bluuebunny/crossref_metadata_2025_split huggingface dataset:
Remote COVID-19 patient monitoring system: a qualitative evaluation
Authors: Oliver Jane , Dutch Martin , Rojek Amanda , Putland Mark , Knott Jonathan C 
Published: May 2022

BackgroundMany COVID-19 patients are discharged home from hospital with instructions to self-isolate. This reduces the burden on potentially overwhelmed hospitals. The Royal Melbourne Hospital (RMH) Home Monitoring Programme (HMP) is a model of care for COVID-19 patients which chiefly tracks pulse oximetry and body temperature readings.ObjectiveTo evaluate the feasibility and acceptability of the HMP from a patient perspective.Design, settings and participantsOf 46 COVID-19 patients who used the HMP through RMH during April to August 2020, 16 were invited to participate in this qualitative evaluation study; all accepted, including 6 healthcare workers. Attempts were made to recruit a gender-balanced sample across a range of COVID-19 severities and comorbidities. Participants completed a brief semistructured phone interview discussing their experience of using the HMP.Outcome measures and analysisA thematic analysis of interview data was conducted. Feasibility was defined as the HMP’s reported ease of use. Acceptability was considered holistically by reviewing themes in the interview data.ResultsThe HMP allowed clinical deterioration to be recognised as it occurred enabling prompt intervention. All participants reported a positive opinion of the HMP, stating it was highly acceptable and easy to use. Almost all participants said they found using it reassuring. Patients frequently mentioned the importance of the monitoring clinicians as an information conduit. The most suggested improvement was to monitor a broader set of symptoms.ConclusionsThe HMP is highly feasible and acceptable to patients. This model of care could potentially be implemented on a mass-scale to reduce the burden of COVID-19 on hospitals. A key benefit of the HMP is the ability to reassure patients they will receive suitable intervention should they deteriorate while isolating outside of hospital settings.
Deferred consent in emergency obstetric research: findings from qualitative interviews with women and recruiters in theACROBATpilot trial for severe postpartum haemorrhage
Authors: Sweeney Lorna , Lanz Doris , Daru Jahnavi , Rasijeff Annika M P , Khanom Farzana , Thomas Amy , Harden Angela , Green Laura 
Published: May 2022

ObjectiveThe ACROBAT pilot trial of early cryoprecipitate for severe postpartum haemorrhage used deferred consent procedures. Pretrial discussions with a patient and public involvement group found mixed views towards deferred consent. This study aimed to build an understanding of how the deferred consent procedures worked in practice, to inform plans for a full-scale trial.SettingQualitative interview study within a cluster-randomised pilot trial, involving four London maternity services.ParticipantsIndividual interviews were conducted postnatally with 10 women who had received blood transfusion for severe postpartum haemorrhage and had consented to the trial. We also interviewed four ‘recruiters’—two research midwives and two clinical trials practitioners who conducted trial recruitment.ResultsConsent procedures in the ACROBAT pilot trial were generally acceptable and the intervention was viewed as low risk, but most women did not remember much about the consent conversation. As per trial protocol, recruiters sought to consent women before hospital discharge, but this time pressure had to be balanced against the need to ensure women were not approached when distressed or very unwell. Extra efforts had to be made to communicate trial information to women due to the exhaustion of their recovery and competing demands for their attention. Participant information was further complicated by explanations about the cluster design and change in transfusion process, even though the consent sought was for access to medical data.ConclusionOur findings indicate that deferred consent procedures raise similar concerns as taking consent when emergency obstetric research is occurring—that is, the risk that participants may conflate research with clinical care, and that their ability to process trial information may be impacted by the stressful nature of recovery and newborn care. A future trial may support more meaningful informed consent by extending the window of consent discussion and ensuring trial information is minimal and easy to understand.Trial registration numberISRCTN12146519.
Assessment of whole school approach intervention to reduce violence affecting children in and around schools in Kenya and Tanzania: protocol for a before-and-after, mixed-methods pilot study
Authors: Wangamati Cynthia Khamala , Mdala Ibrahimu , Ogutu Beatrice , Sokoine Kudely , Ochieng Moureen , Majikata Sabrina , Ochieng Christian Bernard , Kelly Susan A. 
Published: May 2022

IntroductionNational violence against children (VAC) surveys in Tanzania and Kenya reported that approximately three-quarters of children in Tanzania experienced physical violence while 45.9% of women and 56.1% of men experienced childhood violence in Kenya. In response to VAC, Investing in Children and their Societies—Strengthening Families & Protecting Children (ICS-SP) developed the whole school approach (WSA) for reducing VAC in and around schools. Objectives of this evaluation are to: (1) determine intervention’s feasibility and (2) the extent to which the WSA reduces prevalence and incidence of VAC in and around schools in Kenya and Tanzania; (3) gain insights into changes in stakeholders’ knowledge, attitudes and practices in relation to VAC following intervention implementation and (4) provide evidence-based recommendations for refining intervention content, delivery and theory of change (ToC).Methods and analysisThe study is a mixed-methods, controlled before-and-after, quasi experimental pilot designed to assess the delivery and potential changes in knowledge, attitudes, behaviours and VAC prevalence and incidence in and around schools following the WSA intervention implementation in Kenya and Tanzania. The preintervention phase will entail stakeholder enhancement of the WSA ToC and baseline cross-sectional surveys of teaching and non-teaching staff and parents (knowledge, attitude and practices), pupils (VAC incidents and school climate) and school safety audits. The WSA intervention implementation phase will include an intervention delivery process assessment and random school visits. In the postintervention phase, end-line surveys will be conducted similarly to baseline. Focus group discussions and in-depth interviews will be held with ICS-SP staff, training facilitators, teachers, parents and pupils to gain insights into acceptability, delivery and potential intervention effects. Quantitative and qualitative data will be analysed using SPSS V.25 and NVIVO V.12, respectively.Ethics and disseminationEthics approvals were received from Amref Health Africa in Kenya (AMREF-ESRC P910/2020) and National Health Research Ethics Committee (NatHREC) in Tanzania (NIMR/HQ/R.8a/Vol.IX/3655). Dissemination will be through research reports.
Impact of financial barriers on health status, healthcare utilisation and economic burden among individuals with cognitive impairment: a national cross-sectional survey
Authors: Lu Kevin , Xiong Xiaomo , Horras Ashley , Jiang Bin , Li Minghui 
Published: May 2022

ObjectiveTo study the impact of financial barriers to healthcare on health status, healthcare utilisation and costs among patients with cognitive impairment.DesignCross-sectional.SettingNational Health Interview Survey (NHIS), 2011–2017.ParticipantsPatients with cognitive impairment aged 18 years or older.InterventionsFinancial barriers to healthcare were identified using a series of NHIS prompts asking about the affordability of healthcare services.Primary outcome measuresHealth status was based on a survey prompt about respondents’ general health. Healthcare utilisation included office visits, home healthcare visits, hospital stays and emergency department (ED) visits. Economic burden was based on the family spending on medical care. Logistic regression models were used to examine the impact of financial barriers to healthcare access on health status, home healthcare visits, office visits, hospital stays and ED visits, respectively.ResultsCompared with cognitively impaired respondents without financial barriers to healthcare access, those with financial barriers were more likely to be unhealthy (OR 0.64, 95% CI 0.57 to 0.72). Cognitively impaired respondents with financial barriers were less likely to have home healthcare (OR 0.69, 95% CI 0.48 to 0.99) and more likely to have hospital stays (OR 1.33, 95% CI 1.19 to 1.48) and ED visits (OR 1.50, 95% CI 1.35 to 1.67). In addition, compared with cognitively impaired respondents without financial barriers to healthcare access, those with the barriers were more likely to have an increased economic burden (OR=1.85, 95% CI 1.65 to 2.07).ConclusionFinancial barriers to healthcare worsened health status and increased use of ED, hospitalisation and economic burden. Policy decision-makers, providers and individuals with cognitive impairment should be aware of the impact of financial barriers and take corresponding actions to reduce the impact.
Effects of 3 months of multi-nutrient supplementation on the immune system and muscle and respiratory function of older adults in aged care (The Pomerium Study): protocol for a randomised controlled trial
Authors: Al Saedi Ahmed , Kirk Ben , Iuliano Sandra , Zanker Jesse , Vogrin Sara , Jayaram Lata , Thomas Shane , Golding Christine , Navarro-Perez Diana , Marusic Petra , Leng Sean , Nanan Ralph , Duque Gustavo 
Published: May 2022

IntroductionImmunosenescence leads to increased morbidity and mortality associated with viral infections and weaker vaccine responses. This has been well documented for seasonal influenza and the current pandemic with SARS-CoV-2 (COVID-19), which disproportionately impact older adults, particularly those in residential aged care facilities. Inadequate nutrient intakes associated with impaired immunity, respiratory and muscle function are likely to augment the effects of immunosenescence. In this study, we test whether the impact of inadequate nutrition can be reversed using multi-nutrient supplementation, consequently enhancing vaccine responses, reducing the risk of viral infections and improving respiratory and muscle function.Methods and analysisThe Pomerium Study is a 3-month, single-blind, randomised, controlled trial testing the effects of two daily servings of an oral multi-nutrient supplement (330 kcal, 20 g protein, 1.5 g calcium 3-hydroxy-3-methylbutyrate monohydrate (CaHMB), 449 mg calcium, 500 IU vitamin D3 and 25 vitamins and minerals) on the immune system and muscle and respiratory function of older adults in aged care in Melbourne, Australia. 160 older adults (≥75 years old) will be recruited from aged care facilities and randomised to treatment (multi-nutrient supplement) or control (usual care). The primary outcome is a change in T-cell subsets CD8 + and CD28null counts at months 1 and 3. Secondary outcomes measured at baseline and month 3 are multiple markers of immunosenescence (also at 1 month), body composition (bioimpedance), handgrip strength (dynamometer), physical function (short physical performance battery), respiratory function (spirometry) and quality of life (EQ-5D-5L). Incidence and complications of COVID-19 and/or viral infections (ie, hospitalisation, complications or death) will be recorded throughout the trial, including 3 months after supplementation is ceased.Ethics and disseminationThis study was approved by Melbourne Health Human Research Ethics Committee (Ref No. HREC/73985/MH-2021, ERM Ref No. RMH73985, Melbourne Health Site Ref No. 2021.115). Written informed consent will be obtained from participants. Results will be published in peer-reviewed journals and made available to key aged care stakeholders, including providers, residents, and government bodies.Trial registration numberACTRN12621000420842.
Health literacy and long-term health outcomes following myocardial infarction: protocol for a multicentre, prospective cohort study (ENHEARTEN study)
Authors: Beauchamp Alison , Talevski Jason , Nicholls Stephen J , Wong Shee Anna , Martin Catherine , Van Gaal William , Oqueli Ernesto , Ananthapavan Jaithri , Sharma Laveena , O’Neil Adrienne , Brennan-Olsen Sharon Lee , Jessup Rebecca Leigh 
Published: May 2022

IntroductionLow health literacy is common in people with cardiovascular disease and may be one factor that affects an individual’s ability to maintain secondary prevention health behaviours following myocardial infarction (MI). However, little is known about the association between health literacy and longer-term health outcomes in people with MI. The ENhancing HEAlth literacy in secondary pRevenTion of cardiac evENts (ENHEARTEN) study aims to examine the relationship between health literacy and a number of health outcomes (including healthcare costs) in a cohort of patients following their first MI. Findings may provide evidence for the significance of health literacy as a predictor of long-term cardiac outcomes.Methods and analysisENHEARTEN is a multicentre, prospective observational study in a convenience sample of adults (aged>18 years) with their first MI. A total of 450 patients will be recruited over 2 years across two metropolitan health services and one rural/regional health service in Victoria, Australia. The primary outcome of this study will be all-cause, unplanned hospital admissions within 6 months of index admission. Secondary outcomes include cardiac-related hospital admissions up to 24 months post-MI, emergency department presentations, health-related quality of life, mortality, cardiac rehabilitation attendance and healthcare costs. Health literacy will be observed as a predictor variable and will be determined using the 12-item version of the European Health Literacy Survey (HLS-Q12).Ethics and disseminationEthics approval for this study has been received from the relevant human research ethics committee (HREC) at each of the participating health services (lead site Monash Health HREC; approval number: RES-21-0000-242A) and Services Australia HREC (reference number: RMS1672). Informed written consent will be sought from all participants. Study results will be published in peer-reviewed journals and collated in reports for participating health services and participants.Trial registration numberACTRN12621001224819.
Injury prevention in medical education: a Canadian medical school survey
Authors: El-Jebaoui Jina , Schmitz Erika , Figueira Sonshire , Lampron Jacinthe 
Published: May 2022

BackgroundInjury has a major societal impact. In Canada, injury is the leading cause of death among those aged 1–44 years, the fifth-leading cause of death among those of all ages and is responsible for a burden of US$26.8 billion in 2010. It holds that most injuries are predictable and preventable, and therefore, such statistics represent a serious public health concern. Given that physicians play a vital role in the prevention and control of injuries, further information regarding the current state of injury prevention education in medical undergraduate programmes in Canada would be beneficial. We hypothesise that the results of an observational survey distribute to all Canadian medical schools will demonstrate a substantial gap in injury prevention education integration in the existing medical school curriculums.Study objectiveTo evaluate the current status of Injury Prevention Education in Canadian Medical Schools preclerkship and clerkship medical curriculum.MethodsElectronic surveys evaluating the current status of injury prevention education were sent via email to each of the 16 Canadian medical schools.ResultsNine Canadian medical faculties (56%, n=9) responded. Eight of the nine medical schools (88.89%, n=8) offered at least five injury prevention related topics in their respective curricula. The most common injury-related courses were Role of physicians in the prevention of injuries (100%, n=9) and epidemiology of injury (88.89%, n=8). All respondent medical faculties (100%, n=9) offered at least a single injury prevention specific topic in their curricula. Most surveyed medical faculties (88.89%, n=8) offered nine injury-specific topics. The most common injury-specific topics included falls, suicide and self-harm, alcohol, burns and scalds, and concussion (100%, n=9)
Disparities in healthcare in psoriatic arthritis: an analysis of 439 patients from 13 countries
Authors: Lucasson Florian , Kiltz Uta , Kalyoncu Umut , Leung Ying Ying , Palominos Penélope , Cañete Juan D , Scrivo Rossana , Balanescu Andra , Dernis Emanuelle , Meisalu Sandra , Ryussen-Witrand Adeline , Soubrier Martin , Aydin Sibel Zehra , Eder Lihi , Gaydukova Inna , Lubrano Ennio , Richette Pascal , Husni Elaine , Coates Laura C , de Wit Maarten , Smolen Josef S , Orbai Ana-Maria , Gossec Laure 
Published: May 2022

ObjectivesPatient care can vary substantially by country. The objective was to explore differences in psoriatic arthritis (PsA) across countries for disease activity, impact and treatments.MethodsA cross-sectional analysis of 13 countries from the Remission/Flare in PsA study (NCT03119805) of consecutive adult patients with definite PsA was performed. Countries were classified into tertiles by gross domestic product (GDP)/capita. Disease activity (Disease Activity in PsA, DAPSA and Minimal Disease Activity, MDA) and their components, disease impact (patient-reported outcomes) and biological disease-modifying antirheumatic drugs (bDMARDs) were analysed per country and compared between the three tertiles of GDP/capita by parametric and non-parametric tests. We also explored the percentage of patients with significant disease activity (DAPSA >14) and no ongoing bDMARD prescription.ResultsIn 439 patients (50.6% male, mean age 52.3 years, mean disease duration 10.1 years), disease activity and disease impact were higher in the lowest GDP/capita countries. DAPSA remission and MDA were attained in the lowest tertile in 7.0% and 18.4% patients, vs 29.1% and 49.5% in the middle tertile and 16.8% and 41.3% in the high tertile, respectively (all p<0.001). bDMARDs use was similar in the tertiles (overall mean 61%). The overall rate of patients with DAPSA >14 and no bDMARDs was 18.5%, and was higher in lower GDP/capita countries (p=0.004).ConclusionPsA patients from countries with the lowest GDP/capita, despite similar use of bDMARDs, were more likely to have high disease activity and worse disease impact. There is a need for more equity in healthcare.
Heterogeneity of axial spondyloarthritis: genetics, sex and structural damage matter
Authors: Li Zhixiu , van der Linden Sjef M , Khan Muhammad Asim , Baumberger Heinz , Zandwijk Hermine van , Khan Mohammad Kazim , Villiger Peter M , Brown Matthew A 
Published: May 2022

ObjectiveAxial spondyloarthritis (axSpA) comprises both radiographic and non-radiographic disease. However, the paucity of specific objective measures for the disease and current classification criteria showing suboptimal specificity contribute to disease heterogeneity observed in clinical practice and research. We used a historical cohort of patients with axSpA to assess sources of heterogeneity.MethodsThe study involved 363 axSpA probands recruited from membership of the Swiss Ankylosing Spondylitis Patient Society. Participants underwent examination by a rheumatologist, completed questionnaires and provided blood samples for HLA typing. Patients underwent radiography of sacroiliac joints and were categorised according to the New York (NY) criteria (ankylosing spondylitis (AS) or non-radiographic axSpA (nr-axSpA)) and HLA-B27 status. Genetic characterisation by single nucleotide polymorphism microarray was performed and AS polygenic risk scores (PRS) were calculated.ResultsConsiderable heterogeneity was observed. The male to female ratio for AS (NY+) was 3:1, but 1:1 for nr-axSpA. For HLA-27(+) AS, the ratio was 2.5:1, but nearly 1:1 for HLA-B27(−) disease. Women with nr-axSpA had strikingly lower mean PRS and lower HLA-B27 prevalence than men with nr-axSpA or NY(+) male and female patients with AS. PRS was able to distinguish male but not female patients with nr-axSpA from related healthy first-degree relatives. Radiographic sacroiliitis was strongly associated with HLA-B27, especially in men.ConclusionWomen clinically diagnosed with axSpA but without radiographic sacroiliitis as a group have a disease that is distinct from AS by the modified New York criteria overall and from nr-axSpA in men. Given the high degree of heterogeneity, stratified or adjusted analysis of effectiveness studies is indicated, taking genetics, sex and radiographic damage (sacroiliitis) into account.
Dark matter and dark energy from a Kaluza–Klein inspired Brans–Dicke gravity with barotropic fluid
Authors: Waeming Areef , Klangburam Tanech , Pongkitivanichkul Chakrit , Samart Daris 
Published: May 2022

AbstractWe study the Kaluza–Klein inspired Brans–Dicke model with barotropic matter. Following from our previous work, the traditional Kaluza–Klein gravity action is introduced with an additional scalar field and 2 gauge fields. The compactification process results in a Brans–Dicke model with a dilaton coupled to the tower of scalar fields whereas a gauge field from 5-dimensional metric forms a set of mutually orthogonal vectors with 2 additional gauge fields. The barotropic matter is then introduced to complete a realistic set up. To demonstrate the analytical solutions of the model, we consider the case in which only 2 lowest modes becoming relevant for physics at low scale. After derivation, equations of motion and Einstein field equations form a set of autonomous system. The dynamical system is analysed to obtain various critical points. Interestingly, by only inclusion of barotropic matter, the model provides us the critical points which capable of determining the presences of dark matter, dark energy and phantom dark energy.
Genuine N-partite entanglement and distributed relationships in the background of dilation black holes
Authors: Wu Shu-Min , Cai Yu-Tong , Peng Wen-Jing , Zeng Hao-Sheng 
Published: May 2022

AbstractWith the complexity of information tasks, the bipartite and tripartite entanglement can no longer meet our needs, and we need more entangled particles to process relativistic quantum information. In this paper, we study the genuine N-partite entanglement and distributed relationships for Dirac fields in the background of dilaton black holes. We present the general analytical expression including all physically accessible and inaccessible entanglement in curved spacetime. We find that the accessible N-partite entanglement exhibits irreversible decoherence as the increase of black hole’s dilaton, and on the other hand the inaccessible N-partite entanglement increases from zero monotonically or non-monotonically, depending on the relative numbers of the accessible to the inaccessible modes, which forms a sharp contrast with the cases of bipartite and tripartite entanglement where the inaccessible entanglement increase only monotonically. We also find two distributed relationships between accessible and inaccessible N-partite entanglement in curved spacetime. The results give us a new understanding of the Hawking radiation.