Clinical Areas Research Articles

Perceptions of Makerere University Undergraduate Radiography Students on Clinical Rotations in Mulago National Referral Hospital

Introduction: Clinical rotations are an integral component of the radiography programs worldwide as it is a practice-based profession and the effectiveness of clinical training is responsible for the competency level demonstrated by radiography students after qualification. Clinical rotations provide opportunities for radiography students to apply theory into practice. The effectiveness of the rotations is greatly affected by the setting of the clinical area. Makerere university undergraduate radiography students experience various circumstances that facilitate or inhibit their clinical learning process in Mulago National Referral Hospital (MNRH). Aim: The study aimed at exploring the perceptions of Makerere University undergraduate radiography students on clinical rotations in Mulago National Referral Hospital. Methodology: A cross-sectional exploratory, qualitative study was done. 19 third- and fourth-year Makerere University undergraduate students offering Bachelor of medical radiography were sampled purposively. Data was collected using semi-structured face to face interviews and analysed thematically. Results: Three major themes emerged from the data: (1) learning experience, (2) effectiveness of clinical rotations in MNRH and (3) challenges faced. Most factors related to the themes above positively impacted the students’ perceptions on clinical rotations in MNRH radiology department with more positives and the rotations meeting expectations of the majority, though with some challenges like limited clinical supervision by university lecturers and inadequate time for practicing some modalities. Conclusion: Clinical rotations can be effective and beneficial when a supportive learning environment is provided. This study reveals mixed student perceptions regarding clinical rotations in radiology department of MNRH, with predominant positive perceptions. Addressing identified challenges can significantly improve the clinical learning environment and thus the effectiveness of clinical rotations.Top of FormBottom of Form

Evaluation of a psychological readiness program and final clinical practicum among final year nursing students: A mixed methods study

BackgroundFinal year nursing students may experience higher levels of stress owing to the increasing complexity and expectations from their clinical practicums. Enhancing psychological readiness may be a potential strategy to enhance nursing students' transition to the clinical area. ObjectiveTo evaluate the effects of a psychological readiness enhancement for transition to professional practice program and a 10-week clinical practicum on students' psychological wellbeing, resilience, practice readiness and confidence. DesignA sequential mixed-methods approach comprising of a single-group evaluation and descriptive qualitative study. SettingFinal year nursing students enrolled in an undergraduate nursing program from one autonomous university in Singapore was recruited. Participants148 final year nursing students participated in the single-group evaluation study. A total of 24 participants who completed the psychological readiness program were recruited in the qualitative study. MethodsThis study included two phases. Phase I comprised of an evaluation of a blended psychological readiness program and clinical practicum. Data was collected across three waves to assess nursing students' psychological wellbeing, resilience, practice readiness and confidence. In Phase II, a qualitative study using individual semi-structured online interviews was conducted to examine students' experiences of the psychological readiness program and clinical practicum. ResultsThe psychological readiness program led to significant changes in students' anxiety and patient centeredness scores. The accumulated effects of the psychological readiness and clinical practicum showed significant improvements in students' practice readiness and confidence. Although there were no significant improvements in depression, stress and resilience scores, there were improvements in the trend across three waves. Students attributed these improvements to the psychological readiness program and sharing by the alumni. ConclusionsThe findings of this study laid the foundation for the development of psychological readiness programs. However, larger scale studies using randomized controlled trial designs should be used to confirm the effects of these interventions.

A Novel Facet of In-Hospital Food Consumption Associated with Hospital Mortality in Patients with Scheduled Admission-Addition of a Study Protocol to Test the Existence of Effects of COVID-19 in the Same Study in the Post-COVID-19 Period.

Humankind has faced unexperienced pandemic events since 2020. Since the COVID-19 pandemic has calmed down, we felt the need to verify whether in-hospital mortality had worsened compared to pre-pandemic conditions due to the COVID-19 pandemic. To test the hypothesis that daily food consumption is associated with in-hospital mortality during hospitalization and to provide baseline data to examine whether the effects of COVID-19 exist or not in post-pandemic period. All hospitalized patients staying in a single institution on the third Thursday of May, August, November, and the following February were included. Compared data: (1) among four seasons, (2) between age < 75 vs. ≥75 years, (3) between <75% vs. ≥75% of in-hospital food, and (4) logistic regression analysis to identify factors associated with in-hospital mortality. In 365 inpatients, the following results were obtained: (1) no seasonality or age effect in in-hospital mortality, (2) the novel cutoff value of 75% of the hospital food requirement was used to identify poor in-hospital survivors, (3) logistic regression analysis showed low food consumption, with <75% of the hospital food requirement as the predictor of high in-hospital mortality. A small eater of in-hospital food < 75% during hospitalization was associated with significantly higher in-hospital mortality in patients with scheduled hospitalization in the pre-pandemic period. Then, a study protocol is proposed to test the existence of the effects of COVID-19 in the same study in the post-COVID-19 period. This study protocol is, to our knowledge, the first proposal to test the effects of food consumption in the post-COVID-19 period on in-hospital mortality in the clinical nutritional areas.

Intravenous fluid therapy: an audit and discussion of improvements required for prescribers and administrators.

Foundation doctors and nurses are the clinicians most closely involved in fluid assessment, intravenous (IV) fluid prescription and administration. However, both groups report challenges regarding IV fluids. At a large NHS trust in England, adherence to the National Institute for Health and Care Excellence (NICE) guideline CG174, regarding IV fluids, was largely unknown. To assess the baseline adherence, within the hospitals, to CG174 and identify areas for improvement. A set of 12 audit standards were developed and used to collect data across 29 clinical areas between September 2022 and May 2023, with 255 patients receiving IV fluids at any time during their inpatient stay included. For two standards target adherence of 95% was achieved, with an adherence less than 50% in most. Areas of particularly poor adherence included assessing and meeting fluid and electrolyte requirements, patient reassessment and developing IV fluid management plans. Trust baseline adherence to NICE CG174 requires improvement, particularly regarding patient assessment and reassessment, and meeting electrolyte requirements.

Evidências sobre fitoterapia para o tratamento da COVID-longa no âmbito da atenção primária à saúde do SUS

About 10% to 20% of patients considered cured of COVID-19 may have changes in the body that lead them to develop COVID-19. Therapeutic alternatives for treatment have been applied in post-COVID-19 clinical management, phytotherapy stands out as an important clinical path. The objective of this study was to carry out a descriptive analysis on the use and application of herbal medicines in the portion of the population affected by COVID-long. This is a narrative review, with data collection in an exploratory way by expertise in the clinical and phytotherapy area. The qualitative approach was carried out from the perspective of identifying and applying the use of herbal medicines within the scope of Primary Health Care (PHC) for the treatment of symptoms in COVID-long. The findings signal an important investigative niche for short- to medium-term treatments in long-term COVID-19. Uncaria tomentosa for cough treatment, Ginkgo biloba for cardiovascular involvement; Mangifera indica Linneaus for neuromuscular and Valeriana officinalis for the Central Nervous System. Some studies may suggest the standardization of herbal medicines in the Unified Health System for their use in PHC as an adjuvant to treatment associated with allopathic medicines.

New horizons in clinical practice guidelines for use with older people.

Globally, more people are living into advanced old age, with age-associated frailty, disability and multimorbidity. Achieving equity for all ages necessitates adapting healthcare systems. Clinical practice guidelines (CPGs) have an important place in adapting evidence-based medicine and clinical care to reflect these changing needs. CPGs can facilitate better and more systematic care for older people. But they can also present a challenge to patient-centred care and shared decision-making when clinical and/or socioeconomic heterogeneity or personal priorities are not reflected in recommendations or in their application. Indeed, evidence is often lacking to enable this variability to be reflected in guidance. Evidence is more likely to be lacking about some sections of the population. Many older adults are at the intersection of many factors associated with exclusion from traditional clinical evidence sources with higher incidence of multimorbidity and disability compounded by poorer healthcare access and ultimately worse outcomes. We describe these challenges and illustrate how they can adversely affect CPG scope, the evidence available and its summation, the content of CPG recommendations and their patient-centred implementation. In all of this, we take older adults as our focus, but much of what we say will be applicable to other marginalised groups. Then, using the established process of formulating a CPG as a framework, we consider how these challenges can be mitigated, with particular attention to applicability and implementation. We consider why CPG recommendations on the same clinical areas may be inconsistent and describe approaches to ensuring that CPGs remain up to date.

A Simplified Version of the Chinese Tinnitus Disorder Scale and its Psychometric Characteristics.

This study aims to design a Concise and Practical Chinese Tinnitus Disorder Scale (CPCTDS), evaluate its psychometric measurement characteristics, and help doctors in making diagnoses and treatments. A sample of 482 tinnitus patients completed CPCTDS. The patients also completed the Center for Epidemiologic Studies-Depression Scale (CES-D), the Beck Anxiety Inventory (BAI), and the Tinnitus Functional Index (TFI). The eight items of CPCTDS were extracted through its exploratory factor analysis, which had strong internal consistency (Cronbach's α = 0.855). The correlations between the total scores of CPCTDS and Tinnitus Disability Inventory (TDI; r = 0.960, P < 0.05) and TFI (r = 0.749, P < 0.05) indicated a good criterion validity. The correlation of the CPCTDS emotional subscale with the TFI emotional subscale (r = 0.650, P < 0.05), CES-D (r = 0.488, P < 0.05), and BAI (r =.384, p< 0.05) showed that the convergent validity of CPCTDS was satisfactory. CPCTDS and the original Chinese version of TDI were highly reliable and valid. This finding shows that the two scales can be reliably used to assess the severity of tinnitus in clinical areas.

Academic Electronic Health Record in Mental Health Clinical: A Quality Review.

Developing competency in the use of EHRs is essential for entry-level professional nurses. Although nursing education has been encouraged to integrate this technology into nursing curriculum, many students still graduate feeling unprepared in this area. As a result, nursing graduates lack the skills necessary to effectively use EHRs, which may have negative consequences for safe patient care. Use of academic EMRs provides students the opportunity to integrate informatics education, develop critical thinking, and incorporate problem-solving skills in the clinical area. An academic EMR was introduced to students in the second semester of a baccalaureate degree nursing program. Students completed documentation on one patient from the mental health clinical rotation. A retrospective chart review was conducted, using a rubric to determine charting efficacy. Data analysis indicated that students struggled with documentation of the mental health assessment, care plan development, and nursing notes. Student documentation was strongest in vital signs and basic information. Students need practice documenting on the critical aspects of nursing care. Utilization of an academic EMR for clinical charting provides an opportunity for students to practice documentation and develop necessary skills for clinical practice.

Evaluation of Vulnerabilities for the Spread of Carbapenem Resistant Organisms at Five Hospitals in India

Background: The 2022 WHO global survey on infection prevention and control (IPC) exposes significant gaps in IPC in the WHO Southeast Asia region. A better understanding of IPC vulnerabilities will inform improvement initiatives. We describe an evaluation of IPC practices known to prevent and contain carbapenem-resistant organisms (CROs) at hospitals participating in the United States Centers for Disease Control Global Action in Healthcare Network –Antimicrobial Resistance in India. Prior hospital evaluations suggest resistance to carbapenems among gram-negative isolates is up to 45%. Methods: We conducted a mixed methods evaluation including cross-sectional surveys, semi-structured interviews, and site observations at five hospitals (one government, two private tertiary care, and two private teaching) located in three cities. The number of hospital beds ranged from 362 to 2,011. Hospital and IPC program characteristics, and CRO prevention and containment activities were examined virtually. Site observations focused on hand hygiene, environmental cleaning, personal protective equipment (PPE), CRO containment practices and use of water for patient care. Results: All sites had IPC programs with established policies and qualified IPC staff. The IPC nurse-to-bed ratio ranged from 1:73 to 1:432 (mean, 1:209). Due to the integral role of microbiology staff in IPC at these hospitals, the two departments had strong communication channels associated with CRO identification. Screening for CRO colonization, if done, targeted patients from outside hospitals. Three of the five hospitals routinely implemented contact precautions for patients with identified CROs, displayed isolation signage at the bedside, and provided adequate PPE at point-of-use; however, all sites reported barriers to effective isolation and/or cohorting patients with CROs. Timely communication of CROs to clinical staff varied and no sites effectively relayed CRO status upon patient discharge to another facility. IPC teams identified gaps in environmental cleaning procedures and practices related to medical devices and equipment. All sites used alternatives to tap water for clinical care and sink etiquette was evident. Each IPC team performed audits of patient isolation and hand hygiene practices. Despite the considerable proportion of IPC resources dedicated to daily education and feedback in clinical areas, the IPC teams reported that improvement was often difficult to achieve. Conclusion: Given the high burden of CROs and limited IPC resources, detailed knowledge of IPC opportunities for improvement will help hospitals target novel interventions for CRO prevention and containment. Further investigation of colonization rates and effective performance improvement methods in these settings is needed.Disclosure: Patricia Simner: Research Contracts: BD Diagnostics, OpGen Inc., Qiagen Sciences Inc, T2 Diagnostics, Accelerate Diagnostics; Research Collaborators:Ares Genetics, CosmosID, IDbyDNA, Illumina; Consulting: OpGen Inc., BD Diagnostics, Shionogi Inc., GeneCapture, Qiagen Sciences Inc, Entasis, Day Zero Diagnostics, Next Gen Diagnostics

Personal protective equipment and health-care workers

Background and Objective: The study was carried out to assess the knowledge, attitude, and practice viz-a-viz to the use of Personnel protective equipment among the health-care staff of a government tertiary care teaching hospital. Methodology: The study was performed in a government tertiary care teaching hospital. The study design was cross-sectional and descriptive. The study was carried out in the Clinical areas of the hospital and included 407 health-care professionals (academic resident doctors, nursing officers, paramedical staff and housekeeping staff) who have consented to participate in the study. A structured and validated questionnaire was prepared based on the standard guidelines described in the Infection Prevention and Control Manual, MOHFW, GOI published in 2018. The parts of the study tool were divided into five parts. The results were statistically analyzed (MS Office spreadsheet version 2007 and IBM-SPSS Version 20). Results: The study included 407 participants; 91 (22.4%) academic resident doctors, 122 (30%) nursing officers, 23 (5.7%) paramedical staff, and 171 (42%) housekeeping staff, respectively. The overall knowledge, attitude, and practice aspect of the personal protective equipment (PPE) were comparatively low. The overall mean score of knowledge, attitude, and practice regarding PPE was 0.73, 0.72, and 0.22 out of 1. Conclusion and Recommendations: The knowledge aspect of PPE of health-care professionals was good for nursing officers whereas with respect to the attitude and practice aspect, it was found that in the majority of areas, the housekeeping staff were performing better than the other cadres. The author recommends regular inspection by the clinicians and administrators to ensure compliance; and to provide training for the health-care professionals with regard to the types of PPE to be used and when all to be used as per the job undertaken as a reminder/continuous medical education.

Use of a peracetic acid (PAA) disinfectant to reduce total viable bacteria count in hospital wastewater drains

The periphery of the hospital water system interfaces at multiple points with patients and staff in clinical areas. This comprises mostly sinks and showers and presents a significant infection control risk. Wastewater drains in particular act as a reservoir of pathogens that can be transmitted to patients. Numerous strategies have been investigated as potential methods to reduce biofilm and bacterial load including regular application of biocidal chemicals. Traditional methods of assessing the efficacy of such products relies on culture-based microbiological techniques, usually targeting a limited range of key pathogens. We assessed the efficacy of a peracetic acid containing drain disinfectant product on seven clinical handwash basin drains, taking daily samples over six weeks (before, during and after use of the drain disinfectant product). We used a rapid, culture-independent estimation of total bacterial viable count (TVC) to assess efficacy. We applied long-read metagenomic sequencing to study the entire drain microbiome, which allowed taxonomic changes to be documented following use of the drain disinfectant product. All samples were found to be heavily contaminated, however the drain disinfectant product reduced the TVC from an estimated mean of 4228cfu/mL to 2874cfu/mL. This reduction was sustained in the two weeks following cessation of the product. Long-read metagenomic sequencing showed a microbiome dominated with Gram-negative organisms, with some taxonomic shifts in samples before and after application of the drain disinfectant. The impact on hospital-acquired infections from reducing bioburden in hospital drains by approximately a third, along with any associated changes in bacterial composition, needs evaluation in future studies.

Exploring the role of dysfunctional attitudes and unhelpful thoughts in the relationship between personality traits and psychological distress in Australian University students

The impact of dysfunctional attitudes and unhelpful thinking upon clients presenting with personality-related psychological distress is an important clinical area of investigation as it informs psychological interventions. Despite this, there is limited research in this area. Thus, this study had two main aims: (1) examine the interrelationships between maladaptive personality traits, dysfunctional attitudes, unhelpful thinking, and psychological distress; and (2) explore the potential mediating roles of dysfunctional attitudes and unhelpful thinking on the relationship between maladaptive personality traits and psychological distress. A convenience sample of 728 undergraduate psychology students (mean age: 31.57 years; 76% female) completed an online questionnaire for course credit. The results supported the first hypothesis that after controlling for gender and age, there would be significant positive correlations among maladaptive personality traits, dysfunctional attitudes, and psychological distress. A structural equation model with an excellent fit (CMIN/df = 2.23, p = .063, TLI = 0.98, CFI = 0.99, SRMR, = 0.01, and RMSEA = 0.04) provided partial support for the second hypothesis in that dysfunctional attitudes and unhelpful thoughts mediated the relationship between maladaptive personality traits and psychological distress. Specifically, negative affectivity and detachment’s relationship with psychological distress were partially mediated via dysfunction attitudes and unhelpful thoughts, and dysfunctional attitudes respectively. These findings suggest that while dysfunctional attitudes and unhelpful thinking contribute to the relationship between personality traits and psychological distress, identification of other factors are required to improve theoretical understanding and subsequently psychological interventions.

Effect of pharmacist care on clinical outcomes and therapy optimization in perioperative settings: A systematic review.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Integration of pharmacists into the perioperative practice has the potential to improve patients' clinical outcomes. The aim of this systematic review is to systematically investigate the evidence on the roles of pharmacists in perioperative settings and the effects of pharmacist interventions on clinical outcomes and therapy optimization. A protocol-led (CRD42023460812) systematic review was conducted using search of PubMed, Embase, CINAHL and Google Scholar databases. Studies that investigated the roles and impact of pharmacist-led interventions in the perioperative settings on clinical outcomes were included. Data were extracted and quality assessed independently by two reviewers using the DEPICT-2 (Descriptive Elements of Pharmacist Intervention Characterization Tool) and the Crowe Critical Appraisal Tool (CCAT), respectively. Studies were grouped according to the clinical area into 5 sections: (1) pain control and opioid consumption; (2) venous thromboembolism (VTE); (3) surgery-related gastrointestinal complications; (4) postoperative medication management; and (5) total parenteral nutritional. Nineteen studies involving a total of 7,168 patients were included; most studies were conducted in gastrointestinal (n = 7) and orthopedics (n = 6) surgical units. Most included studies (n = 14) employed a multicomponent intervention including pharmaceutical care, education, guideline development, drug information services, and recommendations formulation. The processes of developing the implemented interventions and their structures were seldom reported. Positive impacts of pharmacist intervention on clinical outcomes included significant improvement in pain control and reductions in the incidence of VTE, surgery-related stress ulcer, nausea, and vomiting. There is inconsistency in the findings related to medication management (ie, achieving desired therapeutic ranges) and management of chronic conditions (hypertension and type 2 diabetes). Whilst there is some evidence of positive impacts of pharmacist intervention on clinical outcomes and optimizing drug therapy, this evidence is generally of low quality and insufficient volume. While this review suggests that pharmacists have essential roles in improving the care of patients undergoing surgery, more research with rigorous designs is required.

A Morphometric Study of the Femoral Nerve in the Thigh Region of the Malaysian Cadavers

Introduction: The femoral nerve is one of the vital nerves of the thigh region, which has importance in various fields of clinical areas, as well as in the field of Anatomy and the research areas. Femoral nerve blockade plays an important role in surgical interventions of the anterior thigh. Although the femoral nerve is superficial and easier to identify, a profound knowledge regarding the dimensions of the nerve is inevitable to perform successful surgeries and blockades. Objective: The describing study was an attempt to analyze the different dimensions of the femoral nerve in the thigh region of the Malaysian cadavers with relevant clinical implications, as there is a paucity of these studies involving Malaysian cadavers has been reported. Methods: This study had been conducted with the involvement of 78 adult lower limb specimens (cadaveric and disarticulated) of both genders and different ethnicity. Result: The average length of the femoral nerve from the inguinal ligament (IL) till its division and the width at the IL resembled the previous studies conducted on other geographical locations. The width at the division was similar to that of the IL level. The thickness at the IL was 1.32 ± 0.21 (right) and 1.29 ± 0.17 (left); and at the division was 1.50 ± 0.196 (right) and 1.43 ± 0.16 (left). The circumference of the nerve at the IL was 25.44 ± 1.26 (right) and 25.98 ± 0.89 (left); and that at the division was 25.65 ± 1.32 (right) and 25.66 ± 1.25 (left). Conclusion: The knowledge of the morphometric anatomy of the femoral nerve in the thigh region will not only assist neurologists and future researchers but also facilitate clinicians to prevent misdiagnoses and iatrogenic neurological damage.

Treatment of periodontitis ameliorates the severity and extent of psoriasis-A randomized clinical trial.

To assess the impact of non-surgical periodontitis treatment over conventional dermatological treatment on the severity and extent of psoriasis in patients affected by comorbid psoriasis and periodontitis. Seventy-four patients affected by both psoriasis and Stages I-IV periodontitis were randomized to receive either Steps 1-2 (non-surgical) of periodontal therapy (test group; n = 37) or no treatment (control group; n = 37). The two groups were balanced in terms of psoriasis medications, with the majority of the included patients undergoing biologics (74.0%) as monotherapy, while minor proportions were under systemic medications (13.7%) or none/topical/phototherapy (12.3%). The psoriasis area severity index (PASI) was regarded as the primary outcome. The body surface area (BSA) and the dermatology life quality index (DLQI) were additionally considered as dermatological outcomes. Probing pocket depth, recession depth, clinical attachment level periodontal inflamed surface area, and [full mouth plaque score] etc, periodontal inflamed surface area, and full-mouth plaque and bleeding scores (FMPS/FMBS) were also measured. Periodontal therapy in the test group led to statistically significant lower PASI scores at 10 weeks (mean = 3.15; standard deviation [SD] = 3.78) compared to the control group (mean = 7.11; SD = 6.09) (mean difference [MD] = -4.0; 95% confidence interval [CI]: -6.3, -1.6; p = .001). The test group also showed improvements in BSA (MD = -4.3) and periodontal parameters compared to the control group. DLQI only showed a non-statistically significant tendency (MD = -2.0). Steps 1-2 of periodontal therapy showed an additional effect over conventional dermatological treatment in reducing the severity and extent of psoriasis (Clinicaltrials.gov: NCT05311501).

Advances in Lensless Fluorescence Microscopy Design

Lensless fluorescence microscopy (LLFM) has emerged as a promising approach for biological imaging, offering a simplified, high-throughput, portable, and cost-effective substitute for conventional microscopy techniques by removing lenses in favor of directly recording fluorescent light on a digital sensor. However, there are several obstacles that this novel approach must overcome, such as restrictions on the resolution, field-of-view (FOV), signal-to-noise ratio (SNR), and multicolor-imaging capabilities. This review looks at the most current developments aimed at addressing these challenges and enhancing the performance of LLFM systems. To address these issues, computational techniques, such as deconvolution and compressive sensing, hardware modifications and structured illumination, customized filters, and the utilization of fiber-optic plates, have been implemented. Finally, this review emphasizes the numerous applications of LLFM in tissue analysis, pathogen detection, and cellular imaging, highlighting its adaptability and potential influence in a range of biomedical research and clinical diagnostic areas.

Altmetric coverage of health research in Ireland 2017-2023: a protocol for a cross-sectional analysis

Background Scientific publications have been growing exponentially, contributing to an oversaturated information environment. Quantifying a research output’s impact and reach can cannot be solely measured by traditional metrics like citation counts as these have a lag time and are largely focused on an academic audience. There is increasing recognition to consider ‘alternative metrics’ or altmetrics to measure more immediate and broader impacts of research. Better understanding of altmetrics can help researchers better navigate evolving information environments and changing appetites for different types of research. Objectives Our study aims to: 1) analyse the amount and medium of Altmetric coverage of health research produced by Irish organisations (2017 – 2023), identifying changes over time and 2) investigate differences in the amount of coverage between clinical areas (e.g., nutrition vs. neurology) and, where possible, by study types (e.g., clinical trials vs. evidence syntheses). Methods Using Altmetric institutional access, we will gather data on research outputs published 1 January 2017 through 31 December 2023 from active Irish organisations with Research Organisation Registry (ROR) IDs. Outputs will be deduplicated and stratified by their Australian and New Zealand Standard Research Classification relating to ≥1 field of health research: Biological Sciences, Biomedical and Clinical Sciences, Chemical Sciences, Health Sciences, and Psychology. We will clean data using R and perform descriptive analyses, establishing counts and frequencies of coverage by clinical area and medium (e.g., traditional news, X, etc.); data will be plotted on a quarterly and yearly basis. We will use topic modelling using latent Dirichlet allocation to explore prevalent topics over time. Results and Conclusions Improved understanding of one’s information environment can help researchers better navigate their local landscapes and identify pathways for more effective communication to the public. All R code will be made available open-source, allowing researchers to adapt it to evaluate their local landscapes.

Bridging Gaps: A Quality Improvement Project for the Continuing Medical Education on Stick (CMES) Program.

Aimed at bridging the gap in continuing medical education (CME) resource availability in low- and middle-income countries (LMICs), the "Continuing Medical Education on Stick" (CMES) program introduces two technological solutions: a universal serial bus (USB) drive and the CMES-Pi computer facilitating access to monthly updated CME content without data cost. Feedback from users suggests a lack of content on tropical infectious diseases (IDs) and content from a Western perspective, which may be less relevant in LMIC settings. This quality improvement project was intended to identify areas for improvement of the CMES database to better meet the educational needs of users. We compared the CMES content with the American Board of Emergency Medicine (ABEM) Exam content outline to identify gaps. The curriculum map of the CMES library, encompassing content from 2019 to 2024, was reviewed. An anonymous survey was conducted among 47 global users to gather feedback on unmet educational needs and suggestions for content improvements. All healthcare workers who were members of the CMES WhatsApp group were eligible to participate in the survey. The curriculum map included 2,572 items categorized into 23 areas. The comparison with the ABEM outline identified gaps in several clinical areas, including procedures, traumatic disorders, and geriatrics, which were represented -5%, -5%, and -4% in the CMES library compared with the ABEM outline, respectively. Free responses from users highlighted a lack of content on practical skills, such as electrocardiogram (ECG) interpretation and management of tropical diseases. Respondents identified emergency medical services (EMS)/prehospital care (81%), diagnostic imaging (62%), and toxicology/pharmacology (40%) as the most beneficial areas for clinical practice. In response to feedback from users, new content was added to the CMES platform on the management of sickle cell disease and dermatologic conditions in darkly pigmented skin. Furthermore, a targeted podcast series called "ID for Users of the CMES Program (ID4U)" has been launched, focusing on tropical and locally relevant ID, with episodes now being integrated into the CMES platform. The project pinpointed critical gaps in emergency medicine (EM) content pertinent to LMICs and led to targeted enhancements in the CMES library. Ongoing updates will focus on including more prehospital medicine, diagnostic imaging, and toxicology content. Further engagement with users and education on utilizing the CMES platform will be implemented to maximize its educational impact. Future adaptations will consider local relevance over the ABEM curriculum to better serve the diverse needs of global users.

Antimicrobial and Antibiofilm Potential of Flourensia retinophylla against Staphylococcus aureus.

Staphylococcus aureus is a Gram-positive bacteria with the greatest impact in the clinical area, due to the high rate of infections and deaths reaching every year. A previous scenario is associated with the bacteria's ability to develop resistance against conventional antibiotic therapies as well as biofilm formation. The above situation exhibits the necessity to reach new effective strategies against this pathogen. Flourensia retinophylla is a medicinal plant commonly used for bacterial infections treatments and has demonstrated antimicrobial effect, although its effect against S. aureus and bacterial biofilms has not been investigated. The purpose of this work was to analyze the antimicrobial and antibiofilm potential of F. retinophylla against S. aureus. The antimicrobial effect was determined using an ethanolic extract of F. retinophylla. The surface charge of the bacterial membrane, the K+ leakage and the effect on motility were determined. The ability to prevent and remove bacterial biofilms was analyzed in terms of bacterial biomass, metabolic activity and viability. The results showed that F. retinophylla presents inhibitory (MIC: 250 µg/mL) and bactericidal (MBC: 500 µg/mL) activity against S. aureus. The MIC extract increased the bacterial surface charge by 1.4 times and the K+ concentration in the extracellular medium by 60%. The MIC extract inhibited the motility process by 100%, 61% and 40% after 24, 48 and 72 h, respectively. The MIC extract prevented the formation of biofilms by more than 80% in terms of biomass production and metabolic activity. An extract at 10 × MIC reduced the metabolic activity by 82% and the viability by ≈50% in preformed biofilms. The results suggest that F. retinophylla affects S. areus membrane and the process of biofilm formation and removal. This effect could set a precedent to use this plant as alternative for antimicrobial and disinfectant therapies to control infections caused by this pathogen. In addition, this shrub could be considered for carrying out a purification process in order to identify the compounds responsible for the antimicrobial and antibiofilm effect.

Non-human primate studies for cardiomyocyte transplantation-ready for translation?

Non-human primates (NHP) are valuable models for late translational pre-clinical studies, often seen as a last step before clinical application. The unique similarity between NHPs and humans is often the subject of ethical concerns. However, it is precisely this analogy in anatomy, physiology, and the immune system that narrows the translational gap to other animal models in the cardiovascular field. Cell and gene therapy approaches are two dominant strategies investigated in the research field of cardiac regeneration. Focusing on the cell therapy approach, several xeno- and allogeneic cell transplantation studies with a translational motivation have been realized in macaque species. This is based on the pressing need for novel therapeutic options for heart failure patients. Stem cell-based remuscularization of the injured heart can be achieved via direct injection of cardiomyocytes (CMs) or patch application. Both CM delivery approaches are in the late preclinical stage, and the first clinical trials have started. However, are we already ready for the clinical area? The present review concentrates on CM transplantation studies conducted in NHPs, discusses the main sources and discoveries, and provides a perspective about human translation.