bluuebunny/crossref_metadata_2025_split huggingface dataset:
How do aggression source, employee characteristics and organisational response impact the relationship between workplace aggression and work and health outcomes in healthcare employees? A cross-sectional analysis of the National Health Service staff survey in England
Authors: Cheng Shannon , Dawson Jeremy , Thamby Julie , Liaw Winston R , King Eden B 
Published: August 2020

ObjectivesTo examine the prevalence of aggression in healthcare and its association with employees’ turnover intentions, health and engagement, as well as how these effects differ based on aggression source (patients vs colleagues), employee characteristics (race, gender and occupation) and organisational response to the aggression.DesignMultilevel moderated regression analysis of 2010 National Health Service (NHS) survey.Setting147 acute NHS trusts in England.Participants36 850 participants across three occupational groups (14% medical/dental, 61% nursing/midwifery, 25% allied health professionals or scientific and technical staff).Main outcome measuresEmployee turnover intentions, health and work engagement.ResultsBoth forms of aggression (from patients and colleagues) have significant and substantial effects on turnover intentions, health and work engagement; however, for all three outcome variables, the effect of aggression from colleagues is more than twice the size of the effect of aggression from patients. Organisational response was found to buffer the negative effects of aggression from patients for turnover intentions and the negative effects of aggression from patients and colleagues for employee health. The results also demonstrated that nurses/midwives, women and Black employees are more likely to experience aggression; however, no clear patterns emerged on how aggression differentially impacts employees of different races, genders and occupations with respect to the outcome variables.ConclusionsAlthough aggression from patients and colleagues both have negative effects on healthcare employees’ turnover intentions, health and work engagement, these negative effects are worse when it is aggression from colleagues. Having an effective organisational response can help ameliorate the negative effects of aggression on employees’ health; however, it may not always buffer negative effects on turnover intentions and work engagement. Future research should examine other approaches, as well as how organisational responses and resources may need to differ based on aggression source.
Implementing post-discharge care following acute kidney injury in England: a single-centre qualitative evaluation
Authors: Elvey Rebecca , Howard Susan J , Martindale Anne-Marie , Blakeman Thomas 
Published: August 2020

ObjectivesWe sought to understand the factors influencing the implementation of a primary care intervention to improve post-discharge care following acute kidney injury (AKI).DesignQualitative study using semi-structured interviews and thematic analysis.SettingGeneral practices in one Clinical Commissioning Group area in England.ParticipantsA total of 18 healthcare staff took part in interviews. Participants were practice pharmacists, general practitioners, practice managers and administrators involved in implementing the intervention.ResultsWe identified three main factors influencing implementation: differentiation of the new intervention from other practice work; development of skill mix and communication across organisations. Overall, post-AKI processes of care were deemed straightforward to embed into existing practice. However, it was also important to separate the intervention from other work in general practice. Dedicating staff time to proactively identify AKI on discharge summaries and to coordinate the provision of care enabled implementation of the intervention. The post-AKI intervention provided an opportunity for practice pharmacists to expand their primary care role. Working in a new setting also brought challenges; time to develop trusting relationships including an understanding of boundaries of clinical expertise influenced pharmacists’ roles. Unclear and inconsistent information on discharge summaries contributed to concerns about additional work in primary care.ConclusionsThe research highlights challenges around post-discharge management in the primary care context. Coordination and communication were key factors for improving follow-up care following AKI. Further consideration is required to understand patient experiences of the interface between secondary and primary care. The issues pertaining to discharge care following AKI are relevant to practitioners and commissioners as they work to improve transitions of care for vulnerable patient populations.
Productivity losses among people with back pain and among population-based references: a register-based study in Sweden
Authors: Gedin Filip , Alexanderson Kristina , Zethraeus Niklas , Karampampa Korinna 
Published: August 2020

ObjectiveBack pain is the leading cause for years lived with disability globally and among the main reasons for sickness absence (SA) and disability pension (DP). The objective of this study was to explore the occurrence of SA and DP and to estimate productivity losses among individuals with back pain compared with among matched population-based references.DesignExplorative prospective cohort study using register microdata.Participants and settingA total of 23 176 people, aged 19–60 years, with a first visit to inpatient or specialised outpatient healthcare for back pain (International Statistical Classification of Diseases and Related Health Problems code M54) in 2010 in Sweden and a matched population-based reference group (n=115 880).OutcomesLong-term SA (in SA spells >14 days) and DP and productivity losses, measured in € (2018 prices) by multiplying the SA and DP net days by the societal cost of each such day.ResultsIn the back-pain group, 42% had SA or DP days; in the reference group, the corresponding proportion was 15%. Productivity loss per patient with back pain was €8928 during the 12-month follow-up period; in the reference group, it was €3499 (p<0.0001).ConclusionsSA and DP, leading to excess productivity losses among people with back pain, reflect the challenges these patients are facing to maintain their work capacity. Interventions to promote that individuals with back pain remain in paid work should be a priority in order to address the high costs.
Children’s unscheduled primary and emergency care in Ireland: a multimethod approach to understanding decision making, trends, outcomes and parental perspectives (CUPID): project protocol
Authors: McAuliffe Eilish , Hamza Moayed , McDonnell Thérèse , Nicholson Emma , De Brún Aoife , Barrett Michael , Brunsdon Christopher , Bury Gerard , Collins Claire , Deasy Conor , Fitzsimons John , Galligan Marie , Hensey Conor 
Published: August 2020

IntroductionThe aim of this project is to determine the patterns, decision-making processes and parental preferences associated with unscheduled paediatric healthcare utilisation in Ireland. Unscheduled paediatric healthcare is outpatient care provided within primary care settings by general practitioners (GPs), emergency departments (EDs) located in paediatric and general hospitals, and out-of-hours services provided by cooperatives of GPs operating on a regional basis. This project will take a multimethod approach to analysing the utilisation of unscheduled paediatric healthcare nationally within the context of a significant change to the provision of healthcare for young children in Ireland—the introduction of free at the point of delivery GP care for all children aged under 6.Methods and analysisA multimethod approach consisting of three work packages will be employed. Using patient-level data, work package 1 will describe patterns of attendance at primary care, out-of-hours medical services and at EDs. Applying a difference-in-difference methodology, the impact of the introduction of free GP care for children under 6 on attendance will be assessed. Work package 2 will explore geospatial trends of attendance at EDs, identifying disparities in ED attendance by local area and demographic characteristics. Work package 3 will employ two discrete choice experiments to examine parental preferences for unscheduled paediatric healthcare and GP decision making when referring a child to the ED. The insights gained by each of the work packages individually and collectively will inform evidence-based health policy for the organisation of paediatric care and resource allocation.Ethics and disseminationEthical approval for this research has been granted by University College Dublin, The Irish College of General Practitioners and the five participating hospitals. Results will be disseminated via publication in peer-reviewed journals, national and international conferences, and to relevant stakeholders and interest groups.
Calgary Normative Study: design of a prospective longitudinal study to characterise potential quantitative MR biomarkers of neurodegeneration over the adult lifespan
Authors: McCreary Cheryl R , Salluzzi Marina , Andersen Linda B , Gobbi David , Lauzon Louis , Saad Feryal , Smith Eric E , Frayne Richard 
Published: August 2020

IntroductionA number of MRI methods have been proposed to be useful, quantitative biomarkers of neurodegeneration in ageing. The Calgary Normative Study (CNS) is an ongoing single-centre, prospective, longitudinal study that seeks to develop, test and assess quantitative magnetic resonance (MR) methods as potential biomarkers of neurodegeneration. The CNS has three objectives: first and foremost, to evaluate and characterise the dependence of the selected quantitative neuroimaging biomarkers on age over the adult lifespan; second, to evaluate the precision, variability and repeatability of quantitative neuroimaging biomarkers as part of biomarker validation providing proof-of-concept and proof-of-principle; and third, provide a shared repository of normative data for comparison to various disease cohorts.Methods and analysisQuantitative MR mapping of the brain including longitudinal relaxation time (T1), transverse relaxation time (T2), T2*, magnetic susceptibility (QSM), diffusion and perfusion measurements, as well as morphological assessments are performed. The Montreal Cognitive Assessment (MoCA) and a brief, self-report medical history will be collected. Mixed regression models will be used to characterise changes in quantitative MR biomarker measures over the adult lifespan. In this report, we describe the study design, strategies to recruit and perform changes to the acquisition protocol from inception to 31 December 2018, planned statistical approach and data sharing procedures for the study.Ethics and disseminationParticipants provide signed informed consent. Changes in quantitative MR biomarkers measured over the adult lifespan as well as estimates of measurement variance and repeatability will be disseminated through peer-reviewed scientific publication.
The GALANT trial: study protocol of a randomised placebo-controlled trial in patients with a 68Ga-DOTATATE PET-positive, clinically non-functioning pituitary macroadenoma on the effect of lanreotide on tumour size
Authors: Boertien Tessel M , Drent Madeleine L , Booij Jan , Majoie Charles B L M , Stokkel Marcel P M , Hoogmoed Jantien , Pereira Alberto , Biermasz Nienke R , Simsek Suat , Groote Veldman Ronald , Tanck Michael W T , Fliers Eric , Bisschop Peter H 
Published: August 2020

IntroductionAt present, there is no approved medical treatment option for patients with non-functioning pituitary adenoma. A number of open-label studies suggest that treatment with somatostatin analogues may prevent tumour progression. In vivo somatostatin receptor imaging using 68Ga-DOTATATE PET (PET, positron emission tomography) could help in preselecting patients potentially responsive to treatment. Our aim is to investigate the effect of the somatostatin analogue lanreotide as compared with placebo on tumour size in patients with a 68Ga-DOTATATE PET-positive non-functioning pituitary macroadenoma (NFMA).Methods and analysisThe GALANT study is a multicentre, randomised, double-blind, placebo-controlled trial in adult patients with a suprasellar extending NFMA. Included patients undergo a 68Ga-DOTATATE PET/CT of the head and tracer uptake is assessed after coregistration with pituitary MRI. Forty-four patients with a 68Ga-DOTATATE PET-positive NFMA are randomised in a 1:1 ratio between lanreotide 120 mg or placebo, both administered as subcutaneous injections every 28 days for 72 weeks. The primary outcome is the change in cranio-caudal tumour diameter on pituitary MRI after treatment. Secondary outcomes are change in tumour volume, time to tumour progression, change in quality of life and number of adverse events. Final results are expected in the second half of 2021.Ethics and disseminationThe study protocol has been approved by the Medical Research Ethics Committee of the Academic Medical Centre (AMC) of the Amsterdam University Medical Centres and by the Dutch competent authority. It is an investigator-initiated study with financial support by Ipsen Farmaceutica BV. The AMC, as sponsor, remains owner of all data. Results will be submitted for publication in a peer-reviewed journal.Trial registration numberNL5136 (Netherlands Trial Register); pre-recruitment.
Effectiveness of physical therapy in addition to occlusal splint in myogenic temporomandibular disorders: protocol of a randomised controlled trial
Authors: Incorvati Cristina , Romeo Antonio , Fabrizi Adele , Defila Luca , Vanti Carla , Gatto Maria Rosaria Antonella , Marchetti Claudio , Pillastrini Paolo 
Published: August 2020

IntroductionTemporomandibular disorders (TMDs) are considered a collection of musculoskeletal conditions involving the masticatory muscles, the temporomandibular joint and associated structures. The myogenous group appears to represent the most frequently diagnosed category. In the context of a multimodal approach, splint therapy and musculoskeletal physiotherapy are often considered as a preferred therapy. The purpose of this study will be to investigate the effects of musculoskeletal physiotherapy combined with occlusal splint and education versus occlusal splint and education alone in the treatment of chronic myogenous TMD on pain and mandibular range of motion.Methods and analysisAll consecutive adults complaining of TMDs presented to the Department of Biomedical and Neuromotor Sciences of the University of Bologna will be considered eligible. Inclusion criteria shall be based on the presence of myogenous TMDs, as diagnosed through clinical examination in reference to the international diagnostic criteria of TMDs. Randomisation, concealed allocation, blinded assessment and intention-to-treat analysis will be employed. The splint therapy will consist of the use of the splint every night and concurrent delivery of an educational programme; the protocol shall have a duration of three consecutive months. The combined musculoskeletal physiotherapy, splint therapy and education will additionally consist of manual therapy techniques and exercise; such protocol shall consist of a duration of three consecutive months, inclusive of 10 sessions for the enhanced elements. All outcome measures will be collected at baseline, after treatment and at a 6 months follow-up.Ethics and disseminationEthical approval has been obtained from the Independent Ethic Committee in Clinical Research of AUSL Bologna-Italy (47/2018/SPER/AUSLBO). Pursuant to applicable rules,we will obtain informed consent from each participant and collect data anonymously to maintain privacy. Results will be disseminated to clinicians and researchers through peer-reviewed publications and conferences.Trial registration numberNCT03726060
Neurosurgeons’ experiences of conducting and disseminating clinical research in low- and middle-income countries: a qualitative study protocol
Authors: Whiffin Charlotte J , Smith Brandon G , Esene Ignatius N , Karekezi Claire , Bashford Tom , Khan Muhammad Mukhtar , Fontoura Solla Davi J , Hutchinson Peter J , Kolias Angelos 
Published: August 2020

IntroductionLow-income and middle-income countries (LMICs) face the greatest burden of neurotrauma. However, most of the research published in scientific journals originates from high-income countries, suggesting those in LMICs are either not engaging in research or are not publishing it. Evidence originating in high-income countries may not be generalisable to LMICs; therefore, it is important to nurture research capacity in LMICs so that a relevant evidence base can be developed. However, little is published about specific challenges or contextual issues relevant to increasing research activity of neurosurgeons in LMICs. Therefore, the aim of this study was to understand neurosurgeons’ experiences of, aspirations for and ability to conduct and disseminate clinical research in LMICs.Methods and analysisThis is a pragmatic qualitative study situated within the naturalistic paradigm using focus groups and interviews with a purposive sample of neurosurgeons from LMICs. First, we will conduct asynchronous online focus groups with 36 neurosurgeons to broadly explore issues relevant to the study aim. Second, we will select 20 participants for follow-up semistructured interviews to explore concepts in more depth and detail than could be achieved in the focus group. Interviews will be audio-recorded and transcribed verbatim. A thematic analysis will be conducted following Braun and Clarke’s six stages and will be supported by NVIVO software.Ethics and disseminationThe University of Cambridge Psychology Research Ethics Committee reviewed this study and provided a favourable opinion in January 2020 (REF PRE.2020.006). Participants will provide informed consent, be able to withdraw at any time and will have their contributions kept confidential. The findings of the study will be shared with relevant stakeholders and disseminated in conference presentations and journal publications.
Protocol for systematic review and meta-analysis: impact of statins as immune-modulatory agents on inflammatory markers in adults with chronic diseases
Authors: Sabeel Solima , Motaung Bongani , Ozturk Mumin , Mukasa Sandra , Kengne Andre Pascal , Blom Dirk , Sliwa Karen , Nepolo Emmanuel , Günther Gunar , Wilkinson Robert J. , Schacht Claudia , Thienemann Friedrich , Guler Reto 
Published: August 2020

IntroductionStatins, also known as 3-hydroxy-3-methylglutaryl coenzyme-A (HMG-CoA) reductase inhibitors, are lipid-lowering agents that are central in preventing or reducing the complications of atherosclerotic cardiovascular disease. Because statins have anti-inflammatory properties, there is considerable interest in their therapeutic potential in other chronic inflammatory conditions. We aim to identify the statin with the greatest ability to reduce systemic inflammation, independent of the underlying disease entity.Methods and analysisWe aim to conduct a comprehensive search of published and peer-reviewed randomised controlled clinical trials, with at least one intervention arm of a Food & Drug Administration-licensed or European Medicines Agency-licensed statin and a minimum treatment duration of 12 weeks. Our objective is to investigate the effect of statins (atorvastatin, fluvastatin, pitavastatin, pravastatin, rosuvastatin, simvastatin) on lipid profile, particularly, cholesterol low-density lipoprotein and inflammation markers such as high-sensitive C reactive protein (hsCRP), CRP, tumour necrosis factor alpha (TNF-α), interleukin-1β (IL-1β), IL-6, IL-8, soluble cluster of differentiation 14 (sCD14) or sCD16 in adults, published in the last 20 years (between January 1999 and December 2019). We aim to identify the most potent statin to reduce systemic inflammation and optimal dosing. The following databases will be searched: Medline, Scopus, Web of Science and Cochrane Library of Systematic Reviews. The risk of bias of included studies will be assessed by Cochrane Risk of Bias Tool and Quality Assessment Tool for Quantitative Studies. The quality of studies will be assessed, to show uncertainty, by the Jadad Score. If sufficient evidence is identified, a meta-analysis will be conducted with risk ratios or ORs with 95% CIs in addition to mean differences.Ethics and disseminationEthics approval is not required as no primary data will be collected. Results will be presented at conferences and published in a peer-reviewed journal.PROSPERO registration numberCRD42020169919
‘Too male, too pale, too stale’: a qualitative exploration of student experiences of gender bias within medical education
Authors: Brown Megan E L , Hunt George E G , Hughes Ffion , Finn Gabrielle M 
Published: August 2020

ObjectiveTo explore medical student perceptions and experiences of gender bias within medical education.SettingGender bias—‘prejudiced actions or thoughts based on the perception that women are not equal to men’—is a widespread issue. Within medicine, the pay gap, under-representation of women in senior roles and sexual harassment are among the most concerning issues demonstrating its presence and impact. While research investigating experiences of clinicians is gaining traction, investigation of medical students’ experiences is lacking. This qualitative study analyses medical students’ experiences of gender bias within their education to discern any patterns to this bias. Illuminating the current state of medical education gender bias will hopefully highlight areas in which student experience could be improved. Constructivist thematic analysis was used to analyse data, informed by William’s patterns of gender bias, intersectional feminism and communities of practice theory.ParticipantsThirty-two medical students from multiple UK medical schools participated in individual interviews. Nine faculty members were also interviewed to triangulate data.ResultsGender bias has an overt presence during medical student education, manifesting in line with William’s patterns of bias, impacting career aspirations. Physical environments serve to manifest organisational values, sending implicit messages regarding who is most welcome—currently, this imagery remains ‘too male, too pale…too stale’. Existing gender initiatives require careful scrutiny, as this work identifies the superficial application of positive action, and a failure to affect meaningful change.ConclusionsDespite progress having been made regarding overt gender discrimination, implicit bias persists, with existing positive action inadequate in promoting the advancement of women. Institutions should mandate participation in implicit bias education programmes for all staff and must strive to revise the imagery within physical environments to better represent society. Gender initiatives, like Athena Scientific Women’s Academic Network, also require large-scale evaluation regarding their impact, which this work found to be lacking.