bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and Correlates of Insufficient Physical Activity Among Adults Aged 18–69 Years in India: Findings From the National Noncommunicable Disease Monitoring Survey
Authors: Ramamoorthy Thilagavathi , Kulothungan Vaitheeswaran , Mathur Prashant 
Published: February 2022

Background: Sufficient physical activity (PA) significantly contributes to the prevention and control of noncommunicable diseases. This study aims to determine the prevalence of insufficient PA and associated sociodemographic and lifestyle factors among adults aged 18–69 years in India. Methods: A national population-based, cross-sectional survey was conducted during 2017–2018 among 12,000 adults that adapted globally standard data collection tools. The data were weighted and analyzed using complex samples analysis. Logistic regression analysis was performed to identify the sociodemographic and lifestyle factors associated with insufficient PA. Results: Age standardized prevalence of insufficient PA among adults in India was 41.4%. A higher proportion of women (52.4%) and urban adults (51.7%) were not doing sufficient PA. Men (118.8 min) spent more time in PA per day than women (55.3 min). Higher odds of insufficient PA were significantly associated with unemployment (adjusted odds ratio [aOR] = 6.45), highest wealth quintile (aOR = 1.86), presence of central obesity (aOR = 1.24), and raised blood pressure (aOR = 1.22). Conclusion: This study provides the baseline prevalence of insufficient PA to monitor the set PA targets for India by 2025. The identified associated factors can guide policy makers to plan tailored interventions targeting high-risk groups and a multisectoral approach to promote PA.
Coriolis effect recorded in Late Pleistocene Marine Isotope Stage 5e Bahamian aeolianites
Authors: Rendall Ben , Wilson Kat , Kerans Charles , Helper Mark , Mohrig David 
Published: February 2022

Abstract
The windward islands of the Lucayan Archipelago (Bahamas) form an Atlantic Ocean–facing transect spanning &gt;950 km in length and 6° of latitude. The islands' topography is largely constructed from carbonate wind-blown dunes (i.e., aeolianites) deposited during the interglacial phases of the Late Pleistocene and Holocene. New digital elevation data from satellite radar interferometry (TanDEM-X German Earth observation satellite) enables a step change in the ability to map and quantify Bahamian aeolian landforms across the archipelago. A semi-automated mapping approach that leverages object-based image analysis yields a total aeolianite area of ~1674 km2 across Great Abaco, Eleuthera, Cat, San Salvador, Long, Crooked, Acklins, and Mayaguana islands (Bahamas) and the Turks and Caicos Islands. Longitudinal axis measurements from 747 Pleistocene parabolic dunes record increasing consistency of east-west orientation with decreasing latitude. Three U.S. National Data Buoy Center data buoys provided modern wind direction and velocity measurements (n = 730,933 of each) along this transect. Analysis of wind vectors (&gt;P90 [90th percentile], n = 70,095) demonstrates increasing organization of easterlies at southern latitudes and an offset in directionality compared to formational winds of Pleistocene Marine Isotope Stage (MIS) 5e deposits. Southward trends of increasing wind strength and consistency reflect geostrophic flow driven by atmospheric circulation within the Hadley cell and right-hand deflection of the Coriolis effect in the Northern Hemisphere. We propose that the offset in directionality between dune axes and modern wind vectors is related to changes in latitudinal width of the Hadley cell from the Late Pleistocene (MIS 5e) to today. This data set is robust enough to serve as a benchmark against which future atmospheric circulation models can be compared.
Assessing vaccine hesitancy in Arab countries in the Middle East and North Africa (MENA) region: a scoping review protocol
Authors: Galal Bayan , Lazieh Stefany , Al-Ali Samir , Khoshnood Kaveh 
Published: February 2022

IntroductionVaccine-preventable disease outbreaks have increased in past years, and there is great public health interest in monitoring attitudes towards vaccination as well as identifying factors contributing to vaccine hesitancy and refusal. Although the WHO declared vaccine hesitancy as one of the top threats to global health in 2019, studies focused on the determinants and extent of vaccine hesitancy in Arab countries in the Middle East and North Africa (MENA) region are lacking. This scoping review explores the various factors surrounding vaccine hesitancy, including but not limited to geographic, cultural and religious factors, and examines the extent and nature of the existing evidence on this topic. In light of current development of various COVID-19 vaccines, our work seeks to elucidate the barriers to vaccine uptake in specific populations.Methods and analysisThis review will be conducted using the Joanna Briggs Institute Manual for Scoping Reviews. It will comply with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Studies published in English, Arabic and French between January 1998 and December 2020 will be drawn from PubMed, Embase, Cochrane and Scopus. The search strategy will include terms related to vaccination and vaccine hesitancy in Arab countries in the MENA region. We will also include grey literature on the topic by searching Google and Google Scholar. Studies will be selected according to the Participants-Intervention-Comparators-Outcome model, and all study titles and abstracts will be screened by two reviewers. Disagreements will be resolved with a third reviewer’s input.Ethics and disseminationThis review is exempted from ethical approval and will be published in a peer-reviewed open-access journal to ensure wide dissemination.
Protocol for an integrated evaluation framework to study training, curricular and contextual factors impacting the success of a measurement for improvement training programme for healthcare staff in Ireland
Authors: Khurshid Zuneera , De Brún Aoife , McAuliffe Eilish 
Published: February 2022

IntroductionMeasurement for improvement is the process of collecting, analysing and presenting data to demonstrate whether a change has resulted in an improvement. It is also important in demonstrating sustainability of improvements through continuous measurement. This makes measurement for improvement a core element in quality improvement (QI) efforts. However, there is little to no research investigating factors that influence measurement for improvement skills in healthcare staff. This protocol paper presents an integrated evaluation framework to understand the training, curricular and contextual factors that influence the success of measurement for improvement training by using the experiences of trainees, trainers, programme and site coordinators.Methods and analysisThis research will adopt a qualitative retrospective case study design based on constructivist-pragmatic philosophy. The Pressure Ulcers to Zero collaborative and the Clinical Microsystems collaborative from the Irish health system which included a measurement for improvement component have been selected for this study. This paper presents an integrated approach proposing a novel application of two pre-existing frameworks: the Model for Understanding Success in Quality framework and the Kirkpatrick Evaluation Model to evaluate an unexplored QI context and programme. A thematic analysis of the qualitative interview data and the documents collected will be conducted. The thematic analysis is based on a four-step coding framework adapted for this research study. The coding process will be conducted using NVivo V.12 software and Microsoft Excel. A cross-case comparison between the two cases will be performed.Ethics and disseminationThe study has received an exemption from full ethical review from the Human Research Ethics Committee of University College Dublin, Ireland (LS-E-19-108). Informed consent will be obtained from all participants and the data will be anonymised and stored securely. The results of the study will be disseminated in peer-reviewed journals.
Determinants of antenatal care use in nine sub-Saharan African countries: a statistical analysis of cross-sectional data from Demographic and Health Surveys
Authors: Andegiorgish Amanuel Kidane , Elhoumed Mohamed , Qi Qi , Zhu Zhonghai , Zeng Lingxia 
Published: February 2022

ObjectiveTo explore the factors associated with antenatal care (ANC) visits.DesignA secondary data analysis from cross-sectional studies was conducted.SettingSub-Saharan Africa.Participants56 002 women aged 15–49 years in Ghana (3224), Kenya (10 981), Malawi (9541), Namibia (2286), Rwanda (4416), Senegal (6552), Tanzania (5536), Uganda (7979) and Zambia (5487) were analysed.Outcomes4+ANC visits.ResultsOverall, 55.52% (95% CI: 55.11% to 55.93%) of women made 4+ANC visits. The highest 4+ANC visits were in Ghana (85.6%) and Namibia (78.9%), and the lowest were in Senegal (45.3%) and Rwanda (44.5%). Young women 15–19 years had the lowest uptake of 4+ANC visits. Multivariable analysis indicated that the odds of 4+ANC visits were 14% lower among women from rural areas compared with those living in towns (adjusted OR (AOR) 0.86; 95% CI: 0.81 to 0.91). This difference was significant in Kenya, Malawi, Senegal and Zambia. However, in Zambia, the odds of 4+ANC visits were 48% higher (AOR 1.48; 95% CI: 1.2 to 1.82) among women from rural compared with urban areas. Women with higher educational level had more than twofold higher odds of 4+ANC visits in seven of the nine countries, and was significant in Kenya, Malawi, Rwanda and Zambia. Compared with the poorest household wealth category, odds of 4+ANC visits increased by 12%, 18%, 32% and 41% for every 20% variation on the wealth quantile. Women in their first-time pregnancy had higher odds of 4+ANC visits compared with others across all countries, and women who had access to media at least once a week had a 22% higher probability of 4+ANC visits than women who had no access to media (AOR 1.22, 95% CI: 1.15 to 1.29).ConclusionThe number of ANC visits was considered to be inadequate with substantial variation among the studied countries. Comprehensive interventions on scaling uptake of ANC are needed among the low-performing countries. Particular attention should be given to women of low economic status and from rural areas.
Comparison of dexmedetomidine and meperidine for the prevention of shivering following coronary artery bypass graft: study protocol of a randomised controlled trial
Authors: Cao Cuicui , Lv Meng , Wei Chuansong , Yan Jie , Wang Yuelan , Gu Changping 
Published: February 2022

IntroductionShivering is a common complication in the postoperative period. The incidence of shivering has been reported to range from 5% to 65% under general anaesthesia and as 33% during epidural anaesthesia. Shivering can increase perioperative risk in patients. Both dexmedetomidine and meperidine are effective agents for the prevention of postanaesthetic shivering. However, few studies have compared the anti-shivering effects of different agents following coronary artery bypass graft (CABG). This study aims to compare the effects of dexmedetomidine and meperidine on the incidence of shivering in patients undergoing CABG.Methods and analysisA total of 180 patients aged 18–75 years, with an American Society of Anesthesiologists (ASA) grade of II–IV, undergoing elective CABG will be enrolled and randomly assigned to the dexmedetomidine, meperidine and control groups (placebo) in an intended 1:1:1 allocation ratio. The patients will be followed up for 7 days after surgery. The primary outcome is the incidence of shivering within 24 hours postoperatively. The secondary outcomes are the number of remedial drugs used after surgery, the incidence of postoperative hypotension and bradycardia, sedation scores, endotracheal extubation time, intensive care unit length of stay, incidence of postoperative delirium within 7 days after surgery, incidence of postoperative arrhythmias, incidence of postoperative nausea and vomiting, average hospital length of stay and mortality rate 30 days after surgery.Ethics and disseminationThe study protocol was approved by the ethics committee of The First Affiliated Hospital of Shandong First Medical University on 20 January 2021 (YXLL-KY-2021(002)) and registered at ClinicalTrials.gov. The results of this study will be presented at national and international scientific meetings and conferences. We plan to publish the data in peer-reviewed international scientific journals.Trial registration numberNCT04735965.
Antimicrobial-associated organ injury among the elderly: a systematic review and meta-analysis protocol
Authors: Chinzowu Tichawona , Roy Sandipan , Nishtala Prasad S 
Published: February 2022

IntroductionOlder adults (aged 65 years and above) constitute the fastest growing population cohort in the western world. There is increasing evidence that the burden of infections disproportionately affects this cohort of older adults and hence this vulnerable population is frequently exposed to antimicrobials. There is currently no systematic review summarising the evidence for risk of organ injury following antimicrobial exposure among older adults. This protocol will outline how we will conduct a systematic review and meta-analyses to examine the relationship between antimicrobial exposure and organ injury in older adults.Methods and analysisWe will search for PsycINFO, PubMed and EMBASE databases for relevant articles using MeSH terms where applicable. After removing duplicates, articles will be screened for inclusion into or exclusion from the study by two reviewers. Title and abstract screening will be done first, followed by full-text screening. The Newcastle-Ottawa scale will be used to assess the risk of bias for cohort and case control studies, and the Cochrane collaboration’s risk of bias tool will be used for randomised control trials. We will explore the potential sources of heterogeneity and bias using funnel and forest plots of the included studies.Ethics and disseminationDuring the conduct of the review, ethical principles will be observed to ensure integrity. Any potential conflicts of interests will be declared, all contributors acknowledged and no plagiarised material will be included in the review.The systematic review and meta-analysis will be submitted for publication in a peer-reviewed journal in geriatrics. The findings will also be presented at international conferences in geriatrics or pharmacoepidemiology. The results will be communicated to patient and public engagement networks supported by the NHS Research and Development.PROSPERO registration numberThis protocol is registered in the PROSPERO database (registration number CRD42020152621).
More than burnout: qualitative study on understanding attrition among senior Obstetrics and Gynaecology UK-based trainees
Authors: Chakrabarti Rima , Markless Sharon 
Published: February 2022

ObjectivesWorkforce retention among UK-based Obstetrics and Gynaecology (O&G) trainees has been a particular concern for a number of years, with 30% trainees reportedly leaving specialty training. With specialty focused research being limited and tending to analyse the training programme as a whole. The aim of this study was to explain why senior O&G trainees within reach of completing training were leaving the specialty.DesignQualitative study based on Constructivist Grounded Theory methodology using semi-structured interviews. Data collection and analysis continued until theoretical saturation was achieved. The key themes were used to build an explanatory model, in the form of a concept map for attrition.SettingLondon.ParticipantsNine senior O&G trainees (ST5-7) of which six were committed to the specialty, two were not going to pursue a consultancy post once training was complete and one ex-trainee.ResultsFive major themes emerged from the study, of which four; ‘Just get on with it’, ‘Just a number’, ‘Tick-box exercise’ and ‘It has not happened to me but…’ were described by all participants. However, the final theme, relating to the lack of professional identity, ‘I did not see myself as an Obstetrician and Gynaecologist’ was only demonstrated among those who had left or were not going to pursue a consultancy post once training was complete. Potential strategies for facilitating professional identity development were focused into three areas; establishing meaningful connections, adequate support mechanisms and regional initiatives.ConclusionPrevious research on attrition in the medical profession have suggested burnout and the lack of resilience as being the key factors for leaving training. However, based on this study’s findings, an alternative pathway related to the lack of professional identity has been proposed for senior O&G trainees.EthicsThis study was registered at King’s College London, Kings Reference: LRU-18/19-10632 and was awarded ethical approval through the Research Ethics Committee (REMAs).
‘I can’t cope with multiple inputs’: a qualitative study of the lived experience of ‘brain fog’ after COVID-19
Authors: Callan Caitriona , Ladds Emma , Husain Laiba , Pattinson Kyle , Greenhalgh Trisha 
Published: February 2022

ObjectiveTo explore the lived experience of ‘brain fog’—the wide variety of neurocognitive symptoms that can follow COVID-19.Design and settingA UK-wide longitudinal qualitative study comprising online focus groups with email follow-up.Method50 participants were recruited from a previous qualitative study of the lived experience of long COVID-19 (n=23) and online support groups for people with persistent neurocognitive symptoms following COVID-19 (n=27). In remotely held focus groups, participants were invited to describe their neurocognitive symptoms and comment on others’ accounts. Individuals were followed up by email 4–6 months later. Data were audiotaped, transcribed, anonymised and coded in NVIVO. They were analysed by an interdisciplinary team with expertise in general practice, clinical neuroscience, the sociology of chronic illness and service delivery, and checked by people with lived experience of brain fog.ResultsOf the 50 participants, 42 were female and 32 white British. Most had never been hospitalised for COVID-19. Qualitative analysis revealed the following themes: mixed views on the appropriateness of the term ‘brain fog’; rich descriptions of the experience of neurocognitive symptoms (especially executive function, attention, memory and language), accounts of how the illness fluctuated—and progressed over time; the profound psychosocial impact of the condition on relationships, personal and professional identity; self-perceptions of guilt, shame and stigma; strategies used for self-management; challenges accessing and navigating the healthcare system; and participants’ search for physical mechanisms to explain their symptoms.ConclusionThese qualitative findings complement research into the epidemiology and mechanisms of neurocognitive symptoms after COVID-19. Services for such patients should include: an ongoing therapeutic relationship with a clinician who engages with their experience of neurocognitive symptoms in its personal, social and occupational context as well as specialist services that include provision for neurocognitive symptoms, are accessible, easily navigable, comprehensive and interdisciplinary.
Quality of life of older adults and associated factors in Ghanaian urban slums: a cross-sectional study
Authors: Attafuah Priscilla Yeye Adumoah , Everink Irma , Abuosi Aaron Asibi , Lohrmann Christa , Schols Jos M G A 
Published: February 2022

ObjectiveThis study provides insight into the quality of life (QoL) of older adults living in urban slums in Ghana.DesignThe study employed a community-based, cross-sectional design to assess QoL among older adults in two slums between April and May 2020. QoL was assessed using the WHO Quality of Life-Brief version (WHOQOL-BREF) questionnaire.SettingsParticipants were drawn from two slums in Ghana, one in a fishing-dominated community and the other in an industrial community.ParticipantsThis study included 400 participants aged 60 and above who had lived in either slum for at least 1 month and were able to communicate verbally.ResultsAlthough the means of all participants’ transformed scores were poor in the physical and psychological domains, they were moderate in all other domains. When viewed as a whole, the perceived overall QoL is neither poor nor good and participants were neither satisfied nor dissatisfied with their health. Participants had a moderate level of QoL in the WHOQOL-BREF psychological (mean score 45.7), social (mean score 57.0) and environmental (mean score 51.6) domains. The mean score for physical QoL of older adults was 43.3, which denotes poor QoL. In all domains, male participants have a significantly higher mean QoL than their female counterparts. An analysis of variance comparing the living arrangements of participants showed that those who lived with extended family had high mean scores in environmental QoL, overall QoL and satisfaction with health. Regression analysis revealed that QoL was influenced mostly by the environmental (46.2%), followed by the psychological (43.7%), physical (31%) and social (20.4%) domains.ConclusionsThe findings from this study show that older adults living in slums had moderate psychological, social and environmental QoL and poor physical QoL. Although the mean scores for QoL are higher than anticipated, health policy development must take into account the specific needs of older adults.