bluuebunny/crossref_metadata_2025_split huggingface dataset:
Automatic oxygen control for reducing extremes of oxygen saturation: a randomised controlled trial
Authors: Nair Vrinda , Kannan Loganathan Prakash , Lal Mithilesh Kumar , Pringleton Helen , Bachman Thomas Edward , Brodlie Malcolm , Dixon Paul 
Published: August 2022

ObjectiveThe objective of this study was to evaluate the efficacy of the automatic oxygen control (A-Fio2) in reducing the percentage of time spent in severe hypoxaemia (Spo2<80%) in preterm infants for the time period on invasive ventilation and/or nasal continuous positive airway pressure (NCPAP) delivered by AVEA ventilator.DesignA parallel arm randomised controlled trial.SettingA level-III neonatal intensive care unit.PatientsPreterm infants (<33 weeks birth gestation) who received invasive ventilation or NCPAP in the first 72 hours of age.InterventionsA-Fio2vs manual (M-Fio2) oxygen control.OutcomesThe primary outcome of the study was percentage of time spent in severe hypoxaemia (Spo2<80%).Results44 infants were randomised to either A-Fio2or M-Fio2arm and continued in the study for the period of respiratory support (invasive ventilation and/or NCPAP). The total number of study days in A-Fio2 and M-Fio2arm were 194 and 204 days, respectively. The percentage of time spent in Spo2<80% was significantly lower with A-Fio2compared with M-Fio2(median of 0.1% (IQR: 0.07–0.7) vs 0.6% (0.2–2); p=0.03). The number of prolonged episodes (>60 s) of Spo2<80% per day was also significantly lower in A-Fio2(0.3 (0.0–2) vs 2 (0.6–6); p=0.02).ConclusionA-Fio2was associated with statistically significant reduction in the percentage of time spent in severe hypoxaemia when compared with M-Fio2in preterm infants receiving respiratory support.Trial registration numberNCT04223258.
Unravelling the role of the mandatory use of face covering masks for the control of SARS-CoV-2 in schools: a quasi-experimental study nested in a population-based cohort in Catalonia (Spain)
Authors: Coma Ermengol , Català Martí , Méndez-Boo Leonardo , Alonso Sergio , Hermosilla Eduardo , Alvarez-Lacalle Enric , Pino David , Medina Manuel , Asso Laia , Gatell Anna , Bassat Quique , Mas Ariadna , Soriano-Arandes Antoni , Fina Avilés Francesc , Prats Clara 
Published: August 2022

ObjectiveTo assess the effectiveness of mandatory use of face covering masks (FCMs) in schools during the first term of the 2021–2022 academic year.DesignA retrospective population-based study.SettingSchools in Catalonia (Spain).Population599 314 children aged 3–11 years attending preschool (3–5 years, without FCM mandate) and primary education (6–11 years, with FCM mandate).Study periodFrom 13 September to 22 December 2021 (before Omicron variant).InterventionsA quasi-experimental comparison between children in the last grade of preschool (5 years old), as a control group, and children in year 1 of primary education (6 years old), as an interventional group.Main outcome measuresIncidence of SARS-CoV-2, secondary attack rates (SARs) and effective reproductive number (R*).ResultsSARS-CoV-2 incidence was significantly lower in preschool than in primary education, and an increasing trend with age was observed. Six-year-old children showed higher incidence than 5 year olds (3.54% vs 3.1%; OR 1.15 (95% CI 1.08 to 1.22)) and slightly lower but not statistically significant SAR (4.36% vs 4.59%; incidence risk ratio 0.96 (95% CI 0.82 to 1.11)) and R* (0.9 vs 0.93; OR 0.96 (95% CI 0.87 to 1.09)). Results remained consistent using a regression discontinuity design and linear regression extrapolation approaches.ConclusionsWe found no significant differences in SARS-CoV-2 transmission due to FCM mandates in Catalonian schools. Instead, age was the most important factor in explaining the transmission risk for children attending school.
Physical activity and risk of infection, severity and mortality of COVID-19: a systematic review and non-linear dose–response meta-analysis of data from 1 853 610 adults
Authors: Ezzatvar Yasmin , Ramírez-Vélez Robinson , Izquierdo Mikel , Garcia-Hermoso Antonio 
Published: August 2022

Objective
To quantify the association between physical activity and risk of SARS-CoV-2 infection, COVID-19-associated hospitalisation, severe illness and death due to COVID-19 in adults.

Design
A systematic review and meta-analysis.

Data sources
Three databases were systematically searched through March 2022.

Eligibility criteria for selecting studies
Peer-reviewed articles reporting the association between regular physical activity and at least one COVID-19 outcome in adults were included. Risk estimates (ORs, relative risk (RR) ratios or HRs) were extracted and pooled using a random-effects inverse-variance model.

Results

Sixteen studies were included (n=1 853 610). Overall, those who engaged in regular physical activity had a lower risk of infection (RR=0.89; 95% CI 0.84 to 0.95; I
2
=0%), hospitalisation (RR=0.64; 95% CI 0.54 to 0.76; I
2
=48.01%), severe COVID-19 illness (RR=0.66; 95% CI 0.58 to 0.77; I
2
=50.93%) and COVID-19-related death (RR=0.57; 95% CI 0.46 to 0.71; I
2
=26.63%) as compared with their inactive peers. The results indicated a non-linear dose–response relationship between physical activity presented in metabolic equivalent of task (MET)-min per week and severe COVID-19 illness and death (p for non-linearity <0.001) with a flattening of the dose–response curve at around 500 MET-min per week.

Conclusions
Regular physical activity seems to be related to a lower likelihood of adverse COVID-19 outcomes. Our findings highlight the protective effects of engaging in sufficient physical activity as a public health strategy, with potential benefits to reduce the risk of severe COVID-19. Given the heterogeneity and risk of publication bias, further studies with standardised methodology and outcome reporting are now needed.

PROSPERO registration number
CRD42022313629.
Bibliometric analysis of sub-Saharan African and US authorship in publications about sub-Saharan Africa funded by the Fogarty International Center, 2008–2020
Authors: Akudinobi Ezinne A , Kilmarx Peter H 
Published: August 2022

BackgroundAuthorship and author order have been used as one measure to characterise equity in research partnerships. First and last (senior) authorships often denote scientific merit as well as potential for research career advancement. A previous analysis found that only about 20%–25% of publications about Africa with coauthors from top-ranking US universities had a first or last author from the topic country. In this bibliometric analysis, we evaluated authorship of publications about sub-Saharan Africa (SSA) funded by the Fogarty International Center (FIC) of the US National Institutes of Health, an institution with a mission of training and capacity building in low-income and middle-income countries.MethodsWe analysed publications from PubMed and Web of Science that were funded by FIC, about SSA, and published between 2008 and 2020. Relative citation ratio (RCR) data from iCite were used to compare group citation impact measures using the Wilcoxon rank sum test.ResultsA total of 3446 publications met the inclusion criteria, with annual number increasing from 114 in 2008 to 352 in 2020. SSA-affiliated first authors increased from 53 (47%) in 2008 to 224 (63%) in 2020. SSA-affiliated last authors increased from 32 (28%) to 166 (47%). For both first and last authorships, the median RCR value of publications with SSA-affiliated authors was lower than for US-affiliated authors (first authors: 0.84 vs 0.95, p=0.0021; last authors: 0.88 vs 0.91, p=0.010).ConclusionThe increase in first and last authorships by SSA-affiliated authors of publications about SSA suggests increasing equity in research activities funded by FIC. Further investigation and actions are needed to establish how authorship reflects other aspects of equity, the implication of the lower RCR in papers with SSA-affiliated first and last authors and what policies and practices are needed to further promote equity in global health research.
Health, financial and environmental impacts of unnecessary vitamin D testing: a triple bottom line assessment adapted for healthcare
Authors: Breth-Petersen Matilde , Bell Katy , Pickles Kristen , McGain Forbes , McAlister Scott , Barratt Alexandra 
Published: August 2022

ObjectiveTo undertake an assessment of the health, financial and environmental impacts of a well-recognised example of low-value care; inappropriate vitamin D testing.DesignCombination of systematic literature search, analysis of routinely collected healthcare data and environmental analysis.SettingAustralian healthcare system.ParticipantsPopulation of Australia.Outcome measuresWe took a sustainability approach, measuring the health, financial and environmental impacts of a specific healthcare activity. Unnecessary vitamin D testing rates were estimated from best available published literature; by definition, these provide no gain in health outcomes (in contrast to appropriate/necessary tests). Australian population-based test numbers and healthcare costs were obtained from Medicare for vitamin D pathology services. Carbon emissions in kg CO2e were estimated using data from our previous study of the carbon footprint of common pathology tests. We distinguished between tests ordered as the primary test and those ordered as an add-on to other tests, as many may be done in conjunction with other tests. We conducted base case (8% being the primary reason for the blood test) and sensitivity (12% primary test) analyses.ResultsThere were a total of 4 457 657 Medicare-funded vitamin D tests in 2020, on average one test for every six Australians, an 11.8% increase from the mean 2018–2019 total. From our literature review, 76.5% of Australia’s vitamin D tests provide no net health benefit, equating to 3 410 108 unnecessary tests in 2020. Total costs of unnecessary tests to Medicare amounted to >$A87 000 000. The 2020 carbon footprint of unnecessary vitamin D tests was 28 576 kg (base case) and 42 012 kg (sensitivity) CO2e, equivalent to driving ~160 000–230 000 km in a standard passenger car.ConclusionsUnnecessary vitamin D testing contributes to avoidable CO2e emissions and healthcare costs. While the footprint of this example is relatively small, the potential to realise environmental cobenefits by reducing low-value care more broadly is significant.
Nursing, frailty, functional decline and models of care in relation to older people receiving long-term care: a scoping review protocol
Authors: Flyum Ida Røed , Gjevjon Edith Roth , Josse-Eklund Anna , Lærum-Onsager Ellisiv , Borglin Gunilla 
Published: August 2022

IntroductionOlder people receiving healthcare in long-term care contexts (eg, home healthcare, sheltered housing and nursing home contexts) are especially vulnerable to developing frailty and functional decline. Considering the negative effects associated with these conditions and the possibility of preventing them from progressing, it is vital that nurses possess a broad knowledge base related to them. Particularly as prevention related to these conditions lies well within their remit. Such knowledge could guide the development of effective models of care, ensuring continuity and, hence, quality of care. Our objective will be to review published literature on existing models of care targeting frailty and/or functional decline and how these conditions are described by older people themselves, significant others and nurses in relation to long-term care.Methods and analysisThe scoping review will be conducted in accordance with Arksey and O’Malley’s methodological framework. Recent methodological developments will be considered. PubMed, CINAHL and PsycINFO will be searched. Eligibility criteria will be peer-reviewed papers and written in English. All types of study designs will be eligible and included papers will be quality and ethically assessed. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-Protocol checklist for protocols and the PRISMA for Scoping Reviews checklist were followed in this paper.Ethics and disseminationAs the study outlined in this protocol is a scoping review, no ethics approval was needed for this protocol nor for the upcoming study. The findings will be published in an open-access, peer-reviewed journal. Additionally, the findings will guide a research project following the Medical Research Council’s framework for developing and evaluating complex interventions. Thus, supporting us in developing a model of care related to the detection and prevention of frailty and/or functional decline among older people in a long-term care context.
Mixed-methods investigation of barriers and needs in mental healthcare of adults with autism and recommendations for future care (BarrierfreeASD): study protocol
Authors: David Nicole , Dückert Sophia , Gewohn Petia , König Hannah , Rahlff Pascal , Erik Frank , Vogeley Kai , Schöttle Daniel , Konnopka Alexander , Schulz Holger , Peth Judith 
Published: August 2022

IntroductionAutism refers to an early-onset neurodevelopmental condition with characteristic impairments and difficulties in practical living skills, which persist across the lifespan such that adults with autism often require substantial support and comprehensive care. Yet, mental health and other services are frequently unavailable for adults with autism despite considerable need for mental healthcare and individual, familial and socioeconomic burdens. This study will (1) examine current needs, barriers and burdens related to ineffective healthcare of adults with autism in Germany, (2) develop specific recommendations for a need-oriented mental healthcare model and (3) evaluate its future implementation.Methods and analysisA mixed-methods design with three phases will be conducted. In phase 1, current mental healthcare for adults with autism will be assessed at three levels (individual, structural and professional) and from three perspectives (adults with autism, relatives and healthcare providers) using (1) focus groups/interviews (qualitative data) and (2) large-scale online surveys (quantitative data). Furthermore, service utilisation and related costs will be estimated. In phase 2, recommendations for a future healthcare model will be derived based on phase 1, considering the heterogeneous and complex needs within the autism spectrum and specifying indications for recommended services. In phase 3, these will again be evaluated by the three stakeholder groups using mixed-methods and analysed regarding feasibility of implementation and cost-effectiveness. Our study will, thus, contribute to a better translation of recommendations into practice to reduce disability, burden and costs related to ineffective healthcare and improve mental health outcomes for adults with autism and those who support them.Ethics and disseminationThis study was approved by the Local Psychological Ethics Commission of the Center for Psychosocial Medicine at the University Medical Center Hamburg-Eppendorf (LPEK-0227). Findings will be disseminated via scientific meetings and peer-reviewed journals. Cooperating partners and associations will be informed about the study’s course and findings by regular newsletters and meetings.Trial registration numberThis study protocol was preregistered at the Open Science Framework (osf.io/5x8pg).
PP18 The BICeP study: results of a before and after study of a text-message intervention designed to increase confidence and willingness to perform CPR
Authors: Farquharson Barbara , Dixon Diane , Clegg Gareth , Williams Brian , Ramsay Pam , Macinnes Lisa 
Published: August 2022

BackgroundPrompt bystander cardiopulmonary resuscitation (CPR) is the single most important factor determining survival from OHCA, increasing the likelihood of survival up to 4-fold. Much is invested in training lay-people to be competent but many don’t attempt CPR when they encounter OHCA reducing potential for emergency services interventions to be successful.AimTo develop a behaviour-change text-messaging intervention to increase proportion of lay-people who will initiate CPR in the event of OHCA.MethodsWorking with lay-people and expert advisory group we developed a series of 35 text messages comprising 14 behaviour change techniques designed to increase intentions to perform CPR. We recruited 20 lay people to a before and after pilot study to evaluate the acceptability of the messages and explore participant responses to them. Intention to perform CPR was assessed in relation to 4 varied scenarios before and after the intervention.ResultsTwenty lay-people (6F, 14M; aged 20-84) participated in the study. Seventeen received the complete intervention over 4-6 weeks, two received 20+messages and one a single message before opting out. Fifteen participants provided follow-up data. Intentions to initiate CPR in CPR scenarios were greater after the intervention than before with all but one participant maintaining or increasing their original (high) intentions. Increases in psychological predictors of intention: attitudes (pre:57.5 post:63.0), perceived behavioural control(pre:50.0 post:58.0), self-efficacy (pre:74.5 post:81.0) and self-assessed competence (pre:19.5 post:20.5) were observed following the intervention. Qualitative data suggested the intervention was positively received and viewed as helpful in improving confidence by reinforcing and building on messages from training though additional options for delivery format and pace should be considered.ConclusionsA behaviour-change text-message intervention delivered after CPR training is acceptable, easily scalable and may help improve rates of lay CPR initiation. Full scale evaluation of effectiveness is planned.
PP19 Advances in community paramedicine in response to COVID-19
Authors: Batt Alan M , Hultink Amber , Lanos Chelsea , Tierney Barbara , Grenier Mathieu , Heffern Julia 
Published: August 2022

BackgroundAlready well situated in the community, paramedics work collaboratively with other community partners to ensure patients receive the services that they require and the high quality in-home and in-community care they deserve. The ongoing COVID-19 pandemic has highlighted the prevalence of social inequities in Canada, particularly in already marginalized groups, and the importance of social connectedness and caregiver wellbeing solutions. We sought to explore innovations in community paramedicine programs across Canada in response to COVID-19.MethodsWe conducted a scoping literature review of community paramedicine publications since 2020, with a focus on Canadian context, and undertook semi-structured interviews with key informants to capture innovations that may not be well represented in the literature.ResultsA total of 22 studies, combined with 26 grey literature sources were identified through the literature search. We interviewed ten stakeholders from diverse community care and community paramedicine settings across Canada to further explore each element of the conceptual framework. A conceptual framework (Figure 1) was developed to categorize the literature and findings into themes, namely: leveraging technology (e.g., virtual consultations, remote monitoring); responding to COVID-19 (e.g., mass testing and vaccination); addressing social needs (e.g., home visits, helping patients with groceries); caring for vulnerable populations (e.g., providing palliative care at home). These innovations were united in the idea of collaborating with other health care professionals and agencies, while facilitating care and case management coordination.ConclusionsThe COVID-19 pandemic has highlighted the essential collaborative care role community paramedicine programs can provide to patients in their homes or communities. Community paramedicine programs have evolved to meet the needs of their communities. These programs have demonstrated their ability to support public health measures, provide home and community-based care, and most importantly, collaborate with other health care professionals in coordinating and providing care to Canadians regardless of social circumstances.
PP22 Delivery of public health interventions by the ambulance sector
Authors: Ablard Suzanne , Cantrell Anna , Poulton Steven , Miller Elisha , Booth Andrew , Lee Andrew , Mason Suzanne , Bell Fiona 
Published: August 2022

BackgroundWith millions of unscheduled patient contacts every year and increasing call outs clustered around the most deprived communities, it is clear the ambulance sector could have a role to play in improving population health. However, the application and value of a public health approach within the ambulance sector has not been comprehensively explored.A rapid review was undertaken to explore the role of the ambulance sector in the delivery of public health interventions and what impact this has on population health and ambulance sector outcomes.MethodsA search strategy was developed to identify published and peer reviewed literature published since 2000 in OECD countries. Targeted grey literature, reference list, and citation searching was also carried out.Search results were downloaded to Microsoft Excel and screened by three reviewers according to pre-determined inclusion/exclusion criteria. Data from included studies was extracted using a data extraction form and narratively synthesized.Results2,399 records were identified, with 49 references included in the final review.Types of public health activity the ambulance sector is involved in were: public health education and advice; emergency medical services providing vaccines; paramedicine; screening tools and referral pathways; and health intelligence using ambulance sector data.ConclusionEvaluations of public health interventions included in the review focused on demand management outcomes (e.g. ambulance call–outs) rather than longer term public health outcomes. Future evaluations need to include data from multiple health sectors (e.g. social services, primary care) to assess the impact of the initiative both by and beyond the ambulance sectorThe ambulance sector should make every clinical contact count, maximising opportunities for public health intervention, prevention, and education. However, this is contingent on the skills and willingness of the workforce to do so, and sufficient time within the role given significant system and operational pressures in the sector