bluuebunny/crossref_metadata_2025_split huggingface dataset:
Professional Early-Adopter Experiences of Implementing a Novel Rehabilitation Model of Care across Alberta, Canada: A Focused Ethnography
Authors: Manhas Kiran Pohar , Olson Karin , Churchill Katie , Vohra Sunita , Wasylak Tracy 
Published: September 2019

Abstract
Background In 2017, a provincial health-system released a Rehabilitation Model of Care (RMoC) to promote patient-centred care, provincial standardization, and data-driven innovation. Eighteen early-adopter community-rehabilitation teams implemented the RMoC using a 1.5-year long Innovation Learning Collaborative (in-person learning sessions; balanced scorecards). More research is required on developing, implementing and evaluating models of care. Understanding RMoC implementation will expand implementation science knowledge, particularly around factors influencing model-of-care outcomes and sustainability in, and between, jurisdictions. We aimed to explore experiences of early-adopter providers and provincial consultants involved in the community-rehabilitation RMoC implementation in Alberta, Canada.Methods Via focused ethnography, we used focus groups (or interviews for feasibility/confidentiality) and aggregate, site-level data analysis of RMoC standardized metrics. Purposive sampling ensured representation across geography, service types and patient populations. Team-specific focus groups were onsite, at participants’ convenience, and led by a researcher-moderator and co-facilitator. A semi-structured question guide promoted discussions on interesting/challenging occurrences; perceptions of RMoC impact; and, suggested definitions of successful implementation. Focus groups and interviews were audio-recorded and transcribed alongside field notes. Data collection and analysis were concurrent to saturation. Transcripts were coded for implementation-related phrases. Similar ideas were collapsed forming themes, with inter-theme relationships identified. Tactics for rigour included negative case analysis, use of thick description, and an audit trail.Results We completed 11 focus groups and seven interviews (03/2018 to 01/2019) (n=45). Participants were 89.6% female, mostly-Canadian trained and represented diverse rehabilitation professions. Teams varied on their focal health service and patient population. The implementation experience involved navigating emotions, operating amongst dynamics, and integrating the RMoC details. Confident, satisfied early-adopter teams demonstrated traits including strong coping strategies; management support; and, being opportunistic and candid about failure. Teams faced common challenges (e.g. emotions of change; delayed data access; and lack of efficient, memorable communication across team and site). Implementation success targeted patient-, team- and system levels.Conclusions We recommend specific training priorities for future teams including evaluation training for novice teams; timelines for step-wise implementation; on-site, in-person time with a facilitator and full-team present; and prolonged facilitated introductions between similar teams for long-term mentorship.
Lean task boards in healthcare, an improvement tool for tidying up the local chaos and promote professionalism
Authors: Antonsen Yngve , Bye Geir 
Published: September 2019

Abstract
Background: A growing number of public healthcare organisations are now implementing the lean task board as a qualitative improvement tool to help solve problems and reduce wasteful work tasks. The task board itself helps line managers and employees to manage, collaborate and prioritize as it can present tasks that are upcoming, in progress or finished. With this focus, the presented paper’s research question is: How do managers’ and employees’ use of the lean task board promote learning for improvement in the municipal healthcare sector? Method: Qualitative case study data from a Norwegian municipality including 750 internal self-recorded logs from task board sessions from six different units and 25 semi-structured interviews of managers and employees. The data were organised based on content and recoded by comparing the codes and finding abstract theoretical patterns. Results: The task board works for line managers to make employees responsible for forwarding ideas, solutions and implementation of new actions. Line managers and employees used the task boards to systemise work through establishing new routines and focus on improving tidiness at work. The task boards were also used as a project management system to track progress in purchasing of diverse equipment and initiatives to improve the units’ facilities. Line managers and employees also set professionalism on the agenda, discussing and improving both daily attitude, work environment and user’s well-being. Senior management with a long-term strategy, support for line managers, and allocation of resources was essential to the implementation of the task boards. Conclusion: The implications from the study are that the lean task board is well suited to promote learning processes that tidy up chaos in local healthcare organisations. Drawing upon action learning theory, the study explains the learning challenges of using the lean task board in municipalities’ healthcare systems, as the method promotes finding experience-based solutions that do not involve critical reflection and use of theory. The task board has limitations as a method for improving services between healthcare units and for solving difficult problems. In light of the findings further investigation is still required to elicit how municipalities organize improvement through lean methods.
Trypanosome Infection Rate in Glossina tachinoides: Infested Rivers of Limmu Kosa District Jimma Zone, Western Ethiopia
Authors: Meharenet Behablom , Alemu Dereje 
Published: September 2019

Abstract
Objective: Trypanosomosis is a disease of domestic animals and humans resulting from infection with parasitaemic protozoa of the genus Trypanosoma transmitted primarily by tsetse flies and other hematophagous flies. The study was conducted to estimate the infection rate of trypanosome in vector flies and involved parasite species. Result: The study result indicated that there was only one species of Tsetse fly Glossinatachinoides detected with high Flay/Trap/Day = 4.45. Total of n=284 tsetse flies were dissected and n= 5 positive for Glossinatachinoidesresulting in 1.76% infection rate. Higher trypanosome infections were observed in female tsetse with significant infection rate of 1.41%, n=4 and 0.35%, n=1 in males. Furthermore, 1.06% of the trypanosome infections carried by Glossinatachinoides were classified as Trypanosomavivax and the remaining 0.70% was Trypanosomacongolense.The study confirmed the absence of human trypanosomosis in study area with only identified trypanosome parasites were Trypanosomavivax and Trypanosomacongolense. However, the resulted FTD= 4.45 recommend control and suppression of the vector and parasite is mandatory due to Pathogenic Animal Trypanosomosis.
Decision-to-delivery interval of emergency cesarean section in Uganda: a retrospective cohort study
Authors: Hughes Noemi , Namagembe Imelda , Nakimuli Annettee , Sekikubo Musa , Moffett Ashley , Patient Charlotte , Aiken Catherine 
Published: September 2019

Abstract
Background : In many low and medium human development index countries, the rate of maternal and neonatal morbidity and mortality is high. One factor which may influence this is the decision-to-delivery interval of emergency cesarean section. We aimed to investigate the maternal risk factors, indications and decision-to-delivery interval of emergency cesarean section in a large, under-resourced obstetric setting in Uganda.
Methods: Records of 344 singleton pregnancies delivered at ≥24 weeks throughout June 2017 at Mulago National Referral Hospital were analysed using Cox proportional hazards models and multivariate logistic regression models.
Results : An emergency cesarean section was performed every 104 minutes and the median decision-to-delivery interval was 5.5 hours. Longer interval was associated with preeclampsia and premature rupture of membranes/oligohydramnios. Fetal distress was associated with a shorter interval (p<0.001). There was no association between decision-to-delivery interval and adverse perinatal outcomes (p>0.05). Mothers waited on average 6 hours longer for deliveries between 00:00-08:00 compared to those between 12:00-20:00 (p<0.01). The risk of perinatal death was higher in neonates where the decision to deliver was made between 20:00-02:00 compared to 08:00-12:00 (p<0.01).
Conclusion : In this setting, the average decision-to-delivery interval is longer than targets adopted in high development index countries. Decision-to-delivery interval varies diurnally, with decisions and deliveries made at night carrying a higher risk of adverse perinatal outcomes. This suggests a need for targeting the improvement of service provision overnight.
Effects of sugammadex plus rocuronium vs neostigmine plus cisatracurium during renal transplantation on graft function.
Authors: Vargas Maria , Buonanno Pasquale , Sica Andrea , Sabatella Emanuele , D’Alessio Francesco P. , Alfieri Simone , Iacovazzo Carmine , Carrano Rosa , Servillo Giuseppe 
Published: September 2019

Abstract
Background Rocuronium can be used in patients with severe renal failure (creatinine clearance <30 ml/min) but the duration of muscle relaxation is longer and results in an increased risk of postoperative residual curarization. Rocuronium can be antagonized by sugammadex but the elimination of the complex they made (rocuronium-sugammadex complex) varies according to the renal function. Two case reports/series reported the use of rocuronium – sugammadex complex during renal transplantation. This retrospective case-control study aimed to investigate the effects of rocuronium – sugammadex, used during the renal transplantation, on transplanted kidney function.Methods We analyzed 113 medical records of patients undergoing kidney transplantation from January 2015 to December 2018. 47 medical records were excluded because they did not report the administration of rocuronium + sugammadex or cisatracurium + neostigmine during the transplantation. For each medical records the following data were recorded the characteristics of patients and of kidney donor. Blood creatinine, blood urea, blood sodium, blood potassium, blood calcium levels were collected at the day before the surgery, the day of surgery, after 6 hours (hrs), 12 hrs, 24 hrs, 48 hrs and 72 hrs. Diuresis, urinary sodium and urinary potassium levels were collected at the day of surgery, after 6 hrs, 12 hrs, 24 hrs, 48 hrs and 72 hrs. Results We collected data from 66 medical reports. Blood creatinine levels at 6 hrs, 12 hrs and 24 hrs were significantly lower in roc + sug group than cis + neo group (crea 6 hrs =0.05, crea 12 hrs p=0.038, crea 24 hrs p= 0.049). Blood urea levels for 24 hrs after the transplantation were significantly lower in in roc + sug group than cis + neo group (urea 0 hrs p=0.025, urea 6 hrs p= 0.011, urea 12 hrs p=0.03, urea 24 hrs p=0.011). We found no statistically significant differences in blood sodium, blood potassium, blood calcium, diuresis, urinary sodium, urinary potassium levels before and after the transplantation.Conclusions In this retrospective case-control study, the use of rocuronium and sugammadex during the renal transplant surgery did not affect the recovery of the graft function during the first week after the transplantation.
Magnitude of Uncontrolled Hypertension and Associated Factors among Adult Hypertensive Patients in Public Hospitals of Central Zone, Tigray, Ethiopia: A Cross-sectional Study 2018
Authors: Negash Assefa Iyasu , Siyoum Desta , Hailemariam Tsega , Kidanu Berihu Hailu , Gebremeskel Gebreamlak Gebremdhin , Weldesamuel Girmay Teklay , Zemichael Teklewoini Mariye , Gebreslassie Kefle Tekulu , Hagos Haftea 
Published: September 2019

Abstract
Background: - Uncontrolled hypertension is if SBP is ≥140 mm Hg and/or DBP ≥90 mm Hg for general hypertensive population or if SBP ≥130 mm Hg and/or DBP ≥80 mm Hg in patients with established diabetes mellitus or chronic kidney disease based on the average of two or more properly measured, seated, BP readings on each of two or more office visits. The aim of this study was to assess the magnitude of uncontrolled hypertension and associated factors among adult hypertensive patients in public hospitals of central zone, Tigray, Ethiopia, 2018. Methods:- A hospital based cross sectional study design was used. The study population was all sampled adult hypertensive patients who had follow up in public hospitals of central zone, Tigray and the data collection period was from March 01 to April 30, 2018. About 421 study participants were selected using systematic random sampling. Interviewer administered structured questionnaire, chart review checklist and measurements were used. The collected data was checked for its completeness manually and then entered and cleaned in to epi data version 3.1 and exported to Statistical packages for social science version 22 for analysis. Bivariate and multivariable analyses were done to identify factors of uncontrolled hypertension. Then those variables significant at p<0.25 with the outcome variable in bivariate analysis were selected for multivariable analysis and odds ratio with 95% confidence level was computed and p-value < 0.05 was described as a significant association in multivariable analysis. Result: - Among 421 respondents about 177(42%) had uncontrolled hypertension. Co-morbidity [AOR=0.36, (0.205, 0.631)], five to ten years duration of medication taken [AOR=0.398, (0.218, 0.725)], side effect of medication [AOR=0.542, (0.339, 0.866)] and medication adherence [AOR=4.092, (2.419, 6.924)] were significantly associated with uncontrolled hypertension. Conclusion: - In this study the magnitude of uncontrolled hypertension was high. Co-morbidity, antihypertensive medication taken for long duration, side effect of antihypertensive medication and non adherence to antihypertensive medication shows statistical association with uncontrolled hypertension.
The relationship between sleep duration and health status in Qatar’s population
Authors: Althani Maryam , Khaled Salma M 
Published: September 2019

Abstract
Background: Knowledge of correlates of sleep duration is limited to developed countries with dearth of studies conducted in countries of the Eastern Mediterranean Region (EMR). Qatar is a rapidly developing country in the EMR with three distinct population groups Qatari nationals (QNs) or natives; higher income white-collar expatriates (WCEs), and blue-collar workers (BCEs) who are mostly male laborers from South Asia. The. The aim of this study was to explore the association between sleep duration and chronic health conditions in a representative sample of Qatar’s general population. Methods: A total of 2,523 surveys were completed over the phone by trained interviewers; a final sample of 2,499 was retained. Descriptive and multinomial logistic regression analyses accounting for complex survey design were conducted in STATA 14. All regression models were adjusted for age, gender and social group using an alpha value of 0.05 for statistical significance. Results: The overall prevalence of sleeping < 7hrs was observed at 54%, while 42% of respondents reported sleeping 7-8hrs and 4% reported sleeping > 8hrs in the general population of Qatar. Participants who reported the poorest health status had increased odds of sleeping < 7hrs (OR 1.38, P=0.04) compared with those who reported good health after adjustment for covariates. Additionally, participants with two or more diagnosed illnesses had higher odds of sleeping < 7hrs (OR 1.58, P=0.02) compared to healthy participants. An increase in odds of sleeping < 7hrs was also observed in participants with obesity (OR 1.58, P=0.02). Conclusion: Qatar’s population exhibited high prevalence of short sleep duration, which was significantly associated with poor rated health, obesity, and chronic illness independent of age, gender, or social class.
Characteristics and Outcome of Influenza-Associated Encephalopathy/Encephalitis Among Children In A Tertiary Pediatric Hospital In Italy, 2017-2019
Authors: Mastrolia Maria Vincenza , Rubino Chiara , Resti Massimo , Trapani Sandra , Galli Luisa 
Published: September 2019

Abstract
BACKGROUND: Influenza is the most frequent cause of acute upper respiratory tract infections during winter season. Although rare, neurological manifestations are known to occur during influenza infection and approximatively three-quarters of cases are in children. In this study, we aimed to characterize the burden and clinical spectrum of influenza-associated encephalopathy and encephalitis in children admitted at a tertiary pediatric hospital in Italy over two influenza seasons (2017-2019).METHODS: We retrospectively analyzed clinical, laboratory, instrumental data and outcome of patients discharged with ICD9-CM 487.0 code RESULTS: Fifteen children (13.1% of those discharged with a diagnosis of influenza infection in the study period), had influenza-associated central nervous system (CNS) manifestations. Eight patients (53.3%) were diagnosed as influenza encephalitis, 7 (46.7%) as influenza encephalopathy. Median age was 27 months. In children under 2 years of age (40% of all cases) altered consciousness was the most frequent neurological manifestation while respiratory symptoms were present at admission in all cases. Younger children also required intensive care support more frequently. Five subjects (33.3%) presented comorbidity. None of the patients had received seasonal influenza vaccination. The median time from onset of respiratory signs to onset of neurological manifestations was 24 hours. Cerebrospinal fluid (CSF) analysis was normal in most patients and polymerase chain reaction for influenza virus RNA on CSF, when performed, was negative in all samples. Neuroradiological investigations, performed in 5 children, reported cortical and subcortical white matter signal alterations. Oseltamivir was administered only in 2 cases. Fourteen patients recovered without sequelae, and only a 2-year-old girl had minimal impairment in fine motor skills at discharge. CONCLUSIONS: All children presenting acute neurological features during influenza season should be evaluated for influenza-associated CNS complications even if the respiratory involvement is mild. Absence of underlying diseases or other risk factors are not protective factors against CNS influenza-associated complications. The lack of CSF pleocytosis does not exclude CNS involvement. Children under 2 years of age are at higher risk of requiring intensive care support.
Cross-resistance of the pathogenic fungus Alternaria alternata to fungicides with different modes of action
Authors: Yang Li-Na , He Meng-Han , Ouyang Hai-Bing , Zhu Wen , Pan Zhe-Chao , Sui Qi-Jun , Shang Li-Ping , Zhan Jiasui 
Published: September 2019

Abstract
Background: Cross-resistance, a phenomenon that a pathogen resists to one antimicrobial compound also resists to one or several other compounds, is one of major threats to human health and sustainable food production. It usually occurs among antimicrobial compounds sharing the mode of action. In this study, we determined the sensitivity profiles of Alternaria alternata , a fungal pathogen which can cause diseases in many crops to two fungicides (mancozeb and difenoconazole) with different mode of action using a large number of isolates (234) collected from seven potato fields across China. Results: We found that pathogens could also develop cross resistance to fungicides with different modes of action as indicated by a strong positive correlation between mancozeb and difenoconazole tolerances to A. alternata . We also found a positive association between mancozeb tolerance and aggressiveness of A. alternata , suggesting no fitness penalty of developing mancozeb resistance in the pathogen and hypothesize that mechanisms such as antimicrobial compound efflux and detoxification that limit intercellular accumulation of natural/synthetic chemicals in pathogens might account for the cross-resistance and the positive association between pathogen aggressiveness and mancozeb tolerance. Conclusions: The detection of cross-resistance among different classes of fungicides suggests that the mode of action alone may not be an adequate sole criterion to determine what components to use in the mixture and/or rotation of fungicides in agricultural and medical sects. Similarly, the observation of a positive association between the pathogen’s aggressiveness and tolerance to mancozeb suggests that intensive application of site non-specific fungicides might simultaneously lead to reduced fungicide resistance and enhanced ability to cause diseases in pathogen populations, thereby posing a greater threat to agricultural production and human health. In this case, the use of evolutionary principles in closely monitoring populations and the use of appropriate fungicide applications are important for effective use of the fungicides and durable infectious disease management.
Humic Acid Buildup Increases Carbon Dioxide Emissions from Redox‐Oscillating Upland Soils while Catalyzing Iron(III) Reduction and Phosphorus Desorption
Authors: Wilmoth Jared L. , Sexstone Alan J. , McDonald Louis M. 
Published: September 2019

Humic substances comprise chemically and physically complex forms of organic C that are recognized to be involved in the catalytic cycling of electrons in diverse biogeochemical reactions. Recent investigations have indicated that humic substances existing in redox‐dynamic terrestrial environments, such as intermittently wet soils, may be uniquely important for regulating greenhouse gas emissions. However, many relevant studies have relied on the use of commercially available humic substances and/or synthetic humic analogs. In the present study, during a 42‐d anoxic incubation, we investigated the regulatory and catalytic effects of increasing concentrations of site‐specific (i.e., native) humic acid (HA) in an Appalachian upland soil known to experience redox‐oscillating conditions in the field. Extracted native HA was characterized using 13C nuclear magnetic resonance (13C‐NMR), Fourier transformed infrared (FT‐IR), and total CHNS elemental analyses. We found that native HA was relatively enriched in aromatic and amino acid C. Increasing concentrations of native HA added at the start of soil incubations led to higher rates of CO2 emission and microbial Fe(III) reduction, indicating that a buildup of soil HA allows for a greater number of electrons to shuttle between Fe(III) reducers and Fe(III) electron acceptors during microbial oxidation of organic C. Treatments with native HA were also compared against a synthetic HA‐analog treatment containing 0.2 g anthraquinone‐2,6‐disulfonic acid (AQDS) kg−1 dry soil to investigate catalytic electron cycling by native HA and AQDS. Our data suggest that the buildup of native humic substances, which are relatively rich in aromatic and amino acid C, leads to globally relevant increases in CO2 emissions, the redox cycling of Fe, and the availability of organic P after transition to anaerobic conditions in upland soils.Core Ideas
Humic acid buildup increases CO2 emissions from anaerobic soil.
Humic acid buildup catalyzes increasing rates of electron transfer.
Iron complexation and reduction by humic acid appear to be simultaneous.