bluuebunny/crossref_metadata_2025_split huggingface dataset:
End-of-life communication strategies for healthcare professionals: A scoping review
Authors: Chen Weilin , Chung Joyce Oi Kwan , Lam Katherine Ka Wai , Molassiotis Alex 
Published: November 2022

Background: Timely and effective communication about end-of-life issues, including conversations about prognosis and goals of care, are extremely beneficial to terminally ill patients and their families. However, given the context, healthcare professionals may find it challenging to initiate and facilitate such conversations. Hence, it is critical to improving the available communication strategies to enhance end-of-life communication practices. Aim: To summarise the end-of-life communication strategies recommended for healthcare professionals, identify research gaps and inform future research. Design: A scoping review performed in accordance with the Arksey and O’Malley framework. Data sources: A literature search was conducted between January 1990 and January 2022 using PubMed, CINAHL, Embase, PsycINFO, Web of Science, Scopus, Cochrane Library and China National Knowledge Infrastructure databases and Google, Google Scholar and ProQuest Dissertations & Theses Global. Studies that described recommended end-of-life communication strategies for healthcare professionals were included. Results: Fifty-nine documents were included. Seven themes of communication strategies were found: (a) preparation; (b) exploration and assessment; (c) family involvement; (d) provision and tailoring of information; (e) empathic emotional responses; (f) reframing and revisiting the goals of care; and (g) conversation closure. Conclusions: The themes of communication strategies found in this review provide a framework to integrally promote end-of-life communication. Our results will help inform healthcare professionals, thereby promoting the development of specialised training and education on end-of-life communication.
RANTES Concentration at the Time of Surgery Is Associated With Postoperative Stiffness in Patients Undergoing ACL Reconstruction
Authors: Avila Amanda , Petrera Massimo , Duenes Matthew , Kingery Matthew T. , Song Melissa , Jazrawi Laith M. , Strauss Eric J. 
Published: November 2022

Background: Patients undergoing anterior cruciate ligament (ACL) reconstruction have been shown to be at risk for postoperative arthrofibrosis. Diagnostic biomarkers associated with the development of postoperative stiffness are unknown. Hypothesis: Biomarkers found in the synovial fluid at the time of surgery are associated with the development of postoperative arthrofibrosis in a cohort of patients undergoing ACL reconstruction. Study Design: Case-control study; Level of evidence, 3. Methods: Patients undergoing ACL reconstruction were prospectively enrolled. Synovial fluid was collected before surgical incision. A cohort of patients with postoperative stiffness requiring manipulation under anesthesia (MUA) and/or lysis of adhesions (LOA) was retrospectively identified. Matching of cases to controls was performed using a 1:2 pair matching algorithm. Risk factor–adjusted single-biomarker and multivariable models were used to assess the association of synovial fluid biomarkers with postoperative stiffness requiring MUA/LOA. Stepwise logistic regression controlling for clinical risk factors was used to identify biomarkers that are possible predictors of postoperative stiffness. Results: A total of 11 cases (3 male, 8 female) were identified and matched with 21 controls (6 male, 15 female) with no significant differences in age, sex, smoking history, or days from injury to surgery. Concentrations of the biomarker regulated upon activation, normal T-cell expressed and presumably secreted (RANTES) were significantly higher in patients requiring MUA/LOA versus controls (694.20 pg/mL [interquartile range, 214.75-3428.79] vs 113.04 pg/mL [interquartile range, 32.81-517.91], respectively; P = .034). On single-biomarker models, RANTES (odds ratio, 2.28; 95% CI, 1.29-5.37; P = .019) and basic fibroblast growth factor (bFGF) (odds ratio, 1.91; 95% CI, 1.07-3.99; P = .047) were associated with increased risk of postoperative stiffness requiring MUA/LOA after ACL reconstruction. Stepwise logistic regression identified 3 biomarkers that are possible predictors of postoperative stiffness, which were included in the final model: Interleukin 1 receptor antagonist (IL-1RA) ( P = .198), bFGF ( P = .157), and RANTES ( P = .046). Conclusion: Higher concentrations of synovial fluid biomarkers bFGF and RANTES were associated with increased risk for stiffness requiring intervention after ACL reconstruction. Interleukin 6 (IL-6), vascular endothelial growth factor A (VEGF-A), tissue inhibitor of metalloproteinases 1 (TIMP-1), interleukin 1 receptor antagonist (IL-1RA), matrix metalloproteinase 3 (MMP-3), monocyte chemotactic protein 1 (MCP-1), and macrophage inflammatory protein 1B (MIP-1B) were not associated with the development of postoperative arthrofibrosis.
The Effect of Patients’ Understanding of Sling Necessity and Home Assistance on Sling Wear After Shoulder Surgery
Authors: Livesey Michael G. , Weir Tristan B. , Addona Jacqueline L. , Curto Ryan A. , Apte Anuj , Hughes Marcus , Enobun Blessing , Henn R. Frank , Hasan S. Ashfaq , Gilotra Mohit N. 
Published: November 2022

Background: Perioperative education and socioeconomic factors influence patient behavior. Recent evidence has suggested that sling compliance is associated with improved outcomes after shoulder surgery; it is important to investigate factors that influence sling compliance. Purpose: To determine the associations between postoperative sling wear and patients’ understanding of sling necessity, postoperative home assistance, and social deprivation. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 66 patients were prospectively enrolled from 2018 to 2020 if they were ≥18 years of age and undergoing shoulder surgery requiring a sling for at least 1 month postoperatively. Sling wear was measured using a temperature-sensing device. At 6 weeks postoperatively, patients’ understanding for sling necessity was determined by their response to a question on the Medical Adherence Measure questionnaire, “Why did you have to wear a shoulder sling?” The Patient Understanding Grading Scale (PUGS) was developed to quantify patient responses. PUGS was graded 1 to 3, with grade 1 corresponding to the least technical knowledge. Patient characteristics, social deprivation (Area Deprivation Index [ADI]), and home assistance were additionally analyzed. Results: There were no significant differences in baseline characteristics between patients when stratified by PUGS grade. Multivariable linear regression analysis for total hours of sling wear per week showed that patients with PUGS grade 2 (β, 48.2 hours; P = .007) and grade 3 (β, 59.5 hours; P = .003) wore their slings significantly more than grade 1 patients. Patients with home assistance had significantly greater day hours (73.5 ± 33.0 vs 44.0 ± 24.5 hours; P = .037) of sling wear per week, but there was no difference in night sling hours. Patients older than 60 years wore their slings significantly more, while men and those with a higher body mass index (BMI) wore their slings significantly less. ADI was not significantly associated with sling wear. Conclusion: This study demonstrates that patients with greater understanding for sling necessity, those with home assistance, and patients >60 years have greater sling wear, while male patients and those with a higher BMI have lower sling compliance. ADI was not a significant contributor.
Sustainable Healthcare System: Providers Initiatives for Quality Improvement of Healthcare Organisation
Authors: Sharma Sandesh Kumar , Tripathi Vidya Bhushan 
Published: November 2022

The study is designed for sustainable healthcare system with providers’ initiatives to provide quality services in healthcare organisations. Healthcare providers’ initiatives promote quality and ensure better healthcare services. Among the healthcare providers who were studied and reviewed, it was observed that the initiatives of the healthcare providers improved the overall quality. There is a distinct scope of further enhancement with the participation of healthcare providers in healthcare organisations. The purpose of this research is to learn and determine the answers to questions through scientific application. This study shows that an augmented frequency of sustainable healthcare systems is only possible through the initiatives of healthcare providers. In healthcare services, patients remain satisfied without expressing their dissatisfaction to the management. To know the needs of patients, there has to be a certain level of relationship between healthcare providers and patients. For this purpose, the system has to be very proficient in the service conditions and their applicability for quality in the hospital. Healthcare organisations management has the conviction that the participative role of healthcare professionals in hospitals will increase patient satisfaction. In this perspective, the pressing priority of healthcare providers for hospitals will always be patients. Thus, apart from the availability of healthcare facilities and quality of care, the location of the hospital has predominant importance. Based on the findings, it is to be stated that sustainable healthcare is subject to provider’s initiatives and actions for quality in healthcare organisations.
Radiographic features of cardiogenic pulmonary oedema in cats with left-sided cardiac disease: 71 cases
Authors: Diana Alessia , Perfetti Simone , Valente Carlotta , Baron Toaldo Marco , Pey Pascaline , Cipone Mario , Poser Helen , Guglielmini Carlo 
Published: November 2022

Objectives The aims of this study were to describe the radiographic features of cardiogenic pulmonary oedema (CPE) in a large group of cats with left-sided cardiac disease, and to determine the association between the radiographic features of CPE and the underlying cardiac disease. Methods Thoracic radiographs of cats with CPE and echocardiographic evidence of left-sided cardiac disease and left atrial enlargement (LAE) were reviewed, and cardiac silhouette, pulmonary vessels and pulmonary parenchyma evaluation were performed. Interstitial and/or alveolar patterns were classified according to their distribution (ie, diffuse, multifocal or focal) and location (ie, craniodorsal, cranioventral, caudodorsal, caudoventral and perihilar). A Student’s t-test and Mann–Whitney U-test, or the two-proportion z-test, were used to compare continuous or categorical variables, respectively, between cats affected by the two most represented cardiac diseases, namely hypertrophic cardiomyopathy (HCM) and restrictive cardiomyopathy (RCM). Results Seventy-one cats were included; among them, 46 (64.7%) and 13 (18.3%) had presented for HCM and RCM, respectively. Subjective and objective cardiomegaly, and subjective and objective LAE were detected in 97.2% and 91.9% of cats and in 80.3% and 40.6% of cats, respectively. Pulmonary artery abnormalities, in particular caudal pulmonary artery dilation, were found in 77.5% of cats. Pulmonary artery to pulmonary vein ratio = 1 was found in 71.8% and 55% cats on right lateral and ventrodorsal or dorsoventral views, respectively. Interstitial (57.8%) and mixed interstitial–alveolar (38%) pattern, multifocal (84.5%) and symmetrical (75%) distribution with prevalent ventrocaudal (65.6% of cats) and ventrocranial (60.9% of cats) locations were most frequently observed. No difference was found for any of these radiographic features between cats with HCM and RCM. Conclusions and relevance Moderate-to-severe cardiomegaly and LAE, caudal pulmonary artery and vein dilation, as well as a ventral, multifocal and symmetrical interstitial pulmonary pattern, were the main radiographic features of CPE in evaluated cats. Underlying cardiac disease did not influence the aforementioned radiographic features.
Ultrasonographic findings of feline aortic thromboembolism
Authors: Eberlé Olivia , Pouzot-Nevoret Céline , Thomas-Cancian Aurélie , Lurier Thibaut , Nectoux Alexandra , Ségard-Weisse Emilie 
Published: November 2022

Objectives The aim of the study was to describe the ultrasonographic characteristics of feline aortic thromboembolism (ATE) and determine potential associations between ultrasonographic findings and prognosis. Methods Data were retrospectively collected from the medical records (2013–2021) of cats that were diagnosed ultrasonographically with ATE based on the presence of a thromboembolus (TE) in the distal aorta beginning after the departure of the renal arteries. Results Twenty-nine cats were included in this study. The most frequent location for an ATE was at the aortic trifurcation. The median length of TEs was 9 mm (range 3.5–42.9). TEs appeared homogeneous and isoechoic to surrounding tissues in all cases. No correlation was found between the appearance of the TE and the duration of clinical signs. The obstruction of blood flow in the distal aorta at the aortic trifurcation was complete in 66% of cases and incomplete in 34% of cases. The survival rate was significantly lower when the obstruction was complete (11%, 95% confidence interval [CI] 2–34) compared with incomplete (70%, 95% CI 35–92). The arterial wall characteristics were as follows: smooth and thin (62%), and hyperechoic (38%). Conclusions and relevance Increased vascular obstruction of TEs was associated with a lower survival rate.
Veterinary services during the COVID-19 pandemic: less stressful for cats and their carers?
Authors: Caney Sarah MA , Robinson Natalie J , Gunn-Moore Danielle A , Dean Rachel S 
Published: November 2022

Objectives The COVID-19 pandemic saw major changes to small animal veterinary practice, many of which may have had an impact on stress in cats presented to the clinic. The aim of this study was to examine the nature of feline outpatient visits before and during the pandemic, and examine signs of stress noted in cats before, during and after these visits. Methods A questionnaire was used to gather data on cat owner experiences of visits to the veterinary clinic. Data were gathered on the owner’s most recent experience of a consultation, with consultations occurring in February 2020 or earlier coded as a standard consultation, and consultations occurring in March 2020 or later coded as COVID-19 consultations. Results A total of 371 responses were received, with 210 coded as standard consultations and 161 coded as COVID-19 consultations. Consultation type varied significantly between standard and COVID-19 consultations ( P <0.001), with emergency consultations more frequent and preventive healthcare consultations less frequent during the COVID-19 pandemic. The area in which the owner and their cat waited also varied significantly between standard and COVID-19 consultations ( P <0.001), with standard consultations more likely to involve time in a waiting room while COVID-19 consultations were often called straight in or waited outside the practice. Most owners notedbehaviours associated with stress in their cats, regardless of consultation type, although trying to hide or escape were noted more frequently for cats seen prior to the COVID-19 pandemic. Conclusions and relevance The findings suggest that outpatient visits to the veterinary clinic were stressful for cats both prior to and during the COVID-19 pandemic, but some measures taken during the pandemic, for example less use of waiting rooms, could be used alongside existing cat friendly measures to help to reduce stress in feline patients.
Use of serum procalcitonin (PCT) level and PCT mRNA expression as a potential clinical biomarker in cats with bacterial and viral infections
Authors: Matur Erdal , Özcan Mukaddes , Ergül Ekiz Elif , Ergen Ezgi , Erek Mert , Or Erman , Dokuzeylül Banu , Erhan Songül , Bilgiç Bengü 
Published: November 2022

Objectives The aim of this study was to investigate the use of procalcitonin (PCT) as a biomarker in differentiating bacterial infections from viral infections in cats. In addition, the relationship between PCT and mortality rate was also examined. Methods Forty-five cats were included in the study. The cats were categorised into two groups: bacterial (n = 20) and viral (n = 25) infection. Serum PCT level and PCT mRNA expression were analysed from blood samples collected before treatment. Results Serum PCT level and PCT mRNA expression of the cats with presumed bacterial infection were higher than those with viral infection ( P = 0.001 and P = 0.001, respectively). The receiver operating characteristic (ROC) curve analysis revealed an area under the ROC curve value of 0.888 for serum PCT and 0.850 for PCT mRNA expression. There was no statistically significant difference among respiratory, urinary and gastrointestinal tract infections regarding serum PCT level and PCT mRNA expression in the presumed bacterial infection group ( P = 0.741 and P = 0.141, respectively). In the presumed bacterial infection group, serum PCT level and PCT mRNA expression in the non-surviving cats were higher than those of the surviving cats ( P = 0.021 and P = 0.026, respectively). Conclusions and relevance Serum PCT level and PCT mRNA expression were considered efficient biomarkers in cats to distinguish a bacterial infection from a viral infection. Moreover, ROC curve analysis was highly accurate in the discriminative capacity of these two parameters. PCT level and PCT mRNA expression offer substantial assistance in an efficient therapeutic approach and in avoiding unnecessary antibiotic use in feline clinical practice, particularly in emergency patients and those with non-specific clinical signs, decreasing the mortality rate. However, it should be noted that these data are only research data. More detailed future studies are needed.
Feline maxillary sarcoma: clinicopathologic features of spindle cell sarcomas from the maxilla of 25 cats
Authors: Harvey Alexandra , Soukup Jason W , Bell Cynthia M 
Published: November 2022

Case series summary Feline maxillary sarcomas are aggressive spindle cell neoplasms that occur within the maxilla, palate and upper lip of cats. This diagnosis includes fibrosarcoma and sarcomas with indeterminate histomorphology, excluding melanocytic tumors and sarcomas that can be differentiated by histomorphology. In this study of feline maxillary sarcomas in 25 cats, the cats’ ages ranged from 4 to 16 years (median 12.5). These sarcomas presented as smooth thickenings or mass lesions of the gingiva and palate, often involving both the right and left quadrants of the maxilla. Radiographic bone loss was typically absent to mild at the time of diagnosis. Histologically, feline maxillary sarcomas were composed of spindle cells with varying amounts of fibrous stroma and mild inflammation. Metastasis was not documented for any cat in the study, although clinical staging was limited. Cats were often euthanized because of local recurrence following incomplete tumor excision and local tumor progression. Median survival time from the date of histologic diagnosis was 70 days (n = 12). Relevance and novel information Feline maxillary sarcomas are aggressive neoplasms that may be difficult to differentiate from a benign, reactive process or other types of spindle cell neoplasms. Our findings indicate that feline maxillary sarcoma has distinctive clinical and histopathologic features, and the information provided in this paper will facilitate early and specific diagnosis of this tumor.
Surveying Over the Counter and Prescription Only Medication Misuse in Treatment Services During COVID-19
Authors: Gittins Rosalind , Vaziri Roya , Maidment Ian 
Published: November 2022

Background: A greater understanding of Over the Counter (OTC) and Prescription Only Medication (POM) misuse amongst adults accessing substance misuse services (SMS) during COVID-19 is required to identify how SMS can better meet the needs of the people who require treatment. Aim: To use a questionnaire to explore OTC/POM misuse during COVID-19 in adults accessing community SMS in England. Methods: In 2020 to 2021 anonymous self-administered online/paper questionnaires which collated quantitative and qualitative data were completed. They were piloted for suitability and ethical approval was obtained. Thematic analysis was conducted for qualitative data and chi-square tests used to assess the relationship between quantitative variables. Results: Participants were Caucasian (94.6% British), majority male (58.9%), aged 18 to 61 years. Most were prescribed medication for problematic substance use, with a 92.5% self-reported adherence rate. The misuse of benzodiazepines (22.2%) codeine products (30.8%) and pregabalin (14.5%) predominated and 37.5% misused 2 or more medicines. Administration was usually oral and concomitant use of other substances was common: alcohol 44.6% (52% daily), tobacco/vaping 73.2% and illicit substances 58.9%. There were statistically significant associations identified, including between changes during COVID-19 to OTC/POM misuse and illicit use. Only 56 questionnaires were included in the analysis: we believe this low number was because of infection control measures, limited footfall in services, pressures on staff limiting their capacity to distribute the paper questionnaires and reliance upon telephone consultations limiting online distribution. Increasing OTC/POM misuse and obtaining illicit supplies were reported when access to usual supplies were restricted; however, changes to doses/dispensing arrangement liberalisation in response to COVID-19 were positively viewed. Conclusion: OTC/POM misuse, including polypharmacy and concomitant use of other substances occurred during COVID-19: SMS need to be vigilant for these issues and mitigate the associated risks for example with harm reduction interventions. Further qualitative research is required to explore the issues identified.
Developing the pediatric surgery patient satisfaction scale and assessment of its validity and reliability
Authors: Unal Aysun , Bektaş Murat , Turan Mantar Neriman , Ateş Oğuz , Hakgüder Faika Gülce 
Published: November 2022

Aim of this study was to develop a patient satisfaction scale for needs and expectations of pediatric surgery patients and to propose a new measurement tool in this field. Population of study consisted of all patients between May 2018 and February 2020 at a pediatric surgery service of a university hospital in Turkey. A pool of 70 items was prepared for scale. Two items were removed in line with expert opinions and suggestions. As a result of content validity and test application, 36 items were removed, and scale was revised. Data were transferred to SPSS Statistics 23 and AMOS 22 program. After evaluating scope validity of scale, Content Validity, Structural Validity, Exploratory Factor Analysis, and finally Reliability Analysis were examined. As a result of the analyses, 32 items with eight sub-dimensions were obtained from scale. Eight-factor scale explained 60.42% of total variance. Cronbach Alpha internal consistency of scale was found to be 0.88. Item factor loads of scale were created and the reliability of scale were obtained at desired level. The scale is suitable for patients aged 6 to 18 years old.