bluuebunny/crossref_metadata_2025_split huggingface dataset:
Face and content validity of the Carer Support Needs Assessment Tool (CSNAT), and feasibility of the CSNAT intervention, for carers of patients with chronic obstructive pulmonary disease
Authors: Micklewright Kerry , Farquhar Morag 
Published: March 2021

Objectives Informal carers of patients with Chronic Obstructive Pulmonary Disease (COPD) have unmet support needs. Evidence relating to carers’ support needs in chronic conditions informed version 3 of the Carer Support Needs Assessment Tool (CSNAT) which forms part of an intervention to identify and address carer support needs. Aim of study: to establish the face and content validity of CSNAT v3 for use with COPD carers and explore their views on delivery of the CSNAT Intervention in practice. Methods Focus groups conducted September-October 2019 in non-clinical settings recruited eleven COPD carers (two to six participants per group). COPD patients ( n = 2) attended one group to facilitate carer attendance, the impact of which is discussed. Most participating carers were female ( n = 10); carers’ ages ranged 52–79 years. Results CSNAT v3 was easy to understand and complete, and all 15 domains were considered relevant and appropriate, suggesting good face and content validity. The demeanour, relational skills, and knowledge of the CSNAT facilitator appeared more important to carers than being a certain practitioner type. Discussion COPD carers considered the CSNAT Intervention an acceptable way of identifying and responding to their needs. The intervention could potentially be delivered through a range of services.
‘Back to better’: amplifying health equity, and determinants of health perspectives during the COVID-19 pandemic
Authors: Ndumbe-Eyoh Sume , Muzumdar Pemma , Betker Claire , Oickle Diane 
Published: March 2021

Introduction: Equity and social justice have long been key tenets of health promotion practice, policy and research. Health promotion foregrounds the pertinence of social, economic, cultural, political and spiritual life in creating and maintaining health. This necessitates a critical structural determinants of health perspective that actively engages with the experiences of health and wellbeing among diverse peoples. The inequitable impacts of pandemics are well documented, as are calls for improved pandemic responses. Yet, current pandemic and emergency preparedness plans do not adequately account for the social and structural determinants of health and health equity. Methods: Through five one-hour online conversations held in April 2020, we engaged 13 practice, policy, research and community leaders on the intersections of COVID-19 and gender, racism, homelessness, Indigenous health and knowledge, household food insecurity, disability, ethics and equitable futures post-COVID-19. We conducted a thematic analysis of speaker and participant contributions to investigate the impacts and influence of COVID-19 related to the structural and social determinants of health. We analyzed which policies, practices and responses amplified or undermined equity and social justice and identified opportunities for improved action. Findings: Analysis of the COVID-19 pandemic revealed four broad themes: • oppressive, unjust systems and existing health and social inequities; • health and social systems under duress and non-responsive to equity; • disproportionate impacts of COVID-19 driven by underlying structural and socioeconomic inequity; and • enhanced momentum for collective mobilization, policy innovations and social transformation. Discussion: There was a strong desire for a more just and equitable society in a post-COVID-19 world, going ‘back to better’ rather than ‘back to normal.’ Our analysis demonstrates that equity has not been well integrated into pandemic planning and responses. Social movement and systems theories provide insight on ways to build on existing community mobilization and policy openings for sustained social transformation.
Using a fingerstick test for haematological monitoring in patients treated with clozapine
Authors: Atkins Matthew , McGuire Philip , Balgobin Bhirundra , Patel Pravinkumar , Taylor David 
Published: March 2021

Background Treatment with clozapine requires regular blood monitoring in order to minimise the risk of agranulocytosis. The demands on patients and clinicians associated with monitoring may be reduced by using point-of-care, as opposed to lab-based assessments. We assessed the utility of a device that can measure white blood cell (WBC) and neutrophil counts by capillary fingerstick blood. Method The performance of a small, portable device (HemoCue® WBC DIFF System) was compared with that of a widely used laboratory analyser (ADVIA® 2120i) for measuring WBC and neutrophil counts. Patients with schizophrenia who were being treated with clozapine ( n = 201) provided a fingerstick capillary sample and a venous sample for the respective assays. Results WBC counts and neutrophil counts from venous blood as determined by ADVIA 2120i, ranged from 3.0 × 109/l to 19.5 × 109/l, and 1.2 × 109/l to 15.9 × 109/l, respectively. There was a strong correlation between the results from venous and the capillary sample methods (WBC: R = 0.89, neutrophil: R = 0.92). By Passing–Bablok regression analysis, the slope of the association between ADVIA® 2120i and HemoCue WBC DIFF for WBC was 1.0 [95% confidence interval (CI) 0.944–1.086], with intercept at −0.9 (95% CI −1.43 to −0.45). For neutrophils, the slope was 0.870 (95% CI 0.817–0.923), with intercept at −0.19 (95% CI −0.43 to 0.02). Overall, mean biases of −0.95 × 109/l for WBC, and −0.91 × 109/l for neutrophils were observed for the capillary blood method compared with the venous blood method. Below the clinical cutoff intervals for clozapine monitoring WBC (<3.5 × 109/l) and neutrophils (<1.5 × 109/l) these biases were −1.1 × 109/l for WBC, and −0.25 × 109/l for neutrophils. Conclusion Results from the capillary blood HemoCue WBC DIFF analyser compared well with the venous blood ADVIA 2120i analyser for determining WBC and neutrophil counts. There was a slight overall bias, with the capillary method reporting lower values for both measures. Fingerstick point-of-care analysis is suitable for monitoring blood counts in patients on clozapine, although confirmatory standard venous testing is recommended for test results falling below accepted thresholds.
Right ventricular ejection fraction as predictor of outcome in acute heart failure using RV ellipsoid model: A retrospective analysis of a prospective cross-sectional study
Authors: Ashcroft Eshan , Lazariashvili Otar , Belsey Jonathan , Berrill Max , Sharma Pankaj , Baltabaeva Aigul 
Published: March 2021

Objectives The right ventricular (RV) function is an important prognostic factor in acute and chronic heart failure (HF). Echocardiography is an essential imaging modality with established parameters for RV function which are useful and easy to perform. However, these fail to reflect global RV volumes due to reliability on one acoustic window. It is therefore attractive to calculate RV volumes and ejection fraction (RVEF/E) using an ellipsoid geometric model which has been validated against MRI in healthy adults but not in the HF patients. Design This is a retrospective analysis of a prospective cross-sectional study enrolling 418 consecutive patients with symptoms of HF according to a predefined study protocol. All patients underwent echocardiographic assessment of RV function using Tricuspid Annular Plane Systolic Excursion (TAPSE) and RV fractional area change (RVFAC) and RVEF/E. Setting Single centre study with multiple locations for acute in-patients including high dependency units. Participants Patients with acute or exacerbation of chronic HF older than 18 y.o. Main outcome measures Ability of RVEF/E to predict patient outcomes compared with two established parameters of RV function over two-year follow-up period. Primary outcome measure was all-cause mortality. Results RVEF/E is equal to TAPSE & RVFAC in predicting outcome (p ≤ 0.01 vs p ≤ 0.01) and provides additional benefit of RV volume estimation based on standard 2D echo measurements. Conclusions In this study we have shown that RVEF/E derived from ellipsoid model is not inferior to well established measures of RV function as a prognostic indicator of outcome in the acute HF.
Transforming Interprofessional Roles During Virtual Health Care: The Evolving Role of the Medical Assistant, in Relationship to National Health Profession Competency Standards
Authors: Rokicki-Parashar Jesse , Phadke Anuradha , Brown-Johnson Cati , Jee Olivia , Sattler Amelia , Torres Elise , Srinivasan Malathi 
Published: March 2021

Introduction: Medical assistants (MAs) were once limited to obtaining vital signs and office work. Now, MAs are foundational to team-based care, interacting with patients, systems, and teams in many ways. The transition to Virtual Health during the COVID-19 pandemic resulted in a further rapid and unique shift of MA roles and responsibilities. We sought to understand the impact of this shift and to place their new roles in the context of national professional competency standards. Methods: In this qualitative, grounded theory study we conducted semi-structured interviews with 24 MAs at 10 primary care sites at a major academic medical center on their experiences during the shift from in-person to virtual care. MAs were selected by convenience sample. Coding was done in Dedoose version 8.335. Consensus-based inductive and deductive approaches were used for interview analysis. Identified MA roles were compared to national MA, Institute of Medicine, physician, and nursing professional competency domains. Results: Three main themes emerged: Role Apprehension, Role Expansion, and Adaptability/Professionalism. Nine key roles emerged in the context of virtual visits: direct patient care (pre-visit and physical care), panel management, health systems ambassador, care coordination, patient flow coordination, scribing, quality improvement, and technology support. While some prior MA roles were limited by the virtual care shift, the majority translated directly or expanded in virtual care. Identified roles aligned better with Institute of Medicine, physician, and nursing professional competencies, than current national MA curricula. Conclusions: The transition to Virtual Health decreased MA’s direct clinical work and expanded other roles within interprofessional care, notably quality improvement and technology support. Comparison of the current MA roles with national training program competencies identified new leadership and teamwork competencies which could be expanded during MA training to better support MA roles on inter-professional teams.
Self-Tensioning Feature of Knotless Suture Anchor Provides Reproducible Knotless Fixation Independent of Initial Tension
Authors: Athiviraham Aravind , Lee Cody S. , Smith Patrick A. , Piepenbrink Marina , Mackin Alexander P. , Wijdicks Coen A. 
Published: March 2021

Background: Anterior cruciate ligament (ACL) reconstruction with suture tape reinforcement has been shown to biomechanically reduce elongation and increase ultimate strength. However, the amount and consistency of the achieved tension after primary fixation using knotless suture anchors remains unclear. Purpose: To determine whether initial tensioning of suture tape before fixation with a knotless suture anchor significantly affects final tension of the suture tape. Study Design: Controlled laboratory study. Methods: We secured 15 pairs of Sawbones blocks with predrilled tunnels to a tensile testing machine. Suture tape was inserted through a suspensory fixation button on the representative femoral block and threaded top-down through the base of the tibial block over an attachable button system. The suture tape was attached with a knotless suture anchor in a predrilled and tapped hole on the tibial block under the following pretensioning conditions: (1) slight tension of 5 N, (2) no tension, and (3) initial slack. The suture anchor was inserted as the load-time data were recorded. After initial block testing, a porcine model of 24 tibias was used to test the same pretensioning conditions. The initial loads during anchor insertion and screw-in were measured, as well as final tension. Results: During block testing, no difference in final tensioning was found when comparing the slight-tension, no-tension, and slack groups (42.3 ± 5.3, 37.7 ± 6.4, and 40.2 ± 7.0 N, respectively; P = .528). Similar to block testing, no difference in final tensioning was found when comparing the slight-tension, no-tension, and slack groups using the porcine model (43.64 ± 6.69, 48.09 ± 13.93, and 44.52 ± 6.84 N, respectively; P = .633). Conclusion: The final tension of the suture tape construct appears to be reproducible and consistent, independent of the initial tension introduced with suture anchor placement within the tested parameters. Clinical Relevance: The results of the current study can help optimize the placement technique of independent suture tape reinforcement for ACL reconstruction, which is a promising strategy to help prevent ACL rerupture, particularly in the early phases of postoperative rehabilitation.
The Role of Deadlifts in Distal Biceps Brachii Tendon Ruptures: An Alternative Mechanism Described With YouTube Videos
Authors: Kapicioglu Mehmet , Bilgin Emre , Guven Necip , Pulatkan Anil , Bilsel Kerem 
Published: March 2021

Background: The classic injury mechanism of a distal biceps brachii tendon rupture (DBBTR) is eccentric loading to the flexed elbow when the forearm is supinated. Purpose: To determine alternative mechanisms of a DBBTR in powerlifting sports, particularly in deadlift competitions, with the use of YouTube videos. Study Design: Descriptive epidemiology study. Methods: A search on YouTube was performed using the search terms “distal biceps tendon rupture” and “distal biceps tendon injury” combined with “competition,” “deadlift,” and “powerlifting.” The videos underwent an evaluation for accuracy by 3 surgeons according to predetermined criteria. Type of sports activity, participant sex, side of the injury, and arm positions at the time of the injury were recorded. Results: Among the videos reviewed, 35 injuries were found appropriate for an evaluation. All participants were male. The majority of the injuries (n = 25) were observed during the deadlift. Only in 1 deadlift injury were both forearms in supination. In the remaining deadlift injuries (n = 24), all elbows were in extension, with 1 forearm in supination and the other in pronation. Among the deadlift injuries in the mixed-grip position, all ruptures occurred in a supinated extremity: 25% (n = 6) of ruptures occurred on the right side, and 75% (n = 18) of ruptures occurred on the left side; this was a significant difference ( P = .014). Conclusion: We described an alternative mechanism for a DBBTR, namely, eccentric loading to an extended elbow when the forearm is supinated during the deadlift. As all the ruptures occurred in a supinated extremity, holding the bar with both forearms in pronation may prevent or decrease the risk of ruptures during the deadlift.
Nurses’ Attitude Toward Caring for Dying Patients in a Nigerian Teaching Hospital
Authors: Faronbi Joel Olayiwola , Akinyoola Oladele , Faronbi Grace Oluwatoyin , Bello Cecilia Bukola , Kuteyi Florence , Olabisi Isaiah Oluwaseyi 
Published: March 2021

Introduction Death and the dying experience are common phenomena in all clinical settings. Death and the dying presents physical and emotional strain on the dying patient, his relations and professional caregivers. Objective The study therefore assessed the sociodemographic determinants of nurses’ attitudes towards death and caring for dying patient. Method A cross–sectional design was used to study 213 randomly selected nurses, working in one of the tier one teaching hospital in Nigeria. Attitude towards death and the dying was collected with Frommelt Attitude Care of the Dying and Death Attitude Profit–Revised questionnaire. The data collected was analysed with SPSS version 20 and inferential analyses were considered statistically significant at p < 0.05. Results The study revealed that most of the nurses had negative attitudes toward the concept of death (76.5%) and caring for dying patient (68%). Furthermore, a chi-square test revealed significant associations between the nurses’ years of working experience (χ2 = 24.57, p <.00) and current unit of practice (χ2 = 21.464; p = .002) and their attitude towards caring for the dying patient. Also, nurses’ age (χ2 = 13.77, p = .032), professional qualifications (χ2 = 13.774, p = .008), and current ward of practice (χ2 = 16.505, p = .011) were significantly associated with their attitudes to death. Furthermore, the study observed a significant association between nurses’ attitudes to death and caring for the dying patient (χ2 = 11.26, p < 0.01). Conclusion This study concluded that nurses had negative attitudes towards death and dying and therefore prescribes, as part of continuing professional development strategy, the need for requisite positive value – laden, ethnoreligious specific education regarding end of life care.
Dental Caries Severity and Nutritional Status of Nigerian Preschool Children
Authors: Olatosi O.O. , Alade A.A. , Naicker T. , Busch T. , Oyapero A. , Li M. , Pape J. , Olotu J. , Awotoye W. , Hassan M. , Adeleke C. , Adeyemo W.L. , Shaffer J. , Marazita M.L. , Butali A. 
Published: March 2021

Introduction: Malnutrition in children is one of the most prevalent global health challenges, and malnourished children have a higher risk of death from childhood diseases. Early childhood caries (ECC) is the most common chronic disease of childhood. Complications from ECC such as pain, loss of tooth/teeth, and infection can undermine a child’s nutrition and growth. Aim: This study aims to evaluate the severity of decay, missing, and filled tooth (dmft) by nutritional status using the z scores of the anthropometric measurements: height for age (HFA), weight for age (WFA), weight for height (WFH), and body mass index for age (BMIA) among children with ECC in Nigeria. Study Design: This is a cross-sectional study conducted in 5 local government areas (LGAs) in Lagos State, Nigeria. A multistage sampling technique was used. Results: A total of 273 cases of ECC were included in the analyses (mean age 4.19 ± 0.96 y). Overall, the mean dmft was 3.04 ± 2.28, and most (96%) were accounted for by untreated decay. The distribution of dmft within the different z score categories of BMIA (<–3 = severely wasted, –2 to –3 = wasted, –2 to +2 = normal, +2 to +3 = overweight and >+3 = obese) showed the highest dmft scores among the combined severely wasted and wasted groups, lowest among children with normal z scores, and intermediate in the overweight and obese groups. There was a significant negative correlation between BMIA z score, WFH z score, and dmft ( r = −0.181, P < 0.05 and r = −0.143, P < 0.05, respectively). However, the correlations between HFA z score, WFA z score, and dmft were positive but not significant ( r = 0.048, P = 0.44 and r = 0.022, P = 0.77, respectively). Conclusion: Our study showed an increased severity of dental caries among severely wasted or wasted children with ECC compared to those of normal or overweight. Knowledge Transfer Statement: The results from this study will raise awareness among clinicians and policy makers on the need for a primary prevention program for early childhood caries in countries with high burden of malnutrition and limited resources. Also, it will help draw the attention of clinicians to the caries status of malnourished children that can be managed to improve the nutritional outcomes.
COVID-19 and conjunctivitis: a meta-analysis
Authors: Al-Namaeh Mashael 
Published: March 2021

COVID-19 is a disease first identified in Wuhan City, Hubei Province, China, in December 2019, causes by a SARS-COV-2 virus infection. By 27 October 2020, 43,921,473 confirmed cases were reported worldwide, with 1,166,389 COVID-19 deaths. Conjunctivitis has been reported in adults and pediatric patients with COVID-19. Objective: The aim of this meta-analysis is to estimate the odd Ratio (ORs) of conjunctivitis in patients with COVID-19. Methods: A systematic review and meta-analysis have been performed using the PubMed and Google Scholar literature search. The ORs of conjunctivitis in adults and pediatric patients is the outcome of this meta-analysis. Results: There have been 1041 articles published since the outbreak in December 2019, according to the latest literature. For the meta-analysis, 20 studies with a total of 3383 participants were included. The odds ratio (ORs) of conjunctivitis was 0.01 (95% confidence interval [CI]: 0.00–0.02). No bias has been reported. Conclusion: Conjunctivitis is the most common ocular manifestations reported in adults. This comprehensive meta-analysis quantifies the existing evidence linking conjunctivitis with COVID-19 and highlights the high percentage of heterogeneity that is shown in the current studies. Finally, it offers a single review article which includes all the current articles available for COVID-19 and conjunctivitis in adults and children.
Fertility-Related Problems and Ways of Coping of Couples With Primary Infertility in Urban India
Authors: De Devika , Mukhopadhyy Pritha , Roy Prasanta Kumar 
Published: March 2021

Objective: To study the impact of infertility in terms of fertility-related problems and ways of coping among male organic factor, female organic factor, and unexplained factor infertility groups suffering from primary infertility. Infertility is defined as an inability to become pregnant after 1 year of regular sexual relations without use of contraceptives. This study compared coping strategies and specific fertility problems among the 3 infertile groups. Methods: This was a clinic-based cross-sectional comparative study based on consecutive sampling method. Sixty couples were taken, of which 10 couples were from the male factor, 10 from the female factor, and 10 from the unexplained factor group. Fertility Problem Inventory and Ways of Coping Questionnaire were the tools that were administered. Results: The female factor group had greater social and relationship concern and need for parenthood. Seeking social support was used more by the unexplained factor group, whereas positive reappraisal coping style was used more by the female factor group. The male factor group used confrontative and self-controlling strategy to deal with the infertility problem. Conclusion: Men and women had different fertility-related concerns and used different coping methods to address these issues. Mental health professionals can address these concerns with specifically devised psychotherapy module.