bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Strategies for Isolating Anaerobic Bacteria from the Porcine Intestine
Authors: Moote Paul E. , Bescucci Danisa M. , Ortega Polo Rodrigo , Uwiera Richard R. E. , Inglis G. Douglas
Published: February 2021

This work determined that using a combination of isolation methods is necessary to increase the diversity of bacteria recovered from the intestines of monogastric mammals. Direct plating methods have traditionally been used to isolate enteric bacteria, and recent methods (e.g., diffusion methods [i.e., ichip] or differential isolation of endospore-forming bacteria) have been suggested to be superior at increasing diversity, including the recovery of previously uncultured taxa.
The Tail-Specific Protease Is Important for Legionella pneumophila To Survive Thermal Stress in Water and inside Amoebae
Authors: Saoud Joseph , Mani Thangadurai , Faucher Sébastien P.
Published: February 2021

Lp
is a major cause of nosocomial and community-acquired pneumonia.
Lp
is found in water systems, including hot water distribution systems. Heat treatment is a method of disinfection often used to limit the presence of
Lp
in such systems; however, the benefit is usually short term, as
Lp
is able to quickly recolonize these systems.
Proximity Biotin Labeling Reveals Kaposi’s Sarcoma-Associated Herpesvirus Interferon Regulatory Factor Networks
Authors: Kumar Ashish , Salemi Michelle , Bhullar Resham , Guevara-Plunkett Sara , Lyu Yuanzhi , Wang Kang-Hsin , Izumiya Chie , Campbell Mel , Nakajima Ken-ichi , Izumiya Yoshihiro
Published: February 2021

Viral protein interaction with a host protein shows at least two sides: (i) taking host protein functions for its own benefit and (ii) disruption of existing host protein complex formation to inhibit undesirable host responses. Due to the use of affinity precipitation approaches, the majority of studies have focused on how the virus takes advantage of the newly formed protein interactions for its own replication.
Supplemental Material: Low-d18O A-type granites in SW China: Evidence for the interaction between the subducted Paleotethyan slab and the Emeishan mantle plume
Authors: Xu Jian , Xia Xiaoping , al. et
Published: February 2021

Analytical methods, supplementary figures and tables.
Musical hallucinations: a rare and atypical presentation of anti-IgLON5 disease responsive to immunosuppressive therapy
Authors: Stoyanov Alex , McDougall Alan , Urriola Nicolas
Published: February 2021

IgLON5 antibodies are typically associated with the insidious onset of sleep disorder, parasomnia, gait disturbance and abnormal movements, with variable response to immunosuppressive therapy. We describe a case of a 50-year-old man who presented with acute speech difficulties, headache and focal seizures followed by well-formed visual hallucinations, and later, musical hallucinations of mainstream popular music. MRI of the brain demonstrated right temporal lobe changes with corresponding epileptiform activity seen on electroencephalogram. Subsequently, IgLON5 antibodies were detected in the serum. The patient was treated with anticonvulsants, as well as azathioprine with a tapering oral prednisone course with a complete resolution of the symptoms. Our case demonstrates an unusual presentation of the rare but increasingly described anti-IgLON5 disease, with musical hallucinations. The case highlights the variable and evolving clinical phenotypes that can be seen in autoimmune central nervous system disorders.
En bloc resection of cervical adenocarcinoma with late recurrence to the iliopsoas
Authors: Manlubatan Sofia Isabel Tamesa , Lopez Marc Paul Jose , Garcia Carlo Martin Hilomen , Gaston Czar Louie Lopez
Published: February 2021

This is a case of a 50-year-old woman diagnosed with recurrent cervical adenocarcinoma presenting with chronic and persistent low back pain. She underwent myomectomy for myoma uteri 8 years prior. Histopathology report revealed cervical cancer. She underwent chemotherapy, brachytherapy and external beam radiotherapy. All surveillance work-up, over the years, were negative until she was found to have a solitary recurrent lesion in the right iliopsoas muscle on CT scan. A multidisciplinary team of surgeons collaborated to perform wide excision of pelvic recurrence en bloc right internal hemipelvectomy, right hemicolectomy en bloc resection of external iliac artery and vein, external ilio-iliac artery interposition graft and external iliac vein–common femoral vein bypass. Final histopathologic results showed adenocarcinoma with endometrioid features with associated poorly differentiated high-grade carcinoma involving the iliopsoas, cecum and terminal ileum. Two months postoperatively, the patient is ambulating with minimal assistance.
Fibrillary glomerulonephritis or complement 3 glomerulopathy: a rare case of diffuse necrotising crescentic glomerulonephritis with C3-dominant glomerular deposition and positive DNAJB9
Authors: Baker Lyle Wesley , Khan Mahnoor , Cortese Cherise , Aslam Nabeel
Published: February 2021

Fibrillary glomerulonephritis (FGN) and complement 3 glomerulopathy (C3G) are rare forms of glomerulonephritis with distinct aetiologies. Both FGN and C3G can present with nephritic syndrome. FGN is associated with autoimmune disease, dysproteinaemia, malignancy and hepatitis C infection. C3G is caused by the unregulated activation of the alternative complement pathway. We present a rare case of diffuse necrotising crescentic glomerulonephritis with dominant C3 glomerular staining on immunofluorescence—consistent with C3G—but electron microscopy (EM) findings of randomly oriented fibrils with a mean diameter of 14 nm and positive immunohistochemistry for DNAJB9—suggestive of FGN. To the best of our knowledge, this is the first reported case of FGN to show dominant C3 glomerular deposits. This case report reaffirms the utility of EM in the evaluation of nephritic syndrome and highlights the value of DNAJB9—a novel biomarker with a sensitivity and specificity near 100% for FGN.
Covid-19 deaths in Africa: prospective systematic postmortem surveillance study
Authors: Mwananyanda Lawrence , Gill Christopher J , MacLeod William , Kwenda Geoffrey , Pieciak Rachel , Mupila Zachariah , Lapidot Rotem , Mupeta Francis , Forman Leah , Ziko Luunga , Etter Lauren , Thea Donald
Published: February 2021

Objective

To directly measure the fatal impact of coronavirus disease 2019 (covid-19) in an urban African population.

Design

Prospective systematic postmortem surveillance study.

Setting

Zambia’s largest tertiary care referral hospital.

Participants

Deceased people of all ages at the University Teaching Hospital morgue in Lusaka, Zambia, enrolled within 48 hours of death.

Main outcome measure

Postmortem nasopharyngeal swabs were tested via reverse transcriptase quantitative polymerase chain reaction (PCR) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Deaths were stratified by covis-19 status, location, age, sex, and underlying risk factors.

Results

372 participants were enrolled between June and September 2020; PCR results were available for 364 (97.8%). SARS-CoV-2 was detected in 58/364 (15.9%) according to the recommended cycle threshold value of <40 and in 70/364 (19.2%) when expanded to any level of PCR detection. The median age at death among people with a positive test for SARS-CoV-2 was 48 (interquartile range 36-72) years, and 69% (n=48) were male. Most deaths in people with covid-19 (51/70; 73%) occurred in the community; none had been tested for SARS-CoV-2 before death. Among the 19/70 people who died in hospital, six were tested before death. Among the 52/70 people with data on symptoms, 44/52 had typical symptoms of covid-19 (cough, fever, shortness of breath), of whom only five were tested before death. Covid-19 was identified in seven children, only one of whom had been tested before death. The proportion of deaths with covid-19 increased with age, but 76% (n=53) of people who died were aged under 60 years. The five most common comorbidities among people who died with covid-19 were tuberculosis (22; 31%), hypertension (19; 27%), HIV/AIDS (16; 23%), alcohol misuse (12; 17%), and diabetes (9; 13%).

Conclusions

Contrary to expectations, deaths with covid-19 were common in Lusaka. Most occurred in the community, where testing capacity is lacking. However, few people who died at facilities were tested, despite presenting with typical symptoms of covid-19. Therefore, cases of covid-19 were under-reported because testing was rarely done not because covid-19 was rare. If these data are generalizable, the impact of covid-19 in Africa has been vastly underestimated.
Laying the foundation for a Core Set of the International Classification of Functioning, Disability and Health for community-dwelling older adults in primary care: relevant categories of their functioning from the research perspective, a scoping review
Authors: Tomandl Johanna , Heinmüller Stefan , Selb Melissa , Graessel Elmar , Freiberger Ellen , Kühlein Thomas , Hueber Susann , Book Stephanie , Gotthardt Susann
Published: February 2021

Objectives

The objective of this study was to find relevant concepts of functioning in community-dwelling older adults within frequently used assessment instruments published in the scientific literature. This was part of a larger project to develop an International Classification of Functioning, Disability and Health (ICF) Core Set for use in primary care.

Design

A scoping review was conducted. Articles dealing with functioning in older adults were searched and assessed for eligibility. The study population included community-dwelling adults (≥75 years) without dementia, living in high-resource countries. Relevant concepts were extracted from assessment instruments and linked to the ICF using standardised linking rules. Finally, a frequency analysis was conducted.

Setting

Home, primary care.

Participants

Community-dwelling adults aged 75 years and above.

Results

From 5060 identified publications, 68 were included and 30 assessment instruments extracted. Overall, 1182 concepts were retrieved. Most were linked to the ‘activities and participation’ component. The most frequently identified categories were ‘memory functions’, ‘dressing’ and ‘changing basic body position’.

Conclusions

This review provides a list of relevant ICF categories from the research perspective that will be used for developing an ICF Core Set for older primary care patients.

Trial registration numbers

PROSPERO (CRD42017067784), Versorgungsforschung Deutschland Datenbank (VfD_17_003833) and ClinicalTrials.gov (NCT03384732).
Cognitive measures during walking with and without lower-limb prosthesis: protocol for a scoping review
Authors: Yuan Jing , Cline Emily , Liu Ming , Huang He , Feng Jing
Published: February 2021

Introduction

Tuning of lower-limb (LL) robotic prosthesis control is necessary to provide personalised assistance to each human wearer during walking. Prostheses wearers’ adaptation processes are subjective and the efficiency largely depends on one’s mental processes. Therefore, beyond physical motor performance, prosthesis personalisation should consider the wearer’s preference and cognitive performance during walking. As a first step, it is necessary to examine the current measures of cognitive performance when a wearer walks with an LL prosthesis, identify the gaps and methodological considerations, and explore additional measures in a walking setting. In this protocol, we outlined a scoping review that will systematically summarise and evaluate the measures of cognitive performance during walking with and without LL prosthesis.

Methods and analysis

The review process will be guided and documented by CADIMA, an open-access online data management portal for evidence synthesis. Keyword searches will be conducted in seven databases (Web of Science, MEDLINE, BIOSIS, SciELO Citation Index, ProQuest, CINAHL and PsycINFO) up to 2020 supplemented with grey literature searches. Retrieved records will be screened by at least two independent reviewers on the title-and-abstract level and then the full-text level. Selected studies will be evaluated for reporting bias. Data on sample characteristics, type of cognitive function, characteristics of cognitive measures, task prioritisation, experimental design and walking setting will be extracted.

Ethics and dissemination

This scoping review will evaluate the measures used in previously published studies thus does not require ethical approval. The results will contribute to the advancement of prosthesis tuning processes by reviewing the application status of cognitive measures during walking with and without prosthesis and laying the foundation for developing needed measures for cognitive assessment during walking. The results will be disseminated through conferences and journals.
Effectiveness of a sepsis programme in a resource-limited setting: a retrospective analysis of data of a prospective observational study (Ubon-sepsis)
Authors: Booraphun Suchart , Hantrakun Viriya , Siriboon Suwatthiya , Boonsri Chaiyaporn , Poomthong Pulyamon , Singkaew Bung-Orn , Wasombat Oratai , Chamnan Parinya , Champunot Ratapum , Rudd Kristina , Day Nicholas P J , Dondorp Arjen M , Teparrukkul Prapit , West Timothy Eoin , Limmathurotsakul Direk
Published: February 2021

Objective

To evaluate the effectiveness of a Sepsis Fast Track (SFT) programme initiated at a regional referral hospital in Thailand in January 2015.

Design

A retrospective analysis using the data of a prospective observational study (Ubon-sepsis) from March 2013 to January 2017.

Setting

General medical wards and medical intensive care units (ICUs) of a study hospital.

Participants

Patients with community-acquired sepsis observed under the Ubon-sepsis cohort. Sepsis was defined as modified Sequential Organ Failure Assessment (SOFA) Score ≥2.

Main exposure

The SFT programme was a protocol to identify and initiate sepsis care on hospital admission, implemented at the study hospital in 2015. Patients in the SFT programme were admitted directly to the ICUs when available. The non-exposed group comprised of patients who received standard of care.

Main outcome

The primary outcome was 28-day mortality. The secondary outcomes were measured sepsis management interventions.

Results

Of 3806 sepsis patients, 903 (24%) were detected and enrolled in the SFT programme of the study hospital (SFT group) and 2903 received standard of care (non-exposed group). Patients in the SFT group had more organ dysfunction, were more likely to receive measured sepsis management and to be admitted directly to the ICU (19% vs 4%). Patients in the SFT group were more likely to survive (adjusted HR 0.72, 95% CI 0.58 to 0.88, p=0.001) adjusted for admission year, gender, age, comorbidities, modified SOFA Score and direct admission to the ICUs.

Conclusions

The SFT programme is associated with improved sepsis care and lower risk of death in sepsis patients in rural Thailand, where some critical care resources are limited. The survival benefit is observed even when all patients enrolled in the programme could not be admitted directly into the ICUs.

Trial registration number

NCT02217592.
Defining the concepts of a smart nursing home and its potential technology utilities that integrate medical services and are acceptable to stakeholders: a scoping review protocol
Authors: Zhao Yuanyuan , Rokhani Fakhrul Zaman , Shariff Ghazali Sazlina , Chew Boon How
Published: February 2021

Introduction

Smart technologies, digital health and eHealth have been shown to enhance institutional elderly care. Because of the rapidly ageing societies, information technologies in geriatric healthcare are urgently needed. A lot of innovation in smart healthcare has occurred in the past decade, and its use in nursing care assessment, daily living activities and service management is yet to be defined. More fundamentally, the concepts, definitions and scopes of a smart nursing home are still vague. Thus, this scoping review aims to examine the extent, range (variety) and nature (characteristics) of evidence on the existing smart concepts and feasible healthcare technologies, types of medical services in nursing home settings and acceptability of a smart nursing home by the elderly people ≥60 years old, their caregivers, nursing home operators and government agencies.

Methods and analysis

This scoping review will be guided by the smart technology adoption behaviours of elder consumers theoretical model (Elderadopt) by Golant and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews. First, we will conduct an internet search for nursing homes and websites and databases related to the stakeholders to retrieve the definitions, concepts and criteria of a smart nursing home (phase 1). Second, we will conduct an additional systematic electronic database search for published articles on any measures of technological feasibility and integration of medical services in nursing home settings and their acceptability by nursing home residents and caregivers (phase 2). The electronic database search will be carried out from 1999 to 30 September 2020 and limited to works published in English and Chinese languages. For phase 2, the selection of literature is further limited to residents of nursing homes aged ≥60 years old with or without medical needs but are not terminally ill or bed-bound. Qualitative data analysis will follow the Framework Methods and thematic analysis using combined inductive and deductive approaches, conducted by at least two reviewers.

Ethics and dissemination

This protocol is registered on osf.io (URL:https://osf.io/qtwz2/). Ethical approval is not necessary as the scoping review is not a primary study, and the information is collected from selected articles that are publicly available sources. All findings will be disseminated at conferences and published in peer-reviewed journals.
Identifying the competencies of China’s paediatric residents: a modified Delphi method study
Authors: Wang Yujia , Wang Tianyou , Wang Aihua , Chen Shengyu , Jiao Liping , Shi JingYu , Feng Xingmiao , Meng Kai
Published: February 2021

Purpose

Standardised Training of Paediatric Resident (STPR) plays an essential role in training qualified paediatricians. Until now, China had no paediatric resident competency index system to effectively guide and evaluate the competence of paediatric residents. This study aimed to establish a competency index system for paediatric residents in China to provide a reference for improving the training system and quality of STPR.

Study design and setting

This study conducted two rounds of Delphi expert consultation survey among paediatric medical experts (n=16), followed by screening, revising and supplementing indicators using the boundary value method. Next, the analytic hierarchy process was used to determine the weight of indicators and finally establish a competency index system for paediatric residents.

Results

The results of the statistical analysis revealed a positive coefficient of 100% for both rounds of expert consultation. The expert authority coefficient values were 0.82 and 0.83, and the expert coordination coefficient test was p<0.01. After referring to experts’ opinions, a competency index system for paediatric residents with 5 primary indicators, 14 secondary indicators and 73 tertiary indicators was finally formed and the weight of each indicator was calculated. The five primary indicators were professional quality (0.3187), knowledge and skills (0.2734), communication and cooperation (0.1986), lifelong learning (0.1302), and teaching ability (0.0791).

Conclusions

In this study, a competency index system for paediatric residents was constructed following the characteristics and quality requirements for paediatric residents in China and is expected to significantly improve the overall level of paediatricians’ medical service quality and supply.
Mediating effect of coping style on the relationship between clinical leadership and quality of work life among nurses in tertiary-level hospitals in China: a cross-sectional study
Authors: Li Hongli , Chang Hui , Tao Zijun , Zhang Dan , Shi Ying , Li Xiaofei
Published: February 2021

Objective

To explore the association between clinical leadership and quality of work life, as well as the mediating role of coping style in this relationship.

Setting

Three tertiary-level hospitals in Liaoning Province, China.

Participants

A total of 1209 nurses were recruited for this study. Registered nurses who work full time with at least 1 year of work experience were eligible as subjects. Exclusion criteria were nurses who work indirectly with patients, such as in education, administration or research.

Primary and secondary outcome measures

Questionnaires consisting of the work-related Quality of Life Scale, the Nurse Leadership Scale and the Simplified Coping Style Questionnaire, as well as a demographic data sheet, were used to collect participant information. Pearson’s correlation analysis, hierarchical multiple regression analysis, and asymptotic and resampling strategies were used to analyse the data.

Results

The mean overall quality of work life score among Chinese nurses was 3.50±0.60. After adjusting for demographic characteristics, clinical leadership was positively associated with the score of quality of work life (β=0.55, p<0.01). Clinical leadership explained 27% of the variance in quality of work life. Coping style partially mediated the relationship between clinical leadership and quality of work life. The proportion of mediation of active coping was 21.82% and of passive coping was 5.79%.

Conclusions

Clinical leadership was positively associated with quality of work life and coping style partially mediated the relationship between clinical leadership and quality of work life among nurses in China. Implementing measures focusing on both clinical leadership and coping style may provide success in improving the quality of work life of nurses.
Impact of non-communicable disease multimorbidity on health service use, catastrophic health expenditure and productivity loss in Indonesia: a population-based panel data analysis study
Authors: Marthias Tiara , Anindya Kanya , Ng Nawi , McPake Barbara , Atun Rifat , Arfyanto Hafiz , Hulse Emily SG , Zhao Yang , Jusril Hafizah , Pan Tianxin , Ishida Marie , Lee John Tayu
Published: February 2021

Objectives

To examine non-communicable diseases (NCDs) multimorbidity level and its relation to households’ socioeconomic characteristics, health service use, catastrophic health expenditures and productivity loss.

Design

This study used panel data of the Indonesian Family Life Survey conducted in 2007 (Wave 4) and 2014 (Wave 5).

Setting

The original sampling frame was based on 13 out of 27 provinces in 1993, representing 83% of the Indonesian population.

Participants

We included respondents aged 50 years and above in 2007, excluding those who did not participate in both Waves 4 and 5. The total number of participants in this study are 3678 respondents.

Primary outcome measures

We examined three main outcomes; health service use (outpatient and inpatient care), financial burden (catastrophic health expenditure) and productivity loss (labour participation, days primary activity missed, days confined in bed). We applied multilevel mixed-effects regression models to assess the associations between NCD multimorbidity and outcome variables,

Results

Women were more likely to have NCD multimorbidity than men and the prevalence of NCD multimorbidity increased with higher socioeconomic status. NCD multimorbidity was associated with a higher number of outpatient visits (compared with those without NCD, incidence rate ratio (IRR) 4.25, 95% CI 3.33 to 5.42 for individuals with >3 NCDs) and inpatient visits (IRR 3.68, 95% CI 2.21 to 6.12 for individuals with >3 NCDs). NCD multimorbidity was also associated with a greater likelihood of experiencing catastrophic health expenditure (for >3 NCDs, adjusted OR (aOR) 1.69, 95% CI 1.02 to 2.81) and lower participation in the labour force (aOR 0.23, 95% CI 0.16 to 0.33) compared with no NCD.

Conclusions

NCD multimorbidity is associated with substantial direct and indirect costs to individuals, households and the wider society. Our study highlights the importance of preparing health systems for addressing the burden of multimorbidity in low-income and middle-income countries.
Association between N95 respirator wearing and device-related pressure injury in the fight against COVID-19: a multicentre cross-sectional survey in China
Authors: Jiang Qixia , Liu Yuxiu , Song Siping , Wei Wei , Bai Yuxuan
Published: February 2021

Objectives

To explore the association between N95 respirator wearing and device-related pressure injury (DRPI) and to provide a basis for protecting medical staff from skin injuries.

Design

A cross-sectional, multicentre study.

Setting and participants

Medical staff of 60 hospitals were selected from 145 designated medical institutions located in the epidemic area where the patients with COVID-19 were treated in China.

Results

In total, 1761 respondents wore N95 respirators (use alone 20.8%; combination use 79.2%), and the prevalence of DRPI was 59.2% (95% CI 56.93 to 61.53). A daily wearing time of >4 hours (OR 1.62, 95% CI 1.11 to 2.35), wearing a N95 respirator in combination with goggles both with the presence of sweating (OR 13.40, 95% CI 7.34 to 23.16) and without the presence of sweating (OR 0.80, 95% CI 0.56 to 1.14) and wearing only a N95 respirator with the presence of sweating (OR 9.60, 95% CI 7.00 to 13.16) were associated with DRPI. A correspondence analysis indicated that if there was no sweating, regardless of whether the N95 respirator was worn by itself or in combination with goggles, single-site DRPI mainly occurred on the nose bridge, cheek and auricle. If there was sweating present, regardless of whether the N95 was worn by itself or in combination with goggles, multiple DRPI sites occurred more often on the face.

Conclusions

The prevalence of DRPI among medical staff caused by N95 respirators was very high, which was mainly associated with a longer daily wearing time and interaction with sweating. The nasal bridge, cheeks and auricles were the primary protection locations found.
Distance, difference in altitude and socioeconomic determinants of utilisation of maternal and child health services in Ethiopia: a geographic and multilevel modelling analysis
Authors: Defar Atkure , Okwaraji Yemisrach B. , Tigabu Zemene , Persson Lars Åke , Alemu Kassahun
Published: February 2021

Objective

We assessed whether geographic distance and difference in altitude between home to health facility and household socioeconomic status were associated with utilisation of maternal and child health services in rural Ethiopia.

Design

Household and health facility surveys were conducted from December 2018 to February 2019.

Setting

Forty-six districts in the Ethiopian regions: Amhara, Oromia, Tigray and Southern Nations, Nationalities, and Peoples.

Participants

A total of 11 877 women aged 13–49 years and 5786 children aged 2–59 months were included.

Outcome measures

The outcomes were four or more antenatal care visits, facility delivery, full child immunisation and utilisation of health services for sick children. A multilevel analysis was carried out with adjustments for potential confounding factors.

Results

Overall, 39% (95% CI: 35 to 42) women had attended four or more antenatal care visits, and 55% (95% CI: 51 to 58) women delivered at health facilities. One in three (36%, 95% CI: 33 to 39) of children had received full immunisations and 35% (95% CI: 31 to 39) of sick children used health services. A long distance (adjusted OR (AOR)=0.57; 95% CI: 0.34 to 0.96) and larger difference in altitude (AOR=0.34; 95% CI: 0.19 to 0.59) were associated with fewer facility deliveries. Larger difference in altitude was associated with a lower proportion of antenatal care visits (AOR=0.46; 95% CI: 0.29 to 0.74). A higher wealth index was associated with a higher proportion of antenatal care visits (AOR=1.67; 95% CI: 1.02 to 2.75) and health facility deliveries (AOR=2.11; 95% CI: 2.11 to 6.48). There was no association between distance, difference in altitude or wealth index and children being fully immunised or seeking care when they were sick.

Conclusion

Achieving universal access to maternal and child health services will require not only strategies to increase coverage but also targeted efforts to address the geographic and socioeconomic differentials in care utilisation, especially for maternal health.

Trial registration number

ISRCTN12040912.
Trauma-informed approaches to primary and community mental health care: protocol for a mixed-methods systematic review
Authors: Dawson Shoba , Bierce Angel , Feder Gene , Macleod John , Turner Katrina M , Zammit Stan , Lewis Natalia V
Published: February 2021

Introduction

Exposure to different types of psychological trauma may lead to a range of adverse effects on trauma survivors, including poor mental and physical health, economic, social and cognitive functioning outcomes. Trauma-informed (TI) approaches to care are defined as a service system grounded in and directed by an understanding of how trauma affects the survivors’ neurological, biological, physiological and social development. TI service system involves training of all staff, service improvements and sometimes screening for trauma experiences. The UK started incorporating TI approaches into the National Health Service. While policies recommend it, the evidence base for TI approaches to healthcare is not well established. We aim to conduct a systematic review to synthesise evidence on TI approaches in primary and community mental healthcare globally.

Methods and analysis

We will undertake a systematic search for primary studies in Medline, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Cochrane library, websites of organisations involved in the development and implementation of TI approaches in healthcare, and databases of thesis and dissertation. Included studies will be in English published between 1990 and February 2020. Two reviewers will independently perform study selection with data extraction and quality appraisal undertaken by one reviewer and checked for accuracy by a second reviewer. A results-based convergent synthesis will be conducted where quantitative (narratively) and qualitative (thematically) evidence will be analysed separately and then integrated using another method of synthesis. We set up a trauma survivor group and a professional group to consult throughout this review.

Ethics and dissemination

There is no requirement for ethical approval for this systematic review as no empirical data will be collected. The findings will be disseminated through a peer-reviewed publication, scientific and practitioner conferences, and policy briefings targeted at local and national policy makers.

PROSPERO registration number

CRD42020164752.
Feasibility of continuous monitoring of vital signs in surgical patients on a general ward: an observational cohort study
Authors: Leenen Jobbe P L , Dijkman Eline M , van Dijk Joris D , van Westreenen Henderik L , Kalkman Cor , Schoonhoven Lisette , Patijn Gijsbert A
Published: February 2021

Objective

To determine feasibility, in terms of acceptability and system fidelity, of continuous vital signs monitoring in abdominal surgery patients on a general ward.

Design

Observational cohort study.

Setting

Tertiary teaching hospital.

Participants

Postoperative abdominal surgical patients (n=30) and nurses (n=23).

Interventions

Patients were continuously monitored with the SensiumVitals wearable device until discharge in addition to usual care, which is intermittent Modified Early Warning Score measurements. Heart rate, respiratory rate and axillary temperature were monitored every 2 min. Values and trends were visualised and alerts sent to the nurses.

Outcomes

System fidelity was measured by analysis of the monitoring data. Acceptability by patients and nurses was assessed using questionnaires.

Results

Thirty patients were monitored for a median duration of 81 hours (IQR 47–143) per patient, resulting in 115 217 measurements per parameter. In total, 19% (n=21 311) of heart rate, 51% (n=59 184) of respiratory rate and 9% of temperature measurements showed artefacts (n=10 269). The system algorithm sent 972 alerts (median alert rate of 4.5 per patient per day), of which 90.3% (n=878) were system alerts and 9.7% (n=94) were vital sign alerts. 35% (n=33) of vital sign alerts were true positives. 93% (n=25) of patients rated the patch as comfortable, 67% (n=18) felt safer and 89% (n=24) would like to wear it next time in the hospital. Nurses were neutral about usefulness, with a median score of 3.5 (IQR 3.1–4) on a 7-point Likert scale, ease of use 3.7 (IQR 3.2–4.8) and satisfaction 3.7 (IQR 3.2–4.8), but agreed on ease of learning at 5.0 (IQR 4.0–5.8). Neutral scores were mostly related to the perceived limited fidelity of the system.

Conclusions

Continuous monitoring of vital signs with a wearable device was well accepted by patients. Nurses’ ratings were highly variable, resulting in on average neutral attitude towards remote monitoring. Our results suggest it is feasible to monitor vital signs continuously on general wards, although acceptability of the device among nurses needs further improvement.
What are the barriers and facilitators of volunteering among healthcare students during the COVID-19 pandemic? A Saudi-based cross-sectional study
Authors: AlOmar Reem S , AlShamlan Nouf A , AlAmer Naheel A , Aldulijan Fajar , AlMuhaidib Serene , Almukhadhib Omar , Algarni Saad A , Alshaibani Askar , Darwish Magdy , Al Shammari Malak
Published: February 2021

Objectives

The objectives of this study were to assess the volunteering of undergraduate health students and interns in the Ministry of Health (MOH) services in the Kingdom of Saudi Arabia (KSA) during the COVID-19 pandemic, its motivational factors and barriers, as well as their risk perception of COVID-19.

Design

A cross-sectional study.

Participants

From 12 to 21 May 2020, an online survey was sent to all undergraduate health students and interns in the KSA. This included questions on demographics, volunteering status, risk perception of COVID-19, as well as motivations and barriers towards volunteering.

Results

In a convenience sample of 6016 students and interns across KSA, 1824 (30.31%) have volunteered with the MOH services during the COVID-19 pandemic. Volunteering was more likely among older participants, from the College of Medicine, those with self-perceived at risk of COVID-19 infection and those with self-perceived healthy participants. Females, those who did not think that students had moral duties to volunteer, those who were at risk of seasonal influenza and those with self-perceived at risk of hospitalisation from COVID-19 were less likely to volunteer. Patriotism, gaining experience, assisting when able and religious rewards all were reported as major motivators to volunteer. Non-volunteering participants reported that lack of interest, protocol and knowledge, as well as issues related to their personal health and transportation were the main barriers to volunteering.

Conclusions

About one-third of undergraduate health students and interns volunteered during the first 2 months of the COVID-19 pandemic in KSA. Moral values were the most important motivations among volunteers. Efforts to encourage heath students and interns to volunteer and providing those with appropriate educational programmes are recommended.
Municipal contraceptive services, socioeconomic status and teenage pregnancy in Finland: a longitudinal study
Authors: Jalanko Eerika , Gyllenberg Frida , Krstic Nikolas , Gissler Mika , Heikinheimo Oskari
Published: February 2021

Objectives

Declining teenage pregnancy rates have been linked to improved access to youth-friendly contraceptive services, but information on the combined association of these services and socioeconomic factors with teenage pregnancy is lacking.

Design and setting

This retrospective longitudinal register-based study covers the annual teenage childbirth and induced abortion rates in the 100 largest municipalities in Finland in 2000–2018. We investigated the combined association of regional, socioeconomic (ie, education level and need for social assistance) and adolescent contraceptive service variables (ie, free-of-charge contraception, an adolescent-only clinic and availability of over-the-counter emergency contraception (OTC EC)) with teenage childbirth and induced abortion rates at the municipality level by using Poisson mixed-effects model.

Primary outcome measures

Annual teenage childbirth and induced abortion rates as numbers per 1000 teenage girls aged 15–19 years old in the 100 largest municipalities in Finland from 2000 to 2018.

Results

The following variables were significantly associated with both lower teenage childbirth and induced abortion rates when adjusted for all the other variables used in the model: providing free-of-charge contraception (rate ratio (RR) 0.82 (95% CI 0.73 to 0.92) and RR 0.87 (95% CI 0.79 to 0.96), respectively), availability of OTC EC without age limit (RR 0.70 (95% CI 0.67 to 0.75) and RR 0.74 (95% CI 0.71 to 0.78), respectively), and high education level of the municipality (RR 0.94 (95% CI 0.94 to 0.95) and RR 0.94 (95% CI 0.93 to 0.94), respectively).

Conclusion

Providing free-of-charge contraception and availability of OTC EC without age limit are associated with lower teenage pregnancy rates. These services combined with proper counselling are thus important contents of youth-friendly contraceptive services that should be provided equally for all teenagers in order to further reduce teenage pregnancy rates.
Prescribed exercise regimen versus usual care and hypochlorous acid wound solution versus placebo for treating venous leg ulcers: study protocol for a randomised controlled trial (Factorial4VLU)
Authors: Jull Andrew , Wadham Angela , Bullen Chris , Parag Varsha , Parsons John G M , Laking George , Waters Jill , Klonizakis Markos , O"Brien Jane
Published: February 2021

Introduction

Compression is the mainstay of treatment for venous leg ulcers (VLUs) and there are few effective adjuvant treatments. There is only observational evidence supporting the use of hypochlorous acid (HOCl) as a topical wound solution on VLU and some limited randomised evidence for the effect of a prescribed regimen of exercise.

Methods and analysis

The Factorial4VLU trial is a pragmatic, blinded, factorial randomised controlled trial, with 380 participants receiving either a prescribed exercise regimen compared with usual care and either active HOCl wound solution or placebo wound solution at each dressing change for up to 24 weeks. All participants will receive compression therapy. The primary outcome is the proportion of participants with healed VLU at 12 weeks after randomisation as adjudicated by blinded review of ulcer photographs. Secondary outcomes are proportion healed at 24 weeks, time to healing, estimated change in ulcer area, change in 2-Minute Walk Test, change in health-related quality of life, incidence of infection and incidence of all-cause adverse events. If either of the interventions shows a statistically significant positive difference on healing outcomes, cost-effectiveness will be modelled using a health service perspective.

Ethics and dissemination

The Factorial4VLU trial received ethical approval from the Northern B Health and Disability Ethics Committee. We plan to publish the results within 1 year of trial completion and will include the results on the trial registration page.

Trial registration numbers

Australia and New Zealand Clinical Trials Register (http://www.anzctr.org.au) (ACTRN12620000116921); Universal Trial Number (WHO) (U1111-1236-2997).
Changes in prescribing rates of sodium-containing medications in the UK from 2009 to 2018: a cross-sectional study with interrupted time series analysis
Authors: Ju Chengsheng , Wei Li , Mackenzie Isla S , MacDonald Thomas M , George Jacob
Published: February 2021

Objective

Effervescent, soluble, dispersible formulations contain considerable amounts of sodium. In 2013, we previously confirmed the association between sodium-containing medications and cardiovascular risks. This study aimed to determine the changes in the prescribing pattern in clinical practice following this publication.

Design

A longitudinal cross-sectional study.

Setting

Primary care in the UK from 2009 to 2018.

Participants

Prescribing information in The Health Improvement Network (THIN) and Prescription Cost Analysis (PCA) databases in the UK.

Outcome measurements

Prescription rates per 10 000 inhabitants were calculated using the number of prescriptions or the number of drug-using patients over the total number of inhabitants, and the prescription rates were measured at annual intervals. Prescribing trends from 2009 to 2018 were indexed with yearly data from THIN and PCA. Interrupted time series analysis (ITSA) was conducted with monthly data in THIN.

Results

From the THIN database, a total of 3 651 419 prescription records from 446 233 patients were included. The prescribing rate of sodium-containing medications changed from 848.3/10 000 inhabitants in 2009 to 571.6/10 000 inhabitants in 2018. The corresponding figures from PCA data were of 631.0/10 000 inhabitants in 2009 and 423.8/10 000 inhabitants in 2018. ITSA showed the prescribing trend reduced significantly during the postpublication period (prescribing rate: slope change=−0.26; 95% CI −0.45 to –0.07; p=0.009; proportion of patients: slope change=−0.22; 95% CI −0.35 to –0.09; p<0.001), but no change in postpublication level from baseline. The prescribing rates for the non-sodium-containing standard formulations were relatively stable over the study period. The reduction in the proportion of patients using sodium-containing medications was only significant in patients over 45 years old.

Conclusions

The prescribing of sodium-containing medications in the UK primary care has declined significantly during the postpublication period. Changes in the prescribing trends for sodium-containing medications varied across regions of the UK and patient age groups.
Impact of temperature and relative humidity on the transmission of COVID-19: a modelling study in China and the United States
Authors: Wang Jingyuan , Tang Ke , Feng Kai , Lin Xin , Lv Weifeng , Chen Kun , Wang Fei
Published: February 2021

Objectives

We aim to assess the impact of temperature and relative humidity on the transmission of COVID-19 across communities after accounting for community-level factors such as demographics, socioeconomic status and human mobility status.

Design

A retrospective cross-sectional regression analysis via the Fama-MacBeth procedure is adopted.

Setting

We use the data for COVID-19 daily symptom-onset cases for 100 Chinese cities and COVID-19 daily confirmed cases for 1005 US counties.

Participants

A total of 69 498 cases in China and 740 843 cases in the USA are used for calculating the effective reproductive numbers.

Primary outcome measures

Regression analysis of the impact of temperature and relative humidity on the effective reproductive number (Rvalue).

Results

Statistically significant negative correlations are found between temperature/relative humidity and the effective reproductive number (Rvalue) in both China and the USA.

Conclusions

Higher temperature and higher relative humidity potentially suppress the transmission of COVID-19. Specifically, an increase in temperature by 1°C is associated with a reduction in theRvalue of COVID-19 by 0.026 (95% CI (−0.0395 to −0.0125)) in China and by 0.020 (95% CI (−0.0311 to −0.0096)) in the USA; an increase in relative humidity by 1% is associated with a reduction in theRvalue by 0.0076 (95% CI (−0.0108 to −0.0045)) in China and by 0.0080 (95% CI (−0.0150 to −0.0010)) in the USA. Therefore, the potential impact of temperature/relative humidity on the effective reproductive number alone is not strong enough to stop the pandemic.
Protocol of the COVID-19 Health and Adherence Research in Scotland (CHARIS) study: understanding changes in adherence to transmission-reducing behaviours, mental and general health, in repeated cross-sectional representative survey of the Scottish population
Authors: Den Daas Chantal , Hubbard Gill , Johnston Marie , Dixon Diane
Published: February 2021

Introduction

COVID-19 has unprecedented consequences on population health, with governments worldwide issuing stringent public health directives. In the absence of a vaccine, a key way to control the pandemic is through behavioural change: people adhering to transmission-reducing behaviours (TRBs), such as physical distancing, hand washing and wearing face covering. Non-adherence may be explained by theories of how people think about the illness (the common-sense model of self-regulation) and/or how they think about the TRBs (social cognition theory and protection motivation theory). In addition, outbreaks of infectious diseases and the measures employed to curb them are likely to have detrimental effects on people’s mental and general health. Therefore, in representative repeated surveys, we will apply behavioural theories to model adherence to TRBs and the effects on mental and general health in the Scottish population from June to November 2020, following the initial outbreak of COVID-19.

Methods and analysis

Repeated 20 min structured telephone surveys will be conducted with nationally representative random samples of 500 adults in Scotland. The first 6 weeks the survey will be conducted weekly, thereafter fortnightly, for a total of 14 waves (total n=7000). Ipsos MORI will recruit participants through random digit dialling. The core survey will measure the primary outcomes of adherence to TRBs, mental and general health, and explanatory variables from the theories. Further questions will be added, enabling more detailed measurement of constructs in the core survey, additional themes and questions that align with the evolving pandemic.

Ethics and dissemination

Ethical approval for this study was granted by the Life Sciences and Medicine College Ethics Review Board (CERB) at the University of Aberdeen (CERB/2020/5/1942). Results will be made available to policy makers, funders, interested lay people and other researchers through weekly reports and three bimonthly bulletins placed on the CHARIS website and advertised through social media.