bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between physical activity and immunosuppressive medication adherence among renal transplant recipients: a case–control study
Authors: Zhang Pengpeng , Fan Xiaofei , Xiang Linghui , Zhu Xiao , Liu Dian , Liu Jia 
Published: October 2024

BackgroundBehavioural interventions are closely associated with immunosuppressive medication (IM) adherence. We aimed to explore the relationship between physical activity and IM adherence among renal transplant patients (RTPs) to determine potential interventions to improve IM adherence.DesignA case–control study.SettingSingle-centre study in Changsha, China.ParticipantsThe study population included 624 RTPs who were adherent to IM and 417 RTPs who were non-adherent to IM.Main outcome measuresSociodemographic characteristics of RTPs, IM adherence and the association between physical activity patterns or frequency and IM adherence.ResultsThe proportion of RTPs who were non-adherent to IM was 40.06%. Compared with RTPs non-adherent to IM, those who were adherent were older, more likely to be married, were evaluated closer to initial time of transplant, had shorter pretransplant waiting times and engaged in more physical activity. Multivariate logistic regression analysis showed that, in the pretransplant stage, only high-frequency aerobic physical activity was significantly associated with IM adherence. However, in the post-transplant stage, patients engaging in low-frequency aerobic physical activity, high-frequency resistance physical activity or high-frequency aerobic physical activity had 2.01, 2.96 and 2.67 times greater odds of being adherent to IM, respectively, compared with patients with no physical activity. RTPs without physical activity in the pretransplant stage were more likely to be adherent to IM if they engaged in post-transplant physical activity. RTPs engaging in low-frequency physical activity in the pretransplant stage may have better IM adherence if they engaged in post-transplant physical activity. RTPs engaging in high-frequency post-transplant physical activity were significantly associated with a greater likelihood of being adherent to IM compared with RTPs engaging in low-frequency post-transplant physical activity.ConclusionOur study revealed that physical activity, especially in the post-transplant stage, is closely associated with IM adherence and presents a potential intervention for improving IM adherence by RTPs.
Clinical practice guidelines for person-centred handover practices in emergency departments: a scoping review
Authors: de Lange Santel , Heyns Tanya , Filmalter Celia 
Published: October 2024

ObjectiveTo review the available information on clinical practice guidelines for person-centred and current handover practices between emergency care practitioners (ECPs) and healthcare professionals in emergency departments (EDs). Collating existing clinical practice guidelines may improve handover practices.Eligibility criteriaClinical practice guidelines for person-centred handover practices between ECPs and healthcare professionals in EDs. ECPs transporting and handing patients over to healthcare professionals in EDs. Healthcare professionals including doctors and nurses working in EDs, who are involved in handovers with ECPs. Studies conducted in EDs, emergency rooms or emergency centres in any geographical area. No language or time restrictions were applied. The search included published and unpublished studies, opinion papers as well as primary sources, and evidence synthesis. All qualitative and quantitative research designs were included.Sources of evidenceThe literature on clinical practice guidelines for person-centred handover practices was reviewed. Three electronic databases were searched: MEDLINE (PubMed), CINAHL (EBSCO) and Scopus from inception to May 2023 with no time limits set for the inclusion of published literature in the review. Six guideline organisations were also searched.Charting methodsA data extraction tool was developed, pilot-tested and used to extract data from the included studies.Results19 studies met the inclusion criteria. Various mnemonics exist for handover practices. Where mnemonics are not used, participants have identified important information that should be included during handover practices. We did not find any clinical practice guidelines or information on person-centred handover practices in any of the reviewed articles.ConclusionsCurrently, there is no gold standard for person-centred handover practices, which has led to various practices being implemented. Currently, there is a paucity of literature on person-centred handover practices. Most articles expressed a need for standardised handover practices; however, not all aspects of handover practices can be standardised and should be kept patient and context-specific.Trial and protocol registrationThis scoping review protocol was registered on Figshare (10.6084/m9 /m9.figshare.21731528).
Assessment of the productivity loss due to leading maternal ill-health conditions: a follow-up study of a prospective pregnancy cohort in rural Sri Lanka
Authors: Gunarathna Sajan Praveena , Wickramasinghe Nuwan Darshana , Agampodi Thilini Chanchala , Prasanna Indika Ruwan , Agampodi Suneth Buddhika 
Published: October 2024

ObjectivesThis study aimed to assess the productivity loss and cost due to maternal ill-health conditions and its associated factors throughout pregnancy in rural Sri Lanka.DesignA follow-up study of women registered in the Rajarata Pregnancy Cohort (RaPCo).SettingAnuradhapura district, Sri Lanka.Participants1573 pregnant women who were followed up from pregnancy identification to termination.Primary and secondary outcome measuresThe primary outcome measures of this study are productivity loss due to maternal ill-health conditions expressed by days/month and productivity cost due to maternal ill-health conditions expressed in monetary terms (US$)/month. Data were collected monthly, and all pregnant women were asked to report the leading cause of maternal ill-health condition and the associated loss due to absenteeism and presenteeism.ResultsDuring the pregnancy follow-up, 3595 (81.5%) months had at least one episode of maternal ill-health condition. Of these, only 1729 (48.1%) episodes sought medical care. Assistance for lost routine work was reported in 1281 (35.6%) episodes. The absenteeism, presenteeism and gross and net productivity loss per month were 3.6, 4.5, 8.1 and 5.5 days/month, respectively. The corresponding productivity cost was US$15.26/month. Nausea and vomiting (NVP) reported the highest prevalence (n=1599, 44.5%) until the second month of the third trimester, presenteeism (5.5 days/month) and gross productivity loss (9.5 days/month). Pregnant women with vaginal bleeding reported the highest absenteeism (6.2 days/month) and net productivity loss (6.8 days/month). Pregnant women diagnosed with anaemia reported the highest productivity cost (US$26.98/month). Monthly household expenditure, poverty and receiving assistance were the associated factors of productivity loss (p<0.05).ConclusionMaternal ill-health conditions during pregnancy lead to productivity loss in rural Sri Lanka. NVP, vaginal bleeding and anaemia are the leading causes of productivity loss. Hence, controlling and preventing the leading causes are the recommended priorities.
Efficacy of problem-solving therapy in treating late-life depression with potential cognitive impairment: a systematic review and meta-analysis
Authors: Huang Chun , Fang Yuan , Yan Feng , Wang Tao , Cai Dongbin , Zhang Zhiling , Li Xia , Wang JianJun 
Published: October 2024

IntroductionLate-life depression (LLD) is a global public health issue, often accompanied by cognitive impairments that can exacerbate the severity of depression and impair social functioning. Despite being a well-established treatment for LLD, the suitability of problem-solving therapy (PST) for individuals with LLD and varying degrees of cognitive impairments warrants further investigation. This paper presents the protocol for a systematic review and meta-analysis of randomised controlled trials (RCTs) aimed at evaluating the effectiveness and acceptability of PST for this specific demographic.Methods/analysisFollowing Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we will conduct a systematic review to synthesise existing research on PST for individuals in this demographic. We will comprehensively search multiple databases and sources, including PubMed, EMBASE, the Cochrane Database and APA PsycNET from inception to October 2023, without language, publication year or type restrictions. Relevant studies will be manually screened from the references. Only RCTs involving PST for LLD will be included. The primary efficacy outcome will be the standardised mean difference in total scores on continuous depression severity scales across different comparison arms. Data extraction will be conducted independently by two reviewers (CH and J-JW), and methodological rigour will be assessed using the Cochrane Risk of Bias assessment tool. Subgroup and sensitivity analyses will be performed to investigate the impact of concomitant cognitive impairments and to evaluate the robustness of the findings.Ethics and disseminationThe meta-analysis project is expected to be ethically unproblematic and does not require approval from a research ethics committee. The results of this study will be shared through articles in scholarly peer-reviewed journals and presentations in various formats, both print and digital.PROSPERO registration numberCRD42023473782
Protocol for a community-based, household-randomised, dose–response trial to assess the acceptability, nutritional effects and safety of double-fortified salt containing iodine and folic acid compared with iodised salt among non-pregnant Ethiopian women of reproductive age (DFS-IoFA)
Authors: Brown Kenneth H , Tessema Masresha , McDonald Christine M , Agbemafle Isaac , Woldeyohannes Meseret , Fereja Mengistu , Nane Debritu , Arnold Charles D , Waka Feyissa Challa , Tesfaye Biniyam , Arabi Mandana , Martinez Homero 
Published: October 2024

IntroductionThe prevalence of neural tube defects (NTDs) is higher in Ethiopia than most other countries, and ~84% of Ethiopian women of reproductive age (WRA) have folate insufficiency, a major risk factor for NTDs. Salt fortification with folic acid is a potential strategy to improve women’s folate status, but data are needed on the acceptability, nutritional impact and safety of folic acid fortification of iodised salt.Methods and analysisThe study is designed as a community-based, household-randomised, dose–response trial. A total of 360 non-pregnant WRA 18–49 years of age will be randomly assigned to one of three intervention arms: (1) iodised salt fortified with 30 ppm folic acid to provide ~200 µg folic acid/day; (2) iodised salt fortified with 90 ppm folic acid to provide ~600 µg folic acid/day; or (3) iodised salt (comparator). The preweighed salts will be delivered to participants’ homes biweekly for 26 weeks; unused salt will be collected and weighed. Fasting, venous blood samples will be collected at baseline, end line and a randomly assigned intermediate time point for assessment of folate, iodine, vitamin B12and other micronutrient status biomarkers. Women’s dietary intakes, including discretionary salt consumption, will be measured using weighed food records; 24-hour urine specimens will be analysed for sodium and iodine excretion. Primary outcomes are women’s consumption of study salts, change in biomarkers of folate and iodine status and prevalence of adverse events. Results will be analysed using analysis of covariance models to estimate group mean differences for continuous outcomes, controlling for baseline measurements, and log-binomial or modified Poisson regressions for categorical outcomes. Prespecified effect modifications will be explored.Ethics and disseminationThe study has been approved by the Ethiopian Public Health Institute’s Institutional Review Board, and the protocol has been registered with ClinicalTrials.gov (registration numberNCT06223854). Study results will be published in open access scientific journals and disseminated nationally in Ethiopia.Trial registration numberNCT06223854.
Antifungal combinations in paediatric invasive fungal infections: a protocol for systematic review and meta-analysis
Authors: Ramadhan Roy Novri , Rampengan Derren David Christian Homenta , Gunawan Felicia Angelica , Kadariswantiningsih Ika N , Empitu Maulana 
Published: October 2024

BackgroundInvasive fungal infections (IFIs) significantly impact immunocompromised paediatric patients, contributing to high rates of morbidity and mortality. Despite the evolution of antifungal therapy, the efficacy and safety of combination antifungal therapies in paediatric patients, especially those with haematological malignancies, remain controversial. This systematic review and meta-analysis seeks to critically evaluate the efficacy and safety of antifungal combinations in paediatric IFIs.MethodsWe will conduct a search in PubMed, ScienceDirect, Cochrane Library, BMJ and Springer databases to include randomised controlled trials and observational studies focused on combination antifungal therapies in paediatric patients under 18 years with IFIs, using COVIDENCE for data management and analysis, ensuring rigorous quality assessment and statistical integrity in synthesising data. The time frame for the search will encompass publications from the inception of each database to the present, ensuring a comprehensive coverage of the literature. The database search will not be restricted by date. The review will assess combined antifungal treatment against placebo or single-antifungal therapy, examining outcomes like response rates, survival, mortality, adverse effects, cost-effectiveness and quality of life.Ethics and disseminationThe review will be disseminated to healthcare professionals, community groups and policy-makers via journal publication and conference presentations to help them tailor antifungal prophylaxis treatment and outcomes for paediatric patients with IFIs. The analysis will not include any individual patient data, so ethical approval is not required.PROSPERO registration numberCRD42024503620.
Prevalence and risk factors of primary dysmenorrhoea among medical students: a cross-sectional survey in Indonesia
Authors: Situmorang Herbert , Sutanto Reynardi Larope , Tjoa Kevin , Rivaldo Rivaldo , Adrian Michael 
Published: October 2024

ObjectivesThis study aimed to assess the prevalence and associated risk factors of primary dysmenorrhoea among medical students in Indonesia.DesignA web-based survey was conducted among 630 medical students across Indonesia, selected based on specific inclusion criteria. Dysmenorrhoea prevalence, severity and associated risk factors were assessed using a self-reported questionnaire. To analyse the data, univariate and multiple binary logistic regression analyses were performed. A significance level of 5% (p<0.05) was used for both types of analyses to determine the statistical significance of the observed associations.Setting and participantsIndonesia (2021: n=630 female medical students).OutcomesThe primary outcome is primary dysmenorrhoea, defined as painful menses without previous diagnosis of pelvic pathology. The severity of dysmenorrhoea was measured using the Verbal Multidimensional Scoring System. Independent variables include socio-demographic characteristics, menstrual history and other identified associated risk factors.ResultsOf the 630 Indonesian medical students surveyed, a large proportion (91.27%) reported experiencing dysmenorrhoea, with 52.35% experiencing moderate-to-severe pain. Family history of dysmenorrhoea emerged as a significant predictor for both occurrence (OR 3.76; 95% CI 1.89 to 7.45) and severity (OR 1.47; 95% CI 1.04 to 2.06). Dysmenorrhoea severity was positively associated with cycle length (OR 1.57; 95% CI 1.01 to 2.43), whereas higher body mass index (BMI) (OR 0.94; 95% CI 0.90 to 0.98) and being Indonesian of foreign descent (OR 0.46; 95% CI 0.27 to 0.84) were negatively associated with moderate-to-severe dysmenorrhoea.ConclusionsDysmenorrhoea is prevalent among Indonesian medical students, with family history, BMI, cycle length and race significantly associated with its occurrence or severity. These findings underscore the need for further research on more diverse populations to enhance awareness and address this prevalent gynaecological concern effectively.
Impact of awake extracorporeal membrane oxygenation on patients mortality with cardiogenic shock: a systematic review and trial sequential meta-analysis based on observational studies
Authors: Yue Han-yang , Peng Wei , Luo Kun , Zeng Jun , Ma Wei , Lu Charles Damien , Chang Li , Jiang Hua , Zhou Ping 
Published: October 2024

ObjectivesThe use of awake extracorporeal membrane oxygenation (ECMO, without intubation or sedation under ECMO support in patients with cardiogenic shock is growing rapidly because emerging clinical investigations indicates it may reduce morbidity associated with sedation and intubation. We systematically reviewed the efficacy of awake ECMO and provided evidence for clinical practitioners and researchers.DesignSystematic review and trial sequential meta-analysis based on observational studies.Data sourcesData was retrieved from seven databases (PubMed, Web of Science, Embase, China National Knowledge Infrastructure, Wanfang, Chinese Biomedical Literature Database and Cochrane Library) up to 1 March 2024.Eligibility criteriaWe included observational studies that compared the differences in clinical outcomes between awake ECMO and non-awake ECMO in patients with cardiogenic shock.Data extraction and synthesisTwo reviewers rigorously conducted literature retrieval, screening and data extraction. The RevMan software was used for data synthesis.ResultsFive retrospective observational studies involving 1044 patients with cardiogenic shock were included. Compared with non-awake ECMO, awake ECMO was associated with a lower mortality rate of patients with cardiogenic shock (OR=0.28; 95% CI, (0.15, 0.49); p<0.0001; I2=50%). Trial sequential analysis indicated that the sample mortality outcome reached the required information size. No significant differences were observed between the two groups on secondary outcomes such as the occurrence of ventilator-associated pneumonia, weaning from ECMO, tracheostomy, haemorrhage, thrombosis, limb ischaemia and nosocomial infection.ConclusionsImplementing awake ECMO may result in better clinical outcomes in patients with cardiogenic shock. Because of the limited sample sizes and potential bias of the current studies, more rigorously designed large-scale trials are urgently needed to verify the above findings.PROSPERO registration numberCRD42023407607.
Experiences of commissioning services for child and adolescent mental health in England (UK): a qualitative framework analysis
Authors: Allen Kate , Trethewey Samuel P , Mathews Frances , Price Anna , Newlove-Delgado Tamsin 
Published: October 2024

ObjectivesTo explore commissioners’ experiences of commissioning services for child and adolescent mental health, their perspectives on the needs of their populations, the challenges they face and their needs for support and data.DesignQualitative study involving semi-structured interviews. All interviews were audio-recorded and transcribed verbatim. Data were analysed using framework analysis.SettingEngland, UK.Participants12 integrated care board commissioners, responsible for commissioning NHS England Child and Adolescent Mental Health Services (CAMHS).ResultsWe identified five themes:‘reflections on role’; ‘priorities and tensions: working in a complex and evolving integrated care system’; ‘insights and evidence: the role and use of data and informants’; ‘children’s mental health in the limelight: influences and expectations’; and‘responding to need "CAMHS as the answer to everything"’. Combined, these themes highlight the integral role commissioners play in providing oversight over the local system and challenges to this role including disproportionate funding for services for child and adolescent mental health, different use and value ascribed to ‘qualitative’ and ‘quantitative’ data, rises in demand and the limited focus on early intervention and prevention.ConclusionsCAMHS commissioners are currently negotiating a complex and changing political, social and economic environment with competing priorities and pressures. Our research indicates that commissioners require greater support as their roles continue to evolve.
Qualitative study exploring parenting among mothers and female caregivers living with the IPV, mental health and HIV syndemic in South Africa
Authors: Silima Mpho , Christofides Nicola Joan , Franchino-Olsen Hannabeth , Woollett Nataly , Meinck Franziska 
Published: October 2024

BackgroundIn South Africa, women disproportionately bear the burden of intimate partner violence (IPV), HIV or AIDS, and poor mental health.ObjectiveThis study investigated parenting practices among women affected by IPV, HIV and poor mental health syndemics.Study settingThe study was conducted in two sites, a peri-urban area and a rural area in Mpumalanga, South Africa.Study designA qualitative research design using a narrative approach with in-depth interviews supported by arts-based methods was used. Data were analysed thematically using MAXQDA (2022).Participants20 women aged 20–60 who screened positive for HIV, IPV and/or poor mental health in a larger three-generational cohort study were selected.ResultsLiving with the syndemics exacerbated socioeconomic challenges that often translated into an inability to meet basic child needs. Socioeconomic challenges also led to more harsh parenting practices among women living with IPV-Mental Health and HIV-Mental Health syndemics. Due to lack of trust from family members, women living with the HIV-Mental Health-IPV syndemic were often separated from their children. These women exhibited less harsh parenting practices than the women in the other syndemic groups when they did see their children. A history of childhood trauma, leading to overprotective parenting, was common across the groups except for the IPV-Mental Health group. Women in the IPV-Mental Health group often had strained relations with their children’s fathers, affecting their engagement and connection with their children.ConclusionThe study underlines challenges experienced by women with IPV-Mental Health, HIV-Mental Health and HIV-Mental Health-IPV syndemics. The overlap of these epidemics strains women’s relationships and affects women’s parenting practices detrimentally resulting in an inadequate provision for children’s needs.