Descriptive Analysis Research Articles

Clinical characteristics of women with HIV in the RESPOND cohort: A descriptive analysis and comparison to men.

Women with HIV are globally underrepresented in clinical research. Existing studies often focus on reproductive outcomes, seldom focus on older women, and are often underpowered to assess sex/gender differences. We describe CD4, HIV viral load (VL), clinical characteristics, comorbidity burden, and use of antiretroviral therapy (ART) among women with HIV in the RESPOND study and compare them with those of the men in RESPOND. RESPOND is a prospective, multi-cohort collaboration including over 34 000 people with HIV from across Europe and Australia. Demographic and clinical characteristics, including CD4/VL, comorbidity burden, and ART are presented at baseline, defined as the latter of 1 January 2012 or enrolment into the local cohort, stratified by age and sex/gender. We further stratify men by reported mode of HIV acquisition, men who have sex with men (MSM) and non-MSM. Women account for 26.0% (n = 9019) of the cohort, with a median age of 42.2 years (interquartile range [IQR] 34.7-49.1). The majority (59.3%) of women were white, followed by 30.3% Black. Most women (75.8%) had acquired HIV heterosexually and 15.9% via injecting drug use. Nearly half (44.8%) were receiving a boosted protease inhibitor, 31.4% a non-nucleoside reverse transcriptase inhibitor, and 7.8% an integrase strand transfer inhibitor. The baseline year was 2012 for 73.2% of women and >2019 for 4.2%. Median CD4 was 523 (IQR 350-722) cells/μl, and 73.6% of women had a VL <200 copies/mL. Among the ART-naïve population, women were more likely than MSM but less likely than non-MSM (p < 0.001) to have CD4 <200 cells/μL and less likely than both MSM and non-MSM (p < 0.001) to have VL ≥100 000 copies/mL. Women were also more likely to be free of comorbidity than were both MSM and non-MSM (p < 0.0001). RESPOND women are diverse in age, ethnicity/race, CD4/VL, and comorbidity burden, with important differences relative to men. This work highlights the importance of stratification by sex/gender for future research that may help improve screening and management guidelines specifically for women with HIV.

A Statewide Consultation Helpline for Rapid Linkage to Services for Youths With Opioid Use Disorder and Other Substance Use.

The authors examined the initial implementation of the Indiana Adolescent Addiction Access (AAA) program, modeled on the widely disseminated Child Psychiatry Access Program framework. The AAA program developed a statewide consultation helpline to connect health care providers with adolescent addiction specialists. The AAA line was staffed by a coordinator, who fielded initial questions, and on-call clinical specialists (social workers, nurse practitioners, psychiatrists, and psychologists), who were paged to complete telephone consultations and provide care recommendations. When necessary, AAA providers offered urgent clinical assessments and initiated treatment. Descriptive analyses were performed for key variables over the first 21 months of AAA operations. From July 2021 to March 2023, a total of 125 consultations were completed. Most callers were health care providers (71%) or parents (27%). Calls pertained to youths ages 10-18 years (mean±SD age=16.4±1.3; 62% of callers were male, 84% White, and 11% Black), with concerns around cannabis (63%), opioids (38%), and other substances. About 26% of calls related to an overdose, and 41% of cases were rated as severe. Recommendations included starting new medications (17%) or outpatient therapy (86%), and 17% of consultations resulted in urgent evaluations. The Indiana AAA program helps overcome key barriers to adolescent substance use treatment. Increasing the capacity to initiate medication for opioid use disorder and other treatment rapidly through consultation and direct care is a promising, scalable approach for preventing overdose deaths among youths.

Performance barriers and competence development of graduate architects in construction contract administration (CCA): the mediating role of CCA skills

PurposeEducation focused on the creation of a knowledge base but not on how to bring such knowledge into practice had caused graduate architects to encounter reality shock and fail to perform during building contract administration. Although the effect of performance barriers on competence development is empirically supported, less is known about the mechanisms that explain this effect. Overcoming barriers for graduate architects is crucial while supporting building contract administrators and acquiring professional qualifications. To address this issue, we propose the mediating role of CCA skills as a possible explanation of the relationship between performance barriers and competence development of graduate architects.Design/methodology/approachA survey was conducted among graduate architects in Klang Valley. In total, one hundred and twenty-seven usable questionnaires were returned and analyzed using descriptive analysis and regression analysis.FindingsMediation results indicate that performance barriers have a significant positive influence on competence development through CCA skills in claims and legal matters management, project management, communication and relationship management, quality assessment and management, and design management.Originality/valueThe present study contributes to the construction contract administration literature by integrating performance barriers and the CCA skills model. This advances our understanding of performance barriers and CCA skills engendering competence development of graduate architects.

Telehealth With Comprehensive Live-Fed Real-World Data as a Patient Care Platform for Lung Cancer: Implementation and Evaluation Study.

Telehealth has emerged as a popular channel for providing outpatient services in many countries. However, the majority of telehealth systems focus on operational functions and offer only a sectional patient journey at most. Experiences with incorporating longitudinal real-world medical record data into telehealth are valuable but have not been widely shared. The feasibility and usability of such a telehealth platform, with comprehensive, real-world data via a live feed, for cancer patient care are yet to be studied. The primary purpose of this study is to understand the feasibility and usability of cancer patient care using a telehealth platform with longitudinal, real-world data via a live feed as a supplement to hospital electronic medical record systems specifically from physician's perspective. A telehealth platform was constructed and launched for both physicians and patients. Real-world data were collected and curated using a comprehensive data model. Physician activities on the platform were recorded as system logs and analyzed. In February 2023, a survey was conducted among the platform's registered physicians to assess the specific areas of patient care and to quantify their before and after experiences, including the number of patients managed, time spent, dropout rate, visit rate, and follow-up data. Descriptive and inferential statistical analyses were performed on the data sets. Over a period of 15 months, 16,035 unique users (13,888 patients, 1539 friends and family members, and 174 physician groups with 608 individuals) registered on the platform. More than 382,000 messages including text, reminders, and pictures were generated by physicians when communicating with patients. The survey was completed by 78 group leaders (45% of the 174 physician groups). Of the participants, 84% (65.6/78; SD 8.7) reported a positive experience, with efficient communication, remote supervision, quicker response to questions, adverse event prevention, more complete follow-up data, patient risk reduction, cross-organization collaboration, and a reduction in in-person visits. The majority of the participants (59/78, 76% to 76/78, 97.4%) estimated improvements in time spent, number of patients managed, the drop-off rate, and access to medical history, with the average ranging from 57% to 105%. When compared with prior platforms, responses from physicians indicated better experiences in terms of time spent, the drop-off rate, and medical history, while the number of patients managed did not significantly change. This study suggests that a telehealth platform, equipped with comprehensive, real-world data via a live feed, is feasible and effective for cancer patient care. It enhances inpatient management by improving time efficiencies, reducing drop-off rates, and providing easy access to medical history. Moreover, it fosters a positive experience in physician-patient interactions.

Prevalence, under-reporting, and epidemiological surveillance of COVID-19 in the Araguaína City of Brazil.

Asymptomatic and underreported individuals remain a source of coronafig disease 2019 (COVID-19) transmission to others. Data on the prevalence and epidemiological factors influencing transmission are fundamental for establishing control measures, especially in vulnerable regions such as the Amazon. This study aimed to determine the point prevalence and active infection of COVID-19 among the population in Araguaína, a Brazilian city located in the Amazon region, analyzed the socioeconomic and behavioral variables of a statistically representative sample of this population using an epidemiological survey, and identify the viral genomic diversity in the region. During the sixth epidemiological week of 2021 (February 8 to 12), samples of 497 inhabitants of the municipality asymptomatic for respiratory syndromes underwent reverse transcription-quantitative polymerase chain reaction and serological tests (immunoglobulin M and immunoglobulin G). A questionnaire collated data on socioeconomic factors, prevention measures, and health status history. The active infection rate was 6.2%, and the prevalence was 13.5% of the study population. Active infection cases were under-reported; each reported positive case represented 14-28 under-reported cases. Lineages P.2, P.1, and B.1.1 were detected. Working from home was a protective factor against the infection, and clinical signs of fever, dry cough, and loss of taste or smell were associated with testing positive (p <0.05). A descriptive analysis of the indicators revealed that the entire population was susceptible to the disease. Intensified vaccination strategies are required regardless of socioeconomic factors, health conditions, and preventive measures. Implementation of objective, comprehensive, and efficient management tools to minimize the spread of COVID-19 in this municipality can serve as a model for other regions of Brazil.

Analisis Karakter Bahasa Alay Kaum Remaja Di Kota Makassar

In daily life, human being can never escape from language. There are two types of languages; the standard language and the non-standard languages. In Indonesia, the standard language is Bahasa Indonesia, while the non-standard languages are the languages of vernacular (local languages) and sub-cultural languages (slang, jargon, etc). Nowadays, most of teenagers use the nonstandard language to communicate among their friends, which is called slang. There is a newslang in Indonesia which is called Alay language. The Alay language is popular among teenagers since 2008 until now. The purpose of this study were (1) to know the patterns used to modify Alay Language, (2) to know the effect of using Alay language on the standard form of Indonesian language, and (3) to find out the purpose of Alay Language used by teenagers in Makassar. This research uses descriptive analysis method. The research data were taken from the conversations that contained of Alay's words, which were previously made on the internet by Facebook social network users. Other supporting data were the questionnaires. The results of this study indicated that (1) There were no standard rules in modifying Alay Language, but the most common process was Substitution Process with a frequency of 38%. (2) The use of Alay Language had both the positive and negative effects on the existence of standard language, Indonesian language. (3) One of the reasons of using the Alay language was to be called “cool”.

Exploring Perspectives: The Role of Educational Technologies in Improving the Teachers’ Pedagogical Aspect

The aim of this research is to examine the role of using new educational technologies in improving teachers’ pedagogical aspect. Even though various studies have been conducted on the role of technology in teaching, the pedagogical aspect and its im-provement through the use of educational technologies was not explored to date. Therefore, the lack of research on these variables was a motivation to conduct such a study. Through literature review, the advantages and disadvantages of using educational technologies in the pedagogical aspect during the teaching process are described. This research included 83 lower secondary school teachers from the municipality of Prishtina. The research used mixed methodology, including both qualitative and quan-titative designs. The research questions are: P1: What role does the use of new educational technologies play in improving the pedagogical aspect for teachers? Which was answered through inferential analysis. This shows that the use of new educational technologies plays a positive role in the pedagogical aspect for teachers. P2: What new educational technologies are used by teachers during the teaching process? This question was answered through descriptive analysis. These responses highlighted a positive role of integrating new educational technologies in improving the pedagogical aspect for teachers, making teaching more attractive and enabling greater clarification of new information for students during the lesson.

Are sleep disorders associated with traumatic dental injuries in school children? A cross-sectional study.

To evaluate whether the prevalence of traumatic dental injuries (TDIs) in permanent anterior teeth among school children is associated with sleep behaviours and disorders. A cross-sectional study was carried out with a representative sample of schoolchildren aged 8 to 10 years (n = 1402) from Florianopolis, Brazil. Clinical examinations for TDIs were performed according to the classification proposed by Andreasen. Parents/caregivers completed a questionnaire addressing sociodemographic characteristics and sleep behaviours/disorders (sleep duration, insomnia, sleep rhythmic movement, snoring, and signs of sleep apnoea). Descriptive analysis and Poisson regression were performed. The prevalence of TDIs was 10.9%. Insomnia was observed in 3.0% of the children, snoring in 42.8%, sleep rhythmic movement in 27.9%, and signs of obstructive sleep apnoea in 33.6% of the schoolchildren. Most children (75.2%) slept less than eight hours a day. The prevalence of TDIs was higher among schoolchildren with an increased overjet (PR: 1.65; 95% CI: 1.15-2.35; P < 0.01), after adjusting for monthly family income, caregiver's schooling, and sleep behaviours. The prevalence of TDIs was not associated with sleep behaviours/disorders. Parent-reported sleep disorders such as insomnia, sleep rhythmic movement, snoring and signs of sleep apnoea were not associated with the prevalence of TDIs in schoolchildren. © 2024 Australian Dental Association.

HARMONIZING INTERNATIONAL AND NATIONAL LEGAL SYSTEMS THROUGH THE PRINCIPLES OF SUSTAINABLE DEVELOPMENT IN THE MODERN STATE

Sustainable development is a critical concept used to enhance global welfare. In this context, peremptory norms recognized within international law are integrated as general, universal, essential, and fundamental principles for societal benefit. Therefore, this research aimed to investigate the role of sustainable development within international law and examine the contribution of norms to the formation of a modern legal state. The legal status of norms and capacity to embody universal values are clarified using descriptive analysis with a normative juridical approach and qualitative data. The results show that sustainable development has been developed as an indispensable paradigm, widely confirmed across legal frameworks. In addition, the integration as a universal norm within international law reflects the potential to influence legal systems globally. This depends on the balance of established sources such as treaties and customary practices. Moreover, this research contributes to legal scholarship by stating the role of international norms in advancing sustainable development.

Critical care services in Bagmati province of Nepal: A cross sectional survey

Background This study aimed to assess the current status of critical care services in 13 districts of Bagmati Province in Nepal, with a focus on access, infrastructure, human resources, and intensive care unit (ICU) services. Methods A cross-sectional survey was conducted among healthcare workers employed in 87 hospitals having medical/surgical ICUs across Bagmati Province. Data were collected through structured questionnaires administered via face-to-face and telephone interviews. Descriptive analysis was used for data analysis, involving frequencies and percentages. Results From 87 hospitals, a total of 123 ICUs were identified in the province, providing 1167 beds and 615 functioning ventilators. The average ICU bed availability per 100,000 population was 19, ranging from 3.6 in Makwanpur to 33.9 in Kathmandu. Out of 13 districts, 95% of beds were concentrated in just four districts, while six had no ICU facilities. Of the available facilities, 69.9% were owned by private entities. One-to-one nurse-to-ventilated bed ratio was maintained by 63.4% of ICUs during daytime, and 62.6% at nighttime. Furthermore, 74.8% of ICUs had consultants trained in critical care medicine. While essential equipment availability was higher in Bagmati province, gaps existed in the availability of oxygen plants and isolation rooms. Similarly, many ICUs offered continuous medical education and cardiopulmonary resuscitation (CPR) training, but improvements were necessary in clinical audits, antibiotic stewardship programs, and research engagement. Conclusions Disparities in critical care resources were evident across districts in Bagmati Province, highlighting the need for a balanced and decentralized approach to ensure equitable access to care. Although there were disparities, numerous ICUs were effectively carrying out multiple critical care procedures. This study suggests conducting a nationwide mapping of ICU resources, prioritizing infrastructure development, optimizing resource allocation, and establishing national protocols.

Medication safety strategies in European adult, paediatric, and neonatal intensive care units: a cross-sectional survey

ObjectivesPatients in intensive care units (ICUs) are potentially more vulnerable to medication errors than patients admitted to general wards. However, little is known about medication safety strategies used in European...

Overview of Central Corneal Thickness in Patients with Glaucoma: A Single Center Observational Study at Dr. M. Djamil General Hospital, Padang, Indonesia

Background: Central corneal thickness (CCT) is an important risk factor in the diagnosis and management of glaucoma. This study aims to determine the CCT picture of various types of glaucoma at Dr. M. Djamil General Hospital Padang. Methods: This descriptive retrospective study involved data from glaucoma patients at Dr. M. Djamil General Hospital Padang for the period January 2019 - December 2020. CCT data was obtained from medical records and OCT computer data. Descriptive analysis was carried out to see the distribution of CCT in ocular hypertension (OHT), glaucoma suspect (GS), normal tension glaucoma (NTG), primary open-angle glaucoma (POAG), and juvenile open-angle glaucoma (JOAG) groups. Results: A total of 123 glaucoma patients were analyzed. The overall mean CCT was 535.50 ± 43.82 µm. The highest mean CCT was in the OHT group (566.30 ± 32.07 µm) and the lowest in POAG (523.39 ± 39.43 µm). The mean age of patients was 35.19 ± 16.20 years. The POAG group had the highest mean age (52.52 ± 9.54 years), while the JOAG group had the lowest (22.00 ± 5.84 years). Conclusion: There are variations in CCT in various types of glaucoma, with OHT having the highest CCT and POAG the lowest. This data can be a basis for consideration in the diagnosis and management of glaucoma in Indonesia.

The estimated 10-year risk of first-onset cardiovascular disease in Swedish-born and non-Swedish-born primary healthcare patients

BackgroundSCORE2 has been introduced as an updated risk assessment tool for calculating the 10-year risk of first-onset cardiovascular disease (CVD). However, it does not account for ethnicity or socioeconomic status, known to affect CVD risk. This study investigated and compared SCORE2 estimates in Swedish-born and non-Swedish-born primary healthcare patients. The second aim was to examine if several risk factors could explain differences in CVD risk between the groups.MethodsThis was an observational, cross-sectional study. Data were obtained from the 4D Diabetes Project study, providing a total of 444 participants aged between 40 and 69 years. All participants had complete risk variable data necessary for the SCORE2 tool and no history of previous CVD. Descriptive analysis was conducted to compare distributions of risk factors between Swedes and immigrants and odds ratios of risk factors amongst these two groups in correlation to elevated CVD risk were calculated using logistic regression.ResultsSwedish-born patients showed a significantly higher risk of elevated CVD risk estimates (≥ 2.5% CVD risk increase for individuals < 50 years, respectively, ≥ 5% for individuals aged 51–69) than the non-Swedish-born population, even after adjustment for educational level (OR = 1.61, 95% CI 1.08–2.39). Weekly alcohol consumption implicated a risk of being classified as high risk of CVD risk, regardless of country of birth (OR = 1.93 CI 1.25-3.00). However, Swedes accounted for most of the alcohol consumption (62.6% vs. 19.6%). No other explanatory variable showed significance in association with elevated CVD risk.ConclusionsSwedish-born patients were found to be at higher risk of an increased 10-year CVD risk. The association of alcohol consumption with elevated CVD risk needs to be further studied in longitudinal studies in representative populations, notably among Sweden’s diverse ethnic groups.

The relationship between fear of cancer recurrence and death anxiety among Chinese cancer patients: the serial mediation model

AimsThis study aims to investigate the association between fear of cancer recurrence (FCR) and death anxiety (DA) among Chinese cancer patients, while considering the mediating effects of experiential avoidance (EA) and meaning in life (MIL).MethodsFrom February to June 2023, convenience sampling was used to select newly diagnosed cancer patients in a tertiary Cancer Hospital in Chinese Hunan Province as the survey objects. A total of 436 cancer patients completed the Fear of Cancer Recurrence Inventory, the Meaning in Life Questionnaire, the Acceptance and Action Questionnaire-II, and the Templer’s death anxiety scale. Descriptive analysis and Pearson correlation analysis were conducted using SPSS 28.0 software. Serial mediation analysis was performed by Hayes’ PROCESS macro.ResultsGender, age, educational level, marital status, residence, occupation, per capita monthly household income, tumor type, and cancer stage were controlled in the model. The results revealed that fear of cancer recurrence had a significant direct effect on death anxiety (Effect = 0.075, 95% CI: 0.064 to 0.087). Additionally, three indirect pathways were identified: (1) through experiential avoidance (Effect = 0.037, 95% CI: 0.026 to 0.049), (2) through meaning in life (Effect = 0.022, 95% CI: 0.014 to 0.031), and (3) through the serial mediators involving meaning in life and experiential avoidance (Effect = 0.016, 95% CI: 0.010 to 0.023). The total indirect effect of the three mediation paths was 63.56%.ConclusionFear of cancer recurrence is a significant psychological distress experienced by cancer patients, which not only directly contributes to death anxiety but also may triggers changes, such as experiential avoidance and meaning in life. Ultimately, this comprehensive psychological distress leads to death anxiety.

Patient Safety Culture from a Nursing Perspective in a Chilean Hospital.

Patient safety culture is relevant both in the delivery of care and in the training of nursing staff, its purpose being to prevent and reduce risks associated with health care. This research aims to evaluate patient safety culture from the perspective of the nursing teams in a highly complex public hospital in the city of Valparaíso, Chile. A cross-sectional study with a quantitative approach applying descriptive, bivariate, and inferential statistical analysis was conducted on 259 nurses and nursing assistants from 13 adult medical-surgical units of the Carlos Van Buren hospital. The participants were obtained through a non-probabilistic convenience sample, answering the hospital survey on Patient Safety Culture version 2.0 (HSOPS 2.0), adapted to the Chilean population. The best-evaluated dimension was communication and receptivity; the worst was the support administrators provide for patient safety. This study identified the weaknesses and strengths of the hospital, the most worrying weakness being the shortage of human capital, material, and financial resources necessary to improve patient safety. This study was not registered.

Process evaluation of a data-driven quality improvement program within a cluster randomised controlled trial to improve coronary heart disease management in Australian primary care.

This study evaluates primary care practices' engagement with various features of a quality improvement (QI) intervention for patients with coronary heart disease (CHD) in four Australian states. Twenty-seven practices participated in the QI intervention from November 2019 -November 2020. A combination of surveys, semi-structured interviews and other materials within the QUality improvement in primary care to prevent hospitalisations and improve Effectiveness and efficiency of care for people Living with heart disease (QUEL) study were used in the process evaluation. Data were summarised using descriptive statistical and thematic analyses for 26 practices. Sixty-four practice team members and Primary Health Networks staff provided feedback, and nine of the 63 participants participated in the interviews. Seventy-eight percent (40/54) were either general practitioners or practice managers. Although 69% of the practices self-reported improvement in their management of heart disease, engagement with the intervention varied. Forty-two percent (11/26) of the practices attended five or more learning workshops, 69% (18/26) used Plan-Do-Study-Act cycles, and the median (Interquartile intervals) visits per practice to the online SharePoint site were 170 (146-252) visits. Qualitative data identified learning workshops and monthly feedback reports as the key features of the intervention. Practice engagement in a multi-featured data-driven QI intervention was common, with learning workshops and monthly feedback reports identified as the most useful features. A better understanding of these features will help influence future implementation of similar interventions. Australian New Zealand Clinical Trials Registry (ANZCTR) number ACTRN12619001790134.

Intersection of the lexical-semantic fields “Mentality” and “Physiology” in the poetic language of Igor-Severyanin

The intersection of two lexical-semantic fields “mentality” and “physiology” in the poetic texts of Igor-Severyanin is studied. The relevance of the research is determined by the fact that within the framework of modern anthropocentric approach and increased attention to the mental sphere lexical semantics is investigated, lexical-semantic fields, their intersections, semantic shifts are considered, actual problems of linguistic poetics are touched upon. The aim of the work is to explore the intersection of lexical-semantic fields “mentality” and “physiology” in the language of Severyanin's poems. The material includes lexemes of the mental sphere from Igor-Severyanin's poetic texts. While determining the usual meaning of these lexemes, the authors used the materials of “Explanatory Dictionary of the Russian Language” by S.I. Ozhegov. The methods of description, comparison, contrast, lexical-semantic and contextual analysis, and continuous sampling were applied; the lexical-semantic field - a generally accepted form of representing lexical units by their meaning - was used to structure the vocabulary. The intersections of the lexical-semantic fields “mentality” and “physiology” in Igor-Severyanin's texts, revealed in the research, are primarily due to the inseparable connection between the inner world of man and his bodily organs of sense. The language fixes stable expressions indicating the possibility of comprehending the human consciousness through analyzing the signals of his body. Words used to denote phenomena and processes related to the body, health, gestures, etc., are reinterpreted in poetic language and receive new semantics, which allows to refer these new lexical-semantic units to the lexical-semantic field of mentality. In Igor-Severyanin's poems the inner world of the lyrical subject dominates, which is reflected in the author's word usage. Even words and expressions with the semantics of physiology shift in their meanings, acquiring the semantics of mentality, at the same time thoughts and feelings are endowed with the author's positive evaluation. The prospects of the research are connected primarily with further study of the mental sphere in the Russian linguistic lexical-semantic system, its dynamics, as well as with the analysis of semantic shifts in the poetic language vocabulary.

Identifying and Reducing Insulin Errors in the Simulated Military Critical Care Air Transport Environment: A Human Factors Approach.

During high-fidelity simulations in the Critical Care Air Transport (CCAT) Advanced course, we identified a high frequency of insulin medication errors and sought strategies to reduce them using a human factors approach. Of 169 eligible CCAT simulations, 22 were randomly selected for retrospective audio-video review to establish a baseline frequency of insulin medication errors. Using the Human Factors Analysis Classification System, dosing errors, defined as a physician ordering an inappropriate dose, were categorized as decision-based; administration errors, defined as a clinician preparing and administering a dose different than ordered, were categorized as skill-based. Next, 3 a priori interventions were developed to decrease the frequency of insulin medication errors, and these were grouped into 2 study arms. Arm 1 included a didactic session reviewing a sliding-scale insulin (SSI) dosing protocol and a hands-on exercise requiring all CCAT teams to practice preparing 10 units of insulin including a 2-person check. Arm 2 contained arm 1 interventions and added an SSI cognitive aid available to students during simulation. Frequency and type of insulin medication errors were collected for both arms with 93 simulations for arm 1 (January-August 2021) and 139 for arm 2 (August 2021-July 2022). The frequency of decision-based and skill-based errors was compared across control and intervention arms. Baseline insulin medication error rates were as follows: decision-based error occurred in 6/22 (27.3%) simulations and skill-based error occurred in 6/22 (27.3%). Five of the 6 skill-based errors resulted in administration of a 10-fold higher dose than ordered. The post-intervention decision-based error rates were 9/93 (9.7%) and 23/139 (2.2%), respectively, for arms 1 and 2. Compared to baseline error rates, both arm 1 (P = .04) and arm 2 (P < .001) had a significantly lower rate of decision-based errors. Additionally, arm 2 had a significantly lower decision-based error rate compared to arm 1 (P = .015). For skill-based preparation errors, 1/93 (1.1%) occurred in arm 1 and 4/139 (2.9%) occurred in arm 2. Compared to baseline, this represents a significant decrease in skill-based error in both arm 1 (P < .001) and arm 2 (P < .001). There were no significant differences in skill-based error between arms 1 and 2. This study demonstrates the value of descriptive error analysis during high-fidelity simulation using audio-video review and effective risk mitigation using training and cognitive aids to reduce medication errors in CCAT. As demonstrated by post-intervention observations, a human factors approach successfully reduced decision-based error by using didactic training and cognitive aids and reduced skill-based error using hands-on training. We recommend the development of a Clinical Practice Guideline including an SSI protocol, guidelines for a 2-person check, and a cognitive aid for implementation with deployed CCAT teams. Furthermore, hands-on training for insulin preparation and administration should be incorporated into home station sustainment training to reduced medication errors in the operational environment.

Insights From the National Inpatient Sample (2016-2019) on Laryngeal Cancer Incidence and Trends.

Laryngeal cancer has a significant impact on speech, swallowing, and quality of life. This study aims to analyze laryngeal cancer trends using the National Inpatient Sample (NIS) database, providing insights into its epidemiology. Data from the NIS database was analyzed for a cohort of 14,282 laryngeal cancer cases from 2016 to 2019. Baseline characteristics and demographic parameters, including primary expected payer, age groups, hospital types, and geographic regions, were examined. Descriptive statistics and trend analysis were conducted. The cohort showed consistent annual case numbers (range: 3739-3948). The highest case numbers were in the 40-64 age group (average 1998 cases/year), followed by the 65-80 age group (average 1473 cases/year). Medicare was the most common primary expected payer, followed by Medicaid, private insurance, self-pay, and no charge. The cohort was roughly three times more skewed toward males, with an average of 2936 male cases per year compared to 885 female cases. Notable trends included significant positive correlations with time for urban teaching hospitals, the South region, older age group (65-80 years), and Asian or Pacific Islander individuals. However, the overall correlation between case numbers and time was not statistically significant. The primary expected payer and deaths exhibited moderate correlations with time but did not reach statistical significance. This study provides insights into the baseline characteristics and trends in laryngeal cancer incidence. The observed demographic shifts highlight the need for further investigation into underlying factors influencing case distribution. Understanding these trends can guide targeted interventions for prevention, early detection, and treatment of laryngeal cancer.

Analysis of Critical Thinking Aspects in the Implementation of Blended Learning Model Based on Electric Material Project

The purpose of this study was to determine the aspects of critical thinking in implementing a blended learning-based project model in improving learning outcomes by utilizing digital applications and platforms. The research subjects were 20 students who were interviewed and filled out a questionnaire. Based on the hypothesis, it is revealed that there is a positive impact of critical thinking aspects on learning outcomes. These aspects include interpretation, analysis, evaluation, inference, explanation, and self-regulation. Data were collected through observation, interviews and documentation. This type of research is development research (R&amp;D) with the concept of Thiagarajan 4D theory (Define, Design, Develop, and Disseminate). Data were analyzed using descriptive statistics and qualitative analysis. With the findings: the results of statistical analysis for the critical thinking aspects studied, all aspects influence on student learning outcomes. Based on the six aspects, the highest influence is the interpretation aspect of 82% on student learning outcomes.