bluuebunny/crossref_metadata_2025_split huggingface dataset:
Strategic Communication in Health and Development: Concepts, Applications and Programming
Authors: Gupta Deepak , Jai P Narain , Yadav S. J. 
Published: April 2021

Significance of communication in health and development is well recognised. Strategic communication informs, educates and influences. In addressing varied health and development issues, including the challenges involving diseases control, more targeted communication strategies are designed to make optimum use of available resources to achieve the planned results in a given context. Based on research, that is, the community-based study of risk factors and the operational research, communication theories evolved and so did the strategies and practices for result-driven health and development communication. In this article, some approaches have been examined to better understand the role of strategic communication in development and health, including disease control. Information dissemination through ‘extension approach’, first for agriculture development and later for family planning, adapted and boosted through advertising and marketing frameworks led to wide awareness about the methods and techniques of family planning but not the adoption at the same levels. Experience and research studies demonstrated that mere ‘awareness’ was not adequate for fostering adoption of ‘new’ practices; instead, it required sustained investments in communication for social and behavioural change processes. For this, bottom-up communication design, participatory communication with community involvement, evidence-based advocacy and preparedness for risk communication are required for effective communication and health and development. As HIV/AIDS posed an initial challenge for communication scholars earlier in the 1980s, so is the COVID-19 pandemic throwing a major communication challenge today. The article attempts to analyse the approaches and shed light on the role of communication in health and development, especially in the context of health crisis.
Partnerships in Health Development
Authors: Abeykoon Palitha 
Published: April 2021

The COVID-19 pandemic has thrown into bold relief the need for an all-of-society response supported by regional and global partnerships to control the epidemic. Addressing the social determinants of health, Universal Health Coverage, the non-communicable disease (NCD) burden, the other communicable diseases and the achievement of the Sustainable Development Goals (SDGs) all would require a close collaboration among different sectors and stakeholders, including the private sector. Partnerships connote three fundamental themes—a relative equality between the partners, mutual commitment to agreed objectives and mutual benefit for the stakeholders involved. The decisions are made jointly, and roles are not only respected but are also backed by legal and moral rights. The World Health Organization (WHO) has been and continues to be the foremost promoter as well as the host for many of the global and regional partnerships in health. A typological classification would include technical assistance partnerships supporting service access and provision of services including drugs, partnerships focusing on research and development, advocacy and resource mobilisation and financing partnerships mainly to provide funds for definite disease programmes. Partnerships in health have brought and continue to bring multiple benefits to the countries. But they also engender several challenges, including the duplication of effort and waste, high transaction costs (usually to government), issues of accountability and consequent lack of alignment with country priorities. As partnerships become increasingly significant in the twenty-first century, better coordination, particularly in terms of donor harmonisation with national priorities, would be needed. It is not ambitious to attempt the elusive ideal where all parties will benefit from one other with a give and take between all stakeholders. Partnerships in health could well herald a new dawn for health development in the South-East Asia Region.
The Experiences of Family Members of Ventilated COVID-19 Patients in the Intensive Care Unit: A Qualitative Study
Authors: Chen Chiahui , Wittenberg Elaine , Sullivan Suzanne S. , Lorenz Rebecca A. , Chang Yu-Ping 
Published: April 2021

Background: Visitor restrictions caused challenges for family members when their loved ones had coronavirus disease (COVID-19) and were ventilated. Limited studies have reported on family members’ experiences and support needs. Aim: To explore the experiences and support needs of family members of ventilated COVID-19 patients in the intensive care unit (ICU). Design: Exploratory, qualitative design, using in-depth individual telephone interviews, and analyzed using thematic analysis. Setting/Participants: Ten family members of adult COVID-19 patients in the ICU. Result: Seven key themes represented family members’ experiences: (a) reactions to the COVID-19 diagnosis, (b) COVID-19 as a destabilizing force on the family unit, (c) COVID-19’s effects on bereavement outcomes, (d) desperately seeking information, (e) family member needs, (f) conflicting feelings about video calls, and (g) appreciation of care. Family members’ feelings about the patient’s diagnosis and how the virus was contracted exacerbated their stress and anxiety. They struggled to feel informed about care that they could not witness and had difficulty understanding information. Family members reported that video calls were unhelpful. While these experiences made them question the quality of care, they expressed their appreciation of the frontline healthcare providers taking care of their loved ones. Conclusion: The stress and uncertainty of family members of critically ill patients with COVID-19 were influenced by their inability to feel connected to the patient and informed about care. Healthcare providers should assess each individual family’s burden and preferences, and this should include establishing structured, timely, and consistent communication regarding patient care during the pandemic including early referral to palliative care.
Does Sleep Position Influence Sleep-Disordered Breathing in Infants With Cleft Palate: A Feasibility Study?
Authors: Murray Clare S. , Walsh Tanya , Bannister Trisha , Metryka Aleksandra , Davies Karen , Lin Yin Ling , Williamson Paula , Callery Peter , O’Brien Kevin , Shaw William , Bruce Iain ,   On behalf of the SLUMBRS Study Advisory Group (SAG) and Respiratory Group
Published: April 2021

Objective: Cleft palate (CP) can affect breathing, leading to sleep-disordered breathing (SDB). Sleep position can affect SDB, but the optimum sleep position for infants with CP is unknown. We aimed to determine the design of a pragmatic study to investigate the effect of the 2 routinely advised sleep positions in infants with CP on oxygen saturations. Design: A multicentered observational cohort. Setting: Four UK-based cleft centers, 2 advising supine- and 2 side-lying sleep positions for infants with CP. Participants: Infants with isolated CP born July 1, 2015, and December 31, 2016. Of 48 eligible infants, 30 consented (17 side-lying; 13 supine). Interventions: Oxygen saturation (SpO2) and end-tidal carbon dioxide (ETCO2) home monitoring at age 1 and 3 months. Qualitative interviews of parents. Outcome Measures: Willingness to participate, recruitment, retention, and acceptability/success (>90 minutes recording) of SpO2 and ETCO2 monitoring. Results: SpO2 recordings were obtained during 50 sleep sessions on 24 babies (13 side-lying) at 1 month (34 sessions >90 minutes) and 50 sessions on 19 babies (10 side-lying) at 3 months (27 sessions >90 minutes). The ETCO2 monitoring was only achieved in 12 sessions at 1 month and 6 at 3 months; only 1 was >90 minutes long. The ETCO2 monitoring was reported by the majority as unacceptable. Parents consistently reported the topic of sleep position in CP to be of importance. Conclusions: This study has demonstrated that it is feasible to perform domiciliary oxygen saturation studies in a research setting and has suggested that there may be a difference in the effects of sleep position that requires further investigation. We propose a study with randomization is indicated, comparing side-lying with supine-lying sleep position, representing an important step toward better understanding of SDB in infants with CP.
Contamination of the Mini C-Arm During Foot and Ankle Surgery
Authors: Momenzadeh Kaveh , Williams Caroline , Czerwonka Natalia , Kwon John Y. , Nazarian Ara , Miller Christopher P. 
Published: April 2021

Background: Many orthopedic surgeries utilize intraoperative fluoroscopy. The mini C-arm is an advantageous device as it can be easily used without the need for a dedicated radiology technician. However, there are concerns that the mini C-arm may represent a potential source of contamination and subsequent postoperative infection. Previous investigations of standard C-arm drapes have shown high rates of contamination. Similar contamination rates would be even more concerning for the mini C-arm as it requires physically maneuvering the machine. This study aimed to determine the rate of mini C-arm drape contamination and identify high-risk areas. Methods: Fifty foot and ankle surgeries requiring the use of mini C-arm fluoroscopy were included. Eight locations on the mini C-arm drape were sampled at the conclusion of each procedure. Culture Q-swabs were used for sampling defined locations. Swab samples were then assessed for bacterial growth on a 5% blood agar plate using a semiquantitative technique. Results: In 70% of surgical cases, contamination was observed in at least 1 location. Six of the 8 evaluated locations were found to have significantly higher contamination in comparison with their corresponding negative controls (Mann-Whitney U test, P < .05). The “outer portion of the upper arm” (location 1) exhibited bacteria growth in 26% ( P < .0001) of cases. The “superior portion of the x-ray source” (location 2) exhibited growth in 30% ( P < .0001) of cases. These were the highest-risk areas for contamination and were both significantly more likely to be involved than the “inferior portion of the x-ray source” and “superior portion of the beam receiver,” locations 4 and 5, respectively. Fourteen percent (7/50) C-arm cases and 1.72% (1/58) Achilles tendon surgery control cases developed surgical site infection ( P = .0234; OR, 9.27). Conclusion: Bacterial contamination of the mini C-arm drape was found to be common after foot and ankle procedures. Contamination was more prevalent on the outer ring areas of the C-arm, both at the emitter and receiver. Level of Evidence: Level III, prospective cohort study.
Correlation of Different Methods of Measuring Pronation of the First Metatarsal on Weightbearing CT Scans
Authors: Conti Matthew S. , Patel Tamanna J. , Caolo Kristin C. , Amadio Joseph M. , Miller Mark C. , Costigliola Stephen V. , Ellis Scott J. , Conti Stephen F. 
Published: April 2021

Background: There is no consensus in the foot and ankle literature regarding how to measure pronation of the first metatarsal in patients with hallux valgus. The primary purpose of this study was to compare 2 previously published methods for measuring pronation of the first metatarsal and a novel 3-dimensional measurement of pronation to determine if different measurements of pronation are associated with each other. Methods: Thirty patients who underwent a modified Lapidus procedure for their hallux valgus deformity were included in this study. Pronation of the first metatarsal was measured on weightbearing computed tomography (WBCT) scans using the α angle with reference to the floor, a 3-dimensional computer-aided design (3D CAD) calculation with reference to the second metatarsal, and a novel method, called the triplanar angle of pronation (TAP), that included references to both the floor (floor TAP) and base of the second metatarsal (second TAP). Pearson’s correlation coefficients were used to determine if the 3 calculated angles of pronation correlated to each other. Results: Preoperative and postoperative α angle and 3D CAD had no correlation with each other ( r = 0.094, P = .626 and r = 0.076, P = .694, respectively). Preoperative and postoperative second TAP and 3D CAD also had no correlation ( r = 0.095, P = .624 and r = 0.320, P = .09, respectively). However, preoperative and postoperative floor TAP and α angle were found to have moderate correlations ( r = 0.595, P = .001 and r = 0.501, P = .005, respectively). Conclusion: The calculation of first metatarsal pronation is affected by the reference and technique used, and further work is needed to establish a consistent measurement for the foot and ankle community. Level of Evidence: Level III, retrospective cohort study.
Incidence of hypersensitivity reactions in patients on H1-receptor antagonists receiving oxaliplatin-based chemotherapy
Authors: Barrett Christine , Park Seon Jo , Edmondson Lindsay , Monga Dulabh 
Published: April 2021

Objective This study determined the incidence of hypersensitivity reactions in patients receiving oxaliplatin-based chemotherapy while on H1-receptor antagonists (H1RAs). Prophylaxis for patients receiving oxaliplatin is not currently recommended. H1RAs are used for the treatment of reactions; however, prophylactic H1RAs have not been well-studied. Methods This retrospective chart review included patients with solid tumor malignancies who received H1RAs while on oxaliplatin-based chemotherapy between August 1, 2016 and October 31, 2019. Results Of fifty-one patients, there were four hypersensitivity reactions (8%), most of which were mild, occurred within 60 minutes of the start of the infusion, and did not result in an interruption in treatment. One severe reaction occurred, which required discontinuation of therapy. Forty-two patients (82%) were able to receive at least 9 cycles of oxaliplatin without a reported reaction. Conclusion In this observational study, the incidence rate of hypersensitivity reactions in patients receiving oxaliplatin while on H1RAs was lower than reported in previous literature. Most reactions were mild, and patients were able to continue oxaliplatin-based therapy. With future, randomized controlled trials, H1RAs may prove to be effective in preventing or delaying the onset of hypersensitivity reactions related to oxaliplatin.
Treatment outcomes among human epidermal growth factor receptor 2 positive breast cancer patients: A systematic review
Authors: Degu Amsalu , Yussuf Asha 
Published: April 2021

Background The incidence of human epidermal growth factor receptor 2 (HER 2) positive breast cancers is rapidly rising worldwide. Although there have been many studies on HER 2 breast cancer treatment and management in recent years, there is a lack of comprehensive reports on the treatment outcomes and disparities within the available literature. Hence, this review aimed to determine the treatment outcomes and their associated factors among patients with HER2-positive breast cancer. Methods A computer-based systematic literature search was conducted using PubMed, EMBASE, and Google scholar databases of articles published from 2000 to 2020. The following key terms (HER 2 positive breast cancer, predictor, determinant, associated factor) and Medical Subject Headings (MeSH) terms (breast neoplasms, treatment outcome, and risk factors) were used to search the English language published articles. Results In most studies, trastuzumab was the most commonly used treatment regimen used in combination with chemotherapeutic agents. Generally, most of the studies (15 studies) showed that the overall survival outcome was relatively higher after treatment among HER2 positive breast cancer patients. Nonetheless, two studies showed that the absence of significant change in the overall survival despite adequate treatment was given to the study participants. In addition, three studies demonstrated a partial response after treating HER2-positive breast cancer patients. Conclusion Generally, the overall survival outcome was relatively higher after treatment among HER2 positive breast cancer patients. The addition of trastuzumab in most of the studies has shown improvement in the overall survival and the disease-free survival rate of the study patients.
The Association between ADHD and the Severity of COVID-19 Infection
Authors: Merzon Eugene , Weiss Margaret D. , Cortese Samuele , Rotem Ann , Schneider Tzipporah , Craig Stephanie G. , Vinker Shlomo , Golan Cohen Avivit , Green Ilan , Ashkenazi Shai , Weizman Abraham , Manor Iris 
Published: April 2021

Objective: Patients with ADHD are at increased risk of acquiring COVID-19. The present study assessed the possibility that ADHD also increases the risk of severe COVID-19 infection. Method: We assessed 1,870 COVID-19 positive patients, aged 5 to 60 years, registered in the database of Leumit Health Services (LHS, Israel), February to -June 2020, of whom 231 with ADHD. Logistic regression analysis models evaluated the association between ADHD and the dependent variables of being symptomatic/referral to hospitalization, controlling for demographic and medical variables. Results: Age, male sex, and BMI were confirmed to be significant risk factors for increased COVID-19 severity. ADHD was found to be associated with increased severity of COVID-19 symptoms ( OR = 1.81, 95% CI [1.29, 2.52], p < .05) and referral to hospitalization ( OR =1.93, 95% CI [1.06, 3.51], p = .03). Conclusion: ADHD is associated with poorer outcomes in COVID-19 infection.
Ultrasound-guided peripheral intravenous catheters insertion in patient with difficult vascular access: Short axis/out-of-plane versus long axis/in-plane, a randomized controlled trial
Authors: Privitera Daniele , Mazzone Annamaria , Pierotti Federico , Airoldi Chiara , Galazzi Alessandro , Geraneo Annalisa , Cozzi Mattia , Mora Garrido Raquel , Vailati Paolo , Scaglioni Roberta , Capsoni Nicolò , Ganassin Emanuele Carlo , Salinaro Gianluca , Scala Cristina Grazia Rita , Dal Molin Alberto 
Published: April 2021

Purpose: The aim of this study was to evaluate the rate of successful peripheral cannulation between short-axis and long-axis ultrasound guided techniques. Methods: A single-center, two-arm randomized controlled, intention-to-treat, open-label study was conducted at the Emergency Department, between August and November 2020. Patients requiring a peripheral intravenous catheter insertion and identified as having a difficult intravascular access, were enrolled and followed for up to 96 h. The primary endpoint was the correct placement of the peripheral intravenous catheter. The secondary endpoints were number of venipunctures, intra-procedural pain, local complications, and positive blood return during the follow up. Results: A total of 283 patients were enrolled: 141 subjects were randomized to the short-axis and 142 to the long-axis group. Success rate was 96.45% (135/141; 95% CI, 91.92%–98.84%) in the short-axis group compared with 92.25% (132/142; 95% CI, 86.56%–96.07%) in the long-axis group ( p = 0.126). No significant differences were found in terms of intraprocedural pain and local complications. Higher rate of positive blood return at 72 h [3/17 long-axis, 14/17 short-axis ( p = 0.005)] and 96 h [1/10 long-axis, 9/10 short-axis 96 h, ( p = 0.022)] was found for the short-axis group. Conclusions: No differences were found between short-axis and long-axis techniques in terms of success rate, intraprocedural pain, and local complications. Despite this, a slightly higher success rate, a lower number of venipunctures, and a higher rate of positive blood return at 72 and 96 h together with an easier ultrasound technique could suggest a short-axis approach.
Real-World Outcomes and Clinical Predictors of Immune Checkpoint Inhibitor Monotherapy in Advanced Lung Cancer
Authors: Zhang Shijia , Pease Daniel F , Kulkarni Amit A , Kumar Manoj , Shanley Ryan M , Xu Beibei , Joshi Shilvi P , Patel Manish R 
Published: April 2021

Background: Immune checkpoint inhibitors (ICIs) have changed the treatment paradigm of advanced-stage non-small-cell lung cancer (NSCLC) and small-cell lung cancer (SCLC). The aim of this study was to evaluate the effectiveness and tolerance of ICIs in a real-world patient population and to investigate the predictive factors associated with survival outcomes. Methods: Medical records of patients with advanced lung cancer who started ICI monotherapy were reviewed for data collection. Treatment outcomes included objective response rate, progression-free survival (PFS), and overall survival (OS). Immune-related adverse events (irAEs) were assessed. Multiple Cox regression models were fit to investigate the predictive factors for survival outcomes. Results: We included 220 patients (median 66.5 years). Seventy-nine (35.9%) patients had Eastern Cooperative Oncology Group (ECOG) performance-status (PS) score ⩾2. Median follow-up was 11.4 months. In NSCLC, median PFS was 3.8 months (4.7 months for first line and 3.7 months for subsequent line). Median OS was 12.4 months (15.6 months for first line therapy and 11.5 months for subsequent line). In SCLC, median PFS was 1.8 months, and median OS was 4.6 months. A quarter of patients developed irAEs. There was 1 disease flare among 17 patients with pre-existing autoimmune diseases. ECOG PS of 0 to 1 and body mass index (BMI) ⩾ 25 kg/m2 (but not occurrence of irAE) were independently associated with improved OS in NSCLC, with a hazard ratio of 0.41 (95% confidence interval [CI], 0.29-0.59) and 0.62 (95% CI, 0.44-0.87), respectively. Conclusions: The clinical benefit of ICIs appears to persist in a real-world population of relatively older age, including those with poor PS and pre-existing autoimmune diseases. ECOG PS of 0 to 1 and BMI ⩾ 25 kg/m2 were independently associated with improved OS.
The Impact of Policy Shift from In-kind Transfers to Direct Cash Transfers on Paddy Production: Evidence from Mahaweli H System in Sri Lanka
Authors: Perera Sumudu , Rathnayake Ananda , Fernando Janaka , Navaratne Thilani , Rajapakshe Dilan 
Published: April 2021

In 2016, the Sri Lankan government introduced a policy change related to fertilizer subsidy by converting the in-kind transfer into a direct cash transfer. This research article analyses the consequences of this policy change on the paddy production from economics perspective. The analysis uses national-level data from 1961 to 2013 and farm-level data collected in 2016. Macro-level findings manifest that the use of fertilizer significantly increases the paddy production in Sri Lanka. It was also identified that the cash amount granted under the direct cash transfer policy is not equivalent to the in-kind transfer programme. As a result, paddy production is expected to decline under the direct cash transfer programme when compared to the material subsidy scheme. However, this is against the preference of economists on direct cash transfers over in-kind transfers. The findings reveal that direct cash transfers increase the paddy production under two conditions: (a) when rational farmers effectively utilize the cash grants to optimize their production inputs; and (b) an equivalent amount of in-kind transfer is provided as direct cash transfer. Hence, direct cash transfers are not always better than in-kind transfers; it is better when in-kind transfer is compensated with an equivalent amount of cash transfer. JEL: A1, B1, B2, C1, C5, D6, N5