bluuebunny/crossref_metadata_2025 huggingface dataset:
Responses to the Physical Activity Guidelines and Dissemination Strategies for Behavior Change in a Representative Sample of US Adults
Authors: Polster Malorie , Dooley Erin E. , Olscamp Kate , Piercy Katrina L. , Oh April
Published: September 2021

Background: Dissemination of the Physical Activity Guidelines for Americans (Guidelines) is needed, but how individuals respond to the Guidelines is not well understood. This surveillance study describes US adults’ reported responses to and information sources for hearing about the Guidelines and explores relationships between how respondents heard about the Guidelines and their reported response(s).Methods: Data were analyzed from the population-based 2019 Health Information National Trends Survey 5 Cycle 3. Population-weighted proportions of response were calculated. Among those who had heard about the Guidelines, binary logistic regressions examined associations between the reported response(s) and the information source and number of sources reported.Results: The analytical sample included 5047 adults. Nearly 65% of US adults reported hearing about the Guidelines, and 29% reported a behavioral response (eg, increased physical activity). Hearing about the Guidelines through health professionals (adjusted odds ratio = 2.30, 95% confidence interval, 1.45–3.65) or social media (adjusted odds ratio = 1.89, 95% confidence interval, 1.20–2.96) (vs other sources) was associated with reporting increasing physical activity. Hearing from multiple sources (vs one source) was associated with reporting increasing physical activity (adjusted odds ratio = 1.97, 95% confidence interval, 1.18–3.31).Conclusion: Findings suggest dissemination of the Guidelines across multiple channels may promote greater changes in physical activity.
“A 15% Reduction in Physical Inactivity Will Be Achieved in Australasia by 2030”—Audience Votes Negative in Online Debate
Authors: Foley Bridget C. , McLaughlin Mathew , Edney Sarah , Islam Sheikh Mohammed Shariful , Seymour Jessica , Peralta Louisa R. , Douglas Angela , Rosenbaum Simon , Thorpe Holly , Atkin Janice , Olds Tim , Ding Ding
Published: September 2021

The Australasian Society for Physical Activity aims to advance the science and practice of physical activity in Australia, New Zealand, the Pacific Islands, East Asia, South Asia, Southeast Asia, and Oceania. Fun, enjoyment, and cross-disciplinary discourse are important to ensure the network of physical activity professionals and our collective voice continues to grow. In May 2021, Australasian Society for Physical Activity’s Early Career Network curated an engaging online Physical Activity Debate attended by 206 professionals. This commentary provides a synopsis of the debate and the central arguments presented by the affirmative and negatives teams. The authors describe the debate format and interactive design of the online Physical Activity Debate to provide insights for future online events that aim to boost interaction among physical activity professionals from various disciplines.
CK2 Phosphorylation of Human Papillomavirus 16 E2 on Serine 23 Promotes Interaction with TopBP1 and Is Critical for E2 Interaction with Mitotic Chromatin and the Viral Life Cycle
Authors: Prabhakar Apurva T. , James Claire D. , Das Dipon , Otoa Raymonde , Day Matthew , Burgner John , Fontan Christian T. , Wang Xu , Glass Sarah H. , Wieland Andreas , Donaldson Mary M. , Bristol Molly L. , Li Renfeng , Oliver Anthony W. , Pearl Laurence H. , Smith Brian O. , Morgan Iain M.
Published: September 2021

Human papillomaviruses are causative agents in around 5% of all cancers, with no specific antiviral therapeutics available for treating infections or resultant cancers. In this report, we demonstrate that phosphorylation of HPV16 E2 by CK2 promotes formation of a complex with the cellular protein TopBP1
in vitro
and
in vivo
.
Endothelial Heparan Sulfate Mediates Hepatic Neutrophil Trafficking and Injury during Staphylococcus aureus Sepsis
Authors: Golden Gregory J. , Toledo Alejandro Gómez , Marki Alex , Sorrentino James T. , Morris Claire , Riley Raquel J. , Spliid Charlotte , Chen Qiongyu , Cornax Ingrid , Lewis Nathan E. , Varki Nissi , Le Dzung , Malmström Johan , Karlsson Christofer , Ley Klaus , Nizet Victor , Esko Jeffrey D.
Published: September 2021

Vascular glycocalyx remodeling is critical to sepsis pathology, but the glycocalyx components that contribute to this process remain poorly characterized. This article shows that during
Staphylococcus aureus
sepsis, the liver vascular glycocalyx undergoes dramatic compositional changes in proteins associated with neutrophilic activity and heparin/heparan sulfate binding, all before organ damage is detectable by standard circulating liver damage markers or histology.
Global Analysis of the Specificities and Targets of Endoribonucleases from Escherichia coli Toxin-Antitoxin Systems
Authors: Culviner Peter H. , Nocedal Isabel , Fortune Sarah M. , Laub Michael T.
Published: September 2021

Toxin-antitoxin (TA) systems are widespread genetic modules found in almost all bacteria that can regulate their growth and may play prominent roles in phage defense.
Escherichia coli
encodes 11 TA systems in which the toxin is a known or predicted endoribonuclease. The targets and cleavage specificities of these endoribonucleases have remained largely uncharacterized, precluding an understanding of how each impacts cell growth and an assessment of whether they have distinct or overlapping targets.
HIV-1 Genomes Are Enriched in Memory CD4
+
T-Cells with Short Half-Lives
Authors: Morcilla Vincent , Bacchus-Souffan Charline , Fisher Katie , Horsburgh Bethany A. , Hiener Bonnie , Wang Xiao Qian , Schlub Timothy E. , Fitch Mark , Hoh Rebecca , Hecht Frederick M. , Martin Jeffrey N. , Deeks Steven G. , Hellerstein Marc K. , McCune Joseph M. , Hunt Peter W. , Palmer Sarah
Published: September 2021

The design of future HIV-1 curative therapies requires a more thorough understanding of the distribution of genetically intact HIV-1 within T-cell subsets as well as the cellular mechanisms that maintain this reservoir. These genetically intact and presumably replication-competent proviruses make up the latent HIV-1 reservoir.
Genomic Stability and Genetic Defense Systems in
Dolosigranulum pigrum
, a Candidate Beneficial Bacterium from the Human Microbiome
Authors: Flores Ramos Stephany , Brugger Silvio D. , Escapa Isabel Fernandez , Skeete Chelsey A. , Cotton Sean L. , Eslami Sara M. , Gao Wei , Bomar Lindsey , Tran Tommy H. , Jones Dakota S. , Minot Samuel , Roberts Richard J. , Johnston Christopher D. , Lemon Katherine P.
Published: September 2021

Dolosigranulum pigrum
is a candidate beneficial bacterium with potential for future therapeutic use. This is based on its positive associations with characteristics of health in multiple studies of human nasal microbiota across the span of human life.
Prevalence and Specificity of Chemoreceptor Profiles in Plant-Associated Bacteria
Authors: Sanchis-López Claudia , Cerna-Vargas Jean Paul , Santamaría-Hernando Saray , Ramos Cayo , Krell Tino , Rodríguez-Palenzuela Pablo , López-Solanilla Emilia , Huerta-Cepas Jaime , Rodríguez-Herva José J.
Published: September 2021

Considering the enormous variety of LBDs at sensor proteins, an important question resides in establishing the forces that have driven their evolution and selection. We present here the first clear demonstration that environmental factors play an important role in the selection and evolution of LBDs.
Significance of New Harmony, Indiana, USA, to nineteenth-century paleontological investigations of North America: Progressive education through arts and sciences
Authors: Elliott Jr. William S.
Published: September 2021

William Maclure, Father of North American Geology, partnered with Robert Owen in 1825 to establish an experimental socialistic community focusing on equitable reform in New Harmony, Indiana, USA. Artists, educators, and natural scientists recruited from Philadelphia arrived on a keel boat named Philanthropist in January 1826. Upon their arrival, Maclure established the New Harmony schools using a modified Pestalozzian educational approach under the guidance of Madame Fretageot. The New Harmony schools focused on practical education through direct observation of nature as well as a curriculum involving drawing, music, science, writing, and trade skills such as carpentry, engraving, and printing. Furthermore, the integration of arts and sciences with hands-on experiences led to a productive community of natural scientists who published significant works on the conchology, geology, ichthyology, and paleontology of North America.

In the mid-nineteenth century, hand-drawn illustrations were reproduced through engravings, etchings, or lithography prior to the invention of the daguerreotype process in 1839, collodion wet plate process in 1851, and flexible celluloid film in 1888. In particular, the published works of David Dale Owen demonstrate the increasing importance of evolving reproduction techniques to paleontological illustration as well as the significance of hand-drawn artistic renderings. Interestingly, the modified Pestalozzian educational approach introduced by Maclure in New Harmony has several implications for the modern classroom. For instance, recent studies suggest that drawing improves spatial reasoning skills and increases comprehension of complex scientific principles. Likewise, engaging students in the drawing of fossils delivers a meaningful learning experience in the paleontology classroom.
Does the British Isles Paleocene dike swarm reflect the former location of the Iceland hotspot?
Authors: Dalziel* Ian W.D. , Lawver Lawrence A.
Published: September 2021

The original location and tectonic setting of the prominent Paleocene dike swarm in the British Isles are reconstructed for a “tight fit” of the North Atlantic region prior to any Cenozoic opening of the ocean basin between Greenland and Europe. The present-day northwest-southeast–oriented swarm originally trended toward southern Greenland and the locations of magmatic rocks of comparable age along the eastern and western margins of Greenland and approximately the position of the Iceland hotspot at 70–60 Ma in a “fixed hotspot” model. This raises the possibility that the northeast-southwest–oriented extensional stress field in which the dikes and associated central igneous complexes were emplaced may have been generated by impingement on the base of the lithosphere by a rising plume beneath present-day West Greenland. It is speculated, on the basis of seismic tomography and three-dimensional modeling, that the Paleocene igneous activity in the British Isles may have resulted from flow of a hot “finger” of upper mantle outward from the plume, perhaps controlled by preexisting lithospheric structures and the distant location of a second Paleocene volcanic province in central Europe.
Hidden breast cancer after breast augmentation, not presenting as a hypoechoic mass lesion, diagnosed using colour Doppler ultrasound
Authors: Fujimoto Akihiro , Kosaka Yoshimasa , Hasebe Takahiro , Saeki Toshiaki
Published: September 2021

The main concern after breast augmentation with silicone injection is that silicone granulomas make it difficult to detect breast cancer. A case of breast cancer was diagnosed using colour Doppler ultrasound (CD) to detect an non-palpable mass not presenting as a hypoechoic mass lesion. An 83-year-old woman was incidentally found to have a lesion in her right breast, which was injected with silicone, showing 18F-fluorodeoxyglucose (FDG) uptake; the lesion was suspected to be breast cancer or silicone granuloma. A mass at the FDG uptake site was not detected on ultrasonography (US); however, observation using CD revealed a slightly hypoechoic area with hypervascularity. Core needle biopsy showed invasive ductal carcinoma. Patients in whom US does not reveal lesions after breast augmentation with silicone injection should undergo CD to detect hypervascularised tissue. To prevent false-negative biopsy results, CD is essential to detect cancer at suspected sites.
Topical medication as an initial therapeutic option for protruding and non-protruding condylomata acuminata of the distal urethra
Authors: Mestrovic Tomislav , Sviben Mario , Zember Sanja , Drenjancevic Domagoj
Published: September 2021

Genital warts (also known as condylomata acuminata) caused by the human papillomavirus (HPV) represent one of the most common sexually transmitted infections. Although they are usually found in the outer genital region, a small proportion of men can present with (often unrecognised) intraurethral warts, generally limited to the distal urethra and urethral meatus. This poses a treatment challenge not adequately addressed by the current guidelines. Here, we present two cases of low-risk HPV-positive patients with protruding and non-protruding condylomata acuminata of the distal urethra, which were treated successfully by using two different topical regimens (ie, a combination of policresulen and imiquimod for one patient and 5-fluorouracil monotherapy for the other). Although this type of management results in lower rates of tissue destruction and complications and may be given preference as an initial therapeutic option, additional prospective comparative clinical studies are needed to elucidate its potential in similar cases.
Bilateral endogenous endophthalmitis complicated by scleral perforation: an unusual presentation
Authors: Sinha Prerna , Sinha Upasna , Raj Amit , Pati Binod Kumar
Published: September 2021

Endogenous endophthalmitis complicated by necrotising scleritis has rarely been reported in the literature. We, hereby, report a case of bilateral scleral perforation with endogenous endophthalmitis in an 87-year-old female patient with diabetes who presented as bilateral orbital cellulitis. Systemic workup ruled out autoimmune aetiology. The culture and sensitivity of exudates exuding from the scleral perforation showedEscherichia coli. The Patient was managed conservatively with parenteral and topical antibiotics along with steroid, but the vision could not be salvaged. The report emphasizes on atypical presentation of endogenous endophthalmitis. In old and immunosuppressed individuals presenting with a clinical picture of bilateral orbital cellulitis with profound vision loss, endogenous endophthalmitis should be ruled out.
Pembrolizumab-induced autoimmune haemolytic anemia in a patient with chronic lymphocytic leukaemia successfully treated with ibrutinib
Authors: Yun Nicole K , Alrifai Taha , Miller Ira J , Larson Melissa L
Published: September 2021

We present a unique case of a patient with a long-standing history of indolent chronic lymphocytic leukaemia (CLL) who suddenly developed autoimmune haemolytic anaemia after starting immune checkpoint inhibitor therapy for bladder cancer. He had no clear indication to start CLL-directed treatment based on current clinical practice guidelines; however, targeted treatment of CLL with ibrutinib proved to be effective in treating the haemolytic anaemia.
Technique of re-enclavation of post-traumatic disenclaved haptic of posterior iris claw lens in a vitrectomised eye
Authors: Khokhar Sudarshan , Kumar Saumya , Rani Deeksha , Majumdar Aayush
Published: September 2021

A 58-year-old woman presented to us with sudden onset diminution of vision for 10 days following trauma while using mobile phone. Patient had a history of posterior iris claw implantation 3 years ago. On examination, the patient was aphakic and intraocular lens (IOL) was seen enclaved on nasal side and disenclaved on temporal side on ultrasound biomicroscopy. Patient underwent surgery for re-enclavation of temporal haptic by lifting the IOL using 23-gauge pars plana trocar. Patient had a postoperative uncorrected visual acuity of 6/9 and best-corrected visual acuity of 6/6 with refraction. Re-enclavation of partially disenclaved posterior iris claw lens is a minimally invasive technique to restore visual acuity in such cases.
Severe COVID-19 pneumonia complicated by cardiomyopathy and a small anterior pneumothorax
Authors: Rajendram Rajkumar , Hussain Arif
Published: September 2021

Although, cardiac injury, pneumothorax and pneumomediastinum are associated with COVID-19, differentiation of their symptoms and signs from those of COVID-19 itself is challenging. Without a high index of suspicion, cardiomyopathy and anterior pneumothorax are easily missed. These complications may be underdiagnosed in patients with COVID-19. Cardiomyopathy and pneumothorax may cause or exacerbate respiratory failure. If their management is delayed, cardiac arrest can occur. To increase the awareness of these issues, we describe the course and imaging of a 39-year-old woman with severe COVID-19 who developed cardiomyopathy and a small anterior pneumothorax with pneumomediastinum. Transthoracic echocardiography is technically challenging in the presence of anterior pneumothorax. Furthermore, although CT is the gold standard for the diagnosis of pneumothorax, this is not always feasible in critically ill patients. Lateral decubitus chest X-rays and lung ultrasound may facilitate the diagnosis of pneumothorax at the bedside of patients with COVID-19.
Procalcitonin and lung ultrasonography point-of-care testing to determine antibiotic prescription in patients with lower respiratory tract infection in primary care: pragmatic cluster randomised trial
Authors: Lhopitallier Loïc , Kronenberg Andreas , Meuwly Jean-Yves , Locatelli Isabella , Mueller Yolanda , Senn Nicolas , D’Acremont Valérie , Boillat-Blanco Noémie
Published: September 2021

Objective

To assess whether point-of care procalcitonin and lung ultrasonography can safely reduce unnecessary antibiotic treatment in patients with lower respiratory tract infections in primary care.

Design

Three group, pragmatic cluster randomised controlled trial from September 2018 to March 2020.

Setting

60 Swiss general practices.

Participants

One general practitioner per practice was included. General practitioners screen all patients with acute cough; patients with clinical pneumonia were included.

Interventions

Randomisation in a 1:1:1 of general practitioners to either antibiotics guided by sequential procalcitonin and lung ultrasonography point-of-care tests (UltraPro; n=152), procalcitonin guided antibiotics (n=195), or usual care (n=122).

Main outcomes

Primary outcome was proportion of patients in each group prescribed an antibiotic by day 28. Secondary outcomes included duration of restricted activities due to lower respiratory tract infection within 14 days.

Results

60 general practitioners included 469 patients (median age 53 years (interquartile range 38-66); 278 (59%) were female). Probability of antibiotic prescription at day 28 was lower in the procalcitonin group than in the usual care group (0.40
v
0.70, cluster corrected difference −0.26 (95% confidence interval −0.41 to −0.10)). No significant difference was seen between UltraPro and procalcitonin groups (0.41
v
0.40, −0.03 (−0.17 to 0.12)). The median number of days with restricted activities by day 14 was 4 days in the procalcitonin group and 3 days in the usual care group (difference 1 day (95% confidence interval −0.23 to 2.32); hazard ratio 0.75 (95% confidence interval 0.58 to 0.97)), which did not prove non-inferiority.

Conclusions

Compared with usual care, point-of-care procalcitonin led to a 26% absolute reduction in the probability of 28 day antibiotic prescription without affecting patients’ safety. Point-of-care lung ultrasonography did not further reduce antibiotic prescription, although a potential added value cannot be excluded, owing to the wide confidence intervals.

Trial registration

ClinicalTrials.gov
NCT03191071
.
Effect of C reactive protein point-of-care testing on antibiotic prescribing for lower respiratory tract infections in nursing home residents: cluster randomised controlled trial
Authors: Boere Tjarda M , van Buul Laura W , Hopstaken Rogier M , van Tulder Maurits W , Twisk Jos W M R , Verheij Theo J M , Hertogh Cees M P M
Published: September 2021

Objective

To evaluate whether C reactive protein point-of-care testing (CRP POCT) safely reduces antibiotic prescribing for lower respiratory tract infections in nursing home residents.

Design

Pragmatic, cluster randomised controlled trial.

Setting

The UPCARE study included 11 nursing home organisations in the Netherlands.

Participants

84 physicians from 11 nursing home organisations included 241 participants with suspected lower respiratory tract infections from September 2018 to the end of March 2020.

Interventions

Nursing homes allocated to the intervention group had access to CRP POCT. The control group provided usual care without CRP POCT for patients with suspected lower respiratory tract infections.

Main outcome measures

The primary outcome measure was antibiotic prescribing at initial consultation. Secondary outcome measures were full recovery at three weeks, changes in antibiotic management and additional diagnostics during follow-up at one week and three weeks, and hospital admission and all cause mortality at any point (initial consultation, one week, or three weeks).

Results

Antibiotics were prescribed at initial consultation for 84 (53.5%) patients in the intervention group and 65 (82.3%) in the control group. Patients in the intervention group had 4.93 higher odds (95% confidence interval 1.91 to 12.73) of not being prescribed antibiotics at initial consultation compared with the control group, irrespective of treating physician and baseline characteristics. The between group difference in antibiotic prescribing at any point from initial consultation to follow-up was 23.6%. Differences in secondary outcomes between the intervention and control groups were 4.4% in full recovery rates at three weeks (86.4%
v
90.8%), 2.2% in all cause mortality rates (3.5%
v
1.3%), and 0.7% in hospital admission rates (7.2%
v
6.5%). The odds of full recovery at three weeks, and the odds of mortality and hospital admission at any point did not significantly differ between groups.

Conclusions

CRP POCT for suspected lower respiratory tract infection safely reduced antibiotic prescribing compared with usual care in nursing home residents. The findings suggest that implementing CRP POCT in nursing homes might contribute to reduced antibiotic use in this setting and help to combat antibiotic resistance.

Trial registration

Netherlands Trial Register NL5054
Can a sleep disorder intervention-embedded self-management programme contribute to improve management of diabetes? A pilot single-arm pretest and post-test study
Authors: Sakamoto Ritsuko , Kazawa Kana , Jahan Yasmin , Takeyama Naoko , Moriyama Michiko
Published: September 2021

Objective

To investigate the efficacy and feasibility of a self-management programme incorporating a sleep intervention for improving diabetes outcomes.

Design

A single-arm pre-test and post-test study was conducted within a community setting in Hiroshima, Japan.

Participants

Participants were aged 52–74 years and diagnosed with type 2 diabetic nephropathy stages 1–3.

Interventions

Participants received self-management education from nurses for 6 months. First, the nurses assessed their sleep conditions using insomnia scales and a sleep metre. Then, the participants learnt self-management to increase their physical activity and improve their sleep condition. They also implemented diet therapy and medication adherence.

Outcome measures

Physiological indicators, subjective and objective indicators of sleep quality, self-management indicators, quality of life (QOL) and feasibility were evaluated. To confirm the efficacy of intervention, Freidman tests, analysis of variance, Wilcoxon signed-rank test and t-test were performed. Pearson’s correlations were analysed between activities and sleep condition.

Results

Of the 26 enrolled participants, 24 completed the programme and were analysed. Among them, 15 participants (62.5%) had sleep disorders caused by multiple factors, such as an inappropriate lifestyle and physical factors that interfere with good sleep. Although insomnia scales did not change for the sleep disorders, their subjective health status improved. Regarding indicators related to diabetes management, lifestyles improved significantly. Haemoglobin A1c, body mass index, systolic blood pressure, non-high-density lipoprotein-cholesterol and QOL also improved. All participants except one were satisfied with the programme. However, use of the sleep metre and nurses’ consultation about sleep disturbance were not well evaluated.

Conclusions

This programme was effective in improving diabetes status, lifestyle and behaviour changes. However, its effect on sleep condition was limited because of its complexity. A simple and novel approach is needed to strengthen the motivation for sleep behaviour change and to increase programme efficacy and feasibility.

Trial registration number

UMIN000025906.
Primary care staff’s willingness to participate in compassionate community network and palliative care and the barriers they face: a mixed methods study
Authors: Chang Hsiao-Ting , Lin Ming-Hwai , Kuo Wen-Hua , Chen Chun-Ku , Chen Tzeng-Ji , Hwang Shinn-Jang
Published: September 2021

Objectives

Compassionate community models, successfully applied in several Western countries, have not been extensively promoted in Asian countries. This study explored primary care staff’s willingness to participate and factors associated with their participations in compassionate community education and network, palliative care education, providing palliative care and the barriers they faced.

Methods

Adopting a mixed quantitative–qualitative design, primary care staffs in Beitou and Shilin districts in Taiwan, including physicians, nurses, pharmacists and administrative staff aged ≥20 years who had worked in a clinic for more than 2 months, were recruited. A questionnaire survey was conducted to explore their willingness to participate in compassionate community education and networks and palliative care education and care provision. Logistic regression was used to evaluate factors associated with their willingness, and qualitative perceptions were evaluated by open questions.

Results

About half of the respondents were willing to participate in compassionate community education and network and palliative care education, but only 19.5% were willing to provide palliative care. Compared with other staff, primary care nurses showed significantly more willingness to participate in compassionate community education and network and palliative care education and to provide palliative care. However, physicians were significantly not willing to participate in any of the three services apart from providing care. Capability, administrative and manpower concerns, time, age and motivation were the main barriers.

Conclusions

To encourage primary care staff to participate more in compassionate community education and network and palliative care education and to provide palliative care, policymakers should pay more attention towards removing the barriers to their engagement.
Young and invisible: a qualitative study of service engagement by people who inject drugs in India
Authors: Ganapathi Lakshmi , Srikrishnan Aylur K , Martinez Clarissa , Lucas Gregory M , Mehta Shruti H , Verma Vinita , McFall Allison M , Mayer Kenneth H , Hassan Areej , Rajan Shobini , O’Cleirigh Conall , Harris Sion Kim , Solomon Sunil S
Published: September 2021

Objectives

The HIV epidemic in India is concentrated in key populations such as people who inject drugs (PWID). New HIV infections are high among young PWID (≤30 years of age), who are hard to engage in services. We assessed perspectives of young PWID to guide development of youth-specific services.

Setting

We conducted focus group discussions (FGDs) with PWID and staff at venues offering services to PWID in three Indian cities representing historical and emerging drug use epidemics.

Participants

PWID were eligible to participate if they were between 18 and 35 years, had initiated injection as adolescents or young adults and knew adolescent PWID in their networks. 43 PWID (81% male, 19% female) and 10 staff members participated in FGDs. A semistructured interview guide was used to elicit participants’ narratives on injection initiation experiences, barriers to seeking harm reduction services, service delivery gaps and recommendations to promote engagement. Thematic analysis was used to develop an explanatory model for service engagement in each temporal stage across the injection continuum.

Results

Injection initiation followed non-injection opioid dependence. Lack of services for non-injection opioid dependence was a key gap in the preinjection initiation phase. Lack of knowledge and reliance on informal sources for injecting equipment were key reasons for non-engagement in the peri-injection phase. Additionally, low-risk perception resulted in low motivation to seek services. Psychosocial and structural factors shaped engagement after established injection. Housing and food insecurity, and stigma disproportionately affected female PWID while lack of confidential adolescent friendly services impeded engagement by adolescent PWID.

Conclusions

Development of youth-specific services for young PWID in India will need to address unique vulnerabilities and service gaps along each stage of the injection continuum. Scaling-up of tailored services is needed for young female PWID and adolescents, including interventions that prevent injection initiation and provision of confidential harm reduction services.
EXTending availability of self-management structured EducatioN programmes for people with type 2 Diabetes in low-to-middle income countries (EXTEND)—a feasibility study in Mozambique and Malawi
Authors: Brady Emer M ,   The EXTEND Collaborative, Bamuya Catherine , Beran David , Correia Jorge , Crampin Amelia , Damasceno Albertino , Davies Melanie J , Hadjiconstantinou M , Harrington Deirdre , Khunti Kamlesh , Levitt Naomi , Magaia Ana , Mistry Jayna , Namadingo Hazel , Rodgers Anne , Schreder Sally , Simango Leopoldo , Stribling Bernie , Taylor Cheryl , Waheed Ghazala
Published: September 2021

Background

Globally, there are estimated 425 million people with type 2 diabetes (T2D) with 80% from low-middle income countries (LMIC). Diabetes self-management education (DSME) programmes are a vital and core component of the treatment pathway for T2D. Despite LMIC being disproportionally affected by T2D, there are no DSME available that meet international diabetes federation criterion.

Methods

The aims were to test the feasibility of delivering a proven effective and cost-effective approach used in a UK population in two urban settings in Malawi and Mozambique by; (1) developing a culturally, contextually and linguistically adapted DSME, the EXTending availability of self-management structured EducatioN programmes for people with type 2 Diabetes in low-to-middle income countries (EXTEND) programme; (2) using a mixed-method approach to evaluate the delivery of training and the EXTEND programme to patients with T2D.

Results

Twelve healthcare professionals were trained. Ninety-eight participants received the DSME. Retention was high (100% in Mozambique and 94% in Malawi). At 6 months HbA1c (−0.9%), cholesterol (−0.3 mmol/L), blood pressure (−5.9 mm Hg systolic and −6.1 mm Hg diastolic) improved in addition to indicators of well-being (problem areas in diabetes and self-efficacy in diabetes).

Conclusion

It is feasible to deliver and evaluate the effectiveness of a culturally, contextually and linguistically adapted EXTEND programme in two LMIC. The DSME was acceptable with positive biomedical and psychological outcomes but requires formal testing with cost-effectiveness. Challenges exist in scaling up such an approach in health systems that do not have resources to address the challenge of diabetes.
Association between diffusion tensor imaging findings and domain-specific cognitive impairment in cerebral small vessel disease: a protocol for systematic review and meta-analysis
Authors: Xie Yao , Xie Le , Kang Fuliang , Jiang Junlin , Yao Ting , Li Yingchen , Mao Guo , Wu Dahua
Published: September 2021

Introduction

Cognitive impairment is the main clinical manifestation of cerebral small vessel disease (CSVD). However, the mechanism and structural damage in different domains of cognitive disorders are poorly understood. There is an urgent need to quantify the relation between diffusion tensor imaging (DTI) data and impaired cognitive testing in CSVD, which may help to find biomarkers for early diagnosis or treatment evaluation. We aim to summarise the understanding of association between DTI findings and domain-specific cognitive impairment.

Methods and analysis

PubMed, EMBASE, Web of science, Cochrane library, Chinese National Knowledge Infrastructure Databases, Wanfang, SinoMed and VIP will be searched, from 1 January 1994 to 1 August 2021. The ClinicalTrials.gov and Chictr.org.cn records will also be searched to identify further potential studies. The included studies should report fractional anisotropy and/or and mean diffusivity/apparent diffusion coefficient data for one or more individual regions of interest in DTI analysis. Meanwhile, cognitive testing scores are also needed. This systematic review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The quality of cohort or case–control studies will be evaluated by the Newcastle-Ottawa Scale, and the cross-section studies will be evaluated by Agency for Healthcare Research and Quality scale. Meta-analysis, subgroup and sensitivity analyses, and publication bias will be all performed with Stata.

Ethics and dissemination

Patients and the public will not be involved in this study. The existing data from published studies will be used. The findings from this research will be relevant information regarding the association of DTI metrics with cognitive disorder, which will be published in a peer-reviewed journal. If we need to amend this protocol, we will give the date of each amendment, describe the change and give the rationale. Changes will not be incorporated into the protocol.

PROSPERO registration number

CRD42021226133.
Association between renal function and cardiovascular mortality: a retrospective cohort study of elderly from health check-up
Authors: Huang Ying-Jhen , Hsu Yu-Lin , Chuang Yung-Hsin , Lin Hugo Y -H , Chen Yen-Hsu , Chan Ta-Chien
Published: September 2021

Objectives

This study aimed to investigate the relationship between cardiovascular mortality in elderly Asians and decline in renal function.

Design

A retrospective cohort study.

Setting

Community-based health examination database from Taipei city.

Participants

At the beginning, the database included 315 045 health check-up visits of 97 803 elderly persons aged ≥65 years old from 2005 to 2012. After excluding missing values and outliers, there were 64 732 elderly persons with at least two visits retained for further analyses.

Primary outcome measures

Kidney function indicators include estimated glomerular filtration rate (eGFR) and urine protein, and rapid decline in eGFR was defined as slope ≤ −5 mL/min/1.73 m2per year. The endpoint outcome was defined as the cardiovascular deaths registered in the death registry encoded by the International Classification of Diseases. We applied a Cox proportional hazards model to analyse the association between renal function and cardiovascular mortality.

Results

In this study, we found 1264 elderly persons died from cardiovascular diseases, for whom the data included 4055 previous health check-up visits. We observed significant and independent associations of eGFR <60 mL/min/1.73 m2(HR (95% CI) of 60>eGFR≥45 and eGFR<45 in males: 2.85 (1.33 to 6.09) and 3.98 (1.84 to 8.61); in females: 3.66 (1.32 to 10.15) and 6.77 (2.41 to 18.99)), positive proteinuria (HR (95% CI) of +/−, +,++ and +++, ++++ in males: 1.51 (1.29 to 1.78) and 2.31 (1.51 to 3.53); in females: 1.93 (1.54 to 2.42) and 4.23 (2.34 to 7.65)) and rapid decline in eGFR (HR (95% CI) in males: 3.24 (2.73 to 3.85); in females: 2.83 (2.20 to 3.64) with higher risk of cardiovascular mortality. The joint effect of increased concentration of urine protein and reduced eGFR was associated with a higher risk of cardiovascular mortality.

Conclusions

Renal function and rapid decline in renal function are independent risk factors for cardiovascular mortality in the elderly.
Estimating the equity impacts of the smoking ban in England on cotinine levels: a regression discontinuity design
Authors: Robson Matthew , Lord Joseph , Doran Tim
Published: September 2021

Objective

To estimate the equity impacts of the 2007 smoking ban in England, for both smokers and non-smokers.

Design

Doubly robust regression discontinuity analysis of salivary cotinine levels. Conditional average treatment effects were used to estimate differential impacts of the ban by socioeconomic deprivation (based on the Index of Multiple Deprivation). Distributional impacts were further assessed using conditional quantile treatment effects and inequality treatment effects.

Setting

In 2007, England introduced a ban on smoking in public places. This had little impact on tobacco consumption by smokers but was associated with decreases in environmental tobacco smoke exposure for non-smokers. However, the impact of the ban on socioeconomic inequalities in exposure is unclear.

Participants

766 smokers and 2952 non-smokers responding to the Health Survey for England in 2007.

Outcome measure

Levels of salivary cotinine.

Results

Before the ban, socioeconomic deprivation was associated with higher cotinine levels for non-smokers but not for smokers. The ban caused a significant reduction in average cotinine levels for non-smokers (p=0.043) but had no effect for smokers (p=0.817). Reductions for non-smokers were greater for more deprived groups with higher levels of exposure, and there was a significant reduction in socioeconomic-related inequality in cotinine. Across the whole population (both smokers and non-smokers), there was no significant increase in the concentration of cotinine levels among the socioeconomically deprived.

Conclusion

The 2007 ban on smoking in public places had little impact on smokers, but was, as intended, associated with reductions in both (1) average levels of environmental tobacco smoke exposure and (2) deprivation-related inequality in exposure among non-smokers.
Adherence to clinical practice guidelines (CPGs) for the treatment of cancers in Australia and the factors associated with adherence: a systematic review protocol
Authors: Bierbaum Mia , Rapport Frances , Arnolda Gaston , Tran Yvonne , Nic Giolla Easpaig Bróna , Ludlow Kristiana , Braithwaite Jeffrey
Published: September 2021

Introduction

Clinical practice guidelines (CPGs) synthesise the latest evidence to support clinical and patient decision-making. CPG adherent care is associated with improved patient survival outcomes; however, adherence rates are low across some cancer streams in Australia. Greater understanding of specific barriers to cancer treatment CPG adherence is warranted to inform future implementation strategies.

This paper presents the protocol for a systematic review that aims to determine cancer treatment CPG adherence rates in Australia across a variety of common cancers, and to identify any factors associated with adherence to those CPGs, as well as any associations between CPG adherence and patient outcomes.

Methods and analysis

Five databases will be searched, Ovid Medline, PsychInfo, Embase, Scopus and Web of Science, for eligible studies evaluating adherence rates to cancer treatment CPGs in Australia. A team of reviewers will screen the abstracts in pairs according to predetermined inclusion criteria and then review the full text of eligible studies. All included studies will be assessed for quality and risk of bias. Data will be extracted using a predefined data extraction template. The frequency or rate of adherence to CPGs, factors associated with adherence to those CPGs and any reported patient outcome rates (eg, relative risk ratios or 5-year survival rates) associated with adherence to CPGs will be described. If applicable, a pooled estimate of the rate of adherence will be calculated by conducting a random-effects meta-analysis. The systematic review will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Ethics and dissemination

Ethics approval will not be required, as this review will present anonymised data from other published studies. Results from this study will form part of a doctoral dissertation (MB), will be published in a journal, presented at conferences, and other academic presentations.

PROSPERO registration number

CRD42020222962.
Impact of using spirometry on clinical decision making and quality of life in children: protocol for a single centre randomised controlled trial
Authors: Boonjindasup Wicharn , Marchant Julie M , McElrea Margaret S , Yerkovich Stephanie T , Masters Ian Brent , Chang Anne B
Published: September 2021

Introduction

Although spirometry has been available for decades, it is underused in paediatric practice, other than in specialist clinics. This is unsurprising as there is limited evidence on the benefit of routine spirometry in improving clinical decision making and/or outcomes for children. We hypothesised that using spirometry for children being evaluated for respiratory diseases impacts on clinical decision making and/or improves patient-related outcome measures (PROMs) and/or quality of life (QoL), compared with not using spirometry.

Methods and analysis

We are undertaking a randomised controlled trial (commenced in March 2020) that will include 106 children (aged 4–18 years) recruited from respiratory clinics at Queensland Children’s Hospital, Australia. Inclusion criteria are able to perform reliable spirometry and a parent/guardian who can complete questionnaire(s). Children (1:1 allocation) are randomised to clinical medical review with spirometry (intervention group) or without spirometry (control group) within strata of consultation status (new/review), and cough condition (present/absent). The primary outcome is change in clinical decision making. The secondary outcomes are change in PROM scores, opinions regarding spirometry and degree of diagnosis certainty. Intergroup differences of these outcomes will be determined by χ2test or unpaired t-test (or Mann-Whitney if not normally distributed). Change in outcomes within the control group after review of spirometry will also be assessed by McNemar’s test or paired t-test/Wilcoxon signed-rank test.

Ethics and dissemination

The Human Research Ethics Committee of the Queensland Children’s Hospital approved the study. The trial results will be disseminated through conference presentations, teaching avenues and publications.

Trial registration number

ACTRN12619001686190; Pre-results.
Influence of organisational attributes on registered nurse contributions to well-child care: a scoping review protocol
Authors: Braithwaite Suzanne , Lukewich Julia , Macdonald Danielle , Tranmer Joan
Published: September 2021

Introduction

Universal access to preventative healthcare is essential to children’s health. Registered nurses (RN) are well positioned to deliver well-child care within primary care settings; however, RN role implementation varies widely in this sector and the scope of literature that examines the influence of organisational attributes on nursing contributions to well-child care is not well understood. The aim of this scoping review is to identify the scope and characteristics of the literature related to organisational attributes that act as barriers to, or facilitators for RN delivery of well-child care within the context of primary care in high-income countries.

Methods and analysis

The Joanna Briggs Institute scoping review methodology will be used to conduct this review. Databases that will be accessed include Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE and Embase. Inclusion criteria includes articles with a focus on RNs who deliver well-child care in primary care settings. Literature that meets this inclusion criteria will be included in the study. Covidence software platform will be used to review citations and full-text articles. Titles, abstracts and full-text articles will be reviewed independently by two reviewers. Any disagreements that arise between the reviewers will be resolved through discussion, or with an additional reviewer. Data will be extracted and organised according to the dimensions outlined in the nursing care organisation conceptual framework (NCOF). Principles of the ‘best fit’ framework synthesis will guide the data analysis approach and the NCOF will act as the framework for data coding and analysis.

Ethics and dissemination

This scoping review will undertake a secondary analysis of data already published and does not require ethical approval. Findings will be disseminated via peer-reviewed publications and conference presentations targeting stakeholders involved in nursing practice and the delivery of well-child care.

Trial registration details

Braithwaite, S., Tranmer, J., Lukewich, J., & Macdonald, D. (2021, March 31). Protocol for a Scoping Review of the Influence of Organisational Attributes on Registered Nurse Contributions to Well-child Care.https://doi.org/10.17605/OSF.IO/UZYX5.
Long-term follow-up of children exposed in-utero to progesterone treatment for prevention of preterm birth: study protocol of the AMPHIA follow-up
Authors: Simons Noor E , van Limburg Stirum Emilie V J , van Wassenaer-Leemhuis Aleid G , Finken Martijn J J , Aarnoudse-Moens Cornelieke S H , Oosterlaan Jaap , van Baar Anneloes , Roseboom Tessa J , Lim Arianne C , van Wely Madelon , de Boer Marjon A , Painter Rebecca C , Pajkrt Eva , Oudijk Martijn A , van t Hooft Janneke
Published: September 2021

Introduction

Preterm birth is one of the main problems in obstetrics, and the most important cause of neonatal mortality, morbidity and neurodevelopmental impairment. Multiple gestation is an important risk factor for preterm birth, with up to 50% delivering before 37 weeks. Progesterone has a role in maintaining pregnancy and is frequently prescribed to prevent (recurrent) preterm birth and improve pregnancy outcomes in high-risk patients. However, little is known about its long-term effects in multiple gestations. The objective of this follow-up study is to assess long-term benefits and harms of prenatal exposure to progesterone treatment in multiple gestations on child development.

Methods and analysis

This is a follow-up study of a multicentre, double-blind, placebo-controlled randomised trial (AMPHIA trial,ISRCTN40512715). Between 2006 and 2009 women with a multiple gestation were randomised at 16–20 weeks of gestation to weekly injections 250 mg 17α-hydroxyprogesterone caproate or placebo, until 36 weeks of gestation or delivery. The current long-term follow-up will assess all children (n=1355) born to mothers who participated in the AMPHIA trial, at 11–14 years of age, with internationally validated questionnaires, completed by themselves, their parents and their teachers.

Main outcomes are child cognition and behaviour

Additional outcomes are death (perinatal and up to age 14), gender identity, educational performance and health-related problems. We will use intention-to-treat analyses comparing experimental and placebo group. To adjust for the correlation between twins, general linear mixed-effects models will be used.

Ethics and dissemination

Amsterdam UMC MEC provided a waiver for the Medical Research Involving Human Subjects Act (W20_234#20.268). Results will be disseminated through peer-reviewed journals and summaries shared with stakeholders, patients and participants. This protocol is published before analysis of the results.

Trial registration number

NL8933.