bluuebunny/crossref_metadata_2025 huggingface dataset:
What about the supervisor? Clinical supervisors’ role in student nurses’ peer learning: A phenomenographic study
Authors: Dyar Anna , Stenfors Terese , Lachmann Hanna , Kiessling Anna
Published: December 2020

Introduction

Peer learning is increasingly used for healthcare students in the clinical setting. However, as peer learning between students involves students taking a teaching role, it is unclear what the supervisor's role then becomes. It is vital to determine the role of the supervisor in student peer learning to ensure high quality learning and patient safety.

Methods

Semi‐structured interviews were performed with 15 student nurse supervisors (nurses and assistant nurses) from two hospital wards that practice peer learning to investigate the different ways clinical supervisors view their role in students' peer learning. Transcribed data were coded and analysed using a phenomenographic approach.

Results

Four hierarchical levels of the supervisor's understanding of their role in students’ peer learning were identified: the teacher; the facilitator; the stimulator; and the team player. These categories represent an increasingly inclusive view of which people present on the ward play a role in enabling effective peer learning.

Conclusions

The various understandings of supervisor roles have implications for how supervision of peer learning could be implemented in the future.
A phase‐field lattice Boltzmann method for the solution of water‐entry and water‐exit problems
Authors: De Rosis Alessandro , Tafuni Angelantonio
Published: December 2020

In this paper, an original phase‐field lattice Boltzmann scheme for a system composed of two immiscible and incompressible fluids interacting with moving solids is developed, presented, and tested for the first time. The proposed approach is benchmarked against experimental data and smoothed particle hydrodynamics simulations of four well‐established two‐dimensional problems where a rigid body interacts with the interface between the two fluids. The outlined methodology represents a very good candidate to perform fluid‐structure interaction simulations of hydrodynamic stability problems as well as water‐entry and water‐exit problems.
Patient‐reported outcome measures ( PROMs): making sense of individual PROM scores and changes in PROM scores over time
Authors: van der Willik Esmee M. , Terwee Caroline B. , Bos Willem Jan W. , Hemmelder Marc H. , Jager Kitty J. , Zoccali Carmine , Dekker Friedo W. , Meuleman Yvette
Published: December 2020

Patient‐reported outcome measures (PROMs) are increasingly being used in nephrology care. However, in contrast to well‐known clinical measures such as blood pressure, health‐care professionals are less familiar with PROMs and the interpretation of PROM scores is therefore perceived as challenging. In this paper, we provide insight into the interpretation of PROM scores by introducing the different types and characteristics of PROMs, and the most relevant concepts for the interpretation of PROM scores. Concepts such as minimal detectable change, minimal important change and response shift are explained and illustrated with examples from nephrology care.
A dual spatial clustering method in the presence of heterogeneity and noise
Authors: Zhu Jie , Zheng Jiazhu , Di Shaoning , Wang Shu , Yang Jing
Published: December 2020

The detection of spatial clusters, taking into account both spatial proximity and attribute similarity, plays a vital role in spatial data analysis. Although several dual clustering methods are currently available in the literature, most of them have detected homogeneous spatially adjacent clusters suffering from between‐cluster inhomogeneity and noise, where those spatial points have been described in the attribute domain. This article aims to accommodate both spatial proximity and attribute similarity with the presence of heterogeneity and noise. In this algorithm, Delaunay triangulation with edge‐length constraints, with consideration of arbitrary geometrical shapes, different densities, and spatial noise, is first utilized to construct spatial proximity relationships among points. Then, a clustering strategy employing information entropy is designed to identify clusters having similar attributes. The attribute clustering can adaptively and accurately detect clusters under the consideration of heterogeneity and noise. The efficacy and practicability of the proposed algorithm are illustrated by experiments employing both simulated datasets and real spatial point events.
No pets allowed: A trans-species social justice perspective to address housing issues for older adults and companion animals
Authors: Matsuoka Atsuko , Sorenson John , Graham Taryn Mary , Ferreira Jasmine
Published: December 2020

INTRODUCTION: Significant benefits of companion animals (i.e., pets) for older adults are recognized and publications on Animal-Assisted Intervention, Animal-Assisted Activities and Animal-Assisted Therapies with older adults are growing. Studies on housing and community- residing older adults with companion animals from a non-utilitarian perspective on other animals, however, are rather limited.METHODS: For this scoping review, we used a Critical Animal Studies perspective, in particular, a trans-species social justice framework to address two questions: “What are the scope and size of the literature on housing for community living older adults with companion animals?” and “What is known from the existing literature?” We searched peer-reviewed publications from 1980 to 2019 by using MEDLINE, PsychINFO, ProQuest and Scopus.FINDINGS: Six works from Canada, Aotearoa New Zealand and US met our criteria. A disturbing reality was discovered: Restrictive leasing (‘no pets’ for rental housing) among low-income older adults with companion animals in public housing has persisted for the last 40 years and prevents them from accessing affordable housing. Also, the discourse of pets as problems or risk seems to justify prohibiting older adults from living with companion animals.CONCLUSION: Utilising the concept of speciesism and a trans-species social justice framework for analysis, we argue that intersectional institutional oppression of speciesism and classism is a root cause of the situation. Justice for older adults cannot be achieved without justice for their companion animals. Future studies in human–animal relations and education and practice in social work need to incorporate ideas of speciesism and justice beyond humans.
Spatiotemporal cellular movement and fate decisions during first pharyngeal arch morphogenesis
Authors: Yuan Yuan , Loh Yong-hwee Eddie , Han Xia , Feng Jifan , Ho Thach-Vu , He Jinzhi , Jing Junjun , Groff Kimberly , Wu Alan , Chai Yang
Published: December 2020

Cranial neural crest cells undergo directional cellular movement and binary fate restrictions during mandibular morphogenesis.
Self-assembly–based posttranslational protein oscillators
Authors: Kimchi Ofer , Goodrich Carl P. , Courbet Alexis , Curatolo Agnese I. , Woodall Nicholas B. , Baker David , Brenner Michael P.
Published: December 2020

Mathematical models for two experimentally realizable posttranslational protein oscillators are constructed.
S-adenosyl-l-homocysteine hydrolase links methionine metabolism to the circadian clock and chromatin remodeling
Authors: Greco Carolina Magdalen , Cervantes Marlene , Fustin Jean-Michel , Ito Kakeru , Ceglia Nicholas , Samad Muntaha , Shi Jiejun , Koronowski Kevin Brian , Forne Ignasi , Ranjit Suman , Gaucher Jonathan , Kinouchi Kenichiro , Kojima Rika , Gratton Enrico , Li Wei , Baldi Pierre , Imhof Axel , Okamura Hitoshi , Sassone-Corsi Paolo
Published: December 2020

The S-adenosylhomocysteine (SAH) hydrolyzing enzyme AHCY functionally links the circadian clock to methionine metabolism.
External oxidant-compatible phosphorus(III)-directed site-selective C–H carbonylation
Authors: Dong Ben , Qian Jiasheng , Li Mingjie , Wang Zheng-Jun , Wang Minyan , Wang Dingyi , Yuan Chengkai , Han Ying , Zhao Yue , Shi Zhuangzhi
Published: December 2020

Pd-catalyzed C7-selective C–H carbonylation of indoles with CO using BQ, a key external oxidant, is demonstrated.
Light-dependent photoreceptor orientation in mouse retina
Authors: Chai Zuying , Silverman Daniel , Li Guang , Williams David , Raviola Elio , Yau King-Wai
Published: December 2020

The pupil-aligned orientation of retinal photoreceptors is dynamically phototropic, but different between outer and inner segment.
Lamellar cells in Pacinian and Meissner corpuscles are touch sensors
Authors: Nikolaev Yury A. , Feketa Viktor V. , Anderson Evan O. , Schneider Eve R. , Gracheva Elena O. , Bagriantsev Sviatoslav N.
Published: December 2020

Tactile corpuscles in vertebrate skin use both neuronal and non-neuronal mechanoreception to detect mechanical signals.
Mutant huntingtin and neurofilament light have distinct longitudinal dynamics in Huntington’s disease
Authors: Rodrigues Filipe B. , Byrne Lauren M. , Tortelli Rosanna , Johnson Eileanoir B. , Wijeratne Peter A. , Arridge Marzena , De Vita Enrico , Ghazaleh Naghmeh , Houghton Richard , Furby Hannah , Alexander Daniel C. , Tabrizi Sarah J. , Schobel Scott , Scahill Rachael I. , Heslegrave Amanda , Zetterberg Henrik , Wild Edward J.
Published: December 2020

Longitudinal analysis in 80 patients shows that mutant huntingtin and neurofilament light could predict Huntington’s disease progression.
The ESCRT-I Subunit Tsg101 Plays Novel Dual Roles in Entry and Replication of Classical Swine Fever Virus
Authors: Liu Chun-chun , Liu Ya-yun , Cheng Yan , Zhang Yun-Na , Zhang Jin , Liang Xiao-Dong , Gao Ya , Chen Huan , Baloch Abdul Sattar , Yang Qian , Go Yun Young , Zhou Bin
Published: December 2020

CSF, caused by CSFV, is a World Organization for Animal Health (OIE) notifiable disease and causes significant financial losses to the pig industry globally. The ESCRT machinery plays an important regulatory role in several members of the genera
Flavivirus
and
Hepacivirus
within the family
Flaviviridae
, such as hepatitis C virus, Japanese encephalitis virus, and dengue virus.
Zika Virus Is Transmitted in Neural Progenitor Cells via Cell-to-Cell Spread, and Infection Is Inhibited by the Autophagy Inducer Trehalose
Authors: Clark Alex E. , Zhu Zhe , Krach Florian , Rich Jeremy N. , Yeo Gene W. , Spector Deborah H.
Published: December 2020

Zika virus causes birth defects and can lead to neurological disease in adults. While infection rates are currently low, Zika virus (ZIKV) remains a public health concern with no treatment or vaccine available.
Supplemental Material: Three-dimensional geometry and growth of a basement-involved fault network developed during multiphase extension, Enderby Terrace, North West Shelf of Australia
Authors: Deng Hongdan , McClay Ken
Published: December 2020

Figures S1–S3.
Liver rheumatoid nodules imitating liver malignancy: a rare occurrence
Authors: Wee Jason , Sobhi Salar , De Boer Bastiaan , Xu Dan
Published: December 2020

We describe a case of a 61-year-old man with a background of rheumatoid arthritis who presented to the emergency department with a single-reported episode of haemoptysis on the background of an upper respiratory tract infection. A CT scan revealed an incidental 40 mm mass in upper right lobe of the liver abutting the diaphragmatic surface. A subsequent positron emission tomography scan confirmed the mass and raised the possibility of another lesion in the liver raising the suspicion of malignancy. The case was complicated by the inability to perform a fine needle aspiration biopsy due to the mass’ proximity to the diaphragm. After discussion with the patient, it was decided to resect the affected liver segment. Histological analysis of the mass revealed localised necrotising granulomatous inflammation suggestive of a rheumatoid nodule, which is seldom reported in the literature.
Less liver fibrosis marker increment in overweight chronic hepatitis B patients observed by age-adjusted Fibrosis-4 Index
Authors: Liu Ta-Wei , Huang Chung-Feng , Yeh Ming-Lun , Tsai Pei-Chien , Jang Tyng-Yuan , Huang Jee-Fu , Dai Chia-Yen , Chuang Wan-Long , Yu Ming-Lung
Published: December 2020

Background and aims

Chronic hepatitis B patients in Taiwan with no or limited liver injury are not reimbursed for antiviral treatment by the Taiwan National Health Insurance (NHI). Innovative fibrosis marker, age-adjusted Fibrosis-4 Index (FIB4-AA), was implemented to evaluate the tendency of liver fibrosis in these patients.

Methods

The FIB-4 indices of 256 antiviral treatment-naïve chronic hepatitis B patients at Kaohsiung Medical University Hospital from 2003 to 2019 were reviewed. The difference in initial FIB-4 and lastFIB4-AAwas treated as a categorical variable, representing the tendency of liver fibrosis in each individual aside from ageing. Logistic regression was implemented to evaluate the three parameters most dependent on increment of FIB4-AA: e seroconversion, body mass index (BMI) and initial FIB-4 index.

Results

The yearly FIB-4 growth rate of an individual without chronic hepatitis was lower than that of the study group (0.0237 vs 0.0273 for males, 0.02 vs 0.0288 for females). Patients undergoing or completing e seroconversion were less prone to increment of FIB4-AA (p=0.036, OR 0.524). Logistic regression revealed that BMI ≥25 kg/m2significantly less increment of FIB4-AA (p=0.001, OR 0.383, 95% CI 0.212 to 0.690), while patients with initial FIB-4 <1.29 were prone to increasing liver FIB4-AA (p=0.000, OR 3.687, 95% CI 1.999 to 6.797).

Conclusion

Chronic hepatitis B patients not meeting the reimbursement criteria of the Taiwan NHI are prone to increment of liver fibrosis marker. Overweight is associated with less increment of fibrosis marker, while initial FIB-4 <1.29 is associated with increasing fibrosis marker.
Classroom, club or collective? Three types of community-based group intervention and why they matter for health
Authors: Gram Lu , Desai Sapna , Prost Audrey
Published: December 2020

Interventions involving groups of laywomen, men and adolescents to promote health are increasingly popular, but past research has rarely distinguished between different types of intervention with groups. We introduce a simple typology that distinguishes three ideal types:classrooms, clubsandcollectives. Classrooms treat groups as a platform for reaching a population with didactic behaviour change strategies. Clubs seek to build, strengthen and leverage relationships between group members to promote health. Collectives engage whole communities in assuming ownership over a health problem and taking action to address it. We argue that this distinction goes a long way towards explaining differences in achievable health outcomes using interventions with groups. First, classrooms and clubs are appropriate when policymakers primarily care about improving the health of group members, but collectives are better placed to achieve population-level impact. Second, classroom interventions implicitly assume bottleneck behaviours preventing a health outcome from being achieved can be reliably identified by experts, whereas collectives make use of local knowledge, skill and creativity to tackle complexity. Third, classroom interventions assume individual participants can address health issues largely on their own, while clubs and collectives are required to engender collective action in support of health. We invite public health researchers and policymakers to use our framework to align their own and communities’ ambitions with appropriate group-based interventions to test and implement for their context. We caution that our typology is meant to apply to groups of laypeople rather than professionalised groups such as whole civil society organisations.
Community interventions with women’s groups to improve women’s and children’s health in India: a mixed-methods systematic review of effects, enablers and barriers
Authors: Desai Sapna , Misra Madhavi , Das Aikantika , Singh Roopal Jyoti , Sehgal Mrignyani , Gram Lu , Kumar Neha , Prost Audrey
Published: December 2020

Introduction

India is home to over 6 million women’s groups, including self-help groups. There has been no evidence synthesis on whether and how such groups improve women’s and children’s health.

Methods

We did a mixed-methods systematic review of quantitative and qualitative studies on women’s groups in India to examine effects on women and children’s health and to identify enablers and barriers to achieving outcomes. We searched 10 databases and included studies published in English from 2000 to 2019 measuring health knowledge, behaviours or outcomes. Our study population included adult women and children under 5 years. We appraised studies using standard risk of bias assessments. We compared intervention effects by level of community participation, scope of capability strengthening (individual, group or community), type of women’s group and social and behaviour change techniques employed. We synthesised quantitative and qualitative studies to identify barriers and enablers related to context, intervention design and implementation, and outcome characteristics.

Findings

We screened 21 380 studies and included 99: 19 randomised controlled trial reports, 25 quasi-experimental study reports and 55 non-experimental studies (27 quantitative and 28 qualitative). Experimental studies provided moderate-quality evidence that health interventions with women’s groups can improve perinatal practices, neonatal survival, immunisation rates and women’s and children’s dietary diversity, and help control vector-borne diseases. Evidence of positive effects was strongest for community mobilisation interventions that built communities’ capabilities and went beyond sharing information. Key enablers were inclusion of vulnerable community members, outcomes that could be reasonably expected to change through community interventions and intensity proportionate to ambition. Barriers included limited time or focus on health, outcomes not relevant to group members and health system constraints.

Conclusion

Interventions with women’s groups can improve women’s and children’s health in India. The most effective interventions go beyond using groups to disseminate health information and seek to build communities’ capabilities.

Trial registration number

The review was registered with PROSPERO: CRD42019130633.
Boys are more likely to be undernourished than girls: a systematic review and meta-analysis of sex differences in undernutrition
Authors: Thurstans Susan , Opondo Charles , Seal Andrew , Wells Jonathan , Khara Tanya , Dolan Carmel , Briend André , Myatt Mark , Garenne Michel , Sear Rebecca , Kerac Marko
Published: December 2020

Background

Excess male morbidity and mortality is well recognised in neonatal medicine and infant health. In contrast, within global nutrition, it is commonly assumed that girls are more at risk of experiencing undernutrition. We aimed to explore evidence for any male/female differences in child undernutrition using anthropometric case definitions and the reasons for differences observed.

Methods

We searched: Medline, Embase, Global health, Popline and Cochrane databases with no time limits applied. Eligible studies focused on children aged 0–59 months affected by undernutrition where sex was reported. In the meta-analysis, undernutrition-specific estimates were examined separately for wasting, stunting and underweight using a random-effects model.

Results

74 studies were identified: 44/74 studies were included in the meta-analysis. In 20 which examined wasting, boys had higher odds of being wasted than girls (pooled OR 1.26, 95% CI 1.13 to 1.40). 38 examined stunting: boys had higher odds of stunting than girls (pooled OR 1.29 95% CI 1.22 to 1.37). 23 explored underweight: boys had higher odds of being underweight than girls (pooled OR 1.14, 95% CI 1.02 to 1.26). There was some limited evidence that the female advantage, indicated by a lower risk of stunting and underweight, was weaker in South Asia than other parts of the world. 43/74 (58%) studies discussed possible reasons for boy/girl differences; 10/74 (14%) cited studies with similar findings with no further discussion; 21/74 (28%) had no sex difference discussion. 6/43 studies (14%) postulated biological causes, 21/43 (49%) social causes and 16/43 (37%) to a combination.

Conclusion

Our review indicates that undernutrition in children under 5 is more likely to affect boys than girls, though the magnitude of these differences varies and is more pronounced in some contexts than others. Future research should further explore reasons for these differences and implications for nutrition policy and practice.
Design thinking as an approach for innovation in healthcare: systematic review and research avenues
Authors: Oliveira Mariana , Zancul Eduardo , Fleury André Leme
Published: December 2020

Design thinking has been increasingly adopted as an approach to support innovation in healthcare. Recent publications report design thinking application to various innovation projects, across medical specialties, including paediatrics, psychiatry, radiology, gastroenterology, oncology, orthopaedics and surgery, as well as to innovation in hospital operations and healthcare management. Current literature in the area typically focuses on single case descriptions. With the recent increase in the number of cases, there is an opportunity to assess multiple cases to identify patterns and avenues for further research. This study provides a systematic review of published design thinking projects in healthcare. The aim of the study is to provide an overview of how design thinking has been applied in the healthcare sector. Data collection was based on Institute of Scientific Information (ISI) Web of Science, PubMed and Scopus databases. The systematic review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of 32 original pieces of research was selected for analysis, being classified and assessed. The paper presents current status of research and practice from various perspectives, including the design thinking progression phase—inspiration, ideation, implementation—and the prevalence of design thinking tools. Avenues for further research include the need to increase focus on the inspiration phase, the opportunity for platforms for leveraging the integration of individuals in innovation projects, and the opportunity to enhance the role of lead users in healthcare innovation.
Double standards in healthcare innovations: the case of mosquito net mesh for hernia repair
Authors: Skopec Mark , Grillo Alessandra , Kureshi Alvena , Bhatti Yasser , Harris Matthew
Published: December 2020

With over two decades of evidence available including from randomised clinical trials, we explore whether the use of low-cost mosquito net mesh for inguinal hernia repair, common practice only in low-income and middle-income countries, represents a double standard in surgical care. We explore the clinical evidence, biomechanical properties and sterilisation requirements for mosquito net mesh for hernia repair and discuss the rationale for its use routinely in all settings, including in high-income settings. Considering that mosquito net mesh is as effective and safe as commercial mesh, and also with features that more closely resemble normal abdominal wall tissue, there is a strong case for its use in all settings, not just low-income and middle-income countries. In the healthcare sector specifically, either innovations should be acceptable for all contexts, or none at all. If such a double standard exists and worse, persists, it raises serious questions about the ethics of promoting healthcare innovations in some but not all contexts in terms of risks to health outcomes, equitable access, and barriers to learning.
Are lifestyle pattern changes associated to poor subjective sleep quality?: a cross-sectional study by gender among the general Japanese population underwent specified medical check-ups in 2014 and 2015
Authors: Hidaka Tomoo , Kasuga Hideaki , Endo Shota , Masuishi Yusuke , Kakamu Takeyasu , Takeda Akiko , Koizumi Makoto , Fukushima Tetsuhito
Published: December 2020

Objectives

Subjective sleep quality (SSQ) is defined by the satisfaction of one’s overall sleep experience and is composed of sleep depth and restfulness. It has not been clarified how poor SSQ is associated to changes in lifestyles. The purpose is to reveal the association of lifestyle pattern changes and poor SSQ.

Design

A cross-sectional study.

Setting

The data on basic attributes, SSQ and lifestyle such as presence/absence of smoking, exercise, physical activity, supper time close to bedtime, drinking habits and alcohol intake amount per day were obtained from database and questionnaire of specified medical check-ups in fiscal year 2014–2015 in Japan. The analysis was conducted in 2019.

Participants

The subjects comprised 49 483 residents (26 087 men and 23 396 women), aged 40–74 years who had undergone an annual specified medical check-up from 2014 to 2015 in Fukushima Prefecture, Japan.

Outcome measure

Status of SSQ in 2015 was assessed using a question asking whether or not the subjects usually got enough sleep. Poor SSQ in 2015 and lifestyle pattern changes in 2014–2015 were compared between those who were in healthy status both in 2014 and 2015 (referent) and non-referent, using binary logistic regression analysis.

Results

Unhealthy lifestyle pattern for 2014–2015 was significantly associated to poor SSQ in 2015: ‘absent to absent’ in exercise for men (OR=1.472; 95% CI 1.316 to 1.647) and women (OR=1.428; 95% CI 1.285 to 1.587), physical activity for men (OR=1.420; 95% CI 1.270 to 1.588) and women (OR=1.471; 95% CI 1.322 to 1.638) and ‘present to present’ in supper time for men (OR=1.149; 95% CI 1.020 to 1.294) and women (OR=1.288; 95% CI 1.102 to 1.505).

Conclusions

Healthcare workers may be able to contribute to the improvement of SSQ, focusing on changeable lifestyles.
Effectiveness of routine measurement of health-related quality of life in improving the outcomes of patients with musculoskeletal problems—a cluster randomised controlled trial: protocol paper
Authors: Lam Cindy , Chin Weng Yee , Wong Carlos King Ho , Or Kalun , Fong Daniel Yee Tak , Cheung Jason Pui Yin , Chao David Vai Kiong , Wong Eliza L Y , Kind Paul
Published: December 2020

Introduction

Managing chronic musculoskeletal problems usually focuses on pain control using medications, but outcomes are often unsatisfactory and sometimes harmful. Information on a patient’s health-related quality of life (HRQOL) may trigger a doctor to tailor management improving quality of life. The aim of this trial is to find out whether routine measurement and reporting of a patient’s EuroQoL 5-Dimension 5-Level (EQ-5D-5L) HRQOL data using an electronic platform can improve HRQOL and pain in patients with chronic knee or back problems in primary care. We will also assess the acceptability of routine electronic measurements and reporting of the EQ-5D-5L in primary care settings.

Methods

This is a multicentre, prospective, cluster randomised controlled trial set in six public primary care clinics in Hong Kong. At the intervention clinics, subjects will complete an electronic EQ-5D-5L form at recruitment and at each clinic follow-up over 12 months. A report of the patient’s longitudinal EQ-5D-5L data will be provided to the doctor. Subjects in the control clinics will receive care as usual. All subjects will complete the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), a 10-point Pain Rating Scale and a structured questionnaire to collect sociodemographic information and data on morbidity and service utilisation at recruitment at baseline, 3, 6 and 12 months. Primary outcome is the change in WOMAC total score. Secondary outcomes are change in pain, other patient-reported outcome scores and doctor-rated severity of disease. Group differences in the changes in WOMAC and other outcome scores over time will be analysed using generalised estimating equation model with an intention-to-treat principle.

Ethics and dissemination

Ethics approval has been obtained from The University of Hong Kong/Hospital Authority Hong Kong West Cluster (IRB reference number: UW 18-270). The results of the trial will be submitted for publication in a peer-reviewed journal.

Trial registration number

NCT03609762.
Ideal cardiovascular health in urban Jamaica: prevalence estimates and relationship to community property value, household assets and educational attainment: a cross-sectional study
Authors: McKenzie Joette A , Younger Novie O , Tulloch-Reid Marshall Kerr , Govia Ishtar , Bennett Nadia R , McFarlane Shelly , Walters Renee , Francis Damian K , Webster-Kerr Karen , Grant Andriene , Davidson Tamu , Wilks Rainford , Williams David R , Ferguson Trevor S
Published: December 2020

Objective

Ideal cardiovascular health (ICH) is associated with greater longevity and reduced morbidity, but no research on ICH has been conducted in Jamaica. We aimed to estimate the prevalence of ICH in urban Jamaica and to evaluate associations between ICH and community, household, and individual socioeconomic status (SES).

Design

Cross-sectional study.

Setting

Urban communities in Jamaica.

Participants

360 men and 665 women who were urban residents aged ≥20 years from a national survey, the Jamaica Health and Lifestyle Survey 2016–2017.

Exposures

Community SES, using median land values (MLV); household SES, using number of household assets; and individual SES, using education level.

Primary outcome

The main outcome variable was ICH, defined as having five or more of seven ICH characteristics (ICH-5): current non-smoking, healthy diet, moderate physical activity, normal body mass index, normal blood pressure, normal glucose and normal cholesterol. Prevalence was estimated using weighted survey design and logistic regression models were used to evaluate associations.

Results

The prevalence of overall ICH (seven characteristics) was 0.51%, while the prevalence of ICH-5 was 22.9% (male 24.5%, female 21.5%, p=0.447). In sex-specific multivariable models adjusted for age, education, and household assets, men in the lower tertiles of community MLV had lower odds of ICH-5 compared with men in the upper tertile (lowest tertile: OR 0.33, 95% CI 0.12 to 0.91, p=0.032; middle tertile: OR 0.46, 95% CI 0.20 to 1.04, p=0.062). Women from communities in the lower and middle tertiles of MLV also had lower odds of ICH-5, but the association was not statistically significant. Educational attainment was inversely associated with ICH-5 among men and positively associated among women.

Conclusion

Living in poorer communities was associated with lower odds of ICH-5 among men in Jamaica. The association between education level and ICH-5 differed in men and women.
Association between different types of mass media and antenatal care visits in India: a cross-sectional study from the National Family Health Survey (2015–2016)
Authors: Dhawan Dhriti , Pinnamaneni Ramya , Bekalu Mesfin , Viswanath Kasisomayajula
Published: December 2020

Objective

To generate evidence for the association between different types of mass media and antenatal care (ANC) visits in India.

Design

A cross-sectional study design, analysing data from India’s National Family Health Survey 4 (NFHS-4), 2015–2016.

Setting

Rural and urban India.

Participants

From NFHS-4, women who had given birth in the last 5 years before survey administration were included in this study. Women with missing information about their number of ANC visits and their caste were excluded, leaving 187 894 women in the final analytical sample.

Primary outcome measures

Logistic regression analysis was conducted to determine the association of ANC utilisation with mass media exposure.

Results

Overall, our study showed that high exposure to all four types of mass media was positively associated with making at least eight ANC visits. In rural India, women who had high exposure to newspaper/magazine (adjusted OR (aOR), 1.43; 95% CI, 1.31 to 1.57), radio (aOR, 1.22; 95% CI, 1.09 to 1.37), television (aOR, 2.07; 95% CI, 1.94 to 2.2) and movies (aOR, 1.33; 95% CI, 1.2 to 1.47) were more likely to make at least eight ANC visits. In urban India, women who had high exposure to newspaper/magazine (aOR, 1.12; 95% CI, 1.02 to 1.24), radio (aOR, 1.37; 95% CI, 1.13 to 1.65), television (aOR, 1.39; 95% CI, 1.24 to 1.55) and movies (aOR, 1.23; 95% CI, 1.09 to 1.38) were more likely to make at least eight ANC visits.

Conclusions

Our findings emphasise the need for increased awareness about adequate ANC visits in India, to improve maternal, neonatal and child health outcomes. Our study highlights that television penetration is broader than other forms of media and has the potential to create awareness about health in both urban and rural populations. These findings can inform ANC-related health awareness campaigns in the country to allocate resources to appropriate media sources to encourage healthy behaviours.
Retrospective observational study of temporal trends and outcomes of hepatitis B screening in patients receiving rituximab
Authors: Haider Mahnur , Flocco Gianina , Lopez Rocio , Carey William
Published: December 2020

Objective

Hepatitis B reactivation (HBr) is strongly associated with rituximab therapy. Guidelines advise hepatitis B screening and use of preventive nucleoside analogue (NA) in patients at risk. In this study, we examined screening trends, post-screening interventions and outcomes in patients receiving rituximab in light of recommendations.

Design

Retrospective, observational study.

Setting

Single, tertiary care centre in the USA.

Participants

Patients receiving rituximab from January 2005 to December 2017.

Primary outcome

Trends of hepatitis B screening prior to initiation of rituximab.

Secondary outcome

Results of hepatitis B screening, use of preventive NA therapy and HBr incidence.

Results

Over 13 years, 2219 patients received rituximab. Screening, with at least hepatitis B core antibody (anti-HBc) prior to the first dose of rituximab, improved from 20% to 97%. Because only 4.5% of patients had a positive anti-HBc, the overall HBr incidence was very low (0.42%). In susceptible patients, the incidence of HBr was 8%. In at-risk patients given preventive NA, 96% remained free of HBr. However, only 23% received a preventive NA and no temporal improvement in compliance was seen. Of those with HBr, 87.5% were hepatitis B surface antigen (HbsAg−)/anti-HBc+.

Conclusions

In those treated with rituximab, we demonstrated near-universal anti-HBc screening. Screening unlinked to preventive NA use, in those who are anti-HBc+, is ineffective in reducing HBr. HBr has a high fatality rate. The majority of cases occurred in those who were HBsAg negative. Efforts are needed to educate providers who use rituximab not only to screen for anti-HBc, but to provide preventive NA to those who test positive.
COVID-19 confessions: a qualitative exploration of healthcare workers experiences of working with COVID-19
Authors: Bennett Paul , Noble S , Johnston Stephen , Jones David , Hunter Rachael
Published: December 2020

Objectives

To gain insight into the experiences and concerns of front-line National Health Service (NHS) workers while caring for patients with COVID-19.

Design

Qualitative analysis of data collected through an anonymous website (www.covidconfidential) provided a repository of uncensored COVID-19 experiences of front-line NHS workers, accessed via a link advertised on the Twitter feed of two high profile medical tweeters and their retweets.

Setting

Community of NHS workers who accessed this social media.

Participants

54 healthcare workers, including doctors, nurses and physiotherapists, accessed the website and left a ‘story’.

Results

Stories ranged from 1 word to 10 min in length. Thematic analysis identified common themes, with a central aspect being the experience and psychological consequence of trauma. Specific themes were: (1) the shock of the virus, (2) staff sacrifice and dedication, (3) collateral damage ranging from personal health concerns to the long-term impact on, and care of, discharged patients and (4) a hierarchy of power and inequality within the healthcare system.

Conclusions

COVID-19 confidential gave an outlet for unprompted and uncensored stories of healthcare workers in the context of COVID-19. In addition to personal experiences of trauma, there were perceptions that many operational difficulties stemmed from inequalities of power between management and front-line workers. Learning from these experiences will reduce staff distress and improve patient care in the face of further waves of the pandemic.
Post-discharge care following acute kidney injury: quality improvement in primary care
Authors: Howard Susan J , Elvey Rebecca , Ohrnberger Julius , Turner Alex J , Anselmi Laura , Martindale Anne-Marie , Blakeman Tom
Published: December 2020

Background

Over the past decade, targeting acute kidney injury (AKI) has become a priority to improve patient safety and health outcomes. Illness complicated by AKI is common and is associated with adverse outcomes including high rates of unplanned hospital readmission. Through national patient safety directives, NHS England has mandated the implementation of an AKI clinical decision support system in hospitals. In order to improve care following AKI, hospitals have also been incentivised to improve discharge summaries and general practices are recommended to establish registers of people who have had an episode of illness complicated by AKI. However, to date, there is limited evidence surrounding the development and impact of interventions following AKI.

Design

We conducted a quality improvement project in primary care aiming to improve the management of patients following an episode of hospital care complicated by AKI. All 31 general practices within a single NHS Clinical Commissioning Group were incentivised by a locally commissioned service to engage in audit and feedback, education training and to develop an action plan at each practice to improve management of AKI.

Results

AKI coding in general practice increased from 28% of cases in 2015/2016 to 50% in 2017/2018. Coding of AKI was associated with significant improvements in downstream patient management in terms of conducting a medication review within 1 month of hospital discharge, monitoring kidney function within 3 months and providing written information about AKI to patients. However, there was no effect on unplanned hospitalisation and mortality.

Conclusion

The findings suggest that the quality improvement intervention successfully engaged a primary care workforce in AKI-related care, but that a higher intensity intervention is likely to be required to improve health outcomes. Development of a real-time audit tool is necessary to better understand and minimise the impact of the high mortality rate following AKI.
How Leaders, Teams and Organisations can prevent Burnout and build Resilience: a thematic analysis’
Authors: Koh Mervyn Yong Hwang , Khoo Hwee Sing , Gallardo Marysol Dalisay , Hum Allyn
Published: December 2020

Content

Burnout occurs commonly in palliative care. Building resilience helps to mitigate the effects of burnout. Little is known about the importance of leaders, teams and organisations in preventing burnout and promoting resilience in palliative care.

Objectives

We studied palliative care clinicians with more than a decade’s experience looking into their experiences on the role leaders, teams and organisations play in burnout and resilience.

Patients and methods

This is a thematic analysis focusing on how leaders, teams and organisations influence burnout and resilience. 18 palliative care clinicians—5 doctors, 10 nurses and 3 social workers—who worked in various palliative care settings (hospital, home hospice and inpatient hospice) were interviewed using semistructured questionnaires. The mean age of the interviewees was 52 years old, and the mean number of years practising palliative care was 15.7 years (ranging from 10 to 25 years). The interviews were recorded verbatim and were transcribed and analysed using a thematic analysis approach.

Results

The following themes featured prominently in our study. For leaders: being supportive, caring and compassionate, being a good communicator and showing protective leadership. With teams: being like-minded, caring for the team, sharing the burden and growing together. For organisations: having a strong commitment to palliative care, supporting staff welfare and development, open communication, adequate staffing and organisational activities promoting staff well-being were described as protective against burnout and promoting resilience.

Conclusion

Leaders, teams and organisations play an important role in helping palliative care teams to reduce burnout and promote resilience.
Stability analysis of stem solidness, grain yield, and grain protein concentration in spring wheat
Authors: Subedi Maya , Cárcamo Héctor A. , Knodel Janet J. , Weaver David K. , Cuthbert Richard D. , Pozniak Curtis J. , Nilsen Kirby T. , Beres Brian L.
Published: December 2020

The wheat stem sawfly, Cephus cinctus Norton (Hymenoptera: Cephidae), is a major pest of wheat (Triticum aestivum L.) in the northern Great Plains, where it is a constant threat in Montana and is resurging in Alberta, Saskatchewan, and North Dakota. Adoption of solid-stemmed cultivars is an important management tool for wheat growers; however, the inconsistent pith expression first noted with the release of ‘Rescue’ has been repeatedly observed in modern cultivars such as ‘Lillian’ in Canada. Given the extensive hectares planted to solid-stemmed wheat cultivars during an outbreak, the identification of cultivars that display stable stem solidness, grain yield, and grain protein concentration across a wide range of environments where stem sawfly infestations occur is desirable. We assessed spring wheat plant responses in eight solid-stemmed and two hollow-stemmed genotypes grown across diverse environments using multiple statistical models. Study sites included southern Alberta and Saskatchewan, Montana, and North Dakota. Most models agreed that the genotypes ‘Choteau’, ‘BW925’, and ‘Mott’ consistently displayed high and stable stem solidness concomitant with high grain yield. ‘Choteau’ and ‘BW925’ also consistently met or exceeded the desired threshold of a 3.75/5 pith rating (averaged from the lower four stem internodes) for optimum resistance, whereas ‘Mott’ developed optimal pith at a specific (early) phenological stage when resistance to wheat stem sawfly infestation is critical. Exploring the stability of stem solidness identified ideal genotypes that would enhance germplasm development efforts, which exemplifies how this approach can facilitate the selection, production, and adoption of solid-stemmed wheat cultivars in regions prone to wheat stem sawfly attack.
On the MTO production operations inspired by the pursuit-evasion game
Authors: Wang Fan , Li Jia-Jun , He Peng-Ju , Xue Ying
Published: December 2020

In the present work, we performed a theoretical work to investigate how a make-to-order (MTO) company operates its producing plan for dealing with a rush-order-inserting problem. Firstly, we constructed two models, the time-minimized and cost-minimized model, to investigate the energy-cost generated by the prey during experiencing the pursuit-evasion game. Inspired by the natural pursuit-evasion game, two models have been extended and re-constructed to understand the cost of MTO company induced by the rush-order-inserting problem. In particular, the present results revealed that the optimal strategy adopted by the prey and the MTO manager are significantly coincident. This work provides helpful findings for operating the rush-order-inserting problem and indicates the natural behavior can be appropriately adopted to guide the manager’s decision making.
Butterbur (Petasites hybridus) Extract Ameliorates Hepatic Damage Induced by Ovalbumin in Mice
Authors: Alhusayan Rana M. , Aldahmash Badr Abdullah , El-Nagar Doaa M. , Rady Ahmad , Ibrahim Khalid Elfakki , Alkahtani Saad
Published: December 2020

The liver is the most vital organ that could be influenced by inducers of hypersensitivity such as ovalbumin. The current study was carried out to explore the effects of butterbur (Petasites hybridus) extract on the ovalbumin-induced liver hypersensitivity in Swiss albino male mice. Animals were divided into 4 groups, 1st group served as a control group, 2nd group treated with daily oral administration of 75 mg/kg of butterbur extract, 3rd group received single oral dose 100 mg/kg of ovalbumin to induce hypersensitivity, and 4th group treated with oral administration of butterbur extract one-day post to the hypersensitivity induction. Ovalbumin induces a significant increase in the activity of liver enzymes and MDA and decreased the activity of CAT after the ovalbumin treatment. Histopathological investigations revealed marked pathological alterations in liver tissues in the form of hyaline degeneration and fibrosis. Additionally, heavy immune response indicated by immunostaining of MDA and TNF-α could be observed. In contrast, posttreatment with butterbur extract after hypersensitivity induction resulted in a significant decrease of liver enzymes and oxidative stress and reduced the inflammation and fibrosis of liver tissues. These results suggest that butterbur extract is considered as anti-inflammatory and antioxidant therapeutic herb for hypersensitivity treatment of liver.
Healthspan Improvements in Caenorhabditis elegans with Traditional Chinese Herbal Tea
Authors: Lin Chunxiu , Zhang Xiaoying , Zhuang Chuting , Lin Yugui , Cao Yong , Chen Yunjiao
Published: December 2020

Searching for natural and safe herbal tea with health benefits has attracted more and more attention, which is of great significance for reducing disease risk. A Chinese traditional herbal tea (HT) is rich in active ingredients extracted from natural plants. Numerous pharmacological studies showed that HT had the potential to improve health, including antidepression and antioxidant effects. In this study, we proposed a strategy to explore the role and underlying mechanism of HT in improving healthspan of a Caenorhabditis elegans model. First, we found that HT significantly prolonged the lifespan without reducing fertility in worms. Second, stress resistance (oxidative stress and heat stress) was enhanced and Aβ- and polyQ-induced toxicity was relieved significantly by HT treatment. Both fat deposition and age pigment accumulation were found to be significantly reduced in HT-treated worms. The locomotion in mid-late stages was improved, indicating that behavioral mobility was also significantly enhanced. Furthermore, the main components of HT were eighteen polyphenols and two terpenoids. Finally, it was found that this protective mechanism was positively correlated with the insulin/insulin-like growth factor signaling- (IIS-) dependent manner, which went through promoting the nuclear localization of DAF-16 and its downstream SOD-3 expression. These results suggested that HT had an important role in improving health, which might serve as a promising healthy tea.