bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring Maternal Health in Ethiopia Using Indigenous Approaches: Policy and Practice Implications
Authors: Ibrahima Aissetu Barry
Published: January 2021

The World Health Organization reports reveal that the average risk of dying from pregnancy-related causes in sub-Saharan Africa is about 1 in 45 compared to 1 in 5,400 in high-income countries. In Ethiopia, maternal mortality remains a tremendous problem. Several studies associate the high maternal mortality ratio to the widespread practice of home birth, household income, and lack of transportation. Absent from the findings of these studies is any discussion of the sociocultural contexts that might influence maternal health service utilization. Birthing bears cultural significance accompanied by rituals. Thus, any solution to maternal health problems must consider the sociocultural and grassroots context. It is important to learn the needs and priorities of the mothers who are targets of maternal health policies. Using Indigenous approaches, this study examines the gaps in Ethiopian maternal health policies and programs. The study also identifies culturally relevant solutions that address the needs of communities.
Palliative Care and COVID-19 Pandemic: Retrospective Study of Factors Associated With Infection and Death at an Oncological Palliative Care Reference Center
Authors: de Oliveira Livia Costa , Rosa Karla Santos da Costa , Durante Ana Luísa , Ramadas Rodrigues Luciana de Oliveira , da Cunha Daianny Arrais de Oliveira , de Oliveira Luciana Aparecida Faria , de Freitas Renata , Borsatto Alessandra Zanei , Esteves Eliza Maffioletti Furtunato Leocádio , Sampaio Simone Garruth dos Santos Machado
Published: January 2021

Background:

Advanced cancer patients are part of a group likely to be more susceptible to COVID-19.

Aims:

To describe the profile of advanced cancer inpatients to an exclusive Palliative Care Unit (PCU) with the diagnosis of COVID-19, and to evaluate the factors associated with death in these cases.

Design:

Retrospective cohort study with data from advanced cancer inpatients to an exclusive PCU, from March to July 2020, with severe acute respiratory syndrome. Diagnostic of COVID-19 and death were the dependent variables. Logistic regression analyses were performed, with the odds ratio (OR) and 95% confidence interval (CI).

Results:

One hundred fifty-five patients were selected. The mean age was 60.9 (±13.4) years old and the most prevalent tumor type was breast (30.3%). Eighty-three (53.5%) patients had a diagnostic confirmation of COVID-19. Having diabetes mellitus (OR: 2.2; 95% CI: 1.1-6.6) and having received chemotherapy in less than 30 days before admission (OR: 3.8; 95% CI: 1.2-12.2) were associated factors to diagnosis of COVID-19. Among those infected, 81.9% died and, patients with Karnofsky Performance Status (KPS) < 30% (OR: 14.8; 95% CI 2.7-21.6) and C-reactive protein (CRP) >21.6mg/L (OR: 9.3; 95% CI 1.1-27.8), had a greater chance of achieving this outcome.

Conclusion:

Advanced cancer patients who underwent chemotherapy in less than 30 days before admission and who had diabetes mellitus were more likely to develop Coronavirus 2019 disease. Among the confirmed cases, those hospitalized with worse KPS and bigger CRP were more likely to die.
Dynamic fatigue reliability analysis of turbine blades under combined high and low cycle loadings
Authors: Yue Peng , Ma Juan , Zhou Changhu , Zu Jean W , Shi Baoquan
Published: January 2021

Establishment of damage accumulation models for reflecting the combined damage mechanism on the fatigue behavior of aero-engine turbine blades is crucial for their safety. In this work, a novel combined high and low cycle fatigue (CCF) life prediction methodology is presented as a basis of that to consider the interaction between low and high cycle fatigues. Accordingly, a dynamic reliability model is proposed to study the operational reliability of turbine blades under CCF loadings. Moreover, experimental data of materials along with the collected field data from the actual turbine blades are applied to validate the CCF life prediction model and the dynamic reliability model. The validation of the results is conducted by a comparison analysis, which indicates that the proposed life prediction method yields better accuracy, while the dynamic reliability model is proved to be more in line with the outcomes derived by the Monte Carlo simulation.
Effect of a thermodynamically consistent interface stress on thermal-induced nanovoid evolution in NiAl
Authors: Ghaedi Mohammad Sadegh , Javanbakht Mahdi
Published: January 2021

In the present work, the effect of a thermodynamically consistent inelastic interface stress on nanovoid evolution in NiAl is studied. Such interface stress is introduced for the solid–gas interface of nanovoids within the concept of the phase field approach. The Cahn–Hilliard (CH) equation using the Helmholtz free energy describes the evolution of nanovoid concentration. The interface stress changes the total stress distribution and affects the elastic stress field. Thus, due to the significant effect of the elastic energy on nanovoid dynamics, it can indirectly affect nanovoid nucleation and growth. The highly nonlinear coupled CH and elasticity equations are solved using the finite element method and the COMSOL code. The coupling appears due to the presence of the nonlinear nanovoid inelastic strain in the total strain, the presence of the nonlinear inelastic interface stress in the stress tensor and the presence of elastic energy in the Helmholtz free energy. Several examples of thermal-induced nanovoid evolutions are presented to investigate the effect of the solid–gas interface stress. The obtained results show the significant effect of the interface stress on the total stress distribution, and consequently a different distribution of thermodynamic driving force which can affect the nanostructure evolution and the deformation. Mainly, the interface stress represents a promotive effect on nanovoid growth which results in a faster nanovoid growth and a larger nanovoid concentration and region.
Economic policy uncertainty, consumer confidence in major economies and outbound tourism to African countries
Authors: Gholipour Hassan F , Nunkoo Robin , Foroughi Behzad , Daronkola Hassan Kalantari
Published: January 2021

Uncertainty, which is the only certain thing about the future, influences economic agents, their behaviours and economic activity. Debates and concerns about policy uncertainty have intensified following events such as the financial crisis, Brexit and more recently, the Covid-19 pandemic. The purpose of this study is to investigate the impact of changes in economic policy uncertainty and consumer confidence in a set of major economies on tourism flows to African countries. Using data over the period of 2005–2019 and applying panel difference generalized method of moments method, our results show that a positive change in consumer confidence in Canada, China, France, Japan, Russia and the United Kingdom (UK) has favorable impact on tourism departures from these countries to 25 African countries. We also find that a positive change in uncertainty in Canada, Russia, Spain and the UK has negative effect on tourist departures from these countries to African countries. The implications of the results for tourism development in African countries are discussed.
Injecting as a sexual practice: Cultural formations of ‘slamsex’
Authors: Race Kane , Murphy Dean , Pienaar Kiran , Lea Toby
Published: January 2021

‘Slamsex’ has emerged in gay vernacular in recent years to denote a particular way of taking drugs and a particular kind of sex. Slamming refers in this context to the practice of injecting drugs – typically crystal methamphetamine – intravenously. To pair ‘slamming’ with ‘sex’ is to propose that a particular mode of drug administration is constitutive of a particular kind of sex – a relatively novel idea that deserves some unpacking. What does it mean to make a route of drug administration definitional in the delineation of a sexual practice? What does this move reveal about contemporary practices of sex and drug consumption? In this article, we explore these questions with reference to theories of drug effects and practitioners’ accounts of slamsex. We conclude by considering the implications of our analysis for slamsex relations and associated harm reduction measures.
Measurement of cycle-resolved engine-out soot concentration from a diesel-pilot assisted natural gas direct-injection compression-ignition engine
Authors: Kheirkhah Pooyan , Kirchen Patrick , Rogak Steven
Published: January 2021

Exhaust-stream particulate matter (PM) emission from combustion sources such as internal combustion engines are typically characterized with modest temporal resolutions; however, in-cylinder investigations have demonstrated significant variability and the importance of individual cycles in transient PM emissions. Here, using a Fast Exhaust Nephelometer (FEN), a methodology is developed for measuring the cycle-specific PM concentration at the exhaust port of a single-cylinder research engine. The measured FEN light-scattering is converted to cycle-resolved soot mass concentration ([Formula: see text]), and used to characterize the variability of engine-out soot emission. To validate this method, exhaust-port FEN measurements are compared with diluted gravimetric PM mass and scanning mobility particle sizer (SMPS) measurements, resulting in close agreements with an overall root-mean-square deviation of better than 30%. It is noted that when PM is sampled downstream in the exhaust system, the particles are larger by 50–70 nm due to coagulation. The response time of the FEN was characterized using a “skip-firing” scheme, by enabling and disabling the fuel injection during otherwise steady-state operation. The average response time due to sample transfer and mixing times is 55 ms, well below the engine cycle period (100 ms) for the considered engine speeds, thus suitable for single-cycle measurements carried out in this work. Utilizing the fast-response capability of the FEN, it is observed that cycle-specific gross indicated mean effective pressure (GIMEP) and [Formula: see text] are negatively correlated ([Formula: see text]: 0.2–0.7), implying that cycles with lower GIMEP emit more soot. The physical causes of this association deserve further investigation, but are expected to be caused by local fuel-air mixing effects. The averaged exhaust-port [Formula: see text] is similar to the diluted gravimetric measurements, but the cycle-to-cycle variations can only be detected with the FEN. The methodology developed here will be used in future investigations to characterize PM emissions during transient engine operation, and to enable exhaust-stream PM measurements for optical engine experiments.
Identity, language and culture: Using Africanist Sista-hood and Deaf cultural discourse in research with minority social workers
Authors: Obasi Chijioke
Published: January 2021

Central to any anti-oppressive research endeavour is the importance of reflexivity and the genuine attempt from researchers to turn the research tools on themselves (Hermans, 2019). Beyond research, the social work profession has much to learn from the reflexive accounts of researchers. Issues of identity, language and culture are widely recognised as important when working with service users and carers in social work; however, this is much less the case when considering identities of social work practitioners. Starting with personal and professional positions of Black female and Deaf female social workers, this article reveals the reflexive journey of the Black female hearing researcher undertaking the research. The article takes an original approach to theory construction by introducing ‘ Africanist Sista-hood in Britain’ and marrying this with Deaf cultural discourse in the form of Deafhood, Deaf ethnicity and Deaf Gain, all of which make valuable contribution to existing debates in identity politics and the importance of self-naming and self-actualisation. Within the article the author discusses epistemological challenges in theory construction, data collection, language, transcription and dissemination, as they linked to power, privilege and the different forms this took within the research.

The article makes a number of significant contributions. It introduces Africanist Sista-hood in Britain as a useful theoretical framework in research and at the same time encourages theoretical alliances across other marginalised groups. In discussing issues of knowledge production beyond existing hegemonic frames, it offers a broadening of the lens beyond the ways in which identity, culture and ethnicity are currently understood in the mainstream. In discussing Deaf cultural discourse and its influence on methodological choices it invites researchers to better engage with these issues from perspectives articulated by Deaf people.
Liberty call at sunset: U.S. military retiree bars and the outsourced reproduction of ageing masculinities in Subic Bay, Philippines
Authors: Hawkins Mike
Published: January 2021

This article examines the gendered service economy of bars and restaurants catering to ageing US military retirees in Olongapo City, Philippines. During the Cold War, Olongapo housed Subic Bay Naval Base, one of the largest overseas US military installations, and today thousands of former American service members have retired here. A focus on retiree bars reveals how Filipina bartenders and waitresses facilitate an ageing masculinity for these expatriates wherein men’s internalized senses of social, economic, and sexual marginality in the US are seemingly suspended or deferred in the Philippines. Geopolitical histories of US militarism in Asia-Pacific, unequal military basing agreements, and Subic’s so-called hospitality industry endure decades later to naturalize the hierarchies of accommodation between local hostesses and foreign customers. Drawing on – and further developing – geographic scholarship on ageing and masculinities and focusing on the so-called hospitality industry’s shift over time reveals the expectations placed on service workers to accommodate men’s changing needs and desires. Years after Subic’s closure, interviews with bartenders and customers illuminate how decades of entanglement with US militarism have outsourced some of the reproductive labor that sustains this population of ageing retirees in Subic. More than mere bodies sustaining and serving the outsourced needs of ageing service members, however, through bar work Filipina hostesses experience changes to their own geographies of belonging and leverage opportunities to realize their own dreams and desires. The relations in Subic’s retiree bars attest to US militarism’s intimate afterlives and its enduring dependence on the gendered and racialized labor of local populations.
Trauma Bonding Perspectives From Service Providers and Survivors of Sex Trafficking: A Scoping Review
Authors: Casassa Kaitlin , Knight Logan , Mengo Cecilia
Published: January 2021

A trauma bond is an emotional attachment between an abuser and victim. Trauma bonds in sex trafficking compel victims to submit to continued exploitation and protect the trafficker. This scoping review examines trauma bonds in sex trafficking situations, its conceptualizations, and key characteristics. Ten databases were searched using sex trafficking AND trauma bonding–related terms; sex trafficking AND Stockholm syndrome, attachment, coercion, and manipulation. Articles were included if they featured trauma bonding, were published in English after 2013, or featured sex trafficking victims or traffickers in a Western country. Fifteen articles were included. The features of trauma bonding identified in these articles were (1) imbalance of power that favors trafficker, (2) traffickers’ deliberate use of positive and negative interactions, (3) victim’s gratitude for positive interactions and self-blame for the negative, and (4) victim’s internalization of perpetrator’s view. We also identified four aspects related to trauma bonding: (1) prior trauma made victims vulnerable, (2) victim’s feelings of love remained even after exiting trafficking, (3) love is why victims do not prosecute traffickers, and (4) traffickers’ intentional cultivation of the trauma bond. No article indicated how trauma bonds could be severed and replaced with healthy attachments. These findings reveal the need for practitioners and law enforcement and criminal justice professionals to address trauma bonding in both trafficking and posttrafficking situations. The findings also represent potential targets for urgently needed interventions that promote the replacement of trauma bonds with healthy attachments.
Predicting Mobility: Who Is Forced to Move?
Authors: Siskar Thomas , Evans Megan
Published: January 2021

We use the 2013 American Housing Survey to examine which households are more likely to experience a forced move compared to a voluntary move. We examine how household vulnerability varies by racial and socioeconomic stratification, as well as other household demographics among homeowners and renters. We analyze household-level predictors of experiencing an inclusively defined forced move, including moves caused by disasters, private and government displacement, and eviction (for renters) or foreclosure (for homeowners). Comparing an inclusive definition of displacement to voluntary mobility, we find that lower levels of education, income, and the presence of a disabled household member increase the likelihood of displacement for homeowners. Among renters, the presence of children, older households, and being native-born increase the odds of displacement, but a female-headed household reduces them. When examining type-specific displacement, we find variation in who is most susceptible to experience a forced move.
Participatory Description and Metadata Quality in Rapid Response Archives
Authors: Barrett Susan A.
Published: January 2021

This article describes the establishment of a participatory, rapid response archive, and an assessment of metadata quality applied by student curators between March and September 2020. A Journal of the Plague Year: An Archive of COVID-19 (JOTPY) was founded to document the COVID-19 pandemic, and is titled after Daniel Defoe’s 1722 book of the same name. As a participatory collection, A Journal of the Plague Year: An Archive of COVID-19 relies on a team of student curators to tag materials. This article summarizes an analysis of metadata tags, and describes strategies that improved the quantity and quality of metadata tags in the collection.
The prevalence of Vickers’ ligament in Madelung’s deformity: a retrospective multicentre study of 75 surgical cases
Authors: Farr Sebastian , Martínez-Alvarez Sergio , Little Kevin J. , Henstenburg Jeffrey , Ristl Robin , Stauffer Alexandra , Soldado Francisco , Zlotolow Dan A.
Published: January 2021

In a retrospective multicentre study, we aimed to correlate clinical factors and findings on plain radiographs and MRI with the intraoperative presence of Vickers’ ligament in Madelung’s deformity. We screened the records, in which the absence or presence of Vickers’ ligament was affirmatively indicated, of 75 consecutive operated extremities in 58 patients. In 83% a Vickers’ ligament was observed intraoperatively. The whole bone Madelung type (as opposed to the distal type) and a distal radial notch were independent, significant predictors for the presence of the ligament. The correct Vickers detection rate using MRI was 85% of the 27 cases for which MRI was available. Thus, the MRI was a good but not perfectly reliable modality. We conclude that Vickers’ ligament is present in the majority but not all cases with Madelung deformity. We advise that patients with a more severe type of Madelung’s deformity and a distal radial notch should be monitored closely.

Level of evidence: IV
Gold-nanourchin complexed silicon dioxide-probe on gap-fingered interdigitated electrode surface for Parkinson’s Disease determination by current–volt measurement
Authors: Li Xiaohong , Shi Wei , Zhang Wenyan , Chen Weiyao , Cao Dan , Gopinath Subash CB , Anbu Periasamy , Liu Na
Published: January 2021

Parkinson’s disease (PD) is a nervous disorder, affects physical movement, and leads to difficulty in balancing, walking, and coordination. A novel sensor is mandatory to determine PD and monitor the progress of the treatment. Neurofilament light chain (NfL) has been recognized as a good biomarker for PD and also helps to distinguish between PD and atypical PD syndromes. Immunosensor was generated by current–volt measurement on gap-fingered interdigitated electrode with silicon dioxide surface to determine NfL level. To enhance the detection, anti-NfL antibody was complexed with gold-nanourchin and immobilized on the sensing electrode. The current–volt response was gradually increased at the linear detection range from 100 fM to 1 nM. Limit of detection and sensitivity were 100 fM with the signal-to-noise ratio at n = 3 on a linear curve ( y = 0.081 x + 1.593; R 2 = 0.9983). Limit of quantification falls at 1 pM and high performance of the sensor was demonstrated by discriminating against other neurogenerative disease markers, in addition, it was reproducible even in serum-spiked samples. This method of detection system aids to measure the level of NfL and leads to determine the condition with PD.
The role of Facebook groups in the management and raising of awareness of antidepressant withdrawal: is social media filling the void left by health services?
Authors: White Edward , Read John , Julo Sherry
Published: January 2021

Background:

Antidepressant withdrawal is experienced by about half of people who try to reduce or come off their medication. It can be a debilitating, long lasting process. Many clinicians misdiagnose or minimise symptoms, inadvertently prolonging suffering. Most are unable to help patients safely taper off. There has been little research into the peer support communities that are playing an increasingly important role in helping people withdraw from psychiatric medications.

Methods:

To illustrate the growth and activities of Facebook withdrawal groups, we examined 13 such groups. All were raising awareness of, and supporting individuals tapering off, antidepressants and were followed for 13 months. A further three groups were added for the last 5 months of the study.

Results:

In June 2020, the groups had a total membership of 67,125, of which, 60,261 were in private groups. The increase in membership for the 13 groups over the study period was 28.4%. One group was examined in greater detail. Group membership was 82.5% female, as were 80% of the Administrators and Moderators, all of whom are lay volunteers. Membership was international but dominated (51.2%) by the United States (US). The most common reason for seeking out this group was failed clinician-led tapers.

Discussion:

The results are discussed in the context of research on the prevalence, duration and severity of antidepressant withdrawal. We question why so many patients seek help in peer-led Facebook groups, rather than relying on the clinicians that prescribed the medications. The withdrawal experiences of tens of thousands of people remain hidden in these groups where they receive support to taper when healthcare services should be responsible. Further research should focus on the methods of support and tapering protocols used in these groups to enable improved, more informed support by clinicians. Support from Governments and healthcare agencies is also needed, internationally, to address this issue.
Assessing polycentric urban development in Shanghai, China, with detailed passive mobile phone data
Authors: Xiao Yang , Wang Yao , Miao Siyu , Niu Xinyi
Published: January 2021

Despite growing studies on the distinction between morphological and functional polycentricity, the present methods for identifying polycentricity often focus on the morphological dimension due to a lack of information about intra-urban functional flows, and are limited by the multifarious nature of people’s spatiotemporal interactions. This study proposes a new approach, examining the degree of polycentricity in Shanghai at the intra-urban level using passive mobile phone data. A series of polycentricity indicators are used and are benchmarked against previous studies. Notably, we found that people’s daily movements within a subcenter indicate that morphological polycentricity is also at play in Shanghai. We conclude that morphological and functional polycentricity may coexist at the intra-urban level, and that a mobile phone data approach can offer an alternative method to elucidate both the morphological and functional features of subcenters.
“I am Sapelo”: Racialized uneven development and land politics within the Gullah Geechee Corridor
Authors: Hardy Dean , Heynen Nik
Published: January 2021

The history of land struggles in the United States demonstrates how ongoing patterns of uneven development depend upon and codify the legacies of white supremacy. In this article, we show how the histories of white supremacy continue to be embedded and institutionalized into contemporary land and property politics through the processes of racialized uneven development using the case of Sapelo Island, Georgia. We trace the history of property relations on Sapelo over four periods (covering 1802–2020) to reveal how Black, Saltwater Geechee descendants’ presence on the island has persisted despite manifold attempts to manipulate, control, and dispossess families of their land. We re-interpret Sapelo’s history through the lens of abolition ecology to articulate how the struggle for life through land consistently runs up against state-sanctioned racial violence, which perpetuates and institutionalizes systemic racialized uneven development. We argue that the “racial state” is facilitating the dispossession of Geechee cultural heritage, which lies in having access to and ownership of the land and requires new political imaginaries to combat the persistence of these tactics.
A unified machine learning approach to time series forecasting applied to demand at emergency departments
Authors: Vollmer Michaela A.C. , Glampson Ben , Mellan Thomas , Mishra Swapnil , Mercuri Luca , Costello Ceire , Klaber Robert , Cooke Graham , Flaxman Seth , Bhatt Samir
Published: January 2021

Background

There were 25.6 million attendances at Emergency Departments (EDs) in England in 2019 corresponding to an increase of 12 million attendances over the past ten years. The steadily rising demand at EDs creates a constant challenge to provide adequate quality of care while maintaining standards and productivity. Managing hospital demand effectively requires an adequate knowledge of the future rate of admission. We develop a novel predictive framework to understand the temporal dynamics of hospital demand.

Methods

We compare and combine state-of-the-art forecasting methods to predict hospital demand 1, 3 or 7 days into the future. In particular, our analysis compares machine learning algorithms to more traditional linear models as measured in a mean absolute error (MAE) and we consider two different hyperparameter tuning methods, enabling a faster deployment of our models without compromising performance. We believe our framework can readily be used to forecast a wide range of policy relevant indicators.

Results

We find that linear models often outperform machine learning methods and that the quality of our predictions for any of the forecasting horizons of 1, 3 or 7 days are comparable as measured in MAE. Our approach is able to predict attendances at these emergency departments one day in advance up to a mean absolute error of ±14 and ±10 patients corresponding to a mean absolute percentage error of 6.8% and 8.6% respectively.

Conclusions

Simple linear methods like generalized linear models are often better or at least as good as ensemble learning methods like the gradient boosting or random forest algorithm. However, though sophisticated machine learning methods are not necessarily better than linear models, they improve the diversity of model predictions so that stacked predictions can be more robust than any single model including the best performing one.
“SQiD, the Single Question in Delirium; can a single question help clinicians to detect delirium in hospitalised cancer patients?” running heading Single Question in Delirium” (Bcan-D-20-01665)
Authors: Sands Megan B. , Sharma Swapnil , Carpenter Lindsay , Hartshorn Andrew , Lee Jessica T. , Lujic Sanja , Congdon Megan E. , Buchanan Angus M. , Agar Meera , Vardy Janette L.
Published: January 2021

Aim

A serious syndrome for cancer in-patients, delirium risk increases with age and medical acuity. Screening tools exist but detection is frequently delayed or missed. We test the ‘Single Question in Delirium’ (SQiD), in comparison to psychiatrist clinical interview.

Methods

Inpatients in two comprehensive cancer centres were prospectively screened. Clinical staff asked informants to respond to the SQiD: “Do you feel that [patient’s name] has been more confused lately?”. The primary endpoint was negative predictive value (NPV) of the SQiD versus psychiatrist diagnosis (Diagnostic and Statistics Manual criteria). Secondary endpoints included: NPV of the Confusion Assessment Method (CAM), sensitivity, specificity and Cohen’s Kappa coefficient.

Results

Between May 2012 and July 2015, the SQiD plus CAM was applied to 122 patients; 73 had the SQiD and psychiatrist interview. Median age was 65 yrs. (interquartile range 54–74), 46% were female; median length of hospital stay was 12 days (5–18 days). Major cancer types were lung (19%), gastric or other upper GI (15%) and breast (14%). 70% of participants had stage 4 cancer. Diagnostic values were similar between the SQiD (NPV = 74, 95% CI 67–81; kappa = 0.32) and CAM (NPV = 72, 95% CI 67–77, kappa = 0.32), compared with psychiatrist interview. Overall the CAM identified only a small number of delirious cases but all were true positives. The specificity of the SQiD was 87% (74–95) The SQiD had higher sensitivity than CAM (44% [95% CI 41–80] vs 26% [10–48]).

Conclusion

The SQiD, administered by bedside clinical staff, was feasible and its psychometric properties are now better understood. The SQiD can contribute to delirium detection and clinical care for hospitalised cancer patients.
Ocular abnormalities in a large patient cohort with retinitis pigmentosa in Western China
Authors: Tan Lian , Long Yanling , Li Ziyang , Ying Xi , Ren Jiayun , Sun Cheng , Meng Xiaohong , Li Shiying
Published: January 2021

Background

To report the prevalence of ocular abnormalities and investigate visual acuity in a large cohort of retinitis pigmentosa (RP) patients in Western China.

Methods

The medical records and ophthalmic examination reports of 2127 eyes of 1065 RP patients at one eye hospital were retrospectively reviewed to determined the prevalence of ocular abnormalities and the relationship between best corrected visual acuity (BCVA) and macular abnormalities.

Results

Nyctalopia (58.2%) and blurred vision (27.1%) were the leading reasons for RP patients to request an ophthalmic examination. BCVA measurements in the better eyes at first clinical presentation showed that 304 patients (28.5%) were categorised as blind and 220 patients (20.7%) as low vision. The most common ocular abnormalities were macular abnormalities (59.7%) and cataracts (43.1%). The macular abnormalities included epiretinal membranes (51.1%), cystoid macular edema (18.4%), vitreomacular traction syndrome (2.4%), macular holes (2.3%) and choroidal neovascular membranes (0.05%). Glaucoma was found in 35 eyes (1.6%). The proportions of epiretinal membranes (p = 0.001) and macular holes (p = 0.008) increased significantly with age. Cystoid macular edema was significantly associated with poorer visual acuity in RP patients with clear lens (p = 0.002).

Conclusion

Cataracts and macular abnormalities are common in RP patients. Of the macular abnormalities, cystoid macular edema may have a negative effect on BCVA in RP patients with clear lens. Therefore, optical coherence tomography screening in RP patients is highly recommended for early detection and treatment of maculopathy.
The impact of video gaming on cognitive functioning of people with schizophrenia (GAME-S): study protocol of a randomised controlled trial
Authors: Välimäki Maritta , Yang Min , Lam Yuen Ting Joyce , Lantta Tella , Palva Matias , Palva Satu , Yee Benjamin , Yip Siu Hung , Yu Kin-sun Dan , Chang Hing Chiu Charles , Cheng Po Yee Ivy , Bressington Daniel
Published: January 2021

Background

Video gaming is a promising intervention for cognitive and social impairment in patients with schizophrenia. A number of gaming interventions have been evaluated in small-scale studies with various patient groups, but studies on patients with schizophrenia remain scarce and rarely include the evaluation of both clinical and neurocognitive outcomes. In this study, we will test the effectiveness of two interventions with gaming elements to improve cognitive and clinical outcomes among persons with schizophrenia.

Methods

The participants will be recruited from different outpatient units (e.g., outpatient psychiatric units, day hospitals, residential care homes). The controlled clinical trial will follow a three-arm parallel-group design: 1) cognitive training (experimental group, CogniFit), 2) entertainment gaming (active control group, SIMS 4), and 3) treatment as usual. The primary outcomes are working memory function at 3-month and 6-month follow-ups. The secondary outcomes are patients’ other cognitive and social functioning, the ability to experience pleasure, self-efficacy, and negative symptoms at 3-month and 6-month follow-ups. We will also test the effectiveness of gaming interventions on neurocognitive outcomes (EEG and 3 T MRI plus rs-fMRI) at a 3-month follow-up as an additional secondary outcome. Data will be collected in outpatient psychiatric services in Hong Kong. Participants will have a formal diagnosis of schizophrenia and be between 18 and 60 years old. We aim to have a total of 234 participants, randomly allocated to the three arms. A sub-sample of patients (N = 150) will be recruited to undergo an EEG. For neuroimaging assessment, patients will be randomly allocated to a subset of patients (N=126). We will estimate the efficacy of the interventions on the primary and secondary outcomes based on the intention-to-treat principle. Behavioural and EEG data will be analysed separately.

Discussion

The study will characterise benefits of gaming on patients’ health and well-being, and contribute towards the development of new treatment approaches for patients with schizophrenia.

Trial registration

ClinicalTrials.gov NCT03133143. Registered on April 28, 2017.
Equity of expenditure changes associated with a sweetened-beverage tax in Tonga: repeated cross-sectional household surveys
Authors: Teng Andrea , Buffière Bertrand , Genç Murat , Latavao Telekaki , Puloka Viliami , Signal Louise , Wilson Nick
Published: January 2021

Background

The aim of this study was to examine changes in beverage expenditure patterns before and after a T$0.50/L sweetened-beverage (SB) excise was introduced in Tonga in 2013, by household income, household age composition and island of residence.

Methods

Two cross-sectional surveys involved households being randomly sampled (the Household Income and Expenditure Surveys in 2009 (n = 1982) and 2015/16 (n = 1800)). Changes in soft drink (taxed), bottled water, and milk (both untaxed) expenditure were examined namely: (i) prevalence of households purchasing the beverage; (ii) average expenditure per person (inflation-adjusted); (iii) expenditure as a proportion of household food budget; and (iv) expenditure per person as a proportion of equivalised income.

Results

The pattern found was of decreases in all soft drink expenditure outcomes and these appeared to be greater in low-income than high-income households for purchasing prevalence (− 30% and − 25% respectively, t-test p = 0.98), per-capita expenditure (− 37% and − 34%, p = 0.20) and food budget share (− 27% and − 7%, p = 0.65), but not income share (− 6% and − 32%, p = 0.71). The large expenditure increases in bottled water appeared to be greater in low-income than high-income households for purchasing prevalence (355 and 172%, p = 0.32) and food budget share (665 and 468%, p = 0.09), but greater in high-income households for per-capita expenditure (121 and 373%, p < 0.01) and income share (83 and 397%, p = 0.50).

Conclusions

The sweetened-beverage tax was associated with reduced soft drink purchasing and increased bottled water expenditure. Low-income households appeared to have slightly greater declines in soft drink expenditure.
Quality and readability of web-based Arabic health information on COVID-19: an infodemiological study
Authors: Halboub Esam , Al-Ak’hali Mohammed Sultan , Al-Mekhlafi Hesham M. , Alhajj Mohammed Nasser
Published: January 2021

Background

This study sought to assess the quality and readability of web-based Arabic health information on COVID-19.

Methods

Three search engines were searched on 13 April 2020 for specific Arabic terms on COVID-19. The first 100 consecutive websites from each engine were analyzed for eligibility, which resulted in a sample of 36 websites. These websites were subjected to quality assessments using the Journal of the American Medical Association (JAMA) benchmarks tool, the DISCERN tool, and Health on the Net Foundation Code of Conduct (HONcode) certification. The readability of the websites was assessed using an online readability calculator.

Results

Among the 36 eligible websites, only one (2.7%) was HONcode certified. No website attained a high score based on the criteria of the DISCERN tool; the mean score of all websites was 31.5 ± 12.55. As regards the JAMA benchmarks results, a mean score of 2.08 ± 1.05 was achieved by the websites; however, only four (11.1%) met all the JAMA criteria. The average grade levels for readability were 7.2 ± 7.5, 3.3 ± 0.6 and 93.5 ± 19.4 for the Flesch Kincaid Grade Level, Simple Measure of Gobbledygook, and Flesch Reading Ease scales, respectively.

Conclusion

Almost all of the most easily accessible web-based Arabic health information on COVID-19 does not meet recognized quality standards regardless of the level of readability and ability to be understood by the general population of Arabic speakers.
Distribution and prevalence of musculoskeletal pain co-occurring with persistent low back pain: a systematic review
Authors: Øverås Cecilie K. , Johansson Melker S. , de Campos Tarcisio F. , Ferreira Manuela L. , Natvig Bård , Mork Paul J. , Hartvigsen Jan
Published: January 2021

Background

Co-occurring musculoskeletal pain is common among people with persistent low back pain (LBP) and associated with more negative consequences than LBP alone. The distribution and prevalence of musculoskeletal pain co-occurring with persistent LBP has not been systematically described, which hence was the aim of this review.

Methods

Literature searches were performed in MEDLINE, Embase, CINAHL and Scopus. We considered observational studies from clinical settings or based on cohorts of the general or working populations involving adults 18 years or older with persistent LBP (≥4 wks) and co-occurring musculoskeletal pain for eligibility. Study selection, data extraction and risk of bias assessment were carried out by independent reviewers. Results are presented according to study population, distribution and location(s) of co-occurring pain.

Results

Nineteen studies out of 5744 unique records met the inclusion criteria. Studies were from high-income countries in Europe, USA and Japan. A total of 34,492 people with persistent LBP were included in our evidence synthesis. Methods for assessing and categorizing co-occurring pain varied considerably between studies, but based on the available data from observational studies, we identified three main categories of co-occurring pain – these were axial pain (18 to 58%), extremity pain (6 to 50%), and multi-site musculoskeletal pain (10 to 89%). Persistent LBP with co-occurring pain was reported more often by females than males, and co-occurring pain was reported more often in patients with more disability.

Conclusions

People with persistent LBP often report co-occurring neck pain, extremity pain or multi-site pain. Assessment of co-occurring pain alongside persistent LBP vary considerable between studies and there is a need for harmonisation of measurement methods to advance our understanding of how pain in different body regions occur alongside persistent LBP.

Systematic review registration

PROSPEROCRD42017068807.
Client perceptions of the BreastScreen Australia remote radiology assessment model
Authors: Smith Deborah , Johnston Karen , Carlisle Karen , Evans Rebecca , Preston Robyn , Beckett Jessamy , Geddes Danielle , Naess Helen , Poole Melissa , Larkins Sarah
Published: January 2021

Background

Telehealth and teleradiology are increasingly used around the world to facilitate health care provision when the health care provider and clients are separated by distance. The BreastScreen Australia Remote Radiology Assessment Model (RRAM) is an initiative developed to address the challenges of inadequate access to a local radiological workforce in regional Australia. With the growth in telehealth innovations more broadly, the RRAM represents a departure from the traditional onsite model where a radiologist would be co-located with practice staff during assessment clinics. Understanding client satisfaction is an important consideration with new models. This article explores client perceptions of the RRAM including awareness, satisfaction with experiences, confidence in the quality of care being received, and preferences regarding models of service delivery.

Methods

Clients in four BreastScreen services across three Australian states and territories were invited to provide feedback on their experiences of the RRAM. Brief face-to-face interviews based on a survey were conducted at the conclusion of assessment clinic visits. Clients also provided feedback through surveys completed and returned by post, and online.

Results

144 clients completed the survey regarding their experiences of the RRAM. The majority were aged between 50 and 59 years (55/144, 38.2%). Most had attended a BreastScreen service for either screening or assessment on a total of two to five occasions (85/142, 59.9%) in the past. Nearly all women who attended a RRAM clinic expressed satisfaction with their experience (142/143, 99.3%). Clients were aware that the radiologist was working from another location (131/143, 91.6%) and the majority believed there wouldn’t be any difference in the care they received between the RRAM and the onsite model (120/142, 84.5%). Clients generally had no particular preference for either the onsite or RRAM model of service delivery.

Conclusions

Clients’ high satisfaction with their clinic experiences, high confidence in care being received, and the majority having no preference for either the onsite or remote model indicates their acceptance of the RRAM. Client acceptance of the model supports continuation of the RRAM at these sites and expansion. Findings may inform future telehealth innovations where key health care team members are working remotely.
Understanding the role of oncogenic human papillomavirus (HPV) status on adherence behaviors among women with abnormal cervical cytology
Authors: Buick Catriona , Murphy K. Joan , Howell Doris , Metcalfe Kelly
Published: January 2021

Background

With the introduction of oncogenic Human Papillomavirus (HPV) testing into cervical screening there is a renewed focus on primary prevention among high-risk groups. To date, little is known about the effectiveness of this program, and the extent to which individual-level factors, such as psychosocial health and agency, may play a role. In particular,
it is unclear if knowledge of one’s oncogenic HPV status impacts on adherence behaviors amongst women with screening abnormalities. The purpose of this study was to identify if clinical, demographic or psychosocial factors predict non-adherence with recommended colposcopy follow-up.

Methods

This prospective pilot study included 145 women referred to a large Toronto colposcopy clinic between December, 2013 and September, 2014. Demographic, clinical and psychosocial characteristics were collected at three points in time: (1) at initial colposcopy consultation; (2) 4–6 weeks following initial consultation, and; (3) at time of follow-up appointment (within 12 months of initial consultation).

Results

Overall, 13% (n = 145) of the women were classified as non-adherent. Older women (OR = 0.73, p < 0.01) and those with higher-grade lesions (OR = 0.10, p < 0.01) were less likely to be non-adherent, whereas current smokers (OR = 22.46, p < 0.01) were more likely to be non-adherent. While not statistically significant, variation in rates of non-adherence amongst the various HPV status groups (untested; 15.3%, HPV positive; 5.3%, HPV negative; 6.7%) warrants further study.

Conclusion

Findings of this study indicate that younger women, those with higher-grade lesions and current smokers were more likely to be non-adherent to recommended colposcopy follow-up. While HPV status did not reach statistical significance, the direction of this finding suggests that testing for HPV may have a positive reinforcing role on adherence to follow-up. The direction of this finding warrants further study, and potentially a practical clinical goal as HPV testing for women becomes standard of care.
Exploring the impact of a community participatory intervention on women's capability: a qualitative study in Gulu Northern Uganda
Authors: Belaid Loubna , Ochola Emmanuel , Bayo Pontius , Alii George William , Ogwang Martin , Greco Donato , Zarowsky Christina
Published: January 2021

Background

Community participatory interventions mobilizing women of childbearing age are an effective strategy to promote maternal and child health. In 2017, we implemented this strategy in Gulu Northern Uganda. This study explored the perceived impact of this approach on women's capability.

Methods

We conducted a qualitative study based on three data collection methods: 14 in-depth individual interviews with participating women of childbearing age, five focus group discussions with female facilitators, and document analysis. We used the Sen capability approach as a conceptual framework and undertook a thematic analysis.

Results

Women adopted safe and healthy behaviors for themselves and their children. They were also able to respond to some of their family's financial needs. They reported a reduction in domestic violence and in mistreatment towards their children. The facilitators perceived improved communication skills, networking, self-confidence, and an increase in their social status. Nevertheless, the women still faced unfreedoms that deprived them of living the life they wanted to lead. These unfreedoms are related to their lack of access to economic opportunities and socio-cultural norms underlying gender inequalities.

Conclusion

To expand women's freedoms, we need more collective political actions to tackle gender inequalities and need to question the values underlying women's social status.