bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gender differences in sleep disruption during COVID-19: cross-sectional analyses from two UK nationally representative surveys
Authors: Ding Xuejie , Brazel David M , Mills Melinda C 
Published: May 2022

ObjectiveCOVID-19 related measures have impacted sleep on a global level. We examine changes in sleep problems and duration focusing on gender differentials.DesignCross-sectional analyses using two nationally representative surveys collected during the first and second month after the 2020 lockdown in the UK.Setting and participantsParticipants (age 17 years and above) from the first wave of the Understanding Society COVID-19 Study are linked to the most recent wave before the pandemic completed during 2018 and 2019 (n=14 073). COVID-19 Survey Data was collected from 2 to 31 May 2020 (n=8547) with participants drawn from five nationally representative cohort studies in the UK.AnalysisWe conducted bivariate analyses to examine gender gaps in change in sleep problems and change in sleep duration overall and by other predictors. A series of multivariate ordinary least squares (OLS) regression models were estimated to explore predictors of change in sleep problems and change in sleep time.ResultsPeople in the UK on average experienced an increase in sleep loss during the first 4 weeks of the lockdown (mean=0.13, SD=0.9). Women report more sleep loss than men (coefficient=0.15, 95% CI 0.11 to 0.19). Daily sleep duration on average increased by ten minutes (mean=−0.16, SD=1.11), with men gaining eight more minutes of sleep per day than women (coefficient=0.13, 95% CI 0.09 to 0.17).ConclusionThe COVID-19 related measures amplified traditional gender roles. Men’s sleep was more affected by changes in their financial situation and employment status related to the crisis, with women more influenced by their emotional reaction to the pandemic, feeling anxious and spending more time on family duties such as home schooling, unpaid domestic duties, nurturing and caregiving. Based on our findings, we provide policy advice of early, clear and better employment protection coverage of self-employed and precarious workers and employer recognition for parents.
Compassion fatigue, burnout, compassion satisfaction and depression among emergency department physicians and nurses: a cross-sectional study
Authors: Ma Huan , Huang Shuang Quan , We Bo , Zhong Ying 
Published: May 2022

ObjectivesEmergency department physicians and nurses are at high risk of compassion fatigue, burnout and depression. The purpose of this study was to examine the inter-relationship between compassion fatigue, burnout, compassion satisfaction and depression in emergency department physicians and nurses.DesignA cross-sectional study.SettingThis study was conducted in five tertiary hospitals in five different cities across the province of Sichuan, China, in 2021.ParticipantsA total of 342 emergency department physicians and nurses participated in the study.Main outcome measuresCompassion fatigue, burnout, compassion satisfaction and depression scores.ResultsAmong the study participants, 100% were found to have depressive symptoms, 27.8% had low compassion satisfaction, 2.3% had high burnout and 3.8% had compassion fatigue. In the final multiple linear regression model, marital status (p=0.008; 95% CI –5.205 to –0.789), history of chronic disease (p=0.003; 95% CI –6.461 to –1.386), compassion satisfaction (p<0.001; 95% CI 0.593 to 1.274), burnout (p=0.019; 95% CI 0.084 to 0.930) and compassion fatigue (p<0.001; 95% CI –1.527 to –1.053) among emergency department physicians and nurses were considered to be significant predictors of depression.ConclusionsThe prevalence of depression among emergency department physicians and nurses is high in the province of Sichuan, China. Compassion fatigue, burnout and compassion satisfaction were significantly associated with depression in emergency department physicians and nurses. Hospital administrations should consider these findings to develop appropriate psychological interventions and strategies, to prevent, alleviate or treat severe depression among emergency department physicians and nurses in the province of Sichuan.
Autotransfusion in low-resource settings: a scoping review
Authors: Palmqvist Maria , Von Schreeb Johan , Älgå Andreas 
Published: May 2022

IntroductionGlobally, haemorrhage is the leading cause of both maternal mortality and preventable trauma death. For patients suffering from haemorrhage, prompt blood transfusion can be life-saving; however, safe and sufficient blood is often lacking in low-resource settings (LRS). Autotransfusion (AT), in which the patient’s own blood is collected and transfused back, is an established alternative to donor blood transfusions, although one that is primarily performed with advanced AT systems. Research on basic AT in LRS is scarce. Therefore, we aimed to consolidate all available information on the current use of basic AT in LRS and to identify AT techniques and devices described for use in such settings.DesignScoping review.MethodsWe systematically searched four key databases: PubMed, Web of Science, Global Health and Cochrane Library as well as several grey literature databases and databases of relevant organisations. The final search was conducted on 22 April 2019. We included all types of studies referring to any information on basic AT used or sought to be used in LRS, published in English and dated after 31 December 2008. We synthesised the data from the included studies, results were charted or summarised narratively.ResultsSome 370 records were reviewed, yielding 38 included documents. We found a paucity of scientific evidence as well as contradictory information on the extent of AT use and that AT use is largely undocumented. The most commonly described indications were haemoperitoneum (primarily among obstetric patients) and haemothorax. We identified three AT techniques used in LRS. Additionally, two new devices and one filter are described for potential use in LRS.ConclusionsBasic AT is practiced for certain obstetric and trauma indications. However, context-specific studies are needed to determine the technique’s safety and effectiveness. Extent of use is difficult to assess, but our results indicate that basic AT is not a widely established practice in LRS. Future research should address the bottlenecks hampering basic AT availability. New AT devices for use in LRS are described, but their utility and cost-effectiveness remain to be assessed.
Notion of a good death for patients with cancer: a qualitative systematic review protocol
Authors: Xiao Jinnan , Ding Jinfeng , Huang Chongmei 
Published: May 2022

IntroductionPromoting the quality of death and achieving a good death is one of the most important goals of palliative care in cancer care. Few studies synthesised views of patients with cancer on the notion of a good death and its associated factors. By eliciting the core elements of a good death, the review aims to identify potential unmet needs of patients with cancer and reveal their common values and care preferences at the end of life. The review also has the potential to inform the development of guidelines for clinical care and shared decision-making in palliative care practice.Methods and analysisA qualitative systematic review will be conducted and reported according to the Joanna Briggs Institute (JBI) methodology for systematic review and synthesis of qualitative data and the Preferred Reporting Items for Systematic Review and Meta-Analysis. Comprehensive search will be performed in six English and two Chinese databases from inception to 30 April 2022 to retrieve relevant qualitative articles focusing on the notion of a good death from the perspective of patients with cancer. Data will be extracted using the JBI standardised data extraction tool for qualitative research. The quality of the included studies will be critically appraised using the JBI Qualitative Assessment and Review Instrument. Data extraction and quality appraisal will be conducted by two reviewers independently. A meta-aggregative approach and narrative summary will be used to synthesise data.Ethics and disseminationEthical approval is not needed. We will disseminate the findings through international conferences related to cancer care or palliative care. The final review will be submitted and published in a peer-reviewed journal.PROSPERO registration numberCRD42021266629.
Perspectives of structurally marginalised patients attending contextually tailored and integrated care practices in Canada: a focused ethnography study
Authors: Loignon Christine , Dupéré Sophie , Benhadj Lynda , Carru Diane , Dahrouge Simone 
Published: May 2022

ObjectivesTo better understand the experience of patients attending community-based primary healthcare practices (CBPHCPs) aimed at improving equity and access to primary care for underserved patients, which have been implemented locally in several countries, including Canada. There are currently little data on how, or to what extent, they mitigate patients’ experience of social inequalities in care and improve their access to health. This study explored the impacts of the sociospatial characteristics of these practices on patients’ care experience.Design and methodsQualitative, multisite, focused ethnographic study based on in-situ observations and interviews, incorporating inductive and deductive analysis, and using the concept of sense of place.SettingThree CBPHCPs located in deprived urban areas in two provinces of Canada.Participants28 structurally marginalised persons (17 women) attending the clinics, ranging in age from 18 to 79 years, and 16 managers, clinicians and practitioners working in these clinics.ResultsData underscored the importance of clinic proximity and accessibility in facilitating patients’ navigation of the health system. Patients appreciated the clinics’ positive sociospatial characteristics. Non-judgmental environments and informal spaces fostered patients’ empowerment and social interaction among themselves and with peer navigators and healthcare professionals. The experience of supportive continuity of care had a positive impact on patients’ sense of well-being and, for many, a positive ripple effect and long-term impact on their social integration.ConclusionThese results have important implications for policy given the current context, in which governments are challenged to support primary healthcare that addresses the social determinants of health to achieve greater equity. We conclude that scaling up contextually tailored care and deploying humanistic innovative organisational practices into mainstream care will help narrow the equity gap and reduce current prevalent social inequalities in the health system.
Youth Culturally adapted Manual Assisted Problem Solving Training (YCMAP) in Pakistani adolescent with a history of self-harm: protocol for multicentre clinical and cost-effectiveness randomised controlled trial
Authors: Husain Nusrat , Tofique Sehrish , Chaudhry Imran B , Kiran Tayyeba , Taylor Peter , Williams Christopher , Memon Rakhshi , Aggarwal Shilpa , Alvi Mohsin Hassan , Ananiadou S , Ansari Moin Ahmad , Aseem Saadia , Beck Andrew , Alam Sumira , Colucci Erminia , Davidson Kate , Edwards Sarah , Emsley Richard , Green Jonathan , Gumber Anil , Hawton Keith , Jafri Farhat , Khaliq Ayesha , Mason Thomas , Mcreath Ann , Minhas Ayesha , Naeem Farooq , Naqvi Haider Ali , Noureen Amna , Panagioti Maria , Patel Anita , Poppleton Aaron , Shiri Tinevimbo , Simic Mima , Sultan Sarwat , Nizami Asad Tamizuddin , Zadeh Zainab , Zafar Shehla Naeem , Chaudhry Nasim 
Published: May 2022

IntroductionSuicide is a global health concern. Sociocultural factors have an impact on self-harm and suicide rates. In Pakistan, both self-harm and suicide are considered as criminal offence’s and are condemned on both religious and social grounds. The proposed intervention ‘Youth Culturally Adapted Manual Assisted Problem Solving Training (YCMAP)’ is based on principles of problem-solving and cognitive–behavioural therapy. YCMAP is a brief, culturally relevant, scalable intervention that can be implemented in routine clinical practice if found to be effective.Method and analysisA multicentre rater blind randomised controlled trial to evaluate the clinical and cost-effectiveness of YCMAP including a sample of 652 participants, aged 12–18 years, presenting to general physicians/clinicians, emergency room after self harm or self referrals. We will test the effectiveness of 8–10 individual sessions of YCMAP delivered over 3 months compared with treatment as usual. Primary outcome measure is repetition of self-harm at 12 months. The seconday outcomes include reduction in suicidal ideation, hopelessness and distress and improvement in health related quality of life. Assessments will be completed at baseline, 3, 6, 9 and 12 months postrandomisation. The nested qualitative component will explore perceptions about management of self-harm and suicide prevention among adolescents and investigate participants’ experiences with YCMAP. The study will be guided by the theory of change approach to ensure that the whole trial is centred around needs of the end beneficiaries as key stakeholders in the process.Ethics and disseminationEthics approval has been obtained from the Ethics Committee of University of Manchester, the National Bioethics Committee in Pakistan. The findings of this study will be disseminated through community workshops, social media, conference presentations and peer-reviewed journals.Trial registration numberNCT04131179.
Effects of local handwashing agents on microbial contamination of the hands in a rural setting in Northwest Ethiopia: a cluster randomised controlled trial
Authors: Gizaw Zemichael , Yalew Alemayehu Worku , Bitew Bikes Destaw , Lee Jiyoung , Bisesi Michael 
Published: May 2022

ObjectiveTo evaluate the effectiveness of handwashing with water and wood ash in reducing faecal contamination of the hands.DesignA cluster randomised controlled trial was employed with two arms: handwashing with water and wood ash versus handwashing with water alone.SettingRural households of East Dembiya District, Central Gondar Zone, Amhara National Regional State, Ethiopia.Participants440 mothers and caregivers of children younger than 5 years assigned (1:1, 220 in each group) in clusters, with buffer zones between each cluster.InterventionHealth education on effective handwashing was given to the intervention and control groups. Participants in the intervention group used wood ash of the same quantity (ie, one closed palm).Outcome measuresThe primary outcome was microbial contamination of the hands, measured by means of Escherichia coli counts before and after handwashing.ResultsAt baseline, 75.9% and 67.7% of the participants in the intervention and control groups, respectively, had dirt on their fingernails, and the hands of all participants in both groups were contaminated with E. coli. The mean E. coli counts recovered at baseline were 3.07 log10 colony forming unit (CFU)/swab in the intervention group and 3.03 log10 CFU/swab in the control group, while at endline it was 1.4 log10 CFU/swab in the intervention group and 3.02 log10 CFU/swab in the control group. The mean E.coli counts was reduced by 1.65 log10 due to the intervention (difference-in-differences: β= −1.65, 95% CI= −1.84 to –1.46).ConclusionTwo-thirds of the swab samples tested positive for E. coli after handwashing with water and wood ash, which indicates wood ash is not very effective in terms of completely removing micro-organisms on the hands. However, wood ash was significantly better than water alone in reducing the concentration of faecal coliform organisms on the hands. Local health authorities should primarily promote handwashing with soap. However, in the absence of soap, use of wood ash over water alone might be appropriate.Trial registration numberPACTR202011855730652.
Intimate partner violence against women with disability and associated mental health concerns: a cross-sectional survey in Mumbai, India
Authors: Riley Andrew , Daruwalla Nayreen , Kanougiya Suman , Gupta Apoorwa , Wickenden Mary , Osrin David 
Published: May 2022

ObjectivesThe risk of intimate partner violence (IPV) against women with disability is believed to be high. We aimed to compare the prevalence of past-year IPV against women with and without functional difficulties in urban informal settlements, to review its social determinants and to explore its association with mental health.DesignCross-sectional survey.SettingFifty clusters within four informal settlements.Participants5122 women aged 18–49 years.Primary and secondary outcome measuresWe used the Washington Group Short Set of Questions to assess functional difficulties. IPV in the past year was described by binary composites of questions about physical, sexual and emotional violence. We screened for symptoms of depression using the Patient Health Questionnaire-9 and of anxiety using the Generalised Anxiety Disorder-7. Multivariable logistic regression models examined associations between functional difficulties, IPV and mental health.Results10% of participants who screened positive for functional disability had greater odds of experiencing physical or sexual IPV (adjusted OR (AOR) 1.68, 95% CI 1.23 to 2.29) and emotional IPV (1.52, 95% CI 1.16 to 2.00) than women who screened negative. Women who screened positive for functional disability had greater odds than women who screened negative of symptoms suggesting moderate or severe anxiety (AOR 2.50, 95% CI 1.78 to 3.49), depression (2.91, 95% CI 2.13 to 3.99) and suicidal thinking (AOR 1.94, 95% CI 1.50 to 2.50).ConclusionsThe burden of IPV fell disproportionately on women with functional difficulties, who were also more likely to screen positive for common mental disorder. Public health initiatives need to respond at local and national levels to address the overlapping and mutually reinforcing determinants of violence, while existing policy needs to be better utilised to ensure protection for the most vulnerable.
Can we accurately forecast non-elective bed occupancy and admissions in the NHS? A time-series MSARIMA analysis of longitudinal data from an NHS Trust
Authors: Eyles Emily , Redaniel Maria Theresa , Jones Tim , Prat Marion , Keen Tim 
Published: May 2022

ObjectivesThe main objective of the study was to develop more accurate and precise short-term forecasting models for admissions and bed occupancy for an NHS Trust located in Bristol, England. Subforecasts for the medical and surgical specialties, and for different lengths of stay were realisedDesignAutoregressive integrated moving average models were specified on a training dataset of daily count data, then tested on a 6-week forecast horizon. Explanatory variables were included in the models: day of the week, holiday days, lagged temperature and precipitation.SettingA secondary care hospital in an NHS Trust in South West England.ParticipantsHospital admissions between September 2016 and March 2020, comprising 1291 days.Primary and secondary outcome measuresThe accuracy of the forecasts was assessed through standard measures, as well as compared with the actual data using accuracy thresholds of 10% and 20% of the mean number of admissions or occupied beds.ResultsThe overall Autoregressive Integrated Moving Average (ARIMA) admissions forecast was compared with the Trust’s forecast, and found to be more accurate, namely, being closer to the actual value 95.6% of the time. Furthermore, it was more precise than the Trust’s. The subforecasts, as well as those for bed occupancy, tended to be less accurate compared with the overall forecasts. All of the explanatory variables improved the forecasts.ConclusionsARIMA models can forecast non-elective admissions in an NHS Trust accurately on a 6-week horizon, which is an improvement on the current predictive modelling in the Trust. These models can be readily applied to other contexts, improving patient flow.
Comparison of clinical practice of tonsil surgery from quality register data from Sweden and Norway and one clinic in Denmark
Authors: Stalfors Joacim , Ovesen Therese , Bertelsen Jannik Buus , Bugten Vegard , Wennberg Siri , Sunnergren Ola 
Published: May 2022

ObjectivesTo compare the application of indications, demographics, surgical and haemostatic techniques in tonsil surgery in three countries.DesignNon-randomised, prospective, observational cohort.SettingAll patients registered in the National Tonsil Surgery Quality Registers in Sweden, Norway and West Jutland, Denmark.ParticipantsData were retrieved from 2017 to 2019; registered surgeries: Sweden: 20 833; Norway: 10 294 and West Jutland, Denmark: 505.ResultsTonsil surgery for obstruction was twice as common in Sweden (62.2%) compared with Norway (31%) and Denmark (27.7%). Recurrent tonsillitis was registered twice as frequently in Norway (35.7%) and Denmark (39%) compared with Sweden (16.7%). Chronic tonsillitis was registered more frequently in Norway (29.8%) than in Sweden (13.8%) and Denmark (12.7%). Day surgery (>76%) was comparable. The higher frequency of obstruction in Sweden affected age and gender distributions: Sweden (7 years, 50.4% boys), Norway (17 y, 42.1%) and Denmark (19 y, 38.4%). For obstructive disorders, tonsillotomy with adenoidectomy was used in a majority of Swedish children (72%), whereas tonsillectomy with or without adenoidectomy dominated in Norway (53.5%) and Denmark (57.9%). Cold steel was the technique of choice for tonsillectomy in all three countries. For tonsillotomy, hot dissection techniques dominated in all countries. Disparities were observed with regard to haemostatic techniques. Bipolar diathermy was commonly used in all countries. Monopolar diathermy was practically only used in Sweden. Infiltration with epinephrine in the tonsillar bed was registered in Sweden and Norway but not at all in Denmark. Combined cold surgical and cold haemostatic techniques were more commonly used in Sweden (22.7%) than in Norway (10.4%) and Denmark (6.2%).ConclusionsThis study demonstrates disparities among the Nordic countries in tonsil surgery in terms of indications plus surgical and haemostatic techniques. Increased coverage and further monitoring of outcomes is needed to identify best practices and ideal guidelines for improved care.