bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of alcohol consumption on haemoglobin level among non-pregnant reproductive age women in Ethiopia: a cross-sectional secondary data analysis of the 2016 Ethiopian Demographic Health Survey
Authors: Diress Gedefaw , Endalifer Melese Linger 
Published: February 2022

ObjectiveThe aim of this study was to assess the effect of alcohol consumption on haemoglobin levels among non-pregnant reproductive age women using national representative data.MethodA secondary data analysis was conducted using data from the 2016 Ethiopia Demographic and Health Survey. The main outcome of interest was anaemia defined as a haemoglobin value <12 g/which was measured using HemoCue, and adjusted for both altitude and smoking status. The main exposure variable was alcohol consumption. Both multivariable logistic regression and generalised linear model were employed to assess the association between alcohol consumption and anaemia and to compare the mean of haemoglobin between the non-drinkers and three alcohol consumption frequency categories, respectively, after adjusting for the potential confounders.ResultIn the current analysis, a total of 13 436 non-pregnant women were included. The overall prevalence of anaemia among non-pregnant women was 23.2% of which 17.9% were mildly anaemic, 4.6% were moderately anaemic and 0.7% were severely anaemic. There was a significant negative association between anaemia and respondents’ history and frequency of alcohol consumption in the pooled sample. Among non-pregnant women, the odds of having anaemia were decreased with a history of alcohol drinking (adjusted OR (AOR)=0.32 (95% CI: 0.214 to 0.394)). Women who drunk alcohol less than once a week ((AOR=0.54 (95% CI: 0.31 to 0.94), those who drunk alcohol at least once a week (AOR=0.50 (95% CI: 0.28 to 0.88)) and who drunk alcohol almost every day in the last 12 months (AOR=0.42 (95% CI: 0.21 to 0.81)) had significantly lower odds of having anaemia than women who had not ever taken a drink that contain alcohol.ConclusionThis study showed that nearly a quarter of non-pregnant women in Ethiopia were found to be anaemic. Alcohol consumption increases haemoglobin concentration. Further cohort or experimental studies are therefore needed to further assess the relationship between alcohol consumption and haemoglobin level among Ethiopian populations.
Associations between antenatal maternal diet and other health aspects with infant temperament in a large multiethnic cohort study: a path analysis approach
Authors: Schoeps Anja , Gontijo de Castro Teresa , Peterson Elizabeth R , Wall Clare , D'Souza Stephanie , Waldie Karen E , Morton Susan 
Published: February 2022

ObjectivesThe aim of this study was to assess the association of antenatal maternal dietary patterns (DPs) and other health aspects with infant temperament in a large multiethnic cohort, taking maternal personality and prenatal stress into account.Design and methodsUsing data from 3968 children born in 2009/2010 and their mothers from the Growing Up in New Zealand cohort, infant temperament was assessed at 9 months using the Infant Behavior Questionnaire-Revised Very Short Form. Maternal antenatal diet and other health aspects were assessed antenatally. Maternal DPs (n=4) were derived using principal components analysis based on food intake reported on a 44-item food frequency questionnaire. Path analyses investigated factors associated with infant temperament, namely maternal personality, prenatal maternal stress, DPs and other health aspects, including potential inter-relations and mediating effects.ResultsWomen who scored higher in the fusion DP (standardised beta (β)=0.05; 95% CI 0.02 to 0.09) and healthy DP (β=0.05; 95% CI 0.02 to 0.09), who exercised more (β=0.04; 95% CI 0.01 to 0.07), and who drank less alcohol (β=−0.05; 95% CI −0.08 to –0.02) were more likely to have infants with an overall less difficult temperament. Sex-specific differences were found in the associations between maternal DP and infant temperament. Maternal personality and prenatal stress were significantly associated with all dimensions of infant temperament. The strongest predictors for a more difficult temperament were prenatal stress (β=0.12; 95% CI 0.08 to 0.15) and the personality dimensions neuroticism (β=0.10; 95% CI 0.07 to 0.14) and extraversion (β=−0.09; 95% CI −0.12 to –0.06).ConclusionsAssociations of antenatal maternal diet and health aspects with infant temperament were statistically significant but small. While they should not be overinterpreted as being deterministic, the findings of this study support the link between maternal modifiable health-related behaviours and infant temperament outcomes.
Comparing ivWatch biosensor to standard care to identify extravasation injuries in the paediatric intensive care: a protocol for a randomised controlled trial
Authors: McBride Craig Antony , Rahiman Sarfaraz , Schlapbach Luregn J , Schults Jessica A , Kleidon Tricia M , Kennedy Melanie , Paterson Rebecca S , Byrnes Joshua , Ware Robert S , Ullman Amanda Judith 
Published: February 2022

IntroductionPeripheral intravenous catheters (PIVCs) frequently fail during therapy administration, resulting in infusates pooling in the surrounding tissue. These extravasation injuries can cause significant pain, tissue destruction and scarring. ivWatch is a biosensor that uses visible and near-infrared light to measure tissue changes surrounding the PIVC and alert clinicians when extravasation may occur. The effectiveness of ivWatch, in comparison to clinical observation, in decreasing injury severity is unknown. The present study aims to investigate whether using ivWatch may potentially detect injury earlier and decrease the severity of PIVC extravasation injuries.Methods and analysisA single centre, parallel group, open-label superiority randomised controlled trial comparing (a) standard care (clinical observation) to (b) ivWatch monitoring in addition to standard care, to decrease the severity of extravasation injuries. 200 children with PIVCs inserted in the distal half of the limb, receiving intermediate-risk to high-risk infusates for ≥24 hours, will be consecutively recruited at a paediatric intensive care unit in Queensland, Australia. The primary outcome is extravasation severity, measured by the Cincinnati Children’s Extravasation Harm Scale. Secondary outcomes include severity assessed with three-dimensional camera imaging, extravasation volume, treatment sequelae, the number of PIVCs used and dwell time, quality of life and healthcare costs. The between treatment difference in extravasation severity will be compared using ordinal logistic regression, with the treatment group included as the main effect, and reported with corresponding 95% CIs. Estimates of value will be presented as net monetary benefits and cost per reduction in extravasation injury severity, both presented with corresponding 95% credible intervals.Ethics and disseminationThis study received approval from the Children’s Health Queensland Hospital and Health Service Human Research Ethics Committee (HREC) (reference number: HREC/20/QCHQ/60867) and the Griffith University HREC (reference number: 2020/310) and will be disseminated via peer-reviewed publications and conference presentations.Trial registration numberACTRN12620000317998.
Comparative efficacy and safety of oral anticoagulants for the treatment of venous thromboembolism in the patients with different renal functions: a systematic review, pairwise and network meta-analysis
Authors: Su Xiaole , Yan Bingjuan , Wang Lihua , Cheng Hong , Chen Yipu 
Published: February 2022

ObjectivesTo compare the efficacy and safety of direct oral anticoagulants (DOACs) in patients with venous thromboembolism (VTE) and different renal functions.DesignSystematic review containing pairwise and Bayesian network meta-analysis of randomised controlled trials (RCTs).Data sourcesMEDLINE, EMBASE and Cochrane Library.Eligibility criteriaRCTs reporting the efficacy and safety outcomes of DOACs in different creatinine clearance (CrCl) subgroups.Data extraction and synthesisData extraction and quality assessment were undertaken by two independent reviewers. Data were pooled using the DerSimonian-Laird method in pairwise meta-analysis. Network meta-analysis within a Bayesian framework was conducted.ResultsData from 10 RCTs were included. In the treatment of acute VTE, DOACs did not significantly reduce recurrent VTE or VTE-related death (OR, 0.96; 95% CI, 0.82 to 1.11) but significantly reduced bleeding events (0.76, 0.68 to 0.90) compared with warfarin. In the extended treatment of VTE, DOACs produced significant benefits in recurrent VTE or VTE-related death (0.23, 0.16 to 0.29), but significantly increased bleeding events (1.86, 1.04 to 3.33) compared with placebo/aspirin. There were no significant differences in efficacy and safety of DOACs among the three CrCl stratified subgroups in acute and extended treatment of VTE (p for subgroup heterogeneity >0.1). Bayesian network meta-analysis suggested that apixaban 2.5 mg and 5 mg two times per day were associated with a lower risk of bleeding than dabigatran, rivaroxaban, warfarin and aspirin in the subgroup with CrCl >80 mL/min.ConclusionsFor the treatment of acute VTE, DOACs are similar to warfarin in reducing recurrent VTE and VTE-related death but are significantly superior to warfarin in reducing the risk of bleeding. For the efficacy and safety of DOACs across different CrCl stratifications (30–50, 50–80 and more than 80 mL/min), no significant difference was found. In light of minimal evidence, apixaban might be associated with a lower risk of bleeding in patients with VTE and CrCl >80 mL/min.PROSPERO registration numberCRD42018090896.
Culture and understanding the role of feedback for health professions students: realist synthesis protocol
Authors: Fullerton Paul Douglas , Sarkar Mahbub , Haque Shamsul , McKenzie Wendy 
Published: February 2022

IntroductionClinical education has moved to a ‘competency-based’ model with an emphasis on workplace-based learning and assessment which, in turn, depends on feedback to be effective. Further, the understanding of feedback has changed from information about a performance directed to the learner performing the task, to a dialogue, which enables the learner to act and develop.In health professional education, feedback is a complex interaction between trainee, supervisor and the healthcare system. Most published research on feedback in health professional education originates in Europe and North America. Our interest is on the impact of Culture on this process, particularly in the context of Asian cultures.The (scientific) realist approach of Pawson and Tilley provides a means to examine complex interventions in social situations, and thus is an appropriate lens to use for this study. This is a protocol for a realist synthesis which asks how, why and in what circumstances do Asian Cultures influence health professional trainees to seek, respond to and use feedback given in the clinical environment, if at all.Methods and analysisAn initial search was performed to help define the scope of the review question and develop our initial programme theory. The formal electronic search was carried out in February 2020 and included: CINAHL, ERIC, Medline and PsycInfo, and repeated in October 2020. Retrieved articles were imported into Covidence for screening and data extraction, after which components of the Context–Mechanisms–Outcomes configurations will be sought to refine the initial programme theory.Ethics and disseminationAs this study is a literature review, ethics approval is not required.The findings will be documented in line with the RAMESES (Realist And MEta-narrative Evidence Syntheses: Evolving Standards) publications standards for Realist syntheses, and we plan to disseminate the findings by means of a peer-reviewed journal article and conference presentation(s).
Psychological distress of frontline healthcare workers in the intensive care unit during the early stage of the COVID-19 pandemic: a qualitative study from China
Authors: Yin Zhao , Zhang Wan , Jia Xuedong , Wang Xiaojuan , Hao Jie , Yang Yantao , Zhang Xiaojian , Du Shuzhang , Yue Xiaohong 
Published: February 2022

ObjectiveThe rapid spread of COVID-19 has overwhelmed healthcare systems across the world. During the early stage of the pandemic, frontline healthcare workers (FHWs) caring for patients at intensive care units (ICUs) faced extreme pressure and challenges. This qualitative study aimed to describe the different phases of psychological distress of FHWs during the early stage of the COVID-19 pandemic.DesignQualitative study.SettingThe First Affiliated Hospital of Zhengzhou University, a designated hospital for patients with COVID-19 in central China.ParticipantsEight physicians and six nurses working in the ICU who provided direct patient care for COVID-19 patients.MethodsA descriptive phenomenological study using thematic analysis was applied. Semi-structured one-on-one interviews over telephone or Wechat (a social platform in China) rather than face-to-face interviews were conducted due to quarantine. Interviews were audio-recorded and transcribed verbatim and then were analysed thematically.FindingsA total of 14 interviews were conducted, and each interview lasted 20–60 min. Five thematic categories were identified, and the participants’ psychological experiences were classified into five stages (1) the mobilisation period: a sense of responsibility with worries; (2) the preparation period: worries, fears and doubts about the epidemic; (3) the transitional period: complex and diverse psychological feelings; (4) the adaptation period: self-adjustment and help from external support and (5) the reflection period: a reflection on life and nature.ConclusionThe study showed that the COVID-19 pandemic had significant psychological impacts on FHWs. Self-regulation and external support help FHWs to overcome challenges to a certain extent. More attention should be paid to the psychological wellbeing of ICU FHWs in COVID-19-designated hospitals.
Do difficulties in emotional processing predict procedure pain and shape the patient’s colonoscopy experience?
Authors: Pontone Stefano , Lauriola Marco , Palma Rossella , Panetta Cristina , Tomai Manuela , Baker Roger 
Published: February 2022

ObjectivesPain and fear of colonoscopy are inter-related; they make the colonoscopy experience unpleasant and impede adherence to colorectal cancer screening and prevention campaigns. According to previous research, fear and pain have been found to depend on patients’ maladaptive cognitions and exaggerated emotional responses. The present study investigated whether emotional processing difficulties predicted colonoscopy pain and the associated catastrophising thoughts.DesignProspective, observational, blinded.MethodA sample of 123 patients was assessed for specific emotional processing difficulties (ie, suppression of emotions, unprocessed emotions, failure to control emotions, avoidance of emotional triggers and impoverished emotional experience) and anxiety-related variables (ie, worry, anxiety and depression) before colonoscopy. A trained medical doctor rated patients’ behavioural manifestations of pain during colonoscopy. After complete recovery from sedation, the patients rated the endoscopy experience using perceived pain and situation-specific pain catastrophising scales.ResultsAbout half of the patients were above the cut-off for anxiety before the procedure. Notwithstanding sedation, behavioural manifestations of pain during colonoscopy indicated probable or moderate pain for about one-third of the patients. Failure to control emotions, poor emotional experience and avoiding emotional triggers were positively correlated with behavioural manifestations of pain, self-reported pain and pain catastrophising. Regression analyses, controlling for gender, age, colonoscopy experience and sedation, revealed that avoidance of emotional triggers uniquely contributed to predicting pain outcomes.ConclusionsEarly identification of emotional processing difficulties associated with pain catastrophising can help define personalised psychological preparation paths to manage negative emotions in patients who fear colonoscopy pain.
Off-label indications of aspirin in gynaecology and obstetrics outpatients at two Chinese tertiary care hospitals: a retrospective cross-sectional study
Authors: Shen Sijie , Yang Jianhui , Chen Yao , Xie Jingxian , Huang Yanni , Lin Wubin , Liao Yufang 
Published: February 2022

ObjectiveTo investigate the prevalence of off-label aspirin indications and the level of scientific support for off-label indications of aspirin in gynaecology and obstetrics outpatients.DesignA retrospective cross-sectional study.SettingTwo tertiary hospitals (a general hospital and a women and children’s specialised hospital) in Xiamen, a city located on the southeastern coast of China.ParticipantsA total of 4257 prescriptions were included for 2091 female patients aged >18 who visited the gynaecology and obstetrics outpatient clinics and received aspirin treatment.Outcome measuresThe primary measure of this study was the proportion of off-label indications and of off-label indications supported by strong scientific evidence. Evidence from clinical guidelines and Micromedex is shown using descriptive statements. On-label indications of drugs in the same class as aspirin were also referred to for off-label aspirin use without strong evidence support.ResultsAll indications of aspirin on outpatient prescriptions were determined as off-label use in this study. The most frequent off-label indication was recurrent miscarriage (2244 prescriptions, 52.71%). Totally, 30.94% of the prescriptions were supported by strong evidence for indications, including recurrent miscarriage with antiphospholipid syndrome and prophylaxis for pre-eclampsia. No drugs in the same class as aspirin had on-label indications for off-label aspirin use without strong evidence support.ConclusionsThis study demonstrated that all indications of aspirin used in gynaecology and obstetrics outpatients at the two tertiary hospitals were off-label and not always supported by strong evidence, implicating that physicians should be cautious when issuing off-label prescriptions. More original clinical research on off-label aspirin use is needed to provide reference for routine clinical practice.
Challenges associated with e-cigarette use by people in custody in Scottish prisons: a qualitative interview study with prison staff
Authors: O'Donnell Rachel , Brown Ashley , Eadie Douglas , Mitchell Danielle , Bauld Linda , Demou Evangelia , Purves Richard , Sweeting Helen , Hunt Kate 
Published: February 2022

ObjectivesLittle is known about the perspectives of staff working in prisons where e-cigarettes are permitted. Scotland now permits people in custody (PiC), but not staff/visitors to use e-cigarettes, following implementation of smoke-free prisons policy in 2018. Previous studies, conducted before and immediately after the introduction of e-cigarettes in Scottish prisons, have evidenced stakeholder support for their use by PiC. This study focuses on key challenges associated with e-cigarette use in prisons, using data collected from prison staff once e-cigarettes had been allowed in a smoke-free environment for 6–9 months.SettingFive prisons in Scotland.ParticipantsSixteen qualitative interviews were conducted with prison staff from five prisons varying by population (sex, age and sentence length). Data were managed and analysed using the framework approach.ResultsWhile these staff confirmed strong support for the smoke-free prison policy and reported some benefits of replacing tobacco with e-cigarettes, they also spoke of the challenges e-cigarettes pose. These included: workplace e-cigarette vapour exposures; perceptions that e-cigarettes provide a new, effective way for some PiC to take illegal drugs, particularly new psychoactive substances; organisational challenges relating to the value attached to e-cigarettes in prisons; and implications for long-term nicotine use and tobacco cessation. Staff anticipated difficulties in tightening restrictions on e-cigarette use by PiC given its scale and significance among this population.ConclusionsMaximising the benefits of e-cigarette use by PiC is likely to require multiple measures to support effective and safe use and e-cigarette reduction/cessation where desired. This includes monitoring any misuse of e-cigarettes, and provision of guidance and support on appropriate e-cigarette use and how to limit or quit use if desired. Findings are relevant to jurisdictions considering or planning changes in prison smoking or vaping policies.
Missed opportunities in hypertension risk factors screening in Indonesia: a mixed-methods evaluation of integrated health post (POSBINDU) implementation
Authors: Widyaningsih Vitri , Febrinasari Ratih Puspita , Pamungkasari Eti Poncorini , Mashuri Yusuf Ari , Sumardiyono Sumardiyono , Balgis Balgis , Koot Jaap , Landsman-Dijkstra Jeanet , Probandari Ari 
Published: February 2022

ObjectivesTo assess the implementation and contextual barriers of POSBINDU, a community-based activity focusing on screening of non-communicable diseases (NCDs), mainly hypertension and diabetes, in Indonesia.DesignThis was a concurrent mixed-methods study, with a cross-sectional analysis of secondary data and focus group discussions (FGDs) on stakeholder of POSBINDU.SettingThe study was conducted in seven districts in three provinces in Indonesia, with approximately 50% of the primary healthcare (PHC) were selected as areas for data collection (n PHC=100).ParticipantsFrom 475 POSBINDU sites, we collected secondary data from 54 224 participants. For the qualitative approach, 21 FGDs and 2 in-depth interviews were held among a total of 223 informants.Primary outcomes and measuresProportion of POSBINDU visitors getting the hypertension screening and risk factors’ assessment, and barriers of POSBINDU implementation.ResultsOut of the 114 581 POSBINDU visits by 54 224 participants, most (80%) were women and adults over 50 years old (50%) showing a suboptimal coverage of men and younger adults. Approximately 95.1% of visitors got their blood pressure measured during their first visit; 35.3% of whom had elevated blood pressure. Less than 25% of the visitors reported to be interviewed for NCDs risk factors during their first visit, less than 80% had anthropometric measurements and less than 15% had blood cholesterol examinations. We revealed lack of resources and limited time to perform the complexities of activities and reporting as main barrier for effective hypertension screening in Indonesia.ConclusionsThis study showed missed opportunities in hypertension risk factors screening in Indonesia. The barriers include a lack of access and implementation barriers (capability, resources and protocols).