bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utilisation of health management information and its determinant factors among health professionals working at public health facilities in North Wollo Zone, Northeast Ethiopia: a cross-sectional study
Authors: Ngusie Habtamu Setegn , Ahmed Mohammedjud Hassen , Kasaye Mulugeta Desalegn , Kanfe Shuma Gosha 
Published: April 2022

ObjectiveThe study aimed to assess health management information utilisation and associated factors among health professionals working at public health facilities in North Wollo Zone, Northeast Ethiopia.SettingThe study was conducted at public health facilities in the North Wollo Zone, Northeast Ethiopia.ParticipantsA total of 664 (56.3% male and 43.7% female) health professionals participated in the study. All health professionals permanently working in North Wollo Zone were included in this study. However, health professionals who were not present during the data collection period by any means and who had less than 6 months of experience were not included in this study.Primary and secondary outcome measuresThe main outcome measure was health management information utilisation.ResultAbout 58.4% (n=388) (95% CI: 54.4% to 62.0%) of the study participants use health management information. The multivariable logistic regression model indicated that participants who had managerial positions are more likely to use health management information with an adjusted OR (AOR) of 3.11 and 95% CI 1.84 to 5.24. Similarly, having a good motivation level (AOR=4.42 (95% CI: 2.82 to 6.93)), perceived good culture of health information (AOR=6.17 (95% CI: 3.35 to 11.36)), a standard set of indicators (AOR=4.11 (95% CI: 2.65 to 6.38)), having good governance of health information system (AOR=1.75 (95% CI:1.13 to 2.72)) and health management information system (HMIS) training (AOR=3.10 (95% CI: 1.89 to 5.07)) were the predictors positively associated with higher utilisation of health management information.ConclusionThis study revealed that utilisation of health management information was still inadequate. Enhancing motivation, building a culture of information use, having standardised indicators, strengthening the governance of health information systems and comprehensive HMIS training were measures to be taken to improve utilisation of health management information in this study setting.
Brain functional changes in individuals with bulimia nervosa: a protocol for systematic review and meta-analysis
Authors: Sun Yiming , Ye Q , Wen Q , Liu X R , Sun R , Dai Y 
Published: April 2022

IntroductionBulimia nervosa (BN) is a disorder with high health and socioeconomic burdens that typically arises in late adolescence and early adulthood. Previous neuroimaging studies have found functional brain changes in patients with BN. This study aims to review the latest neurobiological evidence from studies of individuals with BN, examine the consistency of these findings and evaluate the food addiction hypothesis of the disease.Methods and analysisA systematic search will be performed using the Cochrane Library, PubMed, Embase and Web of Science databases, covering the period from database inception to 30 November 2021. Two researchers will be responsible for study selection, quality assessment and data extraction. The anisotropic effect size version of the signed differential mapping method will be used to conduct a coordinate-based meta-analysis. Publication bias will be examined with the Egger test. The quality of studies will be evaluated using the Newcastle-Ottawa Scale.Ethics and disseminationNo ethics approval is required for this is a systematic review protocol and does not require the collection of primary data. Findings will be disseminated through peer-reviewed journal or related conferences.PROSPERO registration numberCRD42022307233.
Effect of obesity treatment interventions in preschool children aged 2–6 years: a systematic review and meta-analysis
Authors: Nordlund Samantha , McPhee Patrick George , Gabarin Ramy , Deacon Charlotte , Mbuagbaw Lawrence , Morrison Katherine Mary 
Published: April 2022

Objectives(1) To summarise the literature on the impact of paediatric weight management interventions on health outcomes in preschool age children with overweight or obesity and (2) to evaluate the completeness of intervention description and real-world applicability using validated tools.DesignSystematic review and meta-analysis.Data sourcesMEDLINE, Embase, CINAHL, Cochrane Library and PsychInfo were searched between 10 March 2015 and 21 November 2021.Eligibility criteriaRandomised controlled trials addressing weight management in preschool children (2–6 years) with overweight or obesity.Data extraction and synthesisTwo reviewers independently extracted key information from each study and assessed risk of bias. Random-effects meta-analysis was performed where there was evidence for homogeneous effects. The certainty of evidence was assessed by the Grading of Recommendations Assessment, Development and Evaluation.ResultsOf the 16 908 studies retrieved, 9 trials (1687 participants) met the inclusion criteria. These interventions used motivational interviewing (MI) or multicomponent educational interventions related to health behaviour approaches and were 6–12 months in duration. All studies contained some risk of bias. A difference was found in the intervention groups compared with controls for body mass index (BMI) z score (mean difference −0.10, 95% CI −0.12 to −0.09; eight trials, 1491 participants; p<0.001; I268%), though there was substantial heterogeneity. There were no subgroup effects between studies using MI compared with studies using multicomponent interventions. The certainty of the evidence was considered low. The trials were reported in sufficient detail and were considered pragmatic.ConclusionsPaediatric weight management interventions delivered to the parents of young children with obesity result in small declines in BMI z score. The results should be interpreted cautiously as they were inconsistent and the quality of the evidence was low.PROSPERO registration numberCRD42020166843.
Children with cancer and their families after active treatment: analyses of biopsychosocial needs and implications for healthcare – a study protocol
Authors: Inhestern Laura , Paul Verena , Winzig Jana , Rutkowski Stefan , Escherich Gabriele , Bergelt Corinna 
Published: April 2022

IntroductionPatients and families affected by paediatric cancer experience psychosocial burden not only during active treatment but also during follow-up care. Use of health services during follow-up treatment should be organised according to patients’ and family members’ needs with regard to their physical and mental situation. This study aims (1) at analysing healthcare use (medical and psychosocial) and associated factors in follow-up care of paediatric cancer patients and (2) at investigating the psychosocial situation and support needs of children and their families during follow-up care. Based on the results, recommendations for healthcare planning and for the development of new and the optimisation of existing support offers will be derived.Methods and analysisWe will conduct a prospective observational study using a naturalistic explorative design with quantitative and qualitative methods. Paediatric cancer patients in follow-up care, their parents and siblings will be invited to fill out a questionnaire at three measurement points (baseline, 6 months follow-up, 12 months follow-up; target n=252 complete data sets over all measurement points). Additionally, parents will be interviewed using a semistructured interview guideline (target n=15–20) at baseline. Quantitative data will be analysed using descriptive statistics, linear mixed models and regression models. Moreover, explorative analyses will be conducted. Qualitative data will be analysed using qualitative content analyses.Ethics and disseminationThe study was approved by the Local Psychological Ethics Committee (LPEK-0281). Our findings will be published in scientific, peer-reviewed journals and presented to clinicians and researchers on conferences. To assure that results will be available to affected patients and families, a lay summary will be written and disseminated using several ways (upload on the homepage of the research group, upload on the homepage of the psychosocial working group in the Society for Paediatric Oncology/Haematology in Germany, sending to relevant patient organisations).Trial registration numberDRKS00025289.
Prehospital risk assessment in patients suspected of non-ST-segment elevation acute coronary syndrome: a systematic review and meta-analysis
Authors: Demandt Jesse P A , Zelis Jo M , Koks Arjan , Smits Geert H J M , van der Harst Pim , Tonino Pim A L , Dekker Lukas R C , van het Veer Marcel , Vlaar Pieter-Jan 
Published: April 2022

ObjectiveTo review, inventory and compare available diagnostic tools and investigate which tool has the best performance for prehospital risk assessment in patients suspected of non-ST-segment elevation acute coronary syndrome (NSTE-ACS).MethodsSystematic review and meta-analysis. Medline and Embase were searched up till 1 April 2021. Prospective studies with patients, suspected of NSTE-ACS, presenting in the primary care setting or by emergency medical services (EMS) were included. The most important exclusion criteria were studies including only patients with ST-elevation myocardial infarction and studies before 1995, the pretroponin era. The primary end point was the final hospital discharge diagnosis of NSTE-ACS or major adverse cardiac events (MACE) within 6 weeks. Risk of bias was evaluated by the Quality Assessment of Diagnostic Accuracy Studies Criteria.Main outcome and measuresSensitivity, specificity and likelihood ratio of findings for risk stratification in patients suspected of NSTE-ACS.ResultsIn total, 15 prospective studies were included; these studies reflected in total 26 083 patients. No specific variables related to symptoms, physical examination or risk factors were useful in risk stratification for NSTE-ACS diagnosis. The most useful electrocardiographic finding was ST-segment depression (LR+3.85 (95% CI 2.58 to 5.76)). Point-of-care troponin was found to be a strong predictor for NSTE-ACS in primary care (LR+14.16 (95% CI 4.28 to 46.90) and EMS setting (LR+6.16 (95% CI 5.02 to 7.57)). Combined risk scores were the best for risk assessment in an NSTE-ACS. From the combined risk scores that can be used immediately in a prehospital setting, the PreHEART score, a validated combined risk score for prehospital use, derived from the HEART score (History, ECG, Age, Risk factors, Troponin), was most useful for risk stratification in patients with NSTE-ACS (LR+8.19 (95% CI 5.47 to 12.26)) and for identifying patients without ACS (LR−0.05 (95% CI 0.02 to 0.15)).DiscussionImportant study limitations were verification bias and heterogeneity between studies. In the prehospital setting, several diagnostic tools have been reported which could improve risk stratification, triage and early treatment in patients suspected for NSTE-ACS. On-site assessment of troponin and combined risk scores derived from the HEART score are strong predictors. These results support further studies to investigate the impact of these new tools on logistics and clinical outcome.FundingThis study is funded by ZonMw, the Dutch Organisation for Health Research and Development.Trial registration numberThis meta-analysis was published for registration in PROSPERO prior to starting (CRD York, CRD42021254122).
Perspectives on factors influencing transmission of COVID-19 in Zambia: a qualitative study of health workers and community members
Authors: Sialubanje Cephas , Sitali Doreen C , Mukumbuta Nawa , Liyali Libonda , Sumbwa Phyllis Ingutu , Kamboyi Harvey Kakoma , Ng'andu Mary , Goma Fastone Matthew 
Published: April 2022

ObjectiveTo explore the health professionals’ and community members’ perspectives on the factors influencing transmission of the novel COVID-19 in Zambia.DesignAn exploratory qualitative study using in-depth interviews as data collection technique.SettingFour primary healthcare facilities and local communities of Lusaka city and Chirundu international border town under Lusaka province, Zambia.ParticipantsPurposive sampling of 60 study participants comprising health professionals (n=15) and community members (n=45). Health staff were health inspectors and surveillance officers. Community members included public market traders, civic and religious leaders, immigration officers, bus and international truck drivers.ResultsBoth health professionals and community members were aware of the COVID-19 pandemic, the preventive and control measures. Nevertheless, stark differences were observed on the two groups’ perspectives on COVID-19 and the factors influencing its transmission. Most health staff expressed high personal risk and susceptibility to the disease and a positive attitude towards the prevention and control measures. Conversely, myths and misconceptions influenced most community members’ perspectives on the disease and their attitude towards the COVID-19 guidelines. Participants were unanimous on the low levels of adherence to the COVID-19 preventive and control measures in the community. Reasons for non-adherence included limited information on COVID-19, negative attitude towards COVID-19 guidelines, social movement and travel patterns, networks and interactions, living and work conditions, water and sanitation facilities, and observation of behaviours of important role models such as politicians and other community leaders. These factors were perceived to increase the risk of COVID-19 transmission.ConclusionThese findings highlight important factors influencing transmission of COVID-19 in Zambia. Future interventions should focus on providing information to mitigate myths and misconceptions, increasing people’s risk perception to the disease, and improving attitude towards the prevention and control interventions and mitigating structural and socioeconomic barriers.
Relationship of age-related hearing loss with cognitive decline and dementia in Sinitic tonal language-speaking populations: protocol for a systematic review and meta-analysis
Authors: Fu Xinxing , Liu Bo , Wang Shuo , Tian Rong , Eikelboom Robert H , Jayakody Dona M P 
Published: April 2022

IntroductionExisting research on the potential association between age-related hearing loss (ARHL) and cognitive decline and dementia in tonal language-speaking populations is limited and inconsistent. There is psychophysiological evidence suggesting a tonal language background may be linked to enhanced general cognitive functions. We aim to systematically review the current evidence on the association between hearing loss and cognitive impairment/decline and dementia in older adults who speak a Sinitic tonal language, the most commonly spoken tonal language.Methods and analysisThis systematic review will consider peer-reviewed articles that employ objective or subjective hearing measurement and cognitive impairment or diagnosis of dementia. All relevant research publications in English or Chinese and published up to March 2022 will be considered for inclusion. Embase, MEDLINE, Web of Science, PsycINFO Google Scholar, SinoMed and Chinese Biomedical Database will be used, using both medical subject heading terms and keywords. The quality of evidence of an association between ARHL and cognitive impairment and/or dementia will be evaluated by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. A random-effects meta-analysis will be carried out with the Comprehensive Meta-Analysis software.Ethics and disseminationEthical approval will not be required for this systematic review. The results will be disseminated through peer-reviewed publications and conferences.PROSPERO registration numberCRD42021235310.
Effect of clinical peer review on mortality in patients ventilated for more than 24 hours: a cluster randomised controlled trial
Authors: Schmitt Jochen , Roessler Martin , Scriba Peter , Walther Felix , Grählert Xina , Eberlein-Gonska Maria , Kuhlen Ralf , Schoffer Olaf 
Published: April 2022

BackgroundAlthough clinical peer review is a well-established instrument for improving quality of care, clinical effectiveness is unclear.MethodsIn a pragmatic cluster randomised controlled trial, we randomly assigned 60 German Initiative Qualitätsmedizin member hospitals with the highest mortality rates in ventilated patients in 2016 to intervention and control groups. The primary outcome was hospital mortality rate in patients ventilated fore more than 24 hours. Clinical peer review was conducted in intervention group hospitals only. We assessed the impact of clinical peer review on mortality using a difference-in-difference approach by applying weighted least squares (WLS) regression to changes in age-adjusted and sex-adjusted standardised mortality ratios (SMRs) 1 year before and 1 year after treatment. Recommendations for improvement from clinical peer review and hospital survey data were used for impact and process analysis.ResultsWe analysed 12 058 and 13 016 patients ventilated fore more than 24 hours in the intervention and control hospitals within the 1-year observation period. In-hospital mortality rates and SMRs were 40.6% and 1.23 in intervention group and 41.9% and 1.28 in control group hospitals in the preintervention period, respectively. The groups showed similar hospital (bed size, ownership) and patient (age, sex, mortality, main indications) characteristics. WLS regression did not yield a significant difference between intervention and control groups regarding changes in SMRs (estimate=0.04, 95% CI= −0.05 to 0.13, p=0.38). Mortality remained high in both groups (intervention: 41.8%, control: 42.1%). Impact and process analysis indicated few perceived outcome improvements or implemented process improvements following the introduction of clinical peer review.ConclusionsThis study did not provide evidence for reductions in mortality in patients ventilated for more than 24 hours due to clinical peer review. A stronger focus on identification of structures and care processes related to mortality is required to improve the effectiveness of clinical peer review.
Abortion education in UK medical schools: a survey of medical educators
Authors: Rennison Catriona , Woodhead Emily Jane , Horan Corrina , Lohr Patricia A , Kavanagh Jayne 
Published: April 2022

AimThe 2019 National Institute for Health and Care Excellence (NICE) guidance on abortion care emphasised the importance of teaching the topic at undergraduate and postgraduate level. This study aimed to investigate the current provision of undergraduate abortion education in UK medical schools.MethodsRelevant medical ethics and clinical leads from the 33 established UK medical schools were invited to complete surveys on the ethico-legal or clinical aspects, respectively, of their institution’s abortion teaching. The surveys explored how abortion is currently taught, assessed the respondent’s opinion on current barriers to comprehensive teaching, and their desire for further guidance on undergraduate abortion teaching.ResultsSome 76% (25/33) of medical schools responded to one or both surveys. The number of hours spent on ethico-legal teaching ranged from under 1 hour to over 8 hours, with most clinical teaching lasting under 2 hours. Barriers to teaching were reported by 68% (21/31) of respondents, the most common being difficulty accessing clinical placements, lack of curriculum time, and the perception of abortion as a sensitive topic. Some 74% (23/31) of respondents would welcome additional guidance on teaching abortion to medical undergraduates.ConclusionsEducation on abortion, particularly clinical education, varies widely among UK medical schools. Most educators experience barriers to providing comprehensive abortion teaching and would welcome up-to-date guidance on teaching both the clinical and ethico-legal aspects of abortion to medical students. It is essential that medical schools address the barriers to teaching, to ensure all medical students have the knowledge, skills and attitudes to provide competent and respectful abortion-related care once qualified.
Comparison of the acute effects of ankle bathing versus moderate-intensity aerobic exercise on vascular function in young adults
Authors: Cho Min Jeong , Choi Ho Il , Kim Hyun Jeong , Bunsawat Kanokwan , Kunutsor Setor K. , Jae Sae Young 
Published: April 2022

We examined the efficacy of ankle bathing versus aerobic exercise to improve vascular function in young adults who were randomized to aerobic exercise (AE) (n = 13, 40%–60% of heart rate reserve), ankle bathing (AB) (n = 15, 43 °C), or a control condition (CON) (n = 14, ankle bathing, 36 °C) for 40 min. Conduit vessel function [brachial artery flow-mediated dilation (FMD)], carotid and femoral artery blood flow and shear rate (SR), and arterial stiffness [carotid-to-femoral pulse wave velocity (cf-PWV), augmentation index (AIx@75), β-stiffness index, and arterial compliance] were evaluated. Compared with CON, AE and AB increased FMD at 30 min and 90 min (interaction: p < 0.05); AB decreased carotid artery blood flow and SR at 30 min, while both AE and AB increased femoral artery blood flow and SR at 30 min and 90 min (interaction: p < 0.05); AE and AB decreased cf-PWV and AIx@75 at 30 min and 90 min (interaction: p < 0.05); and AE improved both carotid and femoral β-stiffness index and arterial compliance, while AB reduced β-stiffness index and increased arterial compliance only in the femoral artery (interaction: p < 0.05). These findings suggest that ankle bathing may serve as an alternative strategy for enhancing vascular function.Novelty: We observed similar improvements in conduit vessel function, femoral artery blood flow and shear rate, and arterial stiffness following ankle bathing and acute aerobic exercise in young adults. These findings have identified ankle bathing as a potential therapeutic strategy for enhancing vascular function, which may be particularly relevant for those with limited ability to engage in regular aerobic exercise.
Changes in antioxidant enzyme levels following capture in juvenile American Alligators (Alligator mississippiensis) are tissue dependent
Authors: Finger John W. , Kelley Meghan D. , Hamilton Matthew T. , Zhang Yufeng , Elsey Ruth M. , Mendonca Mary T. , Kavazis Andreas N. 
Published: April 2022

Many parameters used to investigate stress in vertebrates are temporally sensitive. The act of capture and sampling can influence them, hindering their functionality for evaluating the effects of stressors. Consequently, the investigation and subsequent incorporation of less time-sensitive parameters are necessary to better evaluate stressors affecting vertebrates. In this study, we investigated how capture stress and handling associated with sampling influence antioxidant status in American Alligators ( Alligator mississippiensis (Daudin, 1802); hereinafter Alligator), long-lived, top-trophic carnivores found in the southeastern United States, by measuring levels of two antioxidant enzymes in destructive (brain and pancreas) and nondestructive (tail scutes) tissues: superoxide dismutase 1 (SOD1) and glutathione peroxidase 1 (GPX1). Capture stress had no effect on pancreatic SOD1 and no effect on brain and pancreatic GPX1 (all p > 0.05). However, brain SOD1, scute SOD1, and scute GPX1 were all impacted by capture stress. These disparate results illustrate that the influence of capture stress on antioxidant enzymes in Alligators is tissue and marker dependent, necessitating further investigation. Our results provide a firm foundation to further investigate oxidative status in crocodilians.