bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of not working among treatment-seeking UK veterans: a cross-sectional study
Authors: Hendrikx Laura Josephine , Ross J , Armour C , Murphy D 
Published: May 2020

IntroductionMany veterans do well reintegrating to civilian life following military service. Yet, many face difficulties in finding and securing work. Veterans are more likely than civilians to experience work difficulties, but there remains little research investigating contributing factors, particularly among samples of treatment-seeking veterans. As such, the study examines predictors of not working among UK treatment-seeking veterans.DesignThe study employed a cross-sectional design.MethodsOf 667 treatment-seeking UK veterans, 403 (Mage=50.94) provided information on a range of demographic variables, military-related experiences, the total number of physical health conditions and mental health outcomes. Work status was categorised as not working due to illness (Mage=48.15), not working due to other reasons (Mage=61.92) and currently working (Mage= 46.13).ResultsPrevalence rates of not working was 69%. Not working was predicted by a greater number of physical health problems as well as more years since leaving the military. Not working due to poor health was independently predicted by symptoms of post-traumatic stress disorder (PTSD) and younger age, while not working due to other reasons was predicted by older age.ConclusionsThe study revealed that treatment-seeking veterans of younger age with a high number of physical health difficulties, symptoms of PTSD and more years since leaving the military are most at risk of not working due to ill health. The findings have important implications for identifying veterans most at risk of not working and offer the opportunity to tailor rehabilitation programmes to promote successful veteran reintegration into civilian life.
Broader impacts of an intervention to transform school environments on student behaviour and school functioning: post hoc analyses from the INCLUSIVE cluster randomised controlled trial
Authors: Bonell Christopher , Dodd Matthew , Allen Elizabeth , Bevilacqua Leonardo , McGowan Jennifer , Opondo Charles , Sturgess Joanna , Elbourne Diana , Warren Emily , Viner Russell M 
Published: May 2020

BackgroundWe have previously reported benefits for reduced bullying, smoking, alcohol and other drug use and mental health from a trial of ‘Learning Together’, an intervention that aimed to modify school environments and implement restorative practice and a social and emotional skill curriculum.ObjectivesTo conduct post hoc theory-driven analyses of broader impacts.DesignCluster randomised trial.Settings40 state secondary schools in southern England.ParticipantsStudents aged 11/12 years at baseline.OutcomesStudent self-reported measures at 24 and 36 months of: cyberbullying victimisation and perpetration; observations of other students perpetrating aggressive behaviours at school; own perpetration of aggressive behaviours in and outside school; perceived lack of safety at school; participation in school disciplinary procedures; truancy and e-cigarette use.ResultsWe found evidence of multiple impacts on other health (reduced e-cigarette use, cyberbullying perpetration, perpetration of aggressive behaviours) and educational (reduced participation in school disciplinary procedures and truancy) outcomes.ConclusionThese analyses suggested that the intervention was effective in bringing about a broader range of beneficial outcomes, adding to the evidence that the intervention is a promising approach to promote adolescent health via an intervention that is attractive to schools.Trial registration numberISRCTN10751359.
Impact of point-of-care tests in community pharmacies: a systematic review and meta-analysis
Authors: Albasri Ali , Van den Bruel Ann , Hayward Gail , McManus Richard J , Sheppard James Peter , Verbakel Jan Yvan Jos 
Published: May 2020

ObjectivesTo summarise the literature regarding the use of point-of-care
test (POCT) in pharmacies versus control/usual care.Design and settingSystematic review and random-effects meta-analysis in community pharmacy.Data sourcesMEDLINE, Cochrane Central Register of Controlled Trials, Embase, ClinicalTrial.gov and Web of Science databases were searched.Eligibility criteriaArticles were included if they: involved a POCT conducted by a community pharmacist, member of pharmacy staff or local equivalent; measured a clinically relevant outcome for example, clinical parameter monitoring. No clinical condition or language limits were set.Patient and public involvementNo patient involvement.Data extraction and synthesisData were independently extracted by two members of the review team to capture changes in clinical care that resulted from the use of the POCTs. The methodological quality of included studies was assessed, using the Cochrane Risk of Bias tool and Newcastle-Ottawa scale.ResultsThirteen of the 1584 articles found were included in the meta-analyses. Studies covered four therapeutic areas: targeted anti-malarial therapy (n=3 studies), glycated
haemoglobin (HbA1c) in diabetes (n=2 studies), lipid control (n=3 studies) and international normalised ratio (INR) control in patients taking warfarin (n=5 studies). POCT in pharmacies reduced the risk of receiving antimalarial treatment when not clinically indicated (risk
ratio 0.34, 95% CI 0.31 to 0.37). Lipid and HbA1c control appeared largely unaffected by pharmacy POCTs, and the impact on INR time-in-therapeutic-range was inconclusive.ConclusionsOnly 4 out of 13 included studies used a gold-standard randomised controlled trial (RCT) design, limiting our ability to conclusively determine the clinical utility of POCT conducted in pharmacies. Further RCTs are needed, particularly in areas such as upper respiratory tract infections, which have gathered momentum among service commissioners in recent years.PROSPERO registration numberCRD42017048578.
Response process validity of three patient reported outcome measures for people requiring kidney care: a think-aloud study using the EQ-5D-5L, ICECAP-A and ICECAP-O
Authors: Mitchell Paul Mark , Caskey Fergus John , Scott Jemima , Sanghera Sabina , Coast Joanna 
Published: May 2020

ObjectivesTo determine the response process validity, feasibility of completion, acceptability and preferences for three patient-reported outcome measures that could be used in economic evaluation—the EQ-5D-5L, ICECAP-A and ICECAP-O—in people requiring kidney care.DesignParticipants were asked to ‘think-aloud’ while completing the EQ-5D-5L, ICECAP-A and ICECAP-O, followed by a semistructured interview. Five raters identified errors or struggles in completing the measures from the think-aloud component of the transcripts. Patient preferences for measures were extracted from the semistructured interview.SettingEligible patients were identified through a large UK secondary care renal centre.ParticipantsIn total, 30 participants were included in the study, consisting of patients attending renal outpatients for chronic kidney disease (n=18), with a functioning kidney transplant (n=6) and receiving haemodialysis (n=6).ResultsParticipants had few errors and struggles in completing the EQ-5D-5L (11% error rate, 3% struggle rate), ICECAP-A (2% error rate, 2% struggle rate) and ICECAP-O (4% error rate, 3% struggle rate). The main errors with the EQ-5D-5L were judgements that did not comply with the ‘your health today’ instruction. Comprehension errors were most prominent on ICECAP-O. Judgement errors were the only errors reported on ICECAP-A. Although the EQ-5D-5L had slightly more errors and struggles, it was the measure most preferred, with participants able to make a clearer link with EQ-5D-5L and their health condition.ConclusionsThe EQ-5D-5L, ICECAP-A and ICECAP-O are feasible for people requiring kidney care to complete and can be included in studies conducting economic evaluations of kidney care interventions. Further research is required to assess how health (eg, EQ-5D) and capability (eg, ICECAP) measures can be included in an economic evaluation simultaneously, as well as what ICECAP measure(s) to include when patient groups straddle the age ranges for ICECAP-A (18 years and older) and ICECAP-O (65 years and older).
Trends in oral anticoagulant prescribing in individuals with type 2 diabetes mellitus: a population-based study in the UK
Authors: Alwafi Hassan , Wei Li , Naser Abdallah Y , Mongkhon Pajaree , Tse Gary , Man Kenneth K C , Bell J Simon , Ilomaki Jenni , Fang Gang , Wong Ian C K 
Published: May 2020

ObjectiveTo evaluate oral anticoagulant (OAC) prescribing trends in type 2 diabetes mellitus (T2DM) in the UK from 2001 to 2015.DesignA cross-sectional drug utilisation study.SettingElectronic health records from The Health Improvement Network primary care database in the UK.ParticipantsIndividuals with T2DM who received a record of OAC prescription.Outcome measuresThe prescribing trends of OAC medications in individuals with T2DM were examined from 2001 to 2015, stratified by age, gender and therapeutic classifications.ResultsA total of 361 635 individuals with T2DM were identified, of whom 36 570 were prescribed OAC from 2001 to 2015. The prevalence of OAC prescribing increased by 50.0%, from 1781 individuals receiving OAC prescriptions (IROACP) (4.4 (95% CI 4.2 to 4.6) per 100 persons) in 2001, to 17 070 IROACP (6.6 (95% CI 6.5 to 6.7) per 100 persons) in 2015. The prevalence of warfarin prescribing decreased by 14.0%, from 1761 individuals receiving warfarin prescriptions (IRWP) (98.9 (95% CI 98.4 to 99.4) per 100 persons) in 2001, to 14 533 IRWP (85.1 (95% CI 84.6 to 85.7) per 100 persons) in 2015. This corresponded with increased prescribing of direct oral anticoagulants (DOACs), from 18 individuals receiving DOAC prescriptions (IRDOACP) (0.1 (95% CI 0.08 to 0.23) per 100 persons) in 2010, to 3016 IRDOACP (17.6 (95% CI 17.1 to 18.2) per 100 persons) in 2015, during the same period.ConclusionsPrescribing of OACs in individuals with T2DM increased from 2001 to 2015. Since the introduction of DOACs, there has been a clear shift in prescribing towards these agents. Future studies are needed to assess the safety of coadministration of OAC medications and antidiabetic therapy with T2DM.
Assessing care models implemented in primary healthcare for persons with dementia: a mixed-methods study protocol
Authors: Vedel Isabelle , McAiney Carrie , Couturier Yves , Pakzad Sarah , Arsenault-Lapierre Geneviève , Godard-Sebillotte Claire , Sourial Nadia , Simmons Rachel , Bergman Howard 
Published: May 2020

IntroductionDementia is on the rise in Canada and globally. Ensuring accessibility to diagnosis, treatment and management throughout the course of the disease is a very significant problem worldwide. In order to provide comprehensive care to patients and their caregivers, enhancing primary care-based dementia care is seen as the way forward. In many Canadian provinces various collaborative care models (collCMs) anchored in primary care to improve dementia care have been developed and implemented. The overall objective of our research programme is to identify key factors for the successful implementation of collCMs, and to facilitate dissemination and scale-up of dementia best practices.Methods and analysisWe will use a convergent mixed-methods design. An observational study using chart review (2014–2016) and questionnaires (2014–2018; repeated in 2020) will measure application of guidelines and implementation of collCMs. This study will be complemented with a qualitative descriptive study using interviews (2017–2020) conducted in parallel. Quantitative and qualitative results will be further integrated using a matrix representing sites and findings. An integrated knowledge exchange strategy will ensure uptake by principal stakeholders throughout the research.Ethics and disseminationOur study has been approved by all relevant ethics committees. Our dissemination plan follows an integrated knowledge transfer strategy using provincial, national and international councils. We will present the results individually to the clinical sites and then to these councils. Our research will be the first provincial and cross jurisdictional evaluation of primary care models for patients living with dementia, providing evidence on the ongoing debate on the respective role of clinicians in primary care and specialists in caring for patients with dementia.
Geographic variation in preventable hospitalisations across Canada: a cross-sectional study
Authors: Wilk Piotr , Ali Shehzad , Anderson Kelly K , Clark Andrew F , Cooke Martin , Frisbee Stephanie J , Gilliland Jason , Haan Michael , Harris Stewart , Kiarasi Soushyant , Maltby Alana , Norozi Kambiz , Petrella Robert , Sarma Sisira , Singh Sarah S , Stranges Saverio , Thind Amardeep 
Published: May 2020

ObjectiveThe objective of this study is to examine the magnitude and pattern of small-area geographic variation in rates of preventable hospitalisations for ambulatory care-sensitive conditions (ACSC) across Canada (excluding Québec).Design and settingA cross-sectional study conducted in Canada (excluding Québec) using data from the 2006 Canadian Census Health and Environment Cohort (CanCHEC) linked prospectively to hospitalisation records from the Discharge Abstract Database (DAD) for the three fiscal years: 2006–2007, 2007–2008 and 2008–2009.Primary outcome measurePreventable hospitalisations (ACSC).ParticipantsThe 2006 CanCHEC represents a population of 22 562 120 individuals in Canada (excluding Québec). Of this number, 2 940 150 (13.03%) individuals were estimated to be hospitalised at least once during the 2006–2009 fiscal years.MethodsAge-standardised annualised ACSC hospitalisation rates per 100 000 population were computed for each of the 190 Census Divisions. To assess the magnitude of Census Division-level geographic variation in rates of preventable hospitalisations, the global Moran’s I statistic was computed. ‘Hot spot’ analysis was used to identify the pattern of geographic variation.ResultsOf all the hospitalisation events reported in Canada during the 2006–2009 fiscal years, 337 995 (7.10%) events were ACSC-related hospitalisations. The Moran’s I statistic (Moran’s I=0.355) suggests non-randomness in the spatial distribution of preventable hospitalisations. The findings from the ‘hot spot’ analysis indicate a cluster of Census Divisions located in predominantly rural and remote parts of Ontario, Manitoba and Saskatchewan and in eastern and northern parts of Nunavut with significantly higher than average rates of preventable hospitalisation.ConclusionThe knowledge generated on the small-area geographic variation in preventable hospitalisations can inform regional, provincial and national decision makers on planning, allocation of resources and monitoring performance of health service providers.
Consensus on the exercise and dosage variables of an exercise training programme for chronic non-specific neck pain: protocol for an international e-Delphi study
Authors: Price Jonathan , Rushton Alison , Tyros Vasileios , Heneghan Nicola R 
Published: May 2020

IntroductionClinical guidelines and systematic reviews recommend exercise in the management of chronic non-specific neck pain. Although exercise training programmes that consist of both motor control exercise and exercises for the superficial cervical muscles (segmental exercises) are effective, the exercise variables including dosage vary considerably across trials or are poorly reported. This study aims to gain expert consensus on these exercise variables so that they can be described clearly using intervention reporting checklists to inform clinical practice and future clinical trials.Methods and analysisThis protocol for an international Delphi study is informed by the Guidance on Conducting and REporting DElphi Studies recommendations and published to ensure quality, rigour and transparency. The study will consist of three rounds using anonymous online questionnaires. Expert exercise professionals (physiotherapists, strength and conditioning coaches and so on) and academics in neck pain management will be identified through literature searches, peer referral and social media calls for expression of interest. In round 1, participants will answer open-ended questions informed by intervention and exercise reporting checklists. Responses will be analysed thematically by two independent reviewers. In round 2, participants will rate their level of agreement with statements generated from round 1 and previous clinical trials using a 5-point Likert scale where 1=strongly disagree and 5=strongly agree. In round 3, participants will re-rate their agreement with statements that achieved consensus in round 2. Statements reaching consensus among participants must meet progressively increased a priori criteria at rounds 2 and 3, measured using descriptive statistics: median, IQR and percentage agreement. Inferential statistics will be used to evaluate measures of agreement between participants (Kendall’s coefficient of concordance) and stability between rounds (Wilcoxon rank-sum test). Statements achieving consensus in round 3 will provide expert recommendations of the key exercise and dosage variables in the management of chronic non-specific neck pain.Ethics and disseminationEthical approval was provided by the University of Birmingham Ethics Committee (Ref:ERN_19–1857). Results will be disseminated through peer-reviewed publications and conference presentations.
Role of ethnicity and socioeconomic status (SES) in the presentation of retinoblastoma: findings from the UK
Authors: Bourkiza Rabia , Cumberland Phillippa , Fabian Ido Didi , Abeysekera Hiranya , Parulekar Manoj , Sagoo Mandeep S , Rahi Jugnoo , Reddy M Ashwin 
Published: May 2020

BackgroundThe relationship between the ethnic background or socioeconomic status (SES) and late retinoblastoma (Rb) presentation in the UK is unclear. We aimed to investigate if such correlations exist in a cohort of non-familial Rb cases.MethodsA cross-sectional study based at the two centres providing Rb care in the UK. Included were non-familial Rb cases that presented from January 2006 to December 2011. Epidemiological and clinical data were retrieved from medical charts, as well as patients’ postcodes used to obtain the Index of Multiple Deprivation (IMD) score. A postal questionnaire was sent to participants’ parents to collect further, person-level, information on languages spoken and household socioeconomic position. Statistical correlations to advanced Rb at presentation as well as to treatment by enucleation and need for adjuvant chemotherapy were investigated.ResultsThe cohort included 189 cases, 98 (51.8%) of which were males. The median age at diagnosis was 16 months (IQR 8–34 months). Of the study patients, 153 (81%) presented with advanced Rb; 78 (41%) with group D and 75 (40%) with group E Rb. A total of 134 (72%) patients were treated with enucleation. South Asian ethnicity and being in the most deprived IMD quintile were associated with a higher likelihood of presentation with advanced disease, but these estimates did not reach statistical significance. Older age at presentation was associated with enucleation and bilateral disease with adjuvant chemotherapy.ConclusionsIn this national UK study of patients with non-familial Rb, there was no evidence of an association of ethnicity or SES and the risk of presenting with advanced disease. These findings may reflect equality in access of healthcare in the UK.
Neuroleptic malignant syndrome in patients with cancer: a systematic review
Authors: Sato Izumi , Onishi Hideki , Kawanishi Chiaki , Yamada Shuhei , Ishida Mayumi , Kawakami Koji 
Published: May 2020

BackgroundAntipsychotics potentially cause a low incidence of the side effect called neuroleptic malignant syndrome (NMS), which has a high mortality rate. However, few studies on NMS among patients with cancer exist.AimsWe aimed to examine the characteristics of antipsychotic-induced NMS among patients with cancer.MethodsWe conducted a systematic review of published reports on NMS described during the treatment of patients with any type of cancer. Articles were identified by a comprehensive search of PubMed, Web of Science, the Cochrane Library and reference lists from relevant articles published until 25 December 2019. Original articles or case reports on humans published in English were included. This review summarises the symptoms, characteristics, treatment course and prognosis of patients with cancer with NMS.ResultsEleven patients with various cancer types from ten case reports published from 1988 to 2013 met the eligibility criteria. Mean age of the 11 patients was 52.5 (range, 32–83) years. NMS developed mostly during the postoperative period, and haloperidol and D2 receptor antagonists were determined as the common causative drugs. Ten patients survived following treatment that mostly involved discontinuing the causative drugs and administering dantrolene, if necessary.ConclusionAlthough NMS intrinsically has a low incidence and high mortality, only few reports were available, with most patients surviving after early detection and appropriate treatment. Healthcare providers should consider NMS development while prescribing antipsychotics to ensure prompt recognition of the condition and rapid treatment for preventing unnecessary deaths.
Delirium screening practice in specialist palliative care units: a survey
Authors: Woodhouse Rebecca , Siddiqi Najma , Boland Jason W , Featherstone Imogen , Johnson Miriam J 
Published: May 2020

ObjectivesDelirium is common and distressing in palliative care settings. This survey aims to describe current practice regarding delirium identification in specialist palliative care units (SPCU), such as inpatient hospices, in the UK.MethodsAn 18-item anonymous online survey was distributed by Hospice UK to their network of clinical leads (n=223), and to their research mailing list (n=228). The survey was also sent to the chair of the Hospice UK executive clinical leads forum for direct dissemination to forum representatives (n=20). Clinical leads and forum representatives were asked to distribute the survey to healthcare staff in their SPCUs.Results220 SPCU staff (48% nurses; 31% doctors; 10% healthcare assistants) completed the survey. Approximately half reported using clinical judgement alone to screen (97/204; 48%) and/or diagnose (124/220; 56%) delirium. Over a third used an assessment tool to screen for delirium (76/204; 37%). The majority (150/220; 68%) reported screening in response to clinical symptoms, while few reported routine on-admission (11/220; 5%) or daily-during-admission (12/220; 6%) screening. Most respondents had received some training on delirium (137/220; 62%). However, 130/220 (59%) said their SPCU did not have a training programme for delirium screening and only 79/220 (36%) reported that their SPCU had delirium clinical guidelines. The main barriers to routine screening included: lack of delirium training, lack of guidelines and complexity of patient’s conditions.ConclusionThere is variation in practice for delirium screening and diagnosis in SPCUs. Clinical guidelines for delirium, including consensus on which screening tools to use, are needed for this setting.