bluuebunny/crossref_metadata_2025_split huggingface dataset:
Discharge preparation and readiness after birth: a scoping review of global policies, guidelines and literature
Authors: Smith Helen , Harvey Chloe , Portela Anayda 
Published: April 2022

Abstract
Background
Despite the existence of global recommendations, postnatal care provided following childbirth is variable and often fails to address a woman’s concerns about herself and the parents’ concerns about their baby. Discharge from a facility after birth is a key moment to ensure the woman, parents and newborn receive support for the transition to care in the home. We mapped the current policies, guidance and literature on discharge preparation and readiness to identify key concepts and evidence and inform recommendations to be considered in a World Health Organization (WHO) guidance on postnatal care.

Methods
We were guided by the Johanna Briggs Institute approach, and developed inclusion criteria based on existing defintions of discharge preparation and readiness, and criteria for discharge readiness compiled by international professional organisaitons. To identify guidelines and policies we searched websites and archives of guideline organisations, and contacted individuals and professional societies working on postnatal care. We searched 14 electronic databases to locate published research and other literature on discharge preparation and readiness. For documents that met the inclusion criteria we extracted key characteristics, summarised discharge readiness criteria and components and discharge preparation steps, and characterised interventions to improve discharge preparation.

Results
The review provides a systematic map of criteria for discharge that are in use and the common steps healthcare providers take in preparing women and newborns for the transition home. The mapping also identified interventions used to strengthen discharge preparation, theories and models that conceptualise discharge preparation, scales for measuring discharge readiness and qualitative studies on the perspectives of women, men and healthcare providers on postnatal discharge.

Conclusions
The findings highlight contrasts between the research literature and policy documents. They indicate potential gaps in current discharge policies, and point to the need for more comprehensive discharge assessment and education to better identify and meet the needs of women, parents/caregivers and families prior to discharge and identify those who may require additional support.

Protocol registration details
The protocol for the review was registered with protocols.io on 23 November 2020: 10.17504/protocols.io.bpzymp7w
Pregnant adolescents and nurses perspectives on accessibility and utilization of maternal and child health information in Ohangwena Region, Namibia
Authors: Shatilwe Joyce T. , Hlongwana Khumbulani , Mashamba-Thompson Tivani P. 
Published: April 2022

AbstractBackgroundAdolescent reproductive health is still a challenge in Low and Middle Income Come Countries (LMICs). However, the reasons for the inability of most pregnant adolescent girls to access and utilize maternal and child health information (MCHI) are not well-documented. This is despite the policy guidelines promoting the provision of this necessary information to pregnant adolescents in order to prepare them for delivery. This provision is one of the strategies envisaged to improve their attendance of ANC visits and their maternal and child health.MethodData were generated from 12 adolescent pregnant girls aged 15 to 19 years and eight nurses from four different health centres in the Ohangwena Region of Namibia, using semi-structured in-depth interviews. The study was conducted over the period of three months (December 2018 to March 2019). The data were grouped into clusters aided by NVivo computer software version 12. Data were organized and condensed in small units, prior to being coded, categorized, and finally grouped into main themes and sub-themes.ResultsResults revealed that long travel hours to reach the nearest clinics was amongst the leading challenges affecting accessibility and utilization of MCHI for pregnant adolescent girls. This was exacerbated by poor support with transport fare, poor road infrastructure and non-availability of transport, and these factors were key barriers to accessibility and utilization of clinic services. Other barriers pertained to the family dynamics, such as disclosing the pregnancy to the family members prior to commencing antenatal care (ANC) visits and harsh treatment from family members after the disclosure.ConclusionThe pregnant adolescent girls were concerned about their inability to access and utilize MCHI, thereby making them susceptible to maternal complications. Health educational interventions should prioritize both the adolescent girls and their families for proper support, especially since the reactions of families on the pregnancy of their adolescent girls often negatively affect accessibility and utilization of maternal and child health services. Moreover, further research on adolescents' needs during pregnancy should be expanded to include their parents, in order to better inform policymakers.
FilmArray® Meningoencephalitis panel in the diagnosis of central nervous system infections: stewardship and cost analysis in a paediatric hospital in Chile
Authors: Acuña Mirta , Benadof Dona , Yohannessen Karla , Leiva Yennybeth , Clement Pascal 
Published: April 2022

AbstractBackgroundCentral nervous system (CNS) infection has been an ongoing concern in paediatrics. The FilmArray® Meningoencephalitis (FAME) panel has greater sensitivity in identifying the aetiology of CNS infections. This study’s objective was to compare the aetiological identification and hospitalization costs among patients with suspected CNS infection before and after the use of FAME.MethodsAn analytical observational study was carried out using a retrospective cohort for the pre-intervention (pre-FAME use) period and a prospective cohort for the post-intervention (post-FAME use) period in children with suspected CNS infection.ResultsA total of 409 CSF samples were analysed, 297 pre-intervention and 112 post-intervention. In the pre-intervention period, a total of 85.5% of patients required hospitalization, and in the post-intervention period 92.7% required hospitalization (p < 0.05). Median of ICU days was significantly lower in the post-intervention period than it was in the pre-intervention period. The overall positivity was 9.4 and 26.8%, respectively (p < 0.001). At ages 6 months and below, we found an increase in overall positivity from 2.6 to 28.1%, along with an increased detection of viral agents,S. agalactiae, S. pneumoniae,and N. meningitidis.The use of this diagnostic technology saved between $2916 and $12,240 USD in the cost of ICU bed-days. FAME use provided the opportunity for more accurate aetiological diagnosis of the infections and thus the provision of adequate appropriate treatment.ConclusionsThe cost/benefit ratio between FAME cost and ICU bed-day cost savings is favourable. Implementation of FAME in Chilean public hospitals saves public resources and improves the accuracy of aetiological diagnosis.
Predictors of postnatal depression in the slums Nairobi, Kenya: a cross-sectional study
Authors: Kariuki Esther W. , Kuria Mary W. , Were Fredrick N. , Ndetei David M. 
Published: April 2022

Abstract
Background
Postnatal depression (PND) is a universal mental health problem that prevents mothers’ optimal existence and mothering. Although research has shown high PND prevalence rates in Africa, including Kenya, little research has been conducted to determine the contributing factors, especially in low-resource communities.

Objective
This study aimed to investigate the PND risk factors among mothers attending Lang’ata and Riruta Maternal and Child Health Clinics (MCH) in the slums, Nairobi.

Methods
This study was cross-sectional. It is part of a large study that investigated the effectiveness of a brief psychoeducational intervention on PND. Postnatal mothers (567) of 6-10 weeks postanatal formed the study population. Depression rate was measured using the original 1961 Beck’s Depression Inventory (BDI). In addition, a sociodemographic questionnaire (SDQ) was used to collect hypothesized risk variables. Multivariable logistic regression analysis was used to explore predictors of PND.

Results
The overall prevalence of PND in the sample of women was 27.1%. Women aged 18-24 (β = 2.04 95% C.I.[0.02; 4.05], p = 0.047), dissatisfied with body image (β = 4.33 95% C.I.[2.26; 6.41], p < 0.001), had an unplanned pregnancy (β = 2.31 95% C.I.[0.81; 3.80], p = 0.003 and felt fatigued (β = − 1.85 95% C.I.[− 3.50; 0.20], p = 0.028) had higher odds of developing PND. Participants who had no stressful life events had significantly lower depression scores as compared to those who had stressful life events (β = − 1.71 95% C.I.[− 3.30; − 0.11], p = 0.036) when depression was treated as a continuous outcome. Sensitivity analysis showed that mothers who had secondary and tertiary level of education had 51 and 73% had lower likelihood of having depression as compared to those with a primary level of education (A.O.R = 0.49 95% C.I.[0.31-0.78], p = 0.002) and (A.O.R = 0.27 95% C.I.[0.09-0.75], p = 0.013) respectively.

Conclusion
This study reveals key predictors/risk factors for PND in low-income settings building upon the scanty data. Identifying risk factors for PND may help in devising focused preventive and treatment strategies.
Exploring a parent-focused physical literacy intervention for early childhood: a pragmatic controlled trial of the PLAYshop
Authors: Lane Cassandra , Naylor Patti-Jean , Predy Madison , Kurtzhals Mette , Rhodes Ryan E. , Morton Kayla , Hunter Stephen , Carson Valerie 
Published: April 2022

Abstract
Background
Parents play a key role in young children’s physical activity and physical literacy development. Little research has explored parent-focused interventions to improve young children’s physical literacy. We examined if a theory-based, feasible physical literacy training workshop (PLAYshop) for parents could improve their physical literacy knowledge and confidence and improve parenting practices related to facilitating the physical literacy development of their preschool-aged child (3-5 years). The secondary objective was to explore implementation facilitators and barriers.

Methods
We conducted a pragmatic controlled trial in two Canadian cities (Edmonton and Victoria) from November 2019 – March 2020. A total of 143/151 parents were eligible and assigned to intervention (n = 71) or control group (n = 72). The PLAYshop included: (i) a 75-min in-person workshop with interactive activities and physical literacy educational messages, (ii) educational materials, (iii) an equipment pack, and (iv) two post-workshop booster emails. Surveys measured parents’ knowledge and confidence at baseline and follow-up. Application of PLAYshop concepts and implementation facilitators and barriers were explored with interviews of parents and workshop leaders. Repeated measures ANOVAs and thematic analyses were completed.

Results
Parents’ knowledge and confidence improved significantly over time; intervention group changes were significantly greater than control group changes (p < 0.001; ɳ2 = .32). Parents applied PLAYshop concepts at-home, including child-led play, making activities fun, and promoting child manipulative and locomotor skills. Time was a key parental implementation barrier. Program implementation issues varied by context (location and participants).

Conclusions
PLAYshop participation changed parents’ physical literacy knowledge and confidence and physical literacy enhancing play with their children. Implementation feasibility was high. The findings from this real-world trial highlight an efficacious and scalable intervention that warrants further testing.

Trial registration
ClinicalTrials.gov: NCT04394312. Registered 19/05/2020.
Associations of nonconforming gender expression and gender identity with bullying victimization: an analysis of the 2017 youth risk behavior survey
Authors: Lian Qiguo , Li Ruili , Liu Zhihao , Li Xiaona , Su Qiru , Zheng Dongpeng 
Published: April 2022

Abstract
Purpose
Although gender nonconformity (GNC) and transgender identity are both linked to bullying victimization, few studies have examined them with bullying victimization simultaneously. Using a sample of Youth Risk Behavior Survey, we investigated the associations of GNC and transgender identity with bullying victimization within the same study.

Methods
We analyzed data from the cross-sectional school-based Youth Risk Behavior Survey in 2017 (n = 25,378). The exposures were GNC and transgender identity. The main outcomes were traditional victimization, cyber victimization, and combined victimization. We calculated adjusted prevalence ratios (APRs) with 95% confidence intervals (CIs) using Poisson regression models.

Results
There were 22.15% of high school students with GNC, and 1.61% identified themselves as transgender. GNC is associated with traditional (APR,1.45;95%CI, 1.21–1.73), cyber (APR,2.00; 95%CI, 1.66–2.40) and combined victimization (APR,1.61;95%CI, 1.42–1.83) respectively among assigned male at birth (AMAB) students only. Transgender male and female students are both at higher risk of bullying victimization for all the three outcomes than cisgender peers.

Conclusions
AMAB GNC and transgender identity are associated with a higher risk of bullying victimization. Providing support systems and celebrating gender diversity within and outside schools are important.
Differences in digital health literacy and future anxiety between health care and other university students in England during the COVID-19 pandemic
Authors: Frings Daniel , Sykes Susie , Ojo Adeola , Rowlands Gillian , Trasolini Andrew , Dadaczynski Kevin , Okan Orkan , Wills Jane 
Published: April 2022

Abstract
Background
This study investigates university students’ digital health literacy and web-based information-seeking behaviours during the early stages of the COVID-19 pandemic in England. It compares undergraduate and postgraduate students in non-health related subjects with health care students, many of whom were preparing for, or working in, frontline roles. The survey was conducted as part of a wider study by the COVID-HL research consortium.

Methods
A cross-sectional study was conducted among n = 691 university students aged ≥18 years from 25 universities across England using an adapted digital survey developed by COVID-HL. Data were collected regarding sociodemographic characteristics and specific measures drawn from the Future Anxiety Scale and the Digital Health Literacy Instrument (DHLI). These had been adapted for use in an English setting and to the specific context of the COVID-19 pandemic. Other data collected included students’ anxiety or worries about the future using the Dark Future Scale as well as behaviours in online information-seeking. Data were analysed using correlations to test for relationships between constructs and also between group comparisons to test for differences between students studying health and non-health related subjects.

Results
Across digital health literacy dimensions, there was no significant difference between students studying health-related subjects and other students. Health care students did report greater difficulties in relation to how to behave online. They also relied less on public body sources for information about the pandemic. A significant difference was found between the two student populations in relation to their anxiety about the future with health care students reporting fewer fears about the future.

Conclusions
Although digital health literacy is well developed in university students, a significant proportion of students still face difficulties with evaluating online information which may frustrate public health efforts. This could be addressed by ensuring health students’ curriculum in particular encompasses digital health literacy.
Trends of notification rates and treatment outcomes of tuberculosis cases with and without HIV co-infection in eight rural districts of Uganda (2015 – 2019)
Authors: Baluku Joseph Baruch , Nanyonjo Resty , Ayo Jolly , Obwalatum Jehu Eleazer , Nakaweesi Jane , Senyimba Catherine , Lukoye Deus , Lubwama Joseph , Ward Jennifer , Mukasa Barbara 
Published: April 2022

Abstract
Background
The End TB Strategy aims to reduce new tuberculosis (TB) cases by 90% and TB-related deaths by 95% between 2015 – 2035. We determined the trend of case notification rates (CNRs) and treatment outcomes of TB cases with and without HIV co-infection in rural Uganda to provide an interim evaluation of progress towards this global target in rural settings.

Methods
We extracted retrospective programmatic data on notified TB cases and treatment outcomes from 2015 – 2019 for eight districts in rural Uganda from the District Health Information System 2. We estimated CNRs as the number of TB cases per 100,000 population. Treatment success rate (TSR) was calculated as the sum of TB cure and treatment completion for each year. Trends were estimated using the Mann–Kendall test.

Results
A total of 11,804 TB cases, of which 5,811 (49.2%) were HIV co-infected, were notified. The overall TB CNR increased by 3.7-fold from 37.7 to 141.3 cases per 100,000 population in 2015 and 2019 respectively. The increment was observed among people with HIV (from 204.7 to 730.2 per 100,000, p = 0.028) and HIV-uninfected individuals (from 19.9 to 78.7 per 100,000, p = 0.028).
There was a decline in the TSR among HIV-negative TB cases from 82.1% in 2015 to 63.9% in 2019 (p = 0.086). Conversely, there was an increase in the TSR among HIV co-infected TB cases (from 69.9% to 81.9%, p = 0.807).

Conclusion
The CNR increased among people with and without HIV while the TSR reduced among HIV-negative TB cases. There is need to refocus programs to address barriers to treatment success among HIV-negative TB cases.
Effect of physical activity on the development and the resolution of nonalcoholic fatty liver in relation to body mass index
Authors: Choi Hyo-In , Lee Mi Yeon , Kim Hyunah , Oh Byeong Kil , Lee Seung Jae , Kang Jeong Gyu , Lee Sung Ho , Kim Byung Jin , Kim Bum Soo , Kang Jin Ho , Lee Jong-Young , Sung Ki-Chul 
Published: April 2022

Abstract
Background
Data on whether physical activity (PA) levels are related to nonalcoholic fatty liver disease (NAFLD) when considering body mass index (BMI) are scarce. We assessed whether PA affects the development or resolution of NAFLD in conjunction with BMI changes.

Methods
Overall, 130,144 participants who underwent health screening during 2011–2016 were enrolled. According to the PA level in the Korean version of the validated International PA Questionnaire Short Form, participants were classified into the inactive, active, and health-enhancing PA (HEPA) groups.

Results
In participants with increased BMI, the hazard ratio (HR) and 95% confidence interval after multivariable Cox hazard model for incident NAFLD was 0.97 (0.94–1.01) in the active group and 0.94 (0.89–0.99) in the HEPA group, whereas that for NAFLD resolution was 1.03 (0.92–1.16) and 1.04 (0.88–1.23) (reference: inactive group). With increased BMI, high PA affected only new incident NAFLD. PA enhancement or maintenance of sufficient PA prevented new incident NAFLD. In participants with decreased BMI, the HRs were 0.98 (0.90–1.07) and 0.88 (0.78–0.99) for incident NAFLD and 1.07 (0.98–1.17) and 1.33 (1.18–1.49) for NAFLD resolution in the active and HEPA groups, respectively. With decreased BMI, high PA reduced incident NAFLD and increased NAFLD resolution. Maintenance of sufficient PA led to a considerable resolution of NAFLD.

Conclusion
In this large longitudinal study, PA prevented incident NAFLD regardless of BMI changes. For NAFLD resolution, sufficient PA was essential along with BMI decrease. Maintaining sufficient PA or increasing the PA level is crucial for NAFLD prevention or resolution.
Extracellular vesicles and chronic obstructive pulmonary disease (COPD): a systematic review
Authors: Gomez Nancy , James Victoria , Onion David , Fairclough Lucy C. 
Published: April 2022

AbstractBackgroundChronic Obstructive Pulmonary Disease (COPD) is a common inflammatory disease of the airways characterized by irreversible airflow limitation, ranking the third highest cause of death worldwide. Extracellular vesicles (EVs) are important intercellular communication mediators released by cells into their extracellular environment with the capacity to transfer biological signals. EVs involved in COPD hold great potential to understand disease pathogenesis and identify important biomarkers. This systematic review aims to examine all available research on EVs in the pathogenesis and diagnosis of COPD to identify existing knowledge and support further research within the field.MethodsPublications were searched using PubMed and EMBASE with the search terms (Exosomes or extracellular vesicles or microvesicles or microparticles or ectosomes) AND (chronic obstructive pulmonary disease or COPD or emphysema or bronchitis).ResultsInitial search yielded 512 papers of which 142 were manually selected for review and 43 were eligible for analyses. The studies were divided into groups according to the role of EVs in pathogenesis, EV origin and cargo, their role in COPD exacerbations and their diagnostic utility. EVs were found to be involved in the mechanism of pathogenesis of COPD, derived from various cell types, as well as containing modified levels of miRNAs. EVs also varied according to the pathophysiological status of disease, therefore presenting a possible method for COPD diagnosis and progress monitoring.ConclusionThe current findings show the limited but good quality research looking at the role of EVs in COPD, demonstrating the need for more studies to better define and provide further insight into the functional characteristics of EV in COPD pathogenesis.
Six-minute walk distance in healthy subjects: reference standards from a general population sample
Authors: Cazzoletti Lucia , Zanolin Maria Elisabetta , Dorelli Gianluigi , Ferrari Pietro , Dalle Carbonare Luca Giuseppe , Crisafulli Ernesto , Alemayohu Mulubirhan Assefa , Olivieri Mario , Verlato Giuseppe , Ferrari Marcello 
Published: April 2022

AbstractIntroductionThe 6-min walking distance (6MWD) test is a useful tool to obtain a measure of functional exercise capacity. However, reference equations have been mainly based on selected populations or small samples. The purpose of this study was to determine the reference equations to predict the 6MWD in a large Italian population sample of healthy adults of a wide age range.MethodsIn the frame of the multi case–control population-based study Gene Environment Interaction in Respiratory Diseases (GEIRD), we studied 530 healthy subjects: 287 females ranging 21–76 and 243 males ranging 21–78 years of age. We measured 6MWD, demographic and anthropometric data and collected the reported physical activity. A multiple linear regression model for the 6MWD included age, age2, height, weight and physical activity for both sex equations. The two-way interaction age-height and age-weight and the quadratic terms of weight and height were also tested for inclusion separately in each model.ResultsThe mean ± SD for 6MWD was 581.4 ± 66.5 m (range 383–800 m) for females and 608.7 ± 80.1 m (range 410–875 m) for males. The reference equations were 6MWD = 8.10*age + 1.61*heightcm−0.99*weightkg + 22.58*active−0.10*age2 + 222.55 for females (R squared = 0.238) and 6MWD = 26.80*age + 8.46*heightcm−0.45*weightkg−2.54*active−0.06*age2−0.13*age*heightcm−890.18 for males (R squared = 0.159), where “active” is 1 when the subject is physically active, 0 otherwise.ConclusionThis study is the first to describe the 6MWD in a large population sample of young, middle aged and elderly healthy Caucasian subjects, and to determine reference equations. These findings will help to improve the evaluation of Italian and European patients with diseases influencing their functional capacity.