bluuebunny/crossref_metadata_2025_split huggingface dataset:
Atlases of variation for elective surgery to tackle wasteful care
Authors: Piso B , Buhmann V 
Published: November 2019

Abstract

Background
In 2017, the OECD suggested robust information systems as one of five measures to tackle wasteful care. Atlases of variation identify variations that may not be medically justified. The aim of this study was twofold: 1. to identify atlases that target variations in the provision of elective surgery and 2. to analyse the interventions that have been addressed.

Methods
We conducted an online search for atlases of variation on websites and by a selective literature search in PubMed. When necessary, we contacted public health institutes to retrieve further information. We included online and/or paper-based atlases that analysed data on elective surgery. Other atlases (e.g., epidemiological) were excluded. We transferred basic (e.g., on country, language and methods) and specific information on analysed interventions into a predefined data extraction scheme.

Results
We identified 12 international atlases that fulfilled our inclusion criteria (2 from Germany, 1 from Belgium, France, Great Britain, Norway, The Netherlands, Switzerland, Spain, Australia, New Zealand and the US). In addition to reports/factsheets, 9 atlases provide additional interactive online applications. In total, about 70 different surgical interventions have been analysed, most often the following: Interventions to treat diseases of the musculoskeletal system (11 atlases: e.g.; knee (9), hip (7) and spinal (4) surgery), diseases of the digestive system (9 atlases: e.g., appendectomy (6), cholecystectomy (6), bariatric surgery (4)), diseases of the genitourinary system (8 atlases: e.g., prostatectomy (6), hysterectomy (5)), caesarean sections (8 atlases).

Conclusions
Despite the large number of interventions, their pattern of analyses might point out known problem areas across countries. Atlases of variations cannot solve the problem of inappropriate care, but help prioritise areas of actions with the greatest need and the best chances to improve the quality of care.

Key messages
Atlases are commonly used to provide publicly available information on variations in elective surgery. The analysis of interventions across countries provides information on potentially most relevant areas.
A systematic review of factors influencing pregnant women’s future vaccination choices
Authors: Rosso A , Massimi A , Adamo G , Baccolini V , Pitini E , Vacchio M R , Marzuillo C , De Vito C , Villari P 
Published: November 2019

Abstract

Background
Over the last years, vaccine hesitancy has been increasing globally, leading to a decrease in vaccination coverage in several Countries, mostly in Europe. Several systematic reviews were conducted to assess the determinants of hesitancy and of vaccination choices, but none of them focused on pregnant women, which would represent an ideal population to promote correct information on vaccines.

Methods
We conducted a systematic review of studies assessing knowledge and attitudes on paediatric vaccinations, vaccination choices and their determinants among pregnant women. We searched Medline, Scopus and Web of Science, adapting search terms to the different databases, following PRISMA Statement criteria. No time limits were set.

Results
A total of 5,309 records were retrieved. After duplicates removal and title/abstract selection, 15 full texts were included in the narrative synthesis. Most studies (14/15) were quantitative surveys, 2 focused only on specific vaccines (rotavirus and HPV), 4 studies were conducted in European countries (Germany and Italy). The main factors associated with vaccine hesitancy or refusal were the fear of side effects, in particular for the most recent vaccines, the perception of a greater importance of natural immunity and a low perception of utility of vaccines, the lack of trust in health professionals, having obtained information on vaccines not from a doctor, primiparity and a low level of education (for these two last factors, with inconsistent results between studies).

Conclusions
Available evidence shows that the perceived risks and importance of vaccinations and the information received during pregnancy can influence vaccination choices of future mothers, and that the determinants of hesitancy may vary in different contexts. Pregnant women represent a key population for the implementation of interventions aimed at increasing knowledge and acceptance of vaccinations, which should be based on an analysis of the specific context.

Key messages
The perceived risks and importance of vaccinations and the information received during pregnancy can influence vaccination choices of future mothers. Interventions aimed at increasing knowledge and acceptance of vaccinations should be based on an analysis of the specific context.
Comorbidity associated with Severe Mental illness (The APNA study)
Authors: Aguinaga-Ontoso I , Brugos-Larumbe A , Guillén-Aguinaga S 
Published: November 2019

Abstract

People with severe mental illness (SMI) that includes bipolar disorder or schizophrenia die on average 10-20 years sooner than the general population. Poor mental health can negatively affect quality of life and life expectancy more so than having multiple physical illnesses. The division between health services treating mental and physical health often means that patients suffering from both physical and mental conditions are at particular risk of poor care. Although more than 50 million people in the EU suffer multiple from more than one chronic disease, it is not well know the comorbidity associated with severe mental illness.

Methods
The study is a cross-sectional study within the APNA Study (Navarre primary health care prospective cohort) that included 470942 people over 18 years old in Navarre (Spain). Age, sex, chronic diseases diagnosis and SMI) that includes (bipolar disorder or schizophrenia were extracted. Lineal regression models for the number of chronic disease were computed. Logistic regression adjusted by sex and age, was computed for each chronic disease.

Results
Adjusting by age and sex, people with SMI have 1.47 (95% CI 1.44-1.50) more chronic diseases than people without SMI. Adjusting by age and sex, persons with SMI have a higher prevalence of comorbidity: OR = 13.29 (95% CI = 12.27-14.36). Patients with SMI have a higher prevalence of asthma OR = 1.41 (95% CI 1.21-1.64), COPD OR = 2.30 (95% CI 2.51-3.35), Type 2 DM OR = 1.50 (95% CI 1.31-1.70) hyperthyroidism OR = 1.63 (95% CI 1.26-2.10), Chronic kidney disease OR = 1.,43 (95% IC 1.10-1.88), Obesity OR = 1.68 (95% CI 1.47-1,92) and Hypothyroidism OR 1.63 (95% IC 1.43-1,85).

Conclusions
Patients with severe mental illness have a higher prevalence of comorbidity than the general population with an OR of 13.29. Health service should screen patient with severe mental illness for chronic diseases due to their high prevalence and mortality.

Key messages
Patients with severe mental illness die on average 10-20 years sooner than the general population this could be to a higher prevalence of comorbidity. Health services should screen patients with severe mental illness for chronic diseases due to their higher prevalence.
Organising preventive care and support networks: a need for citizen-centred service delivery
Authors: Fluit M , Reindersma T S , Broekhuis H , Bortolotti T 
Published: November 2019

Abstract

Background
There is a growing interest in providing preventive care and support services at a district level (Goodwin, 2014; Kernaghan, 2005) in a citizen-centred way, i.e., accessible, delivered seamlessly, and complying with citizens’ needs and capabilities (King & Meyer, 2006). Currently, those citizens who might need it most are not reached and services provided suffer from a lack of coherence (Kodner, 2009; Stange, 2009). This study aims to examine how local authorities organise more accessible and integrated preventive care and support services against reasonable costs at a district level.

Methods
An exploratory multiple case study approach was adopted. The unit of analysis was the organisation of the preventive care and support delivery process. Policy documents were analysed and 13 semi-structured interviews were conducted with professionals in four Dutch districts.

Results
Our findings show that three stages of the delivery process should be distinguished, as within each stage a set of specific key design decisions were taken aiming to contribute to easy access and integrated service delivery. These three stages are (a) entrance, (b) exploration of needs and capabilities, and (c) the development of care and support networks. Each case showed a unique constellation of choices on these key decisions, and explicated their motives for organising it in this way. Examples of these key decisions are: the number and location of access points, the number of different professionals involved (indicating the level of (de)coupled process), and the type of professionals involved.

Conclusions
The results show that different stages and design decisions could be identified across the four cases. These, as well as clear interfaces between the stages, can be regarded as a constellation of choices through which citizen-centred delivery could be enhanced.

Key messages
Importance of design decisions in citizen-centred delivery. Focus on multi-faceted issue of organising integration within the different stages.
DNA stable isotope probing reveals contrasted activity and phenanthrene-degrading bacteria identity in a gradient of anthropized soils
Authors: Lemmel Florian , Maunoury-Danger Florence , Leyval Corinne , Cébron Aurélie 
Published: November 2019

ABSTRACTPolycyclic aromatic hydrocarbons (PAHs) are ubiquitous soil organic pollutants. Although PAH-degrading bacteria are present in almost all soils, their selection and enrichment have been shown in historically high PAH contaminated soils. We can wonder if the effectiveness of PAH biodegradation and the PAH-degrading bacterial diversity differ among soils. The stable isotope probing (SIP) technique with 13C-phenanthrene (PHE) as a model PAH was used to: (i) compare for the first time a range of 10 soils with various PAH contamination levels, (ii) determine their PHE-degradation efficiency and (iii) identify the active PHE-degraders using 16S rRNA gene amplicon sequencing from 13C-labeled DNA. Surprisingly, the PHE degradation rate was not directly correlated to the initial level of total PAHs and phenanthrene in the soils, but was mostly explained by the initial abundance and richness of soil bacterial communities. A large diversity of PAH-degrading bacteria was identified for seven of the soils, with differences among soils. In the soils where the PHE degradation activities were the higher, Mycobacterium species were always the dominant active PHE degraders. A positive correlation between PHE-degradation level and the diversity of active PHE-degraders (Shannon index) supported the hypothesis that cooperation between strains led to a more efficient PAH degradation.
Troubled Times: Disability, Sexuality and Futurity in Mozambican, Ugandan and Zimbabwean Political Cultures
Authors: Jones Eleanor K 
Published: November 2019

Abstract
Since the earliest days of European expansionism, Africa has held a dual place in the Western imaginary, cast as a space of futurelessness even as white futurities were predicated on its exploitation. Appropriations of the future have persisted post-liberation, revealed in the divestment of futurity from bodies marked as queer or disabled. Drawing on historical moments and literary texts from Mozambique, Uganda and Zimbabwe, and on insights from queer theory, critical race theory and disability studies, I seek to demonstrate that the logics of white supremacy can be seen at work in these mechanisms of exclusion, even where whiteness itself is displaced – but that literary invocation of queerness and disability can thus be used to mobilize critique of this continuity. In centring the circumscription of futurity at the heart of colonialism, heteronormativity and ableism, then, I underscore the critical value of reading these as reciprocal and inextricable systems of power.
Relining the garbage can of organizational decision-making: modeling the arrival of problems and solutions as queues
Authors: Glynn Peter W , Greve Henrich R , Rao Hayagreeva 
Published: November 2019

Abstract
The garbage can account of organizations where problems, solutions, and people chase each other is often invoked but rarely studied since its publication 44 years ago. It has been critiqued for being a metaphor rather than a model, and offering a deterministic rather than stochastic account. We reline the garbage can model of organizational decision-making by modeling the arrival of problems, people, and solutions as queues that get matched randomly. We show that queuing models allow us to understand the effect of using either experts, supervisor approval, teams, and deviation from supervision on problem resolution and oversight. Our approach shows that manager approval increased the standard deviation of problem resolution, whereas queues are processed faster and have lower variance when there is oversight or teamwork, or when manager approval is bypassed due to independent action by problem solvers. It also shows the costs of using an organizational hierarchy to address problems with different levels of difficulty, or specialization to address a mixture of fundamentally different problems. Thus, a stochastic garbage can model provides insights into why organizations make many decisions but often fail to resolve problems!
Outcome of video-assisted thoracoscopic implantation of epicardial left ventricular leads with visual targeting for cardiac resynchronization therapy
Authors: Stauber Annina , Tanner Hildegard , Noti Fabian , Roten Laurent , Seiler Jens , Lam Anna , Medeiros-Domingo Argelia , Servatius Helge , Tran Van Nam , Carrel Thierry , Weber Alberto 
Published: November 2019

Abstract

OBJECTIVES
Our goal was to analyse the implantation and outcome of thoracoscopic epicardial leads after a failed endovascular approach or follow-up (FU) complications after endovascular implantation.

METHODS
We reviewed the records of patients with failed endovascular left ventricular (LV) lead placement or complications during FU, who were subsequently referred to cardiac surgeons for treatment with thoracoscopic LV lead implantation. We analysed the reasons for endovascular failure; the indications for the surgical procedures; and the clinical, echocardiographic and device FU results.

RESULTS
Between 2010 and 2013, a total of 23 patients were included. Among them, 17 of the patients had no previous cardiothoracic surgery, 13 (76%) had successful video-assisted thoracoscopy (VAT) LV lead implantation, 3 (18%) had a conversion to thoracotomy and 1 (6%) failed. Of the 6 patients with prior cardiothoracic surgery, 2 (33%) had VAT only, 3 (50%) had primary thoracotomies and 1 (17%) had a conversion. Two major complications occurred. The reasons for LV endovascular lead failure were subclavian vein occlusion (n = 2), implant failure (n = 13) and complications during the FU period (n = 8). FU information was available for 20 patients: 17 (85%) had improved symptoms. The median FU period was 33 months. A total of 78% of patients were in New York Heart Association (NYHA) functional class III–IV before the operation; 30% were in NYHA functional class III–IV at the last FU examination. The left ventricular ejection fraction increased from 25% before surgery to 31% at the last FU examination. Overall, sensing and pacing threshold values remained stable over time. In 1 patient, lead revision was necessary due to an increase in the pacing threshold.

CONCLUSIONS
VAT implantation of LV leads had an excellent response rate with an improvement in NYHA functional class and left ventricular ejection fraction. The lead measurements were mainly stable over time.
Serratus plane block for video-assisted thoracoscopic surgery major lung resection: a randomized controlled trial
Authors: Viti Andrea , Bertoglio Pietro , Zamperini Massimo , Tubaro Alessandro , Menestrina Nicola , Bonadiman Silvia , Avesani Renato , Guerriero Massimo , Terzi Alberto 
Published: November 2019

Abstract

OBJECTIVES
The aim of this study was to evaluate the impact of 2 different analgesic approaches on pain, postoperative rehabilitation exercises and rescue analgesics of 2 groups of patients undergoing video-assisted thoracoscopic surgery (VATS) major lung resection for cancer.

METHODS
A total of 94 patients undergoing a VATS major lung resection were randomly allocated to 2 groups: the control group received intravenous and oral (i.e. systemic) analgesics while the intervention group received systemic analgesics plus pre-emptive serratus plane block. Pain perception was recorded until drainage removal or until 2 p.m. of postoperative day (POD) 3. In particular, the primary end point was defined as the peak pain perception on POD 1 (in the time frame between 6 a.m. and 2 p.m.). Secondary end points were the number of forced inspiration manoeuvers during rehabilitative incentive spirometry on POD 1 and 2 and the overall number of rescue analgesics requested by patients.

RESULTS
Serratus plane block provided a better pain control between 6 a.m. and 2 p.m. of POD 1 (Numeric Rating Scale 1.7 vs 3.5; P &lt; 0.001). Patients in the intervention group performed more forced inspiration manoeuvers at a mean higher volume during incentive spirometry (8.9 vs 7, P &lt; 0.001, and 1010 vs 865 ml, P = 0.02). They required fewer rescue doses of analgesics (0.57 vs 1.1; P = 0.008).

CONCLUSIONS
Serratus plane block provided a better pain control, entailing a better performance during postoperative rehabilitation exercises in terms of duration and quality of incentive spirometry. It diminished the patient’s need for rescue analgesics during the early postoperative period.

Clinical trial registration number
NCT03134729.
Epidemiology and management of primary spontaneous pneumothorax: a systematic review
Authors: Mendogni Paolo , Vannucci Jacopo , Ghisalberti Marco , Anile Marco , Aramini Beatrice , Congedo Maria Teresa , Nosotti Mario , Bertolaccini Luca ,   Collaborators of the Pneumothorax Working Group, on behalf of the Italian Society for Thoracic Surgery (endorsed by the Italian Ministry of Health) Collaborators of the Pneumothorax Working Group, D’Ambrosio Ambra Enrica , De Vico Andrea , Guerrera Francesco , Imbriglio Giovanna , Pardolesi Alessandro , Schiavon Marco , Russo Emanuele 
Published: November 2019

Abstract

Primary spontaneous pneumothorax (PSP) is one of the most common thoracic diseases affecting adolescents and young adults. Despite the high incidence of PSP and the availability of several international guidelines for its diagnosis and treatment, a significant behavioural heterogeneity can be found among those management recommendations. A working group of the Italian Society of Thoracic Surgery summarized the best evidence available on PSP management with the methodological tool of a systematic review assessing the quality of previously published guidelines with the Appraisal of Guidelines for Research and Evaluation (AGREE) II. Concerning PSP physiopathology, the literature seems to be equally divided between those who support the hypothesis of a direct correlation between changes in atmospheric pressure and temperature and the incidence of PSP, so it is not currently possible to confirm or reject this theory with reasonable certainty. Regarding the choice between conservative treatment and chest drainage in the first episode, there is no evidence on whether one option is superior to the other. Video-assisted thoracic surgery represents the most common and preferred surgical approach. A primary surgical approach to patients with their first PSP seems to guarantee a lower recurrence rate than that of a primary approach consisting of a chest drainage positioning; conversely, the percentage of futile surgical interventions that would entail this aggressive attitude must be carefully evaluated. Surgical pleurodesis is recommended and frequently performed to limit recurrences; talc poudrage offers efficient pleurodesis, but a considerable number of surgeons are concerned about administering this inert material to young patients.

Clinical trial registration number
International Prospective Register of Systematic Reviews (PROSPERO): CRD42018084247.
Benchmarking as a quality of care improvement tool for patients with ST-elevation myocardial infarction: an NCDR ACTION Registry experience in Latin America
Authors: Caixeta Adriano , Franken Marcelo , Katz Marcelo , Lemos Pedro A , Gomes Ivanise , Yokota Paula Ko , V Alliegro PatrÍcia , Pesaro Eduardo E , Neto Miguel Cendoroglo , Valentine C Michael , Brindis Ralph G , Makdisse Marcia 
Published: November 2019

AbstractObjectiveWe aim to examine the effect of benchmarking on quality-of-care metrics in patients presenting with ST-elevation myocardial infarction (STEMI) through the implementation of the American College of Cardiology (ACC) National Cardiovascular Data Registry (NCDR) ACTION Registry.DesignFrom January 2005 to December 2017, 712 patients underwent primary percutaneous coronary intervention PCI—499 before NCDR ACTION Registry implementation (prior to 2013) and 213 after implementation.SettingSTEMI.Participants712 patients.Intervention(s)Primary PCI.Main Outcome Measure(s)We examined hospital performance for the quality indicators in processes and outcomes of the management of patients presenting with STEMI. Outcome measures include door-to-balloon time (DBT), antiplatelet therapy and anti-ischemic drugs prescribed at discharge from pre-NCDR ACTION Registry to post-implementation.ResultsThere was improvement in DBT, decreasing from 94 min in 2012 (before NCDR adoption) to reach a median of 47 min in 2017 (Ptrend &lt; 0.001). The percentage of cases with the optimal DBT of &lt; 90 min increased from 55.8% before to 90.1% after the implementation of the NCDR ACTION Registry (Ptrend &lt; 0.001). The rate of aspirin (90.3–100%, P &lt; 0.001), P2Y12 inhibitor (70.1–78.4%, P = 0.02), beta-blocker (76.8–100%, P &lt; 0.001) and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (60.1–99.5%, P &lt; 0.001) prescribed at discharge increased from pre-NCDR ACTION Registry to post-implementation. Adjusted mortality before and after NCDR ACTION Registry implementation showed significant change (from 9.04 to 5.92%; P = 0.027).ConclusionsThe introduction of the ACC NCDR ACTION Registry led to incremental gains in the quality in STEMI management through the benchmarking of process of care and clinical outcomes, achieving reduced DBT, improving guideline-directed medication adherence and increasing patient safety, treatment efficacy and survival.