bluuebunny/crossref_metadata_2025_split huggingface dataset:
How do private practitioners in Pakistan manage children suspected having tuberculosis? A cross sectional study
Authors: Yaqoob Aashifa , Hinderaker Sven , Fatima Razia , Najmi Hina , Haq Anwar 
Published: December 2020

Abstract
Background:In Pakistan, private providers provide a large portion of health care, including for tuberculosis (TB). All TB patients are supposed to be reported to the National Tuberculosis Program (NTP), which provides drugs free of charge in addition to monitoring, supervision, and support. However, diagnosis of TB in children is difficult. We aimed to assess the private health care providers’ investigation practices and management of childhood TB. Methods:We used a cross-sectional study, which was based on a national survey measuring under-reporting of children with TB in 12 selected districts in Pakistan from April-June, 2016. We explored the practices of the private health care providers, including the health care workers i.e. general practitioners, pediatricians, pulmonologists and chest specialists, who were involved in the diagnosis of TB in children under 15 years for investigating and managing children suspected having TB.Results:Among 6519 presumptive child TB cases, a total of 5193(79.7%) children under 15 years were diagnosed as TB by private health care providers during second quarter, 2016. Only 187(2.9%) were notified to NTP. The majority of presumptive child TB cases reported cough, fever, and failure to thrive; few had TB contacts with pulmonary TB patients. Failure to thrive, loss of body weight and absence of BCG scar was more common in female children. Private providers relied on chest X-ray in 46.1%, while tuberculin skin test and Gene-Xpert MTB/RIF testing was little utilized. Bacteriological confirmation was present in 7.6%, and clinical assessment was the only basis for diagnosis in 39.3%. Of children with presumptive TB, only 955(14.6%) children were treated by private provider, while 3121(47.9%) cases were referred for diagnosis and 2443(37.5%) were referred after diagnosis for treatment; among all the referred, 3812(68.5%) were sent for investigations to District TB Centre (NTP).Conclusion:This study showed that many private providers referred children suspected having TB to laboratories for further diagnosis, but the cases identified in these investigations were often not notified to the NTP. This problem could be resolved by strengthening the referral linkages between private health providers, NTP laboratories and treatment centres through capacity building and training of their staff.
Nurses’ Knowledge, Attitude, and Fall Prevention Practices at South Korean Hospitals: A Cross-Sectional Survey
Authors: Cho Mi-young , Jang Sun Joo 
Published: December 2020

Abstract
Background: Fall-prevention activities are nursing interventions which are designed to improve patient safety. The introduction of evaluations of medical institutions and an increase in medical litigation has led institutions to emphasize the importance of fall-prevention activities. The current situation regarding falls among patients in small and medium-sized hospitals is poorly understood. This study assessed knowledge and attitudes regarding falls, and fall-prevention activities of nurses working in small- and medium-sized hospitals. Methods: Nurses (N= 162) from seven small- and medium-sized hospitals participated in the study. Data on participants’ characteristics, education regarding patient falls, knowledge of stretcher cart use, attitudes regarding patient falls, and fall-prevention activities were collected from August 1 to September 1, 2016. Results: Nurses’ knowledge of patient falls was positively correlated with their experience with inpatient falls. Furthermore, nurses’ attitudes regarding falls were influenced by their nursing experience and fall prevention education. Attitudes positively correlated with fall-prevention activities, but knowledge did not. Nurses’ attitudes regarding patient falls were correlated with fall-prevention activities. Conclusion: Hospitals should develop incentive programs to improve nurses’ attitudes which are based on their subjective norms and tailored to each hospital’s specific circumstances to ensure engagement in fall prevention activities. In short, we recommend that consistent, repeated, and custom fall-prevention education should be implemented in small- and medium-sized hospitals to promote engagement in fall-prevention activities. Patient safety activities in small- and medium-sized hospitals can be enhanced by creating an environment that encourages active and self-directed participation in developing fall-prevention strategies using motivation and rewards.
Prevalence and factors associated with postpartum depression during the COVID-19 pandemic among women in Guangzhou, China: a cross-sectional study
Authors: Liang Peiqin , Wang Yiding , Shi Si , Liu Yan , Xiong Ribo 
Published: December 2020

Abstract
Background: The 2019 coronavirus disease (COVID-19) is a public health emergency of international concern. To date, there are limited studies that have investigated the impact of COVID-19 pandemic on mental health among female population. Therefore, the study aims to investigate the prevalence of postpartum depression (PPD) and it’s related factors among women in Guangzhou, China, during the COVID-19 pandemic.Methods: A cross-sectional study was performed from 30th March 2020 to 13th April 2020 using anonymous online questionnaire among 864 women at 6-12 weeks postpartum. The Chinese version of Edinburgh Postnatal Depression Scale and a questionnaire regarding associated factors were administered to all participants. Multivariate logistic regression was used to determine factors that were significantly associated with PPD.Results: The prevalence of PPD among women at 6-12 weeks postpartum was 30.0%. A multivariate logistic regression model identified significant factors as: immigrant women, persistent fever, poor social support, concerns about contracting COVID-19 and certain precautionary measures.Conclusions: The findings suggest the need for policies and interventions to not only mitigate the psychological impacts but also target disadvantaged sub-groups of women following childbirth during the COVID-19 pandemic.
Factors affecting patient safety culture in terms of compliance with preventing bloodborne pathogens among general hospital nurses
Authors: Kim Na Young , Moon Kyoung Ja 
Published: December 2020

Abstract
Background: The present study aims to investigate the relationship between patient safety culture and prevention of transmitting bloodborne pathogens among nurses at a general hospital. Methods: The participants were 284 nurses working at a general hospital located in P city, and the data were collected between April 26 and May 15, 2019. Questionnaires on patient safety culture and prevention of bloodborne pathogens were used, and the data were examined on SPSS version 22.0 using for descriptive and hierarchical regression analysis. Results: The results showed that the following factors affected the prevention of bloodborne pathogens: experience of needle stick and sharp injuries (β = -0.94), teamwork (β = 0.41), knowledge and attitude toward patient safety (β = 0.34), leadership (β = 0.15), and priority of patient safety (β = 0.14). The model's explanatory power was 53 % (F = 32.26, p =< 0.001).Conclusions: To increase the compliance of general hospital nurses with practices that promote the prevention of bloodborne pathogens, it is necessary to actively prevent needle stick and sharp injuries. It is also necessary to prioritize patient safety and to develop and verify the effects of various programs that emphasize factors of patient safety culture, such as leadership, teamwork, knowledge, and attitude.
Knowledge and Myths about Preeclampsia and Eclampsia and its influence on Antenatal Service Utilization among pregnant women and their male partners in Mtwara Region-Tanzania: A Cross Sectional Analytical Study.
Authors: Machenje Aziza Shaibu , Kibusi Stephen M. , Gibore Nyasiro , Lilungulu Athanase , Moshi Fabiola V. 
Published: December 2020

Abstract
Background : Pregnancy induced hypertension, including preeclampsia and eclampsia are the major health problem and the main cause of the maternal and perinatal morbidity and mortality in Tanzania. The aim of this study was to assess knowledge and myths about preeclampsia and eclampsia and its influence in Antenatal Clinics (ANC) utilization among pregnant women and their male partiners in Mtwara region. Method : A community based cross-sectional analytical study conducted in Mtwara Region, a random sampling procedure was employed to obtain a sample size of 384 pregnant women and their male partners a total of 768 participants (male=384 and female =384). Interviewer structured questionnaire was used for data collection and Statistical package for social science (SPSS v.20) software was used for data entry and analysis. Descriptive statistics, cross tabulation, Principal component analysis (PCA) was conducted and inferential statistics were used to test association between variables obtained. Results: Among 768 participants, male partners 167(43.5%) and pregnant women 171 (44.5%) had adequate knowledge about preeclampsia and eclampsia. More than a half 396(51.6%) of study respondents had weak myths while 372(48.4%) had strong myths on pre-eclampsia and eclampsia. Furthermore, pregnant women 244 (64%) had adequate antenatal care utilization. Study participants who had adequate knowledge on pre-eclampsia and eclampsia were almost 3 times more likely to utilize antenatal care services (AOR = 2.827; CI = 1.719 – 4.651; p<0.001). Study participants who had weak myth on pre-eclampsia and eclampsia were less likely to have adequate antenatal care attendance (AOR= 0.370; CI= 0.229; p< 0.001) Conclusion : The overall knowledge of preeclampsia and eclampsia was low. Majority of the female had adequate antenatal service utilization. Majority of respondents had weak myths. Government and stakeholders should ensure that community is equipped with knowledge about preeclampsia and eclampsia and the available Myths should be dispelled.
Higher aggrecan 1-F21 epitope concentration in synovial fluid early after anterior cruciate ligament injury is associated with worse knee cartilage quality assessed by gadolinium enhanced magnetic resonance imaging 20 years later
Authors: Neuman Paul , Larsson Staffan , Lohmander L Stefan , Struglics André 
Published: December 2020

Abstract
Background. To investigate if cartilage related biomarkers in synovial fluid are associated with knee cartilage status 20 years after an anterior cruciate ligament (ACL) injury.Methods. We studied 25 patients with a complete ACL rupture without subsequent ACL reconstruction or radiographic knee OA. All had a delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) 20 years after the ACL injury, using the T1 transverse relaxation time in the presence of gadolinium (T1Gd) which estimates the concentration of glycosaminoglycans in hyaline cartilage. Synovial fluid samples were aspirated acutely (between 0 and 18 days) and during 1 to 5 follow up visits between 0.5 and 7.5 years after injury. We quantified synovial fluid concentrations of aggrecan (epitopes 1-F21 and ARGS), cartilage oligomeric matrix protein, matrix metalloproteinase-3 and tissue inhibitor of metalloproteinase-1 by immunoassays, and sulfated glycosaminoglycans by Alcian blue precipitation. Western blot was used for qualitative analyses of aggrecan fragments in synovial fluid and cartilage samples.Results. Western blot indicated that the 1-F21 epitope was located within the chondroitin sulfate 2 region of aggrecan. Linear regression analyses (adjusted for age, sex, body mass index and time between injury and sampling) showed that acute higher synovial fluid 1-F21-aggrecan concentrations were associated with shorter T1Gd values 20 years after injury, i.e. inferior cartilage quality (standardized effects between -0.67 and -1.0). No other statistically significant association was found between molecular biomarkers and T1Gd values. Conclusion. Higher acute synovial fluid 1-F21-aggrecan concentrations in ACL injured patients, who managed to cope without ACL reconstruction and were without radiographic knee OA, were associated with inferior knee cartilage quality assessed by dGEMRIC 20 years after injury.
Ocular and Corneal Aberrations changes in controlled randomized clinical trial MiSight® Assessment Study Spain (MASS)
Authors: Lopes-Ferreira Daniela , Ruiz-Pomeda Alicia , Peréz-Sanchéz Belén , Queirós António , Villa-Collar César 
Published: December 2020

Abstract
Background: To compare ocular and corneal inherent aberrations in the naked eyes of randomly selected children fitted with MiSight contact lenses (CL) for myopia control, versus children corrected with single-vision spectacles (control), over a 24-months period. Methods: Children aged 8 to 12 years, with myopia (-0.75 to -4.00 D sphere) and astigmatism (< -1.00 D cylinder), were assigned to the lens study group (MiSight) or the control group (single-vision spectacles). Axial length (AL) was measured by biometry, the root mean square aberration (RMS) was determined as corneal (RMS_C), corneal high order RMS (HO_RMS_C), corneal low order RMS (LO_RMS_C), ocular total RMS (RMS_T), ocular total high order RMS (HO_RMS_T), ocular total low order RMS (LO_RMS_T), corneal spherical aberration (SA_C) and ocular total SA (SA_T) were calculated by aberrometric measures at the baseline, and on 12- and 24-months visits. A 5 mm diameter was defined for the analysis in all visits for all subjects. Only the dominant eye was analyzed. Results: Seventy-four subjects completed the clinical trial: 41 subjects from the MiSight group (age: 11.01 ± 1.23 years) and 33 from the single-vision group (age: 10.12 ± 1.38 years). In the control group, RMS_T (0.57 ± 0.20 µm, p = 0.029) and LO_RMS_T (0.46 ± 0.18 µm, p = 0.047) registered significant changes after 24-months in the control group. In the MiSight group no significant changes were registered. The SA_C and SA_T did not reveal significant changes between visits or between groups. Conclusions: The wear of MiSight CL did not induce significant changes in aberrations in anterior cornea and contrary of control group the total ocular RMS and low order RMS did not significantly caused by significantly lower eye growth and myopia progression. The naked eye results obtained in present study allow to predict that children do not develop basal corneal or total aberration changes in response of wearing MiSight lens along the time.Trial registration: ClinicalTrials.gov Identifier: NCT01917110.
Clinical Impact of Estradiol/Testosterone Ratio in Patients with Acute Ischemic Stroke
Authors: Choi Jung-Won , Ryoo In Woo , Hong Jun Yeong , Lee Kyung-Yul , Nam Hyo Suk , Kim Won Chan , Oh Seung-Hun , Kang Jaeku , Lee Hoi Young , Na Sang-Jun , Heo Ji Hoe , Lee Kee Ook 
Published: December 2020

Abstract
Background: Sex hormones may be associated with a higher incidence of ischemic stroke or stroke-related events. In observational studies, lower testosterone concentrations are associated with infirmity, vascular disease, and adverse cardiovascular risk factors. Currently, female sexual hormones are considered neuroprotective agents. The purpose of this study was to assess the role of sex hormones and the ratio of estradiol/testosterone (E/T) in patients with acute ischemic stroke (AIS). Methods: Between January 2011 and December 2016, 146 male patients with AIS and 152 age- and sex-matched control subjects were included in this study. Sex hormones, including estradiol, progesterone, and testosterone, were evaluated in the AIS patient and control groups. We analyzed the clinical and physiological levels of sex hormones and hormone ratios in these patients.Results: The E/T ratio was significantly elevated among patients in the stroke group compared to those in the control group (P = 0.001). Categorization of data into tertiles revealed that patients with the highest E/T ratio were more likely to have AIS [odds ratio (OR) 3.084; 95% Confidence interval (CI): 1.616-5.886; P < 0.001) compared with those in the first tertile. The E/T ratio was also an independent unfavorable outcome predictor with an adjusted OR of 1.167 (95% CI: 1.053-1.294; P = 0.003).Conclusions: These findings support the hypothesis that increased estradiol and reduced testosterone levels are associated with AIS in men.
Mental health planning at a very early stage of the COVID-19 crisis: A systematic review of online international strategies and recommendations
Authors: Almeda Nerea , Garcia-Alonso Carlos R. , Salvador-Carulla Luis 
Published: December 2020

Abstract
Background: Mental health care systems have been dramatically affected by COVID-19. Containment measures have been imposed, with negative consequences on population mental health. Therefore, an increase in both symptomatology and mental disorder incidence is expected. This research aims to identify, describe and assess the empirical background on online strategies and recommendations developed by international organizations and governments to cope with the psychological impact of COVID-19 at a very early stage of the pandemic.Methods: The PRISMA guidelines were adapted to review online documents. A new questionnaire was developed to identify the existence of common patterns in the selected documents. Questions were classified into three domains: COVID-19 information, mental health strategies and mental health recommendations. A two-step cluster analysis was carried out to highlight underlying behaviours in the data (patterns). The results are shown as spider graphs (pattern profiles) and conceptual maps (multidimensional links between questions).Results: Twenty-six documents were included in the review. The questionnaire analysed document complexity and identified their common key mental health characteristics (i.e., does the respondent have the tools for dealing with stress, depression and anxiety?). Cluster analysis highlighted patterns from the questionnaire domains. Strong relationships between questions were identified, such as psychological tips for maintaining good mental health and coping with COVID-19 (question nº 4), describing some psychological skills to help people cope with anxiety and worry about COVID-19 (question nº 6) and promoting social connection at home (question nº 8).Conclusions: When fast results are needed to develop health strategies and policies, rapid reviews associated with statistical and graphical methods are essential. The results obtained from the proposed analytical procedure can be relevant to a) classify documents according to their complexity in structuring the information provided on how to cope with the psychological impact of COVID-19, b) develop new documents according to specific objectives matching population needs, c) improve document design to face unforeseen events, and d) adapt new documents to local situations. In this framework, the relevance of adapting e-mental health procedures to community mental health care model principles was highlighted, although some problems related to the digital gap must be considered.
The impact of guidelines on sterility precautions during indwelling urethral catheterization at two acute-care hospitals in Sweden - a descriptive survey
Authors: Kulbay Aysel , Joelsson-Alm Eva , Tammelin Ann 
Published: December 2020

Abstract
Background: To support a uniform and evidence-based practice for indwelling urinary catheterization in adults The European association of Urology Nurses (EAUN) published guidelines for this procedure in 2012. The Swedish national guidelines are based on the sterility precautions advocated by EAUN. Nevertheless, some hospitals have local guidelines with other requirements concerning sterility and leave to staff to decide how to perform the catheterization. The aim of this descriptive survey was to investigate the nurses´ self-reported sterility precautions during indwelling urethral catheterization at two acute-care hospitals, where the local guidelines differ in their sterility requirements. The study also aimed to analyse factors affecting the participants´ conformity with sterility precautions in the EAUN-guidelines. Methods: A structured questionnaire with questions concerning the participant, working conditions and performance of indwelling urethral catheterization was left to 931 nurses in two acute care hospitals. Chi-square test, Fisher´s exact test and Mann-Whitney U-test were used for descriptive statistics. Logistic regression was used to analyse variables associated with practicing the sterility precautions in the EAUN-guidelines.Results: Answers were obtained from 852 persons (91.5%). A majority of the participants called their insertion technique “non-sterile”. Regardless of designation of the technique the participants said that the indwelling urinary catheter (IUC) should be kept sterile during procedure. In spite of that not everyone used sterile equipment to maintain the sterility of the catheter. The nurses´ conformity with all the sterility precautions in the EAUN-guidelines were associated with working at departments for surgery and cardiology (OR 2.35, 95% CI 1.69-3.26), use of sterile set for catheterization (OR 2.08, 95% CI 1.44-3.00), use of sterile drapes for dressing on insertion area (OR 1.87, 95% CI 1.21-2.89) and using the term “sterile technique” for indwelling urethral catheterization (OR 1.70, CI 1.15-2.51). Conclusions: The study showed that only 55-74% of the nurses practised one or more precautions that secured sterility of the IUC thus demonstrating a gap between the EAUN-guidelines and the actual performance. Compliance to disinfection of hands prior to the procedure was however around 90%. Healthcare-settings should ensure education and skill training to achieve sterile IUC-insertion according to the requirements in the EAUN-guidelines.
Associations between substandard housing and depression: Insights from the Korea Welfare Panel Study
Authors: KIM Selin , Jeong Wonjeong , Jang Bich Na , Park Eun-Cheol , Jang Sungin 
Published: December 2020

Abstract
Background: Housing is an important social determinant of health. Poor housing conditions are associated with a wide range of health conditions, including mental health. The study aimed to investigate the association between substandard housing and depression. Methods: We used panel data collected by the Korea Welfare Panel Study and a sample drawn from waves 11 (2016) to 13 (2018). Substandard housing was defined via three criteria: the minimum residential area and number of rooms by application, essential facility standards, and environmental standards. Depression was measured with the CESD-11. A generalized estimating equation model was used to investigate associations between substandard housing and CESD-11 scores. Results: Participants living in substandard housing have higher depression scores (male: β=0.63, female: β=0.40) than participants who do not live in substandard housing. Participants who do not meet environmental standards have higher depression scores (male: β=0.85, female: β=0.66) than participants who do not live in substandard housing; the findings are seen in both men and women. Conclusion: This study identified an association between substandard housing and depression by gender, and the results were significant. We found that among the three criteria, environmental standards are most likely to be associated with depression. In practical terms, we should consider improving environmental factors of housing to mitigate mental health issues related to substandard housing.