788 research outputs found

    The Influence of Faith on Women in Leadership Positions

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    Women are still underrepresented in leadership roles and still suffer from gender stereotypes and injustice. Women of faith are frequently stigmatized by both their faith and place of employment. This study is about women of faith who held leadership roles in rural communities. The objective of this study is to examine the experiences of women of faith in leadership, their qualities, and knowledge as effective leaders. The data used in this study is secondary and it was obtained from a parent study entitled, “Women Ascending to Leadership Positions in Rural Nonprofit Organizations.” This parent study used a snowball approach to interview 32 women who were serving in leadership roles in rural nonprofit organizations. The current study used a phenomenological qualitative approach to determine how their faith influenced their leadership ascension. It is necessary to investigate the journey of women’s leadership development to identify how to best develop future female leaders in nonprofit organizations in rural communities. There is limited research regarding women’s leadership experiences in rural organizations and faith

    The neurochemistry of agitation in Alzheimer's disease: a systematic review

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    OBJECTIVE: To provide an up-to-date systematic review of the characteristics, methodology and findings of studies that have investigated the neurochemistry of agitation in Alzheimer's disease (AD). METHODS: Electronic databases were searched for published peer-reviewed articles which provided data on any neurotransmitter system in relation to agitation in AD. Screening of titles and abstracts and data extraction from full texts were conducted in duplicate. RESULTS: Forty-five studies were included. Monoamines (serotonin, dopamine and noradrenaline) were most commonly investigated. A variety of methods were used to investigate the neurochemistry underlying agitation in AD and, although there were several conflicting findings, there was evidence of serotonergic deficit, relatively preserved dopaminergic function and compensatory overactivity of postsynaptic noradrenergic neurons in agitation in AD. CONCLUSIONS: Disruption of the dynamic balance between multiple neurotransmitter systems could impair functional neural networks involved in affective regulation and executive function. Differences in study design and methodology may have contributed to conflicting findings. Future studies that overcome these limitations (e.g. using standardized criteria to define agitation) and employ neuroimaging methods such as MRI/PET to investigate specific neural networks are needed to clarify the role of neurotransmitter alterations in these patients

    Prediction of distal tibial articular extension in tibial shaft fractures: both posterior malleolar fracture and non posterior malleolar fracture intra-articular extension

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    Abstract Background Multiple authors have highlighted the increased incidence of occult posterior malleolar fractures (PMFs) with spiral tibial shaft fractures, although other reported associated risks of intra-articular extension have been limited. The aim of our study is to investigate both PMFs and non-PMFs intra-articular extensions associated with tibial diaphyseal fractures to try to determine any predictive factors. Methods We undertook a retrospective review of a prospectively collected database. The inclusion criteria for this study were any patient who had sustained a diaphyseal tibial fracture, who had undergone surgery during the study period and who had also undergone a CT scan in addition to plain radiographs. The study time period for this study was between 01/01/2013 and 9/11/2021. Results Out of 764 diaphyseal fractures identified, 442 met the inclusion criteria. A total of 107 patients had PMF extensions (24.21%), and a further 128 patients (28.96%) had intra-articular extensions that were not PMF’s. On multivariate analysis, spiral tibial fracture subtypes of the AO/OTA classification (OR 4.18, p &lt; 0.001) and medial direction of tibial spiral from proximal to distal (OR 4.38, p &lt; 0.001) were both significantly associated with PMF. Regarding intra-articular fractures, multivariate analysis showed significant associations with non-spiral (OR 4.83, p &lt; 0.001) and distal (OR 15.32, p &lt; 0.001) tibial fractures and fibular fractures that were oblique (OR 2.01, p = 0.019) and at the same level as tibia fracture (OR 1.83, p = 0.045) or no fracture of the fibular (OR 7.02, p &lt; 0.001). Conclusion In our study, distal tibial articular extension occurs in almost half of tibial shaft fractures. There are very few fracture patterns that are not associated with some type of intra-articular extension, and therefore, a low threshold for preoperative CT should be maintained. Level of evidence 4. </jats:sec

    The role of pediatric nursing in the provision of quality care in humanitarian settings: a qualitative study in Tonkolili District, Sierra Leone

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    Purpose: Evaluate nurses' and caretakers' perspectives of quality care, barriers to its delivery, and its study in a humanitarian setting. Methods: A qualitative study using semi-structured interviews and direct observation was conducted in the pediatric department of Magburaka Hospital, Tonkolili district, Sierra Leone. Interviews were recorded, transcribed, and inductive coding was used to identify prevalent themes. The observation was used to compare and elaborate on interview findings. Results: Three themes emerged holistic care; the nursing community; and organization and systems of care. For caretakers, holistic care related to their child’s survival, with quality care described as the availability of free medication, provision for basic needs (food, water, shelter, sanitation), hospital cleanliness, and psychosocial support. For nurses, this involved medication administration, cleanliness, and carrying out nursing tasks (e.g., taking vital signs). Observation revealed caretakers, without nursing involvement, performed the majority of “activities of daily living” (e.g., bathing, toileting). The nursing community describes nursing employment types, attitudes, and how a lack of teamwork impacted quality nursing care. The third theme outlines the importance of organization and systems of care, in which training and a good salary were perceived as prerequisites for quality nursing care, whilst a lack of resources and inadequate operational systems were barriers. Conclusion: Caretakers play an integral role in the delivery of quality care. This and important quality care components outlined by nurses and caretakers identified a patient and family-centered approach could contribute to improving quality nursing care in humanitarian settings

    Norovirus infections in young children in Lusaka Province, Zambia: clinical characteristics and molecular epidemiology

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    Abstract Background The burden, clinical features, and molecular epidemiology of norovirus infection in young children in southern Africa are not well defined. Methods Using data from a health facility-based surveillance study of children <5 years in Lusaka Province, Zambia presenting with diarrhea, we assessed the burden of norovirus infection. A convenience sample of 454 stool specimens was tested for norovirus using reverse-transcriptase polymerase chain reaction (RT-PCR). RT-PCR positive samples underwent additional nucleotide sequencing for genogroup and genotype identification. Clinical features and severity of diarrheal illnesses were compared between norovirus-positive and -negative subjects using Chi-squared and t-tests. Results Norovirus was detected in 52/454 (11.5%) specimens tested. Abdominal pain, fever, and vomiting were the most common presenting features in norovirus-associated illnesses. However, there were no significant differences in the clinical features of norovirus-positive compared to norovirus-negative illnesses. Of 43 isolates that were available for sequencing, 31 (72.1%) were genogroup II (GII) and 12 (27.9%) were genogroup I (GI). The distribution of genotypes was diverse. Conclusions Noroviruses were detected in approximately 10% of young children with diarrhea in the Lusaka Province of Zambia, with GII representing the majority of infections. These findings support the role of norovirus in symptomatic diarrhea disease in Africa. Further studies are needed to confirm these observations and to evaluate prevention strategies

    Towards climate resilient and environmentally sustainable health care facilities

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    The aim of building climate resilient and environmentally sustainable health care facilities is: (a) to enhance their capacity to protect and improve the health of their target communities in an unstable and changing climate; and (b) to empower them to optimize the use of resources and minimize the release of pollutants and waste into the environment. Such health care facilities contribute to high quality of care and accessibility of services and, by helping reduce facility costs, also ensure better affordability. They are an important component of universal health coverage. Action is needed in at least four areas which are fundamental requirements for providing safe and quality care: having adequate numbers of skilled human resources, with decent working conditions, empowered and informed to respond to these environmental challenges; sustainable and safe management of water, sanitation and health care waste; sustainable energy services; and appropriate infrastructure and technologies, including all the operations that allow for the efficient functioning of a health care facility. Importantly, this work contributes to promoting actions to ensure that health care facilities are constantly and increasingly strengthened and continue to be efficient and responsive to improve health and contribute to reducing inequities and vulnerability within their local settings. To this end, we propose a framework to respond to these challenges

    Phase 1 study of MLN8054, a selective inhibitor of Aurora A kinase in patients with advanced solid tumors

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    Aurora A kinase is critical in assembly and function of the mitotic spindle. It is overexpressed in various tumor types and implicated in oncogenesis and tumor progression. This trial evaluated the dose-limiting toxicities (DLTs) and maximum tolerated dose (MTD) of MLN8054, a selective small-molecule inhibitor of Aurora A kinase

    Management of Portal Hypertension in Children

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    Management of portal hypertension in children has evolved over the past several decades. Portal hypertension can result from intrahepatic or extrahepatic causes. Management should be tailored to the child based on the etiology of the portal hypertension and on the functionality of the liver. The most serious complication of portal hypertension is gastroesophageal variceal bleeding, which has a mortality of up to 30%. Initial treatment of bleeding focuses on stabilizing the patient. Further treatment measures may include endoscopic, medical, or surgical interventions as appropriate for the child, depending on the cause of the portal hypertension. β-Blockers have not been proven to effectively prevent primary or secondary variceal bleeding in children. Sclerotherapy and variceal band ligation can be used to stop active bleeding and can prevent bleeding from occurring. Transjugular intrahepatic portosystemic shunts and surgical shunts may be reserved for those who are not candidates for transplant or have refractory bleeding despite medical or endoscopic treatment
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