bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patterns of treatment discontinuation in patients receiving anti-vascular endothelial growth factor for neovascular age-related macular degeneration
Authors: Dhingra Narendra , Upasani Deepa , Ghanchi Faruque D 
Published: June 2022

Purpose:
To report the reasons for treatment discontinuation within 5 years in patients receiving intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy for neovascular age-related macular degeneration (nAMD).

Methods:
A retrospective case-notes review of patients commenced on anti-VEGF for nAMD who failed to complete 5 years of follow-up was undertaken. The reasons for treatment discontinuation, baseline age, baseline visual acuity (VA) in Early Treatment Diabetic Retinopathy Study (ETDRS) letters, and the VA change at the last follow-up were recorded. Age-specific all-cause mortality was calculated for deceased patients.

Results:
Of the 1177 patients, 551 patients (46.8%) failed to complete the 5-year follow-up. The reasons for treatment discontinuation were death (251), early discharge due to stable disease (110), further treatment deemed futile (100), failure to attend (15), ill health (14), patient choice (7), and transfer of care (1). In 53 patients, no reason was documented. The mean baseline age of those who completed the 5-year follow-up (77.4 ± 7.8 years, 95% confidence interval (CI): 76.8–77.9) was significantly lower than those who discontinued the treatment for any reason (82 ± 7.7 years, 95% CI: 81.4–82.6) (P < 0.0001). Survival analysis showed that baseline VA was not a factor in treatment discontinuation; however, visual stability (±5 letters from baseline) was associated with treatment continuation. The age-specific all-cause mortality in deceased patients was lower than that in the general population.

Conclusion:
At 5 years, only 53% of patients remained in active care, and death was the most common reason for treatment discontinuation. Lower baseline age and VA stability during therapy were associated with treatment continuation.
Cluster outbreak of Pseudomonas stutzeri acute endophthalmitis following phacoemulsification: A report of 14 cases from North India
Authors: Handa Sabia , Singh Simar Rajan , Sharma Bhawna , Rana Vipin , Bazgain Krinjeela , Tekchandani Uday , Narang Shashank , Angrup Archana , Biswal Manisha , Ray Pallab , Gupta Vishali 
Published: June 2022

Purpose:
To report clinical features, antibiotic susceptibility profile, management, and outcomes of a cluster outbreak of post-cataract surgery Pseudomonas stutzeri endophthalmitis.

Methods:
This was a hospital-based case series in which 14 patients with acute postoperative endophthalmitis who underwent cataract surgery on the same day were included. Based on severity of presentation, they either underwent pars plana vitrectomy (PPV) with intraocular antibiotics (IOAB) or vitreous tap with IOAB. Vitreous aspirates and environmental surveillance samples were inoculated on culture media and further processed by MALDI-TOF MS for identification and Vitek3 for susceptibility profile.

Results:
There were 8 females and 6 males with a mean age of 62.14 ± 8.08 years. Presenting signs included corneal folds (100%), hypopyon (57.1%) and fibrin (50%). Ten patients with mild presentation underwent vitreous tap with IOAB. Four patients with severe presentation underwent PPV with IOAB. Pseudomonas stutzeri was isolated from the vitreous samples and was pan-sensitive. Six eyes required multiple interventions. Favorable outcome was obtained in 12 eyes, one eye developed phthisis, and one patient was lost to follow-up.

Conclusion:
We report the first ever cluster outbreak of Pseudomonas stutzeri endophthalmitis following phacoemulsification with IOL implantation in a single surgeon setting. Majority of the patients had a mild presentation and responded well to targeted anti-microbial treatment.
Safety, efficacy, and patient selection of ripasudil in patients with uncontrolled glaucoma with maximum conventional medical therapy
Authors: Jethva Jignesh , Bhagat Purvi , Prajapati Kamini , Tank Gunjan 
Published: June 2022

Purpose:
Ripasudil hydrochloride hydrate (0.4%) is the first Rho-associated protein kinase (ROCK) inhibitor eye drop that lowers intraocular pressure (IOP) by increasing conventional aqueous outflow through the trabecular meshwork and Schlemm’s canal. We aimed to evaluate the safety and efficacy of ripasudil in patients using the maximum topical anti-glaucoma medications and with uncontrolled IOP.

Methods:
In our prospective interventional study, we enrolled 27 eligible and consenting patients (46 eyes) who presented to us between January 2021 and June 2021. Ripasudil 0.4% was added as adjunctive therapy to the ongoing glaucoma treatment. On follow-up visits at 7 days, 15 days, 1 month, 2 months, and 3 months, the visual acuity, IOP with applanation tonometer, anterior segment, and fundus were evaluated. The IOP before and after the use of ripasudil eye drops was compared by paired t-test.

Results:
Among the 27 patients, 18 were males and 9 were females. A statistically significant reduction in IOP was noted at all time durations (P < 0.00001) with the maximum reduction at 3 months with all patients achieving their target IOP. No patient developed any side effects necessitating the omission of ripasudil. The most common adverse event noted was conjunctival hyperemia (22 patients), which was mild and transient.

Conclusion:
Ripasudil showed additional IOP-lowering effect with other antiglaucoma medications and exhibited no significant side effects.
Assessment of knowledge, attitude, and practice of glaucoma among different cadres of optometrists
Authors: Saravanan Sowmya , Negiloni Kalpa , Asokan Rashima 
Published: June 2022

Purpose:
To assess the level of knowledge, attitude, and clinical practice of glaucoma among optometry students and optometry practitioners with different years of clinical experience and academic background.

Methods:
A survey with 20 questions on knowledge, attitude, and practice (KAP) of glaucoma was prepared and self-administered to optometry students and optometry practitioners practicing in an eye hospital/clinic/optical with varied years of clinical experience and education qualification.

Results:
Among the 558 participants, 57% were optometry practitioners and 43% were students. The knowledge scores among optometry practitioners increased significantly with an increase in the years of clinical experience (P < 0.001). Participants with master’s degrees scored higher than participants with bachelor’s degrees (P = 0.12). There was no statistically significant difference in knowledge scores based on the type of clinical practice - hospital, private practice, or optical (P = 0.39). Practicing optometrists who performed slit-lamp examination, gonioscopy, IOP measurements, and disc evaluation for the detection of glaucoma had significantly higher knowledge scores than those who did not perform these tests in their practice (P < 0.05). A positive attitude toward glaucoma learning through workshops and hands-on training was reported by optometrists and students.

Conclusion:
Knowledge about glaucoma was good among optometrists and optometry students and was better among those who handled the diagnostics. All the optometrists had a positive attitude toward enhancing their practice through proper training.
Effectiveness of meperidine, nalbuphine, and paracetamol in labor analgesia at Tanta University Hospitals
Authors: Nada Amal N.M. , Dawood Ayman S. , Aldbaa Ahmed A. , Marae Safaa K. 
Published: June 2022

Background
Pain during the first stage of labor is visceral pain that originates in the uterus and cervix, and it is produced by uterine muscle hypoxia, lactic acidosis, distention of the lower uterine segment, stretching of the ligaments, and pressure on the bony pelvis. It is mediated through the afferent nerve supply of the uterus through the sympathetic nerve, which finally reaches the thoracic and lumbar segments of the spinal cord.

Aim
The aim of this study is to test and compare the efficacy of intravenous injection of meperidine, nalbuphine, and paracetamol infusion in intrapartum analgesia.

Patients and methods
This prospective randomized comparative study was conducted in the Department of Obstetrics and Gynecology at Tanta University Hospitals from August 2018 till January 2020.

Results
The use of paracetamol as an analgesic in the first stage of labor showed a significant decrease between paracetamol and the groups of pethidine and nalbuphine as regards the potency of analgesia. However, the duration of labor was significantly shortened with paracetamol than pethidine and nalbuphine. The maternal, neonatal, and fetal side effects were more with opioids (pethidine and nalbuphine) than paracetamol.

Conclusion
Parenteral opioids (pethidine and nalbuphine) have nonsignificant difference in effectiveness in intrapartum analgesia. However, they are more effective than paracetamol for pain relief and maternal satisfaction during the first stage of labor.
Relational Systems Thinking
Authors: Goodchild Melanie 
Published: June 2022

This paper extends the analysis begun in Goodchild (2021), with suggestions for engaging with the spirit of relational systems thinking as a dynamic interface theoretical model. It is a perspective offered to help systems change practitioners and scholars transcend binary and hierarchical thinking, in the sacred space between worldviews, to embrace a complexity mindset informed by Indigenous wisdom. It is not about the what of deep systems awareness, but the how.
Az életminőség és az életkor kapcsolata vesebetegek körében
Authors: Barcsa Tímea , Balogh Szabó Viktória 
Published: June 2022

Bevezetés: Vesepótló kezelést igénylő veseelégtelenségnek mind az incidenciája, mind a prevalenciája az életkor előrehaladtával fokozatosan emelkedik. Több hazai és nemzetközi vizsgálat alátámasztotta, hogy a betegség az érintett betegek életminőségére negatív hatást gyakorol.
Célkitűzés: Jelen vizsgálat célja átfogó képet kapni a vesebetegek életminőségéről a téma mélyebb megismeréséhez, a saját kutatómunka megalapozásához.
Anyag és módszer: Hazai és nemzetközi vizsgálatok részletes áttekintése a vesebetegek életminőségének megismeréséhez, különös tekintettel az elmúlt 10 évben végzett kutatásokra.
Eredmények: A hazai mutatók a nemzetközi mutatókhoz viszonyítva rosszabbak. Nőtt az idősebbek aránya az elmúlt években, s ezzel együtt a vesebetegek aránya is növekedett. Esetükben a vesebetegséghez gyakran különböző társbetegségek kapcsolódnak, ezzel és egyéb tényezőkkel együtt rontva a betegek életminőségét. Az életminőséget befolyásoló tényezők közül kiemelendő az életkor. Annak ellenére, hogy az életminőség romlik az életkor előrehaladtával, mégis azt tapasztalják, hogy az idősebb személyek élik meg kevésbé megterhelőnek a krónikus vesebetegséget.
Következtetés: A vesebetegek arányának növekedése egyrészt a szűrővizsgálatok fontosságára hívja fel a figyelmet, másrészt a már kialakult betegség esetén az életminőség javítására.
Revealing the Concept of Aging in Turkish Nursing Students: An Exploratory Metaphor Analysis
Authors: Yilmaz Emel Bahadir , Yüksel Arzu 
Published: June 2022

Purpose:This study aimed to reveal the perceptions of nursing students about the concept of aging through metaphors.
Methods:The study was carried out in a qualitative research design. The study sample consisted of 104 senior nursing students at Aksaray University in the 2021-2022 academic year. In the study, "Metaphoric Perceptions Data Collection Form", which was prepared by the researchers in line with the literature, was used as a data collection tool. In order to collect the data, each student was asked to fill in the blanks of the sentence: "Aging is like … because …" .The analysis of the data was carried out in five stages: (1) Coding and sorting phase, (2) Sample metaphor image compilation phase, (3) Main theme and sub-themes development phase, (4) The stage of ensuring validity and reliability, and (5) Transferring the data to the computer environment.
Results:Students produced a total of 102 valid metaphors for the concept of aging. The metaphors revealed the students' perceptions of the concept of aging, and four main themes and 11 sub-themes were collected. The main themes were aging as an ending story, as a need for care, attention, and support, as a new beginning, and as a source of life. Sub-themes were acceptance, no turning back, approaching the end, deprivation, helplessness, being dependent, rooting, starting, guiding, being a building block, and being valued.
Conclusion:Nursing students' metaphors about aging are generally negative, but also contain expressions of respect.
EFFECTS OF KNOWLEDGE CAPTURE AND ACQUISITION PRACTICES ON ORGANIZATIONAL PERFORMANCE
Authors: Stephen Peter 
Published: June 2022

Purpose: SMEs are an important component of the economy, especially with regard to absorbing a large percentage of the workforce. Good performance of these entities is therefore critical so that they can continue with their economic contribution. However, despite county government efforts of Kisumu and the government of Kenya to promote SME activity, not much progress seems to have been achieved. The general objective of this study was to investigate the influence of knowledge management practices on the performance of small and medium enterprises in Kisumu City County.
Methodology: The study was based on descriptive research design. The target population will be 532 SMEs firms in Kisumu City County. The sample size was 150 SMEs covering different sectors. The study will use questionnaires, containing both open ended and closed ended questions to obtain primary data. Descriptive statistics including the means and standard deviations will be used to analyse the data and capture the characteristics of the variables under the study. The conclusions of this study were informed by the findings based on each study objective and also findings of other similar studies.
Results: The findings of the study revealed that knowledge creation, knowledge acquisition, knowledge sharing and knowledge implementation are positively related with performance of SMEs in Kisumu County. Knowledge creation, knowledge acquisition, knowledge sharing and knowledge implementation were found to be satisfactory variables in explaining performance of SMEs in Kisumu County as supported by coefficient of determination of 51.2%. This shows that knowledge creation, knowledge acquisition, knowledge sharing and knowledge implementation explained 5.2% of the performance of SMEs in Kisumu County.
Unique contribution to theory, practice and policy: The study recommends that SMEs in Kisumu County should adopt knowledge management strategy in running their business so that they can gain improved performance, knowledge management strategies to be adopted are: knowledge sharing, knowledge acquisition, knowledge creation and knowledge implementation.
Clinical Reasoning in Occupational Therapy Practice: A Scoping Review of Qualitative and Conceptual Peer-Reviewed Literature
Authors: da Silva Araujo Angelica , Anne Kinsella Elizabeth , Thomas Aliki , Demonari Gomes Laysla , Quevedo Marcolino Tais 
Published: June 2022

Abstract
Importance: The occupational therapy clinical reasoning literature includes a large proportion of peer-reviewed qualitative and conceptual articles. Although these articles can contribute to the understanding of how clinical reasoning has been conceptualized in occupational therapy, they have not yet received in-depth analytic attention. To address this gap, we conducted a scoping review.
Objective: To examine how qualitative and conceptual literature has addressed clinical reasoning in occupational therapy.
Data Sources: Database searches were conducted in Scopus, Web of Science, PsycINFO, Embase, and MEDLINE.
Study Selection and Data Collection: Included articles were published between 2010 and 2019, were peer reviewed, addressed clinical reasoning in occupational therapy, were qualitative or conceptual articles, focused on practitioners, and were in English. Twenty-six articles met the inclusion criteria. Data were extracted according to relevant categories and were analyzed numerically and thematically.
Findings: Four themes were identified: clinical reasoning processes, factors influencing clinical reasoning, new models or frameworks to guide clinical reasoning, and emergent perspectives on clinical reasoning.
Conclusions and Relevance: This review advances knowledge about how clinical reasoning has been conceptualized in occupational therapy and has been applied in a range of practice contexts. The review highlights discussions about types of reasoning, the dynamic and iterative nature of reasoning, contextual dimensions of reasoning, client-centered and occupation-based approaches, new frameworks and models, and emergent and innovative perspectives on clinical reasoning in occupational therapy.
What This Article Adds: This scoping review represents an important contribution to knowledge about how clinical reasoning has been conceptualized in occupational therapy by mapping key themes and illuminating scholarly conversations in the qualitative and conceptual clinical reasoning literature.
Occupational Therapy Practice Guidelines for People With Parkinson’s Disease
Authors: Wood Julia , Henderson Whitney , Foster Erin R. 
Published: June 2022

Abstract
Importance: Occupational therapy practitioners address the occupational performance and participation needs of people with Parkinson’s disease (PD) and their care partners.
Objective: This Practice Guideline is informed by systematic reviews on the use of occupational therapy interventions to promote participation in occupations for people with PD and to facilitate their caregivers’ participation in the caregiver role. This guideline is meant to support practitioners’ clinical decision making when working with people with PD and their care partners.
Method: We examined and synthesized the results of four systematic reviews and integrated those results into clinical recommendations for practice.
Results: Thirty-three articles from the systematic reviews served as the basis for the clinical recommendations in this Practice Guideline. Clinical recommendations are provided for interventions that have strong or moderate supporting evidence.
Conclusion and Recommendations: Multidisciplinary, tailored, goal-oriented intervention is recommended for people with PD. Various forms of exercise can be used to improve activities of daily living and instrumental activities of daily living performance and social participation, and interventions should incorporate health behavior change techniques to support adequate physical activity levels in daily life. Mindfulness meditation and exercise can be used to support sleep, and task-oriented training can be used to improve performance of specific tasks. Occupational therapy practitioners should incorporate self-management, coaching, compensatory, cognitive–behavioral, and other approaches into multicomponent treatment plans depending on the client’s needs and goals. Additional potentially appropriate intervention approaches or areas to address are discussed on the basis of existing or emerging evidence and expert opinion.
What This Article Adds: This Practice Guideline provides a summary and applications of the current evidence supporting occupational therapy intervention for people with PD. It includes case examples and suggested decision-making algorithms to support practitioners in addressing client goals.
Motor-based priming: isokinetic outcomes of aerobic exercise in children with spastic diplegia
Authors: El-Saeed Tamer Mohamed 
Published: June 2022

IntroductionPriming is a behavioural change generated by preceding stimuli. Priming physical activities with aerobic exercise could improve performance and function. The study aimed to investigate the effect of aerobic exercise before a rehabilitation program on quadriceps peak torque in children with cerebral palsy of spastic diplegia.MethodsOverall, 32 patients participated in this study; they were randomly assigned to 2 groups. Patients in the control group (A) engaged in a selected physical therapy program, while those in the experimental group (B) performed aerobic exercise by using a bicycle ergometer followed by application of the same selected physical therapy program as received by group A. The treatment programs were conducted 3 times per week for 12 successive weeks. Measurements obtained included concentric peak torque of quadriceps muscle at 30° as well as 90°. These measures were recorded 2 times: before and after the application of the treatment program.ResultsThere were statistically significant differences when comparing pre- and post-treatment mean values in each group. Also, there was a significant difference in favour of group B with regard to post-treatment mean values.ConclusionsIn accordance with the applied procedures, aerobic exercise is effective in improving quadriceps peak torque in children with cerebral palsy of spastic diplegia when applied before a physical therapy rehabilitation program.
The contribution of dry needling and Kinesio taping to classic physical therapy in myofascial pain syndrome
Authors: Yildirim Feyza , Alptekin Hasan Kerem , Alptekin Jülide Öncü 
Published: June 2022

IntroductionThis study aimed to investigate the contribution of dry needling and Kinesio taping to classic physical therapy applied in myofascial pain syndrome (MPS) and to determine whether either method was superior.MethodsThis prospective randomized controlled study included 30 patients with MPS with at least 1 active trigger point in the upper trapezius. They were randomly divided into 3 equal groups: classic therapy group (ultrasound + Hot Pack + transcutaneous electrical nerve stimulation + massage + exercise), classic therapy + dry needling group, and classic therapy + Kinesio taping group. All groups received 10 sessions (3 sessions/week). Patients were evaluated at baseline and at the end of therapy. Visual analogue scale (VAS) was used to assess neck pain and 36-item Short Form Survey (SF-36) served to assess quality of life.ResultsAt 4 weeks of follow-up, there was a statistically significant decrease in VAS scores in each group compared with baseline (<i>p</i> < 0.05) and no significant difference in outcomes between the groups (<i>p</i> > 0.05). In the SF-36 assessment, a significant improvement was observed in the physical function, physical role, pain, and general state of health in all groups compared with baseline (<i>p</i> < 0.05). All groups were similar in terms of SF-36 improvement (<i>p</i> > 0.05).ConclusionsVAS and SF-36 results improved in all treatment groups. We suggest that all these methods, including classic therapy, Kinesio taping, and dry needling should be applied to reduce pain and improve quality of life in MPS patients. Further research with larger samples is warranted to determine optimal treatment duration in order to obtain long-term efficacy.