bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation of a complex intervention to improve participation in older people with joint contractures living in nursing homes: A process evaluation of a cluster-randomised pilot trial
Authors: Klingshirn Hanna , Müller Martin , Beutner Katrin , Hirt Julian , Strobl Ralf , Grill Eva , Meyer Gabriele , Saal Susanne 
Published: September 2019

Abstract
Background Joint contractures in frail older people are associated with serious restrictions in participation. We developed the Participation Enabling CAre in Nursing (PECAN) intervention, a complex intervention to enable nurses to promote participation in nursing home residents with joint contractures. The aim of this study was to examine the feasibility of the implementation strategy and to identify enablers and barriers for a successful implementation. Methods The implementation of PECAN was investigated in a 6-month pilot cluster-randomised controlled trial (c-RCT). As a key component of the implementation strategy, nominated nurses were trained as facilitators in a one-day workshop and supported by peer-mentoring (visit, telephone counselling). A mixed-methods approach was conducted in conjunction with the pilot trial and guided by a framework for process evaluations of c-RCTs. Data were collected using standardised questionnaires (nursing staff), documentation forms, problem-centred qualitative interviews (facilitators, therapists, social workers, relatives, peer-mentors), and a group discussion (facilitators). A set of predefined criteria on the nursing home level was examined. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed using directed content analysis. Results Seven nursing homes (n=4 intervention groups, n=3 control groups) in two German regions took part in the study. Facilitators responded well to the qualification measures (workshop participation: 14/14; workshop rating: “good”; peer-mentor visit participation: 10/14). The usage of peer-mentoring via telephone varied (one to seven contacts per nursing home). Our implementation strategy was not successful in connection with supplying the intervention to all the nursing staff. The clear commitment of the entire nursing home and the respect for the expertise of different healthcare professionals were emphasised as enablers, whereas a lack of impact on organisational conditions and routines and a lack of time and staff competence were mentioned as barriers. Conclusion The PECAN intervention was delivered as planned to the facilitators but was unable to produce comprehensive changes in the nursing homes and subsequently for the residents. Strategies to systematically include the management and the nursing team from the beginning, are needed to support the facilitators during implementation in the main trial.
The Effect of Positive Mental Imagery on Labor Pain Tolerance in Primiparous Women Referred to Atieh Teaching-Medical Center of Hamadan, Iran, 2018
Authors: Yavari Caroline , Masoumi Seyedeh Zahra , Kazemi Farideh , Refaei Mansoureh , Yaghoobi Abolghasem 
Published: September 2019

Abstract
Background: Childbirth is an important experience in the woman's life; and its quality has short- and long-term effects on them. The present study aimed to determine the effect of positive mental imagery on the labor pain tolerance in primiparous women referred to Atieh teaching-medical center in Hamadan.Method: The present clinical trial study was conducted on 90 primiparous mothers referred to Atieh Hospital of Hamadan in interventional (n= 45) and control (n= 45) groups. Data collection tools included demographic information forms, Behavioral pain scale, Visual analogue scale (VAS), and the birth registration checklist that were responded by both groups through interviews and observation during labor. The intervention group participated in 4 weekly counseling sessions in groups of 5 to 7 participants, but the control group received only routine care. Finally, the obtained data from above questionnaires was analyzed using SPSS 21 and analysis of covariance (ANCOVA), Independent t-test and chi-square test and the significance level of tests was considered to be at the level of 5%.Results: The research results indicated that the mean age of control and intervention groups was 25.98±4.82 and 25.32± 4.85 respectively. The mean scores of Visual analogue scale (VAS) and the Behavioral Pain Scale significantly decreased compared to the control group (P <0.001). The mean scores of behavioral changes in the intervention group were 1.77 ± 0.68, 2.39± 0.54 and 3.09±0.60 in 4-5 cm, 6-7 cm and 8-10 cm dilatations respectively. That was statistically significant decrease compared to the control group (P=0.005). Conclusion: Positive mental imagery counseling reduced the visual analogue intensity and behavioral pain intensity in primiparous women. It seems that continuing education and counseling during pregnancy and empowering mothers to control themselves and learn mental imagery techniques and practice during pregnancy and childbirth can help mothers to more relax and alleviate the labor pain intensity.Trial registration: Trial Registration Clinical Trial Registry: IRCT20120215009014N242.Registered on 2017-09-10. https://en.irct.ir/trial/9621Sampling start date:2018-10-23
Single Pass Whole-Body versus Organ-Selective Computed Tomography for Trauma: Timely diagnosis versus radiation exposure? – An observational Study
Authors: Ordoñez Carlos , Valle Ana Milena Del , Parra Michael , Guzman-Rodriguez Monica , Herrera-Escobar Juan P. , Garcia Carlos , García Alberto F. , Munevar Hernan E. , Navarro Constanza , Salas Alejandra De Las , Ibarra Laura C. , Holguin Alfonso 
Published: September 2019

Abstract
Background Single Pass Whole-Body Computed Tomography (WBCT) has been used as a high yield diagnostic tool in trauma. However, increased exposure to radiation and delay in treatment, have been cited as challenges to its widespread use. We hypothesized that WBCT has at least the same radiation exposure compared to Organ-Selective CT and it does not inflict further delays in treatment. Methods We retrospectively review all trauma patients in whom CT-scans were performed on arrival at a Level I Trauma Center from January, 2016 to December, 2017. Results 123 patients were included: 53 in the OSCT group and 70 in the WBCT group. In the OSCT group, 64.1% of the patients had penetrating trauma and chest injuries were the most common injured body cavity (79.3%). In the WBCT group, 65.7% had blunt trauma and head injuries were the most common (71.9%) injured organ. The OSCT group required subsequent trips to the scanner suite for follow-up studies to rule out other potential injuries which in turn did not occur in the WBCT group (47.2% vs 0%, p< 0.001). The total radiation exposure dose was higher in the OSCT group compared to the WBCT group [22 mSv (IQR 6-31) vs 15.1 mSv (IQR 9.9-24.8) p<0.001]. Conclusion OSCT has the potential of missing potentially life threatening injuries that require subsequent follow-up scans. This, in turn, would increase the patient’s overall radiation exposure and potentially delay definitive surgical treatment. Trauma patients undergoing WBCT had lower total radiation exposure with no delay in treatment.
Opportunity costs of postpartum care: A national survey of U.S. providers’ priorities and practice
Authors: Krishnamurti Tamar , Simhan Hyagriv N , Borrero Sonya 
Published: September 2019

Abstract
Background: In the wake of new guidelines for improved postpartum care, we examined postpartum care providers’ views to identify aspects of care that may be inefficient, as well as tradeoffs that may be being made between different types of critical care, given a provider’s limited time with each patient. Methods: We surveyed 600 randomly-sampled U.S. providers about postpartum care timing, the priority of specific aspects of care, and the frequency with which they are provided. Results: The survey response rate was 43% across medical specialties. More than 40% of providers reported a single 6-week visit (or more infrequent care) is optimal, regardless of new guidelines. Certain types of postpartum care critical to minimizing maternal mortality risk (e.g., depression screening), were highly valued and routinely performed. Other aspects of care (e.g., pelvic exam), were identified as systematic inefficiencies. Screening for intimate partner violence and addiction were performed less often than similarly-valued care. Certain types of care (e.g. transitioning to parenthood), were identified as crucial but were not currently addressed by national postpartum care practice guidelines. Approximately 25% of respondents regarded distance care as a feasible alternative to much of the postpartum care currently provided in-person. Conclusions: Critical opportunity costs in postpartum care delivery were identified that could have implications for maternal mortality risk. Clear guidelines on the highest value care for each visit, and which practitioner should provide that care, could diminish the burden faced by postpartum care providers, improving universal delivery of needed postpartum care. Complementary distance care (telemedicine or evidence-based apps) represents a novel and potentially equitable approach to implementing new care recommendations.
An exploration of health workers risks of contracting tuberculosis at workplace: a qualitative study
Authors: Mwenya Shadreck - , Stapley Salley 
Published: September 2019

Abstract
Abstract; Background To explore the perceptions of health workers on the risks of contracting tuberculosis at Namwala District Hospital. Tuberculosis literature indicates that health workers are at risk of contracting tuberculosis whilst conducting their daily duties at the workplace mainly due to low tuberculosis awareness. It is against this empirical evidence that this study was conducted to further explore health workers risky behavior, attitude and practices that expose them to tuberculosis infection when on duty and eventually generate effective health promotion and public health interventions. Methods Semi-structured interviews lasting between 35 to 45 minutes were conducted to each participant. A volunteer sampling technique was used to recruit ten participants for this study. All ten interviews were audio recorded in order to enhance consistency during data analysis process. Interview materials were transcribed verbatim, coded and themes generated to form thematic networks. Data analysis was conducted using thematic analysis strategy. Results Four themes were identified; 1. Health workers personal safety : participants reported wearing uniforms and gloves but they were not putting-on face masks hence, exposing themselves to tuberculosis infection. 2. Infection prevention practices : hand washing was described by many participants as a universal method of protecting health staff from the risks of contracting tuberculosis at the hospital however, few health workers frequently washed their hands after attending to tuberculosis patients. 3. Health workers working environment : the working environment at the hospital was not conducive for both health workers and patients due to poor ventilation, unhygienic conditions, overcrowding and lack of an isolation ward. 4. Health promotion : awareness on tuberculosis was reported to be low and no refresher training was conducted to health workers at the hospital. Conclusion The risks of contracting tuberculosis by health workers at Namwala District Hospital did exist hence, a need of advocating for tuberculosis awareness to health workers through appropriate health promotion interventions. Health policy should focus on continuous health promotion activities on prevention and control of tuberculosis at health facilities and communities.
Genetic polymorphisms of CYP2C9/CYP2C19 in chronic obstructive pulmonary disease
Authors: Lu Hui , Yang Yixiu , Xu Dongchuan , Feng Qiong , Sun Juan , Li Quanni , Zhao Jie , Zhou Xiaoli , Niu Huan , He Ping , Liu Jianfang , ding yipeng 
Published: September 2019

Abstract
Background : Chronic obstructive pulmonary disease (COPD) has a high incidence in elderly and significantly affects the quality of life. CYP2C9 and CYP2C19 have an important role in tobacco-related diseases and inflammatory reaction. Thus, in this study we aims to investigate the association between CYP2C9 / CYP2C19 polymorphisms and the risk of COPD. Methods: A total of 821 subjects were recruited which including 313 COPD patients and 508 healthy controls. Seven SNPs of CYP2C9 / CYP2C19 were selected for genotyping. The Odds ratios (ORs) and 95% confidence interval (95% CI) were calculated using a logistic regression analysis to evaluate the association between COPD risk and CYP2C9 / CYP2C19 polymorphisms. Results: The rs9332220 of CYP2C9 “A” allele was associated with reducing COPD risk (OR = 0.64, 95% CI = 0.43 – 0.94, p = 0.021). And rs11853758 “G” allele carrier could significantly decrease 0.35-fold COPD risk compared with T allele carrier (OR = 0.65, 95% CI = 0.45 – 0.96, p = 0.027). Furthermore, gender-based stratification analysis showed that rs9332220 and rs11853758 polymorphisms were associated with risk of COPD in males. Conclusions: Our study firstly reported the effects of CYP2C9 and CYP2C19 genetic variants on COPD risk. We found that rs9332220 in CYP2C9 and rs11853758 in CYP2C19 were associated with a reduced susceptibility to COPD.
Neonatal Near Miss and its associated factors at Injibara General Hospital, Awi Zone, Northwest Ethiopia, 2019
Authors: Belay Habtamu Gebrehana , Limenih Simachew Kassa , Wassie Toyiba Hiyaru , Ambie Minale Bezie 
Published: September 2019

Abstract
Background: Neonatal mortality is a significant problem in many low-resource countries, yet for every death there are many more new-born who suffer a life-threatening complication but survive. Neonatal near miss has been proposed as a tool for assessment of quality of care in neonates who suffered any life-threatening condition. However, there was limited evidence on magnitude of neonatal near miss and determinant factors in Ethiopia. The aim of this study was to assess proportion and associated factors of neonatal near miss among deliveries at Injibara General Hospital, Awi Zone, Northwest Ethiopia, 2019. Methods: Institutional based cross sectional study was conducted from February 1, 2019 to April 30, 2019 among 404 live births. Structured and pretested questioner used for mothers and structured checklist for neonates. Bivariate and multivariate logistic regressions model were fitted to identify factors associated with neonatal near miss. An adjusted odds ratio with 95 % confidence interval (CI) was computed to determine the level of significant. Result: Proportion of neonatal near miss was found to be 23.3 % with 95% CI: (19.1% -27.7%). Primiparous[Adjusted odds ratio(AOR):2.01, 95%CI:(1.03-3.95)], referral linkage [AOR:3.23, 95%CI:(1.89-5.513)], maternal perception of reduced fetal movement[AOR:5.95, 95%CI:2.47-14.33], premature rupture of membrane [AOR: 3.10, 95%CI: (1.27-5.59)], prolonged labor [AOR: 3.00, 95%CI:(1.28-7.06)], obstructed labor/cephalo-pelvic disproportion [AOR: 4.05; 95%CI: (1.55-10.57)] and non-reassuring fetal heart rate pattern [AOR: 3.75, 95%CI: (1.69-8.33)] were significantly associated with neonatal near miss. Conclusion: Proportion of neonatal near miss in the study area was found to be higher than studies in WHO neonatal near miss systemic review. Efforts needed to continue compressive maternal and neonatal care to avoid preventable causes of neonatal morbidity and mortality . Keywords: Neonatal Near Miss, Proportion, Awi Zone, Ethiopia
Prevalence of surgical site infection and associated factors after cesarean section in Ethiopia: systematic review and meta-analysis
Authors: Getaneh Temesgen , Negesse Ayenew , Dessie Getenet 
Published: September 2019

Abstract
Background Surgical site infection (SSI) affects up to one third of patients who have undergone a surgical procedure. It is a significant cause of surgical patient morbidity, mortality and human and financial costs threat. The national prevalence of surgical site infection among mothers who undergo for cesarean section and its risk factors are not well investigated in Ethiopia. Therefore, this systematic and meta-analysis conducted to estimate the pooled prevalence of surgical site infection and associated factors after cesarean section in Ethiopia.Methods Original articles were searched in PubMed/MEDLINE, EMBASE, CINAHL, Google Scholar, HINARI portal (which includes the SCOPUS, African Index Medicus, and African Journals Online databases), and Cochrane Library. Data were extracted using a standard data extraction checklist that developed according to Joanna Briggs Institute (JBI). The I2 statistic was used to quantify heterogeneity across studies. Funnel plot asymmetry and Egger’s tests were used to check for publication bias. A fixed effect model was used to estimate the pooled prevalence of surgical site infection. Odds Ratio (OR) with 95% Confidence Interval (CI) was also used to determine the association of identified variables with surgical site infection. Statistical analysis was conducted using STATA software.Result From initial 179 identified articles, 11 were eligible for inclusion in the final meta-analysis. The pooled estimate of surgical site infection after cesarean section in Ethiopia was 9.72% (95%CI: 8.38, 11.05). PROM >12hrs (OR=5.02, 95%CI: 2.65, 9.51), duration of labor>24hrs (OR=3.69, 95%CI: 2.41, 5.65), chorioamnionitis (OR=9.11, 95%CI: 5.21, 15.93), anemia (OR=4.75, 95%CI: 2.42, 9.33) and having vertical skin incision (OR=4.17, 95%CI: 2.90, 6.02) were factors significantly associated with surgical site infection after cesarean section.Conclusion The prevalence of surgical site infection after cesarean section in Ethiopia was high. Therefore, Minister of Health with its stake holders should emphasis on community and institution based programs in manner to prevent those factors listed above that have significant effect on surgical site infection.
Comparative genomic analysis of the Hafnia genus reveals an explicit evolutionary relationship between the species alvei and paralvei and provides insights into pathogenicity
Authors: Bin Liu , Yin Zhiqiu , Yuan Chao , Du Yuhui , Yang Pan , Qian Chengqian , Wei Yi , Zhang Si , Huang Di 
Published: September 2019

Abstract
Background The Hafnia genus is an opportunistic pathogen that has been implicated in both nosocomial and community-acquired infections. Although Hafnia is fairly often isolated from clinical material, its taxonomy has remained an unsolved riddle, and the involvement and importance of Hafnia in human disease is also uncertain. Here, we used comparative genomic analysis to define the taxonomy of Hafnia, identify species-specific genes that may be the result of ecological and pathogenic specialization, and reveal virulence-related genetic profiles that may contribute to pathogenesis. Results One complete genome sequence and 19 draft genome sequences for Hafnia strains were generated and combined with 27 publicly available genomes. We provided high-resolution typing methods by constructing phylogeny and population structure based on single-copy core genes in combination with whole genome average nucleotide identity to identify two distant Hafnia species (alvei and paralvei) and one mislabeled strain. The open pan-genome and the presence of numerous mobile genetic elements reveal that Hafnia has undergone massive gene rearrangements. Presence of species-specific core genomes associated with metabolism and transport suggests the putative niche differentiation between alvei and paralvei. We also identified possession of diverse virulence-related profiles in both Hafnia species., including the macromolecular secretion system, virulence, and antimicrobial resistance. In the macromolecular system, T1SS, Flagellum 1, Tad pilus and T6SS-1 were conserved in Hafnia, whereas T4SS, T5SS, and other T6SSs exhibited the evolution of diversity. The virulence factors in Hafnia are related to adherence, toxin, iron uptake, stress adaptation, and efflux pump. The identified resistance genes are associated with beta-lactamases and tetracycline. These virulence-related profiles identified at the genomic level provide insights into Hafnia pathogenesis and the differentiation between alvei and paralvei. Conclusions Our research using core genome phylogeny and comparative genomics analysis of a larger collection of strains provides a comprehensive view of the taxonomy and species-specific traits between Hafnia species. Deciphering the genome of Hafnia strains possessing a reservoir of macromolecular secretion systems, virulence factors, and resistance genes related to pathogenicity may provide insights into addressing its numerous infections and devising strategies to combat the pathogen.
HLA-B*5701 Allele Prevalence in Treatment-Naïve HIV-Infected Patients from Colombia
Authors: Martínez-Buitrago Ernesto , Oñate José Millán , García-Goez José Fernando , Álvarez Jorge , Lenis William , Sañudo Luz Marina , Rubiano Luisa Consuelo 
Published: September 2019

Abstract
IBackground: The HLA-B*57:01 allele is associated with a hypersensitivity reaction to abacavir. Due to the lack of knowledge of HLA-B*57:01 prevalence in Colombia, routine screening is not performed and is not recommended by the national guidelines. We aimed to determine the prevalence of HLA-B*57:01 in HIV population from Colombia. Methods: This cross-sectional study included naïve HIV-infected adults from 13 cities of the country. The presence of HLA-B*57:01 was determined by using SSP-PCR in blood samples. Prevalence rates were stratified by sex, race, and region of origin. Results: HLA-B*57:01 allele prevalence in Colombian HIV-infected individuals was 2.7%. When stratifying for the race, the prevalence was 4% for whites, 2.6% for other race (mainly mestizo), and 1.9% for Afro-Colombians. The prevalence varied from 0% up to 11.4% depending on the department of origin. The highest prevalence rates were found in Caldas (11.4%), Antioquia (5%), Risaralda (4.8%), and Valle del Cauca (4.3%). When distributed by country zones, the central, with a racial predominance of Caucasians and mestizos, was the highest (6.0%, 0R=4.1, CI 1.2 – 12.8, p=0,016). Conclusions: The overall prevalence of HLA-B*57:01 in Colombia was lower than the reported rates for other Latin American countries such as Brazil, Costa Rica, and Argentina, but similar in comparison to Chile and Mexico. The diversity in the racial and ethnic heritage shown in our data supports the recommendation to implement routine screening for the HLA-B*57:01 allele before initiation of abacavir-containing antiretroviral therapy in the Colombian HIV management guidelines.