bluuebunny/crossref_metadata_2025 huggingface dataset:
Promoting evidence-based nursing through journal clubs: an integrative review
Authors: Valizadeh Leila , Zamanzadeh Vahid , Alizadeh Samaneh , Namadi Vosoughi Maryam
Published: June 2022

Background

The journal club has been proposed as a tool to fill the gap between theory and practice.

Aim

The present research is an integrative review of studies focussing on journal clubs.

Methods

An integrative review. We searched the databases during 2010–2019 to find papers using the keywords journal club, nursing, evidence-based practice. The modified version of Cooper’s five-stage integrative review was applied.

Results

The results are presented in two sections – the benefits and challenges of nursing journal clubs and an outline of presentation guidelines. We also discuss the effectiveness of journal clubs in the promotion of evidence-based nursing.

Conclusions

The purpose of the nursing journal club is to review existing literature, discuss the latest information and evidence and identify practical changes required to ultimately improve patient outcomes. Further studies are needed to evaluate the effectiveness of journal clubs in patient care.
Septic arthritis of the wrist: a retrospective review of 39 cases
Authors: Krauss Sabrina , Denzinger Markus , Rachunek Katarzyna , Kolbenschlag Jonas , Daigeler Adrien , Illg Claudius
Published: June 2022

We retrospectively analysed characteristics of 39 patients who presented with septic arthritis of the wrist between January 2015 and June 2021. There was a significant positive correlation between the number of risk factors, such as immunosuppression or diabetes, with Pseudomonas arthritis but not with the number of operations needed to treat the infection or the length of hospitalization. The duration of symptoms before admission at our hospital, C-reactive protein values at admission and infection with Pseudomonas were significantly correlated with the length of hospitalization, but Pseudomonas was detected in one patient only. Staphylococci were the most frequently detected bacteria and significantly correlated with the number of operations needed for treatment. Normal white blood cell counts or C-reactive protein values were frequently encountered.

Level of evidence

III
Abductor pollicis brevis rerouting and first web deepening for clasped thumb deformity in arthrogryposis multiplex congenita
Authors: Anbarasan Amaleswaran , Takagi Takehiko , Seki Atsuhito , Takayama Shinichiro
Published: June 2022

In this study, we retrospectively reviewed our results of managing the clasped thumb deformity in arthrogryposis multiplex congenita patients with first web space deepening and abductor pollicis brevis (APB) rerouting. Twenty-six thumb deformities in 16 children with a mean age of 6.2 years were treated with a mean follow-up of 89.6 months. Following reconstruction with the Spinner flap, the mean angle of the first and second metacarpal axis (M1M2) showed significant improvement from 42° to 61° indicating a wider first web space, and the postoperative mean angle of the thumb proximal phalanx to its metacarpal axis (M1P1) was reduced from 41° to 18°, indicative of a straighter thumb. Following reconstruction with a double-opposing Z-plasty, the mean M1M2 and M1P1 also improved from 38° to 52° and 18° to 9°, respectively. Rerouting of the APB with first web deepening is an efficient and reproducible procedure in improving thumb position.

Level of evidence

III
The consequences of the COVID-19 pandemic on the refugee population: a rapid review
Authors: Badanta B , González-Cano-Caballero M , Fernández-García E , Lucchetti G , de Diego-Cordero R
Published: June 2022

Aims:

This is a rapid review examining the available evidence about the repercussions of the COVID-19 pandemic on the refugee population.

Methods:

A search in the databases such as PubMed, Scopus, CINAHL, PsycINFO, and Web of Science was conducted and all relevant original articles, letters, and editorial and policy papers were included.

Results:

From 208 publications matching the search criteria, 36 were included. These publications were categorized into three distinct domains: Public Health, Policies and Financing, and Technology. Our findings revealed that the situation of the refugee population has worsened during the pandemic. Difficulty accessing healthcare, violation of human rights, lack of access to technology devices, unfavorable government policies, and economic crisis were the most important aspects impacted by COVID-19.

Conclusion:

Governments, health managers, health professionals, and policy makers should be aware of refugees’ problems during the pandemic to provide immediate solutions.
Rethinking “the family” in foster care in Italy: The perspective of children in care and of foster parents’ children
Authors: Sità Chiara , Mortari Luigina
Published: June 2022

In Italy, family fostering is in most cases a voluntary service where foster parents are non-professional helpers. About half of the foster parents are couples with children of their own, which makes fostering a “family enterprise.” Within growing attention to children’s voices in research, the paper focuses on children living foster care (as children in care and as foster parents’ children) and the ways they engage in constructing their family landscape. So far, the point of view of the two groups has been considered separately. Although their life trajectories are highly specific, a cross-cutting perspective on family involving the two groups of children can offer new insights on their experiences of family construction and belonging. Starting from a conceptual framework that sees kinship and family as emerging from practices where family actors—including children—are actively engaged, the article presents the main results of interview research involving 69 children and youth who currently live in foster families in Italy, as children in care and as biological children of the foster parents. The results highlight the intense work children do in constructing and naming family ties, in displaying their family in social contexts, and in learning about themselves, the family, and their multiple belongings throughout foster care.
Representing Tibetan Buddhism in Books on Spirituality: A Discourse-Historical Approach
Authors: Sharapan Maria
Published: June 2022

This article looks into how Tibetan Buddhism is framed in terms of East-West dichotomy in six popular books on Buddhism and spirituality. Discourse Historical Approach is employed to uncover the rhetorical representation of Tibetan Buddhism to the readers. A critical post-colonial perspective offers an insight into various power dynamics, arising from these representations, structured according to Yoshikawa's model of intercultural communication between East and West. The various power outcomes of rhetorical styles range from Ethnocentric to Dialogical, with their ethical consequences and problematics discussed.
Retrospective Case Control Study: Clinical and Computer Tomographic Fusion and Subsidence Evaluation for Single Level Uniportal Endoscopic Posterolateral Approach Transforaminal Lumbar Interbody Fusion Versus Microscopic Minimally Invasive Transforaminal Interbody Fusion
Authors: Kim Hyeun Sung , Wu Pang Hung , Kim Ji Yeon , Lee Jun Hyung , Lee Yeon Jin , Kim Dae Hwan , Lee Jun Hyung , Jeon Jun Bok , Jang Il-Tae
Published: June 2022

Study Design:

Retrospective comparative study.

Objective:

Assessment of difference in clinical and computer tomographic outcomes between the 2 cohorts.

Methods:

Computer tomographic evaluation by Bridwell’s grade, Kim’s stage, Kim’s subsidence grade and clinical evaluation by VAS, ODI and McNab’s criteria on both cohorts.

Results:

33 levels of Endo-TLIF and 22 levels of TLIF were included, with a mean follow up of 14.3 (10-24) and 22.9 (13-30) months respectively. Both Endo-TLIF and TLIF achieved significant improvement of pain and ODI at post-operative 4 week, 3 months and at final follow up with VAS 4.39 ± 0.92, 5.27 ± 1.16 and 5.73 ± 1.21in Endo-TLIF and 4.55 ± 1.16, 5.05 ± 1.11 and 5.50 ± 1.20 in TLIF respectively and ODI at post-operative 1 week, 3 months and final follow up were 43.15 ± 6.57, 49.27 ± 8.24 and 51.73 ± 9.09 in Endo-TLIF and 41.73 ± 7.98, 46.18± 8.46 and 49.09 ± 8.98 in TLIF respectively, P < 0.05. Compared to TLIF, Endo-TLIF achieved better VAS with 0.727 ± 0.235 at 3 months and 0.727 ± 0.252 at final follow up and better ODI with 3.88 ± 1.50 at 3months and 3.42 ± 1.63 at final follow up, P < 0.05. At 6 months radiological evaluation comparison of the Endo-TLIF and TLIF showed significant with more favorable fusion rate in Endo-TLIF of −0.61 ± 0.12 at 6 months and −0.49 ± 0.12 at 1 year in Bridwell’s grading and 0.70 ± 0.15 at 6 months and 0.56 ± 0.14 at 1 year in Kim’s stage.There is less subsidence of 0.606 ± 0.18 at 6 months and −0.561 ± 0.20 at 1 year of Kim’s subsidence grade, P < 0.05.

Conclusion:

Application of single level uniportal endoscopic posterolateral lumbar interbody fusion achieved better clinical outcomes and fusion rate with less subsidence than microscopic minimally invasive transforaminal lumbar interbody fusion in mid-term evaluation for our cohorts of patients.
Reducing the Risk of Neurovascular Injury With Posteromedial Plating and Laterally Directed Screw Insertion During Opening-Wedge High Tibial Osteotomy
Authors: Shim Seung Jae , Jeong Ho Won , Park Sung Bae , Lee Yong Seuk
Published: June 2022

Background:

Neurovascular injury is a serious complication after opening-wedge high tibial osteotomy (OWHTO).

Purpose:

To evaluate (1) how neurovascular injuries during fixation can be prevented and (2) whether a lateral hinge–directed posteromedial fixation system provides comparable neurovascular safety during OWHTO to conventional and custom-made locking plate systems.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Included were 275 knees that underwent OWHTO from March 2014 to May 2018. The knees were divided into 4 groups based on the type of fixation system used: (1) lateral hinge–directed system (LCfit HTO; LCfit group), (2) TDM decisive wedge locking plate (TDM group), (3) OhtoFix anatomic locking metal block plate (OhtoFix group), and (4) TomoFix titanium locking plate (TomoFix group). Using postoperative computed tomography, the following variables among the groups were compared: screw insertion angle relative to the tibia posterior cortex in the axial plane, length, proximity to neurovascular structures, and safety angle of screw fixation (angle between the most proximal posterior screw insertion line and a line tangent to the popliteal artery from the screw hole). Radiological and clinical outcomes were also compared between groups.

Results:

The screw angle was significantly smaller and the distance from neurovascular structures to the screw extension line was significantly farther in the LCfit group compared with the other 3 groups ( P < .001 for both). The safety angle was also wider in the LCfit group than in the other groups ( P < .001). There were no significant differences in radiologic or clinical outcomes between the groups during follow-up.

Conclusion:

The distance from the neurovascular structures to the screw extension line was significantly farther, and the safety angle was also significantly wider with the laterally directed posteromedial plate system compared with the other systems. There were no neurovascular injuries in any group or significant differences in clinical outcomes or radiological parameters between the LCfit and the other locking plate systems.
Thanato-geographies of Palestine and the possibility of politics
Authors: Griffiths Mark
Published: June 2022

This article critically examines thanato-geographies of Palestine-Israel and Palestinians and the crucial question of the possibility of politics in the context of sovereign exception. The main argument of the article is that bare life as referent for Palestinians’ lives overstates the subject-making capacities of the sovereign and understates the possibilities of political agency. As a response, the discussion turns to two prominent examples of exception – Israeli checkpoints and the Gaza borderlands – with the aim to keep in sharp focus both the thanatopolitical and that which – whether as complement or counter – exceeds it. Two important correctives arise from such an approach: thanatopolitical formations are i) dependent on broader thanato-geographies of capitalism; and ii) countered by the political agency of those figured as bare life.
Inositol Triphosphate Signaling Triggers Lysosome Biogenesis Via Calcium Release from Endoplasmic Reticulum Stores
Authors: Malek Mouhannad , Haucke Volker
Published: June 2022

Lysosomes serve as cellular degradation and signaling centers that coordinate the turnover of macromolecules with cell metabolism. The adaptation of cellular lysosome content and activity via the induction of lysosome biogenesis is therefore key to cell physiology and to counteract disease. Previous work has established a pathway for the induction of lysosome biogenesis in signaling-inactive starved cells that is based on the repression of mTORC1-mediated nutrient signaling. How lysosomal biogenesis is facilitated in signaling-active fed cells is poorly understood. A recent study by Malek et al. (2022) partially fills this gap by unraveling a nutrient signaling-independent pathway for lysosome biogenesis that operates in signaling-active cells. This pathway involves the receptor-mediated activation of phospholipase C, inositol (1,4,5)-triphosphate (IP3)-triggered release of calcium ions from endoplasmic reticulum stores, and the calcineurin-induced activation of transcription factor EB (TFEB) and its relative TFE3 to induce lysosomal gene expression independent of calcium in the lysosome lumen. These findings contribute to our understanding of how lysosome biogenesis and function are controlled in response to environmental changes and cell signaling and may conceivably be of relevance for our understanding and the treatment of lysosome-related diseases as well as for aging and neurodegeneration.
Statistical Analysis Plan for the Secondary Prevention by Structured Semi-Interactive Stroke Prevention Package in INDIA (SPRINT INDIA): A Randomized Controlled Trial
Authors: Khatter Himani , Pandian Jeyaraj D. , Kate Mahesh , Sarma Sankara , Sylaja PN , Khurana Dheeraj , Vijaya Pamidimukkala , Ray Biman Kanti , Nambiar Vivek , Aaron Sanjith , George Tina , Mittal Gaurav , Sebastian Ivy , Sundarachary Nagarjunakonda V. , Pai Aparna R. , Gorthi Sankar , Somasundaram Kumaravelu , Sharma Meenakshi , Dhaliwal Rupinder , Reddy Y. Muralidhar , Narayan Sunil , Borah NC , Das Rupjyoti , Kulkarni Girish B. , Huded Vikram , Mathew Thomas , Srivastava Padma MV , Bhatia Rohit , Ojha Pawan , Roy Jayanta , Abraham Sherly , Webster Jemin , Vaishnav Anand , Sharma Arvind , Jabeen Shaik A. , Pathak Abhishek , Bhoi Sanjeev , Sharma Sudheer , Sulena Sulena , Saroja Aralikatte Onkarappa , Ramrakhiani Neetu , Kempegowda Madhusudhan B. , Arora Deepti , Verma Shweta J. , Huilgol Rahul , Dasan Aneesh , Renjith Vishnu
Published: June 2022

Background:

Recurrent stroke is one of the major causes of death in stroke patients. Introducing stroke prevention education package to improve the lifestyle behavioral factors could reduce the vascular events. The Secondary Prevention by Structured Semi-Interactive Stroke Prevention Package (SPRINT) study in India aims to assess the role of a stroke prevention education package to reduce recurrent strokes, myocardial infarction, and death in patients with stroke. The objective is to formulate the detailed statistical analysis plan for the SPRINT India prior to trial unblinding.

Methods:

The plan was developed by trial statisticians with the help of principal investigator and management team of the SPRINT study. The chosen primary and secondary outcome measures and knowledge of critical baseline data were used to construct the statistical analysis plan. All collected data will be thoroughly reviewed. Patient baseline characteristics will be summarized with relevant descriptive statistics. The findings are planned and explained for the most appropriate statistical comparison between the groups.

Results:

The final statistical analysis plan corresponds to established criteria and will allow for transparent and efficient reporting.

Conclusions:

The SPRINT trial statistical analysis plan is developed in order to avoid analysis bias arising from prior knowledge of findings and to explicitly summarize prespecified analyses.
Transcriptome analysis reveals the accelerated expression of genes related to photosynthesis and chlorophyll biosynthesis contribution to shade-tolerant in Phoebe bournei
Authors: An Jing , Wei Xiaoli , Huo Honghao
Published: June 2022

Background

Phoebe bournei (P. bournei) is an important and endemic wood species in China. However, the plantation, nursing, and preservation of P. bournei are often affected by light. To investigate its physiological changes and molecular mechanism of low light tolerance, two-year-old P. bournei seedlings were subjected to different shading conditions. With the increase of light intensity in the shade, the leaf color of P. bournei seedlings became darkened, the aboveground/underground biomass significantly increased, the content of chlorophyll increased and the net photosynthetic rate significantly increased.

Results

de novo transcriptome analysis showed that 724 and 3,248 genes were differentially expressed due to low light intensity at T1 (35% light exposure) and T2 (10% light exposure), respectively, when compared to the controls. Furthermore, the differentially expressed genes (DEGs) were implicated in photosynthesis, nitrogen metabolism, plant hormone signal transduction, biosynthesis of secondary metabolites, and protein processing in the endoplasmic reticulum by functional enrichment analysis. Moreover, the expression of HSP, CAB, HEMA1, GSA, DVR, MYB, bHLH, PORA, CAO, GLK, and photosystem I and II complex-related genes significantly increased after low light exposure at T2 and T1.

Conclusions

The present study suggests that the rapid growth of P. bournei seedlings under shading conditions may be the result of the accelerated expression of genes related to photosynthesis and chlorophyll biosynthesis, which enable plants to maintain a high photosynthesis rate even under low light conditions.
I-125 seeds brachytherapy with transcatheter arterial chemoembolization for subcapsular hepatocellular carcinoma
Authors: Gao Fu-Lei , Wang Yong , Huang Xiang-Zhong , Pan Tian-Fan , Guo Jin-He
Published: June 2022

Background

I-125 seeds brachytherapy (ISB) has been used to improve the clinical effectiveness of transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC). We aim to appraise the safety and clinical efficacy of combined ISB and TACE for the treatment of subcapsular HCC.

Materials and methods

A retrospective investigative study extending from January 2017 to December 2020, involved individuals suffering from subcapsular HCC, who were subjected to TACE treatment with or without ISB in our center. The clinical effectiveness was compared between 2 groups.

Results

Sixty-four patients, in total, with subcapsular HCC had to undergo TACE with (n = 32) or without (n = 32) ISB in our center. After CT-guided ISB, only 2 (6.3%) patients experienced a self-limited pneumothorax. Combined treatment resulted in a significantly higher complete response (56.3% vs. 18.8%,P = 0.002) and total response (90.7% vs. 59.4%,P = 0.004) rates than that of TACE alone. In comparison to the TACE alone group, the median progression-free survival was substantially longer in the combined treatment group (11 months vs. 5 months,P = 0.016). Further, 15 and 28 patients in combined and TACE alone groups respectively died within the follow-up. The median OS was comparable between combined and TACE alone groups (22 months vs. 18 months,P = 0.529).

Conclusions

Combined TACE and ISB therapy is a safe treatment method for individuals suffering from subcapsular HCC. When compared, combined treatment had significantly enhanced clinical efficacy as a subcapsular HCC therapy, in comparison to TACE alone.
Implementation of Delayed Cord Clamping in public health facilities: a case study from India
Authors: Chowdhury Archana , Bandyopadhyay Neogi Sutapa , Prakash Ved , Patel Nilam , Pawar Kunal , Koparde Vinay Kumar , Shukla Anupriya , Karmakar Sangeeta , Parambath Smitha Chekanath , Rowe Sarah , Martinez Homero
Published: June 2022

Background

Global and country specific recommendations on Delayed umbilical cord clamping (DCC) are available, though guidance on their implementation in program settings is lacking. In India, DCC (clamping not earlier than 1 min after birth) is a component in the package of services delivered as part of the India Newborn Action Plan (INAP) supported by Nutrition International (NI) in two states. The objective of this case study was to document the learnings from implementation of DCC in these two states and to understand the health system factors that affected its operationalization.

Methods

Mixed methods were followed. Using the World Health Organization (WHO) Health Systems building blocks as a framework, 20 Key-Informant Interviews were conducted to explore facilitators and barriers to routine implementation of DCC in public health settings. Existing quantitative program data and secondary data from labour-room registers from eight NI- supported districts were analysed to assess the prevalence of DCC implementation in public health systems settings.

Results

A demonstrated commitment from the government to implement DCC at all delivery points in NI supported districts was observed. Funds were sufficient, trainings were optimal, knowledge of the health workforce was adequate and a recording mechanism was in place. According to record reviews, DCC was more likely to happen in facilities that provide Basic Emergency Obstetric services and among normal deliveries. It was less likely to be followed in babies delivered by Caesarean section (OR 0.03; 95%CI 0.02,0.05), birthweight < 2000 g (OR 0.22; 95%CI 0.12,0.47), multiple pregnancies (OR 0.17, 95%CI 0.05,0.63), birth asphyxia requiring resuscitation (0.37; 95%CI 0.26,0.52), and those delivered during day shift (OR 0.59, 95%CI 0.40, 0.83).

Conclusions

Wide coverage of DCC in public health settings in the two states was observed. Good governance, adequate funding, commitment of health workforce has likely contributed to its success in these contexts. These are critical elements to guide DCC implementation in India and for consideration in other settings.
Association of maternal obesity with preterm birth phenotype and mediation effects of gestational diabetes mellitus and preeclampsia: a prospective cohort study
Authors: Liu Kan , Chen Yixuan , Tong Jianing , Yin Aiqi , Wu Linlin , Niu Jianmin
Published: June 2022

Background

The association between maternal obesity and preterm birth remains controversial and inconclusive, and the effects of gestational diabetes mellitus (GDM) and preeclampsia (PE) on the relationship between obesity and preterm birth have not been studied. We aimed to clarify the relationship between prepregnancy body mass index (BMI) and the phenotypes of preterm birth and evaluate the mediation effects of GDM and PE on the relationship between prepregnancy BMI and preterm birth.

Methods

We conducted a prospective cohort study of 43,056 women with live singleton births from 2017 through 2019. According to the WHO International Classification, BMI was classified as underweight (BMI < 18.5 kg/m2), normal weight (BMI 18.5–25 kg/m2), overweight (BMI 25–30 kg/m2) and obese (BMI ≥30 kg/m2). Preterm birth was defined as gestational age less than 37 weeks (extremely, < 28 weeks; very, 28–31 weeks; and moderately, 32–36 weeks). The clinical phenotypes of preterm birth included spontaneous preterm birth (spontaneous preterm labor and premature rupture of the membranes) and medically indicated preterm birth. We further analyzed preterm births with GDM or PE. Multivariable logistic regression analysis and causal mediation analysis were performed.

Results

Risks of extremely, very, and moderately preterm birth increased with BMI, and the highest risk was observed for obese women with extremely preterm birth (OR 3.43, 95% CI 1.07–10.97). Maternal obesity was significantly associated with spontaneous preterm labor (OR 1.98; 95% CI 1.13–3.47), premature rupture of the membranes (OR 2.04; 95% CI 1.08–3.86) and medically indicated preterm birth (OR 2.05; 95% CI 1.25–3.37). GDM and PE mediated 13.41 and 36.66% of the effect of obesity on preterm birth, respectively. GDM mediated 32.80% of the effect of obesity on spontaneous preterm labor and PE mediated 64.31% of the effect of obesity on medically indicated preterm birth.

Conclusions

Maternal prepregnancy obesity was associated with all phenotypes of preterm birth, and the highest risks were extremely preterm birth and medically indicated preterm birth. GDM and PE partially mediated the association between obesity and preterm birth.
BARD1 mystery: tumor suppressors are cancer susceptibility genes
Authors: Hawsawi Yousef M. , Shams Anwar , Theyab Abdulrahman , Abdali Wed A. , Hussien Nahed A. , Alatwi Hanan E. , Alzahrani Othman R. , Oyouni Atif Abdulwahab A. , Babalghith Ahmad O. , Alreshidi Mousa
Published: June 2022

The full-length BRCA1-associated RING domain 1 (BARD1) gene encodes a 777-aa protein. BARD1 displays a dual role in cancer development and progression as it acts as a tumor suppressor and an oncogene. Structurally, BARD1 has homologous domains to BRCA1 that aid their heterodimer interaction to inhibit the progression of different cancers such as breast and ovarian cancers following the BRCA1-dependant pathway. In addition, BARD1 was shown to be involved in other pathways that are involved in tumor suppression (BRCA1-independent pathway) such as the TP53-dependent apoptotic signaling pathway. However, there are abundant BARD1 isoforms exist that are different from the full-length BARD1 due to nonsense and frameshift mutations, or deletions were found to be associated with susceptibility to various cancers including neuroblastoma, lung, breast, and cervical cancers. This article reviews the spectrum of BARD1 full-length genes and its different isoforms and their anticipated associated risk. Additionally, the study also highlights the role of BARD1 as an oncogene in breast cancer patients and its potential uses as a prognostic/diagnostic biomarker and as a therapeutic target for cancer susceptibility testing and treatment.
Completeness and selection bias of a Belgian multidisciplinary, registration-based study on the EFFectiveness and quality of Endometrial Cancer Treatment (EFFECT)
Authors: Vanbraband Joren , Van Damme Nancy , Bouche Gauthier , Silversmit Geert , De Geyndt Anke , de Jonge Eric , Jacomen Gerd , Goffin Frédéric , Denys Hannelore , Amant Frédéric
Published: June 2022

Background

With the aim of obtaining more uniformity and quality in the treatment of corpus uteri cancer in Belgium, the EFFECT project has prospectively collected detailed information on the real-world clinical care offered to 4063 Belgian women with primary corpus uteri cancer. However, as data was collected on a voluntary basis, data may be incomplete and biased. Therefore, this study aimed to assess the completeness and potential selection bias of the EFFECT database.

Methods

Five databases were deterministically coupled by use of the patient’s national social security number. Participation bias was assessed by identifying characteristics associated with hospital participation in EFFECT, if any. Registration bias was assessed by identifying patient, tumor and treatment characteristics associated with patient registration by participating hospitals, if any. Uni- and multivariable logistic regression were applied.

Results

EFFECT covers 56% of all Belgian women diagnosed with primary corpus uteri cancer between 2012 and 2016. These women were registered by 54% of hospitals, which submitted a median of 86% of their patients. Participation of hospitals was found to be biased: low-volume and Walloon-region centers were less likely to participate. Registration of patients by participating hospitals was found to be biased: patients with a less favorable risk profile, with missing data for several clinical-pathological risk factors, that did not undergo curative surgery, and were not discussed in a multidisciplinary tumor board were less likely to be registered.

Conclusions

Due to its voluntary nature, the EFFECT database suffers from a selection bias, both in terms of the hospitals choosing to participate and the patients being included by participating institutions. This study, therefore, highlights the importance of assessing the selection bias that may be present in any study that voluntarily collects clinical data not otherwise routinely collected. Nevertheless, the EFFECT database covers detailed information on the real-world clinical care offered to 56% of all Belgian women diagnosed with corpus uteri cancer between 2012 and 2016, and may therefore act as a powerful tool for measuring and improving the quality of corpus uteri cancer care in Belgium.
Pre-hospital exposures to antibiotics among children presenting with fever in northern Uganda: a facility-based cross-sectional study
Authors: Nyeko Richard , Otim Felix , Obiya Evelyn Miriam , Abala Catherine
Published: June 2022

Background

The rise in the indiscriminate use of antibiotics has become a major global public health problem and presents the biggest global health challenge in the twenty-first century. In developing countries, caregivers initiate treatment with antibiotics at home before presentation to a health facility. However, there is a paucity of evolving data towards surveillance of this trend in low-income countries. We investigated antibiotic use among febrile children presenting to a tertiary health facility in northern Uganda.

Methods

We conducted a cross-sectional study in a tertiary health facility in northern Uganda between March and September 2021. Children aged 6–59 months with fever were selected using systematic random sampling. A pre-tested interviewer-administered questionnaire was used the collect clinical data from the caregivers. Data were analyzed using SPSS version 23. Descriptive statistics and multiple logistic regression models were applied. P-value < 0.05 was considered for statistical significance.

Results

Eighty-three (39.5%) of the 210 children with fever in this study used antibiotics prior to the hospital visit, 55.4% of which were on a self-medication basis, while 44.6% were empiric prescriptions. The most commonly used antibiotics were amoxicillin 33/83 (39.8%), erythromycin 18 (21.7%), metronidazole 14 (16.9%), ciprofloxacin 13 (15.7%) and ampicillin 6 (7.2%). The main sources of the antibiotics included buying from drug shops 30/83 (36.1%), issuance from clinics (33.7%), remnants at home (12.0%), picking from a neighbour (7.2%) and others (10.8%). The factors associated with antibiotic use among the febrile children were residence (p < 0.001); distance from the nearest health facility (p = 0.005); caregivers’ gender (p = 0.043); cough (p = 0.012); diarrhoea (p = 0.007); duration of fever (p = 0.002); perceived convulsion complicating fever (p = 0.026), and caregivers’ perception that fever (p = 0.001), cough (p = 0.003), diarrhoea (p < 0.001) and any infection (p < 0.001) are indications for antibiotics.

Conclusions

Inappropriate use of antibiotics for childhood febrile illnesses is prevalent in the study setting, facilitated by the ease of access and use of leftover antibiotics. There is a need to address communities’ health-seeking behaviour and the health providers’ practice alike.
The impact of working as a peer worker in mental health services: a longitudinal mixed methods study
Authors: Gillard Steve , Foster Rhiannon , White Sarah , Barlow Sally , Bhattacharya Rahul , Binfield Paul , Eborall Rachel , Faulkner Alison , Gibson Sarah , Goldsmith Lucy P. , Simpson Alan , Lucock Mike , Marks Jacqui , Morshead Rosaleen , Patel Shalini , Priebe Stefan , Repper Julie , Rinaldi Miles , Ussher Michael , Worner Jessica
Published: June 2022

Background

Peer workers are increasingly employed in mental health services to use their own experiences of mental distress in supporting others with similar experiences. While evidence is emerging of the benefits of peer support for people using services, the impact on peer workers is less clear. There is a lack of research that takes a longitudinal approach to exploring impact on both employment outcomes for peer workers, and their experiences of working in the peer worker role.

Methods

In a longitudinal mixed methods study, 32 peer workers providing peer support for discharge from inpatient to community mental health care - as part of a randomised controlled trial - undertook in-depth qualitative interviews conducted by service user researchers, and completed measures of wellbeing, burnout, job satisfaction and multi-disciplinary team working after completing training, and four and 12 months into the role. Questionnaire data were summarised and compared to outcomes for relevant population norms, and changes in outcomes were analysed using paired t-tests. Thematic analysis and interpretive workshops involving service user researchers were used to analysis interview transcripts. A critical interpretive synthesis approach was used to synthesise analyses of both datasets.

Results

For the duration of the study, all questionnaire outcomes were comparable with population norms for health professionals or for the general population. There were small-to-medium decreases in wellbeing and aspects of job satisfaction, and increase in burnout after 4 months, but these changes were largely not maintained at 12 months. Peer workers felt valued, empowered and connected in the role, but could find it challenging to adjust to the demands of the job after initial optimism. Supervision and being part of a standalone peer worker team was supportive, although communication with clinical teams could be improved.

Conclusions

Peer workers seem no more likely to experience negative impacts of working than other healthcare professionals but should be well supported as they settle into post, provided with in-work training and support around job insecurity. Research is needed to optimise working arrangements for peer workers alongside clinical teams.
Towards health equity: core components of an extended home visiting intervention in disadvantaged areas of Sweden
Authors: Barboza Madelene , Marttila Anneli , Burström Bo , Kulane Asli
Published: June 2022

Background

Understanding the mechanisms of implementation of public health interventions in community settings is a key aspect of programme assessments. To determine core components and establish a programme theory are important tools to improve functioning and support dissemination of programme models to new locations. An extended early childhood home visiting intervention has been developed on-site in a socioeconomically disadvantaged area of Sweden since 2013 with the aim of reducing persisting health inequities in the population. This study aimed at investigating the core programme components and how the intervention was perceived to contribute towards health equity from early childhood.

Methods

Qualitative framework method was applied in a document analysis and subsequent semi-structured interviews with 15 key actors involved in the programme.

Results

The intervention was found to be constituted of five core components centred around the situation-based, parental strengthening work method delivered by a qualified team of child health care nurse and social worker. The programme theory foresaw positive effects on child and parental health, responsive parenting practices, families’ use of welfare services according to need and increased integration and participation in society. The principles of Proportionate Universalism were recognised in the programme theory and the intervention was perceived as an important contribution to creating conditions for improved health equity for the families. Still, barriers to health equity were identified on the structural level which limit the potential impact of the programme.

Conclusions

The core components of the Extended home visiting programme in Rinkeby correspond well to those of similar evidence-based home visiting interventions. Combining focus on early childhood development and responsive parenting with promoting access to the universal welfare services and integration into society are considered important steppingstones towards health equity. However, a favourable macro-political environment is required in the endeavour to balance the structural determinants’ influence on health inequities. Improved availability and accessibility to welfare services that respond to the needs of the families regarding housing, education and employment are priorities.

Trial registration

The study was retrospectively registered on 11/08/2016 in the ISRCTN registry (ISRCTN11832097).
Outcomes of AO/OTA C-type fractures of the distal humerus after open reduction and internal fixation with locking plate constructs in patients at least 65 years old
Authors: Kervinen Kaarlo V. , Salmela Mikko T. , Lähdeoja Tuomas A.
Published: June 2022

Background

Modern treatment options of distal humerus fractures of active elderly patients are osteosynthesis and total elbow arthroplasty. The evidence of outcomes of ORIF after AO/OTA C-type fractures mostly predates the adoption of locking plates. We evaluated the results of open reduction and internal fixation of these fractures treated exclusively with anatomic locking plates.

Methods

A retrospective cohort of 39 patients aged 65 years or above with ORIF for AO/OTA C-type distal humerus fracture using locking plates was analysed. 23 provided follow-up data and 14 attended a follow-up visit. Primary outcome was the Oxford Elbow Score. Secondary outcomes were Mayo Elbow Performance Score, quickDASH, satisfaction, range of motion, complications and revision surgeries.

Results

Mean Oxford Elbow Score pain was 83 (SD 17), Oxford Elbow Score function 83 (17) and Oxford Elbow Score social-psychological 79 (20). Mean total Oxford Elbow Score was 81 (15). Among the 14 patients who attended a follow-up visit, Mayo Elbow Performance Score was 85 (17), qDASH 19 (16), active arc of motion 119 (19) degrees. Mayo Elbow Performance Score and arc of motion were worse than on the healthy side. One patient had a serious deep infection. Eleven patients had at least one revision surgery, of which 6 were implant removals and 2 subsequent total elbow arthroplasties.

Conclusions

Distal AO/OTA C-type distal humerus fractures in older adults can be treated reliably and with good outcomes with ORIF using modern locking plates. The mean qDASH scores are similar to population normal values, but when compared to the healthy arm, single-arm outcomes indicated somewhat impaired function. About 1 in 4 patients had at least one revision surgery.
Comparison of electromagnetic and optical navigation assisted Endo-TLIF in the treatment of lumbar spondylolisthesis
Authors: Xu De-rong , Luan Liang-rui , Ma Xue-xiao , Cong Zhi-chao , Zhou Chuan-li
Published: June 2022

Uniportal full endoscopic posterolateral transforaminal lumbar interbody fusion (Endo-TLIF) with percutaneous pedicle screw fixation is a promising, minimally invasive method for the treatment of lumbar spondylolisthesis. However, repeated radiation exposure from X-rays and the steep learning curve remain to be improved.
Impact of resilience and social support on long-term grief in cancer-bereaved siblings: an exploratory study
Authors: Rasouli Omid , Moksnes Unni Karin , Reinfjell Trude , Hjemdal Odin , Eilertsen Mary-Elizabeth Bradley
Published: June 2022

Background

Bereavement research has mainly explored potential risk factors associated with adverse outcomes, and the role of protective factors has received less attention. More knowledge is needed about factors related to unresolved grief in bereaved siblings. This study aimed to assess grief adjustment and possible gender differences among bereaved young adults 2–10 years after losing a brother or sister to cancer. We also sought to explore how resilience and social support influenced their grief.

Methods

A total of 99 young adults (18–26 years) who had lost a brother or sister to cancer between the years 2009 and 2014 were invited to participate in this Norwegian nationwide study. The study-specific questionnaire was completed by 36 participants (36.4%). Social support during the sibling's illness, after the death, and during the past year, in addition to grief and resilience, were measured.

Results

Overall, the prevalence of unresolved grief was 47.2% among bereaved siblings, whereas 52.8% had worked through their grief. The level of having worked through grief and resilience was similar between male and female siblings. Bereaved siblings with higher Personal Competence reported lower unresolved grief.

Conclusion

Approximately half of the young adults experience unresolved grief 2–10 years after losing a sibling to cancer. The findings also highlight the need for long-term support for bereaved siblings to help improve their resilience and better have worked through their grief.
End of life care in UK care homes during the COVID-19 pandemic: a qualitative study
Authors: Hanna Kerry , Cannon Jacqueline , Gabbay Mark , Marlow Paul , Mason Stephen , Rajagopal Manoj , Shenton Justine , Tetlow Hilary , Giebel Clarissa
Published: June 2022

Purpose

To report the experiences of End of Life (EoL) care in UK care homes during the COVID-19 pandemic.

Methods

UK care home staff and family carers of residents in care home took part in remote, semi-structured interviews from October to November 2020, with 20 participants followed-up in March 2021. Interviews were conducted via telephone or online platforms and qualitatively analysed using inductive thematic analysis.

Results

Forty-two participants (26 family carers and 16 care home staff) were included in a wider qualitative study exploring the impact on dementia care homes during the pandemic. Of these, 11 family carers and 9 care home staff participated in a follow-up interview. Following descriptive thematic analysis, three central themes concerning EoL care during the pandemic specifically, were conceptualised and redefined through research team discussions: 1) Wasting or losing time; 2) Maintaining control, plans and routine; and 3) Coping with loss and lack of support. Lack of suitable, meaningful visits with people with dementia in care homes resulted in negative feelings of guilt and abandonment with both family carers and care home staff. Where families experienced positive EoL visits, these appeared to breach public health restrictions at that time.

Conclusion

It is recommended that care homes receive clear guidance from the government offering equitable contact with relatives at EoL to all family members, to support their grieving and avoid subsequent negative impacts to emotional wellbeing.
Control in patients with advanced cancer: an interpretative phenomenological study
Authors: Rodríguez-Prat Andrea , Pergolizzi Denise , Crespo Iris , Balaguer Albert , Porta-Sales Josep , Monforte-Royo Cristina
Published: June 2022

Background

In the context of life-threatening illness, loss of control is argued as a source of suffering and loss of perceived dignity, whereas having control over the dying process has been seen as a way of maintaining personal independence. Little is known about the meaning of control from the patients’ perspectives. Thus, the aim of this study was to explore how patients with advanced cancer understand control, in terms of underlying beliefs, attitudes, and expectations consistent with self-efficacy, in different dimensions of their life, their illness, and their healthcare.

Methods

We conducted semi-structured qualitative interviews using an interpretive phenomenological analysis approach. Patients with advanced cancer from an oncology unit and a palliative care unit from Barcelona (Spain) were recruited. The inclusion criteria were a) ≥ 18 years old; b) fluency in Spanish or Catalan; c) outpatients diagnosed with advanced cancer; d) Eastern Cooperative Oncology Group (ECOG) between 0 and 3; e) judged by their physician or nurse to be emotionally stable; f) considered to have control over their illness and circumstances according to their responsible physician; and g) signed informed consent.

Results

We interviewed eight participants (ages ranged from 29 to 70 years, six were female). Two themes were identified: 1) factors that influence the perception of control, with subthemes: uncertainty about future suffering, character traits underlying a need for control; sense of lack of care as a source of loss of control; and 2) perceiving control over an uncontrollable illness, explained by perceived control over subjective wellbeing and adjusting the focus of control. The data allowed us to identify strategies that promote a sense of control in these patients.

Conclusions

The illness, according to the participants, was experienced as series of losses. However, attention was often focused on areas where they continued to have control. These findings selectively reflect experiences of those who see themselves able to effect outcomes in life, suggesting future research should address how both family members and healthcare professionals can help to empower all patients.
Exploration factors on smoking among female adolescents based on the viewpoints of Iranian adolescent girls
Authors: Tehrani Hadi , Mahdizadeh Mehrsadat , Peyman Nooshin , Gholian-Aval Mahdi , Charoghchian Khorasani Elham , Jafari Alireza
Published: June 2022

Background

In recent years, the prevalence of smoking in women has increased significantly. This study aimed to explain the effective factors in the tendency to smoke in female adolescents, employing a qualitative method of content analysis in Mashhad, Iran.

Methods

The data for this conventional content analysis were obtained by conducting semi‑structured interviews with 20 female adolescent smokers. For open coding, integrating codes, creating main category and subcategories, and extracting quotation associated with codes and subcategories, MAXQDA software version 10 was used.

Results

Based on the results of the study, one main category and six subcategories were identified to influence the decision to smoke. The main category was interconnection of psychological and gender experiences. The subcategories included self-management weakness, ignoring the side effects, gender orientation, negative psychological experiences, the attraction of cigarettes, and positive psychological experiences.

Conclusion

Psychological and gender factors play an important role in initiating people's behavior and tendency to smoke and smoking prevention programs in educational settings need to focus efforts around what is known about young women smokers.