bluuebunny/crossref_metadata_2025_split huggingface dataset:
Automated phone call and text reminders for childhood immunisations (PRIMM): a randomised controlled trial in Nigeria
Authors: Ekhaguere Osayame A , Oluwafemi Rosena O , Badejoko Bolaji , Oyeneyin Lawal O , Butali Azeez , Lowenthal Elizabeth D , Steenhoff Andrew P 
Published: April 2019

BackgroundSub-Saharan Africa has high under-5 mortality and low childhood immunisation rates. Vaccine-preventable diseases cause one-third of under-5 deaths. Text messaging reminders improve immunisation completion in urban but not rural settings in sub-Saharan Africa. Low adult literacy may account for this difference. The feasibility and impact of combined automated voice and text reminders on immunisation completion in rural sub-Saharan Africa is unknown.MethodsWe randomised parturient women at the Mother and Child Hospitals Ondo State, Nigeria, owning a mobile phone and planning for child immunisation at these study sites to receive automated call and text immunisation reminders or standard care. We assessed the completion of the third pentavalent vaccine (Penta-3) at 18 weeks of age, immunisation completion at 12 months and within 1 week of recommended dates. We assessed selected demographic characteristics associated with completing immunisations at 12 months using a generalised binomial linear model with ‘log’ link function. Feasibility was assessed as proportion of reminders received.ResultsEach group had 300 mother−baby dyads with similar demographic characteristics. At 18 weeks, 257 (86%) and 244 (81%) (risk ratio (RR) 1.05, 95% CI 0.98 to 1.13; p=0.15) in the intervention and control groups received Penta-3 vaccine. At 12 months, 220 (74%) and 196 (66%) (RR 1.12, 95% CI 1.01 to 1.25; p=0.04) in the intervention and control groups received the measles vaccine. Infants in the intervention group were more likely to receive Penta-3 (84% vs 78%, RR 1.09, 95% CI 1.01 to 1.17; p=0.04), measles (73% vs 65%, RR 1.13, 95% CI 1.02 to 1.26; p=0.02) and all scheduled immunisations collectively (57% vs 47%, RR 1.13, 95% CI 1.02 to 1.26; p=0.01) within 1 week of the recommended date. No demographic character predicted immunisation completion. In the intervention group, 92% and 86% reported receiving a verification reminder and at least one reminder during the study period, respectively.ConclusionPaired automated call and text reminders significantly improved immunisation completion and timeliness.Trial registration numberNCT02819895.
Socioeconomic factors associated with choice of delivery place among mothers: a population-based cross-sectional study in Guinea-Bissau
Authors: Yaya Sanni , Bishwajit Ghose , Gunawardena Nathali 
Published: April 2019

BackgroundMaternal death outcome remains high in Guinea-Bissau. Delivery-related complications and maternal mortality could be prevented by increasing women’s access to skilled pregnancy care. Socioeconomic status (SES) is often associated with low health service utilisation in low/middle-income countries. In Guinea-Bissau, little is known on the relationship between SES and use of health facility for delivery. In this study, we examined the association between women’s choice of health facility delivery with their SES.MethodsCurrent data from Multiple Indicator Cluster Survey conducted in Guinea-Bissau, 2014 were used in this study. The place of delivery (home or health facility) was the outcome variable of interest using 7532 women of reproductive age (15–49 years). Respondents’ characteristics were described by summary statistics, while multivariable logistic regression model was used to examine the association of demographic and socioeconomic characteristics on facility-based delivery. Adjusted ORs, 95% CIs and p values were computed to identify significant determinants.ResultsResults show that in proportion of women delivering at home was higher than of delivery at a health facility. Overall percentage of women who delivered at health facility was 39.8%, with the rate being substantially higher among urban (67.8%) compared with their rural (30.2%) counterparts. Percentage of delivering at home was highest in Oio region (23.8%) and that of delivery at a health facility was highest in the Sector Autónomo de Bissau region (18.7%). In the multivariable analysis, women in urban areas compared those who had no education, those who had primary and secondary/higher level of education were 2.2 and 3.3 times more likely to deliver at a health facility. The odds of facility were also highest among the women from the richest households, 5.3 and 5 times among urban and rural women, respectively.ConclusionBased on these findings, the study concludes that the percentage of health facility delivery is low in Guinea-Bissau, which can be promoted through scaling up women’s SES. The findings could guide healthcare policy-makers to address the issue of unskilled delivery services and increase the use of facility-based delivery particularly among the disadvantaged women.
Exploring determinants of health provider choice and heterogeneity in preference among outpatients in Beijing: a labelled discrete choice experiment
Authors: Zhu Jingrong , Li Jinlin , Zhang Zengbo , Li Hao , Cai Lingfei 
Published: April 2019

ObjectiveFor a long time in China, public hospitals have been the most prominent provider of healthcare. However, recent policy reforms mean the private sector is experiencing rapid development. Thus, the purpose of this study is to detect whether the policies published by the government aimed to improve the quality of healthcare services were catering to patient’s preferences.Participants and methodsOur work uses dental care as an example of services provided in outpatient setting and takes advantage of a labelled discrete choice experiment with a random sample of respondents from Beijing. Participants were asked to make a choice between four healthcare providers with different attributes. Mixed logit and latent class models were used for the analysis.ResultCare provided by high-level private hospitals and community hospitals were valued RMB154 and 216 less, respectively, than care provided by class A tertiary hospitals, while the most disliked provider was private clinics. This was the most valued attribute of dental care. Respondents also value: lower waiting times, the option to choose their doctor, lower treatment costs, shorter travel times and a clean waiting room. However, when the level of provider was analysed, the prevailing notion that patients in China were always likely to choose public services than private services no longer holds. Four classes of patients with distinct preferences for dental care provider choice were identified, which can partly be explained by age, income, experience and Hukou status—a household registration permit.DiscussionThe study to some extent challenged the overwhelming predominance of public healthcare providers in China. The preference heterogeneity we found was relatively large. Our findings are significant for providers in developing more specific services for patients and for policymakers in weighing the pros and cons of future initiatives in medical reform.
Social deprivation, gender and obesity: multiple stigma? Results of a population survey from Germany
Authors: Makowski Anna Christin , Kim Tae Jun , Luck-Sikorski Claudia , von dem Knesebeck Olaf 
Published: April 2019

ObjectivesIndividuals with obesity are subject to stigmatisation, resulting in discrimination. Studies focusing on obesity stigma often do not account for social conditions that also may be associated with stigmatisation. Following an intersectional approach, social categories such as gender and socioeconomic status (SES) can interact and form a basis for multiple stigma. The present study analyses differences in public obesity stigma depending on gender and SES, as well as possible interdependencies between these social categories.DesignRepresentative cross-sectional telephone survey.Participants692 randomly selected adults (≥ 18 years) in Germany.MethodsDifferent vignettes were presented, depicting a lawyer (male/female) or a janitor/cleaner (male/female) with obesity. Following the vignette, different components of stigma were assessed: (1) fat phobia, (2) emotional reactions to a person with obesity and (3) desire for social distance. Associations between gender, SES and stigma components were tested in multiple linear regression analyses.ResultsA low SES in the obesity vignette (janitor/cleaner) was significantly associated with higher fat phobia scores as well as desire for social distance, compared with the vignette with a person with obesity and a high SES (lawyer). Being a male with obesity was significantly associated with more pronounced negative emotional reactions and greater desire for social distance. There were no significant interaction effects between gender and SES.ConclusionsResults support the hypothesis of multiple stigma. Being male or of low SES was significantly associated with more pronounced negative attitudes in the German public. Following the concept of intersectionality, our findings indicate that obesity stigma can exacerbate pre-existing inequalities. This needs to be considered in development and implementation of prevention and anti-stigma measures.
Does time spent in the residential neighbourhood moderate the relationship between neighbourhood walkability and transport-related walking? a cross-sectional study from Toronto, Canada
Authors: Chum Antony , Atkinson Peter , O’Campo Patricia 
Published: April 2019

ObjectivesStudies have investigated the influence of neighbourhood walkability on residents’ walking behaviour, aiming to increase physical activity and reduce dependence on automobiles. Previous research, however, has not considered how the amount of time spent in the residential neighbourhood may modify this relationship. Our objective was to determine how time spent in the residential neighbourhood affects the relationship between neighbourhood walkability and walking for transport.DesignUsing a cross-sectional sample of 2411 adults, we analysed the association between walkability (an index combining land-use mix, dwelling density and street connectivity) and transport-related walking (controlling for the effects of gender, age, income, self-rated health and regular access to private transport) testing for interactions by time spent in the neighbourhood.Primary outcome measureMinutes spent walking for transport per week.SettingToronto, Canada.ParticipantsParticipants were aged 25 to 65. The survey had a 72% response rate.ResultsAfter adjusting for potential confounders, the walkability index was weakly associated with walking (1 SD of walkability score is associated with 0.25 more minutes walking/week, p<0.01). Land-use mix was more strongly associated with walking than the walkability index. Time spent at the residential neighbourhood modified the relationship between land-use mix and transport-related walking in a dose-effect manner (p<0.01), those spending 5 hours on average at their residential neighbourhood have 0.2 min/day more walking for each additional land-use mix score and those spending 12 hours have 0.5 min/day more walking for each additional land-use mix score.ConclusionsOur findings suggest that walkability is associated with increased walking time, but it is modified by time spent in the neighbourhood. Our study underscores the importance of testing ‘time spent in the neighbourhood’ as a modifier of environmental exposures in studies of environmental correlates of walking.
Qualitative descriptive study to explore nurses’ perceptions and experience on pain, agitation and delirium management in a community intensive care unit
Authors: Tsang Jennifer L Y , Ross Katie , Miller Franziska , Maximous Ramez , Yung Priscilla , Marshall Carl , Camargo Mercedes , Fleming Dimitra , Law Madelyn 
Published: April 2019

ObjectivesThe purpose of this study was to explore the experiences, beliefs and perceptions of intensive care unit (ICU) nurses on the management of pain, agitation and delirium (PAD) in critically ill patients.DesignA qualitative descriptive study.SettingThis study took place in a community hospital ICU located in a medium size Canadian city.ParticipantsPurposeful sampling was conducted. Participants included full-time nurses working in the ICU. Forty-six ICU nurses participated.MethodsA total of five focus group sessions were held to collect data. There were one to three separate groups in each focus group session, with no more than seven participants in each group. There were 10 separate groups in total. A semistructured question guide was used. Thematic analysis method was adopted to analyse the data, and to search for emergent themes and patterns.ResultsThree main themes emerged: (1) the professional perspectives on patient wakefulness state, (2) the professional perspectives on PAD management of critically ill patients and (3) the factors impacting PAD management. Nurses have different opinions on the optimal level of patient sedation and felt that many factors, including environmental, healthcare teams, patients and family members, can influence PAD management. This potentially leads to inconsistent PAD management in critically ill patients. The nurses also believed that PAD management requires a multidisciplinary approach including healthcare teams and patients’ families.ConclusionsMany external and internal factors contribute to the complexity of PAD management including the attitudes of nursing staff towards PAD. The themes emerged from this study suggested the need of a multifaceted and multidisciplinary quality improvement programme to optimise the management of PAD in the ICU.
Biomarkers of autonomic regulation for predicting psychological distress and functional recovery following road traffic injuries: protocol for a prospective cohort study
Authors: Pozzato Ilaria , Craig Ashley , Gopinath Bamini , Tran Yvonne , Dinh Michael , Gillett Mark , Cameron Ian 
Published: April 2019

IntroductionPsychological distress is a prevalent condition often overlooked following a motor vehicle crash (MVC), particularly when injuries are not severe. The aim of this study is to examine whether biomarkers of autonomic regulation alone or in combination with other factors assessed shortly after MVC could predict risk of elevated psychological distress and poor functional recovery in the long term, and clarify links between mental and physical health consequences of traffic injury.Methods and analysisThis is a controlled longitudinal cohort study, with follow-up occurring at 3, 6 and 12 months. Participants include up to 120 mild to moderately injured MVC survivors who consecutively present to the emergency departments of two hospitals in Sydney and who agree to participate, and a group of up to 120 non-MVC controls, recruited with matched demographic characteristics, for comparison. WHO International Classification of Functioning is used as the framework for study assessment. The primary outcomes are the development of psychological distress (depressive mood and anxiety, post-traumatic stress symptoms, driving phobia, adjustment disorder) and biomarkers of autonomic regulation. Secondary outcomes include indicators of physical health (presence of pain/fatigue, physical functioning) and functional recovery (quality of life, return to function, participation) as well as measures of emotional and cognitive functioning. For each outcome, risk will be described by the frequency of occurrence over the 12 months, and pathways determined via latent class mixture growth modelling. Regression models will be used to identify best predictors/biomarkers and to study associations between mental and physical health.Ethics and disseminationEthical approvals were obtained from the Sydney Local Health District and the research sites Ethics Committees. Study findings will be disseminated to health professionals, related policy makers and the community through peer-reviewed journals, conference presentations and health forums.Trial registration numberACTRN12616001445460.
Management of acute musculoskeletal pain (excluding low back pain): protocol for a systematic review and network meta-analysis of randomised trials
Authors: Busse Jason W , Craigie Samantha , Sadeghirad Behnam , Couban Rachel , Hong Patrick , Oparin Yvgeniy , May Curtis , Lok Annie , Guyatt Gordon H 
Published: April 2019

IntroductionAcute, non-low back-related musculoskeletal pain is common and associated with significant socioeconomic costs. No review has evaluated all interventional studies for acute musculoskeletal pain, which limits attempts to make inferences regarding the relative effectiveness of treatments.Methods and analysisWe will conduct a systematic review of all randomised controlled trials evaluating therapies for acute musculoskeletal pain (excluding low back pain). We will identify eligible, English-language, trials by a systematic search of the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Medline, Physiotherapy Evidence Database (PEDro) and the Cochrane Central Register of Controlled Trials (CENTRAL) from inception to February 2018. Eligible trials will: (1) enrol patients presenting with acute, non-low back-related musculoskeletal pain (duration of pain ≤4 weeks), and (2) randomise patients to alternative interventions or an intervention and a placebo/sham arm. Fractures will be considered ineligible, unless they are non-surgical and therapy is directed at pain relief. Pairs of reviewers will, independently and in duplicate, screen titles and abstracts of identified citations, review the full texts of potentially eligible trials and extract information from eligible trials. We will use a modified Cochrane instrument to evaluate risk of bias. Disagreements will be resolved through discussion to achieve consensus. We will use the Grading of Recommendations Assessment, Development and Evaluation approach to evaluate the quality of evidence supporting treatment effects. When possible, we will conduct: (1) in direct comparisons, a random-effect meta-analysis to establish the effectiveness of therapeutic interventions on patient-important outcomes; and (2) multiple treatment comparison meta-analysis to assess the relative effects of treatments. We will use a priori hypotheses to explain heterogeneity between studies. We will use STATA V.14.2 for all analyses.Ethics and disseminationNo research ethics approval is required for this systematic review, as no confidential patient data will be used. The results of this systematic review will be disseminated through publication in a peer-reviewed journal, conference presentations and will inform a clinical practice guideline.PROSPERO registration numberCRD42018094412.
How to strengthen clinical research in Shenzhen, China: qualitative study
Authors: Ji Ping , Chu Hongling , Zhang Chao , Xiao Ping , Liu Min , Zhou Liping , Wang Haibo , Wang Yanfang , Wu Yangfeng 
Published: April 2019

ObjectivesTo better understand the strengths and weaknesses, and to propose policy recommendations, regarding conducting high-quality clinical research in Shenzhen, China.DesignA qualitative study conducted from August to November 2016 using a semistructured interview format involving both focus group interviews and individual interviews.SettingShenzhen, China.ParticipantsStratified purposive and convenience sampling were used. Thirty individuals experienced in conducting and managing clinical research were selected from key stakeholder groups, comprising 11 from local hospitals, 14 from pharmaceutical/medical device companies and 5 from government agencies.MethodsA semistructured interview guide was developed by the study group and used by experienced interviewers in focus group discussions and individual interviews. The interviewees were encouraged to share their opinions freely and discuss their own topics of interest during the interviews. Thematic analysis was used for analysis and all data were coded and extracted using NVivo V.11.0 software.ResultsFavourable driving factors for clinical research in Shenzhen identified by all stakeholders included the recent trend of increased governmental funding for clinical research, supportive governmental policies, wide recognition of the value of clinical research and high demands from local industry. The major challenges include a lack of technical infrastructure, weak human research subject protection and a lack of capable research resources.ConclusionsDespite the established strengths, Shenzhen still needs to develop suitable technical platforms, human resources training programmes and strong human research subject protection programmes pertaining to clinical research. This would facilitate the establishment of a functional system that can be expected to lead to increased medical research innovation in Shenzhen.
Reporting quality of the Delphi technique in reporting guidelines: a protocol for a systematic analysis of the EQUATOR Network Library
Authors: Banno Masahiro , Tsujimoto Yasushi , Kataoka Yuki 
Published: April 2019

IntroductionReporting guidelines are important tools for improving the quality of medical research. The Enhancing the QUAlity and Transparency Of health Research (EQUATOR) Network’s Library contains a comprehensive and up-to-date database of reporting guidelines relevant to health research. Only 31% of reporting guidelines published from 2010 to 2014 reported using the Delphi technique, and the reporting quality of the Delphi technique in reporting guidelines is unknown even though the use of the Delphi technique was recommended in the guidance for reporting guidelines. We will assess the quality reports of the Delphi technique or modified Delphi technique in reporting guidelines.Methods and analysisThe present study is a systematic analysis of the EQUATOR Network Library. We will include all reporting guidelines in the EQUATOR Network that used the Delphi technique or modified Delphi technique, published since 1 January 2011 and registered in the EQUATOR on or before 31 May 2018. Our primary outcome is the reporting quality of the Delphi technique, measured by the quality score (each item) in the Delphi technique. We will also examine the relationship between the reporting quality score (each item) of the Delphi technique and year of publication, number of authors, impact factor, sources of funding (industry, non-industry), multiple publications and whether the guidelines are published in open access policy.Ethics and disseminationEthics approval will not be applicable for this study. This protocol has been registered in the University Hospital Medical Information Network Clinical Trials Registry. We will publish our findings in a peer-reviewed journal and may also present them at conferences.Trial registration numberUMIN000032685.