Patient Perceptions and Experiences With Maggot Debridement Therapy for Managing Chronic Wounds.

PURPOSE: The purpose of this study was to describe patient experiences and satisfaction with use of maggot debridement therapy (MDT) for hard-to-heal wounds. DESIGN: Descriptive, cross-sectional study. SUBJECTS AND SETTING: The sample comprised 60 participants, 60% were male (n = 36). Their mean age was 62.9 (SD = 20) years. Almost half of participants had lower extremity wounds (n = 26; 43.3%), diabetic foot ulcers (n = 18; 30%), and pressure injuries (n = 9; 15%). Most received maggot therapy via biobags (n = 36; 60%). METHODS: Participants completed a questionnaire designed for purposes of the study that queried demographic and pertinent clinical characteristics, current health status including current topical therapies, and duration of their chronic wound. Nine items queried emotional responses prior to MDT, the amount and method of the maggot therapy, discomfort experienced during therapy, and sources of information regarding this treatment. RESULTS: Emotional responses before starting MDT included disgust (n = 30, 50%), anxiety (n = 26, 43.3%), doubts about its effectiveness (n =20, 33.3%), and disbelief (n = 11, 18.3%). Approximately one-third of participants reported feelings of biting, itching, and fear of the maggots. Despite these feelings, a majority (n = 38, 63.3%) indicated that they were pleased with treatment outcome and willing to undergo additional MDT if needed. CONCLUSIONS: While a majority of participants with nonhealing chronic wounds reported negative emotions association with MDT, more than half indicated that they were pleased with the outcome of treatment and willing to undergo repeat treatment if indicated.

Food perception promotes phosphorylation of MFFS131 and mitochondrial fragmentation in liver.

Liver mitochondria play a central role in metabolic adaptations to changing nutritional states, yet their dynamic regulation upon anticipated changes in nutrient availability has remained unaddressed. Here, we found that sensory food perception rapidly induced mitochondrial fragmentation in the liver through protein kinase B/AKT (AKT)-dependent phosphorylation of serine 131 of the mitochondrial fission factor (MFFS131). This response was mediated by activation of hypothalamic pro-opiomelanocortin (POMC)-expressing neurons. A nonphosphorylatable MFFS131G knock-in mutation abrogated AKT-induced mitochondrial fragmentation in vitro. In vivo, MFFS131G knock-in mice displayed altered liver mitochondrial dynamics and impaired insulin-stimulated suppression of hepatic glucose production. Thus, rapid activation of a hypothalamus-liver axis can adapt mitochondrial function to anticipated changes of nutritional state in control of hepatic glucose metabolism.

Understanding mechanisms behind the oily mouthcoating perception of pure vegetable oils using tribology.

Tribology is the science of measuring friction between surfaces. While it has been widely used to investigate texture sensations of food applications, it is seldom applied in pure edible oil systems. In this research, we measured friction, viscosity, and solid fat content (SFC) of nine vegetable oils at 30 and 60°C. Polarized static microscopy was used to assess crystal formation between 60 and 30°C. Descriptive sensory analysis and quantification of oral oil coatings were performed on the oils at 60°C. Expressing the friction factor of oil over the Hersey number (calculated using high sheer-viscosity values) showed no differences in friction between 30 and 60°C, except for shea stearin. Static microscopy revealed crystallization occurred at 30°C for shea stearin, whereas no or few crystals were present for other oils. At 30°C, friction at 1 × 10-2 m/s showed an inverse correlation with SFC (R = -0.95) and with high shear rate viscosity (R = -0.84), as well as an inverse correlation (R = -0.73) with "oily mouthcoating" perception. These results suggest that friction could be a predictor of fat-related perceptions of simple oil systems. Additionally, we hypothesize that the presence of crystals in oils could lower friction via a ball-bearing lubrication mechanism.

Nurse assistants' perception of caring for older persons who are dying in their own home : An interview study.

BACKGROUND: As the proportion of older persons in society increases, there is a growing trend towards providing end-of-life care in their homes. Palliative care is a complex and knowledge-demanding form of care, and nurse assistants are those who work closest to the older person at the end-of-life in their own homes. However, nurse assistants sometimes have low educational and insufficient levels of knowledge in palliative care, which can affect the quality of care they provide. Moreover, nurse assistants' experiences are relatively unexplored in this context. The purpose of the study was to illuminate nurse assistants' experiences in caring for dying older persons at home. METHOD: An empirical, qualitative interview study was conducted with 14 nurse assistants with experience of palliative care in homecare. The material was analyzed using thematic content analysis. RESULTS: From the nurse assistant's experiences, one main theme emerged: doing everything possible for the dying older person despite challenges. Moreover, three sub-themes emerged: making a difference at a crucial time, death awakens emotions, and balancing personal and professional relationships. The nurse assistants' saw their role primarily as relieving symptoms but also focusing on next of kin. The following are described as essential parts of their role: carrying out practical nursing tasks, focusing on the physical environment, working alone and seeking help from colleagues due to a physical distance to the other members of the multidisciplinary team. The nurse assistants experienced a lack of support as there was no structured guidance or debriefing available in difficult emotional situations. Furthermore, they disclosed that they were left alone to deal with their feelings. CONCLUSION: This study demonstrates that nurse assistants strive to provide comprehensive care for dying older persons despite facing obstacles from their working conditions and work organization. They lack supervision and education in palliative care, but they rely on their experience-based knowledge to a large extent and provide care according to the four cornerstones of palliative care.

Assessing the Impact of Urban Environments on Mental Health and Perception Using Deep Learning: A Review and Text Mining Analysis.

Understanding how outdoor environments affect mental health outcomes is vital in today's fast-paced and urbanized society. Recently, advancements in data-gathering technologies and deep learning have facilitated the study of the relationship between the outdoor environment and human perception. In a systematic review, we investigate how deep learning techniques can shed light on a better understanding of the influence of outdoor environments on human perceptions and emotions, with an emphasis on mental health outcomes. We have systematically reviewed 40 articles published in SCOPUS and the Web of Science databases which were the published papers between 2016 and 2023. The study presents and utilizes a novel topic modeling method to identify coherent keywords. By extracting the top words of each research topic, and identifying the current topics, we indicate that current studies are classified into three areas. The first topic was "Urban Perception and Environmental Factors" where the studies aimed to evaluate perceptions and mental health outcomes. Within this topic, the studies were divided based on human emotions, mood, stress, and urban features impacts. The second topic was titled "Data Analysis and Urban Imagery in Modeling" which focused on refining deep learning techniques, data collection methods, and participants' variability to understand human perceptions more accurately. The last topic was named "Greenery and visual exposure in urban spaces" which focused on the impact of the amount and the exposure of green features on mental health and perceptions. Upon reviewing the papers, this study provides a guide for subsequent research to enhance the view of using deep learning techniques to understand how urban environments influence mental health. It also provides various suggestions that should be taken into account when planning outdoor spaces.

Chinese physician perception on the treatment of chemotherapy-induced anemia: online cross-section survey study.

BACKGROUND: The management of chemotherapy induced anemia (CIA) remains challenging. The potential risk and benefits in providing patient-centered care need to be balanced; the disease is multifactorial; and the major treatments including red blood cell (RBC) transfusions, erythropoiesis-stimulating agents (ESAs) and intravenous injection (i.v.)iron supplementation have a unique set of strengths and limitations. Also, most previous survey based on the patient data could not reveal the process of evaluation and decision-making for CIA treatment from a physician's perspective. As the comparison of China Society of Clinical Oncology (CSCO), National Comprehensive Cancer Network (NCCN) and European Society of Medical Oncology (ESMO) guidelines, the standard of CIA treatment in China will vary from United States and Europe, for example, the initial hemoglobin (Hb) for RBC transfusions. In order to understand the diagnosis, treatment, and unmet medical needs of CIA patients, the China Medical Education Association (CMEA), in conjunction with Cancer Hope Medium, initiated the first national survey of Chinese physicians regarding the diagnosis and treatment of CIA. METHODS: The CMEA sent an online, 12-item questionnaire (via wjx.cn) to physicians across China from September 1, 2022 to October 22, 2022. Two hundred and sixty-five samples were calculated usingsurveyplanet.com. The questionnaire evaluated the impact of anemia on chemotherapy interruption, initial treatment, the target Hb level of CIA in, and the current status of ESAs prescription in clinical practice. Respondents were asked to score their reasons for not using ESAs (including safety issues, drug access in practice or adherence) and the risk options of the current treatment including ESAs, RBC transfusion, and i.v.iron. RESULTS: A total of 331 questionnaires among 5,000 web visits were gathered, covering 247 hospitals in 29 provinces across China, of which 130 (53%) were tier IIIA hospitals, 50 (20%) were tier III B hospitals, 59 (24%) were tier IIA hospitals, and 8 (3%) were tier II B hospitals. The frequency of chemotherapy dose delay/reduction due to anemia was 24% [standard deviation (SD) 49%]. Most responding physicians rated an initial Hb level for ESAs treatment to be 80 g/L, with a favorable Hb level for chemotherapy being 100 g/L (60%), which would not limit treatment availability. The majority (67.6%, n=221) of physicians who responded indicated that they had used ESAs for anemia correction, while the others (32.4%, n=106) reported never using them. CONCLUSIONS: This is the first study in conducting a large-scale survey on the diagnosis and treatment of CIA in China from a physicians' perspective. We found that in China, nearly one-quarter of patients undergoing chemotherapy with concurrent anemia may experience interruption of chemotherapy and that the initiation of anemia treatment is not adequately timed. In treating CIA, most physicians prioritize the completion of chemotherapy via Hb level over treating the symptoms of anemia.

The perception of fungi among Karajá indigenous children and adolescents from Brazil.

BACKGROUND: Environmental perception involves the interpretation and interaction of individuals with their surroundings, influenced by cultural, social, and individual factors. Analyzing the environmental perception of children and adolescents contributes to fostering awareness and ethical behavior toward the environment. Indigenous communities, such as the Karajá from Brazil, possess significant environmental knowledge due to their connection with nature, providing distinctive insights into biodiversity and natural interconnections. In this study, the perception of fungi among Karajá indigenous children and adolescents was investigated. METHODS: The study involved 229 elementary school students from the Macaúba, Fontoura and Santa Isabel do Morro communities, located on Bananal Island, Brazil. Students were encouraged to draw what they knew about fungi and answer where they learned about fungi and what name they give to these organisms. The drawings were analyzed considering seven categories. RESULTS: The term most used to refer to fungi was hedoro(u) (56%), followed by fungus (21%) and mushroom (11%). Most students said they had learned about fungi in nature (38%) and at school (36%). The most represented organisms were in fact fungi (93%), mainly being portrayed in nature (94%). Most participants did not attribute any ecological function to fungi (83%), although 16% of them recognized fungi as decomposers and 1% as phytopathogenic agents. Negative aspects, particularly food contamination, were more frequently represented (13%) than positive aspects (4%). The drawings identified two morphological types: mushrooms (87%) and mold (13%). Among these mushrooms, 68% possibly represent the Amanita muscaria species. CONCLUSIONS: Although the children and adolescents showed that they noticed the fungi around them, the group's concept and understanding were limited to the figure of the mushroom and the negative aspects related to food contamination. Strong association of the fungi with the A. muscaria is noteworthy, since it does not occur in the environment in which the participants live, suggesting that external stimuli, such as TV or the internet, can influence their perception more than the nature they are exposed to.

Negative Association of Lignan and Phytosterol Intake with Stress Perception during the COVID-19 Pandemic-A Polish Study on Young Adults.

BACKGROUND: There has been an increasing global prevalence of depression and other psychiatric diseases in recent years. Perceived stress has been proven to be associated with psychiatric and somatic symptoms. Some animal and human studies have suggested that consuming foods abundant in lignans and phytosterols may be associated with lower levels of stress, depression, and anxiety. Still, the evidence is not yet strong enough to draw firm conclusions. Thus, we investigated the association between dietary intake of these phytochemicals and the level of stress experienced by adult individuals. METHODS: Diet was assessed using self-reported 7-day dietary records. The intakes of lignans and phytosterols were estimated using databases with their content in various food products. The Perceived Stress Scale (PSS) was implemented to measure the level of perceived stress. A logistic regression analysis was used to test for associations. RESULTS: The odds of elevated PSS were negatively associated with dietary intake of total phytosterols, stigmasterol, and ß-sitosterol, with evidence of a decreasing trend across tertiles of phytochemicals. The analysis for doubling the intake reinforced the aforementioned relationships and found protective effects against PSS for total lignans, pinoresinol, and campesterol. CONCLUSIONS: Habitual inclusion of lignans and phytosterols in the diet may play a role in psychological health. To address the global outbreak of depression and other mental health issues triggered by stress, it is important to take a holistic approach. There is a need to develop effective strategies for prevention and treatment, among which certain dietary interventions such as consumption of products abundant in lignans and phytosterols may play a substantial role.

Patient perception of labor support behaviors provided by Finnish midwives.

BACKGROUND: Almost all births in Finland occur in hospitals, but the concept of labor support behavior is not well-known among Finnish midwives. OBJECTIVE: The primary aim was to increase perceived labor support as measured by BANSILQ. METHODS: This study was tailored to evaluate the impacts of short on-the-job training interventions for midwives (n=70) in labor support given to mothers. The training was conducted at one university hospital and and one regional hospital during 2012. The trainings were carried out twice at both hospitals to reach as many miwdwives as possible to participate. Two university hospitals-one regional and one central-were selected as controls. New mothers were asked to complete the Bryanton Adaptation of the Nursing Support in Labor Questionnaire (BANSILQ) in the postpartum wards at all the selected hospitals before the intervention (n=1500) and after the intervention (n=1500). The data were linked to the Finnish Medical Birth Register (MBR). As this is an in-job training intervention study and not a trial, it has not been registered in a trial registry. RESULTS: The response rate was 68% (n=1020) for the pre-intervention survey and 47% (n=704) for the post-intervention survey. At the regional-level intervention hospital, the mean length of the second stage of childbirth decreased significantly. A bonding time of at least three minutes was three times more likely at both intervention hospitals. Support for breastfeeding was twice as likely at the university-level hospital after the intervention. In all the study hospitals, mothers with less education were more likely to receive tangible and informal support than highly educated mothers. CONCLUSIONS: This short on-the-job intervention did not increase labor support provided by Finnish midwives in its entirety, and the effect on birth outcomes was minimal. However, support for breastfeeding increased, and some types of support were targeted at those who needed it most. To improve midwifery care, both training and sufficient resources are needed.

Association of personal and systemic factors on intrapartum risk perception and obstetric intervention rates: a cross-sectional study.

BACKGROUND: Risk perception is fundamental to decision-making; therefore its exploration is essential to gaining a comprehensive understanding of the decision-making process for peripartum interventions. The aim of this study was to investigate associations between personal and systemic factors of the work setting and the risk perception of obstetric healthcare professionals, and in turn how this might influence decisions regarding obstetric interventions. METHODS: Case vignettes were used to measure risk perception. A quantitative cross-sectional online survey was performed within an exploratory sequential mixed-methods design, and an intervention readiness score created. Associations were calculated using location and dispersion measures, t-tests and correlations in addition to multiple linear regression. RESULTS: Risk perception, as measured by the risk assessment score, was significantly lower (average 0.8 points) for midwives than for obstetricians (95%-CI [-0.673; -0.317], p < .001). Statistically significant correlations were found for: years of experience and annual number of births in the current workplace, but this was not clinically relevant; hours worked, with the groups of participants working ≥ 30,5 h showing a statistically significant higher risk perception than participants working 20,5-30 h (p = .005); and level of care of the current workplace, with the groups of participants working in a birth clinic (Level IV) showing a statistically significant lower risk perception than participants working in Level I hospital (highly specialised obstetric and neonatal care; p = .016). The option of midwife-led birthing care showed no correlation with risk perception. The survey identified that risk perception, occupation, years in the profession and number of hours worked (i.e. full or part time) represent significant influences on obstetric healthcare professionals' willingness to intervene. CONCLUSIONS: The results of the survey give rise to the hypothesis that the personal and systemic factors of professional qualification, occupation, number of hours worked and level of acuity of the workplace are related to the risk perception of obstetric healthcare professionals. In turn, risk perception itself made a significant contribution to explaining differences in willingness to intervene, suggesting that it influences obstetricians' and midwives' decision-making. Overall, however, the correlations were weak and should be interpreted cautiously. The significant variations in the use of interventions must be addressed in order to provide the highest quality and best possible care for childbearing women and their families. To this end, developing strategies to improve interdisciplinary relationships and collaboration is of great importance. TRIAL REGISTRATION: German Clinical Trials Register DRKS00017172 (18.06.2019).

Perceptions of adult intensive care unit patients regarding nursing presence and their intensive care experiences: A descriptive-correlational study.

AIMS AND OBJECTIVES: This study aims to determine the relationship between perceptions of nursing presence and intensive care experiences in adult intensive care unit patients'. BACKGROUND: Intensive care units (ICUs) are settings where patients have many negative emotions and experiences, which affect both treatment and post-discharge outcomes. The holistic presence of nurses may help patients turn their negative emotions and experiences into positive ones. DESIGN: A descriptive-correlational design was used and reported according to the STROBE checklist. METHODS: The sample consisted of 182 participants. Data were collected using a personal information form, the Glasgow Coma Scale (GCS), the Intensive Care Experience Scale (ICES), and the Presence of Nursing Scale (PONS). RESULTS: A strong positive correlation existed between total ICES and PONS scores (r = 0.889, p < 0.001). There was a strong positive correlation between PONS total score and ICES subscales (awareness of surroundings (r = 0.751, p < 0.001), frightening experiences (r = 0.770, p < 0.001), recall of experience (r = 0.774, p < 0.001), and satisfaction with care (r = 0.746, p < 0.001)). Males (ß = -0.139, p < 0.05), and patients who were university and higher education graduate (ß = 0.137, p < 0.05) had higher positive ICU experiences. It was also found length of ICU stay was correlated with ICU experiences and nursing presence. CONCLUSIONS: The more positively the patients perceive nurses, the better ICU experiences they have. Gender and education level were found determinants of adult ICU patients' experiences. ICU length of stay predicted what kind of experience patients have and how much they feel the presence of nurses. RELEVANCE TO CLINICAL PRACTICE: Nurses should make their presence felt completely and holistically by using their communication skills for patients have more positive intensive care experiences. Nurses should consider variables which affects patients' ICU experiences and nursing presence.

Older adults' perceptions and experiences of interprofessional communication as part of the delivery of integrated care in the primary healthcare sector: a meta-ethnography of qualitative studies.

BACKGROUND: Communication between patients and healthcare providers, and effective interprofessional communication, are essential to the provision of high-quality care. Implementing a patient-centred approach may lead to patients experiencing a sense of comfort, validation, and active participation in own healthcare. However, home-dwelling older adults' perspectives on interprofessional communication (IPC) are lacking. The aim is therefore to explore how home-dwelling older adults experience communication in connection with the delivery of integrated care. METHODS: The meta-synthesis was conducted in line with Noblit and Hare's seven phases of meta-ethnography. A systematic literature search was conducted by two university librarians in seven databases using the search terms 'older adults', 'communication', 'integrated care' and 'primary care'. All articles were reviewed by two authors independently. 11 studies were included for analysis. RESULTS: Older adults are aware of IPC and have preferences regarding how it is conducted. Three main themes were identified in the reciprocal analysis: (1) Inconsistent care perceived as lack of IPC, (2) individual preferences regarding involvement and awareness of IPC and (3) lack of IPC may trigger negative feelings. CONCLUSIONS: This meta-ethnography shows the perspective of older adults on IPC as part of integrated care. Our study shows that older adults are concerned about whether healthcare personnel talk to each other or not and recognise IPC as fundamental in providing consistent care. The perspectives of older adults are relevant for clinicians and politicians, as well as researchers, when developing and implementing future integrated care services for home-dwelling older adults.

Medical clowning in hospitals: practices, training and perception.

Previous studies on medical clowning focused on patients, while research remains inadequate concerning clowning itself: training programmes and prerequisite requirements, clowning methods, deontology and accepted practices. Diverse approaches and paradigms in this field of complementary medicine are promoted by non-profit organisations worldwide. Based on an ethnographic study, we explore the current forms of medical clowning in 5 Israeli hospitals. The observed clowns are from the two Israeli organisations, Dream Doctors and Simchat Halev (in Hebrew: joy of the heart), consisting of paid professional medical clowns and volunteers, respectively. According to the findings, significant differences were observed to exist between the organisations. Dream Doctors is conceived and pursued as an expertise practised by performance art professionals, requiring extensive training. These clowns work unaccompanied, receive a salary, are considered members of the medical team, and, given their privileged status, have access to hospitals' open and closed areas. The Dream Doctors consider medical clowning as a paramedical practice, in which interventions are individually suited to the circumstances of each patient, and obtain therapeutic results. In contrast, Simchat Halev's medical clowns are volunteers with no prerequisite artistic background and undergo shorter periods of training. The access granted to these clowns, usually working in pairs, is restricted to open areas. Simchat Halev promotes medical clowning as a volunteer-based public practice, offering general entertainment to all patients indiscriminately, and their contribution is characterised as achieving basic entertainment value.

Effect of a Spiritual Care Training Program to Build Knowledge, Competence, Confidence and Self-awareness Among Australian Health and Aged Care Staff: An Exploratory Study.

The aim of this study was to evaluate a new spiritual care training program with health and aged care staff. A four-module program was delivered to 44 participants at a large Catholic health and aged care provider in Australia. Pre, post and 6 week follow-up surveys were administered and included measures of spiritual care competency, confidence, perspectives of spirituality and spiritual care, spiritual well-being, and satisfaction. Paired sample t-tests showed total scores of participants' spiritual well-being, spiritual care competency and confidence significantly improved following the training and were largely maintained at follow-up. Perspectives on spirituality and spiritual care did not significantly change over time.

Antiviral Effects and Mechanisms of Green Tea Catechins on Influenza: A Perception on Combating Symptoms from COVID-19.

Over the centuries, influenza and its associated epidemics have been a serious public health problem. Although vaccination and medications (such as neuraminidase inhibitors) are the mainstay of pharmacological approaches to prevent and treat influenza, however, frequent mutations in the influenza genome often result in treatment failure and resistance to standard medications which limit their effectiveness. In recent years, green tea catechins have been evaluated as potential anti-influenza agents. Herein, in this review, we highlighted the effects and mechanisms underlying the inhibitory effects of epigallocatechin 3-gallate (EGCG), the most abundant ingredient in green tea, against different influenza viral infections, and their clinical benefits toward prevention and treatment. In addition, as the severe acute respiratory syndrome coronavirus 2 (SARSCoV- 2) causes the outbreak of COVID-19 pandemic, our review also delineates the current perspective on SARS-CoV-2 and future insights as to the potential application of EGCG on suppressing the flu-like symptoms caused by COVID-19.

Observation on the Application Effect of Stressor Perception and Response Meticulous Nursing in the Perioperative Period of Acute Myocardial Infarction.

Objective: To investigate the clinical value of stressor perception-based meticulous nursing measures during the perioperative period of percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI). Methods and Design: A prospective randomized trial was conducted involving 104 AMI patients undergoing PCI from March 2021 to March 2022. Patients were divided into an "intervention group" and a "routine group" based on consultation numbers, with equal cases in each group. PCI procedures were performed by the same group of doctors in both groups and that basic treatment measures were similar. Intervention and Comparison: The intervention group received meticulous nursing measures based on stressor perception during the perioperative period, while the routine group received standard care. Outcome measures: The study compared treatment effects, perioperative sleep quality, negative emotion scores, and perioperative complication rates between the two groups. Results Overview: The patients in the intervention group and the conventional group were statistically similar in terms of operative time, X-ray fluoroscopy time, contrast agent dosage, catheter lab nurse preparation time, catheter lab-balloon dilation time, portal-ball time, and PCI success rate (P > .05). In the post-PCI assessment of negative emotions in both groups, the total scores of depression, anxiety, extroverted irritability, and negative emotion scores in the intervention group were higher than those in the routine group (P < .05). In the post-PCI assessment of sleep quality in both groups, subjective sleep quality score, sleep delay score, and total PSQI score in the intervention group were lower than those in the routine group (P < .05). The rate of surgical complications was 7.69% in the intervention group and 15.38% in the routine group, and the differences between the two groups were not statistically significant (P > .05). Conclusion: While meticulous nursing measures based on stressor perception did not notably enhance the effectiveness of PCI, they did significantly improve patients' negative emotions and sleep quality.

Medical students' perception of their 'distance travelled' in medical school applications.

INTRODUCTION: Within medical school's holistic review of applicants includes a review of their distance travelled to get to this point in their education. The AAMC defines distance travelled (DT) as, 'any obstacles or hardships you've overcome to get to this point in your education or any life challenges you've faced and conquered'. What medical students consider as their distance travelled has not been explored. The authors sought to identify the factors medical students perceive are important for medical school admissions to consider when assessing someone's 'distance travelled' by asking current medical students to share their DT experiences along with the barriers and facilitators they encountered on their medical school journey. METHODS: The authors conducted semi-structured interviews with US medical students through purposeful sampling methods. The social-ecological model framework was used to develop questions to elicit participants' experiences that contributed to their distance travelled. Interviews were conducted in 2021 and ranged from 60-75 minutes. Transcribed interviews were qualitatively analysed using interpretive description. RESULTS: A total of 31 medical students from seven medical schools were included in the study. Overall, participants defined distance travelled as an applicant's hardships (e.g. being the primary caregiver for a family member) and privileges (e.g. having physician parents) they experienced. Three major themes were identified: (1) individual-level characteristics and factors, (2) interpersonal relationships and (3) aspects of the participants' community and society. DISCUSSION: Our findings show that medical school applicants considered DT to be a valuable component of a holistic medical school admission process. Participants' experiences of DT were varied and complex. Our research suggests that admissions teams for medical schools should incorporate more comprehensive recruitment practices and inclusive methodological frameworks to accurately capture the diversity of identities and experiences of medical school applicants and to consider the factors that shape their journey to medical schools.

The relationship between perception of COVID-19, fear of COVID-19 and self-care management in individuals with chronic diseases during the pandemic process in Turkey.

AIMS: To determine the relationship between perception of COVID-19, fear of COVID-19 and self-care management in individuals with chronic diseases during the pandemic process. BACKGROUND: Individuals with chronic diseases are a sensitive group during the COVID-19 pandemic process; it is thought that self-care management may be adversely affected as a result of their more intense exposure to the psychological, physiological and economic effects of the pandemic. In the literature, there is no study examining the effect of perception of COVID-19 and fear of COVID-19 on self-care management in individuals with chronic diseases. DESIGN: Descriptive study. METHODS: The study was conducted with 322 individuals who applied to the internal medicine outpatient clinics of a university's Health Practice and Research Center, met the inclusion criteria, agreed to participate in the study and had a chronic disease. Questionnaire form, Perception of COVID-19 Scale (P-COVID-19), The Fear of COVID-19 Scale (FCV-19S) and Self-Care Management Process in Chronic Illness Scale (SCMP-G) were used to collect data. STROBE checklist was used to report the present study. RESULTS: In the study, it can be stated that individuals with chronic diseases had a moderate to the high perception of contagiousness and dangerousness of COVID-19, they had a moderate-high level of fear of COVID-19 and their self-care care management was above moderate level. There was a significant positive correlation between P-COVID-19, FCV-19S and SCMP-G in the study. CONCLUSIONS: It was found that the perception of COVID-19 contagiousness and the fear of COVID-19 had a positive effect on the self-care management of individuals with chronic diseases. RELEVANCE TO CLINICAL PRACTICE: Determining the level of COVID-19 perception and fear of COVID-19 and their effects on the life of the individual, and evaluating self-care management during the difficult pandemic process will increase the success in the holistic nursing care and management of chronic diseases.

Iron supplementation: A qualitative study on the perception of blood donors, blood collection staff and donor physicians.

BACKGROUND AND OBJECTIVES: Iron supplementation is an effective strategy to mitigate donation-induced iron deficiency in blood donors. However, evidence on the perception of individuals involved in blood donation on iron supplementation as a blood service policy is lacking. This study aimed to evaluate the knowledge and perception of whole blood donors (donors), blood collection staff (collection staff) and donor physicians (physicians) regarding donation-induced iron loss and iron supplementation. MATERIALS AND METHODS: Online focus group discussions had four to six participants and followed a structured questioning approach. All participants had to be fluent in Dutch to participate, and donors had donated at least five times. Sixteen donors, eight collection staff members and four physicians participated in this study. Recordings were transcribed, coded and analysed using a grounded theory approach. RESULTS: Awareness of donation-induced iron loss was limited in donors. Donors and physicians were predominantly positive towards iron supplementation; the primary motivator for donors was to prevent deferral and reduce iron-deficiency-related symptoms. Improving donor health was the main argument for physicians to advocate iron supplementation. Staff had a critical view on iron supplementation as a policy, as they perceived it as unethical and possibly ineffective. A knowledge gap might underlie their concerns. CONCLUSION: Most individuals involved in blood donation are positive towards iron supplementation as a blood service policy. If implemented, guidance and monitoring is desired and adequate education of all stakeholders is required.