bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of multimedia‐based information on anxiety, discomfort and satisfaction with care among patients undergoing cerebral angiography: A quasi‐experimental study
Authors: Choi Hyunjung , Kim Jiyoung
Published: July 2021

Aims and objectives

This study investigated the effects of multimedia‐based information on anxiety, discomfort and satisfaction with care among patients undergoing cerebral angiography.

Background

Cerebral angiography is the gold standard for diagnosing cerebrovascular conditions; however, patients might experience related anxiety and discomfort. For such patients, reductions in anxiety related to informational interventions have been inconsistent, and the effects on patient discomfort and satisfaction with nurses were not confirmed.

Design

This quasi‐experimental study with a non‐equivalent, control group, non‐synchronised design was conducted using the TREND checklist.

Methods

Fifty‐five patients who underwent cerebral angiography at a neurosurgery ward were enrolled in this study. Twenty‐seven patients in the experimental group were provided multimedia‐based information on cerebral angiography, including actual on‐site photographs and videos, an explanation of the benefits of cerebral angiography and introduction to medical staff. Twenty‐eight in the control group were provided a printed explanation. The collected data were analysed using the χ²‐test, Fisher's exact test, independent t test, paired t test or ANCOVA.

Results

In the experimental group, anxiety was significantly decreased post‐intervention, and there was a significant difference in state anxiety between the experimental and control groups. Discomfort and satisfaction with care also showed significant differences between these two groups.

Conclusion

This study confirmed that multimedia‐based information decreases patient anxiety and discomfort while increasing satisfaction with care among those undergoing cerebral angiography compared with a printed explanation only.

Relevance to clinical practice

The anxiety and discomfort of patients undergoing cerebral angiography should be considered a major nursing problem. This study evaluated the effects of multimedia‐based information on anxiety, discomfort and satisfaction with care among patients undergoing cerebral angiography and showed it to be an effective nursing intervention.
Quantitative easing and economic growth in Japan: A meta‐analysis
Authors: Ferreira‐Lopes Alexandra , Linhares Pedro , Martins Luís Filipe , Sequeira Tiago Neves
Published: July 2021

We present an original meta‐probit analysis for the effect of the Bank of Japan monetary policy on economic growth for the period 2001–2020, using 45 studies. We use impulse response functions in VAR type models to assess if the effects on output of unconventional monetary policies are significant (positive or negative) or not. Funnel asymmetry and precision effect tests do not provide a striking evidence of publication bias. Additionally, we do not find a consensus regarding the output growth effects during the quantitative easing years. Besides variables linked with the studies’ methodological features, other variables such as industrial production and the price level have a greater effect on the probability of reporting statistically significant (positive) effects of quantitative easing on output growth. However, one of the most important (policy) implications of our study is that the evidence for a significant real effect of unconventional monetary policy is weak.
The Parastagonospora nodorum necrotrophic effector SnTox5 targets the wheat gene Snn5 and facilitates entry into the leaf mesophyll
Authors: Kariyawasam Gayan K. , Richards Jonathan K. , Wyatt Nathan A. , Running Katherine L. D. , Xu Steven S. , Liu Zhaohui , Borowicz Pawel , Faris Justin D. , Friesen Timothy L.
Published: July 2021

Parastagonospora nodorum is an economically important necrotrophic fungal pathogen of wheat. Parastagonospora nodorum secretes necrotrophic effectors that target wheat susceptibility genes to induce programmed cell death (PCD). In this study, we cloned and functionally validated SnTox5 and characterized its role in pathogenesis.

We used whole genome sequencing, genome‐wide association study (GWAS) mapping, CRISPR‐Cas9‐based gene disruption, gain‐of‐function transformation, quantitative trait locus (QTL) analysis, haplotype and isoform analysis, protein modeling, quantitative PCR, and laser confocal microscopy to validate SnTox5 and functionally characterize SnTox5.

SnTox5 is a mature 16.26 kDa protein with high structural similarity to SnTox3. Wild‐type and mutant P. nodorum strains and wheat genotypes of SnTox5 and Snn5, respectively, were used to show that SnTox5 not only targets Snn5 to induce PCD but also facilitates the colonization of the mesophyll layer even in the absence of Snn5.

Here we show that SnTox5 facilitates the efficient colonization of the mesophyll tissue and elicits PCD specific to host lines carrying Snn5. The homology to SnTox3 and the ability of SnTox5 to facilitate the colonizing of the mesophyll also suggest a role in the suppression of host defense before PCD induction.
Improving cognitive control: Is theta neurofeedback training associated with proactive rather than reactive control enhancement?
Authors: Eschmann Kathrin C. J. , Mecklinger Axel
Published: July 2021

Frontal‐midline (FM) theta activity (4–8 Hz) is proposed to reflect a mechanism for cognitive control that is needed for working memory retention, manipulation, and interference resolution. Modulation of FM theta activity via neurofeedback training (NFT) demonstrated transfer to some but not all types of cognitive control. Therefore, the present study investigated whether FM theta NFT enhances performance and modulates underlying EEG characteristics in a delayed match to sample (DMTS) task requiring mainly proactive control and a color Stroop task requiring mainly reactive control. Moreover, temporal characteristics of transfer were explored over two posttests. Across seven 30‐min NFT sessions, an FM theta training group exhibited a larger FM theta increase compared to an active control group who upregulated randomly chosen frequency bands. In a posttest performed 13 days after the last training session, the training group showed better retention performance in the DMTS task. Furthermore, manipulation performance was associated with NFT theta increase for the training but not the control group. Contrarily, behavioral group differences and their relation to FM theta change were not significant in the Stroop task, suggesting that NFT is associated with proactive but not reactive control enhancement. Transfer to both tasks at a posttest one day after training was not significant. Behavioral improvements were not accompanied by changes in FM theta activity, indicating no training‐induced modulation of EEG characteristics. Together, these findings suggest that NFT supports transfer to cognitive control that manifests late after training but that other training‐unspecific factors may also contribute to performance enhancement.
Examining the Extent and Predictors of the Negative Impacts of a Campus Carry Law Among Faculty and Students
Authors: Scherer Heidi L. , McMahon‐Howard Jennifer , McCafferty James T.
Published: July 2021

In response to high‐profile instances of gun violence on college campuses, several states passed legislation allowing certain individuals to carry concealed guns at public universities. Despite claims from opponents that these laws will negatively affect the learning environment, there is little empirical research that has examined how the presence of guns on campus influences the various employment‐ and educational‐related behaviors of campus members. Using a sample of 602 faculty and 4,937 students from a large public university in Georgia, this study estimated the extent and predictors of negative impacts reported in a survey by respondents one year after the passing of a campus carry law. There were 49% of faculty and 35% of student respondents who reported having experienced at least one negative impact of guns on campus. Multivariate analyses indicated that the amount of negative impacts of campus carry was higher for faculty and students who experienced conflicts on campus, perceived campus as unsafe, and feared victimization, but negative impacts were lower for those who had pro‐gun attitudes and prior exposure to guns.
The impact of ageing on the incidence and mortality rate of bloodstream infection: A hospital‐based case–cohort study in a tertiary public hospital of Brazil
Authors: da Silva Natalia C. Z. , da Rocha Jaqueline A. , do Valle Fernanda M. , Silva Ana Sheila D. N. , Ehrlich Shelley , Martins Ianick Souto
Published: July 2021

Objective

Over the past few decades, life expectancy in Brazil has increased from 48 years in 1950s to 76 years in 2017. The aim of this study was to investigate the impact of ageing on: (1) the frequency of hospitalisations due to bloodstream infection (BSI); (2) the incidence of hospital‐acquired BSI (H‐BSI); (3) the incidence of BSI caused by multidrug‐resistant (MDR) agents and (4) the mortality rate of BSI in a public hospital.

Methods

A hospital‐based case‐cohort study was conducted between 1 December 2013 and 31 December 2015. The data were analysed using multivariable logistic regression.

Results

A total of 500 BSI episodes were detected, among 11,102 hospitalizations. The incidence of hospitalisations resulting from BSI was significantly higher in older than younger patients (3.7/100 vs. 2.0/100, p < 0.01). Similarly, the incidence of hospital‐acquired BSI was significantly higher in older patients (2.7/100 vs. 0.9/100, p < 0.01). Klebsiella pneumoniae (15.9%), Staphylococcus aureus (14.3%), Escherichia coli (13.1%) and Acinetobacter spp. (12.1%) were the most common agents isolated. MDR agents caused 37.6% of the BSI episodes; enteric Gram‐negative bacilli resistant to third‐ or fourth‐generation cephalosporins (9.7%) and carbapenem‐resistant Acinetobacter spp. (9.2%) were the most common MDR agents. The following complications were independently associated with ageing: Charlson comorbidity index (OR = 1.16; 95% CI = 1.09–1.24); BSI secondary to urinary tract infection (OR = 2.14; 95% CI = 1.29–3.55); BSI secondary to pneumonia (OR = 1.77; 95% CI = 1.07–2.93) and 30‐day mortality following BSI (OR = 2.19; 95% CI = 1.43–3.36).

Conclusions

These data suggest ageing has a significant impact on hospitalisations due to BSI, H‐BSI incidence and mortality from BSI in older patients attending a Brazilian public hospital. Age was not significantly associated with MDR‐related BSI. These results indicate that age plays an important role in the increase in morbidities and mortality resulting from BSI in Brazil and that with the increased life expectancy observed over recent decades in Brazil, the burden of BSI will be expected to continue to increase. This dynamic needs to be better understood with additional studies.
Monocular Vision-Based Retinal Membrane Peeling With a Handheld Robot
Authors: Han Yuqiao , Routray Arpita , Adeghate Jennifer O. , MacLachlan Robert A. , Martel Joseph N. , Riviere Cameron N.
Published: July 2021

Retinal membrane peeling requires delicate manipulation. The presence of the surgeon's physiological tremor, the high variability and often low quality of the ophthalmic image, and excessive forces make the tasks more challenging. Preventing unintended movement caused by tremor and unintentional forces can reduce membrane injury. With the use of an actively stabilized handheld robot, we employ a monocular camera-based surface reconstruction method to estimate the retinal plane and we propose the use of a virtual fixture with the application of a hard stop and motion scaling to improve control of the tool tip during delaminating in a laboratory simulation of retinal membrane peeling. A hard stop helps to limit downward force exerted on the surface. Motion scaling also improves the user's control of contact force when delaminating. We demonstrate a reduction of maximum force and maximum surface-penetration distance from the estimated retinal plane using the proposed technique.
Impact Characteristics of a Carbonated Water Droplet on Hydrophobic Surface
Authors: Abubakar Abba Abdulhamid , Yilbas Bekir Sami , Al-Qahtani Hussain
Published: July 2021

Carbonated water drops impact on a hydrophobic surface is examined. The influence of CO2 gas bubbles in droplet fluid on impacting droplet characteristics, such as spreading rates and restitution coefficient, are explored. The predictions of droplet wetting diameter and spreading rates are validated through the experimental data obtained from high-speed recording. The findings reveal that predictions agree well with the experimental data. CO2 gas bubbles in the droplet are compressed by the total impact pressure of the droplet liquid while slightly reducing the gas bubble sizes. The small size of close by bubbles at high pressure can merge forming large size bubbles, which occur toward the end of droplet spreading and retraction periods. The pressure increase in the fluid gives rise to the increased vertical height of the droplet and slightly reduces the droplet contact diameter on the impacted surface. The work done during the compression of CO2 gas in bubbles lowers the restitution coefficient of the droplet after the retraction period.
Levitation of fizzy drops
Authors: Panchanathan Divya , Bourrianne Philippe , Nicollier Philippe , Chottratanapituk Abhijatmedhi , Varanasi Kripa K. , McKinley Gareth H.
Published: July 2021

Fizzy water drops levitate and slide freely when placed on a superhydrophobic solid at ambient temperature.
Genome-encoded cytoplasmic double-stranded RNAs, found in
C9ORF72
ALS-FTD brain, propagate neuronal loss
Authors: Rodriguez Steven , Sahin Asli , Schrank Benjamin R. , Al-Lawati Hawra , Costantino Isabel , Benz Eric , Fard Darian , Albers Alefiya D. , Cao Luxiang , Gomez Alexis C. , Evans Kyle , Ratti Elena , Cudkowicz Merit , Frosch Matthew P. , Talkowski Michael , Sorger Peter K. , Hyman Bradley T. , Albers Mark W.
Published: July 2021

Genome-encoded cytoplasmic double-stranded RNAs elicit neuroinflammation and propagated neuronal death.
Down-regulation of A20 promotes immune escape of lung adenocarcinomas
Authors: Breitenecker Kristina , Homolya Monika , Luca Andreea C. , Lang Veronika , Trenk Christoph , Petroczi Georg , Mohrherr Julian , Horvath Jaqueline , Moritsch Stefan , Haas Lisa , Kurnaeva Margarita , Eferl Robert , Stoiber Dagmar , Moriggl Richard , Bilban Martin , Obenauf Anna C. , Ferran Christiane , Dome Balazs , Laszlo Viktoria , Győrffy Balázs , Dezso Katalin , Moldvay Judit , Casanova Emilio , Moll Herwig P.
Published: July 2021

A20 represents an immune checkpoint in lung adenocarcinomas, and its loss may be compensated by targeting the TBK1–STAT1–PD-L1 axis.
Recovery of Nucleic Acids of Enteric Viruses and Host-Specific
Bacteroidales
from Groundwater by Using an Adsorption-Direct Extraction Method
Authors: Miura Takayuki , Takino Hiroyuki , Gima Arisa , Haramoto Eiji , Akiba Michihiro
Published: July 2021

We investigated the presence of enteric viruses and bacterial genetic markers to determine fecal contamination in groundwater samples from deep wells used for the public drinking water supply and private wells in Japan. Groundwater is often subjected to chlorination; malfunctions in chlorine treatment result in waterborne disease outbreaks.
Viable but Nonculturable State of Yeast
Candida
sp. Strain LN1 Induced by High Phenol Concentrations
Authors: Xie Mengqi , Xu Luning , Zhang Rong , Zhou Yan , Xiao Yeyuan , Su Xiaomei , Shen Chaofeng , Sun Faqian , Hashmi Muhammad Zaffar , Lin Hongjun , Chen Jianrong
Published: July 2021

The viable but nonculturable (VBNC) state is known to affect the culturability and activity of microorganisms. However, limited studies have been conducted to investigate the VBNC state of other pollutant degraders, such as fungi.
Enhanced Ability of Plant-Derived PGT121 Glycovariants To Eliminate HIV-1-Infected Cells
Authors: Anand Sai Priya , Ding Shilei , Tolbert William D. , Prévost Jérémie , Richard Jonathan , Gil Hwi Min , Gendron-Lepage Gabrielle , Cheung Wing-Fai , Wang Haifeng , Pastora Rebecca , Saxena Hirak , Wakarchuk Warren , Medjahed Halima , Wines Bruce D. , Hogarth Mark , Shaw George M. , Martin Malcom A. , Burton Dennis R. , Hangartner Lars , Evans David T. , Pazgier Marzena , Cossar Doug , McLean Michael D. , Finzi Andrés
Published: July 2021

PGT121 is a highly potent bNAb and its antiviral activities for HIV-1 prevention and therapy are currently being evaluated in clinical trials. The importance of its Fc-effector functions in clearing HIV-1-infected cells is also under investigation.
Porcine Epidemic Diarrhea Virus Inhibits HDAC1 Expression To Facilitate Its Replication via Binding of Its Nucleocapsid Protein to Host Transcription Factor Sp1
Authors: Xu Jidong , Mao Junyong , Han Xiao , Shi Fushan , Gao Qin , Wang Tingjun , Zhang Zhenning , Shan Ying , Fang Weihuan , Li Xiaoliang
Published: July 2021

The enteric coronavirus porcine epidemic diarrhea virus (PEDV) causes fatal acute intestinal infection in neonatal pigs that rely on innate immune responses. Histone deacetylases (HDACs) play important roles in innate immune regulation.
Spontaneous and Targeted Mutations in the Decapping Enzyme Enhance Replication of Modified Vaccinia Virus Ankara (MVA) in Monkey Cells
Authors: Erez Noam , Wyatt Linda S. , Americo Jeffrey L. , Xiao Wei , Moss Bernard
Published: July 2021

Modified vaccinia virus Ankara (MVA) is an attenuated virus that is approved as a smallpox vaccine and is in clinical trials as a vector for other pathogens. The safety of MVA is due in large part to its inability to replicate in mammalian cells.
Distribution of Antimicrobial Resistance and Virulence Genes within the Prophage-Associated Regions in Nosocomial Pathogens
Authors: Kondo Kohei , Kawano Mitsuoki , Sugai Motoyuki
Published: July 2021

Although we believe phages play an important role in horizontal gene transfer in exchanging genetic material, we do not know the distribution of the antimicrobial resistance (AMR) and/or virulence factor (VF) genes in prophages. We collected different prophage elements from the complete genome sequences of seven species—
Enterococcus faecium
,
Staphylococcus aureus
,
Klebsiella pneumoniae
,
Acinetobacter baumannii
,
Pseudomonas aeruginosa
,
Enterobacter cloacae
, and
Escherichia coli
—and characterized the distribution of antimicrobial resistance and virulence genes encoded in the prophage region.
Supplemental Material: Late Paleoproterozoic mafic magmatism and the Kalahari craton during Columbia assembly
Authors: Djeutchou Cedric , al. et
Published: July 2021

Geochronology, geochemistry, and paleomagnetic datasets.
Supplemental Material: Central nervous system of a 310-m.y.-old horseshoe crab: Expanding the taphonomic window for nervous system preservation
Authors: Bicknell Russell , al. et
Published: July 2021

Figures S1 and S2, and Table S1.
Scoping review exploring the impact of digital systems on processes and outcomes in the care management of acute kidney injury and progress towards establishing learning healthcare systems
Authors: Chew Clair Ka Tze , Hogan Helen , Jani Yogini
Published: July 2021

Objectives

Digital systems have long been used to improve the quality and safety of care when managing acute kidney injury (AKI). The availability of digitised clinical data can also turn organisations and their networks into learning healthcare systems (LHSs) if used across all levels of health and care. This review explores the impact of digital systems i.e. on patients with AKI care, to gauge progress towards establishing LHSs and to identify existing gaps in the research.

Methods

Embase, PubMed, MEDLINE, Cochrane, Scopus and Web of Science databases were searched. Studies of real-time or near real-time digital AKI management systems which reported process and outcome measures were included.

Results

Thematic analysis of 43 studies showed that most interventions used real-time serum creatinine levels to trigger responses to enable risk prediction, early recognition of AKI or harm prevention by individual clinicians (micro level) or specialist teams (meso level). Interventions at system (macro level) were rare. There was limited evidence of change in outcomes.

Discussion

While the benefits of real-time digital clinical data at micro level for AKI management have been evident for some time, their application at meso and macro levels is emergent therefore limiting progress towards establishing LHSs. Lack of progress is due to digital maturity, system design, human factors and policy levers.

Conclusion

Future approaches need to harness the potential of interoperability, data analytical advances and include multiple stakeholder perspectives to develop effective digital LHSs in order to gain benefits across the system.
Effect of reducing ultraprocessed food consumption on obesity among US children and adolescents aged 7–18 years: evidence from a simulation model
Authors: Livingston Anne Scott , Cudhea Frederick , Wang Lu , Steele Euridice Martinez , Du Mengxi , Wang Y Claire , Pomeranz Jennifer , Mozaffarian Dariush , Zhang Fang Fang
Published: July 2021

Background

Children and adolescents in the USA consume large amounts of daily calories from ultraprocessed foods (UPFs). Recent evidence links UPF consumption to increased body fat in youth. We aimed to estimate the potential impact of reducing UPF consumption on childhood obesity rate in the USA.

Methods

We developed a microsimulation model to project the effect of reducing UPF consumption in children’s diet on reducing the prevalence of overweight or obesity among US youth. The model incorporated nationally representative data on body mass index (BMI) percentile and dietary intake of 5804 children and adolescents aged 7–18 years from the National Health and Nutrition Examination Survey 2011–2016, and the effect of reducing UPF consumption on calorie intake from a recent randomised controlled trial. Uncertainties of model inputs were incorporated using probabilistic sensitivity analysis with 1000 simulations.

Results

Reducing UPFs in children’s diet was estimated to result in a median of −2.09 kg/m
2
(95% uncertainty interval −3.21 to –0.80) reduction in BMI among children and adolescents aged 7–18 years. The median prevalence of overweight (BMI percentile ≥85th) and obesity (BMI percentile ≥95th percentile) was reduced from 37.0% (35.9%, 38.1%) to 20.9% (15.1%, 29.9%) and from 20.1% (19.2%, 21.0%) to 11.0% (7.86%, 15.8%), respectively. Larger BMI and weight reductions were seen among boys than girls, adolescents than children, non-Hispanic black and Hispanic youth than non-Hispanic white youth, and those with lower levels of parental education and family income.

Conclusions

Reducing UPF consumption in children’s diet has the potential to substantially reduce childhood obesity rate among children and adolescents in the USA.
Role of temperature, influenza and other local characteristics in seasonality of mortality: a population-based time-series study in Japan
Authors: Madaniyazi Lina , Ng Chris Fook Sheng , Seposo Xerxes , Toizumi Michiko , Yoshida Lay-Myint , Honda Yasushi , Armstrong Ben , Hashizume Masahiro
Published: July 2021

Objectives

To investigate the extent to which temperature and influenza explained seasonality of mortality in Japan and to examine the association of the seasonality with prefecture-specific characteristics.

Design

We conducted time-series analysis to estimate the seasonal amplitude before and after adjusting for temperature and/or influenza-like illness (ILI). Next, we applied linear mixed effect models to investigate the association of seasonal amplitudes with each indicator on prefecture-specific characteristics on climate, demographic and socioeconomic factors and adaptations.

Setting

47 prefectures in Japan

Participants

Deaths for all-cause, circulatory, and respiratory disease between 1999 and 2015.

Outcome measures

Peak-to-trough ratio (PTR, a measure of seasonal amplitude).

Results

The nationwide unadjusted-PTRs for all-cause, circulatory and respiratory mortality were 1.29 (95% CIs: 1.28 to 1.31), 1.55 (95% CI: 1.52 to 1.57) and 1.45 (95% CI: 1.43 to 1.48), respectively. These PTRs reduced substantially after adjusting for temperature but very little after a separate adjustment for ILI. Furthermore, seasonal amplitudes varied between prefectures. However, there was no strong evidence for the associations of PTR with the indicators on prefecture-specific characteristics.

Conclusions

Seasonality of mortality is primarily driven by temperature in Japan. The spatial variation in seasonal amplitudes was not associated with prefecture-specific characteristics. Although further investigations are required to confirm our findings, this study can help us gain a better understanding of the mechanisms underlying seasonality of mortality.
Low rates of serious complications and further procedures following surgery for base of thumb osteoarthritis: analysis of a national cohort of 43 076 surgeries
Authors: Lane Jennifer CE , Craig Richard , Rees Jonathan L , Gardiner Matthew , Mikhail Mark M , Riley Nicholas , Prieto-Alhambra Daniel , Furniss Dominic
Published: July 2021

Objectives

To determine the incidence of further procedures and serious adverse events (SAEs) requiring admission to hospital following elective surgery for base of thumb osteoarthritis (BTOA), and the patient factors associated with these outcomes.

Design

Population based cohort study.

Setting

National Health Service using the national Hospital Episode Statistics data set linked to mortality records over a 19-year period (01 April 1998–31 March 2017).

Participants

43 076 primary surgeries were followed longitudinally in secondary care until death or migration on 37 329 patients over 18 years of age.

Main outcome measures

Incidence of further thumb base procedures (including revision surgery or intra-articular steroid injection) at any time postoperatively, and local wound complications and systemic events (myocardial infarction, stroke, respiratory tract infection, venous thromboembolic events, urinary tract infection or renal failure) within 30 and 90 days. To identify patient factors associated with outcome, Fine and Gray model regression analysis was used to adjust for the competing risk of mortality in addition to age, overall comorbidity and socioeconomic status.

Results

Over the 19 years, there was an increasing trend in surgeries undertaken. The rate of further thumb base procedures after any surgery was 1.39%; the lowest rates after simple trapeziectomy (1.12%), the highest rates after arthroplasty (3.84%) and arthrodesis (3.5%). When matched for age, comorbidity and socioeconomic status, those undergoing arthroplasty and arthrodesis were 2.5 times more likely to undergo a further procedure (subHR 2.51 (95% CI 1.81 to 3.48) and 2.55 (1.91 to 3.40)) than those undergoing simple trapeziectomy. Overall complication rates following surgery were 0.22% for serious local complications and 0.58% for systemic events within 90 days of surgery.

Conclusions

The number of patients proceeding to BTOA surgery has increased over the last 19 years, with a low rate of further thumb base procedures and SAEs after surgery overall registered. Arthrodesis and arthroplasty had a significantly higher revision rate.

Trial registration number

NCT03573765.
Motivations and willingness to provide care from a geographical distance, and the impact of distance care on caregivers’ mental and physical health: a mixed-method systematic review protocol
Authors: Bei Eva , Zarzycki Mikołaj , Morrison Val , Vilchinsky Noa
Published: July 2021

Introduction

Distance caregivers (DCGs) are a growing population with substantial contribution to informal care. While a reasonable amount is known on the determinants of motives and willingness to provide local informal care, and the local caregiver outcomes, reports for the distance caregiving population are lacking. An evidence synthesis of what motivates and makes DCGs willing to care from a distance and the impact of that care on their mental and physical health would highlight any gaps or consensus in knowledge. This would guide the research needed towards the development of tailored interventions, in order to support DCGs and promote the sustainability of distance care.

Methods and analysis

This protocol adheres to Preferred Items for Reporting of Systematic Reviews and Meta-Analyses Protocols guidelines and the Joanna Briggs Institute (JBI) Methodology for mixed-method reviews. A comprehensive search strategy will be conducted in four electronic databases (CINAHL, MEDLINE, PubMed and PsycINFO). Grey literature will also be assessed to minimise publication bias. Two independent reviewers will assess each study for inclusion and any discrepancies will be resolved with the consultation of a third reviewer. Eligible studies for inclusion will be English language studies exploring the motives and willingness to care for a care recipient with a chronic disease, disability or frailty from a geographical distance; or studies focusing on the mental and physical health outcomes of DCGs. Qualitative and quantitative data will be integrated in a single qualitative synthesis following the JBI convergent integrated approach. Study quality will be assessed using the Mixed Methods Appraisal Tool version 2018.

Ethics and dissemination

Ethical approval is not required for this study as no primary data will be collected. Findings will be disseminated through peer-reviewed publication and presentations at academic conferences and lay summaries for various stakeholders.

PROSPERO registration number

CRD42020156350.
Does universal health coverage reduce out-of-pocket expenditures for medical consultations for people living with HIV in Senegal? An exploratory cross-sectional study
Authors: Taverne Bernard , Laborde-Balen Gabrièle , Diaw Khaly , Gueye Madjiguene , Have Ndeye-Ngone , Etard Jean-Francois , Sow Khoudia
Published: July 2021

Objectives

In Senegal, a national health coverage system named Couverture Medicale Universelle (CMU) has been under development since 2013; its impact on out-of-pocket (OOP) expenses for people living with HIV (PLHIV) remains unknown. Our objective was to assess the impact of the national health coverage system on health expenses for PLHIV by measuring the OOP amount for a routine consultation for various categories of PLHIV, in Dakar and different regions in Senegal, viewed from the patients’ perspective.

Design, setting and participants

Cross-sectional survey in 2018 and 2019 using a face-to-face questionnaire with PLHIV: 344 adults followed up at Fann Regional Centre for research and training in clinical treatment in Dakar; 60 adult men who have sex with men (MSM) in 2 hospitals in Dakar and 7 facilities in the regions; and 130 children and adolescents (0–19 years) in 16 care facilities in the southern regions. We have calculated the total price of the consultation and associated prescriptions along with the patient’s OOP medical and transportation contributions. The average amounts were compared using the Student’s t-test.

Results

All patients are on antiretroviral treatment with a median duration of 6 years, 5 years and 3 years for adults, MSM and children/adolescents, respectively. The percentage of people who have health coverage is 26%, 18% and 44% for adults, MSM and children. In practice, these systems are rarely used. The OOP amount (health expenses+transportation costs) for a routine consultation is €11 for adults and children, and €32.5 for MSM.

Conclusion

The number of PLHIV with coverage is low, and the system’s effectiveness remains limited. Currently, this system has proved ineffective in implementing free healthcare, recommended by WHO since 2005.
NHS ‘Learning from Deaths’ reports: a qualitative and quantitative document analysis of the first year of a countrywide patient safety programme
Authors: Brummell Zoe , Vindrola-Padros Cecilia , Braun Dorit , Moonesinghe S Ramani
Published: July 2021

Objectives

To review how National Health Service (NHS) Secondary Care Trusts (NSCTs) are using the Learning from Deaths (LfDs) programme to learn from and prevent, potentially preventable deaths.

Introduction

Potentially preventable deaths occur worldwide within healthcare organisations. In England, inconsistencies in how NSCTs reviewed, investigated and shared LfDs, resulted in the introduction of national guidance on ‘LfDs’ in 2017. This guidance provides a ‘framework for identifying, reporting, investigating and LfDs’. Amendments to NHS Quality Account regulations, legally require NSCTs in England to report quantitative and qualitative information relating to patient deaths annually. The programme intended NSCTs would share this learning and take measurable action to prevent future deaths.

Method

We undertook qualitative and quantitative secondary data, document analysis of all NSCTs LfDs reports within their 2017/2018 Quality Accounts (n=222).

Results

All statutory elements of LfDs reporting were reported by 98 out of 222 (44%) NSCTs. The percentage of deaths judged more likely than not due to problems in healthcare was between 0% and 13%. The majority of NSCTs (89%) reported lessons learnt; the most common learning theme was poor communication. 106 out of 222 NSCTs (48%) have shared or plan to share the learning within their own organisation. The majority of NSCTs (86%) reported actions taken and 47% discussed or had a plan for assessment of impact. 37 out of 222 NSCTs (17%) mentioned involvement of bereaved families.

Conclusions

The wide variation in reporting demonstrates that some NSCTs have engaged fully with LfDs, while other NSCTs appear to have disengaged with the programme. This may reveal a disparity in organisational learning and patient safety culture which could result in inequity for bereaved families. Many themes identified from the LfDs reports have previously been identified by national and international reports and inquiries.
Design features that reduce the use of seclusion and restraint in mental health facilities: a rapid systematic review
Authors: Oostermeijer Sanne , Brasier Catherine , Harvey Carol , Hamilton Bridget , Roper Cath , Martel Andrew , Fletcher Justine , Brophy Lisa
Published: July 2021

Increasing efforts are being made to prevent and/or eliminate the use of seclusion and restraint in mental health facilities. Recent literature recognises the importance of the physical environment in supporting better outcomes in mental health services. This rapid review scoped the existing literature studying what physical design features of mental health facilities can reduce the use of seclusion and physical restraint.

Design

A rapid review of peer-reviewed literature.

Methods

Peer-reviewed literature was searched for studies on architectural design and the use of restraint and seclusion in mental health facilities. The following academic databases were searched: Cochrane Library, Medline, PsycINFO, Scopus and Avery for English language literature published between January 2010 and August 2019. The Joanna Briggs Institute’s critical appraisal tool was used to assess the quality of included studies.

Results

We identified 35 peer-reviewed studies. The findings revealed several overarching themes in design efforts to reduce the use of seclusion and restraint: a beneficial physical environment (eg, access to gardens or recreational facilities); sensory or comfort rooms; and private, uncrowded and calm spaces. The critical appraisal indicated that the overall quality of studies was low, as such the findings should be interpreted with caution.

Conclusion

This study found preliminary evidence that the physical environment has a role in supporting the reduction in the use of seclusion and restraint. This is likely to be achieved through a multilayered approach, founded on good design features and building towards specific design features which may reduce occurrences of seclusion and restraint. Future designs should include consumers in a codesign process to maximise the potential for change and innovation that is genuinely guided by the insights of lived experience expertise.
Measuring research capacity development in healthcare workers: a systematic review
Authors: Bilardi Davide , Rapa Elizabeth , Bernays Sarah , Lang Trudie
Published: July 2021

Objectives

A key barrier in supporting health research capacity development (HRCD) is the lack of empirical measurement of competencies to assess skills and identify gaps in research activities. An effective tool to measure HRCD in healthcare workers would help inform teams to undertake more locally led research. The objective of this systematic review is to identify tools measuring healthcare workers’ individual capacities to conduct research.

Design

Systematic review and narrative synthesis using Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist for reporting systematic reviews and narrative synthesis and the Critical Appraisals Skills Programme (CASP) checklist for qualitative studies.

Data sources

11 databases were searched from inception to 16 January 2020. The first 10 pages of Google Scholar results were also screened.

Eligibility criteria

We included papers describing the use of tools/to measure/assess HRCD at an individual level among healthcare workers involved in research. Qualitative, mixed and quantitative methods were all eligible. Search was limited to English language only.

Data extraction and synthesis

Two authors independently screened and reviewed studies using Covidence software, and performed quality assessments using the extraction log validated against the CASP qualitative checklist. The content method was used to define a narrative synthesis.

Results

The titles and abstracts for 7474 unique records were screened and the full texts of 178 references were reviewed. 16 papers were selected: 7 quantitative studies; 1 qualitative study; 5 mixed methods studies; and 3 studies describing the creation of a tool. Tools with different levels of accuracy in measuring HRCD in healthcare workers at the individual level were described. The Research Capacity and Culture tool and the ‘Research Spider’ tool were the most commonly defined. Other tools designed for ad hoc interventions with good generalisability potential were identified. Three papers described health research core competency frameworks. All tools measured HRCD in healthcare workers at an individual level with the majority adding a measurement at the team/organisational level, or data about perceived barriers and motivators for conducting health research.

Conclusions

Capacity building is commonly identified with pre/postintervention evaluations without using a specific tool. This shows the need for a clear distinction between measuring the outcomes of training activities in a team/organisation, and effective actions promoting HRCD. This review highlights the lack of globally applicable comprehensive tools to provide comparable, standardised and consistent measurements of research competencies.

PROSPERO registration number

CRD42019122310.
Anti-Mullerian hormone (AMH) test information on Australian and New Zealand fertility clinic websites: a content analysis
Authors: Copp Tessa , Nickel Brooke , Lensen Sarah , Hammarberg Karin , Lieberman Devora , Doust Jenny , Mol Ben W , McCaffery Kirsten
Published: July 2021

Objectives

The anti-Mullerian hormone (AMH) test has been promoted as a way to inform women about their future fertility. However, data consistently show the test is a poor predictor of natural fertility potential for an individual woman. As fertility centre websites are often a primary source of information for reproductive information, it is essential the information provided is accurate and reflects the available evidence. We aimed to systematically record and categorise information about the AMH test found on Australian and New Zealand fertility clinic websites.

Design

Content analysis of online written information about the AMH test on fertility clinic websites.

Setting

Accredited Australian and New Zealand fertility clinic websites.

Methods

Data were extracted between April and June 2020. Any webpage that mentioned the AMH test, including blogs specifically about the AMH test posted since 2015, was analysed and the content categorised.

Results

Of the 39 active accredited fertility clinics’ websites, 25 included information about the AMH test. The amount of information varied widely, and embodied four overarching categories; (1) the utility of the AMH test, (2) who the test is suitable for, (3) possible actions in response to the test and (4) caveats and limitations of the test. Eight specific statements about the utility of the test were identified, many of which are not evidence-based. While some websites were transparent regarding the test’s limitations, others mentioned no caveats or included persuasive statements actively promoting the test as empowering for a range of women in different circumstances.

Conclusions

Several websites had statements about the utility of the AMH test that are not supported by the evidence. This highlights the need for higher standards for information provided on fertility clinic websites to prevent women being misled to believe the test can reliably predict their fertility.
Sustaining community-based interventions for people affected by dementia long term: the SCI-Dem realist review
Authors: Morton Thomas , Wong Geoff , Atkinson Teresa , Brooker Dawn
Published: July 2021

Objectives

Community-based support for people with earlier-stage dementia and their care partners, such as regularly meeting groups and activities, can play an important part in postdiagnostic care. Typically delivered piecemeal in the UK, by a variety of agencies with inconsistent funding, provision is fragmented and many such interventions struggle to continue after only a short start-up period. This realist review investigates what can promote or hinder such interventions in being able to sustain long term.

Methods

Key sources of evidence were gathered using formal searches of electronic databases and grey literature, together with informal search methods such as citation tracking. No restrictions were made on article type or study design; only data pertaining to regularly meeting, ongoing, community-based interventions were included. Data were extracted, assessed, organised and synthesised and a realist logic of analysis applied to trace context–mechanism–outcome configurations as part an overall programme theory. Consultation with stakeholders, involved with a variety of such interventions, informed this process throughout.

Results

Ability to continually get and keep members; staff and volunteers; the support of other services and organisations; and funding/income were found to be critical, with multiple mechanisms feeding into these suboutcomes, sensitive to context. These included an emphasis on socialising and person-centredness; lowering stigma and logistical barriers; providing support and recognition for personnel; networking, raising awareness and sharing with other organisations, while avoiding conflict; and skilled financial planning and management.

Conclusions

This review presents a theoretical model of what is involved in the long-term sustainability of community-based interventions. Alongside the need for longer-term funding and skilled financial management, key factors include the need for stigma-free, person-centred provision, sensitive to members’ diversity and social needs, as well as the need for a robust support network including the local community, health and care services. Challenges were especially acute for small scale and rural groups.
Trajectories of mid-life to elderly adulthood BMI and incident hypertension: the China Health and Nutrition Survey
Authors: Zeng Qi , Sun Lin , Zeng Qing
Published: July 2021

Objectives

This study is designed to identify different body mass index (BMI) trajectories of individuals aged 40–70 years and test the effect of distinct BMI trajectories on incident hypertension.

Design

The accelerated longitudinal design was used for this study.

Methods

The study drew data from the third to ninth China Health and Nutrition Surveys (CHNS), and 4697 participants were included between 1991 and 2015. As analysed, three distinct individual BMI trajectories were identified by the latent class growth mixed model (LCGMM). Then, BMI values and BMI slopes were worked out through calculation with LCGMM trajectory parameters and their primary derivatives, respectively. Later, Cox proportional hazard models were applied to examine BMI values and slopes, and find out the relationship between the said predicted data and incident hypertension for different classes.

Results

Three different trajectory classes were identified, that is, low-stable class (n=3711), sharp-increasing class (n=282) and high-stable class (n=704). Compared with the low-stable class, the adjusted HRs (95% CI) were 1.321 (1.119 to 1.559) and 1.504 (1.322 to 1.711) for the sharp-increasing class and the high-stable class, respectively. The HR (95% CI) for BMI values rose from 1.081 (1.030 to 1.135) to 1.221 (1.171 to 1.273) while the HR (95% CI) for BMI slopes dropped from 1.154 (1.100 to 1.211) to 0.983 (0.943 to 1.025). That is, the HR for BMI slopes were higher than that for BMI values for the class aged 40–47 years.

Conclusion

These findings suggest that the calibrated BMI trajectories for the period from mid-life to elderly adulthood have a significant effect on the risk of incident hypertension. The period from age 40 to 47 years is critical and has positive implications for the early prevention of hypertension.
Swedish nationwide time series analysis of influenza and suicide deaths from 1910 to 1978
Authors: Rück Christian , Mataix-Cols David , Malki Kinda , Adler Mats , Flygare Oskar , Runeson Bo , Sidorchuk Anna
Published: July 2021

Objectives

There is concern that the COVID-19 pandemic will be associated with an increase in suicides, but evidence supporting a link between pandemics and suicide is limited. Using data from the three influenza pandemics of the 20th century, we aimed to investigate whether an association exists between influenza deaths and suicide deaths.

Design

Time series analysis.

Setting

Sweden.

Participants

Deaths from influenza and suicides extracted from the Statistical Yearbook of Sweden for 1910–1978, covering three pandemics (the Spanish influenza, the Asian influenza and the Hong Kong influenza).

Main outcome measures

Annual suicide rates in Sweden among the whole population, men and women. Non-linear autoregressive distributed lag models was implemented to explore if there is a short-term and/or long-term relationship of increases and decreases in influenza death rates with suicide rates during 1910–1978.

Results

Between 1910 and 1978, there was no evidence of either short-term or long-term significant associations between influenza death rates and changes in suicides (β coefficients of 0.00002, p=0.931 and β=0.00103, p=0.764 for short-term relationship of increases and decreases in influenza death rates, respectively, with suicide rates, and β=−0.0002, p=0.998 and β=0.00211, p=0.962 for long-term relationship of increases and decreases in influenza death rates, respectively, with suicide rates). The same pattern emerged in separate analyses for men and women.

Conclusions

We found no evidence of short-term or long-term association between influenza death rates and suicide death rates across three 20th century pandemics.