bluuebunny/crossref_metadata_2025_split huggingface dataset:
The cultural politics of civic pride through Hull UK City of Culture 2017
Authors: Howcroft Michael 
Published: July 2023

PurposeThis article explores the cultural politics of civic pride through Hull's year as UK City of Culture (UKCoC) in 2017. It unpicks some of the socio-political meanings and values of civic pride in Hull and critiques the ways in which pride, as an indicator of identity and belonging, was mobilised by UKCoC organisers, funders and city leaders. It argues for more nuanced and critical approaches to the consideration and evaluation of pride through cultural mega events (CMEs) that can take account of pride's multiple forms, meanings and temporalities.Design/methodology/approachA multidimensional, mixed methods approach is taken, incorporating the critical analysis of Hull2017 promotional materials and events and original interviews with a range of stakeholders.FindingsThe desire for socio-economic change and renewed identity has dominated Hull's post-industrial sense of self and is often expressed through the language of pride. This article argues that UKCoC organisers, cognisant of this, crafted and tightly controlled a singular pride narrative to create the feeling of change and legitimise the entrepreneurial re-branding of the city. At the same time, UKCoC organisers overlooked the opportunity to engage with and potentially reactivate the political culture of Hull, which like other “left behind” or “structurally disadvantaged” places, is becoming increasingly anti-political.Originality/valueThrough the case study of a relatively unresearched and under-represented city, this paper contributes to cultural policy literatures concerned with critically assessing the benefits and shortcomings of Cultural Mega Events and to a more specific field concerning Cities of Culture and the political cultures of their host cities. This paper also contributes to an emerging literature on the centrality of pride through the UK's post-Brexit Levelling Up agenda, suggesting that pride in place is becoming figured as a “universal theme” of the neoliberal city script.
Lessons learned in implementing the Low Birthweight Infant Feeding Exploration study: A large, multi‐site observational study
Authors: Vernekar Sunil S. , Somji Sarah , Msimuko Kingsly , Yogeshkumar S. , Nayak Rashmita B. , Nabapure Shilpa , Kusagur Varun B. , Saidi Friday , Phiri Melda , Kafansiyanji Eddah , Sudfeld Christopher R. , Kisenge Rodrick , Moshiro Robert , Tuller Danielle E. , Vesel Linda , Semrau Katherine E. A. , Dhaded Sangappa M. , Bellad Roopa M. , Mvalo Tisungane , Manji Karim 
Published: July 2023

AbstractObjectiveGlobally, early and optimal feeding practices and strategies for small and vulnerable infants are limited. We aim to share the challenges faced and implementation lessons learned from a complex, mixed methods research study on infant feeding.DesignA formative, multi‐site, observational cohort study using convergent parallel, mixed‐methods design.SettingTwelve tertiary/secondary, public/private hospitals in India, Malawi and Tanzania.Population or SampleModerately low birthweight infants (MLBW; 1.50–2.49 kg).MethodsWe assessed infant feeding and care practices through: (1) assessment of in‐facility documentation of 603 MLBW patient charts; (2) intensive observation of 148 MLBW infants during facility admission; and (3) prospective 1‐year follow‐up of 1114 MLBW infants. Focus group discussions and in‐depth interviews gathered perspectives on infant feeding among clinicians, families, and key stakeholders.Main Outcome MeasuresThe outcomes of the primary study were: (1) To understand the current practices and standard of care for feeding LBW infants; (2) To define and document the key outcomes (including growth, morbidity, and lack of success on mother's own milk) for LBW infants under current practices; (3) To assess the acceptability and feasibility of a system‐level Infant and Young Child Feeding (IYCF) intervention and the proposed infant feeding options for LBW infants.ResultsHospital‐level guidelines and provision of care for MLBW infants varied across and within countries. In all, 89% of charts had missing data on time to first feed and 56% lacked discharge weights. Among 148 infants observed in‐facility, 18.5% were discharged prior to meeting stated weight goals. Despite challenges during COVID, 90% of the prospective cohort was followed until 12 months of age.ConclusionsEnrolment and follow‐up of this vulnerable population required additional effort from researchers and the community. Using a mixed‐methods exploratory study allowed for a comprehensive understanding of MLBW health and evidence‐based planning of targeted large‐scale interventions. Multi‐site partnerships in global health research, which require active and equal engagement, are instrumental in avoiding duplication and building a stronger, generalisable evidence base.
Aspirin delays the onset of hypertensive disorders of pregnancy among nulliparous pregnant women: A secondary analysis of the ASPIRIN trial
Authors: Kavi Avinash , Hoffman Matthew K. , Somannavar Manjunath S. , Metgud Mrityunjay C. , Goudar Shivaprasad S. , Moore Janet , Nielsen Eleanor , Goco Norman , McClure Elizabeth M. , Lokangaka Adrien , Tshefu Antoinette , Bauserman Melissa , Mwenechanya Musaku , Chomba Elwyn , Carlo Waldemar A. , Figueroa Lester , Krebs Nancy F. , Jessani Saleem , Saleem Sarah , Goldenberg Robert L. , Das Prabirkumar , Patel Archana , Hibberd Patricia L. , Esamai Fabian , Bucher Sherri , Koso‐Thomas Marion , Silver Robert , Derman Richard J. 
Published: July 2023

AbstractObjectiveTo assess the impact of low‐dose aspirin (LDA) starting in early pregnancy on delaying preterm hypertensive disorders of pregnancy.DesignNon‐prespecified secondary analysis of a randomised masked trial of LDA.SettingThe study was conducted among women in the Global Network for Women's and Children's Health's Maternal and Newborn Health Registry (MNHR) clusters, a prospective, population‐based study in Kenya, Zambia, the Democratic Republic of the Congo (DRC), Pakistan, India (two sites‐Belagavi and Nagpur) and Guatemala.PopulationNulliparous singleton pregnancies between 6+0 weeks and 13+6 weeks in six low‐middle income countries (Democratic Republic of Congo, Guatemala, India, Kenya, Pakistan, Zambia) enrolled in the ASPIRIN Trial.MethodsWe compared the incidence of HDP at delivery at three gestational age periods (<28, <34 and <37 weeks) between women who were randomised to aspirin or placebo. Women were included if they were randomised and had an outcome at or beyond 20 weeks (Modified Intent to Treat).Main Outcome MeasuresOur primary outcome was pregnancies with HDP associated with preterm delivery (HDP@delivery) before <28, <34 and <37 weeks. Secondary outcomes included small for gestational age (SGA) <10th percentile, <5th percentile, and perinatal mortality.ResultsAmong the 11 976 pregnancies, LDA did not significantly lower HDP@delivery <28 weeks (relative risk [RR] 0.18, 95% confidence interval [CI] 0.02–1.52); however, it did lower HDP@delivery <34 weeks (RR 0.37, 95% CI 0.17–0.81) and HDP@delivery <37 weeks (RR 0.66, 95% CI 0.49–0.90). The overall rate of HDP did not differ between the two groups (RR 1.08, 95% CI 0.94–1.25). Among those pregnancies who had HDP, SGA <10th percentile was reduced (RR 0.81, 95% CI 0.67–0.99), though SGA <5th percentile was not (RR 0.84, 95% CI 0.64–1.09). Similarly, perinatal mortality among pregnancies with HDP occurred less frequently (RR 0.55, 95% CI 0.33–0.92) in those receiving LDA. Pregnancies randomised to LDA delivered later with HDP compared with those receiving placebo (median gestational age 38.5 weeks vs. 37.9 weeks; p = 0.022).ConclusionsIn this secondary analysis of a study of low‐risk nulliparous singleton pregnancies, early administration of LDA resulted in lower rates of preterm HDP and delivery before 34 and 37 weeks but not in the overall rate of HDP. These results suggest that LDA works in part by delaying HDP.
National context and the transfer of transgender diversity policy: An institutional theory perspective on multinational corporation subsidiaries in Pakistan
Authors: Ahmad Sabeen Imran , Ozturk Mustafa Bilgehan , Tatli Ahu 
Published: July 2023

AbstractDeploying institutional theory to analyze the transfer of transgender diversity policy in Pakistan, our research highlights the crucial influence of national context with respect to the development and implementation of transgender‐supportive equality measures in multinational corporation subsidiaries. Based on semi‐structured interviews with 4 government officials, and 30 managers, HR leads, and diversity officers working in subsidiary organizations, our thematic analysis highlights how regulatory institutions, normative and cognitive institutions, and institutional distance inform the conditions of possibility for the transfer and execution of diversity policy across national boundaries. Moreover, by highlighting the inadequacy of etic understandings of diversity categories and practices in settings where social structures and ideologies can be different, we argue that utilizing an emic approach is essential in the global diversity field. Our research emphasizes the value of context‐sensitive research instead of generic, and universalistic, applications of ‘Western’ diversity understandings.
Pediatric outpatient experiences of senior nursing students: A qualitative study
Authors: Xie Hong , Luo Dan , Li Xue , Zhang Jianhua , Kang Bingyao 
Published: July 2023

AbstractObjectivesThis study aimed to explore the experiences of senior nursing students working in a pediatric outpatient clinic.MethodsThis study adopted a descriptive phenomenological approach, through semi‐structured interviews. Purposive sampling was used to select 12 senior nursing students in the pediatric outpatient clinic of West China Second University Hospital, Sichuan University, China, from August 2020 to March 2021. The collected data were analyzed using the Colaizzi method.ResultsFour themes were identified in this study: knowledge and skills (triage, emergency care), communication (courage, communication skills), value re‐evaluation (understand of outpatient nurses, judgment of outpatient nurses), and outpatient feelings (satisfaction, empathy, pressure).ConclusionPediatric outpatient internships have a positive impact on senior nursing students. Research has found that constructing a nursing clinical practice pathway in pediatric outpatient clinics helps teachers and students clarify the objectives and content of internships, and the “shadow teaching” model is conducive to nursing students' empathy and thinking. In addition, outpatient internship experience can help students gain communication courage.
Restoration as reconnection: A relational approach to urban stream repair
Authors: Samuelson Logan , Blue Brendon , Thomas Amanda 
Published: July 2023

AbstractUrban stream environments have been significantly altered through processes of colonisation and urbanisation. In Te Whanganui‐a‐Tara Wellington, Aotearoa New Zealand, there is growing interest in peeling back layers of the city to reconnect with waterways. More‐than‐human geographies can play a critical role in contributing to these efforts, guiding understandings of what it means to restore and live alongside urban streams. In our case study of the Waimapihi Stream, we explore one community's ideas and practices of restoration and how they envision a thriving place through the notion of stream daylighting. The Waimapihi shows us that restoration activities are both product and process of co‐creating an ontologically plural space for the renegotiation of what stream restoration means.
Associations between self-reported healthcare disruption due to covid-19 and avoidable hospital admission: evidence from seven linked longitudinal studies for England
Authors: Green Mark A , McKee Martin , Hamilton Olivia KL , Shaw Richard J , Macleod John , Boyd Andy , Katikireddi Srinivasa Vittal 
Published: July 2023

Abstract

Objectives
To examine whether there is an association between people who experienced disrupted access to healthcare during the covid-19 pandemic and risk of an avoidable hospital admission.

Design
Observational analysis using evidence from seven linked longitudinal cohort studies for England.

Setting
Studies linked to electronic health records from NHS Digital from 1 March 2020 to 25 August 2022. Data were accessed using the UK Longitudinal Linkage Collaboration trusted research environment.

Participants
Individual level records for 29 276 people.

Main outcome measures
Avoidable hospital admissions defined as emergency hospital admissions for ambulatory care sensitive and emergency urgent care sensitive conditions.

Results
9742 participants (weighted percentage 35%, adjusted for sample structure of longitudinal cohorts) self-reported some form of disrupted access to healthcare during the covid-19 pandemic. People with disrupted access were at increased risk of any (odds ratio 1.80, 95% confidence interval 1.39 to 2.34), acute (2.01, 1.39 to 2.92), and chronic (1.80, 1.31 to 2.48) ambulatory care sensitive hospital admissions. For people who experienced disrupted access to appointments (eg, visiting their doctor or an outpatient department) and procedures (eg, surgery, cancer treatment), positive associations were found with measures of avoidable hospital admissions.

Conclusions
Evidence from linked individual level data shows that people whose access to healthcare was disrupted were more likely to have a potentially preventable hospital admission. The findings highlight the need to increase healthcare investment to tackle the short and long term implications of the pandemic, and to protect treatments and procedures during future pandemics.
Evaluating trends in private equity ownership and impacts on health outcomes, costs, and quality: systematic review
Authors: Borsa Alexander , Bejarano Geronimo , Ellen Moriah , Bruch Joseph Dov 
Published: July 2023

Abstract

Objective
To review the evidence on trends and impacts of private equity (PE) ownership of healthcare operators.

Design
Systematic review.

Data sources
PubMed, Web of Science, Embase, Scopus, and SSRN.

Eligibility criteria for study selection
Empirical research studies of any design that evaluated PE owned healthcare operators.

Main outcome measures
The main outcome measures were impact of PE ownership on health outcomes, costs to patients or payers, costs to operators, and quality. The secondary outcome measures were trends and prevalence of PE ownership of healthcare operators.

Data synthesis
Studies were classified as finding either beneficial, harmful, mixed, or neutral impacts of PE ownership on main outcome measures. Results across studies were narratively synthesized and reported. Risk of bias was evaluated using ROBINS-I (Risk Of Bias In Non-randomised Studies of Interventions).

Results
The electronic search identified 1778 studies, with 55 meeting the inclusion criteria. Studies spanned eight countries, with most (n=47) analyzing PE ownership of healthcare operators in the US. Nursing homes were the most commonly studied healthcare setting (n=17), followed by hospitals and dermatology settings (n=9 each); ophthalmology (n=7); multiple specialties or general physician groups (n=5); urology (n=4); gastroenterology and orthopedics (n=3 each); surgical centers, fertility, and obstetrics and gynecology (n=2 each); and anesthesia, hospice care, oral or maxillofacial surgery, otolaryngology, and plastics (n=1 each). Across the outcome measures, PE ownership was most consistently associated with increases in costs to patients or payers. Additionally, PE ownership was associated with mixed to harmful impacts on quality. These outcomes held in sensitivity analyses in which only studies with moderate risk of bias were included. Health outcomes showed both beneficial and harmful results, as did costs to operators, but the volume of studies for these outcomes was too low for conclusive interpretation. In some instances, PE ownership was associated with reduced nurse staffing levels or a shift towards lower nursing skill mix. No consistently beneficial impacts of PE ownership were identified.

Conclusions
Trends in PE ownership rapidly increased across almost all healthcare settings studied. Such ownership is often associated with harmful impacts on costs to patients or payers and mixed to harmful impacts on quality. Owing to risk of bias and frequent geographic focus on the US, conclusions might not be generalizable internationally.

Systematic review registration
PROSPERO CRD42022329857.
Prevalence of burnout and mental health problems among medical staff during the COVID-19 pandemic: a systematic review and meta-analysis
Authors: Zhu Hongjin , Yang Xiaoyun , Xie Shiqi , Zhou Jianrong 
Published: July 2023

ObjectiveThe COVID-19 pandemic has had a significant impact on the burnout and mental health of medical staff. This meta-analysis aims to provide additional (and updated) evidence related to burnout and mental health problems among medical staff using a broader data pool.DesignSystematic review and meta-analysis.Data sourcesPubMed, Embase, Cochrane Library, CNKI, Wanfang data and three preprint databases (SSRN, bioRxiv and medRxiv) were searched from 1 January 2020 to 17 May 2021.Eligibility criteriaWe included observational studies investigating the prevalence of burnout and mental health problems among medical staff during the COVID-19 pandemic, including cross-sectional study, cohort study and case–control study.Data extraction and synthesisTwo independent reviewers used a self-designed form to extract the primary data. The Joanna Briggs Institute quality appraisal tool was used to assess the quality of selected studies. Heterogeneity among studies was assessed by I2statistic. A random-effects model was used to pool the prevalence. Subgroup analysis was performed to explore between-group differences.Results250 studies were included, with a sample of 292 230 participants from 46 countries. The pooled prevalence of burnout, anxiety, depression, insomnia, stress, post-traumatic stress disorder symptoms and somatic symptoms was 43.6% (95% CI 36.3% to 51.2%), 37.1% (95% CI 34.7% to 39.7%), 37.6% (95% CI 35.0% to 40.4%), 43.7% (95% CI 39.1% to 48.5%), 41.3% (95% CI 35.1% to 47.9%), 30.6% (95% CI 23.6% to 38.5%) and 25.0% (95% CI 16.7% to 35.6%), respectively. Subgroup analysis showed a higher prevalence of anxiety, depression and insomnia in frontline workers than in non-frontline workers, and a higher prevalence of anxiety in females than males. Mild cases accounted for the most significant proportion of the outcomes except for stress.ConclusionsThis study highlights that identifying the risks of burnout and mental health problems and adopting preventive interventions are priorities for policymakers and medical staff to avoid long-term occupational, health and social impacts.PROSPERO registration numberCRD42021254425.
PerIoperative iNflammatory reSponse assessment In hiGH-risk patienTs undergoing non-cardiac surgery (INSIGHT): study protocol of a prospective non-interventional observational study
Authors: Pichler Alexander , Kurz Andrea , Eichlseder Michael , Graf Alexandra , Eichinger Michael , Taschner Alexander , Kabon Barbara , Fleischmann Edith , Reiterer Christian 
Published: July 2023

IntroductionIncreased inflammatory processes after non-cardiac surgery are very common. The association between postoperative inflammation and the occurrence of cardiovascular complications after non-cardiac surgery are still not entirely clear. Therefore, we will evaluate the association between postoperative inflammation and the occurrence of major cardiovascular complications in patients at-risk for cardiovascular complications undergoing non-cardiac surgery. We will further evaluate the association of postoperative inflammation and days-at-home within 30 days after surgery (DAH30), the incidence of acute kidney injury, postoperative N-terminal probrain natriuretic peptide (NT-proBNP) concentrations and neurocognitive decline.Methods and analysisIn this multicentre study, we will include 1400 patients at-risk for cardiovascular complications undergoing non-cardiac surgery. Our primary aim is to evaluate the association of postoperative maximum C-reactive protein concentration and the occurrence of a composite of five major cardiovascular complications (myocardial infarction, myocardial injury after non-cardiac surgery, new onset of atrial fibrillation, stroke and death) within 30 days after surgery using a Mann-Whitney-U test as well as a logistic regression model. As our secondary aim, we will evaluate the association of a composite of three inflammatory biomarkers (interleukin 6, procalcitonin and copeptin) on the occurrence of our composite of five cardiovascular complications within 30 days and 1 year after surgery, acute kidney injury, DAH30and NT-proBNP concentrations using linear or logistic regression models. We will measure inflammatory biomarkers before surgery, and on the first, second, third and fifth postoperative day. We will check medical records and conduct a telephone survey 30 days and 1 year after surgery. We evaluate neurocognitive function, using a Montreal Cognitive Assessment, before and 1 year after surgery.Ethics and disseminationThis study was approved by the ethics committees at the Medical University of Vienna (2458/2020) and at the Medical University of Graz (33-274 ex 20/21).Trial registration numberNCT04753307.
Meta-review of the barriers and facilitators to women accessing perinatal mental healthcare
Authors: Webb Rebecca , Uddin Nazihah , Constantinou Georgina , Ford Elizabeth , Easter Abigail , Shakespeare Judy , Hann Agnes , Roberts Nia , Alderdice Fiona , Sinesi Andrea , Coates Rose , Hogg Sally , Ayers Susan 
Published: July 2023

Perinatal mental health (PMH) problems are common and can have an adverse impact on women and their families. However, research suggests that a substantial proportion of women with PMH problems do not access care.ObjectivesTo synthesise the results from previous systematic reviews of barriers and facilitators to women to seeking help, accessing help, and engaging in PMH care, and to suggest recommendations for clinical practice and policy.DesignA meta-review of systematic reviews.Review methodsSeven databases were searched and reviewed using a Preferred Reporting Items for Systematic Reviews and Meta Analyses search strategy. Studies that focused on the views of women seeking help and accessing PMH care were included. Data were analysed using thematic synthesis. Assessing the Methodological Quality of Systematic Reviews-2 was used to assess review methodology. To improve validity of results, a qualitative sensitivity analysis was conducted to assess whether themes remained consistent across all reviews, regardless of their quality rating.ResultsA total of 32 reviews were included. A wide range of barriers and facilitators to women accessing PMH care were identified. These mapped across a multilevel model of influential factors (individual, healthcare professional, interpersonal, organisational, political and societal) and across the care pathway (from decision to consult to receiving care). Evidence-based recommendations to support the design and delivery of PMH care were produced based on identified barriers and facilitators.ConclusionThe identified barriers and facilitators point to a complex interplay of many factors, highlighting the need for an international effort to increase awareness of PMH problems, reduce mental health stigma, and provide woman-centred, flexible care, delivered by well trained and culturally sensitive primary care, maternity, and psychiatric health professionals.PROSPERO registration numberCRD42019142854.