bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spiritual Care Practices in Hospices in the Western Cape, South Africa: The Challenge of Diversity
Authors: Mahilall Ronita , Swartz Leslie 
Published: August 2020

Abstract
Background: South Africa is a very diverse middle-income country, still deeply divided by the legacy of its colonial and apartheid past. As part of a larger study, this article explored the experiences and views of representatives of hospices in the Western Cape province of South Africa on the provision of appropriate spiritual care, given local issues and constraints. Methods: Two sets of focus group discussions, with 23 hospice participants, were conducted with 11 of the 12 Hospice Palliative Care Association registered hospices in the Western Cape, South Africa, to understand what spiritual care practices were at play in their hospices against the backdrop of multifaceted diversities. The discussions were analysed using thematic analysis. Results:Two prominent themes emerged: providing relevant spiritual care services in a religiously, culturally, and racially diverse setting, and the organisational context impacting such a spiritual care service. Participants agreed that spiritual care is an important service and that it plays a significant role within the inter-disciplinary team. Participants recognised the need for spiritual care training and skills development, alongside the financial shortfalls. In spite of the diversities and resource constraints, the approach of individual hospices to providing spiritual care remained robust.Discussion:Given the diversities that are largely unique to South Africa, shaped essentially by past injustices, the hospices have to navigate considerable hurdles such as cultural differences, religious diversity, and language barriers to provide spiritual care services, within significant resource constraints. Conclusions:While each of the hospices have established spiritual care services to varying degrees, there was an expressed need for training in spiritual care to develop a baseline guide that was bespoke to the complexities of the South African context. Part of this training needs to focus on the complexity of providing culturally appropriate services.
Do Adolescents Consider Mind-Body Skills Groups an Acceptable Treatment for Depression: Results from a Pilot Study.
Authors: Jones Lindsey , Salgado Eduardo F. , Aalsma Matthew C. , Garabrant Jennifer M. , Staples Julie K. , Gordon James S. , Salyers Michelle P. 
Published: August 2020

Abstract
Background: Mind-Body Skills Groups (MBSGs) have shown promise in reducing adolescent depression symptoms; however, little is known about adolescents’ perspectives on this treatment. The objective of this study was to understand the acceptability of a new treatment for depressed adolescents in primary care settings. Methods: Adolescents participating in a 10-week MBSG treatment were interviewed to understand their perspectives on the acceptability and effectiveness of the treatment. Interviews were collected at post-intervention and at a 3-month follow-up visit. Results: A total of 39 adolescents completed both the post-intervention and 3-month follow-up interview. At post-intervention and follow-up, 84% of adolescents stated the MBSGs helped them. When asked how the MBSGs helped them, 3 areas were identified: learning new MBSG activities and skills, social connection with others within the group, and outcomes related to the group. Many adolescents reported no concerns with the MBSGs (49% at post- intervention; 62% at follow-up). Those with concerns identified certain activities as not being useful, wanting the group to be longer, and the time of group (after school) being inconvenient. Most adolescents reported that their life had changed because of the group (72% at post-intervention; 61% at follow-up), and when asked how, common responses included feeling less isolated and more hopeful. Conclusions: Adolescents found the MBSGs to be helpful and acceptable as a treatment option for depression in primary care. Given the strong emphasis on treatment preference autonomy and the social activities within the group, MBSGs appear well-suited for this age group. Trial Registration: NCT03363750
The Effect of a Decision-Support mHealth Application on Maternal and Neonatal Outcomes in Two District Hospitals in Rwanda: Quasi-Experimental Study
Authors: NISHIMWE Aurore , IBISOMI Latifat , NYSSEN Marc , CONCO Daphney NOZIZWE 
Published: August 2020

Abstract
Background: Globally, mobile health (mHealth) applications are known for their potential to improve healthcare providers’ access to relevant and reliable health information. Besides, electronic decision support tools, such as the Safe Delivery mHealth Application (SDA), help to reduce clinical errors and to ensure quality care at the point of service delivery. The current study assessed the effects of the SDA on basic emergency obstetric and newborn care (BEmONC) outcomes for the most frequent complications in Rwanda; post-partum haemorrhage (PPH) and newborn asphyxia and its complications.Methods: The study adopted a quasi-experimental design. A pre-intervention record review of the BEmONC outcomes: Apgar score and PPH progressions, was conducted. The intervention took place in two district hospitals in Rwanda and entails the implementation of the SDA for six months. Six months’ post-intervention, the effect of the SDA on BEmONC outcomes was evaluated. The study included 327 participants (114 cases of PPH and 213 cases of neonatal complications). The analysis compared the outcome variables between the baseline and the endline data. Fisher’s exact test was used to compare the proportions and test between-group differences and significance level set at p<0.05. Results: Unstable newborn outcome following neonatal resuscitation was recorded in 61.90% and 27.59% newborns cases at baseline and endline respectively, P-value = 0.000. Unstable maternal outcome following PPH management was recorded in 19.40 % and 6.38% maternal cases at baseline and endline respectively, P-value = 0.048. There was a significant association between the SDA intervention and newborns’ and maternal’ outcomes following neonatal resuscitation and PPH management, 6 months after baseline.Conclusion: The use of the SDA supported nurses and midwives in the management of PPH and neonatal resuscitation thus improved maternal and neonatal outcomes after 6 months of the SDA intervention.
Treatment of Pediatric Lateral Condylar Humerus Fractures with Closed Reduction and Percutaneous Pinning
Authors: Xie Li-wei , Wang Juan , Deng Zhi-qiang , Zhao Ren-huan , Chen Wei , Kang Chi , Ye Jia-jun , Liu Xin , Zhou Ying , Shen Hai 
Published: August 2020

Abstract
Background: Lateral condylar humerus fractures (LCHFs) are the second most common fractures in children. Open reduction and internal fixation is recommended for fractures displaced by more than 4 mm. Few studies described using closed reduction and percutaneous pinning (CRPP) for treating fractures with greater displacements. This study aims to explore the feasibility of CRPP in treating displaced LCHFs. Methods: All patients underwent attempted CRPP first. Once a satisfying reduction was obtained, as determined using fluoroscopy based on the relative anatomical position of the fragments, an intraoperative arthrogram was performed to further confirm the congruence of the articular surface of the distal humerus. Open reduction and fixation are necessary to ensure a fracture gap less than 2.0 mm both on anteroposterior view and oblique internal rotational view by fluoroscopy. All included fractures were treated by a single pediatric surgeon.Results: Forty-six patients were included, 29 boys and 17 girls, with an average age of 5.2 years. Of these, 22/28 (78%) Jakob type II fractures and 14/18 (78%) Jakob type III fractures were treated with CRPP. All cases in Song stages II and III, 19/25 (76%) cases in Song stage IV, and 14/18 (78%) cases of Song stage Ⅴ were treated with CRPP. The remaining converted to open reduction with internal fixation. Overall, 36 of the 46 patients (78%) were treated with CRPP. The average pre-op displacement was 7.2 mm, and the average post-op displacement was 1.1 mm on the anteroposterior or oblique internal rotational radiograph in cases treated with CRPP. CRPP was performed in an average of 37 minutes. The average casting period was 4 weeks and the average time of pin removal was 6 weeks postoperatively. The average time of follow-up was 4 months. All patients achieved union, regardless of closed or open reduction. No infection, delayed union, cubitus varus or valgus, osteonecrosis of the trochlea or capitellum, or pain were recorded during follow-up. Conclusions: Closed reduction and percutaneous pinning effectively treats LCHFs with displacement more than 4 mm. More than 3/4 of Song stage V or Jakob type III patients can avoid an incision.
A monthly spatio-temporal modelling of patterns for children on maintenance grant in Namibia
Authors: Dismas Ntirampeba , Brigitte NSHIMYIMANA , Cliff Kikawa Richard 
Published: August 2020

Abstract
Background

Child support grant (CSG) is one of the social protection strategies which is today widely seen as an intervention contributing to poverty reduction. However, despite substantial expenses, it has been documented that Namibia’s social protection benefits do not reach intended beneficiaries in an efficient manner.
Aims

This study aims to determine factors associated with spatial and temporal variation in maintenance child grant and as well as identify regions with elevated incidence rate ratios of maintenance grant in Namibia.
Methods

We fitted a Bayesian spatio-temporal regression model on maintenance grant data available over 9 years in Namibia.
Results

The number of children on grant has almost tripled between March 2007 and October 2015(it changed from 50596 in 2007 to 132840). Unemployment and orphanhood were significantly associated with the incidence rate ratio of maintenance grant (CI:(1.634, 2.627) and CI: (1.000, 1.004), respectively. The adjustment of measurement error in orphanhood through the Berkson error model has ensured the stability of its effect.
Conclusions

This study has shown the strength of using measurement error models for analysing child grant data. Furthermore, the study has demonstrated that the northern regions of Namibia have the highest child incidence rate ratio of maintenance grant whereas the regions in central and south are at low incidence rate at present. The maps produced in this study can be particularly helpful in allocating efficiently limited resources in poor settings.
An Idea Worth Sustaining: Evaluation of the sustainability potential of Choosing Wisely across Ontario Community Hospitals and Family Health Teams
Authors: Kastner Monika , Makarski Julie , Mossman Kate , Harris Kegan , Hayden Leigh , Giraldo Manuel , Sharma Deepak , Asalya Marwan , Jussaume Linda , Eisen David , Wintemute Kimberly , Rolko Edith , Shin Phil , Zadravec Jennifer , McRitchie Donna 
Published: August 2020

Abstract
BackgroundEvidence shows that 30% of healthcare services are unnecessary and unlikely to benefit patients and may even be harmful. Choosing Wisely (CW) is a physician-initiated, international campaign (with campaigns in at least 20 countries) aimed at addressing unnecessary medical care through the provision of evidence-based resources and clinical guidance. Our objectives were to evaluate the sustainability potential of CW across four Ontario community hospitals and affiliated family health teams (FHT). MethodsWe recruited CW implementation teams across Ontario hospitals and their affiliated primary care family health teams (FHTs) to participate in a mixed-methods study to identify and respond to their CW implementation and sustainability challenges. The study involved the administration of a validated sustainability Survey at baseline, 6- and 12-months follow-up, and participation in two focus groups (at baseline and 6 months) to discuss identified successes and opportunities for improvement, and to respond to implementation and sustainability challenges through a team exercise involving the co-creation and implementation of an action plan to directly address them.ResultsFifteen CW implementation teams across five Ontario community hospitals and affiliated FHTs participated in the study. Three CW de-adoption priority areas were investigated by teams: de-prescribing of proton pump inhibitors (PPIs), and reducing Pre-Op testing and BUN/Urea lab testing. All 15 teams achieved a baseline sustainability team score that was well above the threshold of what is considered a potentially sustainable innovation (i.e., >55%). We observed steady improvements in sustainability scores over three time points across all primary care teams, which is a strong indication that CW is sustainable in these settings. Regardless of site or priority area, facilitators that were common across all teams were fit with existing processes and workflows, leadership support, and optimized team communication. Common challenges were: lack of awareness and buy-in, lack of leadership engagement or a champion, and lack of fit with existing workflow and culture. All teams identified at least one challenge (during the baseline focus groups) for which they co-designed and implemented a plan to address them aimed at maximizing the sustainability potential of their CW priority areas. ConclusionsEvaluating the sustainability potential of an innovation such as Choosing Wisely is critical to ensuring that they have the best potential for impact. Our work highlights that implementation teams can be empowered to influence their implementation efforts, and to realize positive outcomes for their healthcare services and patients.
A Novel Experimental Porcine Model to Assess the Impact of Differential Pulmonary Blood Flow on Primary Graft Dysfunction After Unilateral Lung Transplantation
Authors: Frick Anna Elisabeth , Orlitová Michaela , Vanstapel Arno , Ordies Sofie , Claes Sandra , Schols Dominique , Heigl Tobias , Kaes Janne , Saez-Gimenez Berta , Vos Robin , Verleden Geert M. , Vanaudenaerde Bart , Verleden Stijn E. , Raemdonck Dirk E. Van , Neyrinck Arne P. 
Published: August 2020

Abstract
Background Primary graft dysfunction (PGD) remains a major obstacle after lung transplantation. We developed a novel approach to selectively assess reperfusion injury in transplanted lung and investigated the impact of pulmonary flow.Materials Twelve porcine left lung transplants were divided in two groups (n = 6, in low (LF) and high flow (HF) group). Donor lungs were stored for 24 hours on ice, followed by left lung transplantation. Recipient animals were observed for 6h after reperfusion with partially clamping of right PA in HF group. Results Survival at 6 hours was 100% in both groups. PaO2/FiO2 (P/F) ratio of the transplanted lung was lower (229.1 mmHg vs 308.9 mmHg, p=0.01), mPAP was higher (34.62 mmHg vs 29.88 p=0.01) in HF versus LF group. Wet-to-dry (W/D) ratios of right native and left transplanted lung were not different after 6 h of reperfusion. Conclusions Lung transplantation in large animal settings is feasible. P/F ratio in allograft is dependent on PA flow. Our innovative approach to control blood flow to transplanted lung demonstrates that higher flows induce more PGD and allows to further study development and treatment of PGD. Our findings might have an important impact on sequential intra-operative approach during lung transplantation.
Hepatic safety of repeated treatment with pyronaridine-artesunate (PA) versus artemether-lumefantrine (AL) in patients with uncomplicated malaria: A secondary analysis of the WANECAM 1 data from Bobo-Dioulasso, Burkina Faso
Authors: Compaoré Yves Daniel , Zongo Issaka , Somé Anyirékun F. , Barry Nouhoun , Nikiema Frederick , Kabore Talato N. , Aminata Ouattara , Kabre Zachari , Wermi Kadidiatou , Zongo Moussa , Yerbanga Rakiswende S. , Sagara Issaka , Djimdé Abdoulaye , Ouédraogo Jean Bosco 
Published: August 2020

Abstract
BackgroundThe use of pyronaridine-artesunate (PA) has been associated with scarce transaminitis in patients. This analysis aimed to evaluate the hepatic safety profile of repeated treatment with PA versus artemether-lumefantrine (AL) in patients with consecutive uncomplicated malaria episodes in Bobo-Dioulasso, Burkina Faso.MethodsWe secondarily analyzed data from a clinical trial conducted from 2012 to 2015, in which patients with uncomplicated malaria were assigned to either PA or AL arms and followed up to 42 days. Subsequent malaria episodes within a 2-years follow up period were also treated with the same ACT initially allocated. Transaminases (AST/ALT), alkaline phosphatase (ALP), total and direct bilirubin were measured at days 0 (baseline), 3, 7, 28 and on some unscheduled days if required. The proportions of non-clinical hepatic adverse events (AEs) following first and repeated treatments with PA and AL were compared within study arms. The association of these AEs with retreatment in each arm was also determined using a logistic regression models.ResultsA total of 1379 malaria episodes were included in the intention to treat analysis with 60% of all cases occurring in the AL arm. Overall, 179 non-clinical hepatic AEs were recorded in the AL arm versus 145 in the PA arm. Elevated ALT was noted in 3.05% of treated malaria episodes, elevated AST 3.34%, elevated ALP 1.81%, and elevated total and direct bilirubin with 7.90% and 7.40% respectively. Retreated participants were less likely to experience elevated ALT and AST than first episode treated participants in both arms. One case of Hy’s law condition was recorded in a first treated participant of the PA arm. Patients from the retreatment group were 76% and 84% less likely to have elevated ALT and AST respectively in the AL arm and 68% less likely to present elevated ALT in the PA arm. In contrast, they were almost 2 times more likely to experience elevated total bilirubin in both arms.ConclusionPyronaridine-artesunate and artemether-lumefantrine showed similar hepatic safety when used repeatedly in patients with uncomplicated malaria. Pyronaridine-artesunate represents therefore a suitable alternative to the current first line antimalarial drugs in use in endemic areas.Trial RegistrationPan African Clinical Trials Registry. PACTR201105000286876
Investigation of the cognition and attitude of the public towards the disposal of discarded face masks during the COVID-19 pandemic
Authors: Li Fanghua , Zhang Yanqi , Ji Hong , Yang Dong , Wang Aiqing , Li Chang’e , Wu Yan 
Published: August 2020

Abstract
Background: Public perception of the disposal of discarded face masks during the Coronavirus Disease 2019 (COVID-19) pandemic remains unknown. Therefore, this study aimed to assess the cognition level and attitude of the public towards the disposal of discarded face masks during the COVID-19 pandemic, to provide a reference for a standardized disposal of discarded face masks.Methods: The convenience sampling method was applied to conduct a questionnaire survey, assessing personal general information, as well as the management status of, attitudes towards and cognition of the disposal of discarded face masks.Results: A total of 910 valid questionnaires were collected. The results showed that 47% of individuals had a low level of relevant knowledge about the disposal of discarded face masks, but more than 95% showed a positive attitude towards the cooperation with it. In addition, the participants had limited understanding of related regulations, and expected that the relevant departments should increase publicity and training to propagate the related information.Conclusions: This study demonstrated variations in public cognition level and attitude towards the disposal of discarded face masks during the COVID-19 pandemic. Therefore, relevant departments should further clarify the refuse classification of and management regulations for discarded face masks, increase publicity, guide the public to correctly dispose of discarded face masks and enforce supervision, to prevent viral spread and secondary environmental contamination incidents, and to ensure public health and ecological environment safety.
Tumour Microbiome-Based Subtypes of Colorectal Cancer Correlate with Clinical Variables
Authors: Zwinsová Barbora , Petrov Vyacheslav , Hrivňáková Martina , Smatana Stanislav , Micenková Lenka , Kazdová Natálie , Popovici Vlad , Hrstka Roman , Šefr Roman , Bencsiková Beatrix , Zdražilová-Dubská Lenka , Brychtová Veronika , Nenutil Rudolf , Vídeňská Petra , Budinská Eva 
Published: August 2020

Abstract
BackgroundLong-term dysbiosis of the gut microbiome has a significant impact on the development, progression and the aggressiveness of colorectal cancer (CRC) and may explain part of the observed heterogeneity of the disease from phenotypic, prognostic and response to treatment perspectives. Although the shifts in gut microbiome in the normal-adenoma-carcinoma sequence have been described, the landscape of microbiome within CRC and its associations with clinical variables remain under-explored. ResultsWe performed 16S rRNA gene sequencing of paired tumour tissue, adjacent visually-normal mucosa and stool swabs of N=186 patients with stage 0-IV CRC to describe the tumour microbiome and its association with clinical variable and to derive tumour microbial subtypes.We identified new genera never previously associated with CRC tumour mucosa (Flavonifractor, Haemophilus, Howardella, Pseudomonas, Sutterella, Treponema 2) or CRC (Actinobacillus, Aggregatibacter, Bergeyella, Phocaeiola, Defluviitaleaceae UCG-011, Massilia, Tyzzerella 4). The bacteria residing on tumour-mucosa were dominated by genera belonging to (potential) oral pathogens. Based on tumour microbial profiles, we stratified CRC patients into three subtypes. The subtypes were significantly associated with prognostic factors such as tumor grade, primary tumour sidedness and TNM staging, with one subtype enriched in tumours with poor prognosis. Further, we inspected the associations of microbiome with clinical variables in a subtype-agnostic setting. The primary tumour-associated clinical variables predominantly correlated with tumour mucosal microbiome, while the presence of local and distant metastases was mostly associated with the stool microbiome.ConclusionsUnderstanding the interactions of the bacteria residing on tumour mucosa within different CRC tumour microbiome subtypes will help to better understand the underlying biological background of the heterogeneity of this disease. Indeed, the tumour microbiome is a possible source of additional integrative markers of CRC patients’ survival and prognosis. We found that CRC microbiome is strongly correlated with clinical variables, but these associations are dependent on the microbial environment (tumour mucosa, normal mucosa, stool). Our study thus identifies limitations of the usage of microbiome composition as marker of CRC progression, suggesting the need of combining several sampling sites (e.g. stool and tumour swabs).