bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of a virtual reality-based sensory stimulation intervention in preventing delirium in intensive care units: a randomised-controlled trial protocol
Authors: Liang Surui , Liu Yong , Wen Taoxue , Luo Dan , He Mingxin , Tian Jinfei 
Published: January 2025

IntroductionDelirium is a common acute cognitive impairment characterised by confusion, disorientation and attention deficits, particularly prevalent in intensive care unit (ICU) settings. Given its significant impact on patients, caregivers and healthcare resources, preventing delirium in patients in the ICU is of paramount importance. This is the first randomised-controlled trial designed to evaluate the effects of a virtual reality-based sensory stimulation intervention on preventing delirium in ICU patients.Methods and analysisWe employed a paired randomisation method to match eligible participants based on a validated delirium risk scoring model for patients in the ICU. The study will commence in September 2024 and conclude in June 2026. A consecutive sample of 324 patients in the ICU admitted to the study setting will be recruited. Eligible participants will be randomly allocated to receive either virtual reality-based sensory stimulation in addition to usual care or usual care alone. The virtual reality-based sensory stimulation intervention will last for up to 14 days, with all interventions administered by a research team. We define delirium-free days over a 14-day period as the primary outcome. The secondary outcomes will include delirium incidence, duration and severity; patients’ psychological well-being (post-traumatic stress disorder, sleep quality and ICU memory); patients’ clinical outcomes and other outcomes (quality of life, independence and cognitive function). Data will be collected at baseline, post-intervention and 6 months post-intervention. Two independent t-tests or Wilcoxon-Mann-Whitney tests will be used for continuous variables, while χ2or Fisher’s exact tests will be employed for categorical variables. The analysis will adhere to both the intention-to-treat and per-protocol principles. Additionally, mixed-effects models and subgroup analysis will be planned.Ethics and disseminationThis protocol was approved by the Research Ethics Committee of Shenzhen Hospital of Southern Medical University (NYSZYYEC20230068). All participants or their family caregivers will provide written informed consent. Results will be disseminated through scientific publications, and presentations at local and international conferences.Trial registration numberClinicalTrials.govNCT06153472. Trial registration date: 22 November 2023.
Economic burden of musculoskeletal disorders in Tanzania: results from a community-based survey
Authors: Deidda Manuela , Grieve Eleanor , Krauth Stefanie , Hsieh Ping-Hsuan , Yongolo Nateiya , Siebert Stefan , Halliday Jo , Biswaro Sanjura Mandela , Kilonzo Kajiru , Walker Richard , Kelly Clive , Msoka Elizabeth F , Kiula Kiula , Mmbaga Blandina , McIntosh Emma 
Published: January 2025

ObjectivesTo identify, measure and value the economic burden of musculoskeletal (MSK) disorders in the Kilimanjaro region, Tanzania.DesignCommunity-based cross-sectional survey (undertaken between January and September 2021).SettingHai district, Kilimanjaro, Tanzania.ParticipantsHouseholds resident in the Hai district.MethodsA two-stage cluster sampling was used to select a representative sample of all Hai district residents. Clinical screening tools were used to identify and measure MSK disorders through a tiered approach. An economic questionnaire measuring healthcare costs, out-of-pocket costs, absenteeism, presenteeism and work productivity loss was administered to those with likely MSK disorders and selected controls (individuals without MSK disorders, matched by age and gender). Resource use was valued using country-specific costs. Two-part model regressions were fitted. A descriptive analysis of catastrophic expenditure was also conducted.Main outcome measureHealthcare costs, productivity costs and total costs.ResultsAnnual average productivity and healthcare costs were, respectively, 3.5 and 3 times higher for those with likely MSK disorders than controls. Productivity costs of individuals with MSK disorders were Int$487 vs Int$132 in the control group (difference: Int$355, 95% CI Int$222 to Int$488). Healthcare costs in those with MSK were Int$269 vs Int$88 in the control group (difference: Int$181, 95% CI Int$34 to Int$327). The difference in terms of out-of-pocket expenses was economically substantial in magnitude, although not statistically significant.ConclusionThe evidence will be used to inform policies addressing MSK disorders, by promoting the design of interventions, service provision, health promotion and awareness activities at local, regional and national level.
Prevalence of delirium in German nursing homes: protocol for a cross-sectional study
Authors: Dörner Jonas , Houdelet-Oertel Alexandre , Arslan Zafer , Lauer Romy , Otte Ina , Vollmar Horst Christian , Thürmann Petra , Palm Rebecca , Holle Bernhard 
Published: January 2025

IntroductionDelirium is a neuropathological syndrome that is associated with several negative outcomes. Nursing home residents are vulnerable to developing delirium. Valid prevalence data and associated factors are not yet available for Germany. Therefore, the aim of the prevalence study of the DeliA project (Delirium in Nursing Homes) is to assess the prevalence of delirium and its associated factors in 750 nursing home residents.Methods and analysisTrained registered nurses from each participating nursing home will collect the data in a multicentre cross-sectional study. The inclusion criteria for residents are valid informed consent, age ≥65 years and sufficient language skills. The exclusion criteria are aphasia, coma, deafness or end-of-life status. The 4 ‘A’s Test will be used as the primary measurement. Delirium motor subtypes will be determined using the Delirium Motor Subtype Scale. Covariables for associated factors, including functional impairments, pain, cognitive status and nutritional status, are assessed through standardised measurements. Moreover, data such as prescribed drugs or medical diagnosis, hearing impairment or falls will be assessed from the nursing records. Furthermore, the Drug Burden Index will be calculated, and associated factors will be determined using a logistic regression model. The period for data collection in participating nursing homes is planned for 2 consecutive weeks in April 2024.Ethics and disseminationThis study was approved by the Ethics Committee of Witten/Herdecke University (no. 82/2023). Findings will be published in peer-reviewed journals and presented at conferences.Registrationhttps://osf.io/xkfvh/(DOI 10.17605/OSF.IO/XKFVH).
Prevalence, determinants and impact of urinary incontinence on quality of life among Palestinian postpartum women: a cross-sectional study
Authors: Hersh Bayan , Shaban Rawan , Nazzal Zaher 
Published: January 2025

ObjectivesUrinary incontinence (UI) is prevalent among women, particularly during the postpartum period, impacting various aspects of quality of life (QoL). The objectives of this study are to determine the prevalence of postpartum UI among Palestinian women, explore its relationship with delivery mode, identify associated risk factors and assess its impact on QoL.DesignA cross-sectional study.Setting and participantsThe study targeted postpartum women attending primary healthcare centres in the North West Bank of Palestine. Data were collected using interviewer-administered questionnaires. The primary outcome was the prevalence of postpartum UI, and the secondary outcomes included risk factors associated with UI and its impact on QoL. We used multivariate logistic regression analysis to identify factors associated with UI while adjusting for confounding variables. The Institutional Review Board of An-Najah National University approved the study.ResultsOut of 507 participants, 13.6% (95% CI 10.8% to 16.9%) experienced postpartum UI, with 78.3% reporting moderate-to-severe symptoms. Maternal body mass index (BMI) (adjusted OR (aOR) 1.98; 95% CI 1.1 to 3.7; adjusted p=0.033) and experiencing UI during the last pregnancy (aOR 2.25; 95% CI 1.3 to 3.8; adjusted p=0.003) were significant risk factors for postpartum UI. No significant association was found between the normal vaginal delivery and postpartum UI compared with caesarean section (aOR 1.5; 95% CI 0.90 to 1.5; adjusted p=0.284). Postpartum UI severity significantly correlated with QoL, particularly in social embarrassment (p=0.005), psychosocial impact (p≤0.001) and avoidance and limiting behaviours (p≤0.001).ConclusionThe prevalence of postpartum UI in Palestinian women is consistent with global findings. Experiencing UI during the last pregnancy and higher maternal BMI were identified as key risk factors for postpartum UI. These results highlight the need for early detection, intervention and preventive strategies to mitigate the impact of postpartum UI on QoL.
Barriers to early diagnosis and treatment of cervical cancer in Addis Ababa, Ethiopia: qualitative study
Authors: Dereje Nebiyu , Addissie Adamu , Worku Alemayehu , Assefa Mathewos , Gebremariam Alem , Kantelhardt Eva Johanna , Jemal Ahmedin 
Published: January 2025

ObjectiveCervical cancer remains the most diagnosed and deadly cancer among women in low and middle income countries, including Ethiopia, although it can be controlled if detected and treated early. However, research on contextual barriers to early diagnosis and treatment of cervical cancer is limited in Ethiopia. This study aimed to describe the lived experience of the patients and to explore the barriers to early diagnosis and treatment of cervical cancer.DesignWe conducted a phenomenological qualitative study, which was part of a larger mixed-methods study.SettingTikur Anbesa Specialised Comprehensive Hospital, Addis Ababa, Ethiopia.Participants24 purposively selected patients with diagnostic delay and 16 patients with treatment delay were interviewed using an in-depth interview guide (IDI).ResultsTwo broad themes and seven sub-themes to explain the barriers to early diagnosis and treatment of cervical cancer emerged. These themes and sub-themes include patient related barriers (inadequate knowledge, visits to traditional healers and practice of religious rituals as a solution for illness, poor adherence to the treatments and fear of side effects, and financial hardships) and provider related barriers (limited access to diagnostic and treatment infrastructure, inadequate training of healthcare providers and poor quality of care).ConclusionsThe findings of the study underscore the need to reinforce awareness among patients and the community, scale up the screening, diagnostic and treatment infrastructure, and advocate for quality of care in the healthcare facilities in Ethiopia to promote early diagnosis and treatment of cervical cancer.
Mapping the landscape and evidence of cross-sectoral collaboration models targeting individuals referred for assessment of attention-deficit hyperactivity disorder or autism spectrum disorder: protocol for a scoping review
Authors: Kristensen Rikke Kirstine , Andersen Pernille Tanggaard , Bilenberg Niels , Milling Emilie Dalsgaard , Dalgaard Guldager Julie 
Published: January 2025

IntroductionNeurodevelopmental disorders, notably attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), present substantial challenges in mental health. Individuals referred for assessment in a psychiatric unit experience complex needs. This implies that their needs necessitate coordination across multiple sectors. Cross-sectoral collaboration models have emerged as essential strategies for addressing the complexities of these disorders. However, evidence of their existence, implementation and success remains limited. This protocol aims to outline a scoping review where we will explore existing collaboration models, evaluate their implementation and gain an understanding of how cross-sectoral collaboration models can be developed to ultimately benefit individuals referred for assessment of ADHD or ASD.Methods and analysisThis proposed scoping review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. A comprehensive search will be conducted across PubMed, CINAHL, Embase, PsycINFO and Google Scholar, as well as grey literature sources, between 1 December 2024 and 1 January 2025. Inclusion criteria will encompass studies focusing on cross-sectoral collaboration for individuals referred for assessment of ADHD or ASD, published in English, Danish, Norwegian or Swedish. The search will use a three-block search string, with iterative refinement guided by familiarity with the evidence base. Data extraction will involve study characteristics and implementation details, using the Consolidated Framework for Implementation Research in combination with Proctoret al’s implementation outcomes framework. Results will be synthesised into descriptive tables, providing a comprehensive mapping of existing models and emphasising implementation feasibility.Ethics and disseminationEthical approval is not required for this protocol since it involves the review of existing literature without the involvement of human participants or personal data. Findings will be disseminated at national and international conferences and will be integrated into future efforts to develop cross-sectoral collaboration models in Denmark.
Detection of Elder Abuse Through Emergency Care Technicians Screening Tool Revision for Home-Based Primary Care (DETECT-RPC): a cluster randomised controlled trial study protocol
Authors: Cannell Brad , Sevey Nicholas , Livingston Melvin D , Burnett Jason , Lees Haggerty Kristin , Pickering Carolyn 
Published: January 2025

IntroductionThe annual prevalence of elder mistreatment (EM) in cognitively intact older adults is estimated to be 11%, yet the annual prevalence in older adults with Alzheimer’s disease and related dementias (AD/ADRD) is estimated to be as high as 75%. Associated with a decrease in quality of life and increase in risk of mortality, EM represents a significant public health burden. Home-based primary care (HBPC) providers are uniquely positioned to address the critical need for robust EM screening and reporting, especially among individuals with AD/ADRD. This protocol seeks to adapt the Detection of Elder mistreatment Through Emergency Care Technicians (DETECT) screening tool, previously used by emergency medical technicians, for use by HBPC providers.Methods and analysisThe protocol consists of two main phases which include four substudies. Substudy 1 uses a qualitative approach to understand the current barriers to clinician identification and reporting of EM in HBPC, including what adaptations need to be made to DETECT for use in HBPC. Substudy 2 is a cluster randomised controlled trial evaluating the impact of Detection of Elder Abuse Through Emergency Care Technicians Screening Tool Revision for Home-Based Primary Care (DETECT-RPC) on clinician identification of older adult patients with increased risk of EM and referring their concerns to the appropriate authorities and service providers. Substudies 3 and 4 apply a mixed-methods approach to postscreening interviews with clinicians and caregiver/care recipient dyads, respectively. These substudies aim to evaluate DETECT-RPC’s impact on barriers to EM identification and reporting as well as the harms and benefits of using the screening tool from the perspective of patients and their caregivers.Ethics and disseminationAll components of this study are conducted with the approval of the Institutional Review Board of the University of Texas Health Science Center at Houston (HSC-SPH-22-0732, HSC-SPH-23-0105, HSC-SPH-23-0965, HSC-SPH-24-0123). The results of this study will be disseminated through a peer-reviewed journal as well as through presentations at professional conferences, invited talks and other standard channels.Trial registration numberNCT05958654(ClinicalTrials.gov).
Burnout in New Zealand resident doctors: a cross-sectional study of prevalence and risk factors
Authors: Boyle Alex B , Shay Denys , Martyn Tanushk , Savage Earle , MacLean Simon B M , Every-Palmer Susanna 
Published: January 2025

ObjectiveBurnout syndrome, characterised by emotional exhaustion, depersonalisation and decreased personal accomplishment, is well documented in the medical workforce. This study aimed to investigate the prevalence of burnout in New Zealand resident doctors (doctors who have yet to complete their specialty training).DesignCross-sectional survey study of resident doctors in New Zealand.SettingDistributed by email.Participants509 resident doctors currently working in New Zealand. Doctors not currently working or those who have completed their specialty training (consultants) were excluded.Primary and secondary outcome measuresParticipants were asked about a number of demographic and work-related factors and to complete the Maslach Burnout Inventory, which measures the three dimensions of burnout: ‘Emotional Exhaustion’, ‘Depersonalisation’ and low ‘Personal Accomplishment’.Results409/509 (80%) of respondents had scores indicating high burnout on at least one dimension. 163 (32%) had high burnout on one dimension, 111 (22%) on two dimensions and 135 (26%) on all three dimensions. Feeling well supported protected against burnout in all three dimensions: emotional exhaustion (OR 0.34, CI 0.19 to 0.60), depersonalisation (OR 0.52, CI 0.31 to 0.86) and decreased personal accomplishment (OR 0.51, CI 0.29 to 0.78). Having a manageable workload protected against emotional exhaustion (OR 0.23, CI 0.13 to 0.37) and depersonalisation (OR 0.39, CI 0.24 to 0.61). Increasing weekly exercise was protective for personal accomplishment (OR 0.846, CI 0.73 to 0.98). Having children was protective for depersonalisation (OR 0.7, CI 0.53 to 0.90). A personal history of depression or anxiety was associated with burnout on all three dimensions: emotional exhaustion (OR 2.86, CI 1.67 to 5.00), depersonalisation (OR 1.66, CI 1.01 to 2.73) and decreased personal accomplishment (OR 1.71, CI 1.05 to 2.80). Alcohol misuse was associated with an increased risk of depersonalisation (OR 1.68, CI 1.08 to 2.62), and feeling inadequately remunerated was associated with emotional exhaustion (OR 2.27, CI 1.28 to 4.17). Qualitative data revealed concerns about poor staffing, inadequate remuneration, a focus on service provision over education, slow career progression and difficulty balancing work and specialty examinations.ConclusionsBurnout has a high prevalence in New Zealand’s resident doctor workforce. Several associations and qualitative themes were identified. These findings may aid in the development of interventions to mitigate burnout in the medical workforce.
Impact of the COVID-19 pandemic on epidemiological and clinical characteristics of inpatients with burns in a Northwest China burn centre: a retrospective study
Authors: Cui Yiwei , Feng Jian , Xiao Shuao , Liu Jiaqi , Han Yige , Zhang Yuheng , Bian Yongqian , Li Xueyong 
Published: January 2025

ObjectiveThis study aimed to assess the impact of the COVID-19 pandemic on the characteristics and outcomes of patients with burns in a burn centre situated in Northwest China.DesignA retrospective descriptive study.SettingThis study was conducted in Tangdu Hospital, a major regional burn centre in Xi'an, Shaanxi Province of China.ParticipantsA total of 1413 patients with burns were included in the study, with the admission period spanning from 2017 to 2019 (before the pandemic) and 2020 to 2022 (during the pandemic).ResultsBurn hospitalisations decreased during the pandemic for both children (9.80%) and adults (24.68%). The pandemic was associated with a decrease in work-related burns and a corresponding increase in the risk of domestic burns (both p<0.001). The proportions of burns due to scald and flame increased, while electrical injury cases and proportions decreased significantly (both p=0.001). The estimated range of % total body surface area (TBSA) for children increased from 8% (IQR: 5–12%) to 10% (IQR: 8–15%) in children (p<0.001) and from 8% (IQR: 4–18%) to 11% (IQR: 6–25%) in adults (p<0.001). In children, the number of burn cases transferred from other hospitals decreased (p=0.011). Among adults, the number of female patients with burns rose (p=0.013), and the number of patients with inhalation injury also rose (p=0.009).ConclusionDuring the COVID-19 pandemic, the number of inpatients with burns declined. Domestic burns became more common, and scald and flame burns as well as the average burn area (% TBSA) increased. These findings might highlight the significance of implementing specific public health strategies and safety measures to improve family safety both during and after the pandemic.
‘It is an emotional rollercoaster!!!’ Experiences of mothers of preterm newborns seeking care at a tertiary hospital in Ghana: a qualitative phenomenological study
Authors: Nukpezah Ruth Nimota , Atanuriba Gideon Awenabisa 
Published: January 2025

ObjectiveTo describe, through the phenomenological lens, the experiences of mothers following preterm birth and admitted at a tertiary hospital.MethodsDesignDescriptive phenomenological study.SettingNeonatal intensive care unit (NICU) of a tertiary hospital in Ghana.PopulationMothers who delivered prematurely and were admitted.Main outcome measuresExperiences of mothers who delivered prematurely and had their neonates admitted to the NICU.ResultsFour themes and three subthemes were realised: (1) maternal anxiety about unknown outcomes of the newborn condition, (2) the positive impact of family-centred care, (3) maternal roles for preterm care and (4) poor support for maternal involvement in care.ConclusionsMothers of preterm newborns sustained varying degrees of emotional trauma and faced challenges that deprived them of active involvement in their newborn care. Despite these, family-centred care was impactful and gave a window of opportunity for mothers to provide maternal roles. We highly recommend tailored emotional and psychological supports for mothers who have delivered prematurely, as it is crucial to ensuring both maternal and neonatal survival.