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PloS One 2024The stable and site-specific operation of transmission lines is a crucial safeguard for grid functionality. This study introduces a comprehensive optimization design...
The stable and site-specific operation of transmission lines is a crucial safeguard for grid functionality. This study introduces a comprehensive optimization design method for transmission line crossing frame structures based on the Biogeography-Based Optimization (BBO) algorithm, which integrates size, shape, and topology optimization. By utilizing the BBO algorithm to optimize the truss structure's design variables, the method ensures the structure's economic and practical viability while enhancing its performance. The optimization process is validated through finite element analysis, confirming the optimized structure's compliance with strength, stiffness, and stability requirements. The results demonstrate that the integrated design of size, shape, and topology optimization, as opposed to individual optimizations of size or shape and topology, yields the lightest structure mass and a maximum stress of 151.4 MPa under construction conditions. These findings also satisfy the criteria for strength, stiffness, and stability, verifying the method's feasibility, effectiveness, and practicality. This approach surpasses traditional optimization methods, offering a more effective solution for complex structural optimization challenges, thereby enhancing the sustainable utilization of structures.
Topics: Algorithms; Finite Element Analysis
PubMed: 38758938
DOI: 10.1371/journal.pone.0300961 -
Medicine May 2024The aim of this study is to assess the impact of intensive risk awareness management along with cardiac rehabilitation nursing in elderly patients with acute myocardial... (Observational Study)
Observational Study
The aim of this study is to assess the impact of intensive risk awareness management along with cardiac rehabilitation nursing in elderly patients with acute myocardial infarction and heart failure. We selected 101 elderly patients with acute myocardial infarction and heart aging treated from January 2022 to March 2023. They were divided into control and observation groups based on hospitalization numbers. The control group (n = 50) received routine nursing, while the observation group (n = 51) received intensive risk awareness management and cardiac rehabilitation nursing. We compared medication possession ratio (MPR), cardiac function, self-care ability scale scores, quality-of-life, incidents, and satisfaction between the 2 groups. Before intervention, there was no significant difference in MPR values between the 2 groups (P > .05). After intervention, MPR values increased in both groups, with a greater increase in the observation group (P < .05). Cardiac function showed no significant difference before intervention (P > .05), but after intervention, the observation group had lower left ventricular end-systolic and diastolic diameters and higher left ventricular ejection fraction compared to the control group (P < .05). Self-care skills, health knowledge, self-responsibility, and self-concept scores improved in both groups after intervention, with higher scores in the observation group (P < .05). The observation group had higher scores in various quality-of-life domains (P < .05). The total incidence of adverse events was lower in the observation group (5.88%) compared to the control group (20.00%) (P < .05). Patient satisfaction was significantly higher in the observation group (96.08%) than in the control group (84.00%) (P < .05). Intensive risk awareness management combined with cardiac rehabilitation nursing in elderly patients with acute myocardial infarction and heart aging can enhance medication compliance, improve quality-of-life, enhance self-care abilities, boost cardiac function, reduce incidents, and increase patient satisfaction.
Topics: Humans; Male; Female; Aged; Heart Failure; Myocardial Infarction; Quality of Life; Cardiac Rehabilitation; Aged, 80 and over; Self Care; Patient Satisfaction; Medication Adherence; Health Knowledge, Attitudes, Practice
PubMed: 38758887
DOI: 10.1097/MD.0000000000037381 -
Medicine May 2024This study aims to investigate the impact of continuous 4C nursing on patients with diabetes retinopathy (DR) and its influence on self-care ability. A total of 100 DR... (Observational Study)
Observational Study
This study aims to investigate the impact of continuous 4C nursing on patients with diabetes retinopathy (DR) and its influence on self-care ability. A total of 100 DR patients admitted to our hospital from October 2020 to October 2022 were randomly divided into a control group and an observation group, with 50 cases in each group. The control group received routine care, while the observation group received continuous 4C care. The nursing effects of both groups were compared. After nursing, the observation group showed a lower self-rating anxiety scale score and a higher self-care ability scale score compared to the control group (P < .05). The SQQL-VI scores for all social activities were also higher in the observation group (P < .05). Additionally, the observation group had lower levels of fasting blood glucose, 2-hour postprandial blood glucose, and glycated hemoglobin than the control group (P < .05). Moreover, the observation group had higher visual acuity and lower intraocular pressure than the control group (P < .05). The visual impairment rate was lower and the overall compliance rate was higher in the observation group compared to the control group (P < .05). After nursing, both groups showed improvements in symptoms, visual function, physical function, psychological and social activity scores, visual acuity, and patient satisfaction scores. The observation group showed greater improvements compared to the control group (P < .05). The application of continuous 4C nursing in DR patients has shown positive effects, including improved patient compliance and satisfaction, enhanced patient quality of life and visual acuity. These findings suggest that continuous 4C nursing should be widely promoted and applied in clinical practice.
Topics: Humans; Quality of Life; Diabetic Retinopathy; Male; Female; Self Care; Middle Aged; Aged; Visual Acuity; Blood Glucose; Glycated Hemoglobin
PubMed: 38758866
DOI: 10.1097/MD.0000000000037920 -
JMIR Formative Research May 2024Digital patient-centered interventions may be important tools for improving and promoting social interaction, health, and well-being among older adults. In this regard,...
BACKGROUND
Digital patient-centered interventions may be important tools for improving and promoting social interaction, health, and well-being among older adults. In this regard, we developed a mobile app called DigiAdherence for an older adult population, which consisted of easy-to-access short videos and messages, to improve health-related knowledge among them and prevent common health conditions, such as falls, polypharmacy, treatment adherence, nutritional problems, and physical inactivity.
OBJECTIVE
This study aimed to assess the usability and utility of the DigiAdherence app among Portuguese older adults 65 years or older.
METHODS
In this pilot noncontrolled quasi-experimental study, older adults who were patients at the primary health care center in Portimão, Portugal, and owned a smartphone or tablet were recruited. Participants were assessed at baseline, given access to the DigiAdherence app for 1 month, and assessed again immediately after 30 days (first assessment) and 60 days after stopping the use of the app (second assessment). App usability and utility (primary outcomes) were analyzed in the first follow-up assessment using a structured questionnaire with 8 items. In the second follow-up assessment, our focus was on knowledge acquired through the app. Secondary outcomes such as treatment adherence and health-related quality of life were also assessed.
RESULTS
The study included 26 older adults. Most participants rated the different functionalities of the app positively and perceived the app as useful, attractive, and user-friendly (median score of 6 on a 7-point Likert scale). In addition, after follow-up, participants reported having a sense of security and greater knowledge in preventing falls (16/24, 67%) and managing therapies and polypharmacy (16/26, 62%).
CONCLUSIONS
The DigiAdherence mobile app was useful and highly accepted by older adults, who developed more confidence regarding health-related knowledge.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)
RR2-10.2196/29675.
PubMed: 38758585
DOI: 10.2196/46151 -
JAMA Health Forum May 2024Controlled substances have regulatory requirements under the US Federal Controlled Substance Act that must be met before pharmacies can stock and dispense them. However,...
IMPORTANCE
Controlled substances have regulatory requirements under the US Federal Controlled Substance Act that must be met before pharmacies can stock and dispense them. However, emerging evidence suggests there are pharmacy-level barriers in access to buprenorphine for treatment for opioid use disorder even among pharmacies that dispense other opioids.
OBJECTIVE
To estimate the proportion of Medicaid-participating community retail pharmacies that dispense buprenorphine, out of Medicaid-participating community retail pharmacies that dispense other opioids and assess if the proportion dispensing buprenorphine varies by Medicaid patient volume or rural-urban location.
DESIGN, SETTING, AND PARTICIPANTS
This serial cross-sectional study included Medicaid pharmacy claims (2016-2019) data from 6 states (Kentucky, Maine, North Carolina, Pennsylvania, Virginia, West Virginia) participating in the Medicaid Outcomes Distributed Research Network (MODRN). Community retail pharmacies serving Medicaid-enrolled patients were included, mail-order pharmacies were excluded. Analyses were conducted from September 2022 to August 2023.
MAIN OUTCOMES AND MEASURES
The proportion of pharmacies dispensing buprenorphine approved for opioid use disorder among pharmacies dispensing an opioid analgesic or buprenorphine prescription to at least 1 Medicaid enrollee in each state. Pharmacies were categorized by median Medicaid patient volume (by state and year) and rurality (urban vs rural location according to zip code).
RESULTS
In 2016, 72.0% (95% CI, 70.9%-73.0%) of the 7038 pharmacies that dispensed opioids also dispensed buprenorphine to Medicaid enrollees, increasing to 80.4% (95% CI, 79.5%-81.3%) of 7437 pharmacies in 2019. States varied in the percent of pharmacies dispensing buprenorphine in Medicaid (range, 73.8%-96.4%), with significant differences between several states found in 2019 (χ2 P < .05), when states were most similar in the percent of pharmacies dispensing buprenorphine. A lower percent of pharmacies with Medicaid patient volume below the median dispensed buprenorphine (69.1% vs 91.7% in 2019), compared with pharmacies with above-median patient volume (χ2 P < .001).
CONCLUSIONS AND RELEVANCE
In this serial cross-sectional study of Medicaid-participating pharmacies, buprenorphine was not accessible in up to 20% of community retail pharmacies, presenting pharmacy-level barriers to patients with Medicaid seeking buprenorphine treatment. That some pharmacies dispensed opioid analgesics but not buprenorphine suggests that factors other than compliance with the Controlled Substance Act influence pharmacy dispensing decisions.
Topics: Humans; Medicaid; Buprenorphine; United States; Cross-Sectional Studies; Health Services Accessibility; Opioid-Related Disorders; Pharmacies; Community Pharmacy Services; Opiate Substitution Treatment; Narcotic Antagonists
PubMed: 38758569
DOI: 10.1001/jamahealthforum.2024.1077 -
Journal, Physical Therapy Education Jun 2024The purpose of this study was to explore the perceptions of physical therapists (PTs) regarding the importance of financial resource management (FRM) knowledge, skills,...
INTRODUCTION
The purpose of this study was to explore the perceptions of physical therapists (PTs) regarding the importance of financial resource management (FRM) knowledge, skills, and attitudes (KSAs) for entry-level practice and investigate the roles of PT education programs (PTEPs), clinical education experiences (CEEs), and employers in addressing these KSAs.
REVIEW OF LITERATURE
FRM KSAs have been identified as components of professionalism and leadership and, as such, are a required element in student PTs (SPTs) educational preparation.
SUBJECTS
A purposive sampling of convenience strategy was employed by requesting a free mailing list for Ohio-licensed PTs.
METHODS
An online survey was developed based on PT Clinical Performance Instrument Criterion #17, "Patient Management: Financial Resources," as this tool is frequently used to endorse entry-level status of SPTs. Potential participants were solicited through email. Mixed methodology was used to analyze survey results.
RESULTS
The survey was completed by 266 PTs. FRM KSAs in legal and regulatory compliance were perceived as most important, followed by coding and billing. Forty-eight percent of participants indicated that FRM KSAs were "less important" (n = 111) or "considerably less important" (n = 17) than clinical care skills, whereas 39.8% (n = 106) believed that these skills are of the same level of importance. Ten themes were derived from qualitative responses regarding the FRM content that should be provided by PTEPs. Participants indicated that the role of PTEPs was to provide an introduction and foundation to FRM, whereas CEEs should facilitate intentional exposure and opportunities to apply FRM KSAs with supervision. Employers were expected to provide education regarding clinic-specific operations and reimbursement considerations, as well as mentorship that included reviewing complex billing for accuracy, offering guidance for improving time management skills, and discussing fiscal responsibilities to both the employer and patient.
DISCUSSION AND CONCLUSION
This information may guide PTEPs and clinical personnel in providing focused meaningful instruction regarding FRM aspects of PT practice to SPTs and entry-level clinicians.
Topics: Humans; Ohio; Physical Therapists; Surveys and Questionnaires; Male; Health Knowledge, Attitudes, Practice; Female; Clinical Competence; Adult; Financial Management; Middle Aged; Attitude of Health Personnel
PubMed: 38758180
DOI: 10.1097/JTE.0000000000000306 -
Alternative Therapies in Health and... May 2024To establish and determine the content of the genotoxic impurity piperidine in the active pharmaceutical ingredient (API) of rimonabant using a liquid...
OBJECTIVE
To establish and determine the content of the genotoxic impurity piperidine in the active pharmaceutical ingredient (API) of rimonabant using a liquid chromatography-mass spectrometry (LC-MS) method. This study underscores the importance of detecting piperidine due to its potential health risks, including carcinogenic and mutagenic effects, thus highlighting the critical need for rigorous quality control in pharmaceutical products.
METHODS
An Atlantis C18 column (5 μm, 3.9×100 mm) was chosen for separation due to its high efficiency and selectivity for piperidine, with a gradient elution of 0.05% formic acid-water (A) and methanol (B) as the mobile phase at a flow rate of 1.0 mL/min. The column temperature was optimized at 30°C to ensure peak resolution and sensitivity, the injection volume was set to 5.0 μL to minimize sample consumption while maintaining detectability, and the analysis time was kept at 7 min for efficient throughput.
RESULTS
Piperidine demonstrated excellent linearity in the concentration range of 0.03-0.40 μg/mL (R>0.99), with a detection limit of 0.01010 µg/mL. This detection limit is significantly lower than regulatory thresholds, indicating the method's high sensitivity compared to existing methods and its adequacy for regulatory compliance in pharmaceutical quality control.
CONCLUSION
This LC-MS method not only demonstrated high accuracy, good repeatability, and strong durability but also sets a benchmark for future research, regulatory practices, and pharmaceutical quality control. By accurately detecting low levels of genotoxic impurities like piperidine, this method supports the development of safer drug formulations and underscores the importance of stringent quality control measures in the pharmaceutical industry.
PubMed: 38758156
DOI: No ID Found -
Alternative Therapies in Health and... May 2024Hepatobiliary disease requires surgical treatment and T-tube installment postoperatively, and discharged patients' usually still have a T tube. Little nursing care is...
CONTEXT
Hepatobiliary disease requires surgical treatment and T-tube installment postoperatively, and discharged patients' usually still have a T tube. Little nursing care is available in China for patients after discharge, resulting in postdischarge complications. Also, the incidence of nutritional risk in patients with hepatobiliary surgery is high.
OBJECTIVE
The study aimed to investigate the benefits of a precede-proceed model-dominant nursing combined with nutritional support for patients discharged after hepatobiliary surgery with a T tube, so as to improve their prognoses and promote their rehabilitation.
DESIGN
The research team conducted a prospective, single-center, randomized controlled trial.
SETTING
The study took place at Wuhan No. 1 Hospital, Wuhan Hospital of Traditional Chinese and Western Medicine in Wuhan, Hubei, China.
PARTICIPANTS
Participants were 120 patients discharged after hepatobiliary surgery at the hospital between June 2020 and June 2022.
INTERVENTIONS
The research team randomly divided participants into two groups using the random number table method, each with 60 participants: (1) an intervention group, which received precede-proceed model-dominant nursing combined with nutrition support and (2) a control group, which received routine care.
OUTCOME MEASURES
At baseline and postintervention, the research team assessed: (1) nutritional status, (2) self-care agency, (3) compliance, (4) quality of life (QoL), (5) incidence of complications.
RESULTS
At baseline, no significant differences existed between the groups in nutritional status, self-care agency, QoL, or compliance (all P > .05). Postintervention compared to the control group, the intervention group's: (1) nutritional status, including albumin (P = .015), hemoglobin (P < .001), growth hormone (P < .001), BW (P = .047), BMI (P = .046), TST (P = .001), and MAMC (P = .016) were significantly higher and transferrin (P < .001) and NRS-2002 score (P < .001) were significantly lower; (2) self-care agency, including self-concept, self-responsibility, health knowledge, and self-nursing skills were significantly higher (all P < .001); (3) compliance scores, including observing the volume and color of bile correctly, clamping and opening the T tube properly, replacing the drainage bag correctly and in a timely manner, regularly disinfecting the skin around the drainage tube, keeping a balanced diet, adhering to medical regimens, exercising adequately were significantly higher (all P < .001); (4) QoL was significantly higher (P < .001); and (5) incidence of complications was significantly lower (P = .008).
CONCLUSIONS
Precede-proceed model-dominant nursing combined with nutrition support can significantly improve nutritional status, self-care agency, and QoL and can significantly decrease the incidence of complications for patients discharged after hepatobiliary surgery with a T tube and is worthy of promotion in clinics.
PubMed: 38758148
DOI: No ID Found -
Frontiers in Public Health 2024Gynecologists and pediatricians have an essential duty to prevent cervical cancer. In this study, we compared the compliance of gynecologists ( = 22) and...
INTRODUCTION
Gynecologists and pediatricians have an essential duty to prevent cervical cancer. In this study, we compared the compliance of gynecologists ( = 22) and pediatricians ( = 49) with nurse/midwife ( = 66) and non-medical moms ( = 120) with regards to cervical cancer precautions.
METHODS
A questionnaire was used to gather data on their demographics, personal vaccination and screening practices, children's immunization status, and awareness of cervical cancer prevention.
RESULTS
The findings demonstrated that gynecologists and pediatricians were better than others at understanding the risk factors and prevention of cervical cancer. It was noted that compared to other groups, physician mothers and their offspring had higher vaccination rates ( = 13, 18.3%; = 10, 29.4%, respectively). Medical professionals typically provided thorough and accurate answers to informational questions. More frequent Pap smear tests were performed by gynecologists. It was noted that mothers who worked as pediatricians and nurses/midwives neglected their own screening needs.
DISCUSSION
This questionnaire survey sought to ascertain Istanbul's health professionals' present opinions regarding HPV vaccination. Healthcare professionals should be the first to receive information on HPV vaccination and cervical cancer incidence reduction. The public could then readily use them as an example.
Topics: Humans; Female; Turkey; Surveys and Questionnaires; Adult; Uterine Cervical Neoplasms; Mothers; Papillomavirus Vaccines; Pediatricians; Health Knowledge, Attitudes, Practice; Nurses; Papillomavirus Infections; Middle Aged; Gynecology; Male; Gynecologists
PubMed: 38756889
DOI: 10.3389/fpubh.2024.1361509 -
Frontiers in Public Health 2024A significant rise in childhood obesity worldwide over the past three decades highlights the urgent need for early interventions, especially in preschools as key... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
A significant rise in childhood obesity worldwide over the past three decades highlights the urgent need for early interventions, especially in preschools as key settings for child development. This study aimed to assess the feasibility and fidelity of a randomised controlled trial of "I'm an Active Hero" (IAAH), a theory- and evidence-based multi-component behaviour change intervention targeting physical activity and sedentary behaviour amongst preschool-aged children.
METHODS
Two preschools in Taif city, Saudi Arabia were randomly assigned to either the intervention ( = 3 classrooms) or the usual curriculum control group ( = 3 classrooms). The intervention ran for 10 weeks from February to April 2023 and consisted of teacher-led physical activity and sedentary behaviour sessions in preschools, with an additional interactive home component. Primary outcome measures included intervention fidelity, recruitment rates, attrition rates, and compliance with trial procedures. Secondary outcomes included body mass index (BMI), objectively measured physical activity, and sedentary time via the ActiGraph GT3X accelerometer. Outcomes were measured at baseline and at 10 weeks in both study arms.
RESULTS
The preschool intervention component had high fidelity (93.3%), but the home component fidelity was lower (74%). A cluster-level recruitment rate of 12% (13/112 centres) was attained, whilst the individual-level recruitment rate stood at 36% (52/143 children, mean age of 4.16 years; 23 girls). Attrition was 10%. Compliance varied with 90% for BMI, 71% for accelerometery, and 45% for questionnaires. The intervention group showed small decreases in BMI, slight increases in physical activity, and decreases in sedentary time at follow-up compared to the control group. Parents, facilitators, and assistant teachers considered the intervention to be feasible and beneficial.
CONCLUSION
The IAAH intervention was feasible to implement in Saudi Arabian preschools. Facilitators showed high fidelity in delivering it. However, preliminary data did not demonstrate effectiveness. A more comprehensive evaluation across a broader population is warranted. The intervention could be revised to optimise recruitment, compliance, and fidelity of the home-based component. Successful elements from this pilot should be retained whilst adaptations to implementation are made to strengthen key areas.: ClinicalTrials.gov, NCT05754359.
Topics: Humans; Exercise; Female; Child, Preschool; Male; Saudi Arabia; Feasibility Studies; Sedentary Behavior; Health Promotion; Pediatric Obesity; Body Mass Index; Schools; Accelerometry
PubMed: 38756888
DOI: 10.3389/fpubh.2024.1379582