bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lung cancer screening implementation: Complexities and priorities
Authors: Rankin Nicole M. , McWilliams Annette , Marshall Henry M. 
Published: November 2020

ABSTRACTLung cancer is the number one cause of cancer death worldwide. The benefits of lung cancer screening to reduce mortality and detect early‐stage disease are no longer in any doubt based on the results of two landmark trials using LDCT. Lung cancer screening has been implemented in the US and South Korea and is under consideration by other communities. Successful translation of demonstrated research outcomes into the routine clinical setting requires careful implementation and co‐ordinated input from multiple stakeholders. Implementation aspects may be specific to different healthcare settings. Important knowledge gaps remain, which must be addressed in order to optimize screening benefits and minimize screening harms. Lung cancer screening differs from all other cancer screening programmes as lung cancer risk is driven by smoking, a highly stigmatized behaviour. Stigma, along with other factors, can impact smokers' engagement with screening, meaning that smokers are generally ‘hard to reach’. This review considers critical points along the patient journey. The first steps include selecting a risk threshold at which to screen, successfully engaging the target population and maximizing screening uptake. We review barriers to smoker engagement in lung and other cancer screening programmes. Recruitment strategies used in trials and real‐world (clinical) programmes and associated screening uptake are reviewed. To aid cross‐study comparisons, we propose a standardized nomenclature for recording and calculating recruitment outcomes. Once participants have engaged with the screening programme, we discuss programme components that are critical to maximize net benefit. A whole‐of‐programme approach is required including a standardized and multidisciplinary approach to pulmonary nodule management, incorporating probabilistic nodule risk assessment and longitudinal volumetric analysis, to reduce unnecessary downstream investigations and surgery; the integration of smoking cessation; and identification and intervention for other tobacco related diseases, such as coronary artery calcification and chronic obstructive pulmonary disease. National support, integrated with tobacco control programmes, and with appropriate funding, accreditation, data collection, quality assurance and reporting mechanisms will enhance lung cancer screening programme success and reduce the risks associated with opportunistic, ad hoc screening. Finally, implementation research must play a greater role in informing policy change about targeted LDCT screening programmes.
Antimicrobial use quantification in adult dairy cows – Part 2 – Developing a foundation for pharmacoepidemiology by comparing measurement methods
Authors: Schrag Nora F.D. , Apley Michael D. , Godden Sandra M. , Singer Randall S. , Lubbers Brian V. 
Published: November 2020

AbstractAs stewardship programmes seek to influence therapeutic choices and reduce resistance selection pressure, it is essential to understand the multiple factors which may influence any given antimicrobial use measure. This article compares 9 measures of antimicrobial use pertaining to adult cows in US dairy systems based on treatment records standardized to a single standardized regimen (SReg) format. There are 3 fundamental parameters underlying the nine measures: amount of active substance (AMOUNT), number of SRegs (ANIMALS) and treatment time (TIME). Additionally, three use categories were considered in the analysis: control of mastitis (Dry Cow), treatment of detected mastitis (Clinical Mastitis) and treatment of other diseases (Other Treatment). The assumptions necessary for calculation of each of the nine measures are identified. The influence of measure choice on farm rank was explored at the farm level both within and across fundamental parameters. Across all use categories, when measures of TIME and ANIMALS were compared, correlations between measures were greater than 0.91. However, when measures of AMOUNT were compared to either measures of TIME or ANIMALS, the correlation between measures was more variable across use categories (R = 0.31–0.91). These comparisons demonstrate that the selection of antimicrobial use metric can affect which dairies are considered the highest users of antimicrobials. Measurement selection also influences which use category has the greatest potential for use reduction. This indicates that measure selection can influence which use category is prioritized as a target for reduction of antimicrobial use. Utilization of this information may allow those developing dairy antimicrobial stewardship programmes to better understand the potential effects of measurement selection on driving changes in antimicrobial use.
Antimicrobial use quantification in adult dairy cows – Part 3 – Use measured by standardized regimens and grams on 29 dairies in the United States
Authors: Schrag Nora F. D. , Godden Sandra M. , Apley Michael D. , Singer Randall S. , Lubbers Brian V. 
Published: November 2020

AbstractThis study describes antimicrobial use in terms of standardized regimens per cow year (REG/CY) and grams per cow year (GMS/CY) for 29 dairies in the United States during the years 2016 and 2017. To explore potential priorities for antimicrobial stewardship programs, these measures were stratified by both disease syndrome and antimicrobial class. Potential confounders of use measurements are discussed and challenges for measure interpretation are identified. When measured as REG/CY, the results indicate that mastitis is the disease syndrome with the greatest contribution to overall antimicrobial use. However, when GMS/CY is measured, metritis, lameness and unknown disease syndromes are also significant contributors. When use is stratified by antimicrobial class, measures of REG/CY indicate the greatest magnitude of use is the cephalosporin class. However, when measures of GMS/CY are stratified by drug class, use within the penicillin class contributes more than any other single class. These differences highlight the need for a more complete understanding of the relationship between antimicrobial use measures and their relationship to antimicrobial resistance selection pressure.
Pregnant and postnatal women's experiences of interacting with health care providers about their tobacco smoking: a qualitative systematic review protocol
Authors: Small Sandra P. , Swab Michelle , Maddigan Joy 
Published: November 2020

ABSTRACT

Objective:
The objective of this review is to comprehensively identify and synthesize the best available evidence about the experiences of women who smoked tobacco during pregnancy or postnatally (or both) concerning their health care providers’ interactions with them about their smoking.

Introduction:
Smoking tobacco during pregnancy and postnatally continue to be important global public health challenges. Maternal smoking poses risks to the woman's general health and causes pregnancy complications and serious adverse health effects for the fetus and child. Hence, it is essential that health care providers support pregnant and postnatal women to achieve smoking cessation and not relapse. Learning about these women's experiences of health care provider interactions may inform recommendations for health care provider best practice in interpersonal approach.

Inclusion criteria:
The participants of interest are women who smoked tobacco during pregnancy, the postnatal period, or both, with the phenomenon of interest being their experiences of health care provider interactions with them about their smoking. The context is any setting globally. Studies for consideration will have qualitative data, including any mixed methods studies.

Methods:
This qualitative systematic review will be conducted according to JBI methodology. Databases to be searched for published studies include CINAHL, PubMed, APA PsycINFO, Embase, Sociological Abstracts, and SocINDEX. Gray literature will be searched for unpublished studies. The authors will conduct an initial screening and then a full-text review of studies for congruence with the inclusion criteria. A critical appraisal will be performed on eligible studies and data will be extracted from included studies. Meta-aggregation will be used to yield synthesized findings, which will be assigned confidence scores.

Systematic review registration number:
PROSPERO CRD42020178866
Risk factors for hyperglycemia and hypoglycemia in adults with pharmacologically treated type 2 diabetes mellitus: a quantitative systematic review protocol
Authors: Lopes Rafael Oliveira Pitta , Barbosa Genesis de Souza , Leite Kênia Rocha , Mercês Claudia Angélica Mainenti Ferreira , Santana Rosimere Ferreira , Brandão Marcos Antônio Gomes 
Published: November 2020

ABSTRACT

Objective:
The objective of this review is to identify and synthesize the risk factors for hyperglycemia or hypoglycemia in adults with pharmacologically treated type 2 diabetes mellitus in any scenarios and environments for health care.

Introduction:
Studies around the world have investigated which factors are associated with episodes of alteration of blood glucose level. It is through the characterization of these factors that nurses can plan and intervene accurately in the control of serum glucose levels in people with diabetes.

Inclusion criteria:
This review will include studies conducted among adults with pharmacologically treated type 2 diabetes mellitus in any scenarios and environments for health care. Studies should focus on risk factors for the variation of fasting glycemic levels lower than 3.9 mmol/L and higher than 7.21 mmol/L, as well as postprandial glycemic levels lower than 3.9 mmol/L and higher than 10 mmol/L.

Methods:
Databases to be searched include MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, Scopus, LILACS, and ScienceDirect. Following the search, titles and abstracts will be screened by two independent reviewers for assessment against the inclusion criteria for the review. The full text of selected citations will be assessed in detail against the inclusion criteria, and studies selected for retrieval will be assessed by two independent reviewers for methodological validity using JBI critical appraisal tools. Studies will not be excluded based on their quality assessment. Data will be extracted using the standardized data extraction tools. Quantitative data will, where possible, be pooled in statistical meta-analysis.

Systematic review registration number:
PROSPERO (CRD42019134755)
Analysis of the interaction effect of 48 SNPs and obesity on type 2 diabetes in Chinese Hans
Authors: Liu Jia , Wang Lu , Qian Yun , Shen Qian , Chen Hai , Ma Hongxia , Dai Juncheng , Shen Chong , Jin Guangfu , Hu Zhibin , Shen Hongbing 
Published: November 2020

IntroductionBoth environmental and genetic factors contribute to type 2 diabetes (T2D) risk. Dozens of T2D susceptibility loci have been identified by genome-wide association study. However, these loci account for only a small fraction of the familial T2D risk. We hypothesized that the gene-obesity interaction may contribute to the missing heritability.Research design and methodForty-eight T2D-associated variants were genotyped using the TaqMan OpenArray Genotyping System and iPLEX Sequenom MassARRAY platform in two separate studies. Obesity was defined according to multiple indexes (body mass index (BMI), waist circumference and waist-hip ratio). Multiplicative interactions were tested using general logistic regression to assess the gene-obesity interaction effect on T2D risk among a total of 6206 Chinese Hans.ResultsAfter adjusting for the main effects of genes and obesity, as well as covariates (age, sex, smoking and alcohol consumption status), robust multiplicative interaction effects were observed between rs10811661 inCDKN2A/CDKN2Band multiple obesity indices (p ranged from 0.001 to 0.043 for BMI, waist circumference and waist-hip ratio). Obese individuals with the TT genotype had a drastically higher risk of T2D than normal weight individuals without the risk allele (OR=17.58, p<0.001). There were no significant differences between subgroups in the stratification analysis. Plausible biological explanations were established using a public database. However, there were no significant interaction effects between the other 47 single nucleotide polymorphism (SNPs) and obesity.ConclusionOur findings indicated that theCDKN2A/CDKN2Bgene-obesity interaction significantly increases T2D risk in Chinese Hans. The interaction effect identified in our study may help to explain some of the missing heritability in the context of T2D susceptibility. In addition, the interaction effect may play a role in the precise prevention of T2D in Chinese individuals.
Glutathione S-transferases gene polymorphism influence on the age of diabetes type 2 onset
Authors: Klusek Justyna , Błońska-Sikora Ewelina , Witczak Bartosz , Orlewska Katarzyna , Klusek Jolanta , Głuszek Stanisław , Orlewska Ewa 
Published: November 2020

IntroductionType 2 diabetes (T2D) is a multifactorial disease affecting mostly adults older than 40 years. The aim of the study was to examineGSTgene polymorphism influence on the risk of T2D, especially in young adults.Research design and methods200 diabetic patients and 221 healthy controls participated in this study. ThreeGSTgene polymorphism have been analyzed:GSTP1(single-nucleotide polymorphism Ile105Val), homozygous deletion ofGSTT1(null/null) andGSTM1(null/null), using TaqMan real-time quantitative PCR.ResultsThe distribution of examined polymorphisms was similar in patient group and control group. Statistically significant differences were demonstrated for the combination ofGSTP1 Val/ValandGSTT1 null/nullgenotypes between patients diagnosed before 40 years of age and healthy people (12.5% vs 0.9%, p=0.016). Moreover, all three examined gene polymorphism together (GSTP1 Val/Val,GSTM1nul/nullandGSTT1 null/nullgenotype) was observed in 12.5% of patients diagnosed before 40 years of age and in 0.5% of healthy individuals (p=0.013).ConclusionIn conclusion, the results suggest thatGSTpolymorphism may be one of the risk factors for developing T2D at a younger age than the T2D population average.
Development of an informational support questionnaire of transitional care for aged patients with chronic disease
Authors: Shi Xiaoliu , Geng Guiling , Hua Jianing , Cui Min , Xiao Yuhua , Xie Juan 
Published: November 2020

ObjectivesWe developed an informational support questionnaire of transitional care (ISQTC) for aged patients with chronic disease and investigated its reliability and validity.SettingThis study was conducted in three large general hospitals in Nantong, Jiangsu Province, China.ParticipantsA total of 130 aged patients with chronic diseases, admitted into outpatient and inpatient departments from three hospitals in China, participated in the study. The inclusion criteria were: (1) patients must provide consent to participate; (2) being 60 years and above; (3) being diagnosed with at least one chronic disease and hospitalised more than two times within the last 1 year; (4) being able to listen, speak, read and write. The exclusion criteria were: (1) refusing to participate; (2) language expression and communication barriers (and having no caregiver to assist in participation); (3) being in intensive care or long-term hospitalisation.Primary and secondary outcome measuresThe developed questionnaire was validated and tested for reliability. The content validity of the questionnaire was determined through experts’ interviews and Delphi expert consultation, and the structure validity of the questionnaire was determined by performing exploratory factor analysis. The coefficient of reliability of the questionnaire was measured using Cronbach’s alpha.ResultsThrough Delphi expert consultation and exploratory factor analysis, the questionnaire was reduced from four dimensions and 12 items to three dimensions and 11 items. A total of 130 patients responded to the questionnaire. The alpha coefficient was 0.747.ConclusionThe ISQTC is a reliable and valid instrument for evaluating aged patients with chronic disease in transitional care.Trial registration detailsChiCTR1900020923. The trial was registered on 22 January 2019.
National trends in sexual health indicators among gay and bisexual men disaggregated by ethnicity: repeated cross-sectional behavioural surveillance in New Zealand
Authors: Lachowsky Nathan J , Saxton Peter J W , Dickson Nigel Patrick , Hughes Anthony J , Summerlee Alastair J S , Dewey Cate E 
Published: November 2020

ObjectivesTo assess trends in sexual health outcomes among men who have sex with men (MSM) disaggregated by ethnicity.DesignRepeated cross-sectional.SettingBehavioural surveillance data from 2006, 2008, 2011 and 2014 were collected in-person and online across Aotearoa New Zealand.ParticipantsEligible participants were self-identified men aged 16 years or older who reported sex with another man in the past 5 years. We classified 10 525 participants’ ethnicities: Asian (n=1003, 9.8%), Māori (Indigenous people of Aotearoa New Zealand, n=1058, 10.3%), Pacific (n=424, 4.1%) and European (n=7867, 76.8%).Outcome measuresThe sexual health outcomes examined were >20 recent (past 6 months) male sexual partners, past-year sexually transmitted infection (STI) testing, past-year STI diagnosis, lifetime and past-year HIV testing, lifetime HIV-positive diagnosis and any recent (past 6 months) condomless anal intercourse with casual or regular partners.ResultsWhen disaggregated, Indigenous and ethnic minority groups reported sexual health trends that diverged from the European MSM and each other. For example, Asian MSM increased lifetime HIV testing (adjusted OR, AOR=1.31 per survey cycle, 95% CI 1.17 to 1.47) and recent HIV testing (AOR=1.14, 95% CI 1.02 to 1.28) with no changes among Māori MSM or Pacific MSM. Condomless anal intercourse with casual partners increased among Māori MSM (AOR=1.13, 95% CI 1.01 to 1.28) with no changes for Asian or Pacific MSM. Condomless anal intercourse with regular partners decreased among Pacific MSM (AOR=0.83, 95% CI 0.69 to 0.99) with no changes for Asian or Māori MSM.ConclusionsPopulation-level trends were driven by European MSM, masking important differences for Indigenous and ethnic minority sub-groups. Surveillance data disaggregated by ethnicity highlight inequities in sexual health service access and prevention uptake. Future research should collect, analyse and report disaggregated data by ethnicity to advance health equity.
Characteristics and well-being of urban informal home care providers during COVID-19 pandemic: a population-based study
Authors: Chan Emily YY , Lo Eugene SK , Huang Zhe , Kim Jean H , Hung Heidi , Hung Kevin KC , Wong Eliza LY , Wong Samuel YS , Gobat Nina 
Published: November 2020

ObjectivesGlobally, the COVID-19 pandemic has overwhelmed many healthcare systems, which has hampered access to routine clinical care during lockdowns. Informal home care, care provided by non-healthcare professionals, increases the community’s healthcare capacity during pandemics. There is, however, limited research about the characteristics of informal home care providers and the challenges they face during such public health emergencies.DesignA random, cross-sectional, population-based, RDD, telephone survey study was conducted to examine patterns of home care, characteristics of informal home care providers and the challenges experienced by these care providers during this pandemic.SettingData were collected from 22 March to 1 April 2020 in Hong Kong, China.ParticipantsA population representative study sample of Chinese-speaking adults (n=765) was interviewed.Primary and secondary outcome measuresThe study examined the characteristics of informal home care providers and self-reported health requirements of those who needed care. The study also examined providers’ self-perceived knowledge to provide routine home care as well as COVID-19 risk reduction care. Respondents were asked of their mental health status related to COVID-19.ResultsOf the respondents, 25.1% of 765 provided informal home care during the studied COVID-19 pandemic period. Among the informal home care providers, 18.4% of respondents took leave from school/work during the epidemic to provide care for the sick, fragile elderly and small children. Care providers tended to be younger aged, female and housewives. Approximately half of care providers reported additional mental strain and 37.2% reported of challenges in daily living during epidemic. Although most informal home care providers felt competent to provide routine care, 49.5% felt inadequately prepared to cope with the additional health risks of COVID-19.ConclusionDuring public health emergencies, heavy reliance on informal home healthcare providers necessitates better understanding of their specific needs and increased government services to support informal home care.
Beyond the numbers—understanding women’s experiences of accessing care for abnormal uterine bleeding (AUB): a qualitative study
Authors: Henry Claire , Jefferies Regina , Ekeroma Alec , Filoche Sara 
Published: November 2020

ObjectiveTo gain a deeper understanding of women’s experiences of accessing care for abnormal uterine bleeding (AUB) in order to inform future strategies to improve care pathways, including the early detection of endometrial cancer.DesignWe conducted semistructured interviews with 15 women who attended their first gynaecological specialist consultation for AUB at Wellington Regional Hospital between October and December 2019. Inductive thematic analysis was used to explore experiences and barriers to seeking care.ResultsThe median age of the participant cohort was 45 years, with women self-identifying as New Zealand European (9/15), Māori (2/15) and Pasifika (4/15). All women had sought investigation for their AUB in primary care, for some women this was over a timeframe of many years. For all women, AUB had a significant and traumatic impact on their quality of life including their relationships and their work or education. Women described how they felt they often received inadequate care for AUB, and reported negative experiences with their general practitioner. Timely access was further compounded by feelings of embarrassment and that AUB was a taboo subject, and being able to discuss it with family, friends and their general practitioners was difficult.ConclusionWomen in our cohort experienced a multitude of compounding influences that acted as barriers to them having access to appropriate and timely care. Information campaigns that create awareness around ‘abnormal periods’ alongside better health provider practice guidelines for AUB investigation need to be a priority.