bluuebunny/crossref_metadata_2025_split huggingface dataset:
Work profiles of older employees in Germany-results from the lidA-cohort study
Authors: Hasselhorn Hans Martin , Stiller Michael , du Prel Jean-Baptist , Ebener Melanie 
Published: September 2020

Abstract
Background
This study investigates whether a typology of work exposure can be established among older workers in Germany. Work exposure comprises physical work, working time quality, work intensity, skills & discretion, social environment, leadership, continued education, earnings and work prospects.

Methods
Latent profile analysis was conducted on a representative sample of the socially insured workforce in Germany born in 1959 or 1965 (N = 6277). Seven year-prospective associations between the typology and work-related outcomes (physical and mental health, work ability and work-privacy-conflict) were investigated to establish the distinctness of the profiles.

Results
Five profiles were identified: “Poor Quality” (19%), “Relaxed Manuals” (30%), “Strained non-Manuals” (16%), “Smooth Running” (33%) and “High Flying” (3%). These profiles exhibited diverging patterns of association with the selected outcomes, thus representing qualitatively distinct subgroups of older workers in Germany.

Conclusions
We conclude that a typological approach may broaden the understanding of the ageing work force and the complex interplay of the overall work situation with outcomes of high individual and social relevance such as health, work ability and employment. The five work profiles identified in this study may constitute crucial clusters needed to reliably mirror today’s over-all work exposure patterns in the older work force in Germany. They may allow for the comprehensible monitoring of quality of work and personal life among the older work force during their last working years and their transition to retirement in current times of extending working lives.
Exploring spatial variations and factors associated with skilled birth attendant delivery in Ethiopia: geographically weighted regression and multilevel analysis
Authors: Teshale Achamyeleh Birhanu , Alem Adugnaw Zeleke , Yeshaw Yigizie , Kebede Sewnet Adem , Liyew Alemneh Mekuriaw , Tesema Getayeneh Antehunegn , Agegnehu Chilot Desta 
Published: September 2020

Abstract
Background
Skilled birth attendant (SBA) delivery is vital for the health of mothers and newborns, as most maternal and newborn deaths occur at the time of childbirth or immediately after birth. This problem becomes worsen in Ethiopia in which only 28% of women give birth with the help of SBA. Therefore, this study aimed to explore the spatial variations of SBA delivery and its associated factors in Ethiopia.

Methods
A secondary analysis was carried out using the 2016 Ethiopian Demographic and Health Survey. A total weighted sample of 11,023 women who had a live birth in the 5 years preceding the survey was included in the analysis. Arc-GIS software was used to explore the spatial distribution of SBA and a Bernoulli model was fitted using SaTScan software to identify significant clusters of non-SBA delivery. The Geographic Weighted Regression (GWR) was employed in modeling spatial relationships. Moreover, a multilevel binary logistic regression model was fitted to identify factors associated with SBA delivery.

Results
In this study, SBA delivery had spatial variations across the country. The SaTScan spatial analysis identified the primary clusters’ spatial window in southeastern Oromia and almost the entire Somalia. The GWR analysis identified different predictors of non- SBA delivery across regions of Ethiopia. In the multilevel analysis, mothers having primary and above educational status, health insurance coverage, and mothers from households with higher wealth status had higher odds of SBA delivery. Being multi and grand multiparous, perception of distance from the health facility as big problem, rural residence, women residing in communities with medium and higher poverty level, and women residing in communities with higher childcare burden had lower odds of SBA delivery.

Conclusion
Skilled birth attendant delivery had spatial variations across the country. Areas with non-skilled birth attendant delivery and mothers who had no formal education, not health insured, mothers from poor households and communities, Primiparous women, mothers from remote areas, and mothers from communities with higher childcare burden could get special attention in terms of allocation of resources including skilled human power, and improved access to health facilities.
Low-income parents’ perceptions of the importance of a musical training programme for their children: a qualitative study
Authors: Ho Laurie Long Kwan , Li William Ho Cheung , Cheung Ankie Tan , Xia Wei , Ho Ka Yan , Chung Joyce Oi Kwan 
Published: September 2020

Abstract
Background
Despite clear evidence for the effectiveness of musical training in promoting psychological well-being among underprivileged children, parents’ perceptions of the importance of such training for their children remains unknown.

Methods
Of the parents of 171 underprivileged preschool children in Hong Kong who had participated in a free musical training programme, 25 were randomly selected and invited to participate in individual semi-structured interviews. Colaizzi’s descriptive phenomenological data analysis strategy was followed for analysing the data.

Results
The results showed that parents identified numerous benefits of the programme for their child, including increased happiness, improved confidence, positive behavioural changes, and enhanced parent-child relationships. At the beginning of the programme, parents tended to disregard the usefulness of musical training but gradually came to recognise its importance for their children’s psychological and social well-being. However, children were limited by their parents’ financial constraints from participating in musical training after the free programme ended.

Conclusions
These findings imply that existing policy may overlook the psychosocial needs of underprivileged children and suggest that more resources should be allocated to facilitate the continuity and sustainability of such a free programme for this vulnerable population.

Trial registration
ClinicalTrials.gov NCT02762786, registered on May 5, 2016.
Deaths from surgical conditions in Malawi - a randomised cross-sectional Nationwide household survey
Authors: Varela Carlos , Young Sven , Groen Reinou S. , Banza Leonard , Mkandawire Nyengo , Moen Bente Elisabeth , Viste Asgaut 
Published: September 2020

Abstract
Background
Relatively little is known about deaths from surgical conditions in low- and middle- income African countries. The prevalence of untreated surgical conditions in Malawi has previously been estimated at 35%, with 24% of the total deaths associated with untreated surgical conditions. In this study, we wished to analyse the causes of deaths related to surgical disease in Malawi and where the deaths took place; at or outside a health facility.

Methods
The study is based on data collected in a randomised multi-stage cross-sectional national household survey, which was carried out using the Surgeons Overseas Assessment of Surgical Need (SOSAS) tool. Randomisation was done on 48,233 settlements, using 55 villages from each district as data collection sites. Two to four households were randomly selected from each village. Two members from each household were interviewed. A total of 1479 households (2909 interviewees) across the whole country were visited as part of the survey.

Results
The survey data showed that in 2016, the total number of reported deaths from all causes was 616 in the 1479 households visited. Data related to cause of death were available for 558 persons (52.7% male). Surgical conditions accounted for 26.9% of these deaths. The conditions mostly associated with the 150 surgical deaths were body masses, injuries, and acute abdominal distension (24.3, 21.5 and 18.0% respectively). 12 women died from child delivery complications. Significantly more deaths from surgical conditions or injuries (55.3%) occurred outside a health facility compared to 43.6% of deaths from other medical conditions, (p = 0.0047). 82.3% of people that died sought formal health care and 12.9% visited a traditional healer additionally prior to their death. 17.7% received no health care at all. Of 150 deaths from potentially treatable surgical conditions, only 21.3% received surgical care.

Conclusion
In Malawi, a large proportion of deaths from possible surgical conditions occur outside a health facility. Conditions associated with surgical death were body masses, acute abdominal distention and injuries. These findings indicate an urgent need for scale up of surgical services at all health care levels in Malawi.
Prevalence and associated factors of prelacteal feeding among neonates admitted to neonatal intensive care units, North central Ethiopia, 2019
Authors: Bayih Wubet Alebachew , Mekonen Demewoz Kefale , Kebede Solomon Demis 
Published: September 2020

Abstract
Background
Prelacteal feeding compromises the benefits of exclusive breastfeeding, thereby increasing neonatal malnutrition, infection and mortality. About 26% of the Ethiopian neonates are given prelacteal feeds and nearly 48% of whom are attributed to Amhara region. Besides, prior Ethiopian studies have shown significance of the problem at different community settings in the country. However, the prevalence and associated factors of prelacteal feeding among neonatal admissions has been overlooked in the country in general and in the study area in particular. Therefore, this study was aimed to assess the prevalence and associated factors of prelacteal feeding among neonatal admissions in the study setting.

Methods
A cross-sectional study was conducted among 321 mother-neonate pairs admitted to Neonatal Intensive Care Unit (NICU) of Debre Tabor General Hospital between September 2018 and February 2019. Every fourth mother neonate pair was included to the study. Multivariable logistic regressions were fitted to find out adjusted odds ratios (AORs) of factors associated with pre-lacteal feeding.

Results
The prevalence of prelacteal feeding was 20.2% [95% CI: 15.31–26.75%]. Plain water was the most common prelacteal food (32.3%). Factors associated with prelacteal feeding include rural residence (AOR = 4.07, 95% CI: 1.30, 12.81), primiparity (AOR = 4.50, 95% CI: 1.30–12.81), less than four ANC visits (AOR = 4.71, 95% CI: 1.23–17.84), spousal accompany to ANC (AOR = 0.20, 95% CI: 0.05–0.75), home delivery (AOR = 5.94, 95% CI: 1.80–19.67), having twin newborns (AOR = 6.69, 95% CI: 1.25, 35.91) and maternal belief on the purported advantages of prelacteal feeding (AOR = 2.74, 95% CI: 2.09–25.39).

Conclusion and recommendation
One out of five sick neonates was given prelacteal feeds. Twin neonates, home delivered neonates, rural neonates, neonates born to primiparous mothers, neonates delivered from mothers who had less than four ANC visits, neonates born to mothers who weren’t accompanied by their spouse during ANC and those born to mothers who believe on the purported advantages of prelacteal feeding had higher odds of receiving prelacteal feeds. Therefore, mothers of these vulnerable neonates should be provided with more emphasis about counseling of infant and young child feeding practice during their stay at NICU.
Implant contamination as a cause of surgical site infection in spinal surgery: are single-use implants a reasonable solution? – a systematic review
Authors: Schömig Friederike , Perka Carsten , Pumberger Matthias , Ascherl Rudolf 
Published: September 2020

Abstract
Background
In spine surgery, surgical site infection (SSI) is one of the main perioperative complications and is associated with a higher patient morbidity and longer patient hospitalization. Most factors associated with SSI are connected with asepsis during the surgical procedure and thus with contamination of implants and instruments used which can be caused by pre- and intraoperative factors. In this systematic review we evaluate the current literature on these causes and discuss possible solutions to avoid implant and instrument contamination.

Methods
A systematic literature search of PubMed addressing implant, instrument and tray contamination in orthopaedic and spinal surgery from 2001 to 2019 was conducted following the PRISMA guidelines. All studies regarding implant and instrument contamination in orthopaedic surgery published in English language were included.

Results
Thirty-five studies were eligible for inclusion and were divided into pre- and intraoperative causes for implant and instrument contamination. Multiple studies showed that reprocessing of medical devices for surgery may be insufficient and lead to surgical site contamination. Regarding intraoperative causes, contamination of gloves and gowns as well as contamination via air are the most striking factors contributing to microbial contamination.

Conclusions
Our systematic literature review shows that multiple factors can lead to instrument or implant contamination. Intraoperative causes of contamination can be avoided by implementing behavior such as changing gloves right before handling an implant and reducing the instruments’ intraoperative exposure to air. In avoidance of preoperative contamination, there still is a lack of convincing evidence for the use of single-use implants in orthopaedic surgery.
Large autologous ilium with periosteum for tibiotalar joint reconstruction in Rüedi-Allgöwer III or AO/OTA type C3 pilon fractures: a pilot study
Authors: Li Dong , Li Jiao Jiao , Zhu Yuanyuan , Hou Fushan , Li Yuan , Zhao Bin , Wang Bin 
Published: September 2020

Abstract
Background
Management of Rüedi-Allgöwer III or AO/OTA type C3 pilon fracture presents numerous challenges to the orthopaedic surgeon. A joint preservation technique using a large autologous ilium with periosteum in combination with internal implant fixation was reported to improve the outcome of reconstruction.

Methods
Twenty-five patients according to Tscherne/Oestern FxCO-I closed fracture and FxOI open fractures classification after Rüedi-Allgöwer III or AO/OTA type C3 pilon fracture received a large autologous ilium with periosteum for tibiotalar joint reconstruction and open reduction and internal fixation (ORIF), between March 2015 and September 2018. The visual analog scale (VAS), American Orthopaedic Foot & Ankle Society (AOFAS) score, and Burwell and Charnley criteria were used for outcome analysis.

Results
Twenty patients with an average age of 45.2 years were followed for an average of 18.3 months. The VAS and AOFAS scores, and Burwell and Charnley ratings were recorded at the last follow-up after reconstructive surgery. Two patients developed redness and swelling at the wound site, but recovered after local care and dressing changes. No patient displayed deep surgical site infection, donor site complication, non-union or local complication during the final follow-up. The average bone union time was 18.3 months (range 3–36).

Conclusions
Large autologous ilium with periosteum in combination with ORIF can be performed for tibiotalar joint reconstruction. This experimental procedure reduces the risk of post-operative complications following articular reconstruction for Rüedi-Allgöwer III or AO/OTA type C3 pilon fractures in short follow-up.

Level of evidence
Level III, retrospective cohort study.
The status and associated factors of early childhood caries among 3- to 5-year-old children in Guangdong, Southern China: a provincial cross-sectional survey
Authors: Li Jianbo , Fan Weihua , Zhou Yueshan , Wu Linmei , Liu Wei , Huang Shaohong 
Published: September 2020

Abstract
Background
Dental caries of deciduous teeth (Early Childhood Caries, ECC) has become a crucial oral health problem over the decades in China. The aim of this study was to examine the prevalence and severity of ECC among preschool children from Guangdong Province, Southern China. In addition, to assess the association of ECC with reported oral health-related behaviors.

Methods
A cross-sectional survey of 2592 participants was carried out in Guangdong Province by means of an equal-sized, stratified, multistage random sampling method during December 2015 and April 2016. The participants were divided into three groups according to their ages (3-, 4-, and 5-year-olds). Half of the participants were derived from urban areas, while the other from rural areas. According to the standard for clinical dentition examination of the WHO 2013 criteria, the presence of ECC was determined by the dmft (decayed-missing-filled tooth) index using a CPI (Community Periodontal Index) probe. A questionnaire about caries-related factors was completed by each of the participants’ parents or grandparents through a face-to-face and one-on-one interview. Then, t-test, Chi2 tests, One-Way ANOVA served for statistical analysis, and logistic regression analysis as well as covariance analysis were executed to identify potential associated factors for ECC.

Results
The prevalence (% dmft > 0) of ECC was 68.3 (95% CI: 66.5–70.1), the mean dmft was 4.36 (95% CI: 4.17–4.55), and the filled rate was 1.2%. In multivariable modeling, associated factors for both prevalence and mean dmft were older age, rural areas, consumption of sweets before sleep, dental visit history, low household income, and low parental education level. Initiating toothbrushing after 3 years of age and being exclusively/ predominantly breastfed indicated only the prevalence; being female and frequently consuming sweetened milk/powdered milk indicated only the mean dmft.

Conclusions
Preschool children in Guangdong Province, especially children from rural areas, experienced a significant amount of ECC. Associated factors for ECC included demographics, oral health measures, dietary factors, and socioeconomic factors. More attention should be given to prevention of ECC from early life. The construction of social support for oral health should be strengthened. Oral health education and promotion, especially of rural areas, should be intensified to reduce the inequality between urban and rural areas.
“Teach for ethics in palliative care”: a mixed-method evaluation of a medical ethics training programme
Authors: De Panfilis Ludovica , Tanzi Silvia , Perin Marta , Turola Elena , Artioli Giovanna 
Published: September 2020

Abstract
Background
Training in medical ethics aims to educate health care professionals in dealing with daily care ethical issues. To guarantee quality of life and spiritual and emotional support, palliative care professionals have to develop ethical and relational skills. We propose the implementation and evaluation of a specialized training programme in medical ethics dedicated to a hospital-based Palliative Care Unit.

Methods
This study is a mixed-method before-after evaluation with data triangulation.

Results
The results highlight that participants developed their ethical knowledge, and a deeper ethical awareness. They also felt more confident and motivated to widely apply ethical reflections and reasonings in their daily practice.

Conclusion
The participants appreciated the innovative structure of the training, especially regarding the integration of the theoretical-interactive and practical parts. However, they recommended increasing the number of concrete occasions for ethical supervision and practical application of what they learned during the programme. The training programme also has some potential practical implications: the development of advanced ethical skills within a hospital-based PC team may improve the quality of life of the patients and their families. In addition, health care professionals with advanced ethical competencies are able to educate patients and their families towards more active participation in the decision-making process.
Pre-graduation medical training including virtual reality during COVID-19 pandemic: a report on students’ perception
Authors: De Ponti Roberto , Marazzato Jacopo , Maresca Andrea M. , Rovera Francesca , Carcano Giulio , Ferrario Marco M. 
Published: September 2020

Abstract
Background
The Coronavirus Disease 19 (COVID-19) pandemic brought significant disruption to in-hospital medical training. Virtual reality simulating the clinical environment has the potential to overcome this issue and can be particularly useful to supplement the traditional in-hospital medical training during the COVID-19 pandemic, when hospital access is banned for medical students. The aim of this study was to assess medical students’ perception on fully online training including simulated clinical scenarios during COVID-19 pandemic.

Methods
From May to July 2020 when in-hospital training was not possible, 122 students attending the sixth year of the course of Medicine and Surgery underwent online training sessions including an online platform with simulated clinical scenarios (Body Interact™) of 21 patient-based cases. Each session focused on one case, lasted 2 h and was divided into three different parts: introduction, virtual patient-based training, and debriefing. In the same period, adjunctive online training with formal presentation and discussion of clinical cases was also given. At the completion of training, a survey was performed, and students filled in a 12-item anonymous questionnaire on a voluntary basis to rate the training quality. Results were reported as percentages or with numeric ratings from 1 to 4. Due to the study design, no sample size was calculated.

Results
One hundred and fifteen students (94%) completed the questionnaire: 104 (90%) gave positive evaluation to virtual reality training and 107 (93%) appreciated the format in which online training was structured. The majority of participants considered the platform of virtual reality training realistic for the initial clinical assessment (77%), diagnostic activity (94%), and treatment options (81%). Furthermore, 97 (84%) considered the future use of this virtual reality training useful in addition to the apprenticeship at patient’s bedside. Finally, 32 (28%) participants found the online access difficult due to technical issues.

Conclusions
During the COVID-19 pandemic, online medical training including simulated clinical scenarios avoided training interruption and the majority of participant students gave a positive response on the perceived quality of this training modality. During this time frame, a non-negligible proportion of students experienced difficulties in online access to this virtual reality platform.