bluuebunny/crossref_metadata_2025_split huggingface dataset:
Doctors experiences on the quality of care for pesticide poisoning patients in hospitals in Kampala, Uganda: a qualitative exploration using donabedian’s model
Authors: Ssemugabo Charles , MPH Sarah Nalinya , Halage Abdullah Ali , Neebye Ruth Mubeezi , Musoke David , Jørs Erik 
Published: August 2019

Abstract
Background

Pesticide poisoning is a major public health problem in many Low-and-Middle Income Countries (LMICs). Pesticides are responsible for a significant percentage of deaths globally with majority occurring in sub-Saharan Africa. Majority of the pesticide related deaths can be averted if poisoning patients are managed well. However, the quality of care given to pesticide poisoning patients is still insufficient especially in sub-Saharan Africa. Therefore, this study was aimed at exploring doctors’ experiences on quality of care for pesticide poisoning cases in hospitals in Kampala, Uganda.

Methods

Fifteen (15) in-depth interviews were conducted with doctors who were directly involved in management of pesticide poisoning patients in the accident and emergency, Medicine, Pediatrics and Intensive Care Unit wards in 5 hospitals in Kampala, Uganda. All interviews were transcribed and subjected to directed content analysis with the guidance of the Donabedian model of quality of care which emphasizes structure, process and outcome measures as pertinent ensuring quality care.

Results

Presence of hospital units such as medical wards including Intensive Care Unit (ICU), pediatrics and internal medicine; availability of equipment and clinical guidelines such as airway, breathing and consciousness (ABC) protocol; and doctors’ knowledge and experiences improved the quality of care given to pesticide poisoning patients. Doctors relied on history, and signs and symptoms to establish the cause and severity of pesticide poisoning. However, some patients and caretakers provided inaccurate pesticide poisoning history. Due to its availability in hospitals, doctors largely relied on atropine to manage pesticide poisoning cases. Although majority of the cases treated recovered, those due to suicide were further referred to the hospital psychiatrist. Sharing experiences of managing pesticide poisoning patients among health workers and engaging in sensitization outreaches against pesticide poisoning were reported as potential activities to improve quality of care for pesticide poisoning patients.

Conclusion

Doctors reflected on the structure, process and outcome measures of quality of care given to pesticide poisoning patients. The implications of hospital structures and clinical process to the quality of the outcomes of care demonstrates their importance to improving management of pesticide poisoning cases in hospitals in Kampala, Uganda.
Patient-level factors influencing hypertension control in adults in Accra, Ghana
Authors: Okai Darlene Esinam , Manu Abubakar , Amoah Emefa Modey , Laar Amos , Akamah Joseph , Torpey Kwasi 
Published: August 2019

Abstract
Background

Effective control of blood pressure is necessary to avert the risk of cardiovascular diseases from uncontrolled hypertension. Despite evidence on the benefits of hypertension control, rates of control in Ghana remain low.

Objective

This study assessed the patient-level factors that influence hypertension control among adults in Accra, Ghana.

Methods

360 patients from two hospitals in Accra, Ghana were enrolled into the study. Client socio-demographic characteristics were tabulated and associations between client characteristics and hypertension control were estimated using chi-square tests and logistic regression.

Results

Approximately 27.8% of clients were adherent to their antihypertensive medications. High pill burden predicted non-adherence [AOR=0.20 (95% CI 0.08; 0.48)] . The client’s sex [AOR=3.13 (95% CI:1.48-6.62], presence of a comorbidity [AOR=2.59 (95% CI 1.35; 4.96)] and adherence to medication [AOR=6.60[3.54-11.95)] predicted increased BP control among clients. An increased pill burden however reduced BP control [AOR=0.42(95% CI: 0.23-0.77)]. Majority of patients reported forgetfulness, side effects of medication and high pill burden as reasons for missing their medications.

Conclusion

There is the need for better implementation of hypertension treatment guidelines with emphasis on client education on hypertension, its management and reducing patient pill burden to improve adherence and hypertension control.
Management Outcome and Associated Factors among Intestinal Obstruction Patients Treated Surgically, Eastern Ethiopia
Authors: Derseh Tesfaye , Biniam Minuye , Yusouf Mohammed , Dingeta Tariku 
Published: August 2019

Abstract
Background

Intestinal obstruction is a global problem consuming much in terms of surgical services. It is a common surgical emergency and a significant health problem in Ethiopia. Several factors contribute to poor management outcomes in the case of intestinal obstruction. Post-operative mortality rate ranges from 3% to 30%. Despite this high rate of mortality, there is no recently published literature that has explored Intestinal Obstruction and its associated factors at Chiro General Hospital.

Methods

Institution based cross-sectional study was conducted among 254 of patients admitted with Intestinal obstruction who treated surgically at Chiro General Hospital. Data were collected using checklists from individual patient cards by trained three BSc nurses from 13 to 18 July 2018 and completeness of data collection was checked every day by the principal Investigator. Data were entered to Epi-Data version 3.1 computer software and exported to SPSS statistical software version 22 for analysis. Bivariable binary logistic regression was used to saw the association between each independent variable and dependent variable. All variables with P-value < 0.2 during bi-variable analyses were considered for multivariable logistic regression analyses. Odds ratio along with 95%CI were estimated to measure the strength of the association. Level of statistical significance was declared at p value less or equal to 0.05.

Results

In this study the magnitude of unfavorable outcome of Intestinal Obstruction was 21.3% (95% CI: (16.5, 26.4). Age group of 55 years or above [AOR=2.9, 95%CI: (1.03, 8.4)], duration of illness of 24hrs or above [AOR=3.1, 95%CI: (1.03, 9.4)], pre-operative diagnosis of gangrenous SBO & gangrenous LBO [(AOR=3.6, 95%CI: (1.3, 9.8)), (AOR=4.2, 95%CI: (1.3, 13.7))], respectively were significantly associated with unfavorable outcome.

Conclusions

The magnitude of unfavourable management outcome of patients with Intestinal obstruction who treated surgically in this study was high. Old age, late presentation of illness and gangrenous bowel obstruction were significantly associated with unfavourable management outcome. So that early detection prompt management of patients with Intestinal obstruction reduce the occurrence of unfavourable outcome of patients.
A narrative systematic review of quantitative and qualitative evidence on the impacts of HIV on women living with HIV and their families in developing countries
Authors: Fauk Nelsensius Klau , Ward Paul R. , Hawke Karen , Mohamadi Leila , Mwanri Lillian 
Published: August 2019

Abstract
Background

HIV infections among women cause a range of detrimental impacts on the affected women and their families. This review seeks to understand what impacts are associated with living with HIV in women and their families; and how the identified impacts relate to each other.

Methods

A systematic review of literature was conducted to identify the impacts of HIV on women and their families in developing countries. We conducted a systematic search of literatures published up to September 2018 in the following databases: Medline, PsycINFO, CINAL, Emcare, Scopus and ProQuest. Articles were included if they were published in English language, with full text available, in developing countries, involving married and non-married women age 15 years and above with HIV and focusing on the impacts of HIV on women and their families. Critical appraisal tools developed by Joana Briggs Institute (JBI) were used to assess methodological quality of the studies and thematic narrative synthesis was used to analyse the findings of the included articles.

Results

A total of 20 articles were included in the review. The review indicated that HIV infections among women living with HIV (WLHIV) caused numerous negative impacts on WLHIV and their families. They included (i) psychological impacts, (ii) poor physical health and intimate partner violence, (iii) social impacts such as stigma and discrimination, disruption of children’s social life and education, family separation and child-parent conflict, and (iv) economic impacts including loss of job and increased family health expenditure leading to poor family economic condition, the sale of family assets, food insecurity and hunger and poverty.

Conclusions

The findings indicate the need for interventions that address among impacts, psychological, stigma and discrimination and economic consequences of HIV facing WLHIV and their families in developing countries.
An operon consisting of a P-type ATPase gene and a transcriptional regular gene given the different cadmium resistances in Bacillus vietamensis 151-6 and Bacillus marisflavi 151-25
Authors: Yu Xiaoxia , Ding Zundan , Ji Yangyang , Zhao Jintong , Liu Xiaoqing , Tian Jian , Wu Ningfeng , Fan Yunliu 
Published: August 2019

Abstract
Cadmium (Cd) is a severely toxic heavy metal to most microorganisms. Many bacteria have developed Cd2+ resistance. In this study, we isolated two different Cd2+ resistance Bacillus sp. strains, Bacillus vietamensis 151-6 and Bacillus marisflavi 151-25, which could be grown in the presence of Cd2+ at concentration up to 0.3 mM and 0.8 mM, respectively. According to the genomic sequencing, transcriptome under cadmium stress and related biological experiments, a gene cluster in plasmid p25 containing orf4802 and orf4803, which encode an ATPase transporter and a transcriptional regulator protein, respectively, was a major contributor to Cd2+ resistance in B. marisflavi 151-25. Although 151-6 has much lower Cd2+ resistance than 151-25, they contain similar gene cluster, but in different locations. A gene cluster on the chromosome containing orf4111, orf4112 and orf4113, which encode an ATPase transporter, a cadmium efflux system accessory protein and a cadmium resistance protein, respectively, was found to be a major role on the Cd2+ resistance for B. vietamensis 151-6. Based on homologies to the cad system (CadA-CadC) in Staphylococcus aureus, the mechanisms of cadmium resistance in B. vietamensis 151-6 and B. marisflavi 151-25 were as same as the cad system. Our study on the cadmium mechanism for B. vietamensis 151-6 and B. marisflavi 151-25 proved preliminarily that the cad system is widespread in Bacillus sp. bacteria.
Performance of diabetes screening tests: an evaluation study of Iranian diabetes screening program
Authors: Kianpour Fateme , Fararouei Mohammad , Hassanzadeh Jafar , Mohammadi Mohammadnabi 
Published: August 2019

Abstract
Background

Diabetes is a common non-communicable disease which is responsible for about 9% of all deaths and 25% reduction in life expectancy and nearly half of the diabetic patients are not aware of their disease. In this regard, diabetes screening to identify un-known diabetic patients is of great importance.The aims of this study were first to evaluate the performance of two commonly used diabetes screening tests, which are currently used by the Iranian national screening program for diabetes (NSPD).

Methods

Validity of diabetes screening tests among 1057 participants older than 30 years was measured. Screening tests included Capillary fasting blood glucose (CBG) with glucometer and glycated haemoglobin (HbA1c). In addition, the validity of the tests was measured based on venous fasting plasma glucose (VPG) as golden standard test.

Results

According to the results, the sensitivity of CBG and HbA1c tests were 69.01% and 84.5% and the specificity of the tests were 95.7% and 79.3% respectively. Positive and negative predictive values were 53.84% and 97.72% for CBG and 22.72% and 98.61% for HbA1c respectively. New cut points for CBG (116.5 mg/dl) and HbA1c (7.15%) are obtained. Using these values as new cut points, sensitivity and specificity of CBG raised to 80.30% and decreased 89.10% respectively. Similarly, using 7.15% as cut point of HbA1c test, sensitivity and specificity changed to 77.50% and 94.20% respectively.

Conclusions

Compared to several other countries, the performance of NSPD is relatively higher. ROC analysis suggested new cut points for significantly better performance of NSPD.
Irritable Bowel Syndrome Among University Students in Jordan
Authors: Al-Shdaifat Amjad , Al-Kassar Anwar , Johannessen Asgeir , Al-Dabbagh Zaid , Al-Ethawi Mohamed , Al-Obaidi Faisal , El-Halabi Ihsan 
Published: August 2019

Abstract
Background

Irritable bowel syndrome (IBS) is one of the commonest diagnosed gastrointestinal disorders (GI) in primary care and gastroenterology practices. This study aimed to explore the prevalence of IBS, and identify associated factors, among university students in Jordan.

Methods

A cross-sectional study was conducted among students at the Hashemite University in Jordan. A validated, confidential, self-administered data collection questionnaire was used for the collection of personal and sociodemographic data, and the Rome III criteria were used to define IBS. Logistic regression analysis was done to identify factors associated with IBS.

Results

A total of 198 students participated in the study, of whom 163 had complete data and could be assessed by the Rome III criteria. The age range of the students was 18 to 35 years, and 91 (55.8%) were women. Overall, 26 (16.0%) of the respondents were diagnosed with IBS.

Poor sleep (Adjusted Odds Ratio [AOR] 3.9; 95% confidence interval [CI] 1.5-10.4; p<0.01), being married (AOR 7.6; 95% CI 2.0-28.8; p<0.01) and a family history of IBS (AOR 2.9; 95% CI 1.1-7.7; p=0.03) were independently associated with IBS in multivariable analysis.

Conclusion

IBS was common among otherwise healthy university student in Jordan. Lifestyle factors such as poor sleep appeared to be associated with IBS symptoms.
Changes in body mass index and outcomes after kidney transplantation: a single centre, retrospective, observational study
Authors: Arshad Adam , Hodson James , Khalil Khalid , Sharif Adnan 
Published: August 2019

Abstract
Background

The aim of this study was to describe the changes in body mass index (BMI) after kidney transplantation and assess how this influences long-term outcomes.

Methods

Data were collected for all kidney transplant recipients between January 2007 and July 2016. Changes in BMI over the post-transplant period were modelled using a generalised estimating equation. The change in BMI from pre-transplantation to six months was then calculated for each patient. These were categorised into three groups: stable BMI (a change of ±1.5 kg/m2), BMI reduction and BMI increase (changes of >1.5 kg/m2), between which a range of outcomes were compared.

Results

Data was available for 1,344 patients, who had a geometric mean pre-transplant BMI of 27.3 kg/m2. This declined significantly (P<0.001), to a geometric mean of 25.6 kg/m2 one month after transplantation, before increasing and stabilising to pre-transplant levels by 36 months (geometric mean 27.2 kg/m2, P=0.522).

The n=882 patients with BMI measurements at six months, were divided into groups of reduced (n=303), stable (n=388) and increased (n=131) BMI, relative to pre-transplantation levels. On multivariate analysis, 12-month creatinine levels were significantly higher in the BMI reduction cohort, with adjusted levels of 160.6 μmol/l, compared to 135.0 μmol/l in stable BMI. However, no significant associations were detected between six-month BMI change and patient survival, graft survival, incidence of post-transplant diabetes, cancer, or a range of clinical and histological outcomes (all P>0.05).

Conclusions

Our data demonstrates that BMI significantly reduces in the first month after kidney transplantation, before increasing to pre-transplant levels at 3-5 years. Furthermore, patients with decreasing BMI at six-months have impaired graft function in the long-term. These observations conflict with the existing literature and warrant further investigation.
Unmet need for family planning and associated factors among married women in Asebot town, west Hararge zone, Oromia regional state, Ethiopia, Cross- sectional study design, 2018
Authors: Muche Misganaw , Kaso Muhammedawel , Eshete Amde , kalayu ismael 
Published: August 2019

Abstract
Background

Unmet need for family planning was one of the several frequently used indicators for monitoring and evaluation of family planning programs. It also helps to identify women at greatest risk of unintended pregnancy for satisfying the unmet need for modern contraception. So this study aimed to assess the prevalence and associated factors of unmet need for modern contraceptive among women of reproductive age in Asebot town, west Harargie zone, Oromia Regional state, Ethiopia.

Methods

A community based cross-sectional study design was conducted in Asebot town. Systematic random sampling techniques were used to select 410 reproductive age women. Data collection was carried out from July 19 to August 05, 2018 using a pre- tested structured questionnaire. The collected data were entered to Epi-info version 7 and exported to SPSS version 21 for analysis. Candidate variables with p-value of <0.25 in bivariate analysis were entered into multivariable logistic regression and AOR at 95% CI with p-value of <0.05 was considered as significant.

Result

The magnitude of unmet need for modern family planning in the study area was 37.3%. [95% CI (32.7, 42.2)]. After multivariate analysis Age, monthly income, desire to have children within two years and partner approval of family planning use were statistically significantly associated factors of unmet need for family planning with their 95% CI as follows (2.00-39.83), (1.10-6.10), (4.79-15.67), (3.88-14.61) respectively.
What did the community health worker do that was helpful? Perceptions from patients with type 2 diabetes
Authors: Yan Connie H , Rodriguez Aida , Gerber Ben S , Sharp Lisa K 
Published: August 2019

Abstract
Background: Evidence supporting the effectiveness of community health worker (CHW) programs in improving type 2 diabetes mellitus (T2DM) outcomes is mixed. CHWs provide numerous activities; although, it is not clear what is effective or considered helpful by patients. This summative evaluation reports on patients’ perspectives of CHW activities offered as part of a larger randomized controlled trial of a team-based diabetes-management program.

Methods: Following one-year of access to CHW support, 192 racial/ethnic minorities with uncontrolled T2DM were provided a two-item summative evaluation that assessed how helpful they found the CHWs, on a ten-point scale, along with an open-ended question about specific activities they found most helpful.

Results: Patients’ mean age was 57 years, and 25% Hispanic/Latino, of which 47% preferred Spanish. The mean number of CHW visits was higher among Hispanics/Latinos compared to African-Americans (9.8, standard deviation [SD] 5.4 vs. 5.0, SD 4.7; p<0.001); however, perceived helpfulness was similar for both groups (Hispanic/Latinos 9.2, SD 1.5 vs. African-Americans 9.1, SD 1.9). Although the frequency of CHW visits was similar between Spanish- and English-speaking Hispanic/Latinos, the mean helpfulness rating was higher for Spanish-speakers than for English-speakers (9.6, SD 0.8 vs. 8.8, SD 1.8; p=0.05). After qualitative coding of the list of helpful activities, four major themes emerged: social support, health education, communication with the healthcare team and care coordination.

Conclusion: This is among the first reports of differential CHW engagement within racial/ethnic groups. Additional research is needed to understand the relationship between CHW activities and mechanisms influencing outcomes.
Verifying participant reported clinical outcomes: challenges and implications
Authors: Breeman Suzanne , Constable Lynda , Duncan Anne , Starr Kath , McDonald Alison , Wileman Samantha , Cotton Seonaidh 
Published: August 2019

Abstract
Background

Researchers often rely on trial participants to self-report clinical outcomes (for example fracture, re-operation). Little information exists as to the “accuracy” of participant reported clinical outcomes, particularly in randomised controlled trials (RCTs). To help address this evidence gap, we report four case-studies, nested within different RCTs where participant reported clinical outcome data were compared with that reported by clinicians or extracted from medical notes.

Methods

Four publicly-funded RCTs with different methods of verifying participant reported outcomes were identified:

KAT: Participants were asked about hospital admissions for any reason. Where it was thought to be relevant to the trial knee, further information was sought from the lead surgeon at the admitting site to confirm whether or not the admission was relevant to the trial knee.

REFLUX: Participants were asked about hospital admissions for any reason. For participants who reported a re-operation, further information was sought from the lead surgeon at the admitting site to confirm this.

RECORD: Participants were asked three questions regarding broken bones. Where they were thought to be low-trauma fractures, clinical verification was sought, initially from the research nurse at site.

CATHETER: Participants were asked about urinary tract infections (UTIs) and a prescription of antibiotics for treatment of UTIs following urethral catheterisation. The GPs of those who reported a UTI were contacted to confirm that an antibiotic prescription had been issued for the suspected UTI.

Results
KAT: 397 of 6882 (6%) participant reported hospital admissions were confirmed as relevant to the trial knee.

REFLUX: 16 of 19 participants (84%) who appeared to have had a re-operation were confirmed as having had one.

RECORD: 473 of 781 (61%) fractures reported by participants were confirmed as low-trauma fractures.

CATHETER: 429 of 830 participant reported UTIs (52%) were confirmed as such by the GPs.

Conclusions
We used different approaches to the verification of participant reported outcomes in clinical trials, and it is our opinion that there is no one optimal solution. Consideration of issues such as what information is sought from participants, the phrasing of questions, whether the medical records are a true “gold standard” and costs and benefits to the RCT may help determine the appropriate approach.