Practice Research Research Articles

Primary Liver Cancer Risk and Mortality in Patients With Alcohol-Related Cirrhosis in England and Denmark: Observational Cohort Studies.

Patients with alcohol-related cirrhosis (ALD cirrhosis) have an increased risk of primary liver cancer (hepatocellular carcinoma [HCC] or intrahepatic cholangiocarcinoma [iCCA]). England recommends surveillance for HCC in these patients, while Denmark does not. We performed an observational cohort study using the English Clinical Practice Research Datalink and the nationwide Danish healthcare registries to identify 17,110 English (2000-2016) and 22,122 Danish (1994-2022) patients with diagnosis codes of ALD cirrhosis. We computed and compared incidence rates and cumulative incidence of primary liver cancer, annual ultrasound scan rates, and mortality following diagnosis of primary liver cancer. The overall risk of primary liver cancer was similar in England and Denmark: 5-year risk was 2.24% (95% confidence interval 2.00-2.49) in England (iCCA 0.07%, HCC 2.16%) and 2.36% (2.15-2.57) in Denmark (iCCA 0.05%, HCC 2.30%). The annual rate of ultrasound scans per person was 0.65 (0.63-0.67) in England and 0.44 (0.42-0.46) in Denmark. The 1-year mortality after a diagnosis of primary liver cancer was 59.2% (54.4-64.0) in England and 60.9% (57.4-64.4) in Denmark. The 3-year risks of HCC in those on vs off surveillance in England were 2.3% (1.0-4.6) vs 1.5% (1.0-2.2). The risk of primary liver cancer was the same in English and Danish patients with ALD cirrhosis, and HCCs constituted 97% of primary liver cancers. Mortality with primary liver cancer was equally high in both countries. Notably, in England, where guidance recommends biannual HCC surveillance with ultrasound, patients with ALD cirrhosis were undergoing fewer than 1 ultrasound scan per year.

Research on the Practice and Strategy of Community Cultural Education Under the Common Prosperity

Haining is located in the Hangjia Lake Plain, and its economic development is rapid. With the surrounding demolition and the surplus labor of rural areas, the phenomenon of "aging aging" and "population gathering" are becoming more and more prominent. Chinese society is in a period of important transformation, diversified value collisions, and complex social environment. Therefore, the construction of targeted communities has gradually attracted much attention. Essence. With the goal of achieving common prosperity, this paper explores the practical forms and strategies of community cultural education in promoting the development of common prosperity for community residents, managing community residents, and enhancing cultural literacy. Through practical implementation, research and statistics, analyze the current resource allocation, activity development, and resident participation in community cultural education. Fully leverage the educational resources of local universities, combine with regional cultural backgrounds, and carry out community cultural education practices with traditional culture as the core. Research has found that community cultural practice education through school local collaboration can stimulate residents' sense of participation and creativity, enhance cohesion and centripetal force, and promote harmonious community management. The study proposes corresponding strategies and suggestions from three aspects: community, local universities, and government, which helps to promote the efficient and sustainable development of community cultural education.

The Participants

While universities increasingly offer institutional support for academic filmmaking, in the specific case of ethics this support can sometimes become an impediment to creativity. The requirement to follow comprehensive university ethical procedures - which are usually developed with great care and attention to the needs of researchers but with little or no focus on creative practice research - might stymie the artistic practice of filmmakers. My video The Participants: a reflection on the ethics of smartphone filmmaking as research aims to offer a provocation intended to challenge university practitioner-researchers to consider the ethics of their practice, but also, at the same time, a provocation to university ethics protocols and procedures. Specifically, the films seeks to encourage the viewer to reflect on the ways in which filmmaker researchers working in in public places might better consider the ethical issues raised by their practice, especially when subsequently employing (and manipulating) footage of individuals who have not given their consent to be filmed. For The Participants I used an iPhone 11 to capture video images of tourists videoing with their smartphones at Grand Central Station, New York.

Identities and Methodologies of Doctoral Candidates Undertaking Audiovisual Research-by-Practice

“Identities and Methodologies of Doctoral Candidates Undertaking Audiovisual Research-by-Practice” comprises a triptych of video essays, crafted by the co-organisers of the inaugural B-Film Creative Practice Colloquium at the University of Birmingham. In each video, the creators reflect upon data collected during this event (including a videographic exercise, digital questionnaires, and filmed interviews). Through analysing how attendees described and executed their practice and methods, the three videos jointly and separately interrogate: • relationships of process and product in audiovisual research-by-practice; • the place of experimental filmmaking in academia; • opportunities for, and impediments to, the adoption and development of filmmaking in the academy. These works have a specific focus on postgraduate researchers and thus may provide guidance for both supervisors and future students working in creative practice research.

Research on factors that activate university students’ research work using the iterative examination process

Introduction. Many issues related to the activation of research work of university students remain insufficiently studied and are an urgent problem of higher professional education. Aim. The present research aimed to identify the main factors influencing the processes of activating students’ research work and to develop recommendations for increasing the activity of students’ participation in this activity. Methodology and research methods. The authors used iterative examination, analysis, comparison, synthesis, and systematisation methods to analyse the results obtained through empirical methods such as questionnaires and sociological surveys. Data collection was conducted through an online survey using the Google Forms Internet service and offline surveys at 16 universities in the Republic of Kazakhstan and the Russian Federation in 2023. A total of 351 scientific experts participated in the survey. The survey results were processed using the IBM SPSS statistical package. Results and scientific novelty. It has been established that a significant contribution to attracting students to research activities is made by the expansion of the use of information technologies in the research process and a system of incentives aimed at increasing the importance of students’ research work in the educational process. The scientific novelty lies in identifying and systematising the main factors that influence the activation of students’ research work in the learning process through the iterative examination process. Practical significance. The results of the conducted research can be used in the practical research work of university students.

Data quality assessment of interventional trials in public trial databases

ObjectiveHigh-quality data entry in clinical trial databases is crucial to the usefulness, validity, and replicability of research findings, as it influences evidence-based medical practice and future research. Our aim is to assess the quality of self-reported data in trial registries and present practical and systematic methods for identifying and evaluating data quality. Study Design and SettingWe searched ClinicalTrials.Gov (CTG) for interventional total knee arthroplasty (TKA) trials between 2000 and 2015. We extracted required and optional trial information elements and used the CTG's variables' definitions. We performed a literature review on data quality reporting on frameworks, checklists, and overviews of irregularities in healthcare databases. We identified and assessed data quality attributes as follows: consistency, accuracy, completeness, and timeliness. ResultsWe included 816 interventional TKA trials. Data irregularities varied widely: 0%–100%. Inconsistency ranged from 0% to 36%, and most often nonrandomized labeled allocation was combined with a “single-group” assignment trial design. Inaccuracy ranged from 0% to 100%. Incompleteness ranged from 0% to 61%; 61% of finished TKA trials did not report their outcome. With regard to irregularities in timeliness, 49% of the trials were registered more than 3 months after the start date. ConclusionWe found significant variations in the data quality of registered clinical TKA trials. Trial sponsors should be committed to ensuring that the information they provide is reliable, consistent, up-to-date, transparent, and accurate. CTG's users need to be critical when drawing conclusions based on the registered data. We believe this awareness will increase well-informed decisions about published articles and treatment protocols, including replicating and improving trial designs.

Why School Bus Drivers Stay in Their Jobs

With the current shortage of school bus drivers in many states, access to education is at risk for the many students who get to and from school by bus. Despite the critical role drivers play, little is known about why they stay in their jobs, and what can be done to keep them. To learn more about school bus driver retention, 301 drivers in 32 districts in New York were surveyed. Drawing on an overarching model of person-environment fit, perspectives of job satisfaction, meaningful work and public service motivation were used to explore what aspects of the driver role relate to turnover intention. Findings indicated lower turnover intention when drivers reported higher extrinsic satisfaction, when they found their work to hold personal significance, and when they saw their work as a source of broader meaning for their lives. Drivers also viewed themselves as making a difference in the lives of students and considered themselves a significant part of their education. They also indicated that pay and benefits were important in their decision to stay or leave. Findings are discussed in terms of implications for school leadership practice and future research.

Reconstruction of extended ureteral defects using sections of the ileum and colon

The incidence of extended ureteral strictures has been on the rise in the past decade. This increase is attributed to the growing number of endoscopic surgeries, expanded criteria for surgical treatment of cancer patients, and complications from radiation therapy. When correcting an extended ureteral stricture, if there is a lack of urinary system tissues to replace the defect or if they are involved in the pathological process, replacement reconstruction using a segment of small or large intestine becomes necessary. Options for ureteral reconstructions using ileum and colon sections were discussed, as well as the use of the appendix as a graft. Data on the effectiveness and frequency of postoperative complications were analysed, and the pros and cons of different surgical techniques for ureteroplasty were evaluated. It is necessary to conduct further scientific and practical research and evaluation of long-term results to solve the remaining unclear problems and to inform the doctors of our country about the existence of this pathology.

METACOGNITION AS A CATALYST FOR IMPROVED LEARNING OUTCOMES IN OPEN & DISTANCE EDUCATION

Challenges in open and distance education are unique to the learner and generally result in a gap between what is desired and what is realized. This paper explores how metacognition works wonders in bridging this gap and leading to improved learning outcomes within Open and Distance Education (ODE) environments. Metacognitive strategies foster self-regulated learning and assist students in properly planning, monitoring, and assessing their learning processes. In line with this, this paper discusses how metacognition could make a difference in improving academic achievement, promoting independent learning, and building lifelong learning skills within ODE. We demonstrate, from in-depth research and analysis of best practices, how the integration of metacognitive approaches into practice could go a long way in closing the achievement gap and optimizing the educational experience for distance learners. The findings underscore the critical role of metacognition in letting students rise above intrinsic ODE difficulties toward superior learning outcomes.<p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/soc/0715/a.php" alt="Hit counter" /></p>

Improving Treatment in Treatment Court: A Qualitative Interpretive Meta-Synthesis (QIMS) of the Drug Court Experience

Drug courts have played a key role in criminal justice reform, particularly in supporting substance use and mental health disorder recovery. Little is known, though, related to drug court participants’ views on the strengths of the program that support their recovery and what suggestions they have to improve programming. This qualitative interpretive meta-synthesis (QIMS) provides a behind-the-scenes perspective of drug court programming from the voices of participants (n = 183). Based on data extracted from a synthesis of nine qualitative studies, three new themes emerged related to the strengths of drug court that support recovery and suggestions to improve programming. The new themes are: (1) Improving treatment in treatment court; (2) The interplay between internal motivation for change and dignity and respect for all; and (3) Being future oriented: Developing a sustainable recovery support system. Implications for drug court practice, policy advocacy, and future research are discussed. Drug courts should revisit how clinical information is exchanged between treatment providers and the justice system, and potentially reduce this collaboration. Furthermore, recommendations are offered on how drug courts can support participants in developing internal motivation for recovery and in sustaining recovery post-drug court.

Recurrent cardiovascular and limb events in 294,428 patients with coronary or peripheral artery disease or ischemic stroke on antiplatelet monotherapy: The RESRISK cohort study

Background and aimsUtilising real-world data, we quantified the burden of cardiovascular risk factors and long-term residual risk of atherothrombotic events among routine care cohorts with coronary (CAD) or peripheral (PAD) artery disease or ischemic stroke (IS) on guideline-recommended antiplatelet monotherapy (APMT). MethodsRetrospective cohort study using data (2010–2020) from the United Kingdom Clinical Practice Research Datalink (CPRD) and Hospital Episode Statistics, including adults with CAD, PAD or IS who were first prescribed APMT (CAD/IS: aspirin; PAD: clopidogrel). Primary outcomes (recurrent events): major adverse cardiovascular events (MACE) for CAD/PAD/IS cohorts, major adverse limb events (MALE) for PAD. Results266,478 CAD, 13,162 PAD, and 14,788 IS patients were included (mean age: 71 years; women 37.7%–47.5 %). Risk factor burden was high and attainment of recommended goals was low. There were 73,691, 3,121 and 7,137 MACE among CAD, PAD and IS patients, respectively (median follow-up: 89.9, 42.4 and 75.9 months, respectively), and 4,767 MALE among PAD patients. MACE incidence rate per 1000 person-years was higher in IS (268.7; 95%CI 265.3–272.0) than CAD (92.9; 95%CI 92.5–93.4) or PAD cohorts (97.2; 95%CI 94.6–99.8). MALE incidence rate was 195.9 (95%CI 192.2–199.6) per 1000 person-years. IS patients presented a lower rate of hospitalisations and longer time-to-first hospitalisation, but once hospitalised, they had a longer length-of-stay. PAD patients had the highest hospitalisation rate. ConclusionsAmong a contemporary cohort with cardiovascular disease on APMT, long-term residual atherothrombotic risk remains high despite being on APMT. Greater attention to risk factor control and use of appropriate evidence-based therapy is required to reduce residual risk among this very high-risk population.

Analysis of Rural Elderly Care Strategies: “Policy Guidance-Resource Integration” Pathway

With the development of China's social economy and the aging population, rural areas are facing increasingly challenging elderly care issues due to labor outflow and economic development lagging behind urban areas. To address this problem, this study collected a large amount of relevant literature, summarized and analyzed existing research, and explored pathways to effectively improve the quality of rural elderly care services. Through interdisciplinary theoretical analysis and practical research, the study proposed the “Policy Guidance-Resource Integration” pathway, confirmed its effectiveness, and elaborated on specific implementation methods and underlying rationale. The research findings demonstrate that the “Policy Guidance-Resource Integration” pathway can effectively address some of the current issues in rural elderly care, offering new insights and guidance for academic research and policy formulation in the field of rural elderly care.

Investigating Caregivers’ Advocacy Efforts in Early Intervention Using Auto-Photography and Photo-Elicitation Interviews

Although it is widely known that caregivers advocate for their school-aged children with disabilities, little is understood about how caregivers who have infants and toddlers with delays or disabilities advocate for their young children. The birth-to-three period may be the beginning of some parents’ advocacy efforts and it is possible their efforts may change over time. Given the relevance of this topic and the limited literature, the purpose of this study was to use qualitative inquiry, specifically auto-photography and photo-elicitation interviews, to explore 13 caregivers’ advocacy experiences in their children’s early years. Thematic and constant comparative analyses were used and subsequently 41 major codes within seven categories were identified. The two major findings were (a) caregivers engaged in both individual (i.e., for their children) and outreach advocacy activities (i.e., for other families and children) and (b) their experiences extended beyond interactions with professionals and included everyday interactions with their children, family members and other parents. Directions for future research and implications for practice are discussed.

Most physical interventions for musculoskeletal pain in children and adolescents cannot be reproduced in clinical practice: a meta-research study of randomized clinical trials

IntroductionConservative treatments such as physical therapies are usually the most indicated for the management of musculoskeletal pain; therefore, a detailed description of interventions enables the reproducibility of interventions in clinical practice and future research. The objective of this study is to evaluate the description of physical interventions for musculoskeletal pain in children and adolescents.MethodsWe considered randomized controlled trials that included children and adolescents between 4 and 19 years old with acute or chronic/persistent musculoskeletal pain. We included physical therapies related to all types of physical modalities aimed at reducing the intensity of pain or disability in children and adolescents with musculoskeletal pain. The description of interventions was assessed using the Template for Intervention Description and Replication (TIDieR) checklist. We performed electronic searches in the following databases: CENTRAL, MEDLINE, EMBASE, CINAHL, PsyINFO and PEDro up to April 2024. The description of physical interventions was presented using frequencies, percentages and 95% confidence intervals (CIs) of the TIDieR checklist items described in each study. We also calculated the total TIDieR score for each study and presented these data as mean and standard deviation.ResultsWe included 17 randomized controlled trials. The description measured through the TIDieR checklist scored an average of 11 (5.2) points out of 24. The item of the TIDieR that was most described was item 1 (brief name) and most absent was item 10 (modifications).ConclusionThe descriptions of physical interventions for the treatment of musculoskeletal pain in children and adolescents are partially described, indicating the need for strategies to improve the quality of description to enable true clinical reproducibility.

Radiation model and thermal characteristics of OLED glass substrate using electric heating tube

Glass substrate (GS) heating is a fundamental but significant technology for organic light emitting diode (OLED), which is critical to OLED displaying quality and efficiency. A rapid and reliable theoretical model is intensely demanded to guide practical system design, simulation analysis and experimental research for GS heating, but present radiative models are improper or inconvenient. Therefore, this paper establishes a new and direct calculation model with the addition of correctional coefficient 0.5 to blackbody radiation power of electric heating tube (EHT) and the proposal of comprehensive angle coefficient X, which can solve single and multi-source radiation problems theoretically. The simulation and experiment are both conducted for comparison analysis. The temperature errors of theory and simulation for multi EHTs are all within 1 % when compared with experimental results, which well validates the reliability and accuracy of theoretical and simulation models. Large EHT radius r, small distance L between EHT and GS, and suitable EHT number n are suggested, which benefits to the improvement of radiation heating and temperature uniformity of GS. It is hoped that this study can provide a useful tool on thermal radiation analysis and also a valuable promotion for practical OLED heating technology.

The association of type 2 diabetes-related characteristics with fracture risk at different sites.

To determine the association of diabetes-related characteristics with fractures at different sites in individuals with type 2 diabetes (T2D). We conducted a cohort study using the Clinical Practice Research Datalink (CPRD) GOLD. Patients aged over 30 years with T2D were identified within the CPRD. Patients were followed from the start of diabetes treatment until the end of data collection, death, or the occurrence of a fracture. Cox proportional hazards models were used to estimate the hazard ratios for the association of the individual characteristics (diabetes duration, glycated haemoglobin [HbA1c] level, and microvascular complications) with fracture risk, adjusted for demographics, comorbidities and comedication. A diabetes duration of >10 years was associated with an increased risk of any fracture and major osteoporotic fractures (MOFs), while a diabetes duration of >8 years was associated with an increased hip fracture risk, compared to a duration <2 years. An HbA1c level <6% was associated with an increased fracture risk compared to HbA1c values of 6% to <7%. The presence of one or two microvascular complications was associated with an increased risk of any fracture and MOFs and the presence of two microvascular complications was associated with an increased hip fracture risk, compared to no microvascular complications. In conclusion, our study shows that a diabetes duration of 10 years or more, strict glycaemic control resulting in HbA1c levels below 6%, and/or the presence of at least one microvascular complication increased the risk of any fracture, hip fractures, MOFs, and humerus fractures, but not ankle, scapula or skull fractures.

FIP Cape Town 2024: Pharmacy Practice Research

Accepted abstracts under the theme: Pharmacy Practice Research (n=90)

Marketing and food consumption: Nurturing new possibilities

This article introduces the RAM 2024 Special Issue on Marketing and Food, designed to report on and stimulate new scientific advancements in the field. It discusses the conflicting concerns related to food consumption and the emerging practices of consumers and industry players. The Special Issue explores how consumers react to new technologies used in post-purchase situations through the representation of experiences via social media (David et al., 2024). Food is at the heart of today’s sustainability issues, and this Special Issue shows that the environmental impact of food consumption is influenced by the provisioning systems geographically available for consumers (Mourre et al., 2024) and by the perceived and objective accessibility of local food at the moment of choice (in supermarkets or restaurants; Garcia et al., 2024). Consumers’ reactions to retailers’ sustainable initiatives to manage and prevent food waste are shown to be ambivalent (Hanan et al., 2024), revealing a complex relationship. Finally, the Special Issue explores consumers’ reconnection with food consumption through mindful eating, allowing a greater focus on internal sensations and fostering awareness of both personal motivations and the environmental impact of consumption (Dupont Le Priol and Schmitt, 2024). Avenues for future research and implications for practice and policy are discussed.

Autoimmune astrocytopathy double negative for AQP4-IgG and GFAP-IgG: Retrospective research of clinical practice, biomarkers, and pathology.

The objective of this study is to investigate the presence of astrocyte antibodies in patients, excluding aquaporin-4 or glial fibrillary acidic protein (GFAP) antibodies, while evaluating associated biomarkers and pathologies. Patient serum and cerebrospinal fluid (CSF) were tested for antibodies using tissue- and cell-based assays. Neurofilament light chain (NFL) and GFAP in the CSF were detected using single-molecule array (SIMOA). 116 patients accepted SIMOA. Fifteen functional neurological disorders patients without antibodies were designated as controls. Thirty-five patients were positive for astrocyte antibodies (Anti-GFAP: 7; Anti-AQP4: 7; unknown antibodies: 21, designed as the double-negative group, DNAP). The most frequent phenotype of DNAP was encephalitis (42.9%), followed by myelitis (23.8%), movement disorders (19.0%), and amyotrophic lateral sclerosis-like (ALS-like) disease (14.2%). The levels of CSF GFAP and NFL in DNAP were higher than in the control (GFAP: 1967.29 [776.60-13214.47] vs 475.38 [16.80-943.60] pg/mL, p < 0.001; NFL: 549.11 [162.08-2462.61] vs 214.18 [81.60-349.60] pg/mL, p = 0.002). GFAP levels decreased in DNAP (n = 5) after immunotherapy (2446.75 [1583.45-6277.33] vs 1380.46 [272.16-2005.80] pg/mL, p = 0.043), while there was no difference in NFL levels (2273.78 [162.08-2462.61] vs 890.42 [645.06-3168.06] pg/mL, p = 0.893). Two brain biopsy patterns were observed: one exhibited prominent tissue proliferation and hypertrophic astrocytes, with local loss of astrocytes, while the other showed severe astrocyte depletion with loss of neurofilaments around the vessels. Eighteen patients received immunotherapy, and improved except one with ALS-like symptoms. We identified anti-vimentin in this patient. There are unidentified astrocyte antibodies. The manifestations of double-negativity are heterogeneous; nevertheless, the pathology and biomarkers remain consistent with astrocytopathy. Immunotherapy is effective.

Understanding Gratification Disorder in Childhood: A Comprehensive Review of Diagnosis, Differential Diagnosis, and Management Approaches.

Gratification disorder (GD) in childhood is characterized by difficulty delaying immediate rewards and controlling impulsive behaviors. This disorder manifests as a persistent struggle to wait for longer-term rewards and a tendency toward impulsive decision-making, which can disrupt academic performance, social interactions, and daily functioning. The relevance of GD is highlighted by its potential to impede the development of crucial skills such as self-control, problem-solving, and social competence. This comprehensive review aims to provide an in-depth understanding of GD by examining its diagnostic criteria, exploring differential diagnoses, and evaluating various management strategies. Key objectives include clarifying the characteristics of GD, distinguishing it from other disorders with overlapping symptoms, and assessing effective interventions, including behavioral therapies, pharmacological options, and educational modifications. The review underscores the importance of accurate diagnosis and tailored interventions for clinicians, educators, and parents, emphasizing the need for a multidisciplinary approach to support affected children. Understanding GD is essential for improving developmental outcomes and ensuring that children receive appropriate support to navigate the challenges associated with the disorder. Continued research and advancements in diagnostic and therapeutic practices are crucial for enhancing the management of GD and fostering better long-term outcomes for affected individuals.