bluuebunny/crossref_metadata_2025 huggingface dataset:
Whose children? The EU and Member States’ integration policies in education
Authors: Jalušič Vlasta , Bajt Veronika
Published: August 2022

A gap exists between the EU’s professed guarantees of the rights of migrant children and Member States’ individual practices concerning integration. The EU promotes policies claiming to be based on the rights of the child, children’s best interests, and a child‐friendly integration system. Both theory and the EU framework also insist that integration should be understood as a two‐way process. Yet national practices and policies shift responsibility for integration from the reception community to newcomers. Pressures on immigrants, hate speech, and the closure of borders have become the main features of migration policy. The article points out inconsistencies between the EU and its Member States’ own policy frameworks regarding the integration of migrant children in education. Drawing on interviews with stakeholders, we look at the primary triggers for these inconsistencies to learn what they reveal about the EU and its Member States’ integration policies for migrant children. We argue that nationalism and the denial of rights prevent policy processes from becoming a two‐way process and we demonstrate the consequences this has for child‐centred approaches to integration.
Influence of playing surface on match injury risk in men's professional rugby union in England (2013–2019)
Authors: Robertson Charlotte M. , Williams Sean , West Stephen W. , Starling Lindsay , Kemp Simon , Cross Matt , Stokes Keith A.
Published: August 2022

The use of artificial playing surfaces in professional rugby union is growing, but their effect on the injury risk profile remains unclear. The aim of this study was to examine the effect of playing surface on match injury risk in men's professional rugby in England. Six seasons of injury data (2013/14–2018/19) were collected from 15 professional English, men's rugby teams participating in domestic and European competition. The incidence, severity, and burden of match injuries were compared across playing surfaces. The dataset included 3351 injuries from a combined European and domestic data set (separated in to 2 categories; artificial and natural/hybrid surfaces) and 2675 injuries from a domestic only dataset (separated into 3 categories; artificial, hybrid, and natural surfaces). There were no differences in incidence rates between surface types on combined European and domestic match data, but injury burden was significantly greater on artificial (3082 days/1000 h, 95% CI 2847‐3337) in comparison with natural/hybrid surfaces (2364 days/1000 h, 95% CI 2277–2454, p < 0.001). These differences were primarily driven by a significantly greater mean severity of hip/groin, and foot/toe injuries on artificial surfaces. This is the largest study to date to examine the relationship between surface type and injury risk in rugby union. The average severity and burden of injuries sustained on artificial surfaces was significantly greater compared with those sustained on hybrid/natural grass surfaces. This study can inform those involved in selection of surface for elite sport, weighing up the positive and negative elements of the varying surface types.
Equal justice under law? Prosecutor demographics and the death penalty
Authors: Robertson Jami‐Reese Darling , Bell Lauren C.
Published: August 2022

Prior research has established that crime victims’ and defendants’ demographic traits affect the sentence that criminal defendants receive. In addition, previous studies have found that judges’ and juries’ biases affect the outcomes in criminal cases. Yet, despite significant scholarly attention to the effect of race and gender on criminal sentencing, no previous study has explored whether prosecutors’ demographic traits influence the outcome of criminal cases. This is surprising, given that prosecutors are responsible for determining what crimes defendants are charged with and whether to pursue the death penalty in eligible cases. Here, we utilize data on federal death penalty‐eligible cases and the prosecutors who tried those cases to explore whether federal prosecutors’ demographic traits have an effect on whether the death penalty is imposed. We find that both race and gender have statistically significant effects on whether a defendant receives the death penalty, even when case‐specific effects including victim and defendant characteristics are controlled for.
Identification of the HLA‐A allele, HLA‐A*11:03:01:02, in two individuals in a Western Indian family
Authors: Parsaniya Bansi S. , Tambe Manisha , D'Silva Selma Z. , Singh Meenakshi
Published: August 2022

HLA‐A*11:03:01:02 differs from HLA‐A*11:03:01:01 by one nucleotide change at gDNA position 1280 in the intron 3.
English in Northern Cyprus: A sociolinguistic profile
Authors: Selvi Ali Fuad , Silman‐Karanfil Leyla
Published: August 2022

Much has been written and said about the roles, functions, and status of English and its diverse implications in local contexts and for people therein. However, Northern Cyprus stands out as a ‘blind spot’ as it is often annexed in studies related to Turkey or diluted within discussions focusing on Cyprus – which collectively leads to limited, partial, and tangential accounts of the complexities embedded in the local context. Departing from this premise, the current paper offers a comprehensive sociolinguistic profile of English in Northern Cyprus. More specifically, it portrays a historical account of the sociolinguistic situation with present‐day connections to statuses, roles, attitudes, functions, domains, policies, and practices in the local context. It is concluded that as the island morphed first into a postcolonial context and later into a partitioned sociopolitical entity, the linguacultural hegemony of English remained in Turkish Cypriots’ linguistic repertoires, collective psyche, and educational curricula.
Clinical indicators of the nursing diagnosis ineffective health management: Systematic review and meta‐analysis
Authors: da Silva Ricardo Costa , Gondim Micaelle Costa , Lopes Marcos Venícios de Oliveira , da Silva Viviane Martins , Cavalcante Agueda Maria Ruiz Zimmer
Published: August 2022

Background

Nursing diagnoses should reasonably represent global nursing practice phenomena, organizing indicators in their clinical structure that represent different scenarios and populations. However, few studies have summarized the evidence of these indicators, mainly for behavioral diagnoses.

Aim

This systematic review aimed to identify the best clinical indicators (CI) to determine the presence or absence of the nursing diagnosis “Ineffective Health Management” (IHM).

Method

A systematic review with meta‐analysis was utilized. Six electronic databases were consulted to retrieve studies that identified the nursing diagnosis IHM, with at least one CI. The period of data collection was between September and October 2020. The research group independently conducted the selection, quality assessment, data extraction, and analysis of all included studies. Fixed‐effect measures and meta‐analyses summarized sensitivity, specificity measures, and diagnostic odds ratios using the statistical software R. The preferred reporting items for systematic reviews and meta‐analyses and standards for reporting studies of diagnostic accuracy guidelines were used to guide this review, and quality assessment of diagnostic accuracy studies was used for the critical appraisal of the methodological quality of the included studies.

Results

The systematic review included 11 studies on people with chronic conditions, the elderly, and pregnant women. The analyzed four CI showed diagnostic odds ratios statistically higher than the unit value, highlighting the “Failure to include the treatment regimen in daily living” (DOR = 45.53; CI = 10.1, 205.6).

Linking Evidence to Action

Overall, findings showed that all CI of the IHM nursing diagnosis had good sensitivity, specificity, and diagnostic odds ratio measures to identify their presence correctly. These findings can contribute to better accuracy in nurses' decision‐making process, providing indicators to infer the IHM nursing diagnosis early in different population spectra based on the best measures of diagnostic accuracy.
A Method to Determine the Constitutive Parameters of Hyperelastic Films Based on Spherical Indentation
Authors: Zhu Wei , Fan Shengjun , Jia Fei , Leng Jinsong , Liu Yanju
Published: August 2022

An indentation method to determine the properties of hyperelastic thin films is proposed, which is to use a spherical indenter to indent on the film with a small circular hole in the center. During this progress, there exists a maximum indentation load before penetration. Considering geometries of the film and the indenter, the specific form of relationship between the maximum indentation load and the elastic properties of the film is developed for neo-Hookean, Arruda-Boyce, and Ogden hyperelastic constitutive models. On the basis of this relationship, the initial shear modulus of the film can be directly obtained from single data of the maximum load, instead of recording and fitting to indentation curves. Furthermore, other properties of hyperelastic materials are explored from the perspective of the inverse problem. The experiments are performed with natural rubber, silicone rubber, and polydimethylsiloxane (PDMS) films to verify the feasibility of our method, and the optimal radius ratio between the indenter and the hole is concluded from the experimental results.
Acoustical engineering: A complete academic undergraduate program in Brazil
Authors: Fonseca William D'Andrea , Brandão Eric , Mareze Paulo H. , Melo Viviane S. G. , Tenenbaum Roberto A. , Santos Christian dos , Paixão Dinara
Published: August 2022

Acoustics is a broad field of knowledge that extends branches all over the physics of wave phenomena, psychology, natural sciences, and engineering. It is taught, in general, as part of engineering, physics, or architecture programs, or even in graduate programs specialized in the theme. In Brazil, acoustics was taught in graduate programs, until the creation of Acoustical Engineering in 2009, at the Federal University of Santa Maria, an integral undergraduate program dedicated to acoustics, audio, and vibration (lasting ten semesters). This article presents its complete academic program, its creation process, and the professional establishment of the acoustical engineer. In the following, the program of study and subjects are elucidated and detailed, and the teaching methodologies used are also discussed. The program employs several active learning strategies, like project-based learning, aiming to transform abstract into concrete knowledge. The interaction of the university, the acoustical engineer, and society is also presented and clarified. The placement of graduates in fields and their workplaces are presented as outcomes. As a fundamental part of the engineer's formation, the infrastructure used, whether state-of-the-art or cost-effective equipment, is detailed in the context of teaching and research. Finally, some of the ongoing research projects of the students are described.
The acoustic environment before and during the SARS-CoV-2 lockdown in a major German city as measured by ecoacoustic indices
Authors: Haselhoff T. , Hornberg J. , Fischer J. L. , Lawrence B. T. , Ahmed S. , Gruehn D. , Moebus S.
Published: August 2022

The SARS-CoV-2 pandemic drastically changed daily life. Lockdown measures resulted in reduced traffic mobility and, subsequently, a changed acoustic environment. The exceptional lockdown was used to analyze its impact on the urban acoustic environment using ecoacoustic indices. Using data from 22 automated sound recording devices located in 9 land use categories (LUCs) in Bochum, Germany, the normalized difference soundscape index (NDSI) and Bioacoustics index (BIO) were explored. The NDSI quantifies the proportion of anthropophonic to biophonic sounds, and BIO quantifies the total sound activities of biological sources. The mean differences and standard deviation (SD) were calculated 5 weeks before and 5 weeks during the first lockdown. Pronounced peaks for the NDSI and BIO before lockdown that diminished markedly during lockdown were observed, however, with distinct differences in terms of the LUC. The mean NDSI increased from 0.00 (SD = 0.43) to 0.15 (SD = 0.50), the mean BIO decreased from 4.74 (SD = 2.64) to 4.03 (SD = 2.66). Using the NDSI and BIO together reveals that changes of the acoustic environment during lockdown are mainly driven by decreased anthropophonic sound sources. These results suggest that further studies are needed to tailor ecoacoustic indices more accurately to conditions of the urban environment.
Spatial post-filter for linear hydrophone arrays with applications to underwater source localisation
Authors: Bountourakis Vasileios , McCormack Leo , Pulkki Ville
Published: August 2022

This letter presents a spatial post-filter that can be employed in linear hydrophone arrays, commonly found in sonar systems, for the task of improving the bearing estimation and noise suppression capabilities of traditional beamformers. The proposed filter is computed in the time-frequency domain as the normalised cross-spectral density between two beamformed signals, which are generated by applying conventional beamforming to two adjacent non-overlapping sub-arrays. The evaluation on both simulated and real-world data demonstrates promising performance compared to other popular post-filters in some cases, especially for targets near the end-fire direction and in the presence of uncorrelated interferers or diffuse noise.
Lysosomal GPCR-like protein LYCHOS signals cholesterol sufficiency to mTORC1
Authors: Shin Hijai R. , Citron Y. Rose , Wang Lei , Tribouillard Laura , Goul Claire S. , Stipp Robin , Sugasawa Yusuke , Jain Aakriti , Samson Nolwenn , Lim Chun-Yan , Davis Oliver B. , Castaneda-Carpio David , Qian Mingxing , Nomura Daniel K. , Perera Rushika M. , Park Eunyong , Covey Douglas F. , Laplante Mathieu , Evers Alex S. , Zoncu Roberto
Published: August 2022

Lysosomes coordinate cellular metabolism and growth upon sensing of essential nutrients, including cholesterol. Through bioinformatic analysis of lysosomal proteomes, we identified lysosomal cholesterol signaling (LYCHOS, previously annotated as G protein–coupled receptor 155), a multidomain transmembrane protein that enables cholesterol-dependent activation of the master growth regulator, the protein kinase mechanistic target of rapamycin complex 1 (mTORC1). Cholesterol bound to the amino-terminal permease-like region of LYCHOS, and mutating this site impaired mTORC1 activation. At high cholesterol concentrations, LYCHOS bound to the GATOR1 complex, a guanosine triphosphatase (GTPase)–activating protein for the Rag GTPases, through a conserved cytoplasm-facing loop. By sequestering GATOR1, LYCHOS promotes cholesterol- and Rag-dependent recruitment of mTORC1 to lysosomes. Thus, LYCHOS functions in a lysosomal pathway for cholesterol sensing and couples cholesterol concentrations to mTORC1-dependent anabolic signaling.
Tunable light-induced dipole-dipole interaction between optically levitated nanoparticles
Authors: Rieser Jakob , Ciampini Mario A. , Rudolph Henning , Kiesel Nikolai , Hornberger Klaus , Stickler Benjamin A. , Aspelmeyer Markus , Delić Uroš
Published: August 2022

Arrays of optically trapped nanoparticles have emerged as a platform for the study of complex nonequilibrium phenomena. Analogous to atomic many-body systems, one of the crucial ingredients is the ability to precisely control the interactions between particles. However, the optical interactions studied thus far only provide conservative optical binding forces of limited tunability. In this work, we exploit the phase coherence between the optical fields that drive the light-induced dipole-dipole interaction to couple two nanoparticles. In addition, we effectively switch off the optical interaction and observe electrostatic coupling between charged particles. Our results provide a route to developing fully programmable many-body systems of interacting nanoparticles with tunable nonreciprocal interactions, which are instrumental for exploring entanglement and topological phases in arrays of levitated nanoparticles.
Wildlife trade is likely the source of SARS-CoV-2
Authors: Jiang Xiaowei , Wang Ruoqi
Published: August 2022

Multiple transmissions from wildlife at a market in Wuhan probably led to SARS-CoV-2 emergence
James Lovelock (1919–2022)
Authors: Lenton Timothy M.
Published: August 2022

Father of Earth system science
Two New
Rhizobiales
Species Isolated from Root Nodules of Common Sainfoin (Onobrychis viciifolia) Show Different Plant Colonization Strategies
Authors: Ashrafi Samad , Kuzmanović Nemanja , Patz Sascha , Lohwasser Ulrike , Bunk Boyke , Spröer Cathrin , Lorenz Maria , Elhady Ahmed , Frühling Anja , Neumann-Schaal Meina , Verbarg Susanne , Becker Matthias , Thünen Torsten
Published: August 2022

The intensive use of chemical fertilizers has a variety of negative effects on the environment. Increased utilization of biological nitrogen fixation (BNF) is one way to mitigate those negative impacts.
Retrospective Genomic Surveillance of Chikungunya Transmission in Minas Gerais State, Southeast Brazil
Authors: Fritsch Hegger , Giovanetti Marta , Xavier Joilson , Adelino Talita Emile Ribeiro , Fonseca Vagner , de Jesus Jaqueline Góes , de Jesus Ronaldo , Freitas Carla , Peterka Cassio Roberto Leonel , Campelo de Albuquerque Carlos Frederico , Bispo de Filippis Ana Maria , da Cunha Rivaldo Venâncio , Silva Erniria Carvalhais , Alcantara Luiz Carlos Junior , Iani Felipe Campos de Melo
Published: August 2022

Arbovirus infections in Brazil, including chikungunya, dengue, yellow fever, and Zika, result in considerable morbidity and mortality and are pressing public health concerns. However, our understanding of these outbreaks is hampered by the limited availability of genomic data.
Reduced Sensitivity of Commercial Spike-Specific Antibody Assays after Primary Infection with the SARS-CoV-2 Omicron Variant
Authors: Springer David Niklas , Perkmann Thomas , Jani Claudia Maria , Mucher Patrick , Prüger Katja , Marculescu Rodrig , Reuberger Elisabeth , Camp Jeremy Vann , Graninger Marianne , Borsodi Christian , Deutsch Josef , Lammel Oliver , Aberle Stephan Walter , Puchhammer-Stöckl Elisabeth , Haslacher Helmuth , Höltl Eva , Aberle Judith Helene , Stiasny Karin , Weseslindtner Lukas
Published: August 2022

This study demonstrates that the antigenic changes of the SARS-CoV-2 Omicron variant affect test results from commercial Spike- and RBD-specific antibody assays, significantly diminishing their sensitivities and diagnostic abilities to assess neutralizing antibodies.
Assessing Rates of Co-Resistance and Patient Outcomes in Multidrug-Resistant Pseudomonas aeruginosa
Authors: Appaneal Haley J. , Caffrey Aisling R. , Lopes Vrishali , Piehl Emily C. , Puzniak Laura A. , LaPlante Kerry L.
Published: August 2022

We studied antibiotic co-resistance patterns in a national group of hospitalized patients with infections due to multidrug-resistant (MDR)
Pseudomonas aeruginosa
, a type of bacteria that resists treatment to at least three classes of antibiotics. Co-resistance to antibiotic classes most typically used for treatment was common, which makes selecting appropriate antibiotics to successfully treat the infections difficult.
Supplemental Material: Cryogenian glacial erosion of the central Canadian Shield: The “late” Great Unconformity on thin ice
Authors: McDannell Kalin T. , Keller C. Brenhin
Published: August 2022

Supporting text, figures, and analytical data. 
Transmission of SARS-CoV-2 in Norwegian schools during academic year 2020-21: population wide, register based cohort study
Authors: Rotevatn T A , Bergstad Larsen Vilde , Bjordal Johansen Tone , Astrup Elisabeth , Surén Pål , Greve-Isdahl Margrethe , Telle Kjetil Elias
Published: August 2022

Objective

To assess the risk of transmission of SARS-CoV-2 in schools in Norway mainly kept open during the covid-19 pandemic in the academic year 2020-21.

Design

Population wide, register based cohort study.

Setting

Primary and lower secondary schools in Norway open during the academic year 2020-21, with strict infection prevention and control measures in place, such as organisation of students into smaller cohorts. Contact tracing, quarantine, and isolation were also implemented, and testing of students and staff identified as close contacts.

Participants

All students and educational staff in primary and lower secondary schools in Norway, from August 2020 to June 2021.

Main outcome measures

Overall attack rate of SARS-CoV-2 transmission (AR14) was defined as the number of individuals (among students, staff, or both) in the school with covid-19, detected within 14 days of the index case, divided by the number of students and staff members in the school. AR14 to students (attack rates from all index cases to students only) and AR14 to school staff (attack rates from all index cases to staff members only) were also calculated. These measures for student and school staff index cases were also calculated separately to explore variation in AR14 based on the characteristics of the index case.

Results

From August 2020 to June 2021, 4078 index cases were identified; 3220 (79%) students and 858 (21%) school staff. In most (2230 (55%)) schools with an index case, no subsequent individuals with covid-19 were found within 14 days; in 631 (16%) schools, only one more individual with covid-19 within 14 days was found. Overall, AR14 was 0.33% (95% confidence interval 0.32% to 0.33%). When restricting index cases and subsequent individuals with covid-19 to students born in the same year, AR14 to students (0.56-0.78%) was slightly higher.

Conclusions

Regarding the number of people infected with SARS-CoV-2 among students and staff, these results suggest that schools were not an important setting for transmission of the virus in Norway during the covid-19 pandemic in the academic year 2020-21.
Addressing alcohol-related harms in the local night-time economy: a qualitative process evaluation from a complex systems perspective
Authors: McGill Elizabeth , Marks Dalya , Petticrew Mark , Egan Matt
Published: August 2022

Objectives

English local authorities (LAs) are interested in reducing alcohol-related harms and may use discretionary powers such as the Late Night Levy (LNL) to do so. This study aims to describe how system stakeholders hypothesise the levy may generate changes and to explore how the system, its actors and the intervention adapt and co-evolve over time.

Design

A process evaluation from a complex systems perspective, using qualitative methods.

Setting

A London LA with high densities of residential and commercial properties, which implemented the LNL in 2014.

Participants

Data were generated through interviews with LNL implementers and alcohol consumers, observations in bars and during LNL patrols and documentary review.

Intervention

The LNL allows LAs to charge late-night alcohol retailers an annual fee (£299–£4440) to manage and police the night-time economy (NTE).

Results

When the LNL was being considered, stakeholders from different interest groups advanced diverse opinions about its likely impacts while rarely referencing supporting research evidence. Proponents of the levy argued it could reduce crime and anti-social behaviour by providing additional funds to police and manage the NTE. Critics of the levy hypothesised adverse consequences linked to claims that the intervention would force venues to vary their hours or close, cluster closing times, reduce NTE diversity and undermine public–private partnerships. In the first 2 years, levy-funded patrols developed relationships with the licensed trade and the public. The LNL did not undermine public–private partnerships and while some premises varied their hours, these changes did not undermine the intervention’s viability, nor significantly cluster venue closing times, nor obviously damage the area’s reputation for having a diverse NTE.

Conclusions

This study applies a framework for process evaluation from a complex systems perspective. The evaluation could be extended to measure alcohol-related outcomes and to consider the interplay between the national and local systems.
Randomised clinical non-inferiority trial of breathing-based meditation and cognitive processing therapy for symptoms of post-traumatic stress disorder in military veterans
Authors: Bayley Peter J , Schulz-Heik R Jay , Tang Julia S , Mathersul Danielle C , Avery Tim , Wong Melinda , Zeitzer Jamie M , Rosen Craig S , Burn Adam S , Hernandez Beatriz , Lazzeroni Laura C , Seppälä Emma M
Published: August 2022

Objective

Test whether Sudarshan Kriya Yoga (SKY) was non-inferior to cognitive processing therapy (CPT) for treating symptoms of post-traumatic stress disorder (PTSD) among veterans via a parallel randomised controlled non-inferiority trial.

Setting

Outpatient Veterans Affairs healthcare centre.

Participants

85 veterans (75 men, 61% white, mean age 56.9) with symptoms of PTSD participated between October 2015 and March 2020: 59 participants completed the study.

Interventions

SKY emphasises breathing routines and was delivered in group format in a 15-hour workshop followed by two 1-hour sessions per week for 5 weeks. CPT is an individual psychotherapy which emphasises shifting cognitive appraisals and was delivered in two 1-hour sessions per week for 6 weeks.

Measures

The primary outcome measure was the PTSD Checklist-Civilian Version (PCL-C). The secondary measures were the Beck Depression Inventory-II (BDI-II) and Positive and Negative Affect Scale (PANAS).

Results

Mean PCL-C at baseline was 56.5 (±12.6). Intent-to-treat analyses showed that PCL-C scores were reduced at 6 weeks (end of treatment) relative to baseline (SKY, −5.6, d=0.41, n=41: CPT, −6.8, d=0.58, n=44). The between-treatment difference in change scores was within the non-inferiority margin of 10 points (−1.2, 95% CI −5.7 to 3.3), suggesting SKY was not inferior to CPT. SKY was also non-inferior at 1-month (CPT–SKY: −2.1, 95% CI −6.9 to 2.8) and 1-year (CPT–SKY: −1.8, 95% CI −6.6 to 2.9) assessments. SKY was also non-inferior to CPT on the BDI-II and PANAS at end of treatment and 1 month, but SKY was inferior to CPT on both BDI-II and PANAS at 1 year. Dropout rates were similar (SKY, 27%, CPT, 34%: OR=1.36, 95% CI 0.51 to 3.62, p=0.54).

Conclusions

SKY may be non-inferior to CPT for treating symptoms of PTSD and merits further consideration as a treatment for PTSD.

Trial registration number

NCT02366403.
Meanings and senses of organisational silence by male nurses in the emergency department: an interpretative phenomenological study protocol
Authors: Liu Ting , Xu Min , Ye Menghua , Pan Yue , Xu Nafei , Tan Xiaoxue , Sun Qiuhua
Published: August 2022

Introduction

The organisational silence of nursing teams has received increasing attention from managers. Chinese nurses have a relatively high score for organisational silence, and male nurses score higher than female nurses. Lack of professional empathy, high pressure in the work environment, and traditional Chinese cultural factors suggest that Chinese male nurses’ experiences of and reasons for organisational silence are complex and unique. Taking male nurses in the emergency department as an example, this study explores the experience and meaning of male nurses’ organisational silence and provides ideas for nursing managers to understand the silence of male nurses.

Methods and analysis

An interpretative phenomenological approach underpins the study design. In this study, the purposive sampling method will be used to select male nurses who meet the inclusion criteria with maximum differentiation as a strategy. Face-to-face semistructured interviews and Van Manen analysis methods will be used for data collection and analysis.

Ethics and dissemination

The study was approved by the Ethics Committee of the First Affiliated Hospital of Zhejiang Chinese Medical University (ethical approval ID: 2019-KL-036-01). Participants will provide informed consent, will be able to withdraw at any time and will have their contributions kept confidential. The findings of the study will be shared with relevant stakeholders and disseminated in conference presentations and journal publications.

Trial registration number

Chinese Clinical Trial Registry (ChiCTR2100047057).
Risk factors for non-invasive (skin and soft tissue) and invasive Staphylococcus aureus infections among children and adults living in southeastern USA: a retrospective cohort study
Authors: Portela Gerard Thomas , Leong Traci , Webster Andrew , Giarrusso Anthony , Fridkin Scott , Ray Susan M , Swerdlow David , Immergluck Lilly Cheng
Published: August 2022

Objective

To characterise individual and area-level risks associated with invasive or skin and soft tissue (SSTIs) Staphylococcus aureus infections comparing methicillin-resistant S. aureus (MRSA) with methicillin-sensitive S. aureus (MSSA); and highlight differences between children and adults.

Setting

A population-based study from 21 reporting laboratories located in Georgia Health District 3 (HD3), an eight-county catchment area around metro Atlanta.

Participants

A case is a resident of HD3 from whom S. aureus had been isolated in 2017.

Primary outcome

Culture-confirmed S. aureus infections, classified as skin and soft tissue (proxy for non-invasive) or invasive, by methicillin-sensitivity status.

Results

The incidence of SSTIs was 19.7/100 000, compared with 5.2/100 000 for invasive infections. Adults experienced higher rates of SSTIs (22.3/100 000) and invasive infections (6.7/100 000) compared with children with SSTIs (13.0/100 000) and invasive infections (1.3/100 000). Risks of MRSA versus MSSA SSTIs were similar for children and adults. Black individuals with SSTIs were more likely to have MRSA than white individuals (children (OR 1.43, 95% CI 1.16 to 1.76); adults (OR 1.24, 95% CI 1.08 to 1.42)). Adults with invasive MRSA were more likely to be black (adjusted OR 1.69, 95% CI 1.25 to 2.29) compared with those with invasive MSSA. Children with invasive MRSA were more likely from a racial-ethnic concentrated area (OR 4.66, 95% CI 1.85 to 11.71). Hotspots of MRSA were found in crowded areas with higher rates of black populations.

Conclusions

The risk of MRSA infections in children and adults can be defined by unique area-level sociodemographic characteristics which were distinct for those areas associated with MSSA infections. Place-based risks of MRSA or MSSA can be used to develop target public health interventions to decrease transmission and incidence.
Utility of screening for adverse childhood experiences (ACE) in children and young people attending clinical and healthcare settings: a systematic review
Authors: Cibralic Sara , Alam Mafruha , Mendoza Diaz Antonio , Woolfenden Susan , Katz Ilan , Tzioumi Dimitra , Murphy Elisabeth , Deering April , McNamara Lorna , Raman Shanti , Eapen Valsamma
Published: August 2022

Objective

To examine and synthesise the literature on adverse childhood experience (ACE) screening in clinical and healthcare settings servicing children (0–11) and young people (12–25).

Design

A systematic review of literature was undertaken.

Data source

PsycInfo, Web of Science, Embase, PubMed and CINAHL were searched through June 2021. Additional searches were also undertaken.

Eligibility criteria

English language studies were included if they reported results of an ACE tool being used in a clinical or healthcare setting, participants were aged between 0 and 25 years and the ACE tool was completed by children/young people or by parents/caregivers/clinicians on behalf of the child/young person. Studies assessing clinicians’ views on ACE screening in children/young people attending health settings were also included.

Data extraction and synthesis

Two independent reviewers extracted data and assessed for risk of bias using the Mixed Methods Appraisal Tool. Results were synthesised qualitatively.

Results

Initial searches identified 5231 articles, of which 36 were included in the final review. Findings showed that the most commonly used tool for assessing ACE was the ACE questionnaire; administering ACE tools was found to be feasible and acceptable; there were limited studies looking at the utility, feasibility and acceptability of assessing for ACE in First Nations people; and while four studies provided information on actions taken following ACE screening, no follow-up data were collected to determine whether participants accessed services and/or the impact of accessing services.

Conclusion

As the evidence stands, widespread ACE screening is not recommended for routine clinical use. More research is needed on how and what specific ACE to screen for and the impact of screening on well-being.

PROSPERO registration number

University of York Centre for Reviews and Dissemination (CRD42021260420).
Decision aids for home and community care: a systematic review
Authors: Lognon Tania , Plourde Karine V , Aubin Emmanuelle , Giguere Anik M C , Archambault Patrick M , Stacey Dawn , Légaré France
Published: August 2022

Objectives

Decision aids (DAs) for clients in home and community care can support shared decision-making (SDM) with patients, healthcare teams and informal caregivers. We aimed to identify DAs developed for home and community care, verify their adherence to international DA criteria and explore the involvement of interprofessional teams in their development and use.

Design

Systematic review reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Data sources

Six electronic bibliographic databases (MEDLINE, Embase, CINAHL Plus, Web of Science, PsycINFO and the Cochrane Library) from inception to November 2019, social media and grey literature websites up to January 2021.

Eligibility criteria

DAs designed for home and community care settings or including home care or community services as options.

Data extraction and synthesis

Two reviewers independently reviewed citations. Analysis consisted of a narrative synthesis of outcomes and a thematic analysis. DAs were appraised using the International Patient Decision Aid Standards (IPDAS). We collected information on the involvement of interprofessional teams, including nurses, in their development and use.

Results

After reviewing 10 337 database citations and 924 grey literature citations, we extracted characteristics of 33 included DAs. DAs addressed a variety of decision points. Nearly half (42%) were relevant to older adults. Several DAs did not meet IPDAS criteria. Involvement of nurses and interprofessional teams in the development and use of DAs was minimal (33.3% of DAs).

Conclusion

DAs concerned a variety of decisions, especially those related to older people. This reflects the complexity of decisions and need for better support in this sector. There is little evidence about the involvement of interprofessional teams in the development and use of DAs in home and community care settings. An interprofessional approach to designing DAs for home care could facilitate SDM with people being cared for by teams.

PROSPERO registration number

CRD42020169450.
Effectiveness of a nurse-led coaching of self-care agency intervention for elderly patients with total laryngectomy: study protocol for a randomised controlled trial
Authors: Zheng Liyuan , Luo Zhen , Wang Huifen , Liu Shu'e , Li Xue , Peng Danxia , Liu Yan , Ye Sanxia , Lu Yuchen , Chen Jian , Mei Zhidan , Wei Lai , Qian Yu , Lin Xi , Xu Chun
Published: August 2022

Introduction

Due to functional defects and structural destruction after total laryngectomy, patients experienced the poor quality of life, especially for elderly. The barriers to accessing self-care in elderly patients were considered to result from complex and multifaceted interactions of biologic and social factors. Therefore, specific efforts to improve elderly patients’ quality of life are needed. The purpose of our study is to verify nurse-led coaching of elderly patient self-care approaches, which can reduce logistic burden of patients and obtain the successful functional rehabilitation ultimately.

Methods and analysis

Elderly patients (n=60) scheduled for total laryngectomy will be randomly divided into the intervention group and the control group. Patients in the control group received routinely nursing during hospitalisation and thereby at home after discharge received conventional family care without regular supervision of nurses. Patients in the intervention group will receive a series of self-care intervention based on the transtheoretical model during hospitalisation. During home after discharge, nurses will additionally evaluate and supervise the self-care effect of patients. The two groups of patients’ self-care agency, self-efficacy, quality of life and nutritional status will be recorded separately at different time points. Primary outcome is the improvement of patients’ self-care agency, and secondary outcome is the improvements of patients’ self-efficacy, quality of life, nutritional states and 3-month unplanned readmission rate.

Ethics and dissemination

The Ethics Committee of Hubei Cancer Hospital has approved this protocol (KYLLBA2020006). The findings of the trial will be disseminated through peer-reviewed journals, national or international conferences.

Trial registration number

ChiCTR2100043731.
Systematic review and meta-analysis assessing the diagnostic test accuracy of procalcitonin in the diagnosis of invasive bacterial infections in febrile infants: a study protocol
Authors: Norman-Bruce Hannah , Umana Etimbuk , Mills Clare , McFetridge Lisa , Mitchell Hannah , Waterfield Tom
Published: August 2022

Introduction

Young febrile infants are at higher risk of invasive bacterial infections (IBIs) compared with older children. The clinical features of IBI are subtle in this cohort mandating that clinicians take a cautious approach to their initial assessment and management. This includes the measurement of blood biomarkers of infection such as C reactive protein (CRP) and procalcitonin (PCT). In the UK, PCT is not widely available and not recommended for routine use in hospital. This is in contrast to Europe and the USA where PCT is regularly used to assist clinical decision-making. The objective of this review and meta-analysis is to report the diagnostic test accuracy of PCT in detecting IBI in febrile infants less than 91 days old, compare its accuracy with CRP and define optimal PCT cut-off values in this cohort.

Methods and analysis

A search strategy will include MEDLINE, EMBASE, Web of Science, The Cochrane Library and grey literature. There will be no language or date limitations. Diagnostic accuracy studies compliant with STARD criteria will be considered against eligibility criteria. Abstracts, then full texts, of potentially eligible studies will be independently screened for selection. Data extraction and quality assessment, using the QUADAS-2 tool, will be completed by two independent authors and a third author used for any inconsistencies. True positives, false positives, true negatives and false negatives will be pooled to collate specificity and sensitivity with 95% CIs. Results will be portrayed in forest plots, alongside their quality assessments.

Ethics and dissemination

This review does not require ethical clearance. This review will be published in peer-reviewed journals and key messages will be disseminated through presentations at local and international conferences related to this field. The authors aim for this review to be completed and published in 2023.
Quality and safety indicators for home care recipients in Australia: development and cross-sectional analyses
Authors: Caughey Gillian Elizabeth , Lang Catherine E , Bray Sarah Catherine Elizabeth , Sluggett Janet K , Whitehead Craig , Visvanathan Renuka , Evans Keith , Corlis Megan , Cornell Victoria , Barker Anna L , Wesselingh Steve , Inacio Maria C
Published: August 2022

Objectives

To develop and examine the prevalence of quality and safety indicators to monitor care of older Australians receiving home care packages (HCPs), a government-funded aged care programme to support individuals to live at home independently.

Design

Cross-sectional.

Setting

Home care recipients, Australia.

Participants

90 650 older individuals (aged ≥65 years old and ≥50 years old for people of Aboriginal or Torres Strait Islander descent) who received a HCP between 1 January 2016 and 31 December 2016 nationally were included.

Primary and secondary outcome measures

The Registry of Senior Australians developed 15 quality and safety indicators: antipsychotic use, high sedative load, chronic opioid use, antimicrobial use, premature mortality, home medicines reviews, chronic disease management plan, wait-time for HCP, falls, fractures, medication-related adverse events, weight loss/malnutrition, delirium/dementia-related hospitalisations, emergency department (ED) presentations and pressure injuries. Risk adjusted prevalence (%, 95% CI) and geographical area (statistical level 3) variation during 2016 were examined.

Results

In 2016, a total of 102 590 HCP episodes were included for 90 650 individuals, with 66.9% (n=68 598) level 1–2 HCP episodes (ie, for basic care needs) and 33.1% (n=33 992) level 3–4 HCP (ie, higher care needs). The most prevalent indicators included: antibiotic use (52.4%, 95% CI 52.0 to 52.7), chronic disease management plans (38.1%, 95% CI 37.8 to 38.4), high sedative load (29.1%, 95% CI 28.8 to 29.4) and ED presentations (26.4%, 95% CI 25.9 to 26.9). HCP median wait time was 134 days (IQR 41–406). Geographical variation was highest in chronic disease management plans and ED presentations (20.7% of areas outside expected range).

Conclusion

A comprehensive outcome monitoring system to monitor the quality and safety of care and variation for HCP recipients was developed. It provides a pragmatic, efficient and low burden tool to support evidence-based quality and safety improvement initiatives for the aged care sector.
Exploring changes in maternal and congenital syphilis epidemiology to identify factors contributing to increases in congenital syphilis in Florida: a two time-period observational study (2013–2014 vs 2018–2019)
Authors: Matthias James , Spencer Emma C , Bowen Virginia B , Peterman Thomas A
Published: August 2022

Objectives

As, cases of congenital syphilis (CS) and infectious syphilis among women more than doubled in Florida and across the nation during 2013–2019, we sought to understand what may be contributing to these increases in Florida.

Design

A two time-period observational study.

Setting

Pregnant women with reported syphilis infections and their pregnancy outcomes (2013–2014 and 2018–2019) in Florida.

Participants

1213 pregnant women with reported syphilis infections living in Florida and 341 infants meeting the CS case definition.

Outcome measures

We assessed what proportion of the increase in CS was from increases in maternal syphilis infections. We examined maternal demographics, infection characteristics and timing of diagnoses that could explain the increase in CS. Finally, we reviewed if changes in presentation or severity of CS cases occurred.

Results

During 2013–2014, 83 (21%) of 404 pregnant women with syphilis delivered babies with CS. During 2018–2019, 258 (32%) of 809 pregnant women with syphilis delivered babies with CS. Comparing CS prevention rates, it was determined that 65% of the increase in CS was due to the increases in maternal syphilis infections. The proportion of maternal cases staged as primary or secondary increased over time (7%–13%) (p<0.01) and reports of drug use became slightly more common (6%–10%) (p=0.02). During 2018–2019, women delivering CS infants were more likely to be reinfected during the same pregnancy (27 (10%) vs 5 (6%) p=0.23) and more had negative third trimester screening tests (43 (17%) vs 7 (8% p=0.07)). The percentage of infants with CS who had ≥1 sign or symptom increased from 35% to 40%, and the combined total of stillbirths and infant deaths increased from 5 to 26.

Conclusions

Recently, more pregnant women are being infected with syphilis and a higher per cent are not being treated to prevent CS. The reasons for this finding are unclear.
Coproduced resources to support parents caring for children with gastrostomies
Authors: Page Bethan , Harrop Emily , Beale Tania , Boyce Katherine , Smith Colette , Butler Siobhan , Sharrard Alison , Vincent Charles , Lee Alex CH
Published: August 2022

Objective

To describe and disseminate a package of support for parents who care for children with gastrostomies, consisting of a library of videos and resources to support families from referral for gastrostomy surgery, to long-term support at home.

Methods

The resources were systematically developed and evaluated by parents, hospital and community-based nurses, paediatricians, a surgeon and researchers.

Results

The videos empower families, reduce their anxiety and increase their confidence, providing support throughout the families’ journey. Surveys and feedback from parents and clinicians show that the video library is seen as providing clear and comprehensive guidance and is suitable for integration into routine practice. To effectively disseminate these resources across a region, the videos need to be shared widely with relevant community and hospital-based teams, and shared through parent networks. The videos should be viewed as one part of a wider package of training and support, in combination with hands-on-practice and clinical support.

Conclusions

The resources described have been developed with and for families. Critically the videos are founded in the lived-experience of families, as well as the expertise of clinicians from community and hospital services. Similar resources are needed to support families performing other types of specialist care. The resources are freely available to any parent or clinical team.
Exploring the phenotype of Italian patients with ALS with intermediateATXN2polyQ repeats
Authors: Chio Adriano , Moglia Cristina , Canosa Antonio , Manera Umberto , Grassano Maurizio , Vasta Rosario , Palumbo Francesca , Gallone Salvatore , Brunetti Maura , Barberis Marco , De Marchi Fabiola , Dalgard Clifton , Chia Ruth , Mora Gabriele , Iazzolino Barbara , Peotta Laura , Traynor Bryan , Corrado Lucia , D'Alfonso Sandra , Mazzini Letizia , Calvo Andrea
Published: August 2022

Objective

To detect the clinical characteristics of patients with amyotrophic lateral sclerosis (ALS) carrying an intermediateATXN2polyQ number of repeats in a large population-based series of Italian patients with ALS.

Methods

The study population includes 1330 patients with ALS identified through the Piemonte and Valle d’Aosta Register for ALS, diagnosed between 2007 and 2019 and not carryingC9orf72, SOD1, TARDBPandFUSmutations. Controls were 1274 age, sex and geographically matched Italian subjects, identified through patients’ general practitioners.

Results

We found 42 cases and 4 controls with≥31 polyQ repeats, corresponding to an estimated OR of 10.4 (95% CI 3.3 to 29.0). Patients with≥31 polyQ repeats (ATXN2+) compared with those without repeat expansion (ATXN2−) had more frequently a spinal onset (p=0.05), a shorter diagnostic delay (p=0.004), a faster rate of ALSFRS-R progression (p=0.004) and King’s progression (p=0.004), and comorbid frontotemporal dementia (7 (28.0%) vs 121 (13.4%), p=0.037). ATXN2+ patients had a 1-year shorter survival (ATXN2+ patients 1.82 years, 95% CI 1.08 to 2.51; ATXN2− 2.84 years, 95% CI 1.67 to 5.58, p=0.0001).ATXN2polyQ intermediate repeats was independently related to a worse outcome in Cox multivariable analysis (p=0.006).

Conclusions

In our population-based cohort, ATXN2+ patients with ALS have a distinctive phenotype, characterised by a more rapid disease course and a shorter survival. In addition, ATXN2+ patients have a more severe impairment of cognitive functions. These findings have relevant implications on clinical practice, including the possibility of refining the individual prognostic prediction and improving the design of ALS clinical trials, in particular as regards as those targeted explicitly toATXN2.