bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of a health educational intervention on cardiovascular disease knowledge, motivation and behavioral skills: A cluster randomized controlled trial
Authors: Amoah John , Md. Salmiah , Rampal Lekhraj , Manaf Rosliza A , Ibrahim Normala , Amoah Lordina 
Published: August 2019

Abstract
Background

Cardiovascular diseases (CVD) are the number one public health challenge of the 21st century. Globally, the disease causes more deaths than any other cause. Unfortunately, many people are not aware of CVDs and its risk factors and because of this the disease burden keeps on rising. Objective of this study was to develop, implement and evaluate the effects of a health education program to improve CVD knowledge, motivation, and behavioral skills among secondary school students in Ghana.

Methods

A parallel single-blind cluster randomized controlled trial was carried out for a period of six-months with baseline and post intervention evaluations. Participants (n=848) were secondary school students of ages of 14-19 years from four schools (clusters) in Brong Ahafo, Ghana. Students in the intervention group received health education intervention whereas those of the control group received no intervention. The intervention included information on cardiovascular diseases and its risk factors, motivation, and behavioral skills modules. At six months, a follow-up data using same questionnaire were collected after the intervention was completed. The generalized linear mixed model (GLMM) was used to assess the overall effects of the intervention.

Results

Of the 848 students, 836 completed the follow-up assessment immediately after six-month. The GLMM showed the intervention was significant in improving 6.85(p<0.001), 0.90(p<0.001), 0.94(p<0.001) higher total CVD knowledge, motivation, and behavioral skills scores respectively for the intervention group when compared to the control group.

Conclusions

The intervention was effective in increasing CVD knowledge, motivation, and behavioral skills of students in the intervention arm of the study. It is recommended that the health education module be implemented into secondary schools education curricula in Ghana to improve CVD knowledge, motivation, and behavioral skills. Equipping students with the IMB will reduce CVD risk factors and prevent the onset of CVDs in future.
Comparison of Sequential feeding and Continuous feeding on Blood Glucose of critically ill patients: A non-inferiority Randomized Controlled Trial
Authors: Ren Changjie , Yao Bo , Tuo Miao , Lin Hui , Wan Xiangyu , Pang Xufeng 
Published: August 2019

Abstract
Objective: The goal of this study is to compare sequential feeding and continuous feeding on blood glucose of critically ill patients. Methods: A non-inferiority randomized controlled trail was adopted in this study. A total of 62 patients were finally enrolled, who were fed with enteral nutritional suspension through gastric tubes. After achieving 80% of the nutrition target calories (25kcal/kg/d) through continuous feeding, the patients were then randomly assigned into sequential feeding and continuous feeding group. In sequential feeding group, the feeding/fasting time was reasonably determined, according to the circadian rhythm of the human body in traditional Chinese medicine theory. The total daily dosage of enteral nutritional suspension was equally distributed to the three time periods of 7-9 o 'clock, 11-13 o 'clock and 17-19 o 'clock. Enteral nutritional suspension in each time period was pumped at a uniform rate within two hours by enteral feeding pump. While in continuous feeding group, patients received continuous feeding with constant velocity by enteral feeding pump during the study. Blood glucose values at 5 points (6:00/11:00/15:00/21:00/1:00) were monitored and recorded in 7 consecutive days after randomization. Meanwhile, enteral feeding intolerance was also recorded. Results: No significant demographic or physiologic differences between the sequential feeding and continuous feeding group (P >0.05). The average of glucose in sequential feeding was no inferior to continuous feeding [8.8(7.3-10.3) mmol/L vs. 10.7(9.1-12.1) mmol/L, P for non-inferiority =0.038). Hyperglycemia in CF group was more often than SF group (36.1% vs. 23.0%, P＜0.01). There was no significant differences in glucose standard deviations and Glucosemax -Glucosemin between two groups (P＞0.05). But the coefficient of glucose variation in sequential feeding group was higher than continuous feeding group [24.5(22.2-27.6) % vs. 18.9(13.7-25.3) %, P=0.013). Moreover, no significant difference in the incidence of feeding intolerance during the 7 days were found (P> 0.05). Conclusions: In this non-inferiority study, average blood glucose value of critically ill patients with sequential feeding was not higher than continuous feeding. And the feeding intolerance in sequential feeding was similar to continuous feeding.
Conditional cash transfers, uptake of maternal and child health services, and health outcomes in western rural China: A cluster controlled design
Authors: Zhou Huan , Wu Yuju , Liu Chengfang , Sun Chang , Shi Yaojiang , Zhang Linxiu , Medina Alexis , Rozelle Scott 
Published: August 2019

Abstract
Background: Empirical evidence suggests that the uptake of maternal and child health (MCH) services is still low in poor rural areas of China. There is concern that low uptake of MCH services may detrimentally affect child health outcomes. Previous studies have not yet identified the exact nature of the impact that conditional cash transfer (CCT) have on the uptake of MCH services and ultimately, on child health outcomes. The objective of this study is to examine the relationship between CCT, uptake of MCH services and health outcomes among children in poor rural areas of western China.

Methods: We designated two different sets of comparison villages and households that were used as comparison against which outcomes of the treated households could be assessed. We conducted a large-scale survey of 1,522 households at 75 villages (including 25 treatment and 50 comparison) from nine nationally-designated poverty counties in two provinces of China in 2014. In each village, 21 households were selected based on their eligibility status for the CCT program. Propensity score matching analyses were used to assess the impact of CCT on outcomes in terms of both Intention-to-treat (ITT) and average-treatment-effects-on-the-treated (ATT).

Results: Overall, the uptake of MCH services in the sample households were low, especially in terms of post-partum care visit, early breast feeding, exclusive breast feeding, and physical examination of the baby. The uptake of the seven types of MCH services in the CCT treatment villages was significantly higher than that in the comparison villages. Results from both the ITT and ATT analyses showed the CCT program had a positive, although small, impact on the uptake of MCH services and the knowledge of mothers about MCH health issues. Nonetheless, the CCT program had no noticeable effect on child health outcomes.

Conclusions: The CCT program generated modest improvements in the uptake of MCH services and mothers’ knowledge of MCH services in poor rural areas of Western China. These improvements, however, did not translate into substantial improvements in child health outcomes for two possible reasons: poor CCT implementation and the low quality of the rural health facilities.
The Effect of a Stress and Anxiety Coping Program on Objective Structured Clinical Examination Performance Among Nursing Students in Shiraz, Iran
Authors: Mojarrab Sadaf , Bazrafkan Leila , Jaberi Azita 
Published: August 2019

Abstract
ABSTRACT
Background: Nursing students experience a significant level of stress and anxiety prior to the objective structured clinical examination (OSCE). The present study aimed to evaluate the effect of anxiety coping program on the OSCE performance level of first-year nursing students in Shiraz, Iran.
Methods: The present two-stage interventional study was conducted among 76 nursing students; control group: n=35 and intervention group: n=41. Data collection instruments included a demographic characteristic form and State-Trait Anxiety Inventory (STAI) questionnaire. The intervention group followed anxiety coping program before taking the OSCE. The STAI questionnaire was filled in before and after the OSCE and the results were compared with those of the control group. The data were analysed using SPSS software (version 22.0). P<0.05 was considered statistically significant.
Results: Demographic characteristics of the participants indicated an overall homogeneity within the study population. As a result of the anxiety coping program, a substantial reduction in the anxiety score (by 11.61 units) in the intervention group was observed. There was a significant difference in the pre- and post-exam anxiety scores between the control and intervention groups (P=0.001). The anxiety coping program improved the examination results of nursing students in the final exam compared to the midterm results (an increase of 0.9487 units, P=0.001).
Conclusion: The anxiety coping program reduced the anxiety level among nursing students and improved their OSCE results. Educational planners should consider anxiety reduction strategies to help students improve their examination results.
Keywords: Anxiety, Nursing Students, State-Trait Anxiety Inventory
Safety and efficacy of intravenous oxycodone in geriatric patients undergoing general anesthesia for ophthalmic surgeries:a randomized controlled trial
Authors: Li Shuangshuang , Yao Dongdong , Hu Xiao , Li Wenxian , Tan Fang 
Published: August 2019

Abstract
Abstract

Background: The present study aimed to compare the safety and efficacy of intravenous oxycodone with fentanyl in geriatric patients undergoing general anesthesia for ophthalmic surgeries.

Methods: 107 geriatric patients (age 65-79 years old) with the ASA physical status 1 or 2 undergoing general anesthesia for glaucoma or retina surgeries between May 2016 and November 2017 were divided into three groups: Group O1, Group O2, and Group F. After exclusion, 105 patients were included for the final analysis, with 35 patients in each group. Oxycodone (0.1 mg/kg in Group O1, or 0.2 mg/kg in Group O2) or fentanyl (2 mcg/kg in Group F) was administered intravenously during induction of general anesthesia. Patient demographics, surgical time and anesthesia time, perioperative hemodynamic parameters and requirement of vasoactive medication, postoperative pain and requirement of rescue analgesics, postoperative sedation level and recovery time, and perioperative complications were recorded.

Results: Patients in Group O1 experienced less clinically significant hypotension compared to either Group F or Group O2. Consistently, patients in Group O1 required less intraoperative vasoactive medication (ephedrine) than those in Group F. The postoperative pain on extubation was more severe and more patients required rescue analgesia in Group F compared to Group O2, but not Group O1. The recovery time was longer and sedation level was higher in Group O2 than Group F or O1. The incidence of hypoxia during postoperative recovery was higher in Group O2 than Group F or O1.

Conclusion: Oxycodone at 0.1mg/kg can be a safe and effective application for geriatric patients undergoing general anesthesia for ophthalmic surgeries, with adequate pain control and less side effects.

Trial registration: The study was registered at http://www.chictr.org.cn , Clinical Trial Number: ChiCTR-IPR-16007927. Date of registration: February 15, 2016.

Keywords: Oxycodone, Fentanyl, Geriatric, Ophthalmology, General anesthesia
The initiation of a neuraxial analgesia service on the rate of cesarean delivery in Hubei, China. a 1-year restrospective study
Authors: ZHAO Yun , GAO YING , SUN Guoqiang , YU Lin , LIN Ying 
Published: August 2019

Abstract
Background

No Pain Labor &Delivery (NPLD) is a nongovernmental project to increase access to safe neuraxial analgesia through specialized training. This study explores the change of overall cesarean delivery(CD) and maternal request CD(MRCD) rate in our hospital after the initiation of neuraxial analgesia service. Methods The neuraxial labor analgesia was initiated in May 1st 2015. A multidisciplinary NPLD team from America was invited to our hospital to give education and training for 7 days. After training, the application of neuraxial labor analgesia became a routine operation in our hospital, and every parturient can choose to use neuraxial analgesia or not according to her own requirement. The rates of neuraxial labor analgesia(NA), CD, MRCD, intrapartum CD, episiotomy, postpartum hemorrhage (PPH), operative vaginal delivery and neonatal asphyxia of vaginal delivery were analyzed from May 1st 2015 to April 30th 2016. Results The rate of NA in our hospital was getting increasingly higher from 26.1% in May 2015 to 44.6% in April 2016 ( p< 0.001); the rate of CD decreased from 50.4% in May 2015 to 36.3% in April 2016 (, p< 0.001); the rate of MRCD decreased from 10.8%in May 2015 to 5.7% in April 2016( p< 0.001). There was a negative correlation between the rate of NA and that of overall CD, r=-0.803 (95%CI[-0.951,-0.642], p =0.002), and also a negative correlation between the utilization rate of NA and that of MRCD, r=-0.790 (95%CI[-0.971,-0.497], p =0.004). The rates of episiotomy, PPH, operative vaginal delivery and neonatal asphyxia in vaginal delivery women and the rates of intrapartum CD, neonatal asphyxia, and PPH in CD women remained unchanged from May 2015 to April 2016.Conclusions

Our study shows that the rates of CD and MRCD in our department significantly decreased over a year period(2015 05~2016. 04), which may be due to the increasing use of NA during vaginal delivery.
Trauma to Transformation: The Lived Experience of Bereaved Parents of Children with Chronic Life-Threatening Illnesses in Singapore
Authors: Dutta Oindrila , Tan-Ho Geraldine , Choo Ping Ying , Low Casuarine Xinyi , Chong Poh Heng , Ng Carolyn , Ganapathy Sashikumar , Ho Andy Hau Yan 
Published: August 2019

Abstract
Background:
In 2016, over 6.6 million children died globally, and 245 children died in Singapore. Chronic illnesses are prevalent causes of child mortality around the world. Despite growing research that examines the lived experience of parents bereaved by their child’s chronic life-threatening illness, there is no such study within the Asian context.

Methods:
To bridge this knowledge gap, meaning-oriented, strength-focused interviews were conducted with 25 parental units (i.e. 6 couples, 13 lone mothers, 4 lone fathers, and 2 primary parental figures) who lost their child to chronic life-threatening illness in Singapore (N=31), including those of Chinese (n=17), Malay (n=10) and Indian ethnicities (n=4).

Results:
Data analysis adhering to the grounded theory approach revealed 7 themes and 25 sub-themes that were organized into a Trauma-to-Transformation Model of Parental Bereavement. This model shows the major milestones in participants’ lived experience of their child’s chronic life-threatening illness and death, starting from the diagnosis of their child’s chronic life-threatening illness and the subsequent emotional turmoil (Theme 1), the mourning of their child’s death and the losses which accompanied the death (Theme 3) and participants’ experience of posttraumatic growth as an outcome of their journey (Theme 5). The model further describes the deliberate behaviors or ‘rituals’ that aided participants to regain power over their lives (Theme 2), helped them to sustain an intimate bond with their child beyond death (Theme 4), and aided participants’ transcendence of their loss by deriving positive outcomes from their experience (Theme 6). Finally, the model denotes that the lived experiences and well-being of participants were embedded within the health-and-social-care ecosystem, and in turn impacted by it (Theme 7).

Conclusions:
These themes and their corresponding sub-themes are discussed, with recommendations for enhancing culturally-sensitive support services for grieving Asian parents around the globe.
A text-mining analysis of nursing care for overseas visitors in Japan
Authors: Nishikawa Mariko , Kimura Masako Okayasu , Tsuda Yuko , Niiya Kiyoka 
Published: August 2019

Abstract
Background

The provision of health and nursing care for overseas visitors to Japan is becoming more important for nurses and hospitals owing to the sharp increase in visitor numbers. We investigated the attitudes and concerns of Japanese nurses when caring for overseas visitors, focusing on preparedness.

Methods

We carried out a cross-sectional text-mining study. The analysis was both qualitative and quantitative with a descriptive aim, including two open-ended questions to nurses. A total of 513 nurses participated, representing 350 hospitals from eight prefectures across Japan. We collected data from nurses enrolled in a first-level management course from August 2011 to February 2012. We analyzed the responses to the open-ended question with Text Mining Studio 5.1, and numeric data with JMP 11.0.

Results

Only 32.8% (167) of the nurses affirmed that their hospitals were prepared to care for overseas visitors. Nurses from hospitals that had prepared for overseas visitors were more concerned about culture and lifestyle differences. In contrast, nurses from hospitals that lacked appropriate preparation were strongly concerned about their foreign language skills. Among all hospitals, many nurses were most concerned about language communication, informed consent, and payment of medical expenses.

Conclusion

Hospitals in Japan should require that their nurses be better prepared to care for overseas visitors. We conclude that formal preparation will help nurses take into consideration various unique characteristics of overseas visitors to provide necessary healthcare. Japanese nursing professionals need greater knowledge of global health issues to understand patients from foreign countries.
Characterization of Lactic Acid Bacteria Isolated from the Gastrointestinal Tract of Ethiopian Rhode Island Red Chicken and their Potential Use as Probiotics
Authors: Tsega Kibrnesh Tegenaw , Maina Kagira , Berhane Nega 
Published: August 2019

Abstract
Background Chicken productivity and survival is affected by environmental stress and incidences of different diseases. After the ban of antibiotics growth promoters by different countries, the use of probiotics feed additives is mentioned as one alternative to antibiotics. The objective of this study was to isolate and identify potential probiotic lactic acid bacteria strains from the digestive tract content of Rhode Island Red chicken. Results The study was conducted in Gondar town of Amhara region, North West Ethiopia from November, 2018 to March, 2019. From the gastro intestinal content of 5 chicken 190 isolates were randomly selected. The isolates were identified and screened by their biochemical, morphological and 16S rRNA gene sequence. The in vitro probiotic potential of isolates was characterized by various tests. From 190 isolates 73 were found as gram positive, catalase negative and were able to grow at pH4. The bacteria were either rod (83.6%) or round (16.4%) shaped. Ten isolates were then randomly selected for further in vitro probiotic characterization due to higher cell surface hydrophobicity, good survival at pH2 and survival at 0.1% bile salt. From the 10 isolates 6 were able to survive at pH1 for 3hrs incubation. Five isolates (IS1, IS2, IS5, IS7 and IS8) were resistance to ampicillin, chloramphenicol, ciprofloxacin and erythromycin antibiotics. All the ten isolates showed antagonistic activity against Escherichia coli, Staphylococcus aureus, Salmonella typhimurium, Staphylococcus intermedius and Salmonella enteritidis. The optimum temperature for all ten isolates was 450C and all the isolates were able to grow at 0.69 mol/L of NaCl, and were able to ferment galactose, glucose, fructose, mannitol, sorbitol and sucrose. Using phylogenetic analysis of 16SrRNA gene sequence; IS3 was identified as Lactobacillus salivarius while IS4, IS6 and IS7 were identified as Lactobacillus reuteri. Conclusion The study concludes that the 10 selected isolates can be able to survive the stress conditions of gastrointestinal tract and can thus be considered as potential probiotics candidates for chickens.
Comparison of clinical manifestation, diagnosis and outcomes of invasive pulmonary aspergillosis and pulmonary mucormycosis
Authors: lin chun yu , Wang I-Ting , Chang Che‐Chia , Lee Wei-Chun , Liu Wei‐Lun , Huang Yu-Chen , Chang Ko-Wei , Huang Hung-Yu , Hsiao Hsuan-Ling , Kao Kuo‐chin , Huang Chung-Chi , Dimopoulos George 
Published: August 2019

Abstract
Objects

Invasive pulmonary mold infection usually has devastating outcomes. Timely differentiation between invasive pulmonary aspergillosis (IPA) from pulmonary mucormycosis (PM) is critical for treatment decision-making. However, information on IPA and PM differentiation is limited.

Methods

We conducted a retrospective, multicenter, observational study, with proven and probable IPA and PM patients from January 2004 to December 2017. Demographics, clinical manifestations, image reports, histopathological findings and outcomes were analyzed.

Results

A total of 47 IPA (34 proven and 13 probable) and 22 PM (21 proven and 1 probable) cases were analyzed. The majority of tissues (80% in IPA and 67% in PM) were obtained using bronchoscopy. While influenza infection was independently correlated to IPA, prior voriconazole exposure was independently associated with PM (p=0.036, p=0.043, respectively). The positive culture rate for PM was lower than that for IPA (41% vs. 69%, p=0.0363). The galactomannan (GM) level from serum and bronchoalveolar lavage (BAL) fluid was higher in IPA than in PM (3.1 ± 0.5 vs 0.7 ± 0.6, p=0.0313; 4.3 ± 0.6 vs. 1.5 ±1.0, p=0.0375, respectively). The overall mortality rate was 64%, which was similar among IPA and PM groups. Systemic steroid exposure and high Acute Physiology and Chronic Health Evaluation II (APACHE II) scores on admission were independently correlated to mortality in IPA (p=0.024), and concurrent bacterial sepsis predicted the in-hospital mortality among PM patients (p=0.029).

Conclusions

Influenza infection and prior exposure to voriconazole may help physicians to differentiate IPA and PM. Bronchoscopy-guided biopsy and lavage specimen provide timely and definite diagnosis. While the prognosis of IPA is associated with systemic steroid exposure and higher APACHE II scores on admission, concurrent bacterial sepsis is the only independent predictor for mortality in PM.
El trabajo informal en el Espinal-Tolima: un análisis desde la perspectiva de género
Authors: Castro Güiza Omar Ernesto , Lozano Martínez Diana del Rocío 
Published: August 2019

Este estudio analiza el fenómeno del trabajo informal desde la perspectiva de género, y describe las condiciones precarias y de desprotección social en que las mujeres desempeñan este tipo de actividades, desde los resultados de investigación obtenidos sobre el caso especifico de El Espinal-Tolima.En el presente artículo se exponen los conceptos de informalidad laboral y trabajo decente, desde el marco internacional. Asi mismo, se referencian los datos más relevantes sobre el fenómeno, a nivel mundial, nacional y local y se presentan: el marco legal, los pronunciamientos gubernamentales y diversos estudios sobre el tema en Colombia que pretenden coadyuvar a examinarlo y encontrar soluciones al mismo.