BACKGROUND AND OBJECTIVES

The global pandemic caused by Coronavirus Disease 2019 (COVID-19) has affected millions, with growing evidence of the potential role of ocular tissues in viral transmission. At the time of writing, local data regarding the phenomenon was limited. This study investigated external ocular manifestations in patients with COVID-19 at a referral center in the Philippines, examined correlations between demographics, systemic manifestations, and laboratory results with ocular manifestations, and determined their timing relative to systemic symptoms.

METHODS

This single-center, descriptive cross-sectional study was carried out from December 8 to 18, 2020 at the adult COVID-19 wards of the Philippine General Hospital involving 72 participants. Data collection involved relevant clinical history taking and performing gross eye examination. The prevalence of ocular manifestations was described with 95% confidence intervals. Correlations between ocular manifestations and quantitative variables were analyzed with point-biserial correlation, and associations with qualitative variables were tested using chi-square or Fisher’s exact tests.

RESULTS

Among participants, 31.9% presented with ocular manifestations with foreign body sensation as the most prevalent ocular symptom (11.1%) and conjunctival hyperemia as the most prevalent ocular finding (19.4%). The median age of patients with ocular manifestations was 41 years old with a higher prevalence in the male population (73.9%, CI=95%, p=0.001). No significant correlation was observed between presence of external ocular manifestations and the different systemic and ocular co-morbidities as well as with COVID-19 clinical classification. Among those who experienced symptoms, majority (29.2%) of the patients experienced systemic symptoms prior to the onset of ocular symptoms. Ocular complaints may present as the sole manifestation (13.9%). Several laboratory parameters were measured and only temperature and AST levels showed a low positive correlation with the presence of ocular manifestations. 

CONCLUSION

Ocular manifestations occur in roughly one third of patients with COVID-19 based on this study population. With some individuals presenting with ocular signs or symptoms as the initial and sole manifestation, healthcare practitioners must exercise caution and remain vigilant in managing patients who present as such. At the time of writing, this is the first local study investigating the different external ocular manifestations in patients with COVID-19. There is a need to pursue more robust studies and conduct more local investigations which will guide both ophthalmologists and other practitioners in strengthening existing guidelines regarding precautionary practices, clinical diagnosis, and management of COVID-19 patients.

Human ; Sars-cov-2 ; Covid-19 ; Philippines ; Adult ; Association ; Classification ; Collection ; Confidence Intervals ; Coronavirus ; Cross-sectional Studies ; Data Collection ; Demography ; Diagnosis ; Disease ; Exercise ; Eye ; Foreign Bodies ; History ; Hospitals ; Hospitals, General ; Hyperemia ; Laboratories ; Male ; Morbidity ; Ophthalmologists ; Pandemics ; Patients ; Population ; Prevalence ; Referral And Consultation ; Role ; Sensation ; Temperature ; Time ; Tissues ; Volition ; World Health Organization ; Writing

Academic publishing is at a critical juncture. The challenges faced by the academics are mired in controversy. Among theseare three hotly debated concerns. First is the issue of whether technological innovations such as artificial intelligence (AI)improves research efficiency or if its use sacrifices research integrity.Another is the controversy between paywall publishingand open access. Lastly, adapting an appropriate business model for sustainability is a contentious issue and the choice betweena commercial or a university-based publishing platform is a difficult one.

Traditional models of scientific investigation relied on tedious intellectual calisthenics in all aspects of research —identifying research gaps, reviewing of published literature, devising valid methodology, collecting data, analysing results, and,finally, drawing conclusions. With the advent of powerful tools employing artificial intelligence, these heavy tasks are efficientlycarried out. The dilemma lies in determining which parts of the work can be attributed to the authors and which are ascribedto the output of large language models (LLMs) and other automated assistance employed.Despite requiring adequate vettingby experts of these AI-aided output, many in the scientific community still question these methods. Can research employingAI be considered honest work? Will full disclosure answer doubts as to the integrity of the scientific work?

Indeed, LLMs just gather information that is already out there, albeit more efficiently. After all, science progresses bystanding on the shoulder of giants. AI makes such work comprehensive and efficient. Standing on those proverbial shoulders,however, require access to prior work, hence our next challenge in academic publishing--open access versus paid access.Paywalls limit the benefits of valuable research to institutions and universities with the capacity to pay. Excluded from these arethose from low resourced countries, with nations from the global south being affected disproportionately. Additionally, whilenumerous authors appreciate the features of open access as it improves their impact and visibility, many feel unduly burdenedsince the cost of publishing in this format is passed on to them.

This brings us to our third issue: who bears the cost of academic publishing? Indeed, it is a lucrative industry, generatingan annual revenue of US$19 billion and an estimated 40 percent profit margin. Many, however, find fault in this businessmodel as concerns about the profit motives of the commercial publishers far overshadow their sustainability goals.

How do we navigate this landscape of controversies? We, at the ACTA, as part of the community of scholars, would needto clarify our mission. Our goals for this publication should be consistent with our values. These values, such as scientific rigor,integrity, and accountability, should be reflected in our policies. We should be cognizant of the role we play in national scientificdiscourse while we endeavor to make an impact in the global scene. We are accountable to our stakeholders — nurturingearly career scholars, supplying evidence to health policymakers, and being accountable to those who provide resources tosustain us. This stewardship is essential so that ACTA will stand shoulder to shoulder with the giants on which science buildsupon to benefit future generations.

Artificial Intelligence ; Commerce ; Costs And Cost Analysis ; Disclosure ; Drawing ; Efficiency ; Family Characteristics ; Forecasting ; Goals ; Gymnastics ; Health ; Health Resources ; Industry ; Intelligence ; Inventions ; Language ; Literature ; Methods ; Play And Playthings ; Policy ; Publications ; Publishing ; Research ; Residence Characteristics ; Role ; Science ; Shoulder ; Social Responsibility ; Universities ; Ursidae ; Volition ; Work ; World Health Organization

OBJECTIVES

Patients undergoing modified radical mastectomy (MRM) often experience significant preoperative anxiety. Effective preoperative education could alleviate anxiety and improve patient outcomes. This research aimed to evaluate whether audiovisual aids during preoperative education correlated with decreased anxiety levels among female MRM patients, and it also aimed to investigate if enhanced preoperative education could lead to reduced anxiety and improved postoperative outcomes.

METHODS

A randomized controlled trial was conducted comparing anxiety levels in MRM patients receiving audiovisual aids versus verbal instructions. Purposive sampling selected female breast cancer patients scheduled for MRM. Data was collected using pre- and post-intervention questionnaires, and statistical analysis was used to test hypotheses.

RESULTS

There was no significant difference in pre-intervention anxiety levels between the control group (mean = 2.77 ± 0.32) and the experimental group (mean = 2.49 ± 0.27; t = 1.49, p = 0.176), indicating comparable baseline anxiety between groups. Following the intervention, the experimental group exhibited a significant reduction in anxiety (mean = 1.83 ± 0.20) compared to the control group (mean = 2.59 ± 0.16; t = 2.79, p = 0.046). Pearson correlation analysis revealed a moderate negative correlation between the use of audiovisual aids and preoperative anxiety levels (r = –0.643, p = 0.017), suggesting that audiovisual education was significantly associated with reduced preoperative anxiety among patients scheduled for MRM.

DISCUSSION

The study found that audiovisual aids significantly reduced anxiety levels in the experimental group but had no effect on the control group. This suggested that such interventions could be effective in reducing preoperative anxiety, particularly in females undergoing MRM. However, further research with larger and more diverse samples was needed to confirm these findings and explore influencing factors in clinical settings

CONCLUSION

The study findings suggested that incorporating audiovisual aids in preoperative education for MRM effectively reduced anxiety levels, warranting further research with larger and more diverse participant groups to validate these results

Human ; Female ; Adult: 25-44 Yrs Old ; Middle Aged: 45-64 Yrs Old ; Audiovisual Aids ; Breast Neoplasms ; Control Groups ; Neoplasms ; Mastectomy, Radical ; Mastectomy, Modified Radical ; Volition ; Female ; Breast ; Acquired Immunodeficiency Syndrome

OBJECTIVES

To determine if there is a difference in the prevalence of abnormal spirometry in female adult residents of OLBAC who have significant and nonsignificant exposure to biomass fuel smoke

METHODS

A convenience sample of 54 adult female residents of OLBAC in San Mateo, Rizal, will be recruited in this analytical cross-sectional study. After enrollment, they will undergo a single spirometry procedure to determine their lung function status. The primary data to be collected from the experimental groups are FEV1, FVC and FEV1/ FVC ratio. The data will undergo descriptive and inferential analysis, and the lung function variable will be analyzed with logistic regression to account for confounding variables.

EXPECTED RESULTS

The descriptive data analysis will determine the mean values of lung function parameters (FEV1 and FVC) where long exposures may lead to an abnormal FVC compared to short or no exposure. The results in the inferential analysis may indicate a negative association between length of biomass fuel exposure and percentage predicted FVC among the sample, suggesting that more prolonged exposure to biomass fuel increases the risk of impaired lung function.

CONCLUSION

 

Human ; Female ; Adult: 25-44 Yrs Old ; Young Adult: 19-24 Yrs Old ; Adult ; Biomass ; Cross-sectional Studies ; Female ; Logistic Models ; Regression (psychology) ; Smoke ; Volition ; World Health Organization ; Spirometry

PURPOSE: This study aimed to identify factors associated with maternal attachment of breastfeeding mothers, with a focus on the mothers' breastfeeding characteristics. METHODS: Data were collected from 217 mothers who breastfed their healthy baby for 1 month after childbirth and had no postpartum complications. The data were analyzed by hierarchical regression analysis. RESULTS: The factors significantly associated with maternal attachment were an emotional exchange with one's baby (β=.41, p < .001), breastfeeding confidence (β=.20, p=.022), depression (‘quite a bit or more’, β= −.18, p=.005), and depression (‘a little’, β=−.14, p=.024). The model explained 38.4% of variance in maternal attachment. CONCLUSION: In order to improve attachment, nurses should be actively supported in helping mothers in the first month postpartum adapt to breastfeeding. Interventions to prevent postpartum depression should also be conducted.
Adaptation, Psychological ; Breast Feeding* ; Depression ; Depression, Postpartum ; Female ; Humans ; Mother-Child Relations ; Mothers* ; Object Attachment ; Parturition ; Postpartum Period ; Volition

OBJECTIVE: This study examined the factors affecting the satisfaction of emergency medical services in capital and non-capital areas. METHODS: Descriptive and logistic regression analysis was performed using the data from the 2014 Korea Health Panel Survey. RESULTS: Patients who resided in capital areas were likely to be more satisfied than those who resided in non-capital areas. In capital and non-capital areas, post-of-service action was an influential factor. Capital area patients, who were transferred to other hospitals instead of being admitted or returned to their homes, reported less satisfaction. In non-capital areas, delayed emergency room arrival that was self-perceived was also an influential factor. Moreover, patients who were transferred to other hospitals instead of being returned to their homes reported less satisfaction. CONCLUSION: In both capital and non-capital areas, the satisfaction of emergency medical services can be increased by avoiding transferring patients to other hospitals. For Koreans to be satisfied with emergency medical services, efficient and rapid emergency medical services will e needed to avoid delays in emergency room arrivals, particularly in non-capital areas.
Emergencies ; Emergency Medical Services ; Emergency Service, Hospital ; Humans ; Korea ; Logistic Models ; Volition

PURPOSE: The purpose of this study was to assess current levels of awareness of clinical trials (CTs), perceptions regarding their benefits and willingness to participate to CTs among Korean cancer patients. MATERIALS AND METHODS: From December 2012 to August 2015, we distributed questionnaires to cancer patients receiving systemic anti-cancer therapy at Seoul National University Hospital, Seoul, Korea. RESULTS: A total of 397 out of 520 requested patients (76.3%) responded to the survey. Among the 397 patients, 62.5% were female and the median age was 52 years. Overall, 97.4% (387/397) answered that they have at least heard of CTs. When asked about their level of awareness, 23.8% (92/387) answered that they could more than roughly explain about CTs. The average visual analogue scale score of CT benefit in all patients was 6.43 (standard deviation, 2.20). Patients who were only familiar with the term without detailed knowledge of the contents had the least expectation of benefit from CTs (p=0.015). When asked about their willingness to participate in CTs, 56.7% (225/397) answered positively. Patients with higher levels of awareness of CTs showed higher willingness to participate (p < 0.001). Heavily treated patients and patients with previous experience regarding CTs also showed a higher willingness to participate (p < 0.001). The perceived benefit of CTs was higher in the group willing to participate (p=0.026). CONCLUSION: The patient’s level of awareness regarding CTs was positively related to the positive perception and willingness to participate. Although the general awareness of CTs was high, a relatively large proportion of patients did not have accurate knowledge; therefore, proper and accurate patient education is necessary.
Female ; Humans ; Korea ; Patient Education as Topic ; Seoul ; Volition

PURPOSE: The purpose of this study was to define and clarify the concept of volition for health behavior. METHODS: For this study the process of Walker & Avant’s concept analysis was used. Seventeen studies from electronic data basses met criteria for selection. RESULTS: Volition can be defined by the following attributes: 1) planning, 2) maintenance of self-efficacy, and 3) self regulation. The antecedents of volition consisted of: 1) risk awareness, 2) outcome expectation, 3) perceived self-efficacy, and 4) social support. The consequences occurring as a result of volition were: 1) prevention of disability and complications, 2) improvement of functional ability, and 3) enhencement of quailty of life. CONCLUSION: Definition and attributes of volition identified by this results can be applied to develop measurements and intervention programs for chronic patients health behavior.
Bass ; Chronic Disease* ; Health Behavior* ; Humans ; Self-Control ; Volition* ; Walkers

PURPOSE: This study is a qualitative research to identify new nurses' adaptation experience to sleep changes. METHODS: Grounded theory methodology was utilized. Participants were 10 new nurses from one university hospital. The information was collected and analyzed using the grounded theory of Corbin and Strauss'(2008). RESULTS: Through constant comparative analysis, central phenomenon was identified as 'Shaky daily life due to the sleep change'. A core category emerged as 'In the shaky daily life, go grab my position', Causal conditions were 'Heaviness in shift work', 'Not released after getting off work', and 'Body and mind are exhausted'. Context were 'An environment that does not tolerate mistakes' and 'Clogged breathing due to worries'. Intervening factors were 'Support of colleagues', 'Recovery volition in restoration of altered relationships due to sleep'. Action/Interaction Strategies were 'To strive for a good sleep', 'Require a reasonable duty schedule' and 'Find a breakthrough'. Consequences were 'Become the master of shaky daily life' and 'Accepting the life of a nurse'. CONCLUSION: New nurses experience sleep patterns changes from the hospital shift system. but throughout the process of adaptation, came to accept sleep disorder as part of the life of a nurse.
Qualitative Research ; Respiration ; Volition

Wilson's disease is an inherited disease of copper metabolism leading to the toxic accumulation of copper, primarily in the liver and brain. Although the literature shows successful outcomes after proper treatment, pregnant patients with Wilson's disease still need close monitoring and management. Here, we report the case of a successful pregnancy in a Korean woman with Wilson's disease. A 33-year-old primigravid patient with Wilson's disease visited our antenatal clinic. Of her own volition, she had stopped her medication 2 years earlier. Oral zinc oxide therapy was started, and she was closely monitored throughout her pregnancy. She delivered a healthy female infant weighing 3.13 kg through a cesarean section. After delivery, the clinical course of both the mother and the baby were uneventful. We review crucial points in the treatment and the management dilemmas raised by the patient.
Adult ; Brain ; Cesarean Section ; Copper ; Female ; Hepatolenticular Degeneration* ; Humans ; Infant ; Liver ; Metabolism ; Mothers ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Volition ; Zinc ; Zinc Oxide