bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of nurse-home visiting on intimate partner violence and maternal income, mental health and self-efficacy by 24 months postpartum: a randomised controlled trial (British Columbia Healthy Connections Project)
Authors: Catherine Nicole L A , MacMillan Harriet , Jack Susan , Zheng Yufei , Xie Hui , Boyle Michael , Sheehan Debbie , Gonzalez Andrea , Gafni Amiram , Tonmyr Lil , Barr Ronald , Marcellus Lenora , Varcoe Colleen , Waddell Charlotte 
Published: January 2025

ObjectiveTo evaluate the impact of Nurse-Family Partnership (NFP), a home-visiting programme, on exploratory maternal outcomes in British Columbia (BC), Canada.DesignPragmatic, parallel arm, randomised controlled trial conducted October 2013–November 2019. Random allocation of participants (1:1) to comparison (existing services) or NFP (plus existing services). Researchers were naïve to allocation.Setting26 local health areas across four of five BC regional health authorities.Participants739 young (<25 years), first-time mothers (enrolled <28 weeks gestation), experiencing socioeconomic disadvantage.InterventionPublic health nurses with NFP education offered home visits (up to 64) during pregnancy and until children’s second birthday plus existing services on offer in BC.Outcome measuresPrespecified exploratory outcomes included exposure to intimate partner violence (IPV), income (annual from employment) and not in education, employment or training (NEET) by 24 months postpartum, and psychological distress and self-efficacy across five time points (34–36 weeks gestation, 2, 10, 18 and 24 months postpartum).ResultsA total of 739 participants were randomised (368 NFP, 371 comparison) and analysed via an intention-to-treat analysis. At 24 months postpartum, for participants receiving NFP, a lower percentage reported IPV (group difference −7.14; 95% CI: –14.17, –0.10); incomes were larger ($1629.74, 95% CI: $5.20, $3254.28) after adjusting for baseline differences and no difference in percentage of NEET (−2.41, 95% CI: −10.11, 5.30). For participants receiving NFP, psychological distress was lower across time points (−1.59, 95% CI: −2.35 to –0.84); self-efficacy was greater at 34–36 weeks gestation (0.78, 95% CI: 0.34, 1.22), then decreasing and becoming insignificant by 24 months postpartum (0.29, 95% CI: −0.18, 0.75). No unanticipated serious adverse events were reported.ConclusionRelying on the maternal report, at 24 months postpartum, the NFP group had reduced IPV exposure and increased incomes. Benefits observed in late pregnancy were sustained to study end for psychological distress, but not self-efficacy. Longer-term follow-up is recommended.Trial registrationNCT01672060.
Mixed-methods reproductive health knowledge, attitudes and practices survey of IDPs, returnees and host communities in Jonglei State, South Sudan
Authors: Lieberman Lawry Lynn , Gabor Rachel , Katele Jacques , Baak Madut Lazarus , Sommers Katina , Manuel David , Nadolski Claire , Lado Mounir , Koehlmoos Tracey , Clemmer William 
Published: January 2025

ObjectivesTo understand the current state of maternal, newborn and child health (MNCH) among internally displaced persons (IDPs), returnees and host communities in remote counties of Jonglei state.DesignCross-sectional, randomly sampled, mixed-methods, population-based household study.SettingAyod, Nyirol, Fangak and Pigi counties of Jonglei, South Sudan.Participants859 households, including 586 adult females and 273 adult males.Primary and secondary outcome measuresKnowledge, attitudes and practices of MNCH. Secondary: contraception, pregnancies, pregnancy outcomes, use or non-use of antenatal care (ANC)/postnatal care (PNC), use of skilled birth attendants, breastfeeding, knowledge of warning or danger signs of pregnancy, gender-based violence (GBV) and MNCH attitudes/cultural norms.ResultsA total of 859 households consented to the study (586 females and 273 males) with a response rate of 96% among females and 94% among males. The ability to list at least three warning/danger signs or essentials of care for different MNCH categories among respondents was low (range, 37·0%–47·1%). 1% of females and 3% of males use contraception. ANC and PNC are suboptimal and largely provided by unskilled providers. 26% of women exclusively breastfed for up to 6 months. For respondents with children<2 years of age, 68·9% (95% CI 64·7 to 72·7) had received three doses of Penta valent vaccine. Females and males reported similar lifetime GBV rates.ConclusionConflict and flooding in the remote survey areas are significant barriers to MNCH. Evidence-based interventions that decrease mortality and morbidity are lacking and the dearth of skilled health providers and healthcare facilities limits improvements in MNCH. Establishing cost-effective and evidence-based interventions proven to reduce MNCH mortality either at fixed facilities and/or in combination with mobile clinics and community outreach are necessary to ensure that IDPs and returnees are reached.
Aetiological, seasonal and antibiotic susceptibility patterns of diarrhoeal diseases in Bhutan (2016–2022): a retrospective study of surveillance data
Authors: Gyem Kinley , Pelden Sonam , Tshering Dorji , Penjor Kinley , Wangchuk Rinzin , Dorji Sangay , Tenzin Jigme , Phuyel Birdi Lal 
Published: January 2025

ObjectivesThis study aimed to identify the aetiological spectrum, seasonal distribution and antimicrobial resistance patterns of diarrhoeal diseases in Bhutan.Study design and settingThe study used a cross-sectional, retrospective analysis of secondary data gathered through a passive, hospital-based sentinel surveillance for diarrhoeal disease across 12 hospitals, representing Bhutan’s demographically diverse regions.ParticipantsA total of 3429 participants’ data of all age groups who presented with diarrhoea at sentinel hospitals between 1 January 1 2016 and 31 December 2022 were analysed.ResultsDiarrhoeagenicEscherichia coli(DEC),Shigella,SalmonellaandAeromonasspp. were predominant bacterial pathogens, whileRotavirus, AstrovirusandNoroviruswere the leading viral pathogens. Coinfections were observed in 195 cases. Children under nine were significantly affected than the other age groups. Seasonal trends revealed that bacterial pathogen incidence peaked during the summer/monsoon season, viral pathogens were more common in winter and spring, and parasites persisted year-round. Among the antibiotics tested, gentamicin, chloramphenicol, ceftriaxone and tetracycline exhibited high efficacy, with susceptibility rates of 93.4%, 87.2%, 81.5% and 69.5%, respectively. Conversely, high resistance rates were observed for amoxicillin (80.3%), ampicillin (77.4%) and nalidixic acid (69.5%). Multidrug resistance was prevalent, with β-lactamase production contributing to resistance rates of 80.7% to penicillin and 65.4% to fluoroquinolones groups. Cephalosporin resistance was also notable, with rates of 34.4% for cephalexin, 40.0% for cefazolin and 16.9% for ceftriaxone.ConclusionsDEC andRotaviruswere identified as the leading causes of diarrhoea, with significant resistance patterns observed in common bacterial isolates. These findings underscore the need for DEC screening in paediatric cases and emphasise the need for sustained antimicrobial resistance surveillance.
Prevalence of and factors associated with long COVID among diverse healthcare workers in the UK: a cross-sectional analysis of a nationwide study (UK-REACH)
Authors: Al-Oraibi Amani , Martin Christopher A , Woolf Katherine , Bryant Luke , Nellums Laura B , Tarrant Carolyn , Khunti Kamlesh , Pareek Manish 
Published: January 2025

ObjectivesTo assess the prevalence of UK healthcare workers (HCWs) who reported symptoms of COVID-19 lasting for longer than 5 weeks and examine associated factors with experiencing long COVID in an ethnically diverse cohort.DesignA cross-sectional study using data from the UK Research study into Ethnicity And COVID-19 Outcomes in HCWs cohort study.SettingData were collected electronically between December 2020 and March 2021.ParticipantsIndividuals aged 16 years or older, residing in the UK, and working as HCWs or ancillary workers in a healthcare setting and/or registered with one of the seven major UK healthcare professional regulators.Primary and secondary outcome measuresThe main outcome was long COVID (symptoms>5 weeks). The primary exposure of interest was self-reported ethnicity. We employed univariable and multivariable logistic regression to identify associations. We adjusted for demographic information, health status and existing long-term conditions in our multivariate analysis.ResultsIn our analysis of 11 513 HCWs, we found that 2331 (20.25%) reported COVID-19, of whom 525 (22.52%) experienced long COVID. There were no significant differences in risk of long COVID by ethnic group. In terms of other demographic characteristics, the majority of those experiencing long COVID were female (80.0%) and were slightly older than those who did not experience long COVID (median age 46 (IQR 36–54)). In multivariable analyses of those who reported having had COVID-19, HCWs in nursing/midwifery roles (adjusted OR (aOR) 1.76, 95% CI 1.26 to 2.46; p=0.001) and allied health professions (aOR 1.42, 95% CI 1.05 to 1.93; p=0.023) had higher odds of experiencing long COVID compared with those in medical roles. Other factors significantly associated with long COVID included self-reported psychological conditions (eg, depression and anxiety) and respiratory conditions (eg, asthma).ConclusionsIn this large ethnically diverse cohort study, more than one in five UK HCWs reported experiencing long COVID after acute COVID-19 during the first year of the pandemic. We found that specific demographic (older age and female gender) and occupational factors (nursing/midwifery and allied health professions) were associated with higher odds of long COVID. Notably, there were no significant differences in the risk of long COVID by ethnic group. Further research and collaborative efforts are urgently needed to address these factors effectively, develop targeted interventions and understand the temporal and longitudinal dynamics of the condition.
Exploring fatigue in Marfan and hypermobile Ehlers-Danlos syndromes: an analytical cross-sectional study in two Italian healthcare centres
Authors: Udugampolage Nathasha , Taurino Jacopo , Bassotti Alessandra , Pini Alessandro , Caruso Rosario , Callus Edward , Magon Arianna , Conte Gianluca , De Angeli Giada , Paglione Giulia , Baroni Irene , Trifirò Giuliana 
Published: January 2025

ObjectiveThis study investigates the prevalence and underlying factors of fatigue in individuals with Marfan syndrome (MFS) and hypermobile Ehlers-Danlos syndromes (hEDS), highlighting the necessity for focused research on this symptom within these patient populations.DesignCross-sectional, multicentre study.SettingData were collected from participants diagnosed with MFS or hEDS across multiple healthcare centres.ParticipantsThe study enrolled 282 participants (127 with MFS and 155 with hEDS).Primary and secondary outcome measuresFatigue was measured using the Fatigue Severity Scale (FSS). Additional assessments included the Patient Health Questionnaire-9 (PHQ-9) for depression and the Insomnia Severity Index (ISI) for sleep disturbances.ResultsParticipants with hEDS exhibited significantly higher median fatigue scores (FSS median=5.9, IQR=5.00–6.44) compared with the MFS group (FSS median=4.0, IQR=2.88–5.00). Significant predictors of fatigue included being female, having hEDS, participating in psychotherapy, and elevated scores on depression and insomnia scales. In the overall sample, hEDS significantly predicted fatigue (B=0.430, p=0.022), with depression and insomnia as strong influencers (PHQ-9: B=0.12, p<0.001; ISI: B=0.092, p<0.001). Notably, 80% of the hEDS group reported clinically relevant fatigue levels, compared with 31.5% in the MFS group. Daily persistence of fatigue was especially pronounced in hEDS, with 72.2% reporting everyday fatigue versus 25.2% in MFS. Temporal fatigue patterns also differed, with a more evenly distributed pattern throughout the day in hEDS, correlating with higher insomnia scores.ConclusionsThe results underscore the severe impact of fatigue on individuals with hEDS compared with those with MFS, suggesting the need for targeted, multidisciplinary management strategies to enhance quality of life.Trial registration numberNCT05712564.
Completion of registration of risk factor variables during telephone vs on-site follow-up after myocardial infarction: a nationwide observational study in 101 199 patients from contemporary clinical practice in Sweden
Authors: Ögmundsdottir Michelsen Halldora , Bäck Maria , Ekström Mattias , Hadziosmanovic Nermin , Hagstrom Emil , Leosdottir Margret 
Published: January 2025

ObjectivesThe objective of this study was to assess the completeness of registration of secondary preventive variables comparing on-site visits with telephone consultations during follow-up after myocardial infarction.DesignThis was an observational study based on the Swedish quality registry SWEDEHEART.Setting and outcome measuresWe analysed the proportion of missing values for major secondary preventive target data registered at the 2-month and 1-year follow-up visits, during 2006–2022 (n=101 199). χ2tests were used to compare differences in data registration comparing on-site visits with telephone consultations. Patient characteristics and time trends in the proportion of missing values were also analysed.ResultsBaseline characteristics for patients with on-site visits and telephone consultations were similar. At the 2-month follow-up, the proportion of missing data registered at on-site visits compared with telephone consultations was systolic blood pressure 2.4% (n=1729) vs 28.0% (n=5462), low-density lipoprotein cholesterol 9.1% (n=6525) vs 32.6% (n=6360), weight 20.1% (n=14 343) vs 43.0% (n=8401) and haemoglobin A1c for patients with diabetes mellitus 39.4% (n=4594) vs 69.4% (n=2225), p for all <0.0001. The differences were similar at the 1-year follow-up. Self-reported measures such as smoking status, level of physical activity and current medication had a low proportion of missing data (≤2.1%) for both follow-up modalities.ConclusionRegistration of secondary preventive variables was less complete at telephone consultations compared with on-site cardiac rehabilitation follow-up visits, which might indicate lower quality of care during telephone follow-up. Further analysis on the possible impact of lack of registration of secondary preventive variables on patient outcomes is warranted.
Gender-based violence and associated factors during armed conflict among female high school students in Kobo town, North Wollo, Ethiopia: a facility-based cross-sectional study
Authors: Andargie Gezahegn Aychew , Amlak Baye Tsegaye , Alamneh Genet Degu , Aycheh Moges Wubie 
Published: January 2025

ObjectiveThis study aimed to assess gender-based violence and associated factors during the time of armed conflict among female high school students in Kobo administration town, North Wollo, Ethiopia.Study designAn institutional-based, quantitative and cross-sectional study was conducted.SettingThis research was carried out in Kobo town, North Wollo, Ethiopia high schools.Study participantsThis study was conducted among 422 female high school students in Kobo administration town at time of armed conflict from May 20 to 5 June 2022.Outcome measuresGender-based violence (GBV) was assessed using a self-administered questionnaire. Data were entered in Epidemiological data (EPI-Data) V.3.1 and exported to SPSS V.25 for analysis. A binary logistic regression model was used to identify significant factors associated with GBV.ResultsThe magnitude of GBV among female high school students at Kobo town during armed conflict was 45%, with 95% CI 40.2% to 49.8%. Students with poor current academic performance (Adjusted Odds Ratio (AOR)=3.001; 95% CI 1.335 to 6.750), students with a family member who participated in conflict (AOR=1.809; 95% CI 1.135 to 2.882), students with a family member who was subjected to conflict (AOR=1.954; 95% CI 1.164 to 3.281), students who drank alcohol (AOR=8.158; 95% CI 4.325 to 15.386) and students who did not freely disclosing reproductive health issues (AOR=3.267; 95% CI 1.509 to 7.075) were more likely to suffer GBV.ConclusionsThe magnitude of GBV during the armed conflict was high. Variables such as poor academic performance, family members who participated in the war, family members subjected to the war, students who drank alcohol and not freely discussing reproductive health issues were statistically associated with GBV. It is recommended to put in place programmes that address factors such as academic challenges, alcohol use, family trauma and the need for open discussions on reproductive health to help to reduce GBV.
Impact of education and training on LGBT-specific health issues for healthcare students and professionals: a systematic review of comparative studies
Authors: Damery Sarah , Sekoni Adekemi Oluwayemisi , Retzer Ameeta , Okafor Ifeoma , Manga-Atangana Bibiane , Posaner Rachel , Gale Nicola Kay , Jolly Kate 
Published: January 2025

ObjectivesTraining/education is increasingly used to improve healthcare professionals’ knowledge, attitudes and clinical skills about lesbian, gay, bisexual and transgender (LGBT) health, but few reviews have assessed their effectiveness. This review describes the impact of training about LGBT healthcare for healthcare professionals on participants’ knowledge, attitudes and clinical practice.DesignSystematic review of intervention studies with contemporaneous comparators.Data sourcesMedline, CINAHL (Cumulated Index in Nursing and Alllied Health Literature), PsycINFO, Social Sciences Citation Index, Education Resources Information Center, Cochrane Library, University of York CRD, PROSPERO and Ethos e-thesis database were searched from 15/12/2015 to 29/11/2023 to update a review published in 2017.Eligibility criteriaInterventional studies of training/education for healthcare professionals or students about LGBT-specific health issues, compared with standard or no training/education. Outcomes were changes in participants’ knowledge, attitudes or clinical practice regarding LGBT health.Data extraction and synthesisReviewer pairs independently screened titles/abstracts and full texts. Data were extracted by one reviewer and checked by a second (population, training content, development, delivery, duration/intensity and outcomes). The National Institutes of Health tool for controlled intervention studies assessed study quality. Synthesis was descriptive.Results11 734 citations were screened, and 10 studies were included. 8/10 were published since 2019. Study quality was poor (8/10) or fair (2/10), and all were conducted in high-income countries. Four focused on transgender care. All studies used multi-component approaches, with topics covering terminology, lived experience, LGBT-specific health, sexuality and sexual history taking. Training duration ranged from 40 min to 50+ hours. Five studies included LGBT individuals in training development and/or delivery. 7/7 studies assessing attitudes, 2/4 studies assessing knowledge and 4/6 studies assessing skills/practice (actual or intended) reported statistically significant improvements.ConclusionsMulti-component healthcare professional training on LGBT health can significantly improve participants’ knowledge, attitudes and skills. However, there was substantial heterogeneity in training content, delivery and duration, and most studies were of poor quality.PROSPERO registration numberCRD42023414431 (26/06/2023).
Inpatient autopsy rate and associated factors in a Chinese megacity: a population-based retrospective cohort study
Authors: Li Hange , Wang Yu , Wang Zihan , Zhao Dachun , Guo Xidong , Zhang Hanbo , He Yanrong , Zeng Huatang , Zhu Jiming 
Published: January 2025

ObjectivesThis study investigated the autopsy rate of hospital deaths in Shenzhen megacity and identified factors that may impact the decision to perform an autopsy in hospital deaths.DesignThis is a population-based retrospective cohort study.SettingShenzhen is a megacity in China with a population of more than 17 million and a total of 151 hospitals. The official dataset of the inpatient medical record home page was used. Demographic, clinical and hospital information was extracted.ParticipantsAll the 35 272 inpatient deaths between 2016 and 2022 with known autopsy status were included to calculate the overall autopsy rate. Among them, a total of 34 577 cases with complete data, classified hospital and Chinese nationality, were included for further multivariable rare events logistic regression and Poisson pseudo maximum likelihood regression.Outcome measuresWhether the inpatient death was autopsied or not.ResultsThe autopsy procedure was performed in 0.9% (319/35 272) of hospital deaths. The autopsy decision was significantly and positively associated with being married (OR= 1.60, 95% CI: 1.16 to 2.21), self-paying (OR=1.56, 95% CI: 1.07 to 2.26), death due to external causes of injury and poisoning (OR=1.69, 95% CI: 1.02 to 2.81) and pregnancy (OR=13.58, 95% CI: 4.94 to 37.36), but negatively associated with age (OR=0.97, 95% CI: 0.96 to 0.98), emergency admission (OR=0.66, 95% CI: 0.49 to 0.88), referral (OR=0.47, 95% CI: 0.25 to 0.88), neoplasms (OR=0.35, 95% CI: 0.22 to 0.56), respiratory diseases (OR=0.49, 95% CI: 0.26 to 0.95) and for-profit hospitals (OR=0.45, 95% CI: 0.23 to 0.91). There were no statistically significant differences in autopsy rates between large teaching hospitals and other hospitals.ConclusionsThe autopsy rate of hospital deaths was extremely low, largely due to healthcare providers. Even large teaching hospitals do not request more autopsies compared with other hospitals, after controlling for the patient characteristics. More efforts are urged to encourage hospitals and healthcare providers to proactively request autopsies, helping to revive this important procedure.