bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of a decision-support mHealth application on maternal and neonatal outcomes in two district hospitals in Rwanda: pre – post intervention study
Authors: Nishimwe Aurore , Ibisomi Latifat , Nyssen Marc , Conco Daphney Nozizwe 
Published: January 2022

Abstract
Background
Globally, mobile health (mHealth) applications are known for their potential to improve healthcare providers’ access to relevant and reliable health information. Besides, electronic decision support tools, such as the Safe Delivery mHealth Application (SDA), may help to reduce clinical errors and to ensure quality care at the point of service delivery. The current study investigated the use of the SDA and its relationship to basic emergency obstetric and newborn care (BEmONC) outcomes for the most frequent complications in Rwanda; post-partum haemorrhage (PPH) and newborn asphyxia.

Methods
The study adopted a pre–post intervention design. A pre-intervention record review of BEmONC outcomes: Apgar score and PPH progressions, was conducted for 6 months’ period (February 2019 - July 2019). The intervention took place in two district hospitals in Rwanda and entails the implementation of the SDA for 6 months (October 2019- March 2020), and included 54 nurses and midwives using the SDA to manage PPH and neonatal resuscitation. Six months’ post-SDA intervention, the effect of the SDA on BEmONC outcomes was evaluated. The study included 327 participants (114 cases of PPH and 213 cases of neonatal complications). The analysis compared the outcome variables between the baseline and the endline data. Fisher’s exact test was used to compare the proportions and test between-group differences and significance level set at p < 0.05.

Results
Unstable newborn outcomes following neonatal resuscitation were recorded in 62% newborns cases at baseline and 28% newborns cases at endline, P-value = 0.000. Unstable maternal outcomes following PPH management were recorded in 19% maternal cases at baseline and 6% maternal cases at endline, P-value = 0.048. There was a significant association between the SDA intervention and newborns’ and maternal’ outcomes following neonatal resuscitation and PPH management, 6 months after baseline.

Conclusion
The use of the SDA supported nurses and midwives in the management of PPH and neonatal resuscitation which may have contributed to improved maternal and neonatal outcomes during 6 months of the SDA intervention. The findings of this study are promising as they contribute to a broader knowledge about the effectiveness of SDA in low and middle income hospital settings.
Tele-care intervention performed by parents involving specific task- environment- participation (STEP protocol) for infants at risk for developmental delay: protocol of randomized controlled clinical trial
Authors: Lima Camila Resende Gâmbaro , dos Santos Adriana Neves , dos Santos Mariana Martins , Morgan Catherine , Rocha Nelci Adriana Cicuto Ferreira 
Published: January 2022

Abstract
Background
With the implementation of social distancing due to the Covid-19 pandemic, many at-risk infants are without therapy. An alternative mode of therapy in this situation is tele-care, a therapy in which assessments and interventions are carried out online, in the home environment. We describe a tele-care protocol involving parent delivered task and context specific movement training, participation and environmental adaptation for infants at risk for developmental delay.

Methods
Randomized controlled trial. Infants at risk, with 3 to 9 months corrected age, will be included, and randomized into two groups: control group (conventional guidelines) and experimental group (task, environment and participation in context-specific home program). Infants will be assessed for motor capacity (Infant Motor Profile and Alberta Infant Motor Scale); participation (Young Children’s Participation and Environment Measure) and environment factors (Parent-Child Early Relational Assessment; Affordances in the Home Environment for Motor Development). The intervention period will be 10 weeks, and evaluations will be carried out before and after that period. All the assessment and intervention procedures will be carried out online, with instructions to parents for home therapy. The statistical analysis will be guided according to the distribution of the data, and a significance level of 5% will be adopted. All ethical approvals were obtained by the Ethics Committee of the University of São Carlos (Case number 31256620.5.0000.5504). The protocol will follow the SPIRIT statement. Findings will be disseminated in peer-reviewed publications and presented at national and international conferences.

Discussion
The results of this study will describe the effectiveness of a home intervention, focusing on specific activities, participation and environmental changes. These results will support the implementation of a remote protocol, with lower financial costs and focused on the particularities of the family. This type of care model can possibly help public policies to ensure equal access to evidence-based quality healthcare.

Trial registration
Brazilian Clinical Trials Registry: RBR8xrzjs, registered September 1, 2020.
Association of cardiovascular metabolic risk factor measurements with psychiatric readmission among in-hospital patients with severe mental illness: a retrospective study
Authors: Tan Xiao Wei , Chan Christopher Yi Wen , Lum Alvin Wai Mum , Lee Eng Sing , Mok Yee Ming , Fung Daniel Shuen Sheng , Tor Phern Chern 
Published: January 2022

AbstractBackgroundPatients with severe mental illness (SMI) and comorbid physical conditions were often associated with higher risks of mortality and hospital readmission. In this study, we aim to examine the association of cardiovascular metabolic risk factor measurements with risks of psychiatric readmissions among in-hospital patients with severe mental illness (SMI).MethodsWe collected the longitudinal information of laboratory investigations, blood pressure and body mass index (BMI) among in-hospital patients who had been diagnosed with schizophrenia, major depression disorder or bipolar disorder and with comorbid diagnosis of hypertension, hyperlipidemia or diabetes from Jan 2014 to Jan 2019. The primary outcome was time to first psychiatric readmission. Cox proportional hazard model was utilized to calculate the hazard risks (HR) of cardiovascular metabolic risk factors with psychiatric readmission.ResultsA total of 5,256 patients were included in the analysis. Compared to patients with normal blood parameters, patients with aberrant tests of high-density dyslipidemia (HDL) and diastolic blood pressure (DBP) during in-hospitalization period were associated with higher risks to first psychiatric readmission [ HR (Hazard Ratio), 1.37 95% Confidence interval (CI), 1.03–1.83 for HDL and HR, 1.32 (95% CI, 1.04–1.67])for DBP]. Compared to patients with optimal monitoring, patients with suboptimal monitoring of blood lipids and blood pressure during in-hospitalization period or recommended window period of cardiovascular disease (CVD) risk management were associated with higher risks to first psychiatric readmission.ConclusionsAberrant cardiovascular metabolic blood test and blood pressure and missing measurements among in-hospital patients with SMI were associated with increased risks of psychiatric readmissions. This calls for more active screening and monitoring of CVD risk factors for those in-hospital patients in need.
To isolate or not to isolate: the impact of changing behavior on COVID-19 transmission
Authors: Agusto Folashade B. , Erovenko Igor V. , Fulk Alexander , Abu-Saymeh Qays , Romero-Alvarez Daniel , Ponce Joan , Sindi Suzanne , Ortega Omayra , Saint Onge Jarron M. , Peterson A. Townsend 
Published: January 2022

Abstract
Background
The COVID-19 pandemic has caused more than 25 million cases and 800 thousand deaths worldwide to date. In early days of the pandemic, neither vaccines nor therapeutic drugs were available for this novel coronavirus. All measures to prevent the spread of COVID-19 are thus based on reducing contact between infected and susceptible individuals. Most of these measures such as quarantine and self-isolation require voluntary compliance by the population. However, humans may act in their (perceived) self-interest only.

Methods
We construct a mathematical model of COVID-19 transmission with quarantine and hospitalization coupled with a dynamic game model of adaptive human behavior. Susceptible and infected individuals adopt various behavioral strategies based on perceived prevalence and burden of the disease and sensitivity to isolation measures, and they evolve their strategies using a social learning algorithm (imitation dynamics).

Results
This results in complex interplay between the epidemiological model, which affects success of different strategies, and the game-theoretic behavioral model, which in turn affects the spread of the disease. We found that the second wave of the pandemic, which has been observed in the US, can be attributed to rational behavior of susceptible individuals, and that multiple waves of the pandemic are possible if the rate of social learning of infected individuals is sufficiently high.

Conclusions
To reduce the burden of the disease on the society, it is necessary to incentivize such altruistic behavior by infected individuals as voluntary self-isolation.
Exploring the association between school-based peer networks and smoking according to socioeconomic status and tobacco control context: a systematic review
Authors: Littlecott H. J. , Moore G. F. , McCann M. , Melendez-Torres G. J. , Mercken L. , Reed H. , Mann M. , Dobbie F. , Hawkins J. 
Published: January 2022

Abstract
Background
Whilst prevalence of youth smoking in middle and high income countries has decreased, inequality has prevailed. The introduction of legislation regulating tobacco use in public spaces varies across countries, impacting the tobacco control context. Thus reviewing our knowledge of how social networks may influence smoking differently within different contexts is required to facilitate the development of context-specific interventions.

Methods
The search, conducted on 31st May 2019, included the following smoking-related terms; schools, adolescents, peers and social networks. Inclusion and exclusion criteria were applied throughout the title and abstract screening and full text screening. Quality assessment and synthesis followed. Studies were narratively synthesised to identify changes according to legislative context. This synthesis was conducted separately for findings relating to three categories: socioeconomic status; social selection and influence; and network position.

Results
Thirty studies were included. Differences in the relationship between network characteristics and smoking according to socioeconomic status were measured in five out of fifteen studies in Europe. Results varied across studies, with differences in network characteristics and their association with smoking varying both between schools of a differing and those of a similar socioeconomic composition. For studies conducted both before and after the introduction of comprehensive smoking legislation, the evidence for selection processes was more consistent than influence, which varied according to reciprocity. Findings showed that isolates were more likely to smoke and in-degree and out-degree centrality were related to smoking both before and after the introduction of legislation. The relationship between popularity and smoking was contingent on school level smoking prevalence in studies conducted before the introduction of legislation, but not after.

Conclusions
Overall, effects according to socioeconomic status were underreported in the included studies and no consistent evidence of change after the introduction of a comprehensive smoking ban was observed. Further network analyses are required using more recent data to obtain a comprehensive understanding of how network processes may influence smoking differently according to socioeconomic status, and how adaptation could be used to enhance intervention effectiveness.

Systematic review registration
International Prospective Register of Systematic Reviews (PROSPERO) registration number: CRD42019137358.
The source and fate of Mycobacterium tuberculosis complex in wastewater and possible routes of transmission
Authors: Mtetwa Hlengiwe N. , Amoah Isaac D. , Kumari Sheena , Bux Faizal , Reddy Poovendhree 
Published: January 2022

Abstract
Background
The Mycobacterium tuberculosis complex (MTBC) consists of causative agents of both human and animal tuberculosis and is responsible for over 10 million annual infections globally. Infections occur mainly through airborne transmission, however, there are possible indirect transmissions through a faecal-oral route which is poorly reported. This faecal-oral transmission could be through the occurrence of the microbe in environments such as wastewater. This manuscript, therefore, reviews the source and fate of MTBC in the wastewater environment, including the current methods in use and the possible risks of infections.

Results
The reviewed literature indicates that about 20% of patients with pulmonary TB may have extra-pulmonary manifestations such as GITB, resulting in shedding in feaces and urine. This could potentially be the reason for the detection of MTBC in wastewater. MTBC concentrations of up to 5.5 × 105 (±3.9 × 105) copies/L of untreated wastewater have been reported. Studies have indicated that wastewater may provide these bacteria with the required nutrients for their growth and could potentially result in environmental transmission. However, 98.6 (± 2.7) %, removal during wastewater treatment, through physical-chemical decantation (primary treatment) and biofiltration (secondary treatment) has been reported. Despite these reports, several studies observed the presence of MTBC in treated wastewater via both culture-dependent and molecular techniques.

Conclusion
The detection of viable MTBC cells in either treated or untreated wastewater, highlights the potential risks of infection for wastewater workers and communities close to these wastewater treatment plants. The generation of aerosols during wastewater treatment could be the main route of transmission. Additionally, direct exposure to the wastewater containing MTBC could potentially contribute to indirect transmissions which may lead to pulmonary or extra-pulmonary infections. This calls for the implementation of risk reduction measures aimed at protecting the exposed populations.
Future healthcare providers and professionalism on social media: a cross-sectional study
Authors: Soubra Rabih , Hasan Ibrahim , Ftouni Louna , Saab Adam , Shaarani Issam 
Published: January 2022

Abstract
Background
Nowadays, social media have become central in the daily lives of people, including healthcare professionals. Fears arise that the accelerated growth of these social platforms was not accompanied by the appropriate training of the healthcare students and workers on the professional use of social media. This study primarily aimed to assess the awareness of the healthcare students at Beirut Arab University, Lebanon on the professional standards of social media. It also aimed to assess the presence of differences in the practices and attitudes of healthcare students according to gender and major.

Methods
A cross-sectional study was designed, and a paper-based questionnaire was distributed to healthcare students. Chi-Square test was used to analyse certain findings.

Results
Out of 1800 students approached, 496 participated in the questionnaire. All participants used social media. Only 19.5% (96/496) of them had received a structured education on the professional use of social media during their university study. The majority of students (349/488, 71.5%) thought that the professional standards on social media are distinct from those established in face-to-face interactions. Female students were more likely to get adequate answers in accordance with international guidelines. There were statistically significant differences in the practices and attitudes of students belonging to different majors (p value < 0.05).

Conclusion
The line between what is professional on social media, and what is not, remains blurred for healthcare students. This study uncovered the need for clear and updated evidence-based guidelines assisting students in making the most appropriate decisions in the various online scenarios faced in healthcare practice.
Effects of the liaison nurse management on the infectious stroke complications: a randomized controlled trial
Authors: Kalani Zohreh , Ebrahimi Sedigheh , Fallahzadeh Hossein 
Published: January 2022

Abstract
Background
Two of the most serious complications after stroke are pneumonia, and urinary tract infection. Liaison nurse, from hospital admission to discharge and then at home helps patients with complicated caring issues stroke. This study investigates the effect of liaison nurse management on the incidence of pneumonia and urinary tract infection in patients with stroke after discharge from the hospital.

Methods
This randomized controlled trial was conducted on 80 patients in a hospital in Iran. The intervention group was assessed and developed a caring program by the liaison nurse and the control group received routine care. Two weeks and two months after discharge, the patients were evaluated for the incidence of pneumonia and urinary tract infection. Collected data were analyzed using the Chi-square test. P < 0.05 was considered statistically significant.

Results
The two groups were homogenous in terms of mean age; gender frequently distribution and having urinary catheter. The incidence of pneumonia in intervention and control groups (11.6% vs. 19.2%, P = 0.35) had no statistically significant differences, but there was a significant difference in the incidence of urinary tract infection (0% vs. 24.6%, P < 0.001).

Conclusions
With liaison nurse performance, there was a significant difference in the incidence of urinary tract infection, in two months after discharge from hospital, but the incidence of pneumonia had no statistically significant differences in two groups. Nurse’s evaluation each patient individually according to needs, developing and monitoring the home-based care program, beyond overall education to these patients, could reduce some of complications of a stroke.

Trial registration
This study is retrospectively registered by Iranian Registry of Clinical Trials with decree code: IRCT20170605034330N3 on April 4, 2018.
A cross-sectional study of knowledge and practices in the management of patients with Parkinson’s disease amongst public practice-based general practitioners and geriatricians
Authors: Lim Isis Claire Z. Y. , Saffari Seyed Ehsan , Neo Shermyn 
Published: January 2022

AbstractBackgroundAs most patients are likely to first interface with their community general practitioner (GP) or geriatrician for chronic healthcare conditions, these non-neurologists practitioners are well-placed to diagnose, initiate treatment in symptomatic Parkinson’s disease (PD) patients, and provide regular and timely management of their PD. However, current studies suggest that the role of the GP and geriatrician in providing holistic care for PD patients may be limited by factors such as patient perceptions, and a lack of knowledge base in the quality measures of care. This paper aims to better understand the different management styles between GPs and geriatricians practicing in public institutions in Singapore, qualify the difficulties they face in providing patient-centric care for PD patients, and identify any gaps in quality measures of care.MethodsA questionnaire was completed anonymously by GPs (n = 43) and geriatricians (n = 33) based at public institutions, on a voluntary basis before a compulsory didactic teaching on PD. Questions were modelled after quality measures set out by the American Academy of Neurology, specifically eliciting information on falls, non-motor symptoms, exercise regime and medication-related symptoms. “PD management practices and styles” questions were answered by the respondents on a 4-point Likert scale.ResultsGeriatricians spent more time in consult with PD patients compared with GPs (median [Q1-Q3] = 20 [15–30] vs 10 [10–15] minutes,p <  0.001). Geriatricians were more comfortable initiating PD medications than GPs (OR = 11.8 [95% CI: 3.54–39.3],p <  0.001), independent of gender, years of practice and duration of consult. Comfort in initiating dopamine replacement therapy (OR 1.06 [1.00–1.36],p = 0.07; aOR = 1.14 [1.02–1.26],p = 0.02) also increased with physician’s years of practice. Unfamiliarity with the types and/or doses of the medications was the most cited barrier faced by GPs (76.7%). Geriatricians were more likely than GPs to ask about falls (100% vs 86.0%,p = 0.025), non-motor symptoms (75.8% vs 53.5%,p = 0.049) and the patient’s regular physical activities (72.7% vs 41.9%,p = 0.01).ConclusionsThis study identified key patterns in the management practices and styles of non-neurologists physicians, and identified gaps in current practice. Our data suggests that interventions directed at education on PD medication prescriptions and provision of patient PD education, creation of best clinical practice guidelines, and accreditation by national bodies may instil greater confidence in practitioners to initiate and continue patient-centric PD care. A longer consultation duration with PD patients should be considered to allow physicians to get a greater scope of the patient’s needs and better manage them.