bluuebunny/crossref_metadata_2025 huggingface dataset:
How do local authority plans to tackle obesity reflect systems thinking?
Authors: Taheem R , Woods-Townsend K , Lawrence W , Baird J , Godfrey KM , Hanson M
Published: July 2022

Aims:

A whole systems approach to tackling obesity has been recommended by Public Health England for several years. This qualitative study aimed to investigate whether systems thinking is reflected in local authority plans and strategies to tackle obesity, using the leverage points for intervention in a complex system, as a framework.

Method:

We sought to identify obesity strategies/plans for Southampton and 19 other local authority comparators (based on children’s services and Office for National Statistics data). A healthy weight strategy was available for 10 local authorities and a qualitative document analysis was undertaken. The policy actions proposed in the plans were coded against the leverage points for intervention in a complex system and themes were developed to characterise interventions in each category.

Results:

A majority of actions included in the plans were categorised as ‘Numbers, Constants and Parameters’ which reflect downstream measures. However, there were examples of actions that could act on higher leverage points. In addition, some local authority plans included interventions that could act on 10 of the 12 leverage points suggesting incorporation of systems thinking.

Conclusions:

Some local authority plans to tackle obesity do reflect systems thinking when viewed through the lens of the leverage points for intervention in a complex system. Interventions at higher leverage points should be prioritised by public health decision-makers, especially in a climate of competing agendas and limited resources.
Chinese Overseas Finance in Renewable Energy in Argentina and Brazil: Implications for the Energy Transition
Authors: Rubio Tatiana Gélvez , Jáuregui Juliana González
Published: July 2022

China began to accelerate the energy transition in the last decade as a strategy for rebalancing its economy and becoming a more influential actor in the global renewable energy market. This article explores to what extent Chinese investment and financing in renewable energy projects in Argentina and Brazil promote these countries' energy transition strategies and sustainable development more broadly. To approach this question, the article provides a reading of Ostrom’s postulates of the energy transition as an increasingly relevant driver of certain states’ relationships with other countries. General trajectories of Chinese investment and lending in Latin America provide a background to Chinese investment in solar and wind power projects in Argentina and Brazil. The article concludes that China’s overseas finance merges with Argentina and Brazil’s own goals regarding renewable energy deployment and discusses future challenges in the context of the COVID-19 pandemic and its aftermath.
Introduction: The role of nature in the Anthropocene – Defining and reacting to a new geological epoch
Authors: Höfele Philipp , Müller Oliver , Hühn Lore
Published: July 2022

In a paradigmatic selection, the Special Issue unites contributions from biology, sustainability research, psychology and philosophy as well as media science and literary studies. It aims to discuss to what extent and on what basis the concept of nature is treated in the Anthropocene discourse with new perspectives, intentions and narratives. Not only the possibly changed conditions for a definition of nature in the Anthropocene are questioned, but also the necessity of an inter- and transdisciplinary opening, which goes along with this questioning and its connection with theoretical and practical issues.
Sponsorship of Australian and New Zealand medical societies by healthcare companies: an observational study
Authors: Lexchin Joel
Published: July 2022

Summary

Objectives

To examine sponsorship of Australian and New Zealand medical societies by healthcare companies and whether societies have policies to deal with conflicts of interest.

Design

Cross-sectional study conducted in March 2022.

Setting

Australia and New Zealand

Participants

Medical societies in both countries.

Main outcome measures

The percent of medical societies that list sponsorship from healthcare companies on either their home webpages or the webpages of their annual meetings and/or that issue prospectuses to potential sponsors. The percent of societies with sponsorship that also have policies about their interactions with their sponsors. Whether societies feature their sponsors’ logos on their webpages and have hyperlinks to sponsors’ webpages and what percent of societies' annual revenue comes from sponsorships.

Results

Ninety-two medical societies were identified. Sixty-two had healthcare company sponsorship and 10 of the societies with sponsorship had policies to deal with interactions with their sponsors. Fifty-four societies displayed the logos of their sponsors on their home webpages and/or the webpages of their annual meetings. Only 6 societies provided enough information to calculate what percent of their revenue comes from sponsorships. For 5 of the 6 the percent was well below 50%.

Conclusions

The acceptance of sponsorships from healthcare companies by Australian and New Zealand societies is common and few societies have policies to deal with these relationships. In general, societies appear to get only a small percent of their annual revenue from sponsorships.
An Exploration of Students’ Attitudes Toward Employment Services in Private Schools: The Case of the Sanya Institute of Technology
Authors: Wang Kunqiang , Li Li , Li Jun (Justin) , Chen Huazheng , He Biao , Li Long
Published: July 2022

Providing long-term career coaching or counseling has become an increasingly important part of university life as the coronavirus pandemic rapidly sweeps across the world. Career coaching has become one of the most important drivers of revenue and enrollment growth in nongovernmental schools. However, little research has been carried out to evaluate the effectiveness of these long-term career coaching or counseling services. Accordingly, this study aims to use a mixed method approach to track and measure students’ satisfaction from private higher vocational colleges to identify opportunities for improving employment services. Students were asked how satisfied they were with employment services provided by this private vocational school. The results obtained lead us to suggest that private higher vocational colleges could strengthen the employability of graduates by providing a wide variety of enrichment activities and establishing a regular monitoring mechanism to evaluate perceptions of their engagement and educational experiences in the current coronavirus crisis.
Gujarat's industrial status and characteristics: With special reference to defeminization in the labor market
Authors: Lee Bodam
Published: July 2022

In general, the state has become richer, the people returning to work has increased, and more women have joined the labor force. However, even though Gujarat has achieved great economic development during a typical industrial structural transformation, a very small percentage of women participate in economic activities. This study aims to characterize Gujarat's low engagement of female labor force in the process of Gujarat's industrial development. First, this study has captured that Gujarat's labor market structure and industrial structure has grown asymmetrically. It has failed to bring surplus female labor out of agriculture and into manufacturing or services. Second, capital intensity is rising in Gujarat's industries, amplifying male-biased employment. Finally, low formal employment in rural areas possibly discourages participation in economic activities by surplus female labor whose education level has consistently increased.
Relationship Between Posterior Tibial Slope and Lower Extremity Biomechanics During a Single-Leg Drop Landing Combined With a Cognitive Task in Athletes After ACL Reconstruction
Authors: Kikuchi Naoya , Kanamori Akihiro , Kadone Hideki , Kajiwara Masaya , Okuno Kosuke , Hyodo Kojiro , Yamazaki Masashi
Published: July 2022

Background:

A steeper posterior tibial slope (PTS) is an important risk factor for anterior cruciate ligament (ACL) reinjury. The PTS may affect lower extremity biomechanics under competition-like conditions for athletes with a reconstructed ACL.

Hypothesis:

It was hypothesized that the PTS would be associated with lower extremity biomechanics, which may increase ACL strain.

Study Design:

Descriptive laboratory study.

Methods:

Included were 10 athletes (mean age, 20.9 ± 1.8 years) who had undergone ACL reconstruction. The authors recorded the 3-dimensional lower extremity biomechanics while participants performed a single-leg drop jump with the Stroop task (dual task). Kinematic and kinetic data were analyzed and compared between the involved and contralateral limbs. The medial and lateral PTSs were measured using magnetic resonance imaging scans of the involved knee. The correlation between the biomechanical data and the PTS in each knee was evaluated.

Results:

The lateral PTS was significantly correlated with the maximum hip adduction moment ( r = 0.64; P < .05) and maximum internal tibial rotation angle ( r = 0.71; P < .05) in the involved limb. There were no differences in kinematic and kinetic data between the involved and contralateral limbs.

Conclusion:

In athletes after ACL reconstruction, the lateral PTS was directly associated with the maximum internal tibial rotation angle during single-leg drop landing with a cognitive task.

Clinical Relevance:

The findings in this study indicate that a steeper lateral PTS may cause internal rotation of the tibia during landing, which may be associated with reinjury in athletes with a reconstructed ACL.
Controlling the Uncontrollable: Patient Safety and Medication Management From the Perspective of Registered Nurses in Municipal Home Health Care
Authors: Bielsten Therése , Odzakovic Elzana , Kullberg Agneta , Marcusson Jan , Hellström Ingrid
Published: July 2022

Most adverse events in health care are related to medication management and they are almost always preventable. Increased knowledge of patient safety related to medication management in home health care is an urgent issue to provide safe care for all patients regardless of where the health care takes place. This study explored patient safety within medication management in municipal home health care. Vignettes were used as stimulus during qualitative interviews with registered nurses. Three main themes with related subthemes were identified as challenges to patient safety within medication management in home health care: (1) challenges to information transfer, (2) challenges related to delegation, and (3) challenges of advanced medical treatments in the home. The issue of transfer of information permeated our findings. Coordinating medications, delegating tasks, along with more advanced care require clear communication between care providers to be compatible with patient safety within medication management in home health care.
Trends of Shifting Role of University Education towards University–Industry Relations
Authors: Machahary Sasiprova , Upadhyaya Amar
Published: July 2022

The increasing nature of global knowledge has made higher education move to a closer relationship with the industries. Universities in India have been given paramount importance for the country’s development; hence, recommendations were forwarded by various educational commissions and policies to focus on university–industry relations (UIR). The article attempts to understand UIR by highlighting its opportunities and challenges. The present article studied the recommendation of policy documents of higher education in India on UIR in the post-independence period, focusing on the roles of university education. The documents in this article include the reports of various educational commissions, namely the University Education Commission 1948–49, the Education Commission of 1964–66 and the National Knowledge Commission of 2005 and also the documents of significant educational policies of India, namely the National Policy on Education 1968 , National Policy on Education 1986 and National Education Policy 2020. Documents analysis as a method was used to understand the recommendation on UIR. The growing concern of university–industry collaboration can be seen in policy documents.
Mechanisms of action of currently available woman-controlled, vaginally administered, non-hormonal contraceptive products
Authors: Chappell B. Todd , Griffin Brooke L. , Howard Brandon
Published: July 2022

Woman-controlled, vaginally administered contraceptives offer women discreet, self-administered, and reversible options. This brief report summarizes the mechanisms of action (MOAs) of currently available, woman-controlled, vaginally administered, non-hormonal products, excluding those that need to be fitted by a healthcare provider. MOAs of three general types of contraceptives will be reviewed, including pH modulators, spermicides, and barrier methods. The recently approved vaginal pH modulator (lactic acid, citric acid, and potassium bitartrate) has a non-hormonal MOA, acting as a buffering agent in the presence of alkaline semen and resulting in sperm immobilization. In contrast, spermicides, such as nonoxynol-9, act by lysing sperm membranes, resulting in sperm death. Barrier methods, such as the diaphragm and female condom, prevent sperm from entering the uterus. In addition to their varying MOAs, each woman-controlled, vaginally administered method has different instructions for use, efficacy, side effects, and availability/insurance coverage, thus providing a range of characteristics to fit different needs and preferences.
RNA-Sequencing based analysis of bovine endometrium during the maternal recognition of pregnancy
Authors: Adhikari Bindu , Lee Chin N. , Khadka Vedbar S. , Deng Youping , Fukumoto Glen , Thorne Mark , Caires Kyle , Odani Jenee , Mishra Birendra
Published: July 2022

Background

Maternal recognition is the crucial step for establishing pregnancy in cattle. This study aims to identify endometrial genes and biological pathways involved in the maternal recognition of pregnancy. Caruncular endometrial tissues were collected from Day 15–17 of gestation (pregnant), non-pregnant (absence of conceptus), and cyclic (non-bred) heifers.

Results

Total RNAs were isolated from the caruncular endometrial tissues of pregnant, non-pregnant, and cyclic heifers, and were subjected to high-throughput RNA-sequencing. The genes with at least two-fold change and Benjamini and Hochbergp-value ≤ 0.05 were considered differentially expressed genes and further confirmed with quantitative real-time PCR. A total of 107 genes (pregnant vs cyclic) and 98 genes (pregnant vs non-pregnant) were differentially expressed in the pregnant endometrium. The most highly up-regulated genes in the pregnant endometrium wereMRS2,CST6,FOS,VLDLR,ISG15, IFI6, MX2,C15H11ORF34,EIF3M,PRSS22,MS4A8, andTINAGL1. Interferon signaling, immune response, nutrient transporter, synthesis, and secretion of proteins are crucial pathways during the maternal recognition of pregnancy.

Conclusions

The study demonstrated that the presence of conceptus at Day 15–17 of gestation affects the endometrial gene expression related to endometrial remodeling, immune response, nutrients and ion transporters, and relevant signaling pathways in the caruncular region of bovine endometrium during the maternal recognition of pregnancy.
Analysis of clinical features and prognostic factors in patients with hepatic hydrothorax: a single-center study from China
Authors: Ma Bo , Shang Tianling , Huang Jianjie , Tu Zhixin , Wang Yan , Han Yujin , Wen Xiaoyu , Jin Qinglong
Published: July 2022

Background

The clinical features and factors affecting the prognostic survival of hepatic hydrothorax (HH) are currently unknown.

Methods

We conducted a retrospective cohort study of 131 patients with HH using the Kaplan–Meier method and Cox proportional hazards regression analysis to assess factors influencing the prognosis of HH.

Results

A total of 131 patients were enrolled: the male to female ratio was 80:51 (1.59:1), and the mean age was 52.76 ± 11.88 years. Hepatitis B cirrhosis was the main cause of HH, and abdominal distention and dyspnea were the most common clinical signs. Ascites was present in varying amounts in all patients and was the most common decompensated complication, with pleural effusions mostly seen on the right side (107/131; 82%), followed by the left side (16/131; 12%) and bilateral effusions (8/131; 6%). For overall survival without transplantation, the estimated median survival time was 21 (95% confidence interval [CI]:18–25) months, and survival rates at 6 months, 1 year, and 2 years were 77.2%, 62.4%, and 29.7%, respectively. After controlling for covariates that were associated with liver-related mortality in the univariate analysis, males (hazard ratio [HR]: 1.721, 95% CI: 1.114–2.658, P = 0.005) and combined hepatic encephalopathy (HR: 2.016, 95% CI: 1.101–3.693, P = 0.001) were found to be associated with an increase in liver-related mortality.

Conclusions

In this cohort of HH patients without liver transplantation, male sex and hepatic encephalopathy were associated with a higher risk of liver-related death.
Incidence and predictors of multimorbidity among older adults in Korea: a 10-year cohort study
Authors: Lee Tae Wha , Chung Jane , Song Kijun , Kim Eunkyung
Published: July 2022

Background

Due to the rapid growth of the older adult population, multimorbidity has become a global concern for an aging society. Multimorbidity has been associated with poor health outcomes, including low quality of life and a high risk of mortality, resulting in an overload of healthcare systems. However, multimorbidity incidence and its related factors are poorly understood among older adults. This study aimed to determine whether sociodemographic characteristics, lifestyle, and psychosocial factors predict multimorbidity incidence among older adults in Korea.

Methods

This longitudinal study used the Korean Longitudinal Study of Aging (KLoSA) dataset from 2008 to 2018. The KLoSA is a panel survey of nationally representative samples aimed at providing data for developing socioeconomic policies for the increasing aging population in Korea. The study sample included 1967 older adults aged 65 years and over who had none or one of the chronic diseases at the baseline in 2008. Multimorbidity incidence was defined as the co-existence of two or more chronic diseases among 12 doctor-diagnosed diseases based on self-reports. Cox’s proportional hazards models were used to identify significant predictors of multimorbidity incidence over a 10-year follow-up period.

Results

Among 1967 respondents (female 54.5%, mean age 72.94), 625 (31.8%) incidents of multimorbidity were reported, contributing to 47.5 incidents per 1000 people after 10 years of follow-up. Low levels of social interaction, obesity, past smoking habits, and current or past drinking habits were identified as significant predictors of multimorbidity incidence among older adults in Korea.

Conclusions

This study identified older adults at high risk for multimorbidity incidence. These groups require more attention from health care providers in the course of chronic disease monitoring and management. Specific interventions and health policies to promote social interaction and a healthy lifestyle are essential to delay multimorbidity incidence. This longitudinal approach will contribute to developing preventive strategies to reduce the incidence of multimorbidity among older adults.
Two entities in pulmonary nodules of a diabetic patient receiving corticosteroid therapy for bullous pemphigoid: an autopsy case report
Authors: Mizushima Reimi , Haruhara Kotaro , Fukasawa Nei , Satake Mari , Fukui Akira , Koike Kentaro , Tsuboi Nobuo , Takahashi Hiroyuki , Yokoo Takashi
Published: July 2022

Background

Invasive pulmonary aspergillosis (IPA) is a serious complication occurring in immunocompromised patients, who often show multiple nodular lesions with or without cavitation. Due to high mortality and poor prognosis, the earlier detection and initiation of treatment are needed, while the definitive diagnosis is often difficult to make in clinical settings. Septic pulmonary embolism (SPE) is a complication that occurs in patients with bloodstream infections (e.g., infectious endocarditis). Patients with SPE also present with multiple nodules, nodules with or without cavitation, which are quite similar to the findings of IPA. We herein report an autopsy case that showed multiple nodules due to IPA and infectious endocarditis-related SPE.

Case

A 69-year-old man receiving maintenance hemodialysis due to diabetic nephropathy was admitted with worsening skin rash due to bullous pemphigoid and toxic epidermal necrolysis. He was treated with intravenous methylprednisolone followed by an increased dose of oral prednisolone. On the 6th week of admission, he was diagnosed with infectious endocarditis after the isolation of Corynebacterium in blood samples, with a nodule lesion with cavitation in the right lung. Intravenous vancomycin was initiated. After antibacterial treatment, the nodules in the right lung gradually diminished, whereas a nodule with cavitation in the left lung emerged. The nodule in the left lung showed rapid growth along with elevation of serum β-d-glucan and galactomannan antigen. Despite starting treatment with antifungal agents, he died from respiratory failure. An autopsy revealed Groccott staining-positive aspergillus in the left lung, but not in the right lung. We found fibrosis with mitral valve vegetation, indicating a recovery from infectious endocarditis.

Conclusion

Although similar features of nodules with cavitation on CT imaging were shared with SPE and IPA, this case demonstrated that these heterogeneous diseases can occur within the lungs and the distinctly different transitions of CT imaging are helpful for suspecting the presence of multiple pathogeneses.
CpG ODN (K3)—toll-like receptor 9 agonist—induces Th1-type immune response and enhances cytotoxic activity in advanced lung cancer patients: a phase I study
Authors: Otsuka Tomoyuki , Nishida Sumiyuki , Shibahara Takayuki , Temizoz Burcu , Hamaguchi Masanari , Shiroyama Takayuki , Kimura Keiko , Miyake Kotaro , Hirata Haruhiko , Mizuno Yumiko , Yagita Mayu , Manabe Yusuke , Kuroda Etsushi , Takeda Yoshito , Kida Hiroshi , Ishii Ken J. , Kumanogoh Atsushi
Published: July 2022

Background

Cytosine-phosphate-guanine oligodeoxynucleotide (CpG ODN) (K3)—a novel synthetic single-stranded DNA immune adjuvant for cancer immunotherapy—induces a potential Th1-type immune response against cancer cells. We conducted a phase I study of CpG ODN (K3) in patients with lung cancer to assess its safety and patients’ immune responses.

Methods

The primary endpoint was the proportion of dose-limiting toxicities (DLTs) at each dose level. Secondary endpoints included safety profile, an immune response, including dynamic changes in immune cell and cytokine production, and progression-free survival (PFS). In a 3 + 3 dose-escalation design, the dosage levels for CpG ODN (K3) were 5 or 10 mg/body via subcutaneous injection and 0.2 mg/kg via intravenous administration on days 1, 8, 15, and 29.

Results

Nine patients (eight non-small-cell lung cancer; one small-cell lung cancer) were enrolled. We found no DLTs at any dose level and observed no serious treatment-related adverse events. The median observation period after registration was 55 days (range: 46–181 days). Serum IFN-α2 levels, but not inflammatory cytokines, increased in six patients after the third administration of CpG ODN (K3) (mean value: from 2.67 pg/mL to 3.61 pg/mL after 24 hours). Serum IFN-γ (mean value, from 9.07 pg/mL to 12.7 pg/m after 24 hours) and CXCL10 levels (mean value, from 351 pg/mL to 676 pg/mL after 24 hours) also increased in eight patients after the third administration. During the treatment course, the percentage of T-bet-expressing CD8+ T cells gradually increased (mean, 49.8% at baseline and 59.1% at day 29, p = 0.0273). Interestingly, both T-bet-expressing effector memory (mean, 52.7% at baseline and 63.7% at day 29, p = 0.0195) and terminally differentiated effector memory (mean, 82.3% at baseline and 90.0% at day 29, p = 0.0039) CD8+ T cells significantly increased. The median PFS was 398 days.

Conclusions

This is the first clinical study showing that CpG ODN (K3) activated innate immunity and elicited Th1-type adaptive immune response and cytotoxic activity in cancer patients. CpG ODN (K3) was well tolerated at the dose settings tested, although the maximum tolerated dose was not determined.

Trial registration

UMIN-CTR number 000023276. Registered 1 September 2016, https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000026649
Outcomes of neonatal congenital diaphragmatic hernia in a non-ECMO center in a middle-income country: a retrospective cohort study
Authors: Lum Lucy Chai See , Ramanujam Tindivanum Muthurangam , Yik Yee Ian , Lee Mei Ling , Chuah Soo Lin , Breen Emer , Zainal-Abidin Anis Siham , Singaravel Srihari , Thambidorai Conjeevaram Rajendrarao , de Bruyne Jessie Anne , Nathan Anna Marie , Thavagnanam Surendran , Eg Kah Peng , Chan Lucy , Abdel-Latif Mohamed E. , Gan Chin Seng
Published: July 2022

Background

Most studies examining survival of neonates with congenital diaphragmatic hernia (CDH) are in high-income countries. We aimed to describe the management, survival to hospital discharge rate, and factors associated with survival of neonates with unilateral CDH in a middle-income country.

Methods

We retrospectively reviewed the medical notes of neonates with unilateral CDH admitted to a pediatric intensive care unit (PICU) in a tertiary referral center over a 15-year period, from 2003–2017. We described the newborns’ respiratory care pathways and then compared baseline demographic, hemodynamic, and respiratory indicators between survivors and non-survivors. The primary outcome measure was survival to hospital discharge.

Results

Altogether, 120 neonates were included with 43.3% (52/120) diagnosed antenatally. Stabilization occurred in 38.3% (46/120) with conventional ventilation, 13.3% (16/120) with high-frequency intermittent positive-pressure ventilation, and 22.5% (27/120) with high frequency oscillatory ventilation. Surgical repair was possible in 75.0% (90/120). The overall 30-day survival was 70.8% (85/120) and survival to hospital discharge was 66.7% (80/120). Survival to hospital discharge tended to improve over time (p > 0.05), from 56.0% to 69.5% before and after, respectively, a service reorganization. For those neonates who could be stabilized and operated on, 90.9% (80/88) survived to hospital discharge. The commonest post-operative complication was infection, occurring in 43.3%. The median survivor length of stay was 32.5 (interquartile range 18.8–58.0) days. Multiple logistic regression modelling showed vaginal delivery (odds ratio [OR] = 4.8; 95% confidence interval [CI] [1.1–21.67]; p = 0.041), Apgar score $$\ge$$
≥
7 at 5 min (OR = 6.7; 95% CI [1.2–36.3]; p = 0.028), and fraction of inspired oxygen (FiO2) < 50% at 24 h (OR = 89.6; 95% CI [10.6–758.6]; p < 0.001) were significantly associated with improved survival to hospital discharge.

Conclusions

We report a survival to hospital discharge rate of 66.7%. Survival tended to improve over time, reflecting a greater critical volume of cases and multi-disciplinary care with early involvement of the respiratory team resulting in improved transitioning from PICU. Vaginal delivery, Apgar score $$\ge$$
≥
7 at 5 min, and FiO2 < 50% at 24 h increased the likelihood of survival to hospital discharge.
Acute drug reaction to phenylephrine and tropicamide collyrium in a late-preterm newborn: a case report
Authors: Baldo Francesco , Travan Laura
Published: July 2022

Background

Collyrium administration is a common procedure in the neonatal ward, both in preterm and at term babies. Various molecules are used to induce mydriasis and cycloplegia: among them, phenylephrine and tropicamide are the most popular, and their administration is generally considered safe.

Case presentation

A 35 + 2 weeks-old, 2510 g, well-appearing male newborn required an ophthalmologic evaluation after a doubtful red reflex test. A collyrium with 1% phenylephrine and 0.95% tropicamide was administered prior to the consult, one drop per eye. Two minutes after the administration, the baby developed a severe apnea that required tactile stimulation. Moreover, the area around his eyes became visibly pale. Three minutes later, the baby became severely bradycardic (59 bpm), but remained in good general condition, so that resuscitation maneuvers were not required. Bradycardia lasted for almost three hours and then gradually resolved.

Conclusions

Cardiopulmonary manifestations, such as bradycardia and even cardiopulmonary arrest, are severe complications that can happen after phenylephrine collyrium administration in preterm newborns. However, they have been described in babies below 1500 g or with concurrent respiratory manifestations. Our patient, on the other hand, was late preterm, and never required a ventilatory support prior to the collyrium administration. Practitioners who deal with premature babies, even if late preterm, must be aware of these possible complications and administer phenylephrine collyrium carefully, where cardiopulmonary resuscitation equipment and personnel are available.
Single-case experimental designs for bumetanide across neurodevelopmental disorders: BUDDI protocol
Authors: Geertjens Lisa , Cristian Gianina , Haspels Eva , Ramautar Jennifer , van der Wilt Gert Jan , Verhage Matthijs , Bruining Hilgo
Published: July 2022

Background

Bumetanide is a selective NKCC1 chloride importer antagonist which is being repurposed as a mechanism-based treatment for neurodevelopmental disorders (NDDs). Due to their specific actions, these kinds of interventions will only be effective in particular subsets of patients. To anticipate stratified application, we recently completed three bumetanide trials each focusing on different stratification strategies with the additional objective of deriving the most optimal endpoints. Here we publish the protocol of the post-trial access combined cohort study to confirm previous effects and stratification strategies in the trial cohorts and in new participants.

Method/design

Participants of the three previous cohorts and a new cohort will be subjected to 6 months bumetanide treatment using multiple baseline Single Case Experimental Designs. The primary outcome is the change, relative to baseline, in a set of patient reported outcome measures focused on direct and indirect effects of sensory processing difficulties. Secondary outcome measures include the conventional questionnaires ‘social responsiveness scale’, ‘repetitive behavior scale’, ‘sensory profile’ and ‘aberrant behavior scale’. Resting-state EEG measurements will be performed at several time-points including at Tmax after the first administration. Assessment of cognitive endpoints will be conducted using the novel Emma Tool box, an in-house designed battery of computerized tests to measure neurocognitive functions in children.

Discussion

This study aims to replicate previously shown effects of bumetanide in NDD subpopulations, validate a recently proposed treatment prediction effect methodology and refine endpoint measurements.

Trial registration

EudraCT: 2020–002196-35, registered 16 November 2020, https://www.clinicaltrialsregister.eu/ctr-search/trial/2020-002196-35/NL
Evidence-Based Intervention (EBI) Mapping: a systematic approach to understanding the components and logic of EBIs
Authors: Walker Timothy J. , Foster Maya , Szeszulski Jacob , Craig Derek W. , Mullen Patricia Dolan , Fernández Maria E.
Published: July 2022

Background

Despite the development of numerous evidence-based interventions (EBIs), many go unused in practice. Hesitations to use existing EBIs may be due to a lack of understanding about EBI components and what it would take to adapt it or implement it as designed. To improve the use of EBIs, program planners need to understand their goals, core components, and mechanisms of action. This paper presents EBI Mapping, a systematic approach based on Intervention Mapping, that can be used to understand and clearly describe EBIs, and help planners put them into practice.

Methods

We describe EBI Mapping tasks and provide an example of the process. EBI Mapping uses principles from Intervention Mapping, a systematic framework for planning multilevel health promotion interventions. EBI Mapping applies the Intervention Mapping steps retrospectively to help planners understand an existing EBI (rather than plan a new one). We explain each EBI Mapping task and demonstrate the process using the VERB Summer Scorecard (VSS), a multi-level community-based intervention to improve youth physical activity.

Results

EBI Mapping tasks are: 1) document EBI materials and activities, and their audiences, 2) identify the EBI goals, content, and mechanisms of action, 3) identify the theoretical change methods and practical applications of those methods, 4) describe design features and delivery channels, and 5) describe the implementers and their tasks, implementation strategies, and needed resources. By applying the EBI Mapping tasks, we created a logic model for the VSS intervention. The VSS logic model specifies the links between behavior change methods, practical applications, and determinants for both the at-risk population and environmental change agents. The logic model also links the respective determinants to the desired outcomes including the health behavior and environmental conditions to improve the health outcome in the at-risk population.

Conclusions

EBI Mapping helps program planners understand the components and logic of an EBI. This information is important for selecting, adapting, and scaling-up EBIs. Accelerating and improving the use of existing EBIs can reduce the research-to-practice gap and improve population health.
Professional help-seeking behaviour for mental health problems among veterinarians in Norway: a nationwide, cross-sectional study (The NORVET study)
Authors: Dalum Helene Seljenes , Tyssen Reidar , Moum Torbjørn , Thoresen Magne , Hem Erlend
Published: July 2022

Background

Veterinarians have a relatively high prevalence of mental health problems; however, research on professional help-seeking is limited. The main purpose of the present study was to investigate the prevalence of mental health problems and professional help-seeking behaviour for such problems, and the independent factors associated with help-seeking behaviour among veterinarians in Norway.

Method

This cross-sectional study included all veterinarians in Norway (response rate 75%, 70% women). Logistic regression was used to calculate odds ratios (OR) for professional help-seeking for mental health problems. Analyses were controlled for socio-demographic, individual (personality trait reality weakness, SCL-5, attitudes toward mental illness), and work-related factors (work field, job stress).

Results

The prevalence of self-reported mental health problems in need of treatment was 30% (746/2494), significantly higher among women than men (36% vs. 15%). Fifty-four percent had sought professional help, women significantly more often (56%) than men (41%). Among veterinarians with serious suicidal thoughts, 50% (69/139) had sought help. Veterinarians most frequently related mental health problems to work problems (47%), women significantly more often (49%) than men (34%). Factors significantly associated with help-seeking were being female, OR = 2.11 (95% CI: 1.24–3.60), working with production animals, OR = 0.35 (0.13–0.98), public administration, OR = 2.27 (1.15–4.45), academia/research, OR = 4.78 (1.99–11.47) or ‘other’ fields, OR = 2.79 (1.23–6.32), and attitudes toward mental illness, OR = 1.32 (1.03–1.68).

Conclusions

Thirty percent of veterinarians in Norway reported mental health problems in need of treatment, and only half of them had sought professional help. A low degree of help-seeking was also seen among those with serious suicidal thoughts. Being female, positive attitudes toward treatment of mental illness, working in public administration, academia/research and ‘other’ field were associated with more help-seeking, while working in production animal practice was associated with less help-seeking. Interventions to increase help-seeking behaviour for mental health problems among veterinarians are warranted.
Contraceptive uptake and associated factors among women in the immediate postpartum period at Kawempe Hospital
Authors: Nakiwunga Noor , Kakaire Othman , Ndikuno Cynthia Kuteesa , Nakalega Rita , Mukiza Nelson , Atuhairwe Susan
Published: July 2022

Introduction

Within Africa, contraceptive use is low although about 214 million women who are not using contraception want to avoid pregnancy. In Uganda, modern contraceptive uptake is at 35% resulting in unwanted or unplanned pregnancies which may increase morbidity and mortality among children and mothers. Contraceptive uptake at 6 weeks postpartum is encouraged but it is not very effective since there is low attendance during this visit. Additionally, some women may have become sexually active by the visit at 6 weeks postpartum leading to early conception.

Objectives

This study sought to determine contraceptive uptake in the immediate postpartum period and the associated factors among women delivering at Kawempe Hospital.

Methods

This study employed a cross-sectional study design where 397 women aged 18–49 years were recruited using systematic random sampling. The women who were discharged within 72 h after delivery were considered. Data collection was done using an interviewer-administered data collection tool. Data was double entered into EpiData version 4.2 and analyzed using STATA version 13 at univariate using descriptive statistics then at bivariate and multivariate levels using logistic regression with contraceptive uptake as the outcome.

Results

We enrolled 397 participants. Their mean age range was 18–45 years and a median of 25 years (IQR 22, 30). The majority of the participants, 333 (83.88%), were married and 177 (44.58%) were housewives or unemployed. Contraceptive uptake in the immediate postpartum period among these participants was 15.4% (61/397). The factors independently associated with immediate postpartum contraceptive uptake were grand multiparity (aOR = 2.57; 95% CI 1.11–5.95; p = 0.028), cesarean delivery (aOR = 2.63; 95% CI 1.24–5.57; p = 0.011), and prior contraceptive counseling during Antenatal (aOR = 9.05; 95% CI 2.65–30.93; p =  < 0.001).

Conclusion

There was a 15.4% contraceptive uptake among immediate postpartum women which is very low. The factors independently associated with immediate postpartum contraceptive uptake were grand multiparity, cesarean section, and prior contraceptive counseling during antenatal care. Efforts need to be made to improve contraceptive uptake among immediate postpartum mothers such that the high unmet need for contraception is reduced and short inter-pregnancy intervals are controlled.
Ethical values and principles to guide the fair allocation of resources in response to a pandemic: a rapid systematic review
Authors: O’Sullivan Lydia , Aldasoro Edelweiss , O’Brien Áine , Nolan Maeve , McGovern Cliona , Carroll Áine
Published: July 2022

Background

The coronavirus 2019 pandemic placed unprecedented pressures on healthcare services and magnified ethical dilemmas related to how resources should be allocated. These resources include, among others, personal protective equipment, personnel, life-saving equipment, and vaccines. Decision-makers have therefore sought ethical decision-making tools so that resources are distributed both swiftly and equitably. To support the development of such a decision-making tool, a systematic review of the literature on relevant ethical values and principles was undertaken. The aim of this review was to identify ethical values and principles in the literature which relate to the equitable allocation of resources in response to an acute public health threat, such as a pandemic.

Methods

A rapid systematic review was conducted using MEDLINE, EMBASE, Google Scholar, LitCOVID and relevant reference lists. The time period of the search was January 2000 to 6th April 2020, and the search was restricted to human studies. January 2000 was selected as a start date as the aim was to capture ethical values and principles within acute public health threat situations. No restrictions were made with regard to language. Ethical values and principles were extracted and examined thematically.

Results

A total of 1,618 articles were identified. After screening and application of eligibility criteria, 169 papers were included in the thematic synthesis. The most commonly mentioned ethical values and principles were: Equity, reciprocity, transparency, justice, duty to care, liberty, utility, stewardship, trust and proportionality. In some cases, ethical principles were conflicting, for example, Protection of the Public from Harm and Liberty.

Conclusions

Allocation of resources in response to acute public health threats is challenging and must be simultaneously guided by many ethical principles and values. Ethical decision-making strategies and the prioritisation of different principles and values needs to be discussed with the public in order to prepare for future public health threats. An evidence-based tool to guide decision-makers in making difficult decisions is required. The equitable allocation of resources in response to an acute public health threat is challenging, and many ethical principles may be applied simultaneously. An evidence-based tool to support difficult decisions would be helpful to guide decision-makers.
The use of co-production, co-design and co-creation to mobilise knowledge in the management of health conditions: a systematic review
Authors: Grindell Cheryl , Coates Elizabeth , Croot Liz , O’Cathain Alicia
Published: July 2022

Background

Knowledge mobilisation is a term used in healthcare research to describe the process of generating, sharing and using evidence. ‘Co’approaches, such as co-production, co-design and co-creation, have been proposed as a way of overcoming the knowledge to practice gap. There is a need to understand why researchers choose to adopt these approaches, how they achieve knowledge mobilisation in the management of health conditions, and the extent to which knowledge mobilisation is accomplished.

Methods

Studies that explicitly used the terms co-production, co-design or co-creation to mobilise knowledge in the management of health conditions were included. Web of Science, EMBASE via OvidSP, MEDLINE via OvidSP and CINHAL via EBSCO databases were searched up to April 2021. Quality assessment was carried out using the Joanna Briggs Institute qualitative quality assessment checklist. Pluye and Hong’s seven steps for mixed studies reviews were followed. Data were synthesised using thematic synthesis.

Results

Twenty four international studies were included. These were qualitative studies, case studies and study protocols. Key aspects of ‘co’approaches were bringing people together as active and equal partners, valuing all types of knowledge, using creative approaches to understand and solve problems, and using iterative prototyping techniques. Authors articulated mechanisms of action that included developing a shared understanding, identifying and meeting needs, giving everyone a voice and sense of ownership, and creating trust and confidence. They believed these mechanisms could produce interventions that were relevant and acceptable to stakeholders, more useable and more likely to be implemented in healthcare. Varied activities were used to promote these mechanisms such as interviews and creative workshops. There appeared to be a lack of robust evaluation of the interventions produced so little evidence in this review that ‘co’approaches improved the management of health conditions.

Conclusion

Those using ‘co’approaches believed that they could achieve knowledge mobilisation through a number of mechanisms, but there was no evidence that these led to improved health. The framework of key aspects and mechanisms of ‘co’approaches developed here may help researchers to meet the principles of these approaches. There is a need for robust evaluation to identify whether ‘co’approaches produce improved health outcomes.

Trial Registration

PROSPERO CRD42020187463.
Using combined Global Position System and accelerometer data points to examine how built environments and gentrification are associated with physical activity in four Canadian cities
Authors: Firth Caislin L. , Kestens Yan , Winters Meghan , Stanley Kevin , Bell Scott , Thierry Benoit , Phillips Kole , Poirier-Stephens Zoé , Fuller Daniel
Published: July 2022

Background

Built and social environments are associated with physical activity. Global Positioning Systems (GPS) and accelerometer data can capture how people move through their environments and provide promising tools to better understand associations between environmental characteristics and physical activity. The purpose of this study is to examine the associations between GPS-derived exposure to built environment and gentrification characteristics and accelerometer-measured physical activity in a sample of adults across four cities.

Methods

We used wave 1 data from the Interventions, Research, and Action in Cities Team, a cohort of adults living in the Canadian cities of Victoria, Vancouver, Saskatoon, and Montreal. A subsample of participants wore a SenseDoc device for 10 days during May 2017–January 2019 to record GPS and accelerometry data. Two physical activity outcomes were derived from SenseDoc data: time spent in light, moderate, and vigorous physical activity; and time spent in moderate or vigorous physical activity. Using corresponding GPS coordinates, we summarized physical activity outcomes by dissemination area—a Canadian census geography that represents areas where 400 to 700 people live- and joined to built (active living space, proximity to amenities, and urban compactness) and gentrification measures. We examined the associations between environmental measures and physical activity outcomes using multi-level negative binomial regression models that were stratified by city and adjusted for covariates (weekday/weekend), home dissemination area, precipitation, temperature) and participant-level characteristics obtained from a survey (age, gender, income, race).

Results

We found that adults spent more time being physically active near their homes, and in environments that were more walkable and near parks and less time in urban compact areas, regardless of where participants lived. Our analysis also highlighted how proximity to different amenities was linked to physical activity across different cities.

Conclusions

Our study provides insights into how built environment and gentrification characteristics are associated with the amount of time adults spend being physically active in four Canadian cities. These findings enhance our understanding of the influence that environments have on physical activity over time and space, and can support policies to increase physical activity.