bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quantifying Infant Exploratory Learning
Authors: Kim Jeong Ah , Park Sungwoo , Fetters Linda , Eckel Sandrah P. , Kubo Masayoshi , Sargent Barbara 
Published: January 2022

Exploration is considered essential to infant learning, but few studies have quantified infants’ task exploration. The purpose of this study was to quantify how infants explored task space with their feet while learning to activate a kick-activated mobile. Data were analyzed from fifteen 4-month-old infants who participated in a 10-min mobile task on 2–3 consecutive days. Infants learned that their vertical leg movements above a systematically increased threshold height activated the mobile. Five kinematic variables were analyzed: (a) exploration space volume, (b) exploration path length, (c) duration of time in the region of interest around the threshold that activated the mobile, (d) task-specific vertical variance of kicks, and (e) non-task-specific horizontal variance of kicks. The infants increased their general spatial exploration, volume, and path, and the infants adapted their exploration by maintaining their feet within the region of interest, although the task-specific region increased in height as the threshold increased. The infants used task-specific strategies quantified by the increased variance of kicks in the vertical direction and no change in the horizontal variance of kicks. Quantifying infants’ task exploration may provide critical insights into how learning emerges in infancy and enable researchers to more systematically describe, interpret, and support learning.
Exploratory randomised trial of face-to-face and mobile phone counselling against usual care for tobacco cessation in Indian primary care: a randomised controlled trial protocol for project CERTAIN
Authors: Panda Rajmohan , Omar Rumana , Hunter Rachael , Prabhu Rajath R , Mishra Arti , Nazareth Irwin 
Published: January 2022

IntroductionDespite widespread use of smokeless tobacco products by people within the Indian subcontinent, there is little awareness among Indians of its health hazards when compared with smoked tobacco. We hypothesise that mobile phone counselling will be feasible and effective for smokeless tobacco cessation intervention in India. This paper presents the protocol of the development and conduct of an exploratory trial before progression to a full randomised controlled trial.Methods and analysisAn exploratory randomised controlled trial will be conducted in urban primary health centres in the state of Odisha, India. A total of 250 smokeless tobacco users will be recruited to the study (125 in each arm). Participants in the intervention arm will receive routine care together with a face-to-face counselling intervention followed by advice and reminder mobile messages. The control arm will receive routine care, delivered by a primary care physician based on ‘Ask’ and ‘Advice’. All participants will be followed up for 3 months from the first counselling session. The primary outcome of this trial is to assess the feasibility to carry out a full randomised controlled trial.Ethics and disseminationEthical approvals were obtained from the Institutional Ethics Committee of Public Health Foundation of India, Health Ministry’s Screening Committee, Odisha State Ethics Board and also from University College London Research Ethics Committee, UK. The study findings will be published in a peer-reviewed scientific journal.Trial registration numberCTRI/2019/05/019484.
Do baseline characteristics and treatments account for geographical disparities in the outcomes of patients with newly diagnosed atrial fibrillation? The prospective GARFIELD-AF registry
Authors: Fox Keith A A , Virdone Saverio , Bassand Jean-Pierre , Camm A John , Goto Shinya , Goldhaber Samuel Z , Haas Sylvia , Kayani Gloria , Koretsune Yukihiro , Misselwitz Frank , Oh Seil , Piccini Jonathan P , Parkhomenko Alex , Sawhney Jitendra Pal Singh , Stepinska Janina , Turpie Alexander G G , Verheugt Freek W A , Kakkar Ajay K 
Published: January 2022

ObjectiveIn patients with newly diagnosed atrial fibrillation (AF), do baseline risk factors and stroke prevention strategies account for the geographically diverse outcomes.DesignGlobal Anticoagulant Registry in the FIELD-Atrial Fibrillation is a prospective multinational non-interventional registry of patients with newly diagnosed AF (n=52 018 patients).SettingInvestigator sites (n=1317) were representative of the care settings/locations in each of the 35 participating countries. Treatment decisions were all determined by the local responsible clinicians.ParticipantsThe patients (18 years and over) with newly diagnosed AF had at least 1 investigator-determined stroke risk factor and patients were not required to meet specific thresholds of risk score for anticoagulant treatment.Main outcomes and measuresObserved 1-year event rates and risk-standardised rates were derived.ResultsRates of death, non-haemorrhagic stroke/systemic embolism and major bleeding varied more than three-to-four fold across countries even after adjustment for baseline factors and antithrombotic treatments. Rates of anticoagulation and antithrombotic treatment varied widely. Patients from countries with the highest rates of cardiovascular mortality and stroke were among the least likely to receive oral anticoagulants. Beyond anticoagulant treatment, variations in the treatment of comorbidities and lifestyle factors may have contributed to the variations in outcomes. Countries with the lowest healthcare Access and Quality indices (India, Ukraine, Argentina, Brazil) had the highest risk-standardised mortality.ConclusionThe variability in outcomes across countries for patients with newly diagnosed AF is not accounted for by baseline characteristics and antithrombotic treatments. Residual mortality rates were correlated with Healthcare Access and Quality indices. The findings suggest the management of patients with AF needs to not only address guideline indicated and sustained anticoagulation, but also the treatment of comorbidities and lifestyle factors.Trial registration numberNCT01090362.
Residents transitioning between hospital and care homes: protocol for codesigning a systems-level response to safety issues (SafeST study)
Authors: Scott Jason , Brittain Katie , Byrnes Kate , Dawson Pam , Mulrine Stephanie , Spencer Michele , Waring Justin , Young-Murphy Lesley 
Published: January 2022

IntroductionThe aim of this study is to develop a better understanding of incident reporting in relation to transitions in care between hospital and care home, and to codesign a systems-level response to safety issues for patients transitioning between hospital and care home.Methods and analysisTwo workstreams (W) will run in parallel. W1 will aim to develop a taxonomy of incident reporting in care homes, underpinned by structured interviews (N=150) with care home representatives, scoping review of care home incident reporting systems, and a review of incident reporting policy related to care homes. The taxonomy will be developed using a standardised approach to taxonomy development. W2 will be structured in three phases (P). P1a will consist of ≤40 interviews with care home staff to develop a better understanding of their specific internal systems for reporting incidents, and P1b will include ≤30 interviews with others involved in transitions between hospital and care home. P1a and P1b will also examine the impact of the SARS-CoV-2 pandemic on safe transitions. P2 will consist of a retrospective documentary analysis of care home data relating to resident transitions, with data size and sampling determined based on data sources identified in P1a. A validated data extraction form will be adapted before use. P3 will consist of four validation and codesign workshops to develop a service specification using National Health Service Improvement’s service specification framework, which will then be mapped against existing systems and recommendations produced. Framework analysis informed by the heuristic of systemic risk factors will be the primary mode of analysis, with content analysis used for analysing incident reports.Ethics and disseminationThe study has received university ethical approval and Health Research Authority approval. Findings will be disseminated to commissioners, providers and regulators who will be able to use the codesigned service specification to improve integrated care.
Concerns and desires of healthcare workers caring for patients with COVID-19 in April and July 2020 in Japan: a qualitative study of open-ended survey comments
Authors: Kayama Mami , Aoki Yumi , Matsuo Takahiro , Kobayashi Daiki , Taki Fumika 
Published: January 2022

ObjectivesThe prolonged effects of the COVID-19 pandemic continue to have a serious impact on healthcare workers. We described and compared the experiences of healthcare workers in Japan during the first wave of the COVID-19 pandemic from March to May 2020, and during the lull from June to July 2020.DesignIn this qualitative study, we used a web-based survey to obtain comments from healthcare workers about their experiences during the pandemic, and explored these using inductive content analysis.SettingA tertiary emergency hospital in Tokyo, in April and July 2020.ParticipantsParticipants were staff in the hospital, including physicians, nurses, pharmacists, radiological technicians and laboratory medical technicians. Many, but not all, had directly cared for patients with COVID-19.ResultsIn total, 102 participants in the first survey and 154 in the second survey provided open-ended comments. Three themes were extracted: concerns, requests and gratitude. There were four subthemes under concerns: the hospital infection control system, fear of spreading infection to others, uncertainty about when the pandemic would end and being treated as a source of infection. There were 53 requests in the first survey and 106 in the second survey. These requests were divided into seven subthemes: compensation, staffing, information, facilities, leave time, PCR tests and equitable treatment. The theme on gratitude had two subthemes: information and emotional support, and material support. The fears and desires of healthcare workers included two types of uncertainty-related concerns, and requests were very different across the two surveys.ConclusionsIt is important to apply a balance of information to help staff adjust to their new work environment, as well as support to minimise the burden of infection and impact on their families.
Innovative approach to improve information accuracy in a two-district cross-sectional study in Bihar, India
Authors: Jeffery Caroline , Pagano Marcello , Devkota Baburam , Valadez Joseph J 
Published: January 2022

ObjectiveCombine Health Management Information Systems (HMIS) and probability survey data using the statistical annealing technique (AT) to produce more accurate health coverage estimates than either source of data and a measure of HMIS data error.SettingThis study is set in Bihar, the fifth poorest state in India, where half the population lives below the poverty line. An important source of data, used by health professionals for programme decision making, is routine health facility or HMIS data. Its quality is sometimes poor or unknown, and has no measure of its uncertainty. Using AT, we combine district-level HMIS and probability survey data (n=475) for the first time for 10 indicators assessing antenatal care, institutional delivery and neonatal care from 11 blocks of Aurangabad and 14 blocks of Gopalganj districts (N=6 253 965) in Bihar state, India.ParticipantsBoth districts are rural. Bihar is 82.7% Hindu and 16.9% Islamic.Primary outcome measuresSurvey prevalence measures for 10 indicators, corresponding prevalences using HMIS data, combined prevalences calculated with AT and SEs for each type of data.ResultsThe combined and survey estimates differ by <0.10. The combined and HMIS estimates differ by up to 84.2%, with the HMIS having 1.4–32.3 times larger error. Of 20 HMIS versus survey coverage estimate comparisons across the two districts only five differed by <0.10. Of 250 subdistrict-level comparisons of HMIS versus combined estimates, only 36.4% of the HMIS estimates are within the 95% CI of the combined estimate.ConclusionsOur statistical innovation increases the accuracy of information available for local health system decision making, allows evaluation of indicator accuracy and increases the accuracy of HMIS estimates. The combined estimates with a measure of error better informs health system professionals about their risks when using HMIS estimates, so they can reduce waste by making better decisions. Our results show that AT is an effective method ready for additional international assessment while also being used to provide affordable information to improve health services.
The effects of health behaviours and beliefs based on message framing among patients with chronic diseases: a systematic review
Authors: Gao Ruitong , Guo Hui , Li Fei , Liu Yandi , Shen Meidi , Xu Linqi , Yu Tianzhuo , Li Feng 
Published: January 2022

ObjectiveThe effectiveness of integrating message framing into educational interventions to promote the health behaviour of patients with chronic diseases is still being debated in nursing research. The objective of this study was to assess the impact of educational interventions based on gain and loss frames on the health behaviours and beliefs of patients with chronic diseases and to identify the frame that achieves better outcomes.DesignThe systematic review was based on PRISMA guidelines for comprehensively searching, appraising and synthesising research evidence.Data sourcesWe searched the PubMed, Web of Science, PsycINFO and CINAHL databases for reports published from database inception until 26 March 2021.Eligibility criteriaIntervention studies, published in English, with adult patients with chronic disease conditions, and with intervention contents involved in the implementation of message framing, were considered. The outcomes were health behaviours or beliefs, such as knowledge, self-efficacy, intention or attitudes.Data extraction and synthesisData extraction and entry were performed using a predesigned data extraction form and assessed independently by two reviewers using the Cochrane Collaboration Risk of Bias I.ResultsA total of 11 intervention studies were included. We found that educational intervention based on both gain and loss frames could enhance the positive effects of communication, and promote healthy behaviours and beliefs in patients with chronic disease. Many of the studies we included here showed the advantage of loss framing messages. Due to the limited number of articles included and without quantitative analysis, this result should be interpreted cautiously.ConclusionsIntegrating message framing into health education might be a promising strategy to motivate patients with chronic disease to improve their health behaviours and beliefs. More extensive and well-designed trials are needed to support the conclusions and discuss the effective framing, moderators and mediators of framing.PROSPERO registration numberCRD42021250931.
Validity and reliability of Psychiatric Nurse Self-Efficacy Scales: cross-sectional study
Authors: Yada Hironori , Odachi Ryo , Adachi Keiichiro , Abe Hiroshi , Yonemoto Fukiyo , Fujiki Toshiya , Fujii Mika , Katoh Takahiko 
Published: January 2022

ObjectivesTo develop the Psychiatric Nurse Self-Efficacy Scales, and to examine their reliability and validity.DesignWe developed the Improved Self-Efficacy Scale (ISES) and Decreased Self-Efficacy Scale (DSES) using existing evidence. Statistical analysis was conducted on the data to test reliability and validity.SettingThe study’s setting was psychiatric facilities in three prefectures in Japan.ParticipantsData from 514 valid responses were extracted of the 786 responses by psychiatric nurses.Outcome measuresThe study measured the reliability and validity of the scales.ResultsThe ISES has two factors (‘Positive changes in the patient’ and ‘Prospect of continuing in psychiatric nursing’) and the DSES has three (‘Devaluation of own role as a psychiatric nurse’, ‘Decrease in nursing ability due to overload’ and ‘Difficulty in seeing any results in psychiatric nursing’). With regard to scale reliability, the Cronbach’s alpha coefficient was 0.634–0.845. With regard to scale validity, as the factorial validity of the ISES and DSES, for the ISES, χ2/df (110.625/37) ratio=2.990 (p<0.001), goodness-of-fit index (GFI)=0.962, adjusted GFI (AGFI)=0.932, comparative fit index (CFI)=0.967 and root mean square error of approximation (RMSEA)=0.062; for the DSES, χ2/df (101.982/37) ratio=2.756 (p<0.001), GFI=0.966, AGFI=0.940, CFI=0.943, RMSEA=0.059 and Akaike Information Criterion=159.982. The concurrent validity of the General Self-Efficacy Scale was r=0.149–0.446 (p<0.01) for ISES and r=−0.154 to −0.462 (p<0.01) for DSES, and the concurrent validity of the Stress Reaction Scale was r=−0.128 to 0.168 for ISES, r=0.214–0.398 for DSES (p<0.01).Statistical analyses showed the scales to be reliable and valid measures.ConclusionsThe ISES and DSES can accurately assess psychiatric nurses’ self-efficacy. Using these scales, it is possible to formulate programmes for improving psychiatric nurses’ feelings of self-efficacy.
Protocol for data extraction: how real-world data have been used in the National Institute for Health and Care Excellence appraisals of cancer therapy
Authors: Kang Jiyeon , Cairns John 
Published: January 2022

IntroductionDue to the limitations of relying on randomised controlled trials, the potential benefits of real-world data (RWD) in enriching evidence for health technology assessment (HTA) are highlighted. Despite increased interest in RWD, there is limited systematic research investigating how RWD have been used in HTA. The main purpose of this protocol is to extract relevant data from National Institute for Health and Care Excellence (NICE) appraisals in a transparent and reproducible manner in order to determine how NICE has incorporated a broader range of evidence in the appraisal of oncology medicines.Methods and analysisThe appraisals issued between January 2011 and May 2021 are included following inclusion criteria. The data extraction tool newly developed for this research includes the critical components of economic evaluation. The information is extracted from identified appraisals in accordance with extraction rules. The data extraction tool will be validated by a second researcher independently. The extracted data will be analysed quantitatively to investigate to what extent RWD have been used in appraisals. This is the first protocol to enable data to be extracted comprehensively and systematically in order to review the use of RWD.Ethics and disseminationThis study is approved by the Ethics Committee of the London School of Hygiene and Tropical Medicine on 14 November 2019 (17315). Results will be published in peer-reviewed journals.
Quality initiative to improve emergency department sepsis bundle compliance through utilisation of an electronic health record tool
Authors: Warstadt Nicholus Michael , Caldwell J Reed , Tang Nicole , Mandola Staci , Jamin Catherine , Dahn Cassidy 
Published: January 2022

IntroductionSepsis is a common cause of emergency department (ED) presentation and hospital admission, accounting for a disproportionate number of deaths each year relative to its incidence. Sepsis outcomes have improved with increased recognition and treatment standards promoted by the Surviving Sepsis Campaign. Due to delay in recognition and other barriers, sepsis bundle compliance remains low nationally. We hypothesised that a targeted education intervention regarding use of an electronic health record (EHR) tool for identification and management of sepsis would lead to increased EHR tool utilisation and increased sepsis bundle compliance.MethodsWe created a multidisciplinary quality improvement team to provide training and feedback on EHR tool utilisation within our ED. A prospective evaluation of the rate of EHR tool utilisation was monitored from June through December 2020. Simultaneously, we conducted two retrospective cohort studies comparing overall sepsis bundle compliance for patients when EHR tool was used versus not used. The first cohort was all patients with intention-to-treat for any sepsis severity. The second cohort of patients included adult patients with time of recognition of sepsis in the ED admitted with a diagnosis of severe sepsis or septic shock.ResultsEHR tool utilisation increased from 23.3% baseline prior to intervention to 87.2% during the study. In the intention-to-treat cohort, there was a statistically significant difference in compliance between EHR tool utilisation versus no utilisation in overall bundle compliance (p<0.001) and for several individual components: initial lactate (p=0.009), repeat lactate (p=0.001), timely antibiotics (p=0.031), blood cultures before antibiotics (p=0.001), initial fluid bolus (p<0.001) and fluid reassessment (p<0.001). In the severe sepsis and septic shock cohort, EHR tool use increased from 71.2% pre-intervention to 85.0% post-intervention (p=0.008).ConclusionWith training, feedback and EHR optimisation, an EHR tool can be successfully integrated into current workflows and appears to increase sepsis bundle compliance.