cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.6084/m9.figshare.21551824
title: Using simulation-based interprofessional education to change attitudes towards collaboration among higher specialty trainee physicians and registered nurses: a mixed methods pilot study

description: Interprofessional collaboration (IPC) is important for delivering safe patient care and can be enhanced through interprofessional education (IPE). In postgraduate medical education, the most effective model for delivering IPE remains unclear. A multi-site non-randomized mixed methods study was undertaken to investigate the effectiveness of a simulation-based IPE (SB-IPE) intervention on changing attitudes among higher specialty trainee (HST) physicians in general internal medicine and registered nurses (RNs). The intervention, underpinned by intergroup contact theory, is comprised of paired participants (HSTs:RNs) undertaking six simulated scenarios. The Jefferson Scale of Attitudes toward Interprofessional Collaboration (JeffSATIC) was administered pre-and-post intervention. Focus groups were conducted to explore participants’ perceptions of IPC and the SB-IPE intervention. Fifty-six participants attended the SB-IPE intervention and 37 completed focus group interviews. Overall, attitudes toward IPC changed positively (p &lt; .001), with greater change among HSTs (p = .001) compared to RNs (p = .12). Attitudes to “working relationships” significantly increased for HSTs (p &lt; .001) but not RNs (p = .047). Focus group analysis identified three processes by which SB-IPE led to attitudinal change: 1) Shared vulnerability, 2) Positive affirmation, and 3) Negotiating professional hierarchies, mainly through relationship building. Further research is needed to investigate the long-term impact of attitudinal change, including the extent to which benefits transfer into practice.
DOI: 10.6084/m9.figshare.21551824.v1
title: Using simulation-based interprofessional education to change attitudes towards collaboration among higher specialty trainee physicians and registered nurses: a mixed methods pilot study

description: Interprofessional collaboration (IPC) is important for delivering safe patient care and can be enhanced through interprofessional education (IPE). In postgraduate medical education, the most effective model for delivering IPE remains unclear. A multi-site non-randomized mixed methods study was undertaken to investigate the effectiveness of a simulation-based IPE (SB-IPE) intervention on changing attitudes among higher specialty trainee (HST) physicians in general internal medicine and registered nurses (RNs). The intervention, underpinned by intergroup contact theory, is comprised of paired participants (HSTs:RNs) undertaking six simulated scenarios. The Jefferson Scale of Attitudes toward Interprofessional Collaboration (JeffSATIC) was administered pre-and-post intervention. Focus groups were conducted to explore participants’ perceptions of IPC and the SB-IPE intervention. Fifty-six participants attended the SB-IPE intervention and 37 completed focus group interviews. Overall, attitudes toward IPC changed positively (p &lt; .001), with greater change among HSTs (p = .001) compared to RNs (p = .12). Attitudes to “working relationships” significantly increased for HSTs (p &lt; .001) but not RNs (p = .047). Focus group analysis identified three processes by which SB-IPE led to attitudinal change: 1) Shared vulnerability, 2) Positive affirmation, and 3) Negotiating professional hierarchies, mainly through relationship building. Further research is needed to investigate the long-term impact of attitudinal change, including the extent to which benefits transfer into practice.
DOI: 10.6084/m9.figshare.21202653
title: Interdisciplinary collaborative working on surgical ward rounds: reality or rhetoric? A systematic review

description: Daily surgical ward rounds shape the quality of postoperative care and contribute to positive patient outcomes. Despite their importance, strategies to facilitate and promote deliberate interdisciplinary collaboration within surgical ward rounds have not been comprehensively investigated. This paper systematically reviews the literature to identify what is known from existing publications about interdisciplinary working on surgical ward rounds. Pubmed, Embase, CINAHL, Scopus, and Web of Science were searched from database inception until May 2021 for studies involving interdisciplinary surgical ward rounds. Also, journal hand searches were undertaken. All potential abstracts and papers were screened independently by two reviewers to determine inclusion. All included papers were assessed for methodological quality using the accepted quality criteria outlined in the BEME No. 1 guide. A modified Kirkpatrick model was employed to analyze and synthesize the included studies. The search identified 1765 studies. Reviews of 861 abstracts resulted in the retrieval of 124 articles for full-text screening. Thirty-two papers met the inclusion/exclusion criteria. The levels of research evidence were low with 11 papers scoring either grade 4 (results are clear and very likely to be true) or grade 5 (results are unequivocal) in accordance with the BEME No. 1 guide. These 11 studies had three foci (1) full teams managing specific medical conditions through deliberate interdisciplinary collaboration on ward rounds (n = 5); (2) suggestions on the best format for interdisciplinary collaboration on ward rounds (n = 3); and, (3) the roles of specific disciplines in a collaborative surgical round (n = 3). Physicians, intensivists, and pediatricians embrace the benefits of interdisciplinary working to facilitate the improvement of communication, collaboration, and patient safety. Yet, persistent hierarchies within surgical wards act as a barrier often preventing allied health professionals from speaking up, thus perpetuating intra disciplinary siloed behaviors. This barrier contributes to a dearth of research evidence to facilitate interdisciplinary collaborative intentionality in surgical ward rounds and surgical education. Given the high-risk nature of surgery, interdisciplinary collaboration is a critical component for patient safety. Our findings serve as a call to action to address the rhetoric of interdisciplinary collaboration on surgical ward rounds. An evidence-base is required to design, educate for and implement interdisciplinary collaborative opportunities in surgical wards so this critical aspect of patient care becomes a reality.
DOI: 10.6084/m9.figshare.21202653.v1
title: Interdisciplinary collaborative working on surgical ward rounds: reality or rhetoric? A systematic review

description: Daily surgical ward rounds shape the quality of postoperative care and contribute to positive patient outcomes. Despite their importance, strategies to facilitate and promote deliberate interdisciplinary collaboration within surgical ward rounds have not been comprehensively investigated. This paper systematically reviews the literature to identify what is known from existing publications about interdisciplinary working on surgical ward rounds. Pubmed, Embase, CINAHL, Scopus, and Web of Science were searched from database inception until May 2021 for studies involving interdisciplinary surgical ward rounds. Also, journal hand searches were undertaken. All potential abstracts and papers were screened independently by two reviewers to determine inclusion. All included papers were assessed for methodological quality using the accepted quality criteria outlined in the BEME No. 1 guide. A modified Kirkpatrick model was employed to analyze and synthesize the included studies. The search identified 1765 studies. Reviews of 861 abstracts resulted in the retrieval of 124 articles for full-text screening. Thirty-two papers met the inclusion/exclusion criteria. The levels of research evidence were low with 11 papers scoring either grade 4 (results are clear and very likely to be true) or grade 5 (results are unequivocal) in accordance with the BEME No. 1 guide. These 11 studies had three foci (1) full teams managing specific medical conditions through deliberate interdisciplinary collaboration on ward rounds (n = 5); (2) suggestions on the best format for interdisciplinary collaboration on ward rounds (n = 3); and, (3) the roles of specific disciplines in a collaborative surgical round (n = 3). Physicians, intensivists, and pediatricians embrace the benefits of interdisciplinary working to facilitate the improvement of communication, collaboration, and patient safety. Yet, persistent hierarchies within surgical wards act as a barrier often preventing allied health professionals from speaking up, thus perpetuating intra disciplinary siloed behaviors. This barrier contributes to a dearth of research evidence to facilitate interdisciplinary collaborative intentionality in surgical ward rounds and surgical education. Given the high-risk nature of surgery, interdisciplinary collaboration is a critical component for patient safety. Our findings serve as a call to action to address the rhetoric of interdisciplinary collaboration on surgical ward rounds. An evidence-base is required to design, educate for and implement interdisciplinary collaborative opportunities in surgical wards so this critical aspect of patient care becomes a reality.
DOI: 10.6084/m9.figshare.21370612
title: Analysis of shared cognitive tasks in the application of non-invasive ventilation to patients with COPD exacerbation

description: Interprofessional teamwork plays a key role in the uptake of evidence-based interventions, such as noninvasive ventilation (NIV) for patients with exacerbated Chronic Obstructive Pulmonary Disease (COPD). We aimed to identify the shared cognitive tasks in interprofessional teams using NIV for patients with COPD exacerbation. We used a cognitive task analysis approach (CTA) to engage nurses, rapid response team members, respiratory therapists, and physicians involved in the use of NIV to treat patients with COPD exacerbation. Clinicians participated in a semi-structured interview (<i>n</i> = 21) that elicited cognitions needed to treat COPD exacerbation. Three shared cognitive tasks were identified: Complete a thorough assessment, Formulate a care plan, and Continuously monitor patient status. Findings attest to the importance of having access to up-to-date information and expertise necessary to make accurate clinical inferences for patient assessment. Shared understanding of the formulated care plan among all members of the care team was important to its execution. Continuous monitoring was crucial; however, this cognitive task relied on patient assessment skills and ongoing collaboration within the clinical care team. Application of NIV for patients with COPD exacerbation may require enhancing collaboration through nontechnical skills and interprofessional training.
DOI: 10.6084/m9.figshare.21370612.v1
title: Analysis of shared cognitive tasks in the application of non-invasive ventilation to patients with COPD exacerbation

description: Interprofessional teamwork plays a key role in the uptake of evidence-based interventions, such as noninvasive ventilation (NIV) for patients with exacerbated Chronic Obstructive Pulmonary Disease (COPD). We aimed to identify the shared cognitive tasks in interprofessional teams using NIV for patients with COPD exacerbation. We used a cognitive task analysis approach (CTA) to engage nurses, rapid response team members, respiratory therapists, and physicians involved in the use of NIV to treat patients with COPD exacerbation. Clinicians participated in a semi-structured interview (<i>n</i> = 21) that elicited cognitions needed to treat COPD exacerbation. Three shared cognitive tasks were identified: Complete a thorough assessment, Formulate a care plan, and Continuously monitor patient status. Findings attest to the importance of having access to up-to-date information and expertise necessary to make accurate clinical inferences for patient assessment. Shared understanding of the formulated care plan among all members of the care team was important to its execution. Continuous monitoring was crucial; however, this cognitive task relied on patient assessment skills and ongoing collaboration within the clinical care team. Application of NIV for patients with COPD exacerbation may require enhancing collaboration through nontechnical skills and interprofessional training.
DOI: 10.6084/m9.figshare.23243687
title: Supplementary Material for: Risk Factors for Common Kidney Stones Are Correlated with Kidney Function Independent of Stone Composition

description: Background: Kidney stone type varies with age, sex, season, and medical conditions. Lower estimate glomerular filtration rate (eGFR) leads to changes in urine chemistry, and risk factors for kidney stones are thought to vary by stone type. We explore the association between eGFR, urine risk factors, and common stone compositions. Methods: This was a retrospective cohort study of 811 kidney stone patients seen at Yale Medicine between 1994-2021 with serum chemistries and 24-hour urine chemistries matched within one year of baseline stone analysis. Patients’ eGFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) 2021 equation. Demographics and medical history were compared by Chi-squared tests. 24-hour urine chemistries and stone analyses were analyzed by one-way ANOVA. Linear regressions were performed to control for demographics, comorbidities, and stone composition. Results: With lower eGFR, the proportion of calcium stones declined while uric acid stones increased. On univariable analysis, lower eGFR was associated with lower urine pH, calcium, citrate, uric acid, magnesium, phosphorus, and ammonium. On multivariable analysis, controlling for age, sex, ethnicity, BMI, comorbidities, and stone type, these factors remained significant. Stone formers with lower eGFR had elevated supersaturation for uric acid, but reduced supersaturations for calcium-containing stones. Though urine oxalate was significant on univariable analysis, it was not on multivariable analysis. Discussion/Conclusion: Changes in urine parameters are strongly correlated with eGFR regardless of stone type. Renal function may play a key role in modulating kidney stone risk factors. Strategies to mitigate stone risk may need to vary with kidney function, especially when patient urine or stone composition data is unavailable.
DOI: 10.6084/m9.figshare.23243687.v1
title: Supplementary Material for: Risk Factors for Common Kidney Stones Are Correlated with Kidney Function Independent of Stone Composition

description: Background: Kidney stone type varies with age, sex, season, and medical conditions. Lower estimate glomerular filtration rate (eGFR) leads to changes in urine chemistry, and risk factors for kidney stones are thought to vary by stone type. We explore the association between eGFR, urine risk factors, and common stone compositions. Methods: This was a retrospective cohort study of 811 kidney stone patients seen at Yale Medicine between 1994-2021 with serum chemistries and 24-hour urine chemistries matched within one year of baseline stone analysis. Patients’ eGFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) 2021 equation. Demographics and medical history were compared by Chi-squared tests. 24-hour urine chemistries and stone analyses were analyzed by one-way ANOVA. Linear regressions were performed to control for demographics, comorbidities, and stone composition. Results: With lower eGFR, the proportion of calcium stones declined while uric acid stones increased. On univariable analysis, lower eGFR was associated with lower urine pH, calcium, citrate, uric acid, magnesium, phosphorus, and ammonium. On multivariable analysis, controlling for age, sex, ethnicity, BMI, comorbidities, and stone type, these factors remained significant. Stone formers with lower eGFR had elevated supersaturation for uric acid, but reduced supersaturations for calcium-containing stones. Though urine oxalate was significant on univariable analysis, it was not on multivariable analysis. Discussion/Conclusion: Changes in urine parameters are strongly correlated with eGFR regardless of stone type. Renal function may play a key role in modulating kidney stone risk factors. Strategies to mitigate stone risk may need to vary with kidney function, especially when patient urine or stone composition data is unavailable.
DOI: 10.6084/m9.figshare.23243690
title: Supplementary Material for: Association of self-reported nighttime sleep duration with chronic kidney disease: China Health and Retirement Longitudinal Study

description: Introduction: The cohort study aimed to assess the association of nighttime sleep duration and the change in nighttime sleep duration with chronic kidney disease (CKD), and whether the association between nighttime sleep duration and CKD differed by daytime napping. Methods: This study included 11677 individuals of the China Health and Retirement Longitudinal Study (CHARLS) and used data from the 2011 baseline survey and four follow-up waves. Nighttime sleep duration was divided into three groups: short (&lt;7h per night), optimal (7-9h), and long nighttime sleep duration (&gt;9h). Daytime napping was divided into two groups: no nap, with a nap. We used Cox proportional hazards model to examine the effect of nighttime sleep duration at baseline and change in nighttime sleep duration on incident CKD, and a joint effect of nighttime sleep duration and nap time on onset CKD. Results: With a follow-up of 7 years, the incidence of CKD among those with short, optimal and long nighttime sleep duration was 9.89, 6.75, and 9.05 per 1000 person-years, respectively. Compared to individuals with optimal nighttime sleep duration, short nighttime sleepers had a 44% higher risk of onset CKD (hazard ratio [HR]: 1.44, 95% Confidence intervals [CIs]:1.21-1.72). Compared to participants with persistent optimal nighttime sleep duration, those with persistent short or long nighttime sleep duration had an increased risk of incident CKD (HR:1.44, 95%CI:1.15-1.80). We found a lower incidence of CKD in participants with short nighttime sleep duration and a nap (HR:0.74, 95%CI:0.60-0.93), compared to those with short nighttime sleep duration and no nap. Discussion/Conclusion: Short nighttime sleep duration and persistent long or short nighttime sleep duration were associated with a higher risk of onset CKD. Keeping persistent optimal nighttime sleep duration may help reduce CKD risk later in life. Daytime napping may be protective against onset CKD.
DOI: 10.6084/m9.figshare.23243690.v1
title: Supplementary Material for: Association of self-reported nighttime sleep duration with chronic kidney disease: China Health and Retirement Longitudinal Study

description: Introduction: The cohort study aimed to assess the association of nighttime sleep duration and the change in nighttime sleep duration with chronic kidney disease (CKD), and whether the association between nighttime sleep duration and CKD differed by daytime napping. Methods: This study included 11677 individuals of the China Health and Retirement Longitudinal Study (CHARLS) and used data from the 2011 baseline survey and four follow-up waves. Nighttime sleep duration was divided into three groups: short (&lt;7h per night), optimal (7-9h), and long nighttime sleep duration (&gt;9h). Daytime napping was divided into two groups: no nap, with a nap. We used Cox proportional hazards model to examine the effect of nighttime sleep duration at baseline and change in nighttime sleep duration on incident CKD, and a joint effect of nighttime sleep duration and nap time on onset CKD. Results: With a follow-up of 7 years, the incidence of CKD among those with short, optimal and long nighttime sleep duration was 9.89, 6.75, and 9.05 per 1000 person-years, respectively. Compared to individuals with optimal nighttime sleep duration, short nighttime sleepers had a 44% higher risk of onset CKD (hazard ratio [HR]: 1.44, 95% Confidence intervals [CIs]:1.21-1.72). Compared to participants with persistent optimal nighttime sleep duration, those with persistent short or long nighttime sleep duration had an increased risk of incident CKD (HR:1.44, 95%CI:1.15-1.80). We found a lower incidence of CKD in participants with short nighttime sleep duration and a nap (HR:0.74, 95%CI:0.60-0.93), compared to those with short nighttime sleep duration and no nap. Discussion/Conclusion: Short nighttime sleep duration and persistent long or short nighttime sleep duration were associated with a higher risk of onset CKD. Keeping persistent optimal nighttime sleep duration may help reduce CKD risk later in life. Daytime napping may be protective against onset CKD.
DOI: 10.6084/m9.figshare.23243698
title: Shareholder coalitions and dividends: evidence from the Brazilian capital market

description: ABSTRACT This article examines the effect of the heterogeneity of shareholder coalitions on the distribution of dividends in companies listed in Brazil. To analyze the relationship between large shareholders and dividends, it is essential to consider the way the control is ensured. Large shareholders can share control by forming coalitions, and differences in the composition of coalitions can alter the incentives the cooperating parties have for the activity of monitoring. Based on shareholder agreements, we explore the heterogeneity among shareholder coalitions by presenting elements that can characterize the role of shared control in the corporate governance of companies in a market environment described by the concentration of control in a single large shareholder. This study presents potential economic and social impacts, as it is of particular interest to outsider shareholders, and even potential investors, to know how insiders can use dividend policy, since the distribution of profits tends to mitigate agency problems. To identify the shareholder coalitions we resorted to shareholder agreements. The analysis model was estimated using the two-stage system generalized method of moments (GMM-Sys) with unbalanced panel data for the period from 2008 to 2019. We discovered that the number of shareholders in the coalition and the leveraging of the voting rights of the biggest shareholder in the coalition are negatively related to the dividends distributed, and that the voting rights of the coalition are positively related to the dividends distributed. These results contribute to the principal-principal approach of agency theory and highlight that the incentives and capacity of shareholder coalitions to pursue private benefits of control depend on their own characteristics.