bluuebunny/crossref_metadata_2025_split huggingface dataset:
Why do nursing students leave bachelor program? Findings from a qualitative descriptive study
Authors: Canzan Federica , Saiani Luisa , Mezzalira Elisabetta , Allegrini Elisabetta , Caliaro Arianna , Ambrosi Elisa 
Published: March 2022

Abstract
Background
Over the past few years, the phenomenon of “nursing student attrition” has been unevenly studied. Investigators often focused on independent predictors as age, family obligations, final grade of high school, demanding physical and mental workload and others. Specifically, just a few studies applied qualitative methods to better comprehend the very needs of first year students enrolled in a bachelor’s degree in nursing sciences (BSN), to sustain their learning process and define effective strategies to reduce student drop-out.

Methods
We conducted a qualitative descriptive study. Thirty-one nursing students at Verona University were interviewed using a semi-structured guide. Data analysis was performed according to a descriptive approach by Sandelowski & Barroso (2000).

Results
A total number of 31 students were interviewed. The most recurrent themes regarding the reasons behind BSN drop-out were: understanding that they were not suited to be nurses, perception of missing/lack of psychological, physical and practical resources needed to successfully cope with both nursing school and the nursing profession, inconsistencies between the image of the profession and the reality of the job, feelings of disappointment for the experiences of internship, perceived lack of support from the clinical teacher while going through difficult experiences.

Conclusions
We can consider a part of these drop-out decisions normal, even physiological when students come to realise that they are not suited for the nursing profession. However, it’s important to guide nursing students with adequate counselling in order to give them the essential tools to cope with the training and the future as health professionals.
Provider and community stakeholder perspectives of expanding Medicaid coverage of abortion in Illinois
Authors: Zuniga Carmela , Bommaraju Aalap , Hasselbacher Lee , Stulberg Debra , Thompson Terri-Ann 
Published: March 2022

Abstract
Background
Many people seeking abortion encounter financial difficulties that delay or prevent them from accessing care. Although some patients qualify for Medicaid (a public program that can help cover health care costs), laws in some states restrict the use of Medicaid for abortion care. In 2017, Illinois passed House Bill 40 (HB-40), which allowed patients with Medicaid to receive coverage for their abortion. This study aimed to understand how HB-40 affected abortion affordability from the perspectives of individuals that work directly or indirectly with abortion patients or facilities providing abortion care.

Methods
We conducted interviews with clinicians and administrators from facilities that provided abortion services; staff from organizations that provided resources to abortion providers or patients; and individuals at organizations involved in the passage and/or implementation of HB-40. Interviews were audio-recorded and transcribed. We created codes based on the interview guides, coded each transcript using the web application Dedoose, and summarized findings by code.

Results
Interviews were conducted with 38 participants. Participants reflected that HB-40 seemed to remove a significant financial barrier for Medicaid recipients and improve the experience for patients seeking abortion care. Participants also described how the law led to a shift in resource allocation, allowing financial support to be directed towards uninsured patients. Some participants thought HB-40 might contribute to a reduction in abortion stigma. Despite the perceived positive impacts of the law, participants noted a lack of public knowledge about HB-40, as well as confusing or cumbersome insurance-related processes, could diminish the law’s impact. Participants also highlighted persisting barriers to abortion utilization for minors, recent and undocumented immigrants, and people residing in rural areas, even after the passage of HB-40.

Conclusions
HB-40 was perceived to improve the affordability of abortion. However, participants identified additional obstacles to abortion care in Illinois that weakened the impact of HB-40 for patients and required further action, Findings suggest that policymakers must also consider how insurance coverage can be disrupted by other legal barriers for historically excluded populations and ensure clear information on Medicaid enrollment and abortion coverage is widely disseminated.
Physicians’ preferences and willingness to pay for artificial intelligence-based assistance tools: a discrete choice experiment among german radiologists
Authors: von Wedel Philip , Hagist Christian 
Published: March 2022

Abstract
Background
Artificial Intelligence (AI)-based assistance tools have the potential to improve the quality of healthcare when adopted by providers. This work attempts to elicit preferences and willingness to pay for these tools among German radiologists. The goal was to generate insights for tool providers and policymakers regarding the development and funding of ideally designed and priced tools. Ultimately, healthcare systems can only benefit from quality enhancing AI when provider adoption is considered.

Methods
Since there is no established market for AI-based assistance tools in radiology yet, a discrete choice experiment was conducted. Respondents from the two major German professional radiology associations chose between hypothetical tools composed of five attributes and a no-choice option. The attributes included: provider, application, quality impact, time savings and price. A conditional logit model was estimated identifying preferences for attribute levels, the no-choice option, and significant subject-related interaction effects.

Results
114 respondents were included for analysis of which 46% were already using an AI-based assistance tool. Average adoption probability for an AI-based tool was 81% (95% CI 77.1% − 84.4%). Radiologists preferred a tool that assists in routine diagnostics performing at above-radiologist-level quality and saves 50% in diagnostics time at a price-point of €3 per study. The provider is not a significant factor in the decisions. Time savings were considered more important than quality improvements (i.e., detecting more anomalies).

Conclusions
Radiologists are overall willing to invest in AI-based assistance tools. Development, funding, and research regarding these tools should, however, consider providers’ preferences for features of immediate everyday and economic relevance like time savings to optimize adoption.
Prevention and control of COVID-19 by primary health care facilities in China: a field-survey-based qualitative study in three typical cities
Authors: Yan Yun-yun , Fan Teng-yang , Zheng Yan-ling , Yang Hai-qin , Li Tian-shu , Wang Hai-tang , Gu Yan-feng , Xiao Xue , Du Zhao-hui , Sun Xiao-ming 
Published: March 2022

Abstract
Background
During the coronavirus disease 2019 (COVID-19) containment, primary health care (PHC) facilities inChina played an important role in providing both healthcare and public care services to community populations. The tasks of COVID-19 containment facilitated by PHC facilities were different among different regions and during different periods of COVID-19 pandemic. We sought to investigate the gaps on task participation, explore existing problems and provide corresponding solutions.

Methods
Semi-structured face-to-face interviews with COVID-19 prevention and control management teams of PHC facilities were conducted. Purposive stratified sampling was used and 32 team members of 22 PHC facilities were selected from Wuhan (as high-risk city), Shanghai (as medium-risk city) and Zunyi (as low-risk city). Framework analysis was employed to analyze the transcribed recordings.

Results
The main tasks of PHC facilities during the early period of the pandemic included assisting in contact tracing and epidemiological investigation, screening of populations at high-risk at travel centers/internals, house-by-house, or pre-examination/triage within PHC facilities; at-home/ centralized quarantine management; the work of fever sentinel clinics.
Further analyses revealed the existing problems and suggestions for improvement or resolutions. Regular medical supply reserves were recommended because of the medical supply shortage during the pre-outbreak period. Temporarily converted quarantine wards and centralized quarantine centers could be used to deal with pressures on patients’ treatment and management of the febrile patients. Only after strict evaluation of nucleic acid testing (NAT) results and housing conditions, decision on quarantine at-home or centralized quarantine centers could be made. Settings of fever sentinel clinics at PHC facilities allowed fever patients with no COVID-19 infection risks for treatment without being transferred to fever clinics of the designed secondary hospitals. Psychological intervention was sometimes in need and really helped in addressing individuals’ mental pressures.

Conclusions
During the COVID-19 containment, PHC facilities in China were responsible for different tasks and several problems were encountered in the working process. Accordingly, specific and feasible suggestions were put forward for different problems. Our findings are highly beneficial for healthcare teams and governments in handling similar situations.
Targeted Interdisciplinary Model for Evaluation and Treatment of Neuropsychiatric Symptoms (TIME) in home care services: a cluster randomized feasibility trial
Authors: Hoel Kari-Anne , Lichtwarck Bjørn , Væringstad Anette , Feiring Ingvild Hjorth , Rokstad Anne Marie Mork , Selbæk Geir , Benth Jūratė Šaltytė , Bergh Sverre 
Published: March 2022

Abstract
Background
Behavioral and psychological symptoms of dementia (BPSD) occur frequently in people with dementia and can contribute to an increased need for help and a reduced quality of life, but also predict early institutionalization. The Targeted Interdisciplinary Model for Evaluation and Treatment of Neuropsychiatric Symptoms (TIME) might be a useful personalized approach to BPSD in people with dementia. The main objective of this feasibility trial was to explore the trial design and methods along with the patients’ and the home care staff’s acceptance of the TIME intervention before developing a definitive trial. Additionally, we wanted to explore whether TIME could be appropriate for staff in home care services in their approach towards people with dementia with anxiety and depression.

Methods
This was a 18-month feasibility trial using a parallel cluster randomized controlled design. Nine municipalities from the eastern part of Norway (clusters) — 40 people with dementia and 37 of their next of kin— were randomized to the TIME intervention or to treatment as usual. In addition, qualitative data as field notes were collected and summarized.

Results
The staff in home care services experienced TIME as an appropriate method; in particular, the systematic approach to the patient’s BPSD was experienced as useful. However, the completion of the assessment phase was considered exhaustive and time-consuming, and some of the staff found it challenging to find time for the case conferences.

Conclusions
We consider that TIME, with some adjustments, could be useful for staff in home care services in cases where they face challenges in providing care and support to people with dementia. This feasibility trial indicates that we can move forward with a future definitive randomized controlled trial (RCT) to test the effect of TIME in people with dementia receiving home care services.

Trial registration
ClinicalTrial.gov identifier: SI0303150608.
Mesorectal excision with lateral lymph node dissection for mid-low rectal cancer with lateral lymph node metastasis: efficacy and prognostic analysis
Authors: Zhou Sicheng , Jiang Yujuan , Liang Jianwei , Liu Qian 
Published: March 2022

Abstract
Background
The aim of this study was to evaluate the efficacy of lateral pelvic lymph node (LPN) dissection (LPND) for rectal cancer patients with LPN metastasis (LPNM) and investigate the impact of LPNM on prognosis.

Methods
One hundred twenty-five matched pairs were selected and divided into the total mesorectal excision (TME) group and TME + LPND group for evaluation after propensity matching.

Results
No significant difference was observed in the 3-year local recurrence rate between the TME group and the TME + LPND group (10.7% vs 8.8%, P = 0.817); however, the rate of distant metastasis after TME + LPND was significantly higher (15.2% vs 7.2%, P = 0.044). When the mesorectal LN and LPN groups were subdivided, 3-year RFS was not significantly different between the internal LPN and N2 groups (57.1% vs. 55.3%, P = 0.613). There was no significant difference in RFS between the external group and the stage IV group (49.1% vs. 22.5%, P = 0.302), but RFS in the former group was significantly worse than that in the N2 group (49.1% vs. 55.3%, P = 0.044).

Conclusion
Although patients with suspected LPNM can achieve satisfactory local control after TME + LPND, systemic metastases are more likely to develop after surgery. Patients limited to internal iliac and obturator LN metastasis appear to achieve a survival benefit from LPND and can be regarded as regional LN metastasis. However, patients with LPNM in the external and common iliac LN metastasis have a poor prognosis that is significantly worse than that of N2 and slightly better than that of stage IV, and LPND should be carefully selected.
Fertility treatments and the risk of preterm birth among women with subfertility: a linked-data retrospective cohort study
Authors: Sanders Jessica N. , Simonsen Sara E. , Porucznik Christina A. , Hammoud Ahmad O. , Smith Ken R. , Stanford Joseph B. 
Published: March 2022

AbstractBackgroundIn vitro fertilization (IVF) births contribute to a considerable proportion of preterm birth (PTB) each year. However, there is no formal surveillance of adverse perinatal outcomes for less invasive fertility treatments. The study objective was to describe associations between fertility treatment (in vitro fertilization, intrauterine insemination, usually with ovulation drugs (IUI), or ovulation drugs alone) and preterm birth, compared to no treatment in subfertile women.MethodsThe Fertility Experiences Study (FES) is a retrospective cohort study conducted at the University of Utah between April 2010 and September 2012. Women with a history of primary subfertility self-reported treatment data via survey and interviews. Participant data were linked to birth certificates and fetal death records to asses for perinatal outcomes, particularly preterm birth.ResultsA total 487 birth certificates and 3 fetal death records were linked as first births for study participants who completed questionnaires. Among linked births, 19% had a PTB. After adjustment for maternal age, paternal age, maternal education, annual income, religious affiliation, female or male fertility diagnosis, and duration of subfertility, the odds ratios and 95% confidence intervals (CI) for PTB were 2.17 (CI 0.99, 4.75) for births conceived using ovulation drugs, 3.17 (CI 1.4, 7.19) for neonates conceived using IUI and 4.24 (CI 2.05, 8.77) for neonates conceived by IVF, compared to women with subfertility who used no treatment during the month of conception. A reported diagnosis of female factor infertility increased the adjusted odds of having a PTB 2.99 (CI 1.5, 5.97). Duration of pregnancy attempt was not independently associated with PTB. In restricting analyses to singleton gestation, odds ratios were not significant for any type of treatment.ConclusionIVF, IUI, and ovulation drugs were all associated with a higher incidence of preterm birth and low birth weight, predominantly related to multiple gestation births.
Combined exposure to fine particulate matter and high glucose aggravates endothelial damage by increasing inflammation and mitophagy: the involvement of vitamin D
Authors: Lai Tsai-Chun , Chen Yu-Chen , Cheng Hui-Hua , Lee Tzu-Lin , Tsai Jaw-Shiun , Lee I.-Ta , Peng Kuo-Ti , Lee Chiang-Wen , Hsu Lee-Fen , Chen Yuh-Lien 
Published: March 2022

AbstractBackgroundCardiovascular diseases (CVDs) are related to particulate matter (PM2.5) exposure. Researchers have not clearly determined whether hyperglycemia, a hallmark of diabetes, exacerbates PM2.5-induced endothelial damage. Thus, this study aimed to investigate the combined effects of PM2.5and high glucose on endothelial damage.ResultsHere, we treated human umbilical vein endothelial cells (HUVECs) with 30 mM high glucose and 50 μg/mL PM (HG + PM) to simulate endothelial cells exposed to hyperglycemia and air pollution. First, we showed that HUVECs exposed to PM under high glucose conditions exhibited significant increases in cell damage and apoptosis compared with HUVECs exposed to PM or HG alone. In addition, PM significantly increased the production of reactive oxygen species (ROS) in HUVECs and mitochondria treated with HG and decreased the expression of superoxide dismutase 1 (SOD1), a free radical scavenging enzyme. The coexposure group exhibited significantly increased ROS production in cells and mitochondria, a lower mitochondrial membrane potential, and increased levels of the autophagy-related proteins p62, microtubule-associated protein 1 light chain 3β (LC3B), and mitophagy-related protein BCL2 interacting protein 3 (Bnip3). Moreover, autophagosome-like structures were observed in the HG + PM group using transmission electron microscopy. The expression of intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) were also increased through the JNK/p38 signaling pathway in the HG + PM group. As a ROS scavenger, vitamin D treatment effectively protected cells under HG and PM conditions by increasing cell viability, reducing mitochondrial ROS production, and suppressing the formation of mitophagy and inflammation. Furthermore, diabetes was induced in mice by administering streptozotocin (STZ). Mice were treated with PM by intratracheal injection. Vitamin D effectively alleviated oxidative stress, mitophagy, and inflammation in the aortas of mice treated with STZ and PM.ConclusionTaken together, simultaneous exposure to PM and high glucose exerts significant harmful effects on endothelial cells by inducing ROS production, mitophagy, and inflammation, while vitamin D reverses these effects.
Cultural significance of locusts, grasshoppers, and crickets in sub-Saharan Africa
Authors: van Huis Arnold 
Published: March 2022

AbstractBackgroundIn sub-Saharan Africa, there is a wealth of information about insects which is often only orally available. The purpose of the study was to remedy this shortcoming and make an overview of how orthopteran species are utilised, perceived and experienced in daily life across sub-Saharan Africa.MethodEthno-entomological information on Orthoptera in sub-Saharan Africa was collected by (1) interviews with more than 300 people from about 120 ethnic groups in 27 countries in the region; (2) library studies in Africa, London, Paris and Leiden; and (3) using web search engines.ResultsMore than 126 species of crickets, grasshoppers, and locusts have been identified as edible in sub-Saharan Africa. Some toxic species, such asZonocerusspp., are eaten by some groups who use processing and detoxifying techniques. The katydidRuspolia differensis very popular as food in central and eastern Africa and is captured by indigenous and commercial methods. Vernacular names refer to their morphology, behaviour, characteristics or the beliefs associated with the insect. The aposematic pyrgomorphid species, such asZonocerusspp., are often used as medicine. Children play with grasshoppers, by for instance herding them like cattle, and they consider cricket-hunting for food as a game. The doctrine of signatures probably plays a role, as crickets, because of their chirping, are used to improve the sound of a music instrument, or as medicine to treat earache. Locust plagues are considered a punishment which requires repentance, but also an opportunity to acquire food. Proverbs and stories relate to using the orthopterans as food or to the underground lives of the crickets. Possible explanations are given as to why so many practices, beliefs and stories about orthopterans are so widespread in sub-Saharan Africa. The relevance of recording such ethno-entomological practices is discussed.ConclusionGrasshoppers, locusts and crickets, although they may be agricultural pests, are very popular as food. They are also used in medicine, and as toys, and they play a role in religion, art and literature.
Tobacco use, smoking identities and pathways into and out of smoking among young adults: a meta-ethnography
Authors: Poole Ria , Carver Hannah , Anagnostou Despina , Edwards Adrian , Moore Graham , Smith Pamela , Wood Fiona , Brain Kate 
Published: March 2022

Abstract
Background
This meta-ethnography investigates how young adults describe their tobacco use, smoking identities and pathways into and out of regular smoking, to inform future smoking prevention and harm reduction interventions.

Methods
Eight databases were systematically searched using keywords and indexed terms. Studies were included if they presented qualitative data from young adults aged 16–25 reporting smoking histories and/or smoking identities from countries culturally similar to the UK. A systematic and rigorous meta-ethnographic approach was employed, consistent with Noblit and Hare’s methodology.

Results
Thirty papers were included. Reasons stated for taking up smoking and becoming a smoker included alleviating stress, transforming one’s identity, and coping with the transition to further education, employment or leaving home. Many used smoking to aid acceptance within new peer groups, particularly when alcohol was present. Smoking was also perceived as an act of resistance and a coping mechanism for those with marginalised identities. Barriers to quitting smoking included young adults’ minimisation or denial of the health risks of smoking and not identifying with “being a smoker”.

Conclusions
This meta-ethnography may provide a blueprint to inform the development of health and wellbeing interventions designed specifically for young adults. Smoking cessation interventions should be co-designed with young adults based on their perceived needs, resonant with their desire to quit in the future at key milestones. Harm reduction interventions should address the social aspect of addiction, without reinforcing stigma, particularly for those with marginalised identities.