bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of restrictions imposed due to COVID-19 pandemic on the antenatal care and pregnancy outcomes: a prospective observational study from rural North India
Authors: Goyal Lajya Devi , Garg Priyanka , Verma Madhur , Kaur Navdeep , Bakshi Dapinder , Arora Jatinder 
Published: May 2022

ObjectivesTo assess the difficulties faced by the pregnant women in seeking appropriate antenatal care due to the restrictions imposed during the COVID-19 pandemic; assess the difficulties encountered during delivery and postpartum period; the suitability of the teleconsultation services offered; effect of COVID-19 infection on pregnancy outcomes and the effect of restrictions on the nutrition profile of the pregnant women.DesignProspective observational study.Setting and participantsWe included 1374 pregnant women from the rural areas of three districts of Punjab, India registered at government health centres before the implementation of lockdown due to the COVID-19 pandemic on 24 March 2020.Primary and secondary outcome measuresThe primary outcome was the difficulties faced by the women during their pregnancies due to restrictions imposed during the lockdown. The secondary outcomes included the effect of COVID-19 infections on pregnancy outcomes, satisfaction from the telemedicine services and restrictions on the nutrition profile of the pregnant women.ResultsOne-third of the women (38.4%) considered their last pregnancy unplanned. Women faced difficulties due to the restrictions in getting adequate nutrition (76.5%), accessing transportation facilities (35.4%), consultations from doctors (22.4%) or getting an ultrasonography scan (48.7%). One-fifth (21.9%) of women could not access safe abortion services. Only 3.6% of respondents ever took any teleconsultation services offered by the government. Most of them felt unsatisfied compared with routine visits (77.5%). COVID-19-infected women were primarily asymptomatic (76.1%), but there was a high incidence of preterm birth (42.8%). Frontline workers could visit 64.3% of the women in the postpartum period despite restrictions.ConclusionsLockdown compromised the antenatal care in our study area while the frontline workers attempted to minimise the inconvenience. Telemedicine services did not prove to be of many benefits to pregnant women and should only work as a supplement to the existing protocols of antenatal care.
Prevalence and incidence of diabetes among Aboriginal people in remote communities of the Northern Territory, Australia: a retrospective, longitudinal data-linkage study
Authors: Hare Matthew J L , Zhao Yuejen , Guthridge Steven , Burgess Paul , Barr Elizabeth L M , Ellis Elna , Butler Deborah , Rosser Amy , Falhammar Henrik , Maple-Brown Louise J 
Published: May 2022

ObjectivesTo assess the prevalence and incidence of diabetes among Aboriginal peoples in remote communities of the Northern Territory (NT), Australia.DesignRetrospective cohort analysis of linked clinical and administrative data sets from 1 July 2012 to 30 June 2019.SettingRemote health centres using the NT Government Primary Care Information System (51 out of a total of 84 remote health centres in the NT).ParticipantsAll Aboriginal clients residing in remote communities serviced by these health centres (N=21 267).Primary outcome measuresDiabetes diagnoses were established using hospital and primary care coding, biochemistry and prescription data.ResultsDiabetes prevalence across all ages increased from 14.4% (95% CI: 13.9% to 14.9%) to 17.0% (95% CI: 16.5% to 17.5%) over 7 years. Among adults (≥20 years), the 2018/2019 diabetes prevalence was 28.6% (95% CI: 27.8% to 29.4%), being higher in Central Australia (39.5%, 95% CI: 37.8% to 41.1%) compared with the Top End region (24.2%, 95% CI: 23.3% to 25.1%, p<0.001). Between 2016/2017 and 2018/2019, diabetes incidence across all ages was 7.9 per 1000 person-years (95% CI: 7.3 to 8.7 per 1000 person-years). The adult incidence of diabetes was 12.6 per 1000 person-years (95% CI: 11.5 to 13.8 per 1000 person-years).ConclusionsThe burden of diabetes in the remote Aboriginal population of the NT is among the highest in the world. Strengthened systems of care and public health prevention strategies, developed in partnership with Aboriginal communities, are needed.
Predictors of digital support services use by informal caregivers: a cross-sectional comparative survey
Authors: Hassan Alhassan Yosri Ibrahim , Lamura Giovanni , Hagedoorn Mariët 
Published: May 2022

ObjectivesDigital support services may provide informal caregivers with remote access to information and training about care issues. However, there is limited specific data on how factors such as demographics, socioeconomic resources and the caregiving context may influence caregivers’ use of digital support services. The aim of this study is to identify associations between informal caregiver’s characteristics and the use of the internet to access digital support services in two countries: Italy and Sweden.Setting and participantsA sample of 663 respondents who have access to the internet participated in a cross-sectional survey by completing the online questionnaire. Respondents were recruited by the Italian National Institute of Health and Science on Ageing and the Swedish Family Care Competence Centre.Primary and secondary outcome measuresLogistic regression analyses were performed to assess predictors of caregivers’ frequent use of the internet to access digital support services.ResultsEducational attainment (OR 3.649, 95% CI 1.424 to 9.350, p=0.007), hours per week spent caring (OR 2.928, 95% CI 1.481 to 5.791, p=0.002), total household income (OR 0.378, 95% CI 0.149 to 0.957, p=0.040), care recipient relationship to the caregiver (OR 2.895, 95% CI 1.037 to 8.083, p=0.042) and gender of care recipient (OR 0.575, 95% CI 0.356 to 0.928, p=0.023) were significant predictors in the multivariate analysis for the Italian caregivers group. Hours per week spent caring (OR 2.401, 95% CI 1.105 to 5.218, p=0.027) and age of caregiver (OR 2.237, 95% CI 1.150 to 4.352, p=0.018) were significant predictors in the multivariate analysis for the Swedish caregivers group.ConclusionsDigital support services could be important tools to empower informal caregivers. When it comes to policy and practice in relation to caregivers, similarly to other broad vulnerable groups, there is no ‘one-size-fits-all’ approach, and it is therefore important to consider the specific characteristics and needs of both caregivers and care recipients.
Effectiveness of an educational intervention in improving healthcare workers’ knowledge of early recognition, diagnosis and management of rheumatic fever and rheumatic heart disease in rural far-western Nepal: a pre/post-intervention study
Authors: Bhatt Navin , Karki Ashmita , Shrestha Biplav , Singh Amul , Rawal Lal B , Sharma Sanjib Kumar 
Published: May 2022

ObjectivesRheumatic fever (RF) and rheumatic heart disease (RHD) remain among the major heart problems among children in Nepal. Although these conditions are preventable and treatable, the lack of proper knowledge and resources to diagnose and manage these conditions in rural health centres is a key concern. This study assessed the impact of educational sessions to improve the knowledge of healthcare workers in the early recognition, diagnosis, and management of RF and RHD in rural far-western Nepal.Design, setting and participantsThis study used a pretest and post-test interventional design and was conducted among 64 healthcare workers in two primary healthcare centres and a peripheral district-level hospital in Achham district in the far-western region of Nepal. A self-administered questionnaire was used before and after the educational sessions. Data were analysed using SPSS V.21.ResultsThe overall test scores increased from 10 (SD=2.4) pre-intervention to 13.8 (SD=1.9) post-intervention (p<0.001). Similarly, participant confidence (graded 1–5) in differentiating bacterial from viral sore throat rose from 3.6 (SD=1.08) pre-intervention to 3.98 (SD=1.09) post-intervention (p<0.05). Confidence in managing RF increased from 3.9 (SD=0.88) pre-intervention to 4.30 (SD=0.8) post-intervention (p<0.001).ConclusionThe findings suggest that the investigated educational sessions are promising with respect to improving the knowledge and confidence of healthcare workers in the early recognition, diagnosis, and management of RF and RHD at the primary healthcare level. Further studies with a larger sample size and conducted in different parts of the country are warranted to assess the effectiveness and impact of scaling up such educational interventions in Nepal.
Patients’ expectations of preventive measures of medical institutions during the SARS-CoV-2 pandemic in Germany in women with an increased risk of breast and ovarian cancer: a cross-sectional, web-based survey
Authors: Schwab Roxana , Droste Annika , Stewen Kathrin , Brenner Walburgis , Schmidt Marcus , Hasenburg Annette 
Published: May 2022

ObjectivesTo identify patient-approved contingency measures for protection of patients and healthcare workers (HCWs) from COVID-19 infection and to use these findings to improve staff’s preparedness to cope with the course of this pandemic or similar situations.Methods (design, setting, participants, interventions)We conducted a cross-sectional, web-based survey of women with an increased risk of breast or ovarian cancer, regardless of whether they had experienced an active malignant disease during the pandemic. A self-reported questionnaire, developed for this study, was used to assess expectations and opinions about preventive measures within medical institutions.ResultsSixty-four (71.9%) of the 89 potential participants responded to at least one question regarding contingency measures within medical institutions. Approximately 37% of the respondents preferred having information about their facility’s hygiene protocols before appointment; 57.8% of the respondents endorsed regular SARS-CoV-2 testing of patients prior to medical appointments and 95.3% endorsed regular testing of HCWs. Additionally, 84.4% of the respondents supported HCWs’ use of surgical masks and 68.8% supported HCWs’ use of masks with greater protection. Notably, 75.0% of the respondents advocated for the presence of a significant other during medical consultations; 71.9% approved the use of telemedicine and 93.8% endorsed changes in appointment practices to enable social distancing. No significant associations were found between respondents’ sociodemographic, disease-specific or pandemic-specific factors and their opinions on hygiene precautions.ConclusionsPatients at high risk of infection or severe course of COVID-19 approve strict contingency measures designed to lower the transmission of COVID-19 in medical facilities. Moreover, vulnerable groups may profit from contingency plans in healthcare facilities in order to follow preventive measures, avoid diagnostic delay or avoid worsening of pre-existing conditions. However, they also value the presence of a significant other during medical consultations and procedures.
Clinical practice guideline recommendations for pediatric injury care: protocol for a systematic review
Authors: Moore Lynne , Freire Gabrielle , Ben Abdeljelil Anis , Berube Melanie , Tardif Pier-Alexandre , Gnanvi Eunice , Stelfox Henry Thomas , Beaudin Marianne , Carsen Sasha , Stang Antonia , Beno Suzanne , Weiss Matthew , Labrosse Melanie , Zemek Roger , Gagnon Isabelle J , Beaulieu Emilie , Berthelot Simon , Klassen Terry , Turgeon Alexis F , Lauzier François , Pike Ian , Macpherson Alison , Gabbe Belinda J , Yanchar Natalie 
Published: May 2022

IntroductionEvidence suggests the presence of deficiencies in the quality of care provided to up to half of all paediatric trauma patients in Canada, the USA and Australia. Lack of adherence to evidence-based recommendations may be driven by lack of knowledge of clinical practice guidelines (CPGs), heterogeneity in recommendations or concerns about their quality. We aim to systematically review CPG recommendations for paediatric injury care and appraise their quality.Methods and analysisWe will identify CPG recommendations through a comprehensive search strategy including Medical Literature Analysis and Retrieval System Online, Excerpta Medica dataBASE, Cochrane library, Web of Science, ClinicalTrials and websites of organisations publishing recommendations on paediatric injury care. We will consider CPGs including at least one recommendation targeting paediatric injury populations on any diagnostic or therapeutic intervention from the acute phase of care with any comparator developed in high-income countries in the last 15 years (January 2007 to a maximum of 6 months prior to submission). Pairs of reviewers will independently screen titles, abstracts and full text of eligible articles, extract data and evaluate the quality of CPGs and their recommendations using Appraisal of Guidelines Research and Evaluation (AGREE) II and AGREE Recommendations Excellence instruments, respectively. We will synthesise evidence on recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Evidence-to-Decision framework and present results within a recommendations matrix.Ethics and disseminationEthics approval is not a requirement as this study is based on available published data. The results of this systematic review will be published in a peer-reviewed journal, presented at international scientific meetings and distributed to healthcare providers.PROSPERO registration numberInternational Prospective Register of Systematic Reviews (CRD42021226934).
Conceptualising paediatric advance care planning: a qualitative phenomenological study of paediatricians caring for children with life-limiting conditions in Australia
Authors: Vemuri Sidharth , Hynson Jenny , Williams Katrina , Gillam Lynn 
Published: May 2022

ObjectivesAdvance care planning (ACP) helps families and paediatricians prepare and plan for end-of-life decision-making. However, there remains inconsistency in its practice with the limited literature describing what this preparation involves, and whether paediatricians recognise a difference between the process of ACP and its outcomes, such as resuscitation plans. This study aims to understand how paediatricians conceptualise ACP when caring for children with life-limiting conditions (LLC) who are unable to participate in decision-making for his/herself.DesignIndividual, semistructured, vignette-based qualitative interviews.SettingAcute inpatient and long-term outpatient paediatric care in three secondary and two tertiary centres in Victoria, Australia.Participants25 purposively sampled paediatricians who treat children with LLC, outside the neonatal period. Paediatricians were excluded if they worked within specialist palliative care teams or assisted in this study’s design.ResultsFour key themes were identified when approaching end-of-life decision-making discussions: (1) there is a process over time, (2) there are three elements, (3) the role of exploring parental values and (4) the emotional impact. The three elements of this process are: (1) communicating the child’s risk of death, (2) moving from theoretical concepts to practice and (3) documenting decisions about resuscitation or intensive technologies. However, not all paediatricians recognised all elements as ACP, nor are all elements consistently or intentionally used. Some paediatricians considered ACP to be only documentation of decisions in advance.ConclusionThere is a preparatory process of discussions for end-of-life decision-making, with elements in this preparation practised within therapeutic relationships. Complexity in what constitutes ACP needs to be captured in guidance and training to include intentional exploration of parental values, and recognition and management of the emotional impact of ACP could increase its consistency and value.
Beliefs about back pain and associations with clinical outcomes: a primary care cohort study
Authors: Grøn Søren , Jensen Rikke K , Kongsted Alice 
Published: May 2022

ObjectiveTo investigate associations between beliefs about low back pain (LBP) at baseline and pain intensity and disability at 2-week, 13-week and 52-week follow-up.DesignObservational cohort study.SettingPrimary care private chiropractic clinics in Denmark.ParticipantsA total of 2734 adults consulting a chiropractor for a new episode of LBP, with follow-up data available from 71%, 61% and 52% of the participants at 2, 13 and 52 weeks, respectively.Outcome measuresBeliefs about LBP were measured by the Back Belief Questionnaire (BBQ) before consulting the chiropractor. Pain (Numerical Rating Scale 0–10) and disability (the Roland-Morris Disability Questionnaire) were measured at baseline and after 2, 13 and 52 weeks. Associations were explored using longitudinal linear mixed models estimating interactions between BBQ and time, and by estimating associations between single items of BBQ and 13-week outcomes.ResultsMore positive beliefs about LBP were weakly associated with a reduction in pain at 2 weeks (β interaction BBQ#Time=−0.02 (95% CI −0.04 to −0.001)), at 13 weeks (−0.03 (95% CI −0.05 to −0.01)) and at 52 weeks of follow-up (−0.03 (95% CI −0.05 to −0.01); p=0.003). For disability, the association was uncertain (p=0.7). The item ‘Back trouble means periods of pain for the rest of one’s life’ had the strongest association with both reduction in pain (−0.29, 95% CI −0.4 to −0.19, p<0.001) and disability (−2.42, 95% CI −3.52 to −1.33, p<0.001) at 13-week follow-up.ConclusionPositive beliefs regarding LBP, measured by the BBQ, were associated with a reduction in pain intensity at both short-term and long-term follow-up. However, the association was weak, and the clinical relevance is therefore questionable. No clear association was demonstrated between beliefs and disability. This study did not show promise that back beliefs as measured by the BBQ were helpful for predicting or explaining the course of LBP in this setting.
Developing a typology of models of palliative care delivery in prisons in high-income countries: protocol for a scoping review with narrative synthesis
Authors: Gilbert Emma , Turner M , de Viggiani Nick , Selman Lucy 
Published: May 2022

IntroductionA combination of punitive sentencing practices within ageing populations, compounded by the health challenges faced by people in prison, means that dedicated palliative care provision within prisons is a pressing requirement. However, evidence about exactly how quality palliative and end-of-life care is delivered in this environment remains sparse.This review aims to develop a typology of models of palliative and end-of-life care delivery within prisons in high-income countries to inform service development and policy.Methods and analysisWe will conduct a scoping review of published studies and grey literature, following the Arksey and O’Malley framework. We will report data on models of palliative and end-of-life care delivery in prisons in high-income countries. Searches will be undertaken in Medline, EMBASE, CINAHL, Social Sciences Citation Index and PsyINFO for all study types, published from 1 January 2000 to December 2021, and reference lists from key reviews and studies will be screened for additional references. We will also screen grey literature from within other high-income countries using a targeted search strategy. For published reports of original research, study quality and risk of bias will be assessed independently by two reviewers using the Mixed Methods Appraisal Tool. A narrative synthesis of the data will be undertaken, integrating the results of the quality assessment.Ethics and disseminationApproval by research ethics committee is not required since the review only includes published and publicly accessible data. We will publish our findings in a peer-reviewed journal as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidance.Protocol registrationThe final protocol was registered with the Research Registry on 26 November 2021 (www.researchregistry.com).Unique ID number: reviewregistry1260.
The Geriatric Emergency Care Applied Research (GEAR) network approach: a protocol to advance stakeholder consensus and research priorities in geriatrics and dementia care in the emergency department
Authors: Hwang Ula , Carpenter Christopher , Dresden Scott , Dussetschleger Jeffrey , Gifford Angela , Hoang Ly , Leggett Jesseca , Nowroozpoor Armin , Taylor Zachary , Shah Manish 
Published: May 2022

IntroductionIncreasingly, older adults are turning to emergency departments (EDs) to address healthcare needs. To achieve these research demands, infrastructure is needed to both generate evidence of intervention impact and advance the development of implementation science, pragmatic trials evaluation and dissemination of findings from studies addressing the emergency care needs of older adults. The Geriatric Emergency Care Applied Research Network (https://gearnetwork.org) has been created in response to these scientific needs—to build a transdisciplinary infrastructure to support the research that will optimise emergency care for older adults and persons living with dementia.Methods and analysisIn this paper, we describe our approach to developing the GEAR Network infrastructure, the scoping reviews to identify research and clinical gaps and its use of consensus-driven research priorities with a transdisciplinary taskforce of stakeholders that includes patients and care partners. We describe how priority topic areas are ascertained, the process of conducting scoping reviews with integrated academic librarians performing standardised searches and providing quality control on reviews, input and support from the taskforce and conducting a large-scale consensus workshop to prioritise future research topics. The GEAR Network approach provides a framework and systematic approach to develop a research agenda and support research in geriatric emergency care.Ethics and disseminationThis is a systematic review of previously conducted research; accordingly, it does not constitute human subjects research needing ethics review. These reviews will be prepared as manuscripts and submitted for publication to peer-reviewed journals, and the results will be presented at conferences.Open Science Framework registered DOI:10.17605/OSF.IO/6QRYX,10.17605/OSF.IO/AKVZ8,10.17605/OSF.IO/EPVR5,10.17605/OSF.IO/VXPRS.