bluuebunny/crossref_metadata_2025_split huggingface dataset:
Associations among neuroticism, self-efficacy, resilience and psychological distress in freshman nursing students: a cross-sectional study in China
Authors: Mei Xiaoxiao , Wang Huiyuan , Wang Xinqin , Wu Xiaona , Wu Jieyi , Ye Zengjie 
Published: June 2022

ObjectivesThe current study examines the mediating roles of resilience and self-efficacy and the moderating role of gender in the association between neuroticism and psychological distress in Chinese freshman nursing students (FNSs).MethodsA total of 1220 FNSs were enrolled from the Be Resilient to Nursing Career (ChiCTR2000038693) Programme and the following instruments were administered to them: NEO Five-Factor Inventory, General Self-Efficacy Scale, Connor-Davidson Resilience Scale and Kessler Psychological Distress Scale. A moderated mediation analysis and a generalised additive model analysis were performed.ResultsThe direct and indirect effects of neuroticism on psychological distress were significantly mediated by self-efficacy (B = 0.200, 95% CI 0.001 to 0.039), resilience (B = 0.021, 95% CI 0.007 to 0.038) and the interaction between self-efficacy and resilience (B = 0.016, 95% CI 0.005 to 0.028). The interactions between neuroticism and gender (β = 0.102, 95% CI 0.001 to 0.203, p<0.05) and between resilience and gender were significant (β = 0.160, 95% CI 0.045 to 0.275, p<0.01). A non-linear and positive association was confirmed between neuroticism and psychological distress.ConclusionsSelf-efficacy and resilience significantly mediate the relationship between neuroticism and psychological distress. Gender moderates the relationships between neuroticism and resilience and between resilience and psychological distress.
Continuing education programme on vaccines for primary healthcare professionals: mixed-method protocol
Authors: González-Cano-Caballero María , García-Gámez Marina , Fernández-Fernández Eloísa , Fernández-Ordoñez Eloísa , Cano-Caballero María Dolores , Guerra-Marmolejo Cristina 
Published: June 2022

IntroductionVaccination is a fundamental intervention in disease prevention; therefore, the advice and recommendations of health professionals have a major influence on the population’s decision to be vaccinated or not. Professionals must have sufficient competencies to carry out their work and recommend vaccination with evidence-based knowledge. The aim is to design and validate a strategy to improve professional competencies in vaccination to positively influence adherence and increase vaccination rates in the population.Methods and analysisTraining will be designed based on evidence and previous studies and piloted with healthcare providers. To test changes in knowledge, a pretest and post-test will be conducted. To test feasibility, a think-aloud method will be used with participants and triangulated with focus groups using SWOT (strengths, weaknesses, opportunities and threats) analysis. Transfer will be measured using the questionnaire ‘factors for the indirect evaluation of transfer’ and an efficacy questionnaire 1½ months later; for satisfaction, an ad hoc questionnaire will be used. A summative approach will be used for the analysis of the focus groups and descriptive and bivariate statistics for the questionnaires.Ethics and disseminationThis study was approved by the Andalusian Research Ethics Committee, Spain (approval number: 0524-N-20). The results will be made available to the public at journal publications and scientific conferences.
Diagnostic delay of myositis: protocol for an integrated systematic review
Authors: Namsrai Tergel , Desborough Jane , Chalmers Anita , Lowe Christine , Cook Matthew , Phillips Christine , Parkinson Anne 
Published: June 2022

IntroductionIdiopathic inflammatory myopathies (IIM). described as ‘inflammatory myositis’, are a heterogeneous group of rare muscular autoimmune diseases characterised by skeletal muscle inflammation. Its complex characteristics with lack of accurate diagnostic tests, unified classification system and comprehensive widely used diagnostic criteria could lead to diagnostic delay. This study will review diagnostic delay in myositis and provide an overview and clearer insight of patients’ experiences, causes and consequences of diagnostic delay in myositis.Methods and analysisThe literature source will be a systematic search of PubMed/MEDLINE, Scopus, ProQuest and sources of grey literature, conducted from database inception to December 2021 without restrictions on publication date. All study types (qualitative and quantitative) except review articles, examining diagnostic delay, incorrect diagnosis, missed diagnosis or slow diagnosis of all types of myositis in all ages will be included. Evidence of patients’ experiences associated with diagnostic delay will also be examined. Studies in languages other than English, German and Indonesian will be excluded. Outcomes will be diagnostic delay time, patients’ experiences, and causes and consequences associated with diagnostic delay in myositis. Two review authors will independently screen the titles and abstracts of search results against the inclusion criteria. The Mixed Methods Appraisal Tool (MMAT) will be used to appraise selected studies. Two independent authors will extract data using a prepiloted data extraction tool. If sufficient quantitative data is available, a meta-analysis will be conducted along with subgroup analysis including pooled diagnostic delay in each type of myositis. Qualitative data will be analysed in line with meta-aggregation methods. If data is insufficient, a narrative synthesis will be conducted.Ethics and disseminationAs this work is a systematic review, ethical approval was not required. Findings of the study will be disseminated through publications in peer-reviewed journals, conferences and symposia.PROSPERO registration numberCRD42022289830.
Understanding patient views and experiences of the IDENTIfication of PALLiative care needs (IDENTI-Pall): a qualitative interview study protocol
Authors: Mitchell Sarah , Leach Isabel , Turner Nicola , Mayland C R 
Published: June 2022

IntroductionMore people are living with multimorbidity, defined as two or more long-term physical or mental health conditions. Multimorbidity is associated with poor quality of life and high treatment burden. Palliative care identification tools have been developed for use in primary care to seek out patients who could benefit from a palliative approach to their care. There has been little evaluative research on such tools; patient perspectives on the process of identifying their palliative care needs is a significant gap. The aim of this research is to provide new understanding into patient perspectives of the experience of having their palliative care needs identified, and the impact on their healthcare.Methods and analysisThis qualitative study will employ semistructured interviews to elicit the views of participants. We will purposively sample 10–12 adults with advanced serious illness who have been identified by their primary care team as having palliative care needs, and/or are receiving care from specialist palliative care services. A family member or carer may be included in an interview at the participant’s request. A descriptive, thematic analysis will be carried out using the data analysis software NVivo.Ethics and disseminationEthical approval has been granted by the North of Scotland Research Ethics Committee. Study findings will be disseminated in peer-reviewed journals and through conference presentations. Other activities include the development of patient-centred outcomes for clinical practice and policy in relation to the use of palliative care identification tools.Trial registration numberNational Institute for Health Research (NIHR) Clinical Studies Portfolio, UK Clinical Research Network (UKCRN) Study number 51296.
Improving the turnaround times of infectious disease markers reporting in an NHS stem cell department
Authors: Li Ying , Proudlove Nathan 
Published: June 2022

The Stem Cell Donation and Transplantation Department at NHS Blood and Transplant (NHSBT) facilitates unrelated donor haematopoietic stem cell transplantations for patients with life-threatening haematological malignancies or other blood diseases. Donors must be screened for infectious disease markers (IDMs) prior to donation. The purpose of IDM testing is to assess whether the donor currently has, or previously had, an infectious disease that could be transmitted to the recipient. The turnaround time (TaT) from sample collection to the return of IDM results is important to transplant clinicians and their patients. NHSBT has a target TaT of 80% within seven calendar days. Our initial analysis showed us that we failed to meet this in any week in the previous year, and our service was neither efficient nor consistent, so there was considerable improvement potential.This quality improvement (QI) project aimed to improve the TaT of the IDM reporting service. We tested three change ideas through four Plan-Do-Study-Act (PDSA) cycles. We collected data on TaTs from our laboratory information management system (LIMS) and updated our statistical process control charts after each PDSA cycle. Over the course of the project, we reduced the mean TaT from 8.9 days to 5.5 days and increased the proportion of samples reported within the 7-day benchmark from 50% to 89%, reaching the key performance indicator (KPI) target.Conducting this project was a rewarding experience. Although we encountered unanticipated technical issues during PDSA experiments, and we found that some change plans were not as effective in improving the KPIs as we expected, the improvement by the end of the study period was substantial. This QI project enabled us to meet our TaT targets and, ultimately, help ensure that our patients receive timely transplants. It suggests that QI may have wider applications across our part of NHSBT.
Effects of social influence and implementation climate and leadership on nurse-led early mobility behaviours in critical care
Authors: Boehm Leanne M , Mart Matthew F , Dietrich Mary S , Work Brittany , Wilson William T , Walker Geraldine , Piras Susan E 
Published: June 2022

IntroductionEarly mobility (EM), initiating and advancing physical activity in the earliest days of critical illness, has been described as the most difficult component of the ABCDEF bundle to implement and coordinate. Successful implementation of EM in clinical practice requires multiple targeted implementation strategies.ObjectiveDescribe the associations of nurses’ EM attitudes, subjective norms, perceived behavioural control, intention, and implementation climate and leadership with self-reported and documented EM behaviour in the intensive care unit (ICU).DesignThis was a two-site, descriptive, cross-sectional study to explore nurses’ perception of the factors influencing EM adherence.SettingThree ICUs (medical, surgical and cardiovascular) in an academic medical centre and two ICUs (medical/surgical and cardiovascular) in a regional medical centre in middle Tennessee.PatientsCritically ill adults.InterventionsNone.Main outcome measuresA 34-item investigator-developed survey, Implementation Leadership Scale, and Implementation Climate Scale were administered to ICU nurses. Survey development was informed by a Theory of Planned Behavior based elicitation study and implementation science frameworks.ResultsThe academic medical centre had markedly lower EM documentation. We found no difference in nurses’ EM attitudinal beliefs, social influence, facilitators, and barriers at both sites. Nurses perceived moderate social influence to perform EM similarly across sites and considerable control over their ability to perform EM. We did note site differences for implementation climate and leadership and objective EM adherence with the regional community medical centre demonstrating statistically significant relationships of implementation climate and leadership with self-report and documented EM behaviours.ConclusionsWe identified contextual differences in implementation climate and leadership influence when comparing nurse EM behaviours. Streamlined documentation, leadership advocacy for interprofessional coordination and manpower support, and multicomponent context-based implementation strategies could contribute to better EM adherence.
Study of dynamic debris impact load on flexible debris-resisting barriers and the dynamic pressure coefficient
Authors: Lam H.W.K. , Sze E.H.Y. , Wong E.K.L. , Poudyal S. , Ng C.W.W. , Chan S.L. , Choi C.E. 
Published: June 2022

The use of steel flexible barriers to mitigate landslide risk on natural hillsides is becoming common in the past decade in Hong Kong. The current design approach for this kind of barrier structure involves the adoption of the hydrodynamic load model to predict dynamic impact forces, followed by non-linear structural analyses of flexible barriers using numerical programs based on the pseudo-static force method. From local design guidelines, the dynamic pressure coefficient, a critical input parameter in the hydrodynamic load model, is taken as 2.0. This empirically considers the effect of impacts from boulders up to 2.0 m in diameter. With a view to rationalising the design approach, a series of physical impact tests and numerical analyses was conducted to investigate the dynamic debris impact on flexible barriers and the resulting barrier response. The physical impact tests involved up to 9 m3 of debris resisted by a 1.5 m high steel ring-net barrier. The tests were conducted in the 28 m long large-scale flume facility at the Kadoorie Centre in Hong Kong. Numerical modelling using computer programs LS-DYNA and NIDA-MNN was conducted to analyse the dynamic response of flexible barriers with different structural forms. The study aims to evaluate the dynamic pressure coefficient and to verify the current design approach based on the suggested dynamic pressure coefficient from this study. Results indicate that a dynamic pressure coefficient of 1.0 is, in general, appropriate for design purposes if the debris comprises primarily water and fine-grained particles.
A influência da postura corporal nos parâmetros do sistema de oscilometria de impulso em crianças
Authors: Ferreira Letícia Goulart , Gonçalves Renata Maba , Assumpção Maíra Seabra de , Schivinski Camila Isabel Santos 
Published: June 2022

Oscilometria de impulso (IOS) é um método alternativo e complementar de avaliação da mecânica respiratória, mas cuja técnica de execução ainda necessita padronização. Objetivo: Analisar e comparar os resultados de parâmetros do IOS quando realizado em escolares nas posições ortostática e sentada. Método: estudo analítico observacional transversal. Escolares saudáveis de 6 a 12 anos foram submetidos à espirometria e dois exames de IOS randomizados quanto à postura (sentada e ortostática). Os dados foram analisados no SPSS 20.0. Utilizou-se o teste Shapiro-Wilk e, segundo a normalidade dos dados, aplicou-se o teste de Wilcoxon ou t de Student para comparação das posturas. Na correlação entre dados antropométricos e as variáveis oscilométricas empregou-se o teste de Pearson ou Spearman, com p < 0,05. Resultados: participaram 72 crianças, idade média de 8,42 ± 1,26. Não houve diferença entre as variáveis oscilométricas nas duas posturas. Na posição sentada, houve correlação negativa baixa entre altura de tronco (Altronco) e variáveis: resistência a 20Hz (R20) (p = 0,034) e a 5Hz (R5) (p = 0,041), resistência central (Rescent) (p = 0,018) e impedância (Z) (p = 0,030). Em ortostatismo verificou-se correlação negativa baixa entre idade e resistência periférica (Resper) (p = 0,011), R5 (p = 0,014) e Z (p = 0,009). Conclusão: Não houve diferença nos valores das variáveis oscilométricas entre a postura sentada e ortostática. Contudo, a resistência das vias aéreas foi influenciada pela Altronco, estatura e idade. O ortostatismo parece ser a melhor posição para análise da Resper.
Explaining the Decline of Rural Population in Spain (1900–2018)
Authors: Cañal-Fernández Verónica , Álvarez Antonio 
Published: June 2022

Abstract
The analysis of data at the municipality level from the Municipal Enumerator Books demonstrates that rural population in Spain has declined as a percentage of total population since 1900. A highly granular case study of Asturias, a region in northern Spain, reveals that internal infrastructure and the proximity of a medium-size town were crucial to maintaining population in the countryside. The income gap between rural and urban municipalities, however, also led to significant migration from rural areas.
The Recognition of War Refugees: Lapland, Love, and
Care
Authors: Autti Outi , Intonen Saara 
Published: June 2022

Abstract
According to Honneth, the mutual recognition essential for individual autonomy and a just society divides into three forms—love in primary relationships, rights in legal relationships, and solidarity in the community of value. Such recognition has three corresponding forms of disrespect—abuse, exclusion, and denigration, all of which can raise struggles for recognition. An analysis of empirical data—in this case, oral-history reports from Finnish evacuees to Sweden during the Lapland War (1944–1945)—within this framework of recognition reveals detailed information about the refugees’ wartime experiences, particularly those that they deemed significant enough to be remembered decades after the event.
Anatomical relationship between the omohyoid muscle and the internal jugular vein on ultrasound guidance
Authors: Yang Yun , Wang Xinqiang , Mao Weiliang , He Tongyun , Xiong Zhaodong 
Published: June 2022

Abstract
Background
Internal jugular vein catheterization is widely used in clinical practice, and there are many related studies on internal jugular vein catheterization. However, the omohyoid muscle, which is adjacent to the internal jugular vein, is a rarely mentioned muscle of the infrahyoid muscles group. The purpose of this study is to explore the anatomical relationship between the omohyoid muscle and the internal jugular vein on ultrasound guidance and provide a theoretical reference for jugular puncture and catheterization.

Methods
The study included 30 volunteers. The volunteer’s head lay in the neutral position and was then turned to the left at an angle of 30°, 45° and 60° with the bed surface, as verified using an adjustable protractor. A high-frequency ultrasound probe (6–14 Hz) was used to examine the plane of the apex of sternocleidomastoid triangle (PAST), the triangle consists of anatomical landmarks: a base was clavicle, its sides – heads of sternocleidomastoid muscle. And the plane of the middle of sternocleidomastoid triangle(PMST) which was a horizontal line, connecting midpoints of both sides. The right omohyoid muscle (OM) and the right internal jugular vein (IJV) were observed and recorded for statistical analysis.

Results
There were statistically significant differences in the number of overlapping cases of OM and IJV at each head rotation angle between the PAST and PMST groups. There were statistically significant differences between the angles which OM and IJV centre point line and the left horizontal position of the PAST and PMST at different body angles.

Conclusion
The traditional middle route puncture point is the apex of the sternocleidomastoid triangle, which can effectively avoid injury to the omohyoid muscle, to an extent.

Trail registration
ChiCTR2000034233, Registered 29/06/2020. www. Chinese Clinical Trial Registry.gov.
Comparisons in polypharmacy over a decade in community-dwelling older adults-findings from Israel national health and nutrition surveys
Authors: Goldsmith Rebecca , Dichtiar Rita , Shimony Tal , Nitsan Lesley , Axelrod Rachel , Laxer-Asael Irit , Rasooly Iris , Sinai Tali , Berry Elliot M. 
Published: June 2022

Abstract
Background
Polypharmacy increases with age and is associated with serious health and economic costs. This study reports changes over a decade in medication-use patterns and polypharmacy, in Israeli community-dwelling older adults aged ≥ 65 years.

Methods
Demographic and health data from two representative national health cross-sectional surveys – MABAT ZAHAV 1 (MZ1) in 2005–2006, and MZ2 in 2014–2015 were analyzed. Polypharmacy was defined as use of ≥ 5 medications. Risk factors for polypharmacy were estimated by multivariable logistic regression with adjusted odds ratios (aOR) and their 95% confidence intervals (CI).

Results
Self-reported data on medications taken were available for 1647 participants (91.5%) in MZ1, and for 833 participants (80.2%) in MZ2, 55% women, and about 20% aged ≥ 80, in both surveys. The prevalence of polypharmacy was significantly lower in MZ2 than in MZ1: 64.2% versus 56.3%, p = .0001; with an aOR (95%CI) of 0.64 (0.52, 0.80). The most commonly taken drugs were for hypertension (27.0%, 25.3%), dyslipidemia (9.7%, 12.4%) and anticoagulation (9.2%, 9.8%). For approximately 10% of drugs, indications were either unknown or incorrect. Polypharmacy was significantly associated with poor self-health assessment 2.47 (1.99, 3.06), ≥ 4 versus 1–3 chronic illnesses 6.36 (3.85, 10.50), and age ≥ 80 versus younger 1.72 (1.32, 2.24). Similar associations were observed with major polypharmacy of ≥ 8 medications.

Conclusion
Polypharmacy, although reduced in the last decade, requires constant attention, especially concerning lack of knowledge of indications which leads to poor adherence and adverse side effects. Health-care teams should carry out regular medicine reconciliation in at-risk elderly patients.
Concurrent severe pulmonary tuberculosis with Evans syndrome: a case report with literature review
Authors: Pan Xiao-hong , Xu Jie-kun , Pan Lei , Wang Cai-hong , Huang Xiao-qing , Qiu Jun-ke , Ji Xiao-bo , Mao Min-jie 
Published: June 2022

AbstractBackgroundTuberculosis is a bacterial infection involving multiple organs and systems. Its hematological presentation mainly includes anemia and leukocytosis. Evans syndrome is a rare autoimmune disease characterized by autoimmune hemolytic anemia, immune thrombocytopenia, and neutropenia, with positive results for the direct Coombs test and platelet antibodies. The cooccurrence of tuberculosis and Evans syndrome is rarely reported.Case presentationA 69-year-old female presented with a fever and shortness of breath. Her chest computerized tomography scan showed extensive miliary nodules in the bilateral lung fields. She rapidly developed respiratory failure that required endotracheal intubation and mechanical ventilation. The acid-fast bacilli sputum smear results indicated a grade of 3+. Later on, blood testing revealed hemolytic anemia, a positive direct Coombs test result, and the presence of the platelet antibody IgG. This patient was diagnosed as having disseminated pulmonary tuberculosis and Evans syndrome. She successfully recovered after treatment with antituberculosis drugs and glucocorticoids.ConclusionsTuberculosis can occur together with Evans syndrome. Affected patients should receive both antituberculosis and immunosuppressive drugs.