Search Results (33)

Background: The effective use of electronic health records (EHRs) is an essential clinical skill, but medical schools have traditionally provided limited systematic teaching on the topic. Inefficient use of EHRs results in delays in diagnosis, fragmented care, and clinician burnout. This study investigates the impact on medical students’ confidence, efficiency, and proficiency in extracting clinically pertinent information from patient records following an organised EHR teaching programme. Methods: This observational cohort involved 60 final-year medical students from three London medical schools. Participants received a structured three-phase intervention involving an introductory workshop, case-based hands-on practice, and guided reflection on EHR navigation habits. Pre- and post-intervention testing involved mixed-method surveys, simulated case tasks, and faculty-assessed data retrieval exercises to measure changes in students’ confidence, efficiency, and ability to synthesise patient information. Quantitative data were analysed using paired t-tests, while qualitative reflections were theme-analysed to identify shifts in clinical reasoning. Results: All 60 students successfully finished the intervention and assessments. Pre-intervention, only 28% students reported feeling confident in using EHRs effectively, with a confidence rating of 3.0. Post-intervention, 87% reported confidence with a rating of 4.5 (p < 0.01). Efficiency in the recovery of critical patient information improved from 3.2 to 4.6 (p < 0.01). Students also demonstrated enhanced awareness regarding system-related issues, such as information overload and fragmented documentation, and provided recommendations on enhancing data synthesis for clinical decision making. Conclusions: This study emphasises the value of structured EHR instruction in enhancing the confidence and proficiency of medical students in using electronic records. The integration of structured EHR education to medical curricula can better prepare future physicians in managing information overload, improve diagnostic accuracy, and enhance the quality of patient care. Future research should explore the long-term impact of structured EHR training on clinical performance, diagnostic accuracy, and patient outcomes during real-world clinical placements and postgraduate training. Full article

Many patients with major depressive disorder (MDD) feel worse in the morning than in the evening. To clarify the differences in morning physiological characteristics between patients with MDD and healthy participants, a wearable device that measures peripheral wrist skin temperature and heart rate (HR) was adopted. The device incorporates a thermopile sensor to measure peripheral wrist skin temperature using infrared radiation emitted from the skin surface. In total, 30 patients diagnosed with MDD and 24 healthy individuals were recruited. From 00:00 to 12:00, participants wore a wrist-worn device on their non-dominant hand. It was discovered that, at 09:00, the average peripheral wrist skin temperature of patients with MDD was significantly lower (by 0.1% [2.9 °C]) than that of healthy individuals. The dramatic decrease in morning (09:00) peripheral wrist skin temperature in patients with MDD can be attributed to their morning sympathetic surge and peripheral vascular contraction. The average HR of patients with MDD was significantly higher (by 1% [17 beats/min]) than that of healthy controls. Regression analysis, including peripheral wrist skin temperature and HR at 09:00, showed 83.3% sensitivity and a negative predictive value of 76.2%. The potential impact of these results appears promising for future preliminary morning MDD screening. Full article

Background: The cashmere goat is a biological resource that mainly produces cashmere. Cashmere has a soft hand feel and good luster, with high economic value. The quality and yield of cashmere are determined by the process of hair follicle development during the embryonic period. Methods: In this study, the skin of the Inner Mongolia cashmere goat at different embryonic stages (45, 55, 65, and 75d) was collected, and the differentially expressed lncRNA MSTRG.20890.1 at 75d was obtained by screening. Dual luciferase reporter gene system, qRT-PCR, and EDU experiments were used to verify further the regulatory role and molecular mechanism of the lncRNA in dermal fibroblasts. Results: Based on the transcriptome database of Inner Mongolia cashmere goat skin at different embryonic stages, which was previously constructed by our group, according to the characteristics of hair follicle development in the embryonic stage, we screened out the lncRNA MSTRG.20890.1 that was down-expressed on the 75-SHFINI day of the embryonic stage. We found that lncRNA MSTRG.20890.1 was mainly located in the cytoplasm of cells, and it could inhibit the proliferation and directional migration of dermal fibroblasts through the chi-miR-24-3p/ADAMTS3 signaling axis, thereby inhibiting the formation of dermal papilla structure at embryonic stage. Conclusions: This study revealed that lncRNA MSTRG.20890.1 regulated secondary hair follicle morphogenesis and development in cashmere goats through the chi-miR-24-3p/ADAMTS3 signaling axis. Full article

This study builds on past research noting the psychosocial challenges women face in eastern Democratic Republic of Congo as survivors of rape. There is an interpretation of rape in these communities as a sexual taboo and as a danger to the families and communities of the survivors. The participants in this study described how these social norms and beliefs lead to isolation, feelings of shame, interpersonal difficulties, and hesitancy to seek medical and psychological treatment. In this study, we used a qualitative research methodology to investigate the subjective experiences of survivors and what support they thought to be the most useful in their families and communities. Three themes emerged from the data analysis: general social practices and beliefs, social reactions and consequences of rape, and the ideal social reaction to rape. The participants shared insights into two sets of values. On the one hand, there are relationship-focused values with the potential to influence revictimizing social reactions. On the other hand, there are person-focused values with the potential to rally the community in solidarity and support for survivors. These results suggest that local communities and families are key stakeholders in creating a safe and supportive social environment necessary for the survivors’ journey to recovery. Prioritizing efforts to mitigate the conflict between relationship-focused and person-focused values is recommended. Full article

In the context of the Catholic Reformation serious concerns were expressed about the affective potency of naturalistic depictions of beautiful, sensuous figures in religious art. In theological discourse similar anxieties had long been articulated about potential contiguities between elevating, licit desire for an extraordinarily beautiful divinity and base, illicit feeling. In the later fifteenth and early sixteenth centuries, in the decades preceding the Council of Trent, a handful of writers, thinkers and artists asserted a positive connection between spirituality and sexuality. Leonardo da Vinci, and a group of painters working under his aegis in Lombardy, were keenly aware of painting’s capacity to evoke feeling in a viewer. Pictures they produced for domestic devotion featured knowingly sensuous and unusually epicene beauties. This article suggests that this iconography daringly advocated the value of pleasurable sensation to religiosity. Its popularity allows us to envisage beholders who were neither mired in sin, nor seeking to divorce themselves from the physical realm, but engaging afresh with age-old dialectics of body and soul, sexuality and spirituality. Full article

Background: Clinical judgment, also known as gestalt or gut feeling, can predict deterioration and can be easily and rapidly obtained. To date, it is unknown what clinical judgement precisely entails. The aim of this study was to elucidate which features define the clinical impression of health care professionals in the ED. Method: A nominal group technique (NGT) was used to develop a consensus-based instrument to measure the clinical impression score (CIS, scale 1–10) and to identify features associated with either a more severe or less severe estimated disease severity. This single-center observational cohort study included 517 medical patients visiting the ED. The instrument was prospectively validated.. The predictive value of each feature for the clinical impression was assessed using multivariate linear regression analyses to adjust for potential confounders and validated in the infection group. Results: The CIS at the ED was associated with ICU admission (OR 1.67 [1.37–2.03], p < 0.001), in-hospital mortality (OR 2.25 [1.33–3.81], p < 0.001), and 28-day mortality (OR 1.33 [1.07–1.65], <0.001). Dry mucous membranes, eye glance, red flags during physical examination, results of arterial blood gas analysis, heart and respiratory rate, oxygen modality, triage urgency, and increased age were associated with a higher estimated disease severity (CIS). On the other hand, behavior of family, self-estimation of the patient, systolic blood pressure, and Glascow Coma Scale were associated with a lower estimated disease severity (CIS). Conclusion: We identified several features that were associated with the clinical impression of health care professionals in the ED. Translating the subjective features and objective measurements into quantifiable parameters may aid the development of a novel triage tool to identify patients at risk of deterioration in the ED. Full article

A formaldehyde-free reactive flame retardant, an ammonium salt of triethylenetetramine phosphoryl dimethyl ester phosphamide phosphoric acid (ATPEPDPA), was synthesized and characterized using nuclear magnetic resonance (NMR). Fourier transform infrared spectroscopy test (FT-IR), durability test and scanning electron microscopy (SEM) results suggested that ATPEPDPA was successfully grafted on cotton fabrics through a -N-P(=O)-O-C covalent bond. Moreover, the limiting oxygen index (LOI) value of 20 wt% ATPEPDPA-treated cotton was 44.6%, which met stringent washing standard after 50 laundering cycles (LCs). The high washing resistance of the ATPEPDPA-treated cotton was due to the p-π conjugation between the N atom and the P(=O) group in the flame-retardant molecule, which strengthened the stability of the -N-P(=O)-O-C bonds between ATPEPDPA and cellulose, and the -N-P(=O)-(O-CH₃)₂ groups in the ATPEPDPA. The cone calorimetric test showed that the treated cotton had excellent flame retardance. In addition, the TG and TG-IR tests suggested that ATPEPDPA performed a condensed flame retardance mechanism. Furthermore, the physical properties and hand feel of the treated cotton were well maintained. These results suggested that introducing -N-P(=O)-(O-CH₃)₂ and -N-P(=O)-(ONH₄)₂ groups into ATPEPDPA could significantly increase the fire resistance and durability of cotton fabrics. Full article

The modification of cellulose woven fabrics and viscose nonwovens was carried out with the aim of preparing sustainable coatings from biodegradable natural polymers. The modification of fabrics with biodegradable natural polymers represents an ecological alternative to other textile modifications, such as the sol-gel process. Coatings were prepared from erythritol, gelatin, and collagen in various formulations with the addition of propolis and alginate fibers and a natural plasticizer (glycerin). The morphology of the materials was determined before and after modification with Dino-Lite. Moreover, the pH value, the drop test method, the angle recovery angle, the thickness, and the mass per unit area were monitored before and after modification. The results have shown that modifications had no significant effect on the thickness or mass per unit area. In contrast, in a larger proportion, they show hydrophilic properties, which favor their application for medical purposes—for example; for the absorption of exudates in wound dressings; etc. In addition, due to the neutral and slightly alkaline pH values of the modified samples, they can be suitable for external application on the skin. The results of the recovery angle of the modified samples proved that the samples did not tend to crease and that they retained their elasticity after modification with a very pleasant textile feel (fabric hand), making them even more suitable for everyday applications. Full article

A new intervention model for promoting healthy ageing grounded on integrated value-based care was developed and tested in the city of Valencia (Spain). Its implementation raised relevant barriers for older adults in their access to health, health promotion, and health self-management linked with their health and digital literacy. This new intervention model included several aspects. On the one hand, researchers together with older adults and their informal caregivers participating in the study, designed personalized care plans, based on older adults’ specific needs, to be implemented with the support of a digital solution. On the other hand, researchers and health and social professionals implemented a series of workshops in different locations of the city to encourage a sense of community among participants, reinforcing their trust in the new care model and increasing their adherence. Social activities were at the core of the workshops to understand older people’s interaction with the health and social services provided in the neighborhood. Qualitative and quantitative methods were combined to extract information from older participants on how to engage them as active actors of their health and understand their values and preferences. In the present manuscript, we focus on the qualitative results, which show that after a post-pandemic situation, they were more concerned about social isolation and desired face-to-face contact with their professional care team; however, feelings of loneliness and/or sadness were not considered among the reasons to visit health professionals. Some of the conclusions revealed that the use of technology as a supportive tool is well received but with a stress on its role as “supportive”, and not replacing the close contact with healthcare professionals. Professionals recognized the benefits of this new approach but required more time and incentives to dedicate the effort needed. The main aim of this study was to present these barriers related to health access, health promotion, and health self-management, as well as the actions developed to face them. Full article

Participant engagement, psychosocial factors, and dietary behaviors are important components of “Food as Medicine” and cooking education programs. The purpose of this study is to describe a multidisciplinary cooking program at a Federally Qualified Health Center in central Texas. During biannual harvest seasons (2022–2023), patients participated in four or six weekly 1.5 h hands-on cooking classes with shared meals, education, and produce delivery. Pretest–posttest surveys assessed sociodemographic information, health, psychosocial factors, and dietary behaviors; follow-up assessed group cohesion/sense of community in classes. Survey data were described using means and proportions. Across four cohorts, participants (n = 33; mean age: 45 ± 16 years) were 30% Hispanic/Latino, 18% non-Hispanic Black, and 52% non-Hispanic White; on average, participants attended 66% of sessions. Increases in cooking self-efficacy (p < 0.001) and diet-related self-management strategies (p < 0.001) were observed for those with follow-up data (n = 16); further, 44% reported increased vegetable consumption. All participants (100%) reported feeling like a valued member of their cooking group and 94% reported high levels of belonging. In a diverse community health center serving low-income patients, provision of produce and cooking education classes supported strategies to improve diet-related confidence, skills, and behavior. Cross-sector partnership within a health care setting may help patients and physicians prioritize nutrition and food access. Full article

Language not only plays a powerful role in human life, as it is also a crucial factor in our minds. It shapes our personality, memory and even the way in which we see the world, as well as playing a fundamental role in the building of self-concept and self-esteem. Having a good self-concept, that is, knowing one’s own qualities and strengths, will, in turn, promote good self-esteem. The aim of this research was to analyze self-concept in 50 children (aged 5–7) with functional dyslalia in the city of Granada (Spain). A quantitative approach was taken, with a non-experimental design; it was descriptive, cross-sectional and correlational. The Perception of Child Self-concept Scale (PCS), a Spanish scale, was used. In general, the children who were interviewed showed a medium level of self-concept. It is noteworthy that differences were found in the average scores on the scale according to the sex of the children, with girls showing a higher level of self-concept than boys. Participants scored higher on Factor 1, family attachment, followed by Factor 3, feelings, with the values of both these factors decreasing with age. On the other hand, lower average scores were found for Factor 2, environment, and Factor 4, autonomy. It was found that self-concept was higher in young children (five-year-old children) as well as in those who studied in rural areas. Finally, guidelines for improvement were provided. Self-concept is a fundamental aspect of personality, but it is not innate; it develops and evolves. Full article

Climate change is a significant threat, and insurance can provide a significant impulse to provide systemic responses. While several normative frameworks for sustainable business models have been developed, it is still unclear what customers expect and how companies should actually act in their specific business environments. We investigated customer expectations in the context of Swiss retail insurance and found that less than a fifth of customers consider sustainability a very important factor in their next purchase decision, and that core customers in the 35–54 age range are comparatively less concerned about sustainability in general. Customers place most value on social rather than environmental issues. Insurers should improve their efforts in the core business, especially regarding sustainable claims handling, rather than regarding investment management or their own footprint. On the other hand, more than 40% of customers do not feel they know enough to have an opinion about their insurer’s efforts toward sustainability, and there were no significant differences in customer perceptions among the different insurers. These results should have profound implications for communication, business model development, and business transformation efforts for insurers. They also provide important missing detail about customer expectations regarding sustainability in the academic literature. Full article

This paper discusses the domain of do-it-yourself (DIY) biomaterials applied to design, by analysing aims, speculative value and aesthetics emerging from this encounter. From a transdisciplinary perspective, the convergence of postanthropocentric philosophies with systematic experiments in two different laboratories, located in Italy and China, demonstrates how design practices can contribute to new forms of human–nature relationships, highlighting a pluriverse way to understand life. Because of the dual approach of philosophical theories and hands-on experiments, biomaterials become tangible tools which change the very idea of “designed objects”: they assign to artefacts circular, living, and integrated properties, thereby placing them within the notion of an ecosystem. Nevertheless, beyond bio-based properties, the three most interesting qualities emerging from this theoretical–practical study are (1) 1:1 scale of production, (2) organic-formless aesthetic, and (3) multispecies coexistence. We argue that through such a model of bioproduction, the designer can assume the role of catalyst for a postanthropocentric vision, dismantling the feeling of separation, alterity, and not-belonging between the human and the nonhuman, between objects and organisms. Full article

This study aimed to examine the relation between the feeling of meaningfulness and also the characteristics of engaged participation (namely, the frequency of participation in voluntary groupings) and the level of anxiety among those who train a group of elite taekwon-do fighters. The research encompassed 58 people, all of whom were taekwon-do ITF (International Taekwon-do Federation) athletes at an elite level. The Questionnaire of Life Orientation (SOC-29) and the Inventory of the State and Features of Anxiety were used. The data were supplemented by the authors’ own questions referring to activities in the field of taekwon-do. The group of taekwon-do fighters chosen was internally divided with regard to the level of the state of anxiety and the feeling of meaningfulness (p < 0.01). It was found that, together with the growth in the values stipulated in the accepted model, the frequency of taekwon-do groupings (β = −0.38), as well as the feeling of meaningfulness (β = −0.31), the value of the level of intensification of the state of anxiety dropped. The data revealed that, together with age, the level of anxiety decreased and the feeling of meaningfulness increased. The difference in the levels of anxiety between women and men was statistically non-significant (p > 0.05). The research findings illustrate that the feeling of meaningfulness and participation in groupings constitute a differentiating factor in terms of the intensification of the average level of anxiety in the elite taekwon-do group. More frequent participation in training goes hand-in-hand with the greater feeling of meaningfulness; perhaps, this is associated with the specific training, which, among other factors, favours adaptation to challenges and actions under pressure. Full article

We investigated the effect of arm pivot joints that are typically used during haptic exploration by evaluating four joints of the human arm (metacarpophalangeal joint of the index finger, wrist, elbow, and shoulder joints). Using a virtual stiffness discrimination task, a four-session psychophysical experiment was conducted with 38 participants (25 male and 13 female); each session was conducted with one of the four joints as the pivot joint during haptic exploration. The participants were asked to judge the stiffness of the top surface of two computer-generated cylinders by determining the stiffer one while using their dominant hand’s index finger. A two-alternative forced-choice procedure was employed by assigning one cylinder a constant stiffness value of 1.0 N/mm (standard side) and the remaining cylinder a variable stiffness value (comparison side). Using a custom-made stylus for the Geomagic TouchTM (3D Systems, Inc., Rock Hill, SC, USA) haptic interface, the participants were able to feel the stiffness of these virtual surfaces only with their index fingers. It was observed that the average Weber fraction monotonically decreased as the pivot joint shifted toward the torso (i.e., a shift from the metacarpophalangeal joint to the shoulder joint); this decrease was not statistically significant, which suggests that the selection of the pivot joint was not a determining factor for the sensitivity to discriminate stiffness. In general, the palpation speed and force exerted by the participants on the standard side during the haptic exploration showed a tendency to increase when the pivot joint shifted toward the torso; the difference in average palpation speed and force across the pivot joints was not statistically significant. Full article