bluuebunny/crossref_metadata_2025_split huggingface dataset:
Injury patterns in a large-scale ski resort in the host city of 2022 Winter Olympic Games: a retrospective cross-sectional study
Authors: Chen Nayun , Yang Yuping , Jiang Yanfang , Ao Yingfang 
Published: November 2020

ObjectivesThe aims of the study are to describe the injury patterns among recreational skiers and snowboarders in China and to provide primary data to guide the reconstruction of regional healthcare facilities to deal with the increasing number of participants in snow sports.DesignRetrospective cross-sectional study.MethodsA retrospective study was performed in Wanlong Ski Resort in Chongli, China. Data of all injured skiers and snowboarders treated in the resort clinic during the 2018–2019 season were collected. Patients’ information, including sex, age, equipment, skill level and injured body part, was analysed.ResultsA total of 753 sports injuries were recorded. The estimated incidence of injury was 1.98 per 1000 skier days. 453 cases (60.2%) were associated with skiing. The mean age of skiers was older than snowboarders (35.1±14.5 vs 29.0±8.9, p<0.01). Injury not involving others constituted 67.9% of all injuries. The most common injured body part among skiers was lower extremity, contrary to injury in the upper extremity among snowboarders. Head and cervical injury was identified in 13.7% of skiers and 13.6% of snowboarders.ConclusionThe incidence of skiing/snowboarding injury in China was similar to other countries. Injury pattern differed among different sports and causes of injury.
Evaluation of a national complex oral health improvement programme: a population data linkage cohort study in Scotland
Authors: Kidd Jamie BR , McMahon Alex D , Sherriff Andrea , Gnich Wendy , Mahmoud Ahmed , Macpherson Lorna MD , Conway David I 
Published: November 2020

ObjectivesChild dental caries is a global public health challenge with high prevalence and wide inequalities. A complex public health programme (Childsmile) was established. We aimed to evaluate the reach of the programme and its impact on child oral health.SettingEducation, health and community settings, Scotland-wide.InterventionsChildsmile (national oral health improvement programme) interventions: nursery-based fluoride varnish applications (FVAs) and supervised daily toothbrushing, community-based Dental Health Support Worker (DHSW) contacts and primary care dental practice visits—delivered to the population via a proportionate universal approach.Participants50 379 children (mean age=5.5 years, SD=0.3) attending local authority schools (2014/2015).DesignPopulation-based individual child-level data on four Childsmile interventions linked to dental inspection survey data to form a longitudinal cohort. Logistic regression assessed intervention reach and the independent impact of each intervention on caries experience, adjusting for age, sex and area-based Scottish Index of Multiple Deprivation (SIMD).Outcome measuresReach of the programme is defined as the percentage of children receiving each intervention at least once by SIMD fifth. Obvious dental caries experience (presence/absence) is defined as the presence of decay (into dentine), missing (extracted) due to decay or filled deciduous teeth.Results15 032 (29.8%) children had caries experience. The universal interventions had high population reach: nursery toothbrushing (89.1%), dental practice visits (70.5%). The targeted interventions strongly favoured children from the most deprived areas: DHSW contacts (SIMD 1: 29.5% vs SIMD 5: 7.7%), nursery FVAs (SIMD 1: 75.2% vs SIMD 5: 23.2%). Odds of caries experience were markedly lower among children participating in nursery toothbrushing (>3 years, adjusted OR (aOR)=0.60; 95% CI 0.55 to 0.66) and attending dental practice (≥6 visits, aOR=0.55; 95% CI 0.50 to 0.61). The findings were less clear for DHSW contacts. Nursery FVAs were not independently associated with caries experience.ConclusionsThe universal interventions, nursery toothbrushing and regular dental practice visits were independently and most strongly associated with reduced odds of caries experience in the cohort, with nursery toothbrushing having the greatest impact among children in areas of high deprivation.
Ketamine for the treatment of prehospital acute pain: a systematic review of benefit and harm
Authors: Sandberg Mårten , Hyldmo Per Kristian , Kongstad Poul , Dahl Friesgaard Kristian , Raatiniemi Lasse , Larsen Robert , Magnusson Vidar , Rognås Leif , Kurola Jouni , Rehn Marius , Vist Gunn Elisabeth 
Published: November 2020

BackgroundFew publications have addressed prehospital use of ketamine in analgesic doses. We aimed to assess the effect and safety profile of ketamine compared with other analgesic drugs (or no drug) in adult prehospital patients with acute pain.MethodsA systematic review of clinical trials assessing prehospital administration of ketamine in analgesic doses compared with other analgesic drugs or no analgesic treatment in adults. We searched PubMed, EMBASE, Cochrane Library and Epistemonikos from inception until 15 February 2020, including relevant articles in English and Nordic languages. We used the Cochrane and Grading of Recommendations Assessment, Development and Evaluation methodologies and exclusively assessed patient-centred outcomes. Two independent authors screened trials for eligibility, extracted data and assessed risk of bias.ResultsWe included eight studies (2760 patients). Ketamine was compared with various opioids given alone, and intranasal ketamine given with nitrous oxide was compared with nitrous oxide given alone. Four randomised controlled trials (RCTs) and one cluster randomised trial included 699 patients. One prospective cohort included 27 patients and two retrospective cohorts included 2034 patients. Five of the eight studies had high risks of bias. Pain score with ketamine is probably lower than after opioids as demonstrated in a cluster-RCT (308 patients) and a retrospective cohort (158 patients) study, Δvisual analogue scale −0.4 (−0.8 to 0.0) and Δnumeric pain rating scale −3.0 (−3.86 to −2.14), respectively. Ketamine probably leads to less nausea and vomiting (risk ratio (RR) 0.24 (0.11 to 0.52)) but more agitation (RR 7.81 (1.85 to 33)) than opioids.ConclusionsThis systematic literature review finds that ketamine probably reduces pain more than opioids and with less nausea and vomiting but higher risk of agitation. Risk of bias in included studies is high.OtherScandinavian society of anaesthesiology and intensive care medicine funded meetings and software. The Norwegian Air Ambulance Foundation funded publication. Otherwise this research received no grant from any agency in the public, commercial or not-for-profit sectors.PROSPERO registration numberCRD42018114399.
Screening tools for early identification of children with developmental delay in low- and middle-income countries: a systematic review
Authors: Faruk Tasnuva , King Catherine , Muhit Mohammad , Islam Md Kafiul , Jahan Israt , Baset Kamran ul , Badawi Nadia , Khandaker Gulam 
Published: November 2020

ObjectiveTo systematically review, identify and report the screening tools used for early identification of developmental delay in low- and middle-income countries.DesignSystematic review.Data sourcesFour bibliographic databases: Medline (1946 to 13 July 2020), Embase (1974 to 13 July 2020), Scopus (1823 to 11 July 2020) and PsycINFO (1987 to July week 1 2020).Eligibility criteriaPeer-reviewed original articles published in English addressing validated culturally sensitive developmental screening tools among children aged <5 years were included in this review.Data extraction and synthesisOne author (CK, medical librarian) developed the search strategy. Three authors conducted the database search (phase I: CK; phase II: IJ and MKI). Three authors (TF, IJ and MKI) independently screened the title and abstracts. TF, MKI and GK independently performed the full-text review of the screened articles. During each step of the study selection process, disagreements were resolved through discussion. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was used to guide the systematic review. Data extraction and analysis were performed using MS Excel. Meta-analysis was not possible due to heterogeneity of the study findings.ResultsWe identified 3349 articles, of which 18 studies from 10 countries, reporting 16 screening tools, were selected for qualitative synthesis. Six cultural contexts were explored. Twelve general, two motor and two speech-language tools were identified. Seven of them found to be parent-completed ones. Five screening tools (American Speech-Language and Hearing Association, Guide for Monitoring Child Development, Infant Neurological International Battery, New Delhi-Development Screening Questionnaire and Woodside Screening Technique) reported relatively higher sensitivity (82.5%–100%) and specificity (83%–98.93%).ConclusionsLimited number of culturally sensitive developmental screening tools were validated for children aged <5 years in low- and middle-income countries. Revising existing screening tools in different ethnic and cultural settings and subsequent validation with normative value should be a research priority.
Feedback of patient-reported outcomes to healthcare professionals for comparing health service performance: a scoping review
Authors: Hancock Shaun L , Ryan Olivia F , Marion Violet , Kramer Sharon , Kelly Paulette , Breen Sibilah , Cadilhac Dominique A 
Published: November 2020

ObjectivePatient-reported outcomes (PROs) provide self-reported patient assessments of their quality of life, daily functioning, and symptom severity after experiencing an illness and having contact with the health system. Feeding back summarised PROs data, aggregated at the health-service level, to healthcare professionals may inform clinical practice and quality improvement efforts. However, little is known about the best methods for providing these summarised data in a way that is meaningful for this audience. Therefore, the aim of this scoping review was to summarise the emerging approaches to PROs data for ‘service-level’ feedback to healthcare professionals.SettingHealthcare professionals receiving PROs data feedback at the health-service level.Data sourcesDatabases selected for the search were Embase, Ovid Medline, Scopus, Web of Science and targeted web searching. The main search terms included: ‘patient-reported outcome measures’, ‘patient-reported outcomes’, ‘patient-centred care’, ‘value-based care’, ‘quality improvement’ and ‘feedback’. Studies included were those that were published in English between January 2009 and June 2019.Primary and secondary outcome measuresData were extracted on the feedback methods of PROs to patients or healthcare providers. A standardised template was used to extract information from included documents and academic publications. Risk of bias was assessed using Joanna Briggs Institute Levels of Evidence for Effectiveness.ResultsOverall, 3480 articles were identified after de-duplication. Of these, 19 academic publications and 22 documents from the grey literature were included in the final review. Guiding principles for data display methods and graphical formats were identified. Seven major factors that may influence PRO data interpretation and use by healthcare professionals were also identified.ConclusionWhile a single best format or approach to feedback PROs data to healthcare professionals was not identified, numerous guiding principles emerged to inform the field.
Development of a new tool for the assessment of patient-defined benefit in hospitalised older patients: the Patient Benefit Assessment Scale for Hospitalised Older Patients (P-BAS HOP)
Authors: van der Kluit Maria Johanna , Dijkstra Geke J , van Munster Barbara C , De Rooij Sophia 
Published: November 2020

ObjectivesTo support the shift from disease-oriented towards goal-oriented care, we aimed to develop a tool which is capable both to identify priorities of an individual older hospitalised patient and to measure the outcomes relevant to him.DesignMixed-methods design with open interviews, three step test interviews (TSTIs) and a quantitative field test.SettingUniversity teaching hospital and a regional teaching hospital.ParticipantsHospitalised patients ages 70 years and older.ResultsThe Patient Benefit Assessment Scale for Hospitalised Older Patients (P-BAS HOP) consists of a baseline questionnaire and an evaluation questionnaire. Items were based on 15 qualitative interviews with hospitalised older patients. Feedback from a panel of four community-dwelling older persons resulted in some adaptations to wording and one additional item. Twenty-six hospitalised older patients participated in TSTIs with Version 1 of the baseline questionnaire, revealing indications for a good content validity and barriers in completion behaviour, global understanding and understanding of individual items, which were solved with several adaptations. Four additions were made by participants. After TSTIs with ten patients with the evaluation questionnaire, one adaptation was made. A field test with 91 hospitalised older patients revealed a small number of missing values.To enhance the feasibility, the number of items was reduced from 32 to 22, based on correlations and mean impact score. The field test was repeated with 104 other patients in a regional teaching hospital. To enhance the understanding, the tool was split into two phases. This version was tested with TSTIs with eight patients and appeared to be understandable. The final version was an interview-based tool and took about 11 min to complete.ConclusionsThe P-BAS HOP is a potentially suitable tool to identify priorities and relevant outcomes of the individual patient. Further research is needed to investigate its validity, reliability and responsiveness.
Experiences and perceived health benefits of individuals with a disability participating in sport: A systematic review protocol
Authors: Aitchison Beth , Rushton Alison , Martin Paul , Soundy Andrew , Heneghan Nicola R 
Published: November 2020

IntroductionSports participation has many physical and mental health benefits for individuals with a disability, including improved functionality and reduced anxiety. Despite this, a large proportion of individuals with a disability are inactive. This review will be the first to synthesise the literature on the experiences and perceived health benefits of sport participation for children, adolescents, adults, elite athletes and veterans with a disability. Investigation of these phenomena will enable an understanding of the positive aspects and benefits of sport participation specific to each population, which may help to improve participation rates and ultimately improve health through promotion of these benefits.MethodsA protocol for systematic review is reported in line with Preferred Reporting Items for Systematic Reviews and Meta-Analysis-P. The phenomena of interest are the experiences and perceived health benefits of individuals with a disability participating in sport. There will be no age limit on participants and all study designs, besides reviews, will be included. Studies in languages other than English will be excluded. Two independent reviewers will conduct the searches, study selection, data collection and quality assessment independently. The online databases MEDLINE, EMBASE, PsychINFO, CINAHL Plus, Web of Science and SportDiscus will be electronically searched from database inception to February 2020. Grey literature will be searched and several sport-related journals will be hand-searched. The Quality Assessment Tool for Studies with Diverse Designs will be used for quality assessment of included studies. Thematic synthesis will be used to analyse the qualitative studies, narrative synthesis will be used to analyse the quantitative studies and the perceived health benefits will be analysed using content analysis. The strength of the overall body of evidence will be assessed and reported using GRADE-CERQual (Grading of Recommendations, Assessment, Development and Evaluation–Confidence in the Evidence from Reviews of Qualitative research) for qualitative studies and GRADE for quantitative studies. These approaches will be applied to mixed-methods studies, respectively, where necessary.Ethics and disseminationThis systematic review raises no ethical issues. Results will be published in a peer reviewed journal and disseminated to key stakeholders to inform practice.PROSPERO registration numberCRD42020169224.
Strategies for enhancing the initiation of cholesterol lowering medication among patients at high cardiovascular disease risk: a qualitative descriptive exploration of patient and general practitioners’ perspectives on a facilitated relay intervention in Alberta, Canada
Authors: Campbell David J T , Lee-Krueger Rachelle C W , McBrien Kerry , Anderson Todd , Quan Hude , Leung Alexander A , Chen Guanmin , Lu Mingshan , Naugler Christopher , Butalia Sonia 
Published: November 2020

ObjectiveThe objective of our study was to explore the perspectives of patients and general practitioners (GPs) regarding interventions to increase initiation of cholesterol lowering medication (or statins), including a proposed laboratory-based facilitated relay intervention.DesignQualitative descriptive study using interviews and focus groups for data collection, and thematic analysis for data analysis.SettingPrimary care providers and patients in Calgary, Alberta, Canada.Participants17 GPs with primarily community-based, non-academic practices with at least 1 year of practice experience participated in semistructured interviews. 14 patients at high risk of cardiovascular disease participated in focus groups.Main outcome measuresExploration of strategies that might be used to enhance the prescription of, and adherence to statin therapy for patients with statin-indicated conditions.ResultsGPs proposed a variety of interventions to improve statin prescription, including electronic record audit solutions, GP directed education, and patient-oriented campaigns. Patients expressed that they may benefit from being provided access to their laboratory test results, as well as targeted education. Both parties provided positive feedback on the proposed laboratory-based facilitated relay intervention, while pointing out areas for improvement. Notably, GPs were concerned that the patient-directed component of the intervention might jeopardise therapeutic relationships, and patients were concerned about accidental disclosure of personal health information. Important considerations for the design of facilitated relay messaging should include brevity, simplicity and the provision of contact information for inquiries.ConclusionsGPs and patients described several suggestions for increasing statin initiation and welcomed the proposal of a laboratory-based facilitated relay strategy. These findings support further testing of this intervention which may enhance GPs’ ability to successfully engage patients in cardiovascular risk reduction through statin therapy.
Patterns of multimorbidity and their effects on adverse outcomes in rheumatoid arthritis: a study of 5658 UK Biobank participants
Authors: McQueenie Ross , Nicholl Barbara I , Jani Bhautesh D , Canning Jordan , Macdonald Sara , McCowan Colin , Neary Joanne , Browne Susan , Mair Frances S , Siebert Stefan 
Published: November 2020

ObjectiveTo investigate how the type and number of long-term conditions (LTCs) impact on all-cause mortality and major adverse cardiovascular events (MACE) in people with rheumatoid arthritis (RA).DesignPopulation-based longitudinal cohort study.SettingUK Biobank.ParticipantsUK Biobank participants (n=502 533) aged between 37 and 73 years old.Primary outcome measuresPrimary outcome measures were risk of all-cause mortality and MACE.MethodsWe examined the relationship between LTC count and individual comorbid LTCs (n=42) on adverse clinical outcomes in participants with self-reported RA (n=5658). Risk of all-cause mortality and MACE were compared using Cox’s proportional hazard models adjusted for lifestyle factors (smoking, alcohol intake, physical activity), demographic factors (sex, age, socioeconomic status) and rheumatoid factor.Results75.7% of participants with RA had multimorbidity and these individuals were at increased risk of all-cause mortality and MACE. RA and >4 LTCs showed a threefold increased risk of all-cause mortality (HR 3.30, 95% CI 2.61 to 4.16), and MACE (HR 3.45, 95% CI 2.66 to 4.49) compared with those without LTCs. Of the comorbid LTCs studied, osteoporosis was most strongly associated with adverse outcomes in participants with RA compared with those without RA or LTCs: twofold increased risk of all-cause mortality (HR 2.20, 95% CI 1.55 to 3.12) and threefold increased risk of MACE (HR 3.17, 95% CI 2.27 to 4.64). These findings remained in a subset (n=3683) with RA diagnosis validated from clinical records or medication reports.ConclusionThose with RA and other LTCs, particularly comorbid osteoporosis, are at increased risk of adverse outcomes, although the role of corticosteroids could not be evaluated in this study. These results are clinically relevant for the monitoring and management of RA across the healthcare system, and future clinical guidelines for RA should acknowledge the importance of multimorbidity.
Healthcare provider counselling for weight management behaviours among adults with overweight or obesity: a cross-sectional analysis of National Health and Nutrition Examination Survey, 2011–2018
Authors: Greaney Mary L. , Cohen Steven A. , Xu Furong , Ward-Ritacco Christie L , Riebe Deborah 
Published: November 2020

ObjectivesTo determine if adults with overweight or obesity received counselling from their healthcare providers (HCPs) to lose weight and/or adopt healthful behaviours associated with weight loss, and whether they took action on their HCPs’ recommendations.DesignCross-sectional analysis of 2011–2018 National Health and Nutrition Examination Survey (NHANES) data.SampleNHANES respondents aged 18+ who were overweight/obese and had seen an HCP in the previous 12 months (n=13 158).MethodsRespondents reported if their HCPs recommended they control/lose weight, increase exercise/physical activity (PA) and/or reduce fat/calorie intake, and if they adopted the offered recommendation(s). Weighted logistic regression models examined receipt of HCP counselling by sex, age, race/ethnicity, and weight status accounting for demographic characteristics and complex sampling. Similar analyses examined reported adoption of HCPs’ recommendations.ResultsThe sample was 53.1% women, 45.0% were overweight and 55.0% had obesity. In total, 40.4% received counselling to control/lose weight, 49.5% to increase exercise/PA and 38.9% to reduce fat/calorie intake. The following groups were less likely (p<0.001) to receive counselling: men; younger adults (aged 18–39) versus middle-aged (aged 40–64) and older adults (aged 65+); White versus Black and Hispanic respondents; overweight respondents versus respondents with obesity. Approximately half of those advised to make changes reported doing so (53.6% controlled/lost weight, 57.3% increased exercise/PA, 51.8% reduced fat/calorie intake). Differences in the adoption of recommendations were identified by sex, age group, race/ethnicity and weight status (all p<0.05); women, middle-aged and older adults, Black and Hispanic respondents and individuals with obesity were more likely to adopt one or more recommendations.ConclusionMost respondents did not receive HCP counselling, and approximately half of those who received counselling reported taking action. HCPs may need training to provide counselling and to offer recommendations tailored to the social contexts of populations less likely to adopt weight control related recommendations.