bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patients’ experiences of medicines on initiation of antineoplastic agents for the treatment of colorectal cancer: a qualitative study
Authors: Brincat Alison , Vella Bonanno Patricia , Stewart Derek , Weidmann Anita E 
Published: December 2021

ObjectiveTo explore the patients’ experiences on initiation of treatment with antineoplastic medicines for colorectal cancer.DesignA qualitative study using semistructured, face-to-face interviews based on the adapted patients’ lived experience with medicines conceptual model was conducted. Ethics approval was granted. Interviews took place while eligible patients were receiving their first cycle of antineoplastic medicines, audiorecorded and transcribed verbatim. Interpretative phenomenological analysis was used.SettingNational oncology hospital in Malta.ParticipantsAdult patients over 18 years, newly diagnosed with colorectal cancer and initiating treatment with 5-fluorouracil/folinic acid and oxaliplatin (FOLFOX) or capecitabine plus oxaliplatin (XELOX) between October 2018 and September 2019 were recruited. Patients were included if fully aware of their diagnosis and the treatment being received. A purposive sample of 16 patients participated in the study.ResultsFive themes emerged from our analysis: (1) beliefs and knowledge on cancer and treatment; (2) healthcare system in relation to treatment; (3) medicine-taking practice; (4) medicine-related impact and (5) personal support structure. In addition, 16 subthemes were identified to describe the interplay of all aspects of the patients’ experiences on initiation of treatment with antineoplastic medicines.ConclusionThis qualitative study illustrated that the patients find themselves in a complex situation on initiation of treatment with antineoplastic medicines. The patients’ knowledge on their specific treatment and active participation in making an informed decision need to be addressed. The healthcare system should develop tailored patient-centred services that specifically address the lack of patient empowerment and patient’s concern about treatment specific information.
Validation of visual estimation of neonatal jaundice in low-income and middle-income countries: a multicentre observational cohort study
Authors: Darmstadt Gary L , Hamer Davidson H , Carlin John B , Jeena Prakash M , Mazzi Eduardo , Narang Anil , Deorari A K , Addo-Yobo Emmanuel , Chowdhury MAK Azad , Kumar Praveen , Abu-Sarkodie Yaw , Yeboah-Antwi Kojo , Ray Pallab , Bartos Andres E , Saha Samir K , Foote Eric , Bahl Rajiv , Weber Martin W 
Published: December 2021

ObjectiveDetermine the sensitivity and specificity of neonatal jaundice visual estimation by primary healthcare workers (PHWs) and physicians as predictors of hyperbilirubinaemia.DesignMulticentre observational cohort study.SettingHospitals in Chandigarh and Delhi, India; Dhaka, Bangladesh; Durban, South Africa; Kumasi, Ghana; La Paz, Bolivia.ParticipantsNeonates aged 1–20 days (n=2642) who presented to hospitals for evaluation of acute illness. Infants referred for any reason from another health facility or those needing immediate cardiopulmonary resuscitation were excluded.Outcome measuresInfants were evaluated for distribution (head, trunk, distal extremities) and degree (mild, moderate, severe) of jaundice by PHWs and physicians. Serum bilirubin level was determined for infants with jaundice, and analyses of sensitivity and specificity of visual estimations of jaundice used bilirubin thresholds of >260 µmol/L (need for phototherapy) and >340 µmol/L (need for emergency intervention in at-risk and preterm babies).Results1241 (47.0%) neonates had jaundice. High sensitivity for detecting neonates with serum bilirubin >340 µmol/L was found for ‘any jaundice of the distal extremities (palms or soles) OR deep jaundice of the trunk or head’ for both PHWs (89%–100%) and physicians (81%–100%) across study sites; specificity was more variable. ‘Any jaundice of the distal extremities’ identified by PHWs and physicians had sensitivity of 71%–100% and specificity of 55%–95%, excluding La Paz. For the bilirubin threshold >260 µmol/L, ‘any jaundice of the distal extremities OR deep jaundice of the trunk or head’ had the highest sensitivity across sites (PHWs: 58%–93%, physicians: 55%–98%).ConclusionsIn settings where serum bilirubin cannot be measured, neonates with any jaundice on the distal extremities should be referred to a hospital for evaluation and management, where delays in serum bilirubin measurement and appropriate treatment are anticipated following referral, the higher sensitivity sign, any jaundice on the distal extremities or deep jaundice of the trunk or head, may be preferred.
Meibomian gland dysfunction and primary Sjögren’s syndrome dry eye: a protocol for systematic review and meta-analysis
Authors: Zi Changyan , Huang Qun , Ren Yuan , Yao Huan , He Tingting , Gao Yongxiang 
Published: December 2021

IntroductionPrimary Sjögren’s syndrome (pSS) is a systemic autoimmune disorder that primarily affects the exocrine glands such as the lacrimal and the salivary glands. Dry eye disease (DED) is one of the most prevalent manifestations of pSS and is usually classified into aqueous-deficient dry eye and evaporative dry eye. Sjögren’s syndrome dry eye (SSDE) is generally described as aqueous-deficient dry eye. However, as the leading pathophysiological mechanism of evaporative dry eye, meibomian gland dysfunction (MGD) also has influence on SSDE, which has been shown in recent studies. We speculate that SSDE is more than just an aqueous-deficient dry eye. While no related systematic review and meta-analysis has been published, the present study is designed to derive a better understanding of the association between MGD and SSDE.Methods and analysisThe Preferred Reporting items for Systematic Reviews and Meta-Analysis for Protocols 2015 statement was used to prepare this protocol. PubMed, Embase, Web of Science, Cochrane Database, China National Knowledge Infrastructure and Wan Fang Database will be searched from their inception to 31 October 2021, with restrictions to publications in English or Chinese. Two reviewers will independently carry out data extraction and quality assessment. The diagnosis of pSS will meet the standard diagnostic criteria, such as American College of Rheumatology/European League against Rheumatism Classification Criteria (ACR/EULAR) or American-European Consensus Group Classification criteria (AECG), and the definition of MGD and DED will differ between studies. The quality of included studies will be judged using the Newcastle-Ottawa Quality Scale. We will carry out this meta-analysis using RevMan V.5.4.1. The incidence of MGD in patients with SSDE will be indicated as OR with 95% CI.Ethics and disseminationEthical approval is not required as this meta-analysis is performed based on published studies and does not involve human participants. The results will be published in a peer-reviewed journal.PROSPERO registration numberCRD42021226017.
Effectiveness and safety of yoga to treat chronic and acute pain: a rapid review of systematic reviews
Authors: Crevelário de Melo Roberta , Victoria Ribeiro Aline Ângela , Luquine Jr Cézar D , de Bortoli Maritsa Carla , Toma Tereza Setsuko , Barreto Jorge Otávio Maia 
Published: December 2021

BackgroundPain is a sensation of discomfort that affects a large part of the population. Yoga is indicated to treat various health conditions, including chronic and acute pain.ObjectiveTo evaluate the effectiveness and safety of yoga to treat acute or chronic pain in the adult and elderly population.Study selectionA rapid review was carried out, following a protocol established a priori. Searches were carried out in September 2019, in six databases, using PICOS and MeSH (Medical Subject Headings) and DeCS (Descritores em Ciências da Saúde) terms. Systematic reviews were included, and methodological quality was assessed using Assessing the Methodological Quality of Systematic Reviews. The results were presented in a narrative synthesis.FindingsTen systematic reviews were selected. Two reviews were assessed as of high methodological quality, two as of low quality, and six of critically low quality. Results were favourable to yoga compared with usual daily care, particularly in low back and cervical pain cases. There was little evidence about the superiority of yoga compared with active interventions (exercises, pilates or complementary and complementary medicine). It was also less consistent in pain associated with fibromyalgia, osteoarthritis, rheumatoid arthritis, carpal tunnel and irritable bowel syndromes. There was an improvement in the quality of life and mood of the participants, especially for yoga compared with usual care, exercises and waiting list.ConclusionsOverall, the results were favourable to yoga compared with usual care in low back and cervical pain cases. The evidence is insufficient to assert yoga’s benefits for other pain conditions, as well as its superiority over active interventions. The findings must be considered with caution, given their low methodological quality and the small samples in the primary studies reported in the included systematic reviews. Thus, more studies must be carried out to improve the reliability of the results.
Farm living and risk of asthma, atopic eczema, respiratory and food allergy: protocol for a systematic review and meta-analysis
Authors: Kuya Johnstone , Omoronyia Ogban , Fokukora Theopista , Emmanuel Aduroja Posi , Ewemooje Olusegun Sunday , Soyege Adewumni O , Ngo Valery , Anyiam Felix Emeka , Ackah Josephine Akua , Ossai-Chidi Linus , Manuel Beatriz , Okondu Ogechukwu Emmanuel , Nwaru Bright I 
Published: December 2021

IntroductionAsthma and allergic disorders are of global concern and risk for their development results from the interplay of genetic and environmental factors. Among numerous environmental factors identified to influence the disease risk, the role of exposure to a farming environment has gained interest in recent times, but the underlying evidence is conflicting. The review aims to comprehensively identify, critically appraise and synthesise evidence from studies investigating the association between farm living and risk of asthma and allergic diseases in children and adults.Methods and analysisWe will identify relevant analytical observational epidemiological studies, including cross-sectional, case-control and cohort studies, by searching PubMed, Cochrane Library, Google Scholar, Cumulative Index to Nursing and Allied Health Literature (CINAHL), WHO Global Health Library, Web of Science, Scopus and Embase. Screening of identified records, data extraction from eligible studies and risk of bias assssment of eligible studies will be independently undertaken by two reviewers, with arbitration by a third reviewer. The Effective Public Health Practice Project will be employed for the risk of bias assessment. Estimates from studies judged to be clinically, methodologically and statistically homogeneous will be synthesised using random-effects meta-analysis. Heterogeneity will be assessed using the I-squared statistic. We will consider objectively measured or self-reported asthma, atopic dermatitis/eczema, allergic rhinitis, wheeze, and food allergy as primary outcomes.Ethics and disseminationAs this study is based solely on the published literature, no ethics approval is required. The study findings will be presented at scientific meetings related to the field of asthma and allergy and will be published in an international peer-reviewed scientific journal.PROSPERO registration numberCRD42020208805.
Rates of surgical deaths and infections at district hospitals in Malawi and Zambia: a prospective multicentre cohort study
Authors: Gajewski Jakub , Zhang Mengyang , Bijlmakers Leon , Pittalis Chiara , Borgstein Eric , Mwapasa Gerald , Kachimba John , Cheelo Mweene , Waterman Kristen , Brugha Ruairi 
Published: December 2021

ObjectiveThis paper reports perioperative mortality and postoperative infection rates of surgical patients who underwent operations at district-level hospitals in Malawi and Zambia, and the associations of these outcomes with patient characteristics based on routinely available data.DesignProspective cohort study.SettingEight government district hospitals in Malawi and nine mission and government district hospitals in Zambia.Outcome measuresPerioperative mortality and postoperative infection were used as primary outcome measures in this study. Logistic regression and penalised maximum likelihood logistic regression were used to examine the factors correlated with surgical outcomes.ResultsThe average perioperative mortality rates were 0.19% and 0.43% in Malawi and Zambia, respectively. Penalised maximum likelihood logistic regression showed that age (OR=1.046, 95% CI 1.016 to 1.078) and American Society of Anesthesiologists physical status score II (OR=6.658, 95% CI 2.363 to 18.762) were significantly associated with perioperative deaths. General surgery procedures were significantly more likely than obstetrical procedures to result in perioperative deaths (OR=3.821, 95% CI 1.226 to 11.908). The average rates of postoperative infections in Malawi and Zambia were 2.69% and 2.24%, respectively. Age (OR=1.010, 95% CI 1.000 to 1.020) and male sex (OR=0.407, 95% CI 0.260 to 0.637) were significantly associated with postoperative infections. Additional factors, general procedures (OR=2.319, 95% CI 1.397 to 3.850) and trauma-related procedure (OR=5.490, 95% CI 2.632 to 11.449) were significantly associated with infection rates. There was no significant correlation between surgical outcomes and cadre of lead surgeon (a non-physician clinician or doctor).ConclusionRates of mortality and postoperative infections in this sample of district-level hospitals in Malawi and Zambia were relatively low, with poorer preoperative physical status as the main predictor of both greater postoperative infection and mortality. The study demonstrates that outcomes of major surgical cases do not depend on the cadre (type) of surgeon performing it, and outcomes can be monitored using routine data, at district level in these countries.Trial registration numberISRCTN66099597.
Cohort profile: Copenhagen Hospital Biobank - Cardiovascular Disease Cohort (CHB-CVDC): Construction of a large-scale genetic cohort to facilitate a better understanding of heart diseases
Authors: Laursen Ina H , Banasik Karina , Haue Amalie D , Petersen Oscar , Holm Peter C , Westergaard David , Bundgaard Henning , Brunak Søren , Frikke-Schmidt Ruth , Holm Hilma , Sørensen Erik , Thørner Lise W , Larsen Margit A H , Schwinn Michael , Køber Lars , Torp-Pedersen Christian , Ostrowski Sisse R , Erikstrup Christian , Nyegaard Mette , Stefánsson Hreinn , Gylfason Arnaldur , Zink Florian , Walters G Bragi , Oddsson Asmundur , Þorleifsson Guðmar , Másson Gisli , Thorsteinsdottir Unnur , Gudbjartsson Daniel , Pedersen Ole B , Stefánsson Kári , Ullum Henrik 
Published: December 2021

PurposeThe aim of Copenhagen Hospital Biobank-Cardiovascular Disease Cohort (CHB-CVDC) is to establish a cohort that can accelerate our understanding of CVD initiation and progression by jointly studying genetics, diagnoses, treatments and risk factors.ParticipantsThe CHB-CVDC is a large genomic cohort of patients with CVD. CHB-CVDC currently includes 96 308 patients. The cohort is part of CHB initiated in 2009 in the Capital Region of Denmark. CHB is continuously growing with ~40 000 samples/year. Patients in CHB were included in CHB-CVDC if they were above 18 years of age and assigned at least one cardiovascular diagnosis. Additionally, up-to 110 000 blood donors can be analysed jointly with CHB-CVDC. Linkage with the Danish National Health Registries, Electronic Patient Records, and Clinical Quality Databases allow up-to 41 years of medical history. All individuals are genotyped using the Infinium Global Screening Array from Illumina and imputed using a reference panel consisting of whole-genome sequence data from 8429 Danes along with 7146 samples from North-Western Europe. Currently, 39 539 of the patients are deceased.Findings to dateHere, we demonstrate the utility of the cohort by showing concordant effects between known variants and selected CVDs, that is, >93% concordance for coronary artery disease, atrial fibrillation, heart failure and cholesterol measurements and 85% concordance for hypertension. Furthermore, we evaluated multiple study designs and the validity of using Danish blood donors as part of CHB-CVDC. Lastly, CHB-CVDC has already made major contributions to studies of sick sinus syndrome and the role of phytosterols in development of atherosclerosis.Future plansIn addition to genetics, electronic patient records, national socioeconomic and health registries extensively characterise each patient in CHB-CVDC and provides a promising framework for improved understanding of risk and protective variants. We aim to include other measurable biomarkers for example, proteins in CHB-CVDC making it a platform for multiomics cardiovascular studies.
Acceptability and adherence to a Mediterranean diet in the postnatal period to prevent type 2 diabetes in women with gestational diabetes in the UK: a protocol for a single-arm feasibility study (MERIT)
Authors: Bolou Angeliki , Lanz Doris , Drymoussi Zoe , Gonzalez Carreras Francisco Jose , Austin Frances , Dodds Julie , Mehay Anita , Pizzo Elena , Thomas Amy , Heighway James , Sanghi Anita , Harden Angela , Pérez Teresa , Pardo Llorente Maria del Carmen , Hitman Graham , Huda Mohammed SB , Thangaratinam Shakila 
Published: December 2021

IntroductionWomen with gestational diabetes are at increased risk of developing type 2 diabetes later in life. In at-risk general populations, Mediterranean-style diet helps prevent type 2 diabetes. But its effect on postnatal women with a history of gestational diabetes is not known. Prior to a full-scale trial on Mediterranean-style diet in the postnatal period to prevent type 2 diabetes, a feasibility study is required to assess the acceptability of the diet and evaluate the trial processes.Methods and analysisMEditerranean diet for pReventIon of type 2 diabeTes is a single-arm feasibility study (65 women) with qualitative evaluation of women who have recently given birth and had gestational diabetes. The intervention is a Mediterranean-style diet supplemented with nuts and olive oil, with dietary advice and an action plan. A dedicated Health Coach will interact with participants through an interactive lifestyle App. Women will follow the intervention from 6 to 13 weeks post partum until 1 year post partum. The primary outcomes are rates of recruitment, follow-up, adherence and attrition. The secondary outcomes are maternal dysglycaemia, cost and quality of life outcomes, and acceptability of the intervention to participants, and to healthcare professionals delivering the intervention. Feasibility outcomes will be reported using descriptive statistics.Ethics and disseminationEthical approval was obtained through the South Central—Berkshire Research Ethics Committee (19/SC/0064). Study findings will be disseminated via publication in peer-reviewed journals, as well as via newsletters made available to participants and members of Katie’s Team (a women’s health patient and public advisory group).Trial registration numberISRCTN40582975.
Exploring the experiences of stroke survivors, informal caregivers and healthcare providers in Sierra Leone: a qualitative study protocol
Authors: O'Hara Jessica , Thompson Melvina , Deen Gibrilla , Leather Andrew J M , Youkee Daniel , Wall Jurate , Sackley Catherine , Parmar Divya , McKevitt Christopher 
Published: December 2021

IntroductionStroke is now the second leading cause of adult death in Sub-Saharan Africa. Developed in dialogue with stroke survivors and caregivers in Sierra Leone, this will be the first study to explore the experience of stroke as well as the perceptions of the barriers and facilitators to accessing stroke care among stroke survivors, informal caregivers and healthcare providers. Findings will inform future stroke research and care in Sierra Leone.Methods and analysisA cross-sectional qualitative study employing semistructured interviews that will be audiorecorded, translated, transcribed and coded.SettingFreetown, Sierra Leone.ParticipantsInterviews with a purposive sample of stroke survivors, informal caregivers and healthcare providers.AnalysisInterviews will be coded by two authors and inductively analysed using thematic analysis.Ethics and disseminationThis study has received ethical approval from the Sierra Leone Ethics and Scientific Review Committee (8 December 2020) and the KCL Biomedical & Health Sciences, Dentistry, Medicine and Natural & Mathematical Sciences Research Ethics Subcommittee (reference: HR-20/21-21050). The findings of the study and learning in terms of the process of coproduction and involvement of stroke survivors will be disseminated via peer-reviewed publications, conferences, media and lay reports.
‘…you just put up with it for the sake of humanity.’: an exploratory qualitative study on causes of stress in palliative care nursing during the COVID-19 pandemic in Germany
Authors: May Susann , Stahlhut Kerstin , Allsop Matthew , Heinze Martin , Mühlensiepen Felix 
Published: December 2021

ObjectiveTo explore and analyse causes of stress among nurses in palliative and inpatient hospice care settings in Germany during the COVID-19 pandemic.DesignExplorative, qualitative study using problem-centred interviews. Interview data were analysed using structured qualitative content analysis.SettingTelephone interviews with nurses of different settings of palliative and inpatient hospice care.Participants16 nurses from inpatient hospice, palliative care units and specialised palliative home care were recruited.ResultsCOVID-19 infection control measures placed both physical and psychological strain on palliative care nurses. Due to changes in infection control information, workflows were being readjusted on a daily basis, preventing everyday routines and hindering relief from stress. There are reduced and limited opportunities for sharing and reflecting on daily working routines with team colleagues. Specific causes of stress in the individual settings of palliative and inpatient hospice care were identified. Overall, there is a tension between the nurses’ perceptions of proper palliative care nursing, in terms of closeness, psychosocial and emotional support and compliance with infection control measures.ConclusionsPalliative care nurses have been exposed to high levels of both physical and psychological stress during the COVID-19 pandemic. This requires rapid relief and support, with a need to ensure continuity of professional supervision and peer-support, which may be facilitated via digital technologies. The unique role of nurses in inpatient hospice and palliative care during COVID-19 ought to be recognised and valorised.