bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assistive robotic systems in nursing care: a scoping review
Authors: Ohneberg Christoph , Stöbich Nicole , Warmbein Angelika , Rathgeber Ivanka , Mehler-Klamt Amrei Christin , Fischer Uli , Eberl Inge 
Published: March 2023

Abstract
Background
The use of assistive robotic systems in care is intended to relieve nursing staff. Differentiated and literature-based findings on current application possibilities, technological developments and empirical findings are necessary to enable a goal-oriented and participatory development of assistive robotic systems of care. The aim of this review was to identify assistive robotic systems and their areas of application in nursing settings. Furthermore, an overview of existing social and nursing science findings from the research field of assistive robotic systems will be described.

Methods
A systematic literature search was performed based on the JBI scoping review methodology. During the period from May to August 2020, the databases MEDLINE via PubMed, CINAHL, Cochrane Library, Web of Science, and IEEE Xplore Digital Library were searched. In order to reflect current developments and evidence in the present literature work, a supplementary search with these same requirements was conducted in January 2022.

Results
The 47 included publications are divided into 15 studies, 23 technical articles and nine opinion-based articles (text-opinion). A total of 39 different assistive robotic systems were identified. There were 55% in the testing phase and 29% of the systems in the development phase. Assistive robotic systems can be divided into six fields of application: Information and patient data processing, assistance with activities of daily living, fetch and bring activities, telepresence and communication, monitoring, safety and navigation, and complex assistance systems. The description of the study findings is divided into "integration of technology and impact on practice" and "attitude and acceptance of elderly people towards assistive robotic systems".

Conclusion
The results of the research show that the use of assistive robotic systems in care mainly take place in the context of development and testing phases. In addition to usability and acceptance issues, implementation factors must be integrated into theory-driven research projects.
Effectiveness of a critical reflection competency program for clinical nurse educators: a pilot study
Authors: Shin Sujin , Lee Inyoung , Kim Jeonghyun , Oh Eunyoung , Hong Eunmin 
Published: March 2023

Abstract
Background
Critical reflection is an effective learning strategy that enhances clinical nurses’ reflective practice and professionalism. Therefore, training programs for nurse educators should be implemented so that critical reflection can be applied to nursing education. This study aimed to investigate the effects of a critical reflection competency program for clinical nurse educators on improving critical thinking disposition, nursing reflection competency, and teaching efficacy.

Methods
A pilot study was conducted using a pre- and post-test control-group design. Participants were clinical nurse educators recruited using a convenience sampling method. The program was conducted once a week for 90 min, with a total of four sessions. The effectiveness of the developed program was verified by analyzing pre- and post-test results of 26 participants in the intervention group and 27 participants in the control group, respectively. The chi-square test, independent t-test, Mann-Whitney U test, and analysis of covariance with age as a covariate were conducted.

Results
The critical thinking disposition and teaching efficacy of the intervention group improved after the program, and the differences between the control and intervention groups were statistically significant (F = 14.751, p < 0.001; F = 11.047, p < 0.001). There was no significant difference in the change in nursing reflection competency between the two groups (F = 2.674, p = 0.108).

Conclusion
The critical reflection competency program was effective in improving the critical thinking disposition and teaching efficacy of nurse educators. Therefore, it is necessary to implement the developed program for nurse educators to effectively utilize critical reflection in nursing education.
Cost and outcomes of routine HIV care and treatment: public and private service delivery models covering low-income earners in South Africa
Authors: Long L. C. , Girdwood S. , Govender K. , Meyer-Rath G. , Miot J. 
Published: March 2023

Abstract
Background
While South Africa’s national HIV program is the largest in the world, it has yet to reach the UNAIDS 95–95-95 targets. To reach these targets, the expansion of the HIV treatment program may be accelerated through the use private sector delivery models. This study identified three innovative non-governmental primary health care models (private sector) providing HIV treatment, as well as two government primary health clinics (public sector) that served similar populations. We estimated the resources used, and costs and outcomes of HIV treatment across these models to provide inputs to inform decisions around how these services might best be provided through National Health Insurance (NHI).

Methods
A review of potential private sector models for HIV treatment in a primary health care setting was conducted. Models actively offering HIV treatment (i.e. in 2019) were considered for inclusion in the evaluation, subject to data availability and location. These models were augmented by government primary health clinics offering HIV services in similar locations. We conducted a cost-outcomes analysis by collecting patient-level resource usage and treatment outcomes through retrospective medical record reviews and a bottom-up micro-costing from the provider perspective (public or private payer). Patient outcomes were based on whether the patient was still in care at the end of the follow up period and viral load (VL) status, to create the following outcome categories: in care and responding (VL suppressed), in care and not responding (VL unsuppressed), in care (VL unknown) and not in care (LTFU or deceased). Data collection was conducted in 2019 and reflects services provided during the 4 years prior to that (2016–2019).

Results
Three hundred seventy-six patients were included across the five HIV treatment models. Across the three private sector models there were differences in the costs and outcomes of HIV treatment delivery, two of the models had results similar to the public sector primary health clinics. The nurse-led model appears to have a cost-outcome profile distinct from the others.

Conclusion
The results show that across the private sector models studied the costs and outcomes of HIV treatment delivery vary, yet there were models that provided costs and outcomes similar to those found with public sector delivery. Offering HIV treatment under NHI through private delivery models could therefore be an option to increase access beyond the current public sector capacity.
A self-monitoring wellbeing screening methodology for keyworkers, ‘My Personal Wellbeing’, using an integrative wellbeing model
Authors: Elvin Garry , Kurt Zeyneb , Kennedy Angela , Sice Petia , Walton Lee , Patel Paras 
Published: March 2023

Abstract
Background
The detrimental impact of Covid-19 has led to an urgent need to support the wellbeing of UK National Health Service and care workers. This research develops an online diary to support the wellbeing of staff in public healthcare in real-time, allowing the exploration of population wellbeing and pro-active responses to issues identified.

Methods
The diary was co-produced by NHS and care stakeholders and university researchers. It was based on an integrative model monitoring mental health symptoms as well as wellbeing indicators. Diary users were encouraged to reflect on their experience confidentially, empowering them to monitor their wellbeing. The data collected was analysed using Mann-Whitney-Wilcoxon and Kruskal-Wallis statistical tests to determine any significant wellbeing trends and issues.

Results
A statistically significant decline in wellbeing (P < 2.2E-16), and a significant increase in symptoms (P = 1.2E-14) was observed. For example, indicators of post-traumatic stress, including, flashbacks, dissociation, and bodily symptoms (Kruskal-Wallis P = 0.00081, 0.0083, and 0.027, respectively) became significantly worse and users reported issues with sleeping (51%), levels of alertness (46%), and burnout (41%).

Conclusions
The wellbeing diary indicated the value of providing ways to distinguish trends and wellbeing problems, thus, informing how staff wellbeing services can determine and respond to need with timely interventions. The results particularly emphasised the pressing need for interventions that help staff with burnout, self-compassion, and intrusive memories.
Infliximab versus ciclosporin in steroid resistant acute severe ulcerative colitis: a model-based cost-utility analysis of data from CONSTRUCT pragmatic trial
Authors: Alam Mohammed Fasihul , Longo Mirella , Cohen David , Groves Sam , Alrubaiy Laith , Hutchings Hayley A. , Watkins Alan , Sebastain Shaji , Williams John G. 
Published: March 2023

AbstractBackgroundThere is limited evidence in the literature on the long-term effectiveness and cost-effectiveness of treatments for Acute Severe Ulcerative Colitis (ASUC). The study aimed to perform decision analytic model-based long-term cost-utility analysis (CUA) of infliximab versus ciclosporin for steroid-resistant ASUC investigated in CONSTRUCT pragmatic trial.MethodsA decision tree (DT) model was developed using two-year health effect, resource use and costs data from CONSTRUCT trial to estimate relative cost-effectiveness of two competing drugs from the United Kingdom (UK) National Health Services (NHS) perspective. Using short-term trial data, a Markov model (MM) was then developed and evaluated over further 18 years. Both DT and MM were combined to investigate cost-effectiveness of infliximab versus ciclosporin for ASUC patients over 20-year time horizon, with a rigorous multiple deterministic and probabilistic sensitivity analyses to address uncertainty in results.ResultsThe decision tree mirrored trial-based results. Beyond 2-year trial follow-up, Markov model predicted a decrease in colectomy rate, but it remained slightly higher for ciclosporin. NHS costs and quality adjusted life years (QALYs) over base-case 20 year time horizon were £26,793 and 9.816 for ciclosporin and £34,185 and 9.106 for infliximab, suggesting ciclosporin dominates infliximab. Ciclosporin had 95% probability of being cost-effective at a willingness-to-pay (WTP) threshold value up to £20,000.ConclusionUsing data from a pragmatic RCT, the cost-effectiveness models produced incremental net health benefit in favour of ciclosporin relative to infliximab. Results from long-term modelling indicated that ciclosporin remains dominant compared with infliximab for the treatment of NHS ASUC patients, however, these need to be interpreted cautiously.Trial registrationCONSTRUCT Trial registration number ISRCTN22663589; EudraCT number: 2008-001968-36 (Date 27/08/2008).
Level of job satisfaction and associated factors among rural health extension workers in Hadiya Zone, Southern Ethiopia
Authors: Tamene Abayneh , Tediso Dansamo , Gebretsadik Achamyelesh 
Published: March 2023

Abstract
Background
The improvement of various health outcomes, including the reduction of maternal, neonatal, infant, and child mortality as well as the increased use of maternity and newborn health services, was significantly assisted by rural health extension workers. Implementing health extension programs and offering the community high-quality healthcare services requires job satisfaction. In the study area, there has been little research on job satisfaction and related variables. Therefore, the purpose of this study was to evaluate the degree of job satisfaction among rural health extension workers in the Hadiya zone, Southern Ethiopia, as well as associated factors.

Methods
A facility-based cross-sectional study was conducted among 262 rural health extension workers from May 30, 2021, to July 02, 2021. A simple random sampling method was used to select six rural districts. Data were gathered utilizing structured interviewer-administered questions and skilled data collectors. EpiData V4.4.1 was used to store the data, and SPSS Version 25 was used for analysis. To determine the relationship between the variables, bivariate and multivariate logistic regressions were used. The association was reported using the adjusted odds ratio (AOR) with a 95% confidence interval (95%CI), and the significance level was set at a p-value of 0.05.

Results
This study showed that 52.7% of rural health extension workers were satisfied with their jobs. Support from Keble leaders [AOR = 5.3; 95% CI (2.6, 11.1)], on-job training [AOR = 5.7, 95% CI (2.2, 14.9)], supportive supervision [AOR = 4.3; 95% CI (1.7, 10.8)] and reward or recognition [AOR = 7.4, 95% CI (3.0, 18.1)] were factors that associated with job satisfaction of health extension workers.

Conclusion
According to this study, more than half of rural health extension workers were happy with their jobs. Health extension workers’ job satisfaction was affected by support from keble leaders, supportive supervision, on-the-job training, and recognition and rewards. In order to increase the happiness of the health extension workers, supporting supervision must be strengthened and the best performers must be recognized.
Maternal and perinatal outcomes in mixed antenatal care modality implementing telemedicine in the southwestern region of Colombia during the COVID-19 pandemic
Authors: Escobar María Fernanda , Gallego Juan Carlos , Echavarria María Paula , Fernandez Paula , Posada Leandro , Salazar Shirley , Gutierrez Isabella , Alarcon Juliana 
Published: March 2023

AbstractIntroductionContingency measures due to the COVID-19 pandemic limited access to routine prenatal care for pregnant women, increasing the risk of pregnancy complications due to poor prenatal follow-up, especially in those patients at high obstetric risk. This prompted the implementation and adaptation of telemedicine.ObjectiveWe aim to evaluate the maternal and perinatal outcomes of patients who received prenatal care in-person and by telemedicine.MethodsWe conducted a retrospective observational cohort study of pregnant women who received exclusive in-person and alternate (telemedicine and in-person) care from March to December 20,202, determining each group's maternal and neonatal outcomes.ResultsA total of 1078 patients were included, 156 in the mixed group and 922 in the in-person group. The patients in the mixed group had a higher number of prenatal controls (8 (6–9) vs 6 (4–8)p < 0.001), with an earlier gestational age at onset (7.1 (6–8.5) vs 9.3 (6.6–20.3),p < 0.001), however, they required a longer hospital stay (26 (16,67%) vs 86 (9,33%),p = 0.002) compared to those attended in-person; there were no significant differences in the development of obstetric emergencies, maternal death or neonatal complications.DiscussionIncorporating telemedicine mixed with in-person care could be considered as an alternative for antenatal follow-up of pregnant women in low- and middle-income countries with barriers to timely and quality health care access.
Relationship between changes in the public health nurses’ workforce and the empirical Bayes estimates of standardized mortality ratio: a longitudinal ecological study of municipalities in Japan
Authors: Kodama Shimpei , Uwatoko Futoshi , Koriyama Chihaya 
Published: March 2023

AbstractBackgroundThe role of public health nurses (PHNs) in the community is expected to become increasingly important, along with the promotion of a comprehensive community care system. However, a comprehensive study of all municipalities is yet to be undertaken, and the relationship between the workforce of PHNs and health indicators is yet to be clarified. This study examined the effect of workforce change among PHNs, one of the structural indicators of PHNs’ activities regarding changes in the empirical Bayes estimate of standardized mortality ratios (EBSMRs).MethodsAn ecological study was conducted using municipality-level aggregate data. The data used were publicly available Japanese government statistics. The first-difference model of panel data analysis was used to examine the relationship between changes in EBSMR and changes in the number of PHNs per 100,000 population from 2010 to 2015, adjusting for the effects of population and other healthcare resources, including the number of physicians, medical clinics, general hospitals, and welfare facilities. The variation by the 47 prefectures was added to the linear model as a random effect. We also performed a sensitivity analysis using the full Bayesian inference using the Besag-York-Mollie model.ResultsFor males, EBSMRs for all causes and malignant neoplasms significantly decreased with an increase in the number of PHNs per population (coefficients: -1.00 and -0.89,pvalues: 0.008 and 0.043, respectively). For females, although all EBSMRs except malignant neoplasms showed decreased tendencies due to the increase in the number of PHNs per population, none of them were significant. The full Bayesian inference confirmed these associations.ConclusionsAn increase in the number of PHNs per population was significantly associated with a greater reduction in deaths from all causes and malignant neoplasms in males. The results of the full Bayesian inference also suggest that the workforce of PHNs may be related to changes in standardized mortality ratios for deaths from all causes in females.
Genetic architecture of a pollinator shift and its fate in secondary hybrid zones of two Petunia species
Authors: Binaghi Marta , Esfeld Korinna , Mandel Therese , Freitas Loreta B. , Roesti Marius , Kuhlemeier Cris 
Published: March 2023

AbstractBackgroundTheory suggests that the genetic architecture of traits under divergent natural selection influences how easily reproductive barriers evolve and are maintained between species. Divergently selected traits with a simple genetic architecture (few loci with major phenotypic effects) should facilitate the establishment and maintenance of reproductive isolation between species that are still connected by some gene flow. While empirical support for this idea appears to be mixed, most studies test the influence of trait architectures on reproductive isolation only indirectly.Petuniaplant species are, in part, reproductively isolated by their different pollinators. To investigate the genetic causes and consequences of this ecological isolation, we deciphered the genetic architecture of three floral pollination syndrome traits in naturally occurring hybrids between the widespreadPetunia axillarisand the highly endemic and endangeredP. exserta.ResultsUsing population genetics, Bayesian linear mixed modelling and genome-wide association studies, we found that the three pollination syndrome traits vary in genetic architecture. Few genome regions explain a majority of the variation in flavonol content (defining UV floral colour) and strongly predict the trait value in hybrids irrespective of interspecific admixture in the rest of their genomes. In contrast, variation in pistil exsertion and anthocyanin content (defining visible floral colour) is controlled by many genome-wide loci. Opposite to flavonol content, the genome-wide proportion of admixture between the two species predicts trait values in their hybrids. Finally, the genome regions strongly associated with the traits do not show extreme divergence between individuals representing the two species, suggesting that divergent selection on these genome regions is relatively weak within their contact zones.ConclusionsAmong the traits analysed, those with a more complex genetic architecture are best maintained in association with the species upon their secondary contact. We propose that this maintained genotype–phenotype association is a coincidental consequence of the complex genetic architectures of these traits: some of their many underlying small-effect loci are likely to be coincidentally linked with the actual barrier loci keeping these species partially isolated upon secondary contact. Hence, the genetic architecture of a trait seems to matter for the outcome of hybridization not only then when the trait itself is under selection.
The association between menstrual cycle characteristics and cardiometabolic outcomes in later life: a retrospective matched cohort study of 704,743 women from the UK
Authors: Okoth Kelvin , Smith William Parry , Thomas G. Neil , Nirantharakumar Krishnarajah , Adderley Nicola J. 
Published: March 2023

Abstract
Background
Female reproductive factors are gaining prominence as factors that enhance cardiovascular disease (CVD) risk; nonetheless, menstrual cycle characteristics are under-recognized as a factor associated with CVD. Additionally, there is limited data from the UK pertaining to menstrual cycle characteristics and CVD risk.

Methods
A UK retrospective cohort study (1995–2021) using data from a nationwide database (The Health Improvement Network). Women aged 18–40 years at index date were included. 252,325 women with history of abnormal menstruation were matched with up to two controls. Two exposures were examined: regularity and frequency of menstrual cycles; participants were assigned accordingly to one of two separate cohorts. The primary outcome was composite cardiovascular disease (CVD). Secondary outcomes were ischemic heart disease (IHD), cerebrovascular disease, heart failure (HF), hypertension, and type 2 diabetes mellitus (T2DM). Cox proportional hazards regression models were used to derive adjusted hazard ratios (aHR) of cardiometabolic outcomes in women in the exposed groups compared matched controls.

Results
During 26 years of follow-up, 20,605 cardiometabolic events occurred in 704,743 patients. Compared to women with regular menstrual cycles, the aHRs (95% CI) for cardiometabolic outcomes in women with irregular menstrual cycles were as follows: composite CVD 1.08 (95% CI 1.00–1.19), IHD 1.18 (1.01–1.37), cerebrovascular disease 1.04 (0.92–1.17), HF 1.30 (1.02–1.65), hypertension 1.07 (1.03–1.11), T2DM 1.37 (1.29–1.45). The aHR comparing frequent or infrequent menstrual cycles to menstrual cycles of normal frequency were as follows: composite CVD 1.24 (1.02–1.52), IHD 1.13 (0.81–1.57), cerebrovascular disease 1.43 (1.10–1.87), HF 0.99 (0.57–1.75), hypertension 1.31 (1.21–1.43), T2DM 1.74 (1.52–1.98).

Conclusions
History of either menstrual cycle irregularity or frequent or infrequent cycles were associated with an increased risk of cardiometabolic outcomes in later life. Menstrual history may be a useful tool in identifying women eligible for periodic assessment of their cardiometabolic health.