bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of isolation on hospitalised patients who are infectious: systematic review with meta-analysis
Authors: Purssell Edward , Gould Dinah , Chudleigh Jane 
Published: February 2020

ObjectiveTo systematically review the literature exploring the impact of isolation on hospitalised patients who are infectious: psychological and non-psychological outcomes.DesignSystematic review with meta-analysis.Data sourcesEmbase, Medline and PsycINFO were searched from inception until December 2018. Reference lists and Google Scholar were also handsearched.ResultsTwenty-six papers published from database inception to December 2018 were reviewed. A wide range of psychological and non-psychological outcomes were reported. There was a marked trend for isolated patients to exhibit higher levels of depression, the pooled standardised mean difference being 1.28 (95% CI 0.47 to 2.09) and anxiety 1.45 (95% CI 0.56 to 2.34), although both had high levels of heterogeneity, and worse outcomes for a range of care-related factors but with significant variation.ConclusionThe review indicates that isolation to contain the risk of infection has negative consequences for segregated patients. Although strength of the evidence is weak, comprising primarily single-centre convenience samples, consistency of the effects may strengthen this conclusion. More research needs to be undertaken to examine this relationship and develop and test interventions to reduce the negative effects of isolation.
Problem and non-problem gamblers: a cross-sectional clustering study by gambling characteristics
Authors: Guillou Landreat Morgane , Chereau Boudet Isabelle , Perrot Bastien , Romo Lucia , Codina Irene , Magalon David , Fatseas Melina , Luquiens Amandine , Brousse Georges , Challet-Bouju Gaëlle , Grall-Bronnec Marie 
Published: February 2020

ObjectivesGambling characteristics are factors that could influence problem gambling development. The aim of this study was to identify a typology of gamblers to frame risky behaviour based on gambling characteristics (age of initiation/of problem gambling, type of gambling: pure chance/chance with pseudoskills/chance with elements of skill, gambling online/offline, amount wagered monthly) and to investigate clinical factors associated with these different profiles in a large representative sample of gamblers.Design and settingThe study is a cross-sectional analysis to the baseline data of the french JEU cohort study (study protocol : Challet-Boujuet al, 2014). Recruitment (April 2009 to September 2011) involved clinicians and researchers from seven institutions that offer care for or conduct research on problem gamblers (PG). Participants were recruited in gambling places, and in care centres. Only participants who reported gambling in the previous year between 18 and 65 years old were included.Participants gave their written informed consent, it was approved by the French Research Ethics Committee.ParticipantsThe participants were 628 gamblers : 256 non-problem gamblers (NPG), 169 problem gamblers without treatment (PGWT) and 203 problem gamblers seeking treatment (PGST).ResultsSix clustering models were tested, the one with three clusters displayed a lower classification error rate (7.92%) and was better suited to clinical interpretation : ‘Early Onset and Short Course’ (47.5%), ‘Early Onset and Long Course’ (35%) and ‘Late Onset and Short Course’ (17.5%). Gambling characteristics differed significantly between the three clusters.ConclusionsWe defined clusters through the analysis of gambling variables, easy to identify, by psychiatrists or by physicians in primary care. Simple screening concerning these gambling characteristics could be constructed to prevent and to help PG identification. It is important to consider gambling characteristics : policy measures targeting gambling characteristics may reduce the risk of PG or minimise harm from gambling.Trial registration numberNCT01207674(ClinicalTrials.gov); Results.
Community-based doula support for migrant women during labour and birth: study protocol for a randomised controlled trial in Stockholm, Sweden (NCT03461640)
Authors: Schytt Erica , Wahlberg Anna , Eltayb Amani , Small Rhonda , Tsekhmestruk Nataliia , Lindgren Helena 
Published: February 2020

IntroductionMigrant women consistently rate their care during labour and birth more negatively than non-migrant women, due to communication difficulties, lack of familiarity with how care is provided, and discrimination and prejudicial staff attitudes. They also report being left alone, feeling fearful, unsafe and unsupported, and have poorer birth outcomes than non-migrant women. Community-based doulas (CBDs) are bilingual women from migrant communities who are trained in childbirth and labour support, and who facilitate communication between woman-partner-staff during childbirth. This study protocol describes the design, rationale and methods of a randomised controlled trial that aims to evaluate the effectiveness of CBD support for improving the intrapartum care experiences and postnatal well-being of migrant women giving birth in Sweden.Methods and analysisA randomised controlled trial. From six antenatal care clinics in Stockholm, Sweden, we aim to recruit 200 pregnant Somali, Arabic, Polish, Russian and Tigrinya-speaking women who cannot communicate fluently in Swedish, are 18 years or older and with no contraindications for vaginal birth. In addition to standard labour support, women are randomised to CBD support (n=100) or no such support during labour (n=100). Trained CBDs meet with women once or twice before the birth, provide emotional, physical and communication support to women throughout labour and birth in hospital, and then meet with women once or twice after the birth. Women’s ratings of the intrapartum care experiences and postnatal well-being are assessed at 6–8 weeks after the birth using selected questions from the Migrant Friendly Maternity Care Questionnaire and by the Edinburgh Postnatal Depression Scale. The intervention group will be compared with the control group using intention-to-treat analyses. ORs and 95% CIs will be estimated and adjustments made if key participant characteristics differ between trial arms.Ethics and disseminationThe study was approved by the Regional Ethical Review Board in Stockholm (approval number: 2018/12 - 31/2).Trial registration numberNCT03461640; Pre-results.
Use of the nominal group technique to identify UK stakeholder views of the measures and domains used in the assessment of therapeutic exercise adherence for patients with musculoskeletal disorders
Authors: Mallett Ross , McLean Sionnadh , Holden Melanie A , Potia Tanzila , Gee Melanie , Haywood Kirstie 
Published: February 2020

ObjectivesThe objective was to the undertake nominal group technique (NGT) to evaluate current exercise adherence measures and isolated domains to develop stakeholder consensus on the domains to include in the measurement of therapeutic exercise adherence for patients with musculoskeletal disorders.DesignA 1-day NGT workshop was convened. Six exercise adherence measures were presented to the group that were identified in our recent systematic review. Discussions considered these measures and isolated domains of exercise adherence. Following discussions, consensus voting identified stakeholder agreement on the suitability of the six offered adherence measures and the inclusion of isolated domains of exercise adherence in future measurement.SettingOne stakeholder NGT workshop held in Sheffield, UK.ParticipantsKey stakeholders from the UK were invited to participate from four identified populations. 14 participants represented patients, clinicians, researchers and service managers.ResultsAll six exercise adherence measures were deemed not appropriate for use in clinical research or routine practice with no measure reaching 70% group agreement for suitability, relevance, acceptability or appropriateness. Three measures were deemed feasible to use in clinical practice. 25 constructs of exercise adherence did reach consensus threshold and were supported to be included as domains in the future measurement of exercise adherence.ConclusionA mixed UK-based stakeholder group felt these six measures of exercise adherence were unacceptable. Differences in opinion within the stakeholder group highlighted the lack of consensus as to what should be measured, the type of assessment that is required and whose perspective should be sought when assessing exercise adherence. Previously unused domains may be needed alongside current ones, from both a clinician's and patient’s perspective, to gain understanding and to inform future measurement development. Further conceptualisation of exercise adherence is required from similar mixed stakeholder groups in various socioeconomic and cultural populations.
‘I’ve always done what I was told by the medical people’: a qualitative study of the reasons why older adults attend multifactorial falls risk assessments mapped to the Theoretical Domains Framework
Authors: Racine Emmy , Soye Anna , Barry Patrick , Cronin Finola , Hosford Orla , Moriarty Eileen , O’Connor Kieran A , Turvey Spencer , Timmons Suzanne , Kearney Patricia M , McHugh Sheena M 
Published: February 2020

ObjectivesMultifactorial falls risk assessments reduce the rate of falls in older people and are recommended by international guidelines. Despite their effectiveness, their potential impact is often constrained by barriers to implementation. Attendance is an issue. The aim of this study was to explore why older people attend community-based multifactorial falls risk assessment clinics, and to map these reasons to a theoretical framework.DesignThis is a qualitative study. Semi-structured interviews were conducted and analysed thematically. Each theme and subtheme were then mapped onto the Theoretical Domains Framework (TDF) to identify the determinants of behaviour.ParticipantsOlder adults (aged 60 and over) who attended community-based multifactorial falls risk assessments.ResultsSixteen interviews were conducted. Three main themes explained participants’ reasons for attending the multifactorial risk assessment; being that ‘type of person’, being ‘linked in’ with health and community services and having ‘strong social support’. Six other themes were identified, but these themes were not as prominent during interviews. These were knowing what to expect, being physically able, having confidence in and being positive towards health services, imagining the benefits given previous positive experiences, determination to maintain or regain independence, and being ‘crippled’ by the fear of falling. These themes mapped on to nine TDF domains: ‘knowledge’, ‘skills’, ‘social role and identity’, ‘optimism’, ‘beliefs about consequences’, ‘goals’, ‘environmental context and resources’, ‘social influences’ and ‘emotion’. There were five TDF domains that were not relevant to the reasons for attending.ConclusionsThese findings provide theoretically based factors that influence attendance which can be used to inform the development of interventions to improve attendance to falls prevention programmes.
Evaluation of clarity of the STOPP/START criteria for clinical applicability in prescribing for older people: a quality appraisal study
Authors: Sallevelt Bastiaan Theodoor Gerard Marie , Huibers Corlina Johanna Alida , Knol Wilma , Puijenbroek Eugene van , Egberts Toine , Wilting Ingeborg 
Published: February 2020

ObjectivesAppropriate prescribing in older people continues to be challenging. Studies still report a high prevalence of inappropriate prescribing in older people. To reduce the problem of underprescribing and overprescribing in this population, explicit drug optimisation tools like Screening Tool of Older Persons’ potentially inappropriate Prescriptions/Screening Tool to Alert to Right Treatment (STOPP/START) have been developed. The aim of this study was to evaluate the clinical applicability of STOPP/START criteria in daily patient care by assessing the clarity of singular criteria.DesignQuality appraisal study.MethodsFor each of the 114 STOPP/START criteria V.2, elements describing the action (what/howto do), condition (whento do) and explanation (whyto do) were identified. Next, the clarity of these three elements was quantified on a 7-point Likert scale using tools provided by the Appraisal of Guidelines for Research and Evaluation (AGREE) Consortium.Primary and secondary outcomesThe primary outcome measure was the clarity rating per element, categorised into high (>67.7%), moderate (33.3%–67.7%) or low (<33.3%). Secondary, factors that positively or negatively affected clarity most were identified. Additionally, the nature of the conditions was further classified into five descriptive components: disease, sign, symptom, laboratory finding and medication.ResultsSTOPP recommendations had an average clarity rating of 64%, 60% and 69% for actions, conditions and explanations, respectively. The average clarity rating in START recommendations was 60% and 57% for actions and conditions, respectively. There were no statements present to substantiate the prescription of potential omissions for the 34 START criteria.ConclusionsOur results show that the clarity of the STOPP/START criteria can be improved. For future development of explicit drug optimisation tools, such as STOPP/START, our findings identified facilitators (high clarity) and barriers (low clarity) that can be used to improve the clarity of clinical practice guidelines on a language level and therefore enhance clinical applicability.
Pramipexole in peritoneal dialysis patients with restless legs syndrome (RLS): a protocol for a multicentre double-blind randomised controlled trial
Authors: Ma Tian-tian , Yang Zhikai , Zhu Sainan , Zhao Jing-hong , Li Yi , Sun Fu-yun , Zhao Nan , Xiong Zu-ying , Xiong Zi-bo , Dong Jie 
Published: February 2020

IntroductionRestless legs syndrome (RLS) is a common neurological sensorimotor disorder among patients with end stage renal disease. This clinical trial aimed to provide evidence on the efficacy and safety of pramipexole in patients with uremic RLS receiving peritoneal dialysis (PD).Methods and analysisThis is a 12-week, multicentre, randomised, double-blind, placebo-controlled clinical trial. In total, 104 patients with uremic RLS receiving PD will be enrolled from four hospitals and randomly assigned in a 1:1 ratio to either placebo or pramipexole. We will determine the efficacy of pramipexole in the improvement of International RLS Study Group Rating Scale as the primary outcome, while responder rates for other RLS scales at week 12, change from baseline to week 12 for psychological status, sleep disorder and quality of life and blood pressure represent the secondary outcomes.Ethics and disseminationThe study was approved by the ethics committees of Peking University First Hospital, Xinqiao hospital of Army Medical University, Cangzhou Center Hospital and Peking University Shenzhen Hospital. The results will be disseminated in peer-reviewed journals.Trial registration numberNCT03817554
Latent tuberculosis infection screening and treatment in congregate settings (TB FREE COREA): protocol for a prospective observational study in Korea
Authors: Min Jinsoo , Kim Hyung Woo , Stagg Helen R , Lipman Marc , Rangaka Molebogeng X , Myong Jun-Pyo , Yim Hyeon Woo , Lim Jeong Uk , Lee Yunhee , Koo Hyeon-Kyoung , Lee Sung-Soon , Park Jae Seuk , Cho Kyung Sook , Kim Ju Sang 
Published: February 2020

IntroductionSouth Korea regards tuberculosis (TB) incidence in congregate settings as a serious problem. To this end, systematic latent TB infection (LTBI) diagnosis and treatment were provided to approximately 1.2 million individuals in high-risk congregate settings.Methods and analysisWe designed a prospective cohort study of individuals tested for LTBI, based on the data collected on all persons screened for LTBI as part of the 2017 congregate settings programme in South Korea. Four types of databases are kept: LTBI screening database (personal information and LTBI test results), national health information (NHI) database (socio-demographic data and comorbidities), public healthcare information system (PHIS) database, and the Korean national TB surveillance system database (TB outcomes). Information regarding LTBI treatment at private hospitals and public health centres is collected from NHI and PHIS databases, respectively. The screening data are cleaned, duplicates are removed, and, where appropriate, re-coded to analyse specific exposures and outcomes. The primary objective is to compare the number of active TB cases prevented within 2 years between participants undergoing treatment and not undergoing treatment in the LTBI screening programme in congregate settings. Cascade of care for LTBI diagnosis and treatment will be evaluated among those with a positive LTBI test result. A Cox proportional hazards model will be applied to determine the risk factors for developing active TB.Ethics and disseminationThe protocol is approved by the institutional review boards of Incheon St. Mary’s Hospital, the Catholic University of Korea. Study results will be disseminated through peer-reviewed journals and conference presentations.Trial registration numberKCT0003905
High-flow nasal oxygenation versus standard oxygenation for gastrointestinal endoscopy with sedation. The prospective multicentre randomised controlled ODEPHI study protocol
Authors: Eugene Axelle , Fromont Lucie , Auvet Adrien , Baert Olivier , Mfam Willy-Serge , Remerand Francis , Boulain Thierry , Nay Mai-Anh 
Published: February 2020

IntroductionHypoxaemia is a major complication during gastrointestinal endoscopy (GIE) procedures (upper/lower) when performed under deep sedation in the procedure room. Standard oxygen therapy (SOT) is used to prevent hypoxaemia. Data suggest that risk factors for hypoxaemia under deep sedation during GIE are obstructive sleep apnoea syndrome, a body mass index above 30 kg/m², high blood pressure, diabetes, heart disease, age over 60 years old, high American Society of Anesthesiologists physical status class and the association of upper and lower GIE. High-flow nasal oxygenation (HFNO) may potentially improve oxygenation during GIE under deep sedation. We hypothesised that HFNO could decrease the incidence of hypoxaemia in comparison with SOT.Methods and analysisThe ODEPHI (High-flow nasaloxygenation versus standardoxygenation for gastrointestinalendoscopy withsedation. The prospective multicentre randomised controlled) study is a multicentre randomised controlled trial comparing HFNO to SOT during GIE (upper and/or lower) under deep sedation administered by anaesthesiologists in the procedure room. Three hundred and eighty patients will be randomised with a 1:1 ratio in two parallel groups.The primary outcome is the occurrence of hypoxaemia, defined by a pulse oximetry measurement of peripheral capillary oxygen saturation (SpO2) below or equal to 92% during the GIE procedure. Secondary outcomes include prolonged hypoxaemia, severe hypoxaemia, need for manoeuvres to maintain upper airway patency and other adverse events.Ethics and disseminationThis study has been approved by the ethics committee (CPP Sud Est Paris V, France), and patients are included after informed consent. The results will be submitted for publication in peer-reviewed journals. As provided for by French law, patients participating in the study are informed that they have the possibility to ask the investigators, once the study is completed, to be informed of the overall results of the study. Thus, a summary of the results will be sent by post to the participants on request.Trial registration numberClinicalTrials.gov Registry (NCT03829293).
Analysing actual prices of medical products: a cross-sectional survey of Dutch hospitals
Authors: den Ambtman Anouk , Knoben Joris , van den Hurk Dana , Van Houdenhoven Mark 
Published: February 2020

ObjectivesTo assess whether there is a difference between the net prices of medical products used by Dutch hospitals and, if there is, how this difference can be explained.DesignCross-sectional self-administered electronic survey.SettingWe surveyed the prices paid for 17 commonly used medical products, such as pacemakers, gloves and stents in 38 Dutch hospitals (including general, specialised and academic hospitals) in 2017. Hospitals voluntarily and anonymously provided these data and received a personalised free benchmark tool in return. This tool provides information about the variance in prices of the medical products they buy.Participants38 out of 79 hospitals entered and completed the study.Primary and secondary outcome measuresActual price paid excluding Value Added Tax (VAT) per item, the order size per year, total spending for an assortment group and total spending for all products purchased from a specific supplier were measured.ResultsWe found large price variations for the medical products surveyed (average coefficient of variation of 71%). In general, these differences were hard to explain (average R2of 26%). Only purchasing volume (for 8 out of 17 products) was significantly associated with the net price paid by a hospital. Total spending for an assortment group (in euros with a specific supplier) and total spending (for all products in euros with a specific supplier) were not related to the net price paid.ConclusionsWe conclude that only purchasing volume is associated with lower prices paid. Total spending for an assortment group and total spending for all products purchased from a specific supplier are not. These results are in stark contrast to expectations based on economic theory. Other sources of differences in bargaining power might explain these findings. Further research might involve comparing prices across countries.
Using telemedicine to improve access, cost and quality of secondary care for people in prison in England: a hybrid type 2 implementation effectiveness study
Authors: Edge Chantal , George Julie , Black Georgia , Gallagher Michelle , Ala Aftab , Patel Shamir , Edwards Simon , Hayward Andrew 
Published: February 2020

IntroductionPeople in prison tend to experience poorer health, access to healthcare services and health outcomes than the general population. Use of video consultations (telemedicine) has been proven effective at improving the access, cost and quality of secondary care for prisoners in the USA and Australia. Implementation and use in English prison settings has been limited to date despite political drivers for change. We plan to research the implementation of a new prison-hospital telemedicine model in an English county to understand what factors drive or hinder implementation and whether the model can improve healthcare outcomes as demonstrated in other contextual settings.Methods and analysisWe will undertake a hybrid type 2 implementation effectiveness study to gather evidence on both clinical and implementation outcomes. Data collection will be guided by the theoretical constructs of Normalisation Process Theory. We will prospectively collect data through: (1) prisoner/patient focus groups, interviews and questionnaires, (2) prison healthcare, hospital and wider prison staff interviews and questionnaires, (3) routine quality improvement and service evaluation data. Up to four prisons and three hospital settings in Surrey (England) will be included in the telemedicine research, dependent on their telemedicine readiness during the study period. Prisons proposed include male and female prisoners, remand (not yet sentenced) and sentenced individuals and different security categorisations. In addition, focus groups in five telemedicine naïve prisons will provide information on patient preconceptions and concerns surrounding telemedicine.Ethics and disseminationThis study has received National Health Service Research Ethics Committee, Her Majesty’s Prison and Probation Service National Research Committee and Health Research Authority approval. Dissemination of results will take place through peer-reviewed journals, conferences and existing health and justice networks.