bluuebunny/crossref_metadata_2025_split huggingface dataset:
Social Justice in Nursing Education: A Way Forward
Authors: Roy Kaveri , Hunt Karen , Sakai Kanayo , Fletcher Kyle 
Published: August 2022

Background:
Systemic racism and inequity are embedded in higher education, especially in nursing. By disregarding health disparities and inequities, a hidden curriculum is endorsed, implicitly letting both instructors and students know that not addressing these subjects is acceptable.

Method:
Needs assessments were performed to assess faculty and student attitudes about the needs for justice, equity, diversity, and inclusion (JEDI) concepts. Using the Plan-Do-Study-Act model, the School of Nursing leadership, faculty, and students created taskforces to implement anti-oppression curricula throughout prelicensure courses.

Results:
Anti-oppression curricula and workshops were piloted successfully in the first semester of prelicensure nursing. Student feedback was positive with constructive suggestions. JEDI curriculum mapping was completed across the prelicensure nursing curriculum.

Conclusion:

JEDI concepts must be integrated across nursing curricula to identify gaps. Forming a collaboration between leadership, faculty, and students is an optimal way to proceed as they all are invested and accountable for change.

[
J Nurs Educ
. 2022;61(8):447–454.]
Shifting Culture by Creating Synergy and Equity Through the Unification of Tenure Criteria
Authors: Ruel Jennifer , Burson Rosanne , Hollier Saran , Bozimowski Gregory 
Published: August 2022

Background:
Tenure requirements within universities vary; however, most focus on excellence in teaching, service, and scholarship. Within our university, faculty with either research or clinical doctorates were on both tenure and clinical tracks, with reported marginalization from clinical track faculty.

Method:
A task force was convened in 2018 to develop a unified single track that included a single set of criteria for all College of Health Professions faculty to obtain tenure. The Six Sigma DMAIC (Define, Measure, Analyze, Improve, and Control) Roadmap was used to guide the work of the task force.

Result:
The implementation of a single track has influenced discourse around previous notions regarding what is considered “tenure worthy” and has opened the door to contractual equity among faculty.

Conclusion:

Internal structures, such as implementation of a single track, can support cohesion and productivity that facilitates collaborations among faculty of all ranks and degree backgrounds, promoting a culture that continues to embrace intellectual discourse and unity.

[
J Nurs Educ
. 2022;61(8):455–459.]
Having Hard Conversations About Racism Within Nursing Education: A Collaborative Process of Developing an Antiracism Action Plan
Authors: Mayoum Akech , Prajapati Dharti , Lamb Jenna , Kruth Madeleine , Waddell-Henowitch Candice , Baxter Catherine , Beeston Stacey , Graham Jan Marie , Thomson Andrea 
Published: August 2022

Background:
Multiple events that occurred in the United States in early 2020 prompted a widespread response to address racism that exists within systemic and social structures. Third-year psychiatric nursing students at a small Western Canadian university answered the call to action by initiating a process to address racism within clinical and educational settings in their faculty. Methods: The researchers used collaborative autoethnography to examine the experience of students and faculty working collaboratively to create a Faculty of Health Studies antiracism action plan.

Results:
The reflections of the student and faculty researchers highlighted three major themes: what inspired the work of creating an antiracism action plan, doing the work, and lessons learned.

Conclusion:

Engaging in this research provided an opportunity to critically reflect on the process of students and faculty working together in establishing an antiracism action plan.

[
J Nurs Educ
. 2022;61(8):461–468.]
Extended Complicated Punishment: Nursing Students' Experiences of a Transition Program
Authors: Popoola Tosin , Khumalo Nonhlanhla , Popoola Molebi 
Published: August 2022

Background:
A diverse nursing workforce depends on whether higher education is accessible to historically disadvantaged students and whether such students are supported to achieve success. In South Africa, the Extended Curriculum Program (ECP) is a transition degree program created to widen access and success for underrepresented groups, including those aspiring to become nurses. This qualitative study explored the experience of nursing students in an ECP at a South African university.

Method:
Written reflections were collected from 16 nursing students in the ECP.

Results:
Four main themes emerged following thematic analysis: ECP selection process, emotional reaction to ECP placement, ECP as another experience, and acceptance and moving forward. Students reported an altered sense of belonging as the result of hostility from peers and faculty, making social and academic integration challenging.

Conclusion:

Students who gain access to nursing programs and the nursing workforce through transition degree programs may be at risk of low self-efficacy.

[
J Nurs Educ
. 2022;61(8):477–482.]
Measurement Properties of the Health Literacy Questionnaire in the Understanding Multiple Sclerosis Massive Open Online Course Cohort: A Rasch Analysis
Authors: Bessing Barnabas , Honan Cynthia A. , van der Mei Ingrid , Taylor Bruce V. , Claflin Suzi B. 
Published: August 2022

Background:
Online health education and other electronic health improvement strategies are developing rapidly, highlighting the growing need for valid scales to assess health literacy (HL). One comprehensive HL scale is the Health Literacy Questionnaire (HLQ), but little is known about its measurement properties in online health education cohorts.

Objective:
The purpose of this study was to determine if the multidimensional HLQ is an appropriate tool to measure HL in a cohort of Understanding Multiple Sclerosis (MS) online course enrollees.

Methods:

Participants who enrolled in the first two open enrollments of the Understanding MS online course completed the HLQ (
N
= 1,182) in an online survey prior to beginning course materials. We used Rasch analysis to assess the measurement properties of the HLQ.

Key Results:
The nine Domains of the HLQ each had ordered category function and a good fit with the Rasch model. Each domain was one-dimensional and exhibited good internal consistency and reliability. None of the 44 individual items of the HLQ demonstrated item bias or local dependency. However, while the overall fit was good, few measurement gaps were identified in this cohort for participants in each of the nine Domains, meaning that the HLQ may have low measurement precision in some participants.

Conclusion:

Our analysis of the HLQ indicated acceptable measurement properties in a cohort of Understanding MS online course enrollees. Although reliable information on nine separate constructs of HL was obtainable in the current study indicating that the HLQ can be used in similar cohorts, its limitations must be also considered. [

HLRP: Health Literacy Research and Practice
. 2022;6(3):e200–e212.

]

Plain Language Summary:
In this study, we have shown that the HLQ is suitable for measuring HL in an online public health educational platforms for chronic diseases including multiple sclerosis. This finding adds to the evidence that the HLQ can be widely used in measuring HL in different settings, populations, and health educational platforms.
Contratos internacionais online de consumo: transformação digital desde o Mercosul
Authors: Cardoso Squeff Tatiana de A. F. R. , Mucelin Guilherme 
Published: August 2022

A digitalização das relações econômicas, sociais e humanas é uma realidade na pós-modernidade, constituindo a quarta revolução industrial na qual as pessoas e as coisas estão cada vez mais conectadas entre si no ambiente digital. Panorama este que reflete sobremaneira nas relações de consumo na medida em que é crescente o comércio realizado pela via online, notadamente em virtude da pandemia de Covid-19, a qual aqueceu sobremaneira o e-commerce no mundo, assim como no Cone Sul. Entretanto, a transformação digital demanda uma estrutura jurídica definida e centrada na proteção do ser humano para que este adquira a confiança necessária para consumir através da internet. Tal estrutura já vem sendo debatida pelos diversos atores internacionais, inclusive no âmbito do Mercado Comum do Sul (Mercosul). No âmbito desse bloco, pouco havia sobre a proteção do consumidor no âmbito do comércio eletrônico, o que se modificou a partir do Acordo sobre a Lei Aplicável aos Contratos Internacionais de 2017 e pela introdução da Resolução n. 37/2019 do Grupo Mercado Comum. E ao redor destes regramentos é que este texto se centra, sendo o objetivo verificar em que medida estas normativas atentam-se para a proteção do consumidor intrabloco no âmbito da economia digital, avultando as suas prescrições. Ao cabo, desde um estudo do tipo qualitativo, seguindo o método de abordagem analítico-dedutivo e os métodos descritivo e explicativo quanto à análise dos objetivos, e realizado por meio das técnicas bibliográfica e documental, conclui-se que estes textos são importantes acréscimos para a proteção do consumidor no Mercosul, demonstrando o expressivo avanço regional sobre o tema.
A Care Step Pathway for the Diagnosis and Treatment of COVID-19–Associated Invasive Fungal Infections in the Intensive Care Unit
Authors: Jones Carolynn T. , Kopf R. Scott , Tushla Lisa , Tran Sarah , Hamilton Caroline , Lyman Meghan , McMullen Rachel , Shah Drashti , Stroman Angela , Wilkinson Eryn , Kelmenson Daniel , Vazquez Jose , Pappas Peter G. 
Published: August 2022

Background
In March 2020, the World Health Organization declared COVID-19, caused by the SARS-CoV-2 virus, a pandemic. Patients with severe cases resulting in hospitalization and mechanical ventilation are at risk for COVID-19–associated pulmonary aspergillosis, an invasive fungal infection, and should be screened for aspergillosis if they have persistent hemodynamic instability and fever. Early detection and treatment of this fungal infection can significantly reduce morbidity and mortality in this population.

Objective
To develop an evidence-based care step pathway tool to help intensive care unit clinicians assess, diagnose, and treat COVID-19–associated pulmonary aspergillosis.

Methods
A panel of 18 infectious disease experts, advanced practice registered nurses, pharmacists, and clinical researchers convened in a series of meetings to develop the Care Step Pathway tool, which was modeled on a tool developed by advanced practice nurses to evaluate and manage side effects of therapies for melanoma. The Care Step Pathway tool addresses various aspects of disease management, including assessment, screening, diagnosis, antifungal treatment, pharmacological considerations, and exclusion of other invasive fungal coinfections.

Results
The Care Step Pathway tool was applied in the care of a patient with COVID-19–associated aspergillosis. The patient was successfully treated.

Conclusion
The Care Step Pathway is an effective educational tool to help intensive care unit clinicians consider fungal infection when caring for COVID-19 patients receiving mechanical ventilation in the intensive care unit, especially when the clinical course is deteriorating and antibiotics are ineffective.
Comparison of Palonosetron Versus Palonosetron and Dexamethasone for Prevention of Postoperative Nausea and Vomiting After Middle Ear Surgeries
Authors: Kumar Kanhaiya , Kumar Rajnish , Hussain Mumtaz , Kumari Bibha , Kumar Arvind 
Published: August 2022

Background:
Postoperative nausea and vomiting (PONV) are one of the common distressing conditions after anesthesia. The PONV are related to several potential risk factors are patient related, anesthesia related, and surgery related. In surgery-related risk, middle ear surgery is associated with a high incidence of PONV.

Aims:
This study aimed to compare the efficiency of palonosetron versus palonosetron with dexamethasone in the prevention of PONV in middle ear surgeries.

Settings and Design:
This was a prospective, randomized, double-blind study.

Statistical Analysis:
The data were presented as descriptive statistics for continuous variables and percentages for categorical variables and were subjected to Z-test/Chi-square test/Fisher's exact test. The value of P < 0.05 was considered statistically significant.

Results:
Demographic parts in comparison to age, duration of surgery, and duration of anesthesia were similar in both the groups. Our study showed that the incidence of PONV during 0–6 h was 38% (n = 19) in Group A and 12% (n = 6) in Group B and the incidence during 6–12 h postoperatively was 14% (n = 7) in Group A and 8% (n = 4) in Group B. During 12–24 h, the incidence was 8% (n = 4) and 6% (n = 3) in Group A and B, respectively. Hence, the difference of total early PONV in Group A was 60% (n = 30) and in Group B, it was 26% (n = 13) which was statistically significant (P < 0.03).

Conclusions:
The above result proves that palonosetron and dexamethasone group is superior in the prevention of PONV in middle ear surgery.
Randomized Controlled Study Comparing 2-Chloroprocaine and Bupivacaine for Spinal Anesthesia in Gynecological Surgeries
Authors: Thomas Subin , Pawar Devanand Bhimrao , Ruparel Dipakkumar Hiralal , Sedani Shweta 
Published: August 2022

Background:
Ambulatory surgeries are increasing all over. While searching for an ideal anesthetic, the use of lidocaine was linked to a greater rate of transitory neurological symptoms and bupivacaine delays discharge due to a longer duration of motor blockade. 2-chloroprocaine (2CP) with a shorter duration of action is gaining popularity. We aimed to compare intrathecal bupivacaine and 2CP for the subarachnoid block for elective ambulatory gynecological surgeries.

Methods:
A single-blind study was conducted on 90 patients comparing 40 mg 2CP and 10 mg 0.5% bupivacaine heavy measuring pinprick sensation, motor block, time to ambulation, and voiding of urine so as to get ready for discharge.

Results:
In both groups, the beginning of sensory blockage occurred at a similar time, while motor blockade achieved was faster in the 2CP group. The resolution of motor blockade was 1.7 times faster in the 2CP group than in the bupivacaine group. Time taken for ambulation was delayed significantly in the bupivacaine group, i.e., 263.04 ± 29.08 min compared to the 2CP group, i.e., 225.44 ± 29.48 min which was a delay of almost 38 min. Voiding of urine was also delayed in the bupivacaine group by 60 min compared to the 2CP group and was significant finding leading to delay of discharge of patients. Adverse effects were comparable in both groups.

Conclusion:
Intrathecal preservative-free 2CP provides satisfactory surgical block, and has a considerably faster rate of block regression, resulting in earlier ambulation and voiding, allowing the patient to be discharged from the hospital sooner as compared to intrathecal bupivacaine.
A Prospective Observational Study of the Efficacy of Combined Interscalene Block and Superficial Cervical Plexus Block using Peripheral Nerve Stimulator and Landmark-Based Technique, as a Sole Anesthetic for Surgeries on the Clavicle in the COVID-19 Pandemic
Authors: Majumdar Uma , Mitra Anuradha 
Published: August 2022

Background:
Fractures of the clavicle are usually operated under general anesthesia (GA) as they need dense anesthesia, and the airway is difficult to access intraoperatively. There is no established regional anesthesia (RA) technique for clavicular fractures, also as the innervation is contentious. Some studies have been done using RA techniques, but they are all small case numbers. RA is superior to GA in many ways, and we wished to avoid GA specifically during the COVID-19 pandemic.

Aims:
This study aimed to use a peripheral nerve stimulator and a landmark-based technique to give interscalene block (ISB) and superficial cervical plexus block (SCPB) as a sole anesthetic for clavicular fracture surgeries during the COVID-19 pandemic.

Settings and Design:
This was a prospective observational study in a tertiary care teaching hospital in eastern India.

Materials and Methods:
After approval from our ethics committee and informed consent, thirty patients of American Society of Anesthesiologists Class I or II, aged 18–65 years, after exclusion criteria were selected who had to undergo clavicular surgery. Three 10-mL syringes were made, each with 5 mL of 0.75% ropivacaine, 2 mL of 2% lignocaine with 1:200,000 adrenaline, and 3 mL of saline. Using the HNS Stimuplex (B. Braun Melsungen AG, Melsungen, Germany) nerve stimulator, 20 mL was given for an ISB and 5 mL for the SCPB. RA was considered successful if there was no conversion to GA and surgery could be performed.

Results:
With an onset time of 6.53 ± 2.17 min, good operating conditions were obtained in all our patients. Horner's syndrome was noted in two patients. Surgery was successfully carried out in all thirty patients under RA. Pain relief lasted postoperatively for 5 ± 0.92 h.

Conclusion:
ISB combined with SCPB is safe and effective as a sole anesthetic for clavicular surgery. We successfully avoided the use of a general anesthetic in these patients during the COVID-19 pandemic and gave them a safe and effective alternative.
Anti-Bacterial Effect, Fluoride Release, and Compressive Strength of a Glass Ionomer Containing Silver and Titanium Nanoparticles
Authors: Wassel Mariem O. , Allam Gehan G. 
Published: August 2022

Background:
Many attempts have been made to enhance the anti-cariogenic properties of the conventional glass ionomer through incorporation of variable materials. However, most importantly, the incorporation of such materials should not jeopardise the physical or mechanical properties of the final restoration.

Aims:
To investigate the effect of adding silver nanoparticles (

Ag-NPs
) and titanium dioxide nanoparticles (

TiO

2

-NPs
) to conventional glass ionomer cement (

GIC
) on its anti-bacterial effect against Streptococcus mutans (

S. mutans
), fluoride ion release, and compressive strength (

CS
).

Settings and Design:
This study was an in vitro investigation where 30-disc specimens were prepared in each of the three studied groups.

Materials and Methods:
The specimens were categorized into the control group (Group C), in which conventional GIC was used, and Group Ag and Group Ti, in which 5 wt% of Ag-NP and TiO2-NP were added, respectively, to GIC powder. In each group, the anti-bacterial effect against S. mutans, fluoride ion release at 24 hours and 14 and 28 days, and CS were assessed. Data were analysed using one-way analysis of variance, followed by Tukey honest significant difference post-hoc test.

Results:
Both Ag and Ti groups showed a significantly higher anti-bacterial effect than the control group. Ag-NP increased fluoride ion release, whereas TiO2-NP decreased fluoride release; however, cumulative ion release of both experimental groups did not differ significantly compared to the control group. Adding Ag-NP and TiO2-NP increased CS, yet only the Ti group showed the highest CS mean value that was statistically significant compared to other groups.

Conclusions:
Adding 5 wt% TiO2-NP or Ag-NP to conventional GIC significantly increased its anti-bacterial effect and its CS without affecting fluoride release.
Substance Use and Oral Health Sensations among Substance Users Residing in Rehabilitation Centres in an Indian City
Authors: Kumar Gunjan , Jnaneswar Avinash , Rai Shilpa , Vinay S , Jha Kunal , Singh Arpita 
Published: August 2022

Background:
The term substance is usually used to address psychoactive/psychotropic drugs which include both licit and illicit drugs. These substances have varied consequences, including long-term and short-term effects, which include sensations post-consumption.

Aim:
To determine patterns of substance use and short-term oral health effects among substance users.

Materials and Methods:
A self-administered questionnaire-based study was conducted on the inmates of drug deaddiction and rehabilitation centres in Bhubaneswar city.

Results:
All the subjects were males and majority (60.6%) were polydrug users. Alcohol (87.3%) was the most commonly used substance, followed by ganja (57%), bhang (35.3%) and brown sugar (33%). A wide range of oral health sensations like dryness of mouth, taste change, numbness in mouth, feeling like chewing something, loose teeth and stammering/difficulty in speaking were found to be significantly associated with substance use. The age of start of substance use (P < 0.0001), socioeconomic status (P = 0.026) and marital status (P < 0.0001) were significantly associated with the pattern of substance use. About 37.6% of inmates felt that they had very good oral health before starting drug use, while only 15.4% described their oral health as very good at present. Having no oral health problem was the most common reason for not visiting a dentist, followed by ignorant attitude towards oral health.

Conclusion:
A wide range of oral health sensations were found to be caused due to substance use. Understanding of oral health sensations can aid practitioners detect and report cases of substance use in its early phase.
Evaluation of Antimicrobial Activity of Chlorhexidine-Containing Oral Gels Against Aspiration Pneumonia-Inducing Bacteria
Authors: Han Sun-Young , Roh Jiyeon , Jung Yun-Sook , Kim Ki-Rim 
Published: August 2022

Aim:
Hospitalised patients have a high risk of developing aspiration pneumonia because of poor oral care and oral microbial flora changes. Chlorhexidine (CHX) solution has been used to reduce inflammation and prevent infections in oral cavity, but it is difficult to use in inpatients. Gel-type antimicrobial agents rather than the liquid form may be effective for the oral management of hospitalised patients. Therefore, we evaluated the in vitro antimicrobial effects of CHX-containing oral gels on aspiration pneumonia-inducing bacteria compared to the CHX solution.

Materials and Methods:
The experimental products of two oral gel types containing 1% and 0.1% CHX, respectively, were selected. Hexamedine, a 0.12% CHX solution, was used as a positive control. The antimicrobial activity of CHX agents against six pneumonia-causing bacteria and Streptococcus mutans, one of the most common oral bacteria, was comparatively analysed using the agar disk diffusion method.

Results:
In the disk diffusion assay, the 1% CHX gels showed the highest inhibitory effect on all bacteria. All CHX agents including gels and solution had the highest antibacterial activity against Staphylococcus aureus compared with other bacteria.

Conclusions:
We confirmed the significant antimicrobial effects of the 1% CHX oral gels on aspiration pneumonia-inducing bacteria. These results suggest that CHX gels may be an effective oral care method for preventing infection in inpatients who have difficulty using the solution.