, changing the interpretation of reported symptoms can better reduce the Price of Naïveté over adjusting treatment cessation thresholds. Therefore, to improve patients' health outcomes, clinicians must understand how strategic behavior manifests in PROs.
Neurodevelopmental outcomes in children after prenatal marijuana exposure
Authors: Isik Oliver G. , Guo Ling , Whitehouse Andrew J. O. , Li Guohua , Ing Caleb 
Published: June 2023

AbstractBackgroundThe effect of prenatal marijuana exposure (PME) on child neurodevelopment remains poorly understood. Prior studies have demonstrated inconsistent results.ObjectivesThis study evaluated the association between PME and neuropsychological test scores in late childhood and early adulthood, accounting for a wide range of parental characteristics.MethodsThis study evaluated participants from the Raine Study, a cohort of 2868 children born between 1989 and 1992. Children whose mothers provided information on marijuana use during pregnancy were included. The primary outcome was the Clinical Evaluation of Language Fundamentals (CELF) at age 10. Secondary outcomes included the Peabody Picture Vocabulary Test (PPVT), Child Behaviour Checklist (CBCL), McCarron Assessment of Neuromuscular Development (MAND), Coloured Progressive Matrices (CPM), Symbol Digit Modality Test (SDMT) and Autism Spectrum Quotient (AQ) scores. Exposed and unexposed children were matched by propensity score using optimal full matching. Missing covariate data were imputed using multiple imputation. Inverse probability of censoring weighting (IPCW) was used to adjust for missing outcome data. Linear regression within matched sets, adjusted by IPCW, evaluated score differences between exposed and unexposed children. As a secondary analysis, modified Poisson regression, adjusted by match weights and IPCW, evaluated the risk of clinical deficit in each outcome following PME.ResultsOf the 2804 children in this cohort, 285 (10.2%) had PME. After optimal full matching and IPCW, exposed children scored similarly on CELF Total (−0.33 points, 95% confidence interval [CI] −4.71, 4.05), Receptive (+0.65 points, 95% CI −4.08, 5.38) or Expressive (−0.53 points, 95% CI −5.07, 4.02). PME was not associated with secondary outcomes or risks of clinical deficit in any neuropsychological assessments.ConclusionsAfter adjusting for sociodemographic and clinical covariates, PME was not associated with worse neuropsychological test scores at age 10 or autistic traits at 19–20.