bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of acute geriatric unit care on functional decline and process outcomes among older adults admitted to hospital with acute medical complaints: a protocol for a systematic review
Authors: O’Shaughnessy Íde , Robinson Katie , O"Connor Margaret , Conneely Mairéad , Ryan Damien , Steed Fiona , Carey Leonora , Leahy Aoife , Galvin Rose 
Published: October 2021

IntroductionOlder adults are clinically heterogeneous and are at increased risk of adverse outcomes during hospitalisation due to the presence of multiple comorbid conditions and reduced homoeostatic reserves. Acute geriatric units (AGUs) are units designed with their own physical location and structure, which provide care to older adults during the acute phase of illness and are underpinned by an interdisciplinary comprehensive geriatric assessment model of care. This review aims to update and synthesise the totality of evidence related to the effectiveness of AGU care on clinical and process outcomes among older adults admitted to hospital with acute medical complaints.DesignUpdated systematic review and meta-analysisMethods and analysisMEDLINE, Cumulative Index of Nursing and Allied Health Literature, Controlled Trials in the Cochrane Library and Embase electronic databases will be systematically searched from 2008 to February 2021. Trials with a randomised design that deliver an AGU intervention to older adults admitted to hospital for acute medical complaints will be included. The primary outcome measure will be functional decline at discharge from hospital and at follow-up. Secondary outcomes will include length of stay, cost of index admission, incidence of unscheduled hospital readmission, living at home (the inverse of death or institutionalisation combined; used to describe someone who is in their own home at follow‐up), mortality, cognitive function and patient satisfaction with index admission. Title and abstract screening of studies for full-text extraction will be conducted independently by two authors. The Cochrane risk of bias 2 tool will be used to assess the methodological quality of the included trials. The quality of evidence for outcomes reported will be assessed using the Grading of Recommendations Assessment, Development and Evaluations framework. A pooled meta-analysis will be conducted using Review Manager, depending on the uniformity of the data.Ethics and disseminationFormal ethical approval is not required as all data collected will be secondary data and will be analysed anonymously. The authors will present the findings of the review to a patient and public involvement stakeholder panel of older adults that has been established at the Ageing Research Centre in the University of Limerick. This will enable the views and opinions of older adults to be integrated into the discussion section of the paper.PROSPERO registration numberCRD42021237633.
Malnutrition in all its forms and associated factors affecting the nutritional status of adult rural population in Bangladesh: results from a cross-sectional survey
Authors: Rakhshanda Shagoofa , Barua Lingkan , Faruque Mithila , Banik Palash Chandra , Shawon R A , Rahman A K M Fazlur , Mashreky Saidur 
Published: October 2021

IntroductionThe burden of malnutrition is widely evaluated in Bangladesh in different contexts. However, most of them determine the influence of sociodemographic factors, which have limited scope for modification and design intervention. This study attempted to determine the prevalence of underweight, overweight and obesity and their modifiable lifestyle predictors in a rural population of Bangladesh.MethodsThis study was part of a cross-sectional study that applied the WHO Package of Essential Noncommunicable Disease Interventions in a rural area of Bangladesh to assess the burden of diabetes, hypertension and their associated risk factors. Census was used as the sampling technique. Anthropometric measurement and data on sociodemographic characteristics and behavioural risk factors were collected following the standard protocol described in the WHO STEP-wise approach. Analysis included means of continuous variables and multinomial regression of factors.ResultsThe mean body mass index of the study population was 21.9 kg/m2. About 20.9% were underweight, 16.4% were overweight and 3.5% were obese. Underweight was most predominant among people above 60 years, while overweight and obesity were predominant among people between 31 and 40 years. Higher overweight and obesity were noted among women. Employment, consumption of added salt and inactivity increased the odds of being underweight by 0.32, 0.33 and 0.14, respectively. On the other hand, the odds of being overweight or obese increased by 0.58, 0.55, 0.78, 0.21 and 0.25 if a respondent was female, literate, married, housewife and consumed red meat, and decreased by 0.38 and 0.18 if a respondent consumed added salt and inadequate amounts of fruits and vegetables, respectively. Consumption of added salt decreases the odds of being overweight or obese by 0.37.ConclusionThe study emphasised malnutrition to be a public health concern in spite of the dynamic sociodemographic scenario. Specific health messages for targeted population may help improve the nutritional status. Findings from further explorations may support policies and programmes in the future.
Value of age and alarm features for predicting upper gastrointestinal malignancy in patients with dyspepsia: an endoscopic database review of 4664 patients in Thailand
Authors: Kaosombatwattana Uayporn , Charatcharoenwitthaya Phunchai , Pausawasdi Nonthalee , Maneerattanaporn Monthira , Limsrivilai Julajak , Leelakusolvong Somchai , Kachintorn Udom 
Published: October 2021

ObjectiveAge and alarm features are commonly used as indicators for endoscopy in dyspeptic patients; however, the age cut-off and the predictive value of these parameters for identifying upper gastrointestinal (UGI) malignancies are uncertain.DesignCross-sectional study.SettingData were extracted from the Gastrointestinal Endoscopy Centre of Siriraj Hospital, Thailand, during 2005–2011.ParticipantsConsecutive patients underwent a first-time upper endoscopy for dyspepsia. Patients with previous surgery, suspected UGI malignancy by imaging, or indefinite biopsy results on prior examination were excluded.Main outcome measuresAlarm features included dysphagia, unintentional weight loss, GI bleeding/anaemia, and persistent vomiting. The diagnostic performance of each alarm feature and different age cut-off values were evaluated.ResultsA total of 4664 patients (mean age: 52.0±14.4 years, 66% female) were included. Alarm symptoms were presented in 21.6%. The prevalence of activeHelicobacter pyloriinfection was 26.3%. Fifty-eight (1.2%) patients had UGI malignancy. The prevalence of malignancy significantly increased with increasing age (0.6% in patients aged <50 years, and 1.8% in patients aged >60 years (p<0.001)). Cancer was found in two patients aged <50 years who did not have alarm features. Patients with alarm features had a higher prevalence of malignancy (OR 22.3, 95% CI 10.5 to 47.4; p<0.001) than those without. The pooled sensitivity, specificity, positive predictive value and negative predictive value of alarm features for UGI malignancy were 87.0%, 79.1%, 4.7% and 99.8%, respectively. Among all age groups, persistent vomiting had a positive likelihood ratio (PLR) >10, while dysphagia and GI bleeding/anaemia had a PLR >10 in patients <50 years old.ConclusionDespite the overall limited value of age and alarm features, persistent vomiting, dysphagia, and GI bleeding/anaemia are strong predictors for malignancy in patients aged <50 years. Without these symptoms, cancer prevalence is negligible; thus, they are worthy guidance for endoscopic evaluation in this age group.
Experience of the COVID-19 pandemic as lived by patients with hip and knee osteoarthritis: an Italian qualitative study
Authors: Battista Simone , Dell'Isola Andrea , Manoni Mattia , Englund Martin , Palese Alvisa , Testa Marco 
Published: October 2021

ObjectiveTo examine the experience of the COVID-19 pandemic as lived by people with hip and knee osteoarthritis (OA), in Italy.DesignA qualitative study based on semi-structured interviews.SettingUrban and suburban areas in northern Italy.ParticipantsA total of 11 people with OA were enrolled through a purposeful sampling and completed the study.Primary outcome measureThe experience of Italian people with OA during the COVID-19 pandemic.ResultsFour themes were brought to the forefront from the analysis of the interviews. (1)Being Stressed for the Limited Social Interactions and for the Family Members at High Risk of Infection,as the interviewees were frustrated because they could not see their loved ones or felt a sense of apprehension for their relatives. (2)Recurring Strategies to Cope with the Pandemicsuch as an active acceptance towards the situation. (3)Being Limited in the Possibility of Undergoing OA Complementary Treatments and Other Routine Medical Visits.(4)Being Unaware of the Importance of Physical Activity as First-Line Interventionswhich was an attitude already present before the pandemic.ConclusionThe COVID-19 pandemic and related restrictions impacted the quality of life and the care of individuals with hip and knee OA. The social sphere seemed to be the most hindered. However, the interviewees developed a good level of acceptance to deal with the pandemic. When it came to their care, they faced a delay of routine medical visits not related to OA and of other complementary treatments (eg, physical therapies) to manage OA. Finally, a controversial result that emerged from these interviews was that first-line interventions for OA (ie, therapeutic exercise) was not sought by the interviewees, regardless of the restrictions dictated by the pandemic. Policy-making strategies are thus necessary to support the awareness of the importance of such interventions.
Physiological parameters of a plover during nonbreeding and breeding seasons in Patagonia, Argentina
Authors: D’Amico Verónica L. , Hevia Glenda D. , Walker Brian , González Patricia M. , Bertellotti Marcelo 
Published: October 2021

Migratory shorebirds are the most threatened avian species due to the effects of human activities and climate change. Physiological parameters are useful to evaluate the health status of free-living animals. Here we investigated lymphocytes, heterophils, heterophils/lymphocytes, and glucose for female and male Two-banded Plovers (Charadrius falklandicus Latham, 1790) during nonbreeding (body moult) and breeding (incubation) seasons in coastal areas of northern Patagonia, Argentina. We also measured corticosterone for the first time for this species during the breeding season. Nonbreeding Two-banded Plovers were more likely to have higher physiological measurements that were not dependent on body moult nor body condition, being similar between sexes. Differences found in glucose are likely related to recent feeding in nonbreeding birds compared with fasting during incubation. The gregarious nonbreeding behaviour in comparison with the isolated breeding pairs would increase the risk of acquiring parasites and (or) pathogens inducing a response of the immune system reflected in higher values of lymphocytes. Baseline corticosterone during breeding was similar between sexes and were lower compared with other values reported for breeding plovers. Two-banded Plovers undergo energetically demanding physiological changes during the nonbreeding stage, strengthening the idea that conservation of the environmental resources at these locations may be more important than previously thought.
Supplemental Bacillus subtilis PB6 Improves Growth Performance and Gut Health in Broilers Challenged with Clostridium perfringens
Authors: Liu Yan , Zhang Song , Luo Zheng , Liu Dan 
Published: October 2021

Clostridium perfringens (CP) is the principal pathogenic bacterium of chicken necrotic enteritis (NE), which causes substantial economic losses in poultry worldwide. Although probiotics are known to provide multiple benefits, little is known about the potential effects of Bacillus subtilis (B. subtilis) application in preventing CP-induced necrotic enteritis. In this study, 450 male Arbor Acres broilers were divided into 5 experimental treatments: A: basal diet (control group); B: basal diet and CP challenge (model group); C: CP challenge+10 mg/kg enramycin (positive control group); D: CP challenge+

4
×

10

7

CFU
/
kg

of feed B. subtilis PB6 (PB6 low-dosage group); and E: CP challenge+

6
×

10

7

CFU
/
kg

of feed B. subtilis PB6 (PB6 high-dosage group). There were 6 replicate pens per treatment with 15 broilers per pen. The present research examined the effect of Bacillus subtilis PB6 (B. subtilis PB6) on growth performance, mRNA expression of intestinal cytokines and tight junctions, and gut flora composition in broilers challenged with CP. The entire experiment was divided into two phases: the non-CP challenge phase (d0–18) and the CP challenge phase (d18–26). PB6 did not increase the growth performance during the first stage, but the PB6 high-dosage group was found to have larger body weight gain and ADFI during the CP challenge stage. Feed supplementation with PB6 reduced the lesion score of challenged chicks, with increased tight junction-related gene expression (occludin and ZO-1) and decreased TNF-α expression compared with CP-infected birds. A decrease in the abundance of Clostridium XI, Streptococcus, and Staphylococcus was observed after CP infection (

P
<
0.05

), while supplementation with PB6 restored the ileal microbial composition. In conclusion, administration of B. subtilis PB6 improved growth performance, enhanced intestinal barrier function, and mitigated intestinal inflammation/lesions, which might be due to its restoring effects on the ileal microbial composition in CP-challenged broilers.
Characteristics of tobacco consumption among cancer patients at a tertiary cancer hospital in South India—A cross-sectional study
Authors: Ramani Vinod K , V Ganesha D , Benny Neethu , Naik Radheshyam 
Published: October 2021

Introduction Cancer patients commonly present with antecedent addiction to tobacco consumption. Our study describes the characteristics of this substance use. Following the diagnosis of cancer, continued consumption of tobacco results in reduced tolerance to treatment, failure of treatment, tumor progression, other primary tumors, secondary cancers, and poor quality of life. The aim of our study is to enumerate the clinico-social aspects of tobacco consumption among cancer patients. Methods This cross-sectional study includes 100 cancer patients admitted to Healthcare Global cancer hospital, Bangalore, India. The study subjects were assessed for tobacco consumption, as well as other substance use such as intake of alcohol. We assessed various dimensions of exposure to tobacco consumption such as duration, intensity, and cumulative dose as independent risk factors for cancer. Results Among the study subjects, 46.2% were found to smoke filter cigarettes. The mean duration of tobacco consumption among beedi users was found to be longer (25.9 years, SD: 14.4). When stratified for exclusive consumption, the mean durations were as follows: beedis (29 ± 14.4 years), cigarettes (23.8 ± 13.3 years), and chewing (15.9 ± 9.6 years). Along with tobacco, a large proportion (59.3%) of patients consumed alcohol as well. After attempts to quit, 89.01% patients had reversal of tobacco substance use. The data did not show significance for duration, intensity, and cumulative dose of tobacco consumption. Conclusion The diagnosis of cancer is a life-altering event, which results in higher motivation to quit the use of tobacco. Smoking cessation initiatives can reduce the risk of developing tobacco-related malignancies.
The Lived Experiences of Caregivers of Lung Transplant Recipients
Authors: Glaze Joy A. , Brooten Dorothy , Youngblut Jo Anne , Hannan Jean , Page Timothy 
Published: October 2021

Introduction Lung transplantation is a treatment crucial for the survival of patients with end-stage lung diseases. An identified caregiver is obligatory for a patient to be eligible for a lung transplant and plays an essential role in the transplant recipient's care. Most caregiver research, however, has been on caregivers of persons with Alzheimer's disease or the elderly, with limited research on caregivers’ experiences caring for transplant recipients. This study examined the experiences of caregivers of recipient's pre- and post-lung transplantation. Methods/Approach Caregivers of lung transplant recipients were recruited using purposeful sampling. Audiotaped semi-structured open ended interviews were conducted until data saturation. Each interview was transcribed verbatim, and conventional content analysis performed to extract significant themes and subthemes. Findings Four main themes and 12 sub-themes were identified. The former included (1) establishing the diagnosis, (2) caregiver roles, (3) caregiver psychological and psychosocial issues, and (4) support. Caregivers lacked basic knowledge related to lung transplantation. The caregivers’ roles necessitated rearranging priorities, lifestyle changes, and redirecting emotional and physical energy. Support played an important role in caregiving experiences. Discussion Each caregiver shared their unique caregiving experiences. Caregivers lack knowledge about transplantation, experience dramatic changes in their family life, social activities, employment, and often financial status. Healthcare providers can use the findings of this study in developing informational, and psychological interventions to alleviate caregivers’ stress and anxiety.
Population status and distribution of the critically endangered Indian Courser (Cursorius coromandelicus) on Delft Island, Sri Lanka
Authors: Aloysius Nitharsan , Madhushanka Shashi , Chandrika Chathuri 
Published: October 2021

The critically endangered Indian Courser ( Cursorius coromandelicus) is a rare resident bird species in Sri Lanka. This bird species is restricted to the northern avifaunal region of Sri Lanka, and even there it has been recorded from only a few locations. Thus, it is identified as one of the rarest birds in Sri Lanka. A 1-year study was conducted to investigate Indian Courser population and their distribution within the Delft Island from 5th of January to 20th of December 2020. Ten (10) randomly selected points were investigated in this study. Of the 10 sampling points, the Indian Courser was observed within three (03) sampling points year around while several sightings were recorded in points 8, and 9 during 3 months of the year. Their abundance significantly varied among sampling locations (one-way ANOVA, F = 15.04, p < .05). The maximum number of individuals recorded was 18 ± 4.64 in December and the minimum number was 4 ± 4.64 during the non-migrant season. Although most of the area in the island is covered with dry grasslands, their distribution in Delft is largely confined to a few grassland patches where human activities are minimum. Hunting, egg collection, and trampling of their nest by the Delft ponies (feral horses) can be identified as the main threats of this species. It is of utmost importance to immediately implement holistic conservation measures to save this critically endangered bird as Delft is the only known location where a viable resident population of Indian Courser is found.
Rural Michigan Farmers’ Health Concerns and Experiences: A Focus Group Study
Authors: Wright Nathan , Scherdt Marylee , Aebersold Michelle L. , McCullagh Marjorie C. , Medvec Barbara R. , Ellimoottil Chad , Patel Minal R. , Shapiro Shoshana , Friese Christopher R. 
Published: October 2021

Objectives: Rural residents comprise approximately 15% of the United States population. They face challenges in accessing and using a health care system that is not structured to meet their unique needs. It is important to understand rural residents’ perceptions of health and experiences interacting with the health care system to identify gaps in care. Methods: Our team conducted focus groups with members of the Michigan Farm Bureau during their 2019 Annual Meeting. Topics explored included resources to manage health, barriers to virtual health care services, and desired changes to localized healthcare delivery. Surveys were used to capture demographic and internet access information. Conclusion: Analysis included data from 2 focus groups (n = 14). Participants represented a wide age range and a variety of Michigan counties. The majority were full-time farm owners with most—93% (n = 13)—reporting they had access to the internet in their homes and 86% (n = 12) reporting that their cellphones had internet capabilities. Participants identified challenges and opportunities in 4 categories: formal health care; health and well-being supports; health insurance experiences; and virtual health care. Conclusion: The findings from this study provide a useful framework for developing interventions to address the specific needs of rural farming residents. Despite the expressed challenges in access and use of health care services and resources, participants remained hopeful that innovative approaches, such as virtual health platforms, can address existing gaps in care. The study findings should inform the design and evaluation of interventions to address rural health disparities.
Early Determinants of Length of Hospital Stay: A Case Control Survival Analysis among COVID-19 Patients admitted in a Tertiary Healthcare Facility of East India
Authors: Agarwal Neeraj , Biswas Bijit , Singh Chandramani , Nair Rathish , Mounica Gera , H Haripriya , Jha Amit Ranjan , Das Kumar M. 
Published: October 2021

Background: Length of hospital stay (LOS) for a disease is a vital estimate for healthcare logistics planning. The study aimed to illustrate the effect of factors elicited on arrival on LOS of the COVID-19 patients. Materials and Methods: It was a retrospective, record based, unmatched, case control study using hospital records of 334 COVID-19 patients admitted in an East Indian tertiary healthcare facility during May to October 2020. Discharge from the hospital (cases/survivors) was considered as an event while death (control/non-survivors) as right censoring in the case-control survival analysis using cox proportional hazard model. Results: Overall, we found the median LOS for the survivors to be 8 days [interquartile range (IQR): 7-10 days] while the same for the non-survivors was 6 days [IQR: 2-11 days]. In the multivariable cox-proportional hazard model; travel distance (>16 km) [adjusted hazard ratio (aHR): 0.69, 95% CI: (0.50-0.95)], mode of transport to the hospital (ambulance) [aHR: 0.62, 95% CI: (0.45-0.85)], breathlessness (yes) [aHR: 0.56, 95% CI: (0.40-0.77)], number of co-morbidities (1-2) [aHR: 0.66, 95% CI: (0.47-0.93)] (≥3) [aHR: 0.16, 95% CI: (0.04-0.65)], COPD/asthma (yes) [ [aHR: 0.11, 95% CI: (0.01-0.79)], DBP (<60/≥90) [aHR: 0.55, 95% CI: (0.35-0.86)] and qSOFA score (≥2) [aHR: 0.33, 95% CI: (0.12-0.92)] were the significant attributes affecting LOS of the COVID-19 patients. Conclusion: Factors elicited on arrival were found to be significantly associated with LOS. A scoring system inculcating these factors may be developed to predict LOS of the COVID-19 patients.