bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving continuity of patient care across sectors: study protocol of the process evaluation of a quasi-experimental multi-centre study regarding an admission and discharge model in Germany (VESPEERA)
Authors: Forstner Johanna , Kunz Aline , Straßner Cornelia , Uhlmann Lorenz , Kuemmel Stephanie , Szecsenyi Joachim , Wensing Michel 
Published: November 2019

IntroductionHospital stays are critical events as they often disrupt continuity of care. This process evaluation aims to describe and explore the implementation of the VESPEERA programme (Improving continuity of patient care across sectors: An admission and discharge model in general practices and hospitals, Versorgungskontinuitaet sichern: Patientenorientiertes Einweisungs- und Entlassmanagement in Hausarztpraxen und Krankenhauesern). The evaluation concerns the intervention fidelity, reach in targeted populations, perceived effects, working mechanisms, feasibility, determinants for implementation, including contextual factors, and associations with the outcomes evaluation. The aim of the VESPEERA programme is the development, implementation and evaluation of a structured admission and discharge programme in general practices and hospitals.Methods and analysisThe process evaluation is linked to the VESPEERA outcomes evaluation, which has a quasi-experimental multi-centre design with four study arms and is conducted in hospitals and general practices in Germany. The VESPEERA programme comprises several components: an assessment before admission, an admission letter, a telephonic discharge conversation between hospital and general practice before discharge, discharge information for patients, structured planning of follow-up care after discharge in the general practice and a telephone monitoring for patients with a risk of rehospitalisation. The process evaluation has a mixed-methods design, incorporating interviews (patients, both care providers who do and do not participate in the VESPEERA programme, total n=75), questionnaires (patients and care providers who participate in the VESPEERA programme, total n=475), implementation plans of hospitals, data documented in general practices, claims-based data and hospital process data. Data analysis is descriptive and explorative. Qualitative data will be transcribed and analysed using framework analysis based on the Consolidated Framework for Implementation Research. Associations between the outcomes of the program and measures in the process evaluation will be explored in regression models.Ethics and disseminationEthics approval has been obtained by the ethics committee of the Medical Faculty Heidelberg prior to the start of the study (S-352/2018). Results will be disseminated through a final report to the funding agency, articles in peer-reviewed journals and conferences.Trial registration numberhttp://www.drks.de/DRKS00015183.Trial statusThe study protocol on hand is the protocol V.1.1 from 18 June 2018. Recruitment for interviews started on 3 September 2018 and will approximately be completed by the end of May 2019.
Capitalising on shared goals for family planning: a concordance assessment of two global initiatives using longitudinal statistical models
Authors: Li Qingfeng , Rimon Jose G , Ahmed Saifuddin 
Published: November 2019

ObjectiveFamily planning is unique among health interventions in its breadth of health, development and economic benefits. The complexity of formulating effective strategies to promote women’s and girls’ access to family planning calls for closer coordination of resources and attention from all stakeholders. Our objective was to quantify the concordance of two global initiatives: Family Planning 2020’s adding 120 million modern contraceptive users by 2020 (proposed during The London Summit 2012 by Gates Foundation) and satisfying the 75% demand for modern contraceptives by 2030 (proposed by United States Agency for International Development). A demonstration of their concordance, or lack thereof, provides an understanding of the proposed quantitative goals and helps to formulate collective strategies.Design and settingWe applied fixed effects longitudinal models to assess the convergence of the two initiatives. The implications of success in one initiative on achieving the other are simulated to illustrate their shared goals. Publicly available data on contraceptive use, unmet need and met need from national surveys are used. Extensive model validations were conducted to check and confirm models’ predictive performance.ResultsOur results show that the 75% demand satisfied initiative will reach 82 million additional modern users by 2020 and 120 million by early 2023. Following FP2020’s proposed annual increase of modern contraceptive use, 9 of the 41 commitment-making countries will reach the 75% target by 2020; another 8 countries will do so by 2030. Extending FP2020’s proposed contraceptive growth to 2030 implies the achievement of the 75% target in less than half (17) of the 41 commitment-making countries.ConclusionThe results from the statistical exercise demonstrate that the two global initiatives move toward the same goal of promoting access to family planning and overall both are ambitious. Closer coordination between major stakeholders in international family planning may stimulate more efficient mobilisation and utilisation of global sources, which is urgently needed to accelerate the progress toward satisfying women’s need for family planning.
Exploring sustainable primary care responses to intimate partner violence in New Zealand: Qualitative use of complexity theory
Authors: Gear Claire , Koziol-Mclain Jane , Eppel Elizabeth 
Published: November 2019

ObjectiveTo explore what affects sustainable responses to intimate partner violence within New Zealand primary care settings using complexity theory.DesignPrimary care professional interviews on intimate partner violence as a health issue are analysed using a complexity theory-led qualitative research methodology grounded in poststructuralism.SettingFour general practices in one region of the North Island of New Zealand, two serving a general patient population and two adopting an indigenous approach.ParticipantsSeventeen primary care professionals and management from the four recruited general practices.ResultsThe complex adaptive system approach the ‘Triple R Pathway’, calls attention to system interactions influencing intimate partner violence responsiveness across health system levels. Four exemplars demonstrate the use of the Triple R Pathway. Two key system areas challenge the emergence of primary care responsiveness: (1) Non-recognition of intimate partner violence as a key determinant of ill-health. (2) Uncertainty and doubt.ConclusionsThe relationship between intimate partner violence and ill-health is not well recognised, or understood in New Zealand, at both policy and practice levels. Inadequate recognition of socioecological determinants of intimate partner violence leads to a simple health system response which constrains primary care professional responsiveness. Constant intervention in system interactions is needed to promote the emergence of sustainable responses to intimate partner violence.
Inequality of trauma care under a single-payer universal coverage system in Taiwan: a nationwide cohort study from the National Health Insurance Research Database
Authors: Kuo Ling-wei , Fu Chih-Yuan , Liao Chien-An , Liao Chien-Hung , Hsieh Chi-Hsun , Wang Shang-Yu , Chen Shao-Wei , Cheng Chi-Tung 
Published: November 2019

​ObjectivesTo assess the impact of lower socioeconomic status on the outcome of major torso trauma patients under the single-payer system by the National Health Insurance (NHI) in Taiwan.​DesignA nationwide, retrospective cohort study.​SettingAn observational study from the NHI Research Database (NHIRD), involving all the insurees in the NHI.​ParticipantsPatients with major torso trauma (injury severity score ≥16) from 2003 to 2013 in Taiwan were included. International Classification of Disease, Ninth Revision, Clinical Modification codes were used to identify trauma patients. A total of 64 721 patients were initially identified in the NHIRD. After applying the exclusion criteria, 20 009 patients were included in our statistical analysis.​Primary and secondary outcome measuresThe primary outcome measure was in-hospital mortality, and we analysed patients with different income levels and geographic regions. Multiple logistic regression was used to control for confounding variables.​ResultsIn univariate analysis, geographic disparities and low-income level were both risk factors for in-hospital mortality for patients with major torso trauma (p=0.002 and <0.001, respectively). However, in multivariate analysis, only a low-income level remained an independent risk factor for increased in-hospital mortality (p<0.001).​ConclusionEven with the NHI, wealth inequity still led to different outcomes for major torso trauma in Taiwan. Health policies must focus on this vulnerable group to eliminate inequality in trauma care.
Later emergency provider shift hour is associated with increased risk of admission: a retrospective cohort study
Authors: Tyler Patrick D , Fossa Alan , Joseph Joshua W , Sanchez Leon D 
Published: November 2019

BackgroundUnderstanding factors that drive admissions is critical to containing cost and optimising hospital operations. We hypothesised that, due to multiple factors, emergency physicians would be more likely to admit a patient seen later in their shift.MethodsRetrospective study examining all patient visits at a large academic hospital from July 2010 to July 2016. Patients with missing data (n=191) were excluded. 294 031 emergency department (ED) visits were included in the final analysis. The exposure of interest was the time during the shift at which a patient was first evaluated by the clinician, and outcome was hospital admission. We used a generalised estimating equation with physician as the clustering level to adjust for patient age, gender, Emergency Severity Index (ESI, 1=most severe illness, 5=least severe illness) and 24 hours clock time. We also conducted a stratified analysis by three ESI categories.ResultsFrom the 294 031 ED visits, 5977 were seen in the last hour of the shift. Of patients seen in the last shift hour, 43% were admitted versus 39% seen at any other time during the shift. There was a significant association between being evaluated in the last hour (RR 1.03, 95% CI 1.01 to 1.06) and last quarter (RR 1.02, 1.01 to 1.03) of shift and the likelihood of admission. Patients with an ESI Score of 4–5 saw the largest effect sizes (RR 1.62, 0.996–2.635 for last hour and RR 1.24, 0.996–1.535 for last quarter) but these were not statistically significant. Additionally, there was a trend towards increased likelihood of admission later in shift; the relative risk of admission was 1.04 in hour 6, (1.02–1.05), 1.03 in hour 7 (1.01–1.05), 1.04 in hour 8 (1.01–1.06) and 1.06 in hour 9 (1.013–1.101).ConclusionsThere is a small but significant association between a patient being evaluated later in an emergency physician’s shift and their likelihood of being admitted to the hospital.
Palliative and end-of-life care and junior doctors: a systematic review and narrative synthesis
Authors: Bharmal Aamena , Morgan Tessa , Kuhn Isla , Wee Bee , Barclay Stephen 
Published: November 2019

BackgroundPalliative and end-of-life care is a core competency for doctors and is increasingly recognised as a key clinical skill for junior doctors. There is a growing international movement to embed palliative care education in medical student and junior doctor education. To date there has been no review of the literature concerning the views and experiences of junior doctors delivering this care.AimTo review the published literature between 2000 and 2019 concerning junior doctors’ experience of palliative and end-of-life care.MethodsSystematic literature review and narrative synthesis.ResultsA search of six databases identified 7191 titles; 34 papers met the inclusion criteria, with a further 5 identified from reference searching. Data were extracted into a review-specific extraction sheet and a narrative synthesis undertaken. Three key themes were identified: (1) ‘Significance of death and dying’: all papers found that junior doctors care for many patients approaching the end of life, and this often causes emotional distress and can leave persisting memories for many years afterwards; (2) ‘Thrown in at the deep end’: junior doctors feel unprepared and unsupported in providing palliative and end-of-life care; and (3) ‘Addressing the gaps’: junior doctors often experience a medical culture of disengagement towards dying patients and varying attitudes of senior doctors. Subsequently they have to learn the skills needed through seeking their own opportunities.ConclusionMedical education needs to change in order to better prepare and support junior doctors for their role in caring for dying patients. This education needs to focus on their knowledge, skills and attitudes.
High rates of treatment failure forMycoplasma genitaliumamong men and women attending a sexual health clinic
Authors: Ovens Katie Jane , Reynolds-Wright John Joseph , Cross Elizabeth Louise Anne , Rickwood Lucinda , Hassan-Ibrahim Mohammed Osman , Soni Suneeta 
Published: November 2019

BackgroundMycoplasma genitalium(Mgen) causes non-gonococcal urethritis (NGU) and is believed to cause pelvic inflammatory disease (PID). High rates of macrolide resistance are well documented globally for Mgen. In Brighton, patients with NGU and PID are tested for Mgen and test of cure (TOC) offered post-treatment.MethodsDemographic, clinical and treatment history data were collected over a 12-month period for all Mgen-positive patients in a Brighton-based genitourinary clinic.ResultsThere were 114 patients with Mgen. 18% (61/339) of men with NGU and 9% (15/160) of women with PID had Mgen. 62/114 (54%) returned for first test TOC 4 weeks after treatment. 27/62 (44%) had a positive TOC; 25/27 (92.6%) had received azithromycin first line (500 mg stat then 250 mg OD for 4 days), 1/27 (3.7%) had received moxifloxacin first line (400 mg OD for 14 days) and 1/27 (3.7%) had received doxycycline first line (100 mg BD for 7 days). 20/27 (74%) returned for a second TOC 4 weeks later. 5/20 (25%) patients were positive on second TOC; 3/5 (60%) had received azithromycin second line and 2/5 (40%) had received moxifloxacin second line. Patients were more likely to have a positive TOC if they were at risk of reinfection (9/27 positive TOC vs 3/35 negative TOC; p=0.02). Patients given moxifloxacin were more likely to have a negative TOC (1/27 positive TOC vs 9/35 negative TOC; p=0.03) than those who received other antibiotic regimens.ConclusionsTreatment failure rates for Mgen following azithromycin use are substantial, raising concerns regarding resistance. However, reinfection risk may contribute, suggesting a requirement for improved public awareness and clinician knowledge.
Reproductive health needs of recently incarcerated youth during community reentry: a systematic review
Authors: Barnert Elizabeth , Sun Ava , Abrams Laura , Chung Paul J 
Published: November 2019

BackgroundYouth involved in the juvenile justice system have high reproductive health needs and, on exiting detention, face the challenging transition of reentry. We conducted a systematic literature review to describe what is known about youths’ reproductive health needs during community reentry after incarceration.MethodsWe searched PubMed, CINAHL, Cochrane Library, and Google Scholar for articles containing key words with the concepts ‘child or adolescent’, ‘incarcerated’ and 'reentry'. In the search, we defined the concept of ‘reentry’ as within 1 month prior to release (to include interventions involving pre-release planning) and up to 18 months after release from incarceration.ResultsOur search yielded 2187 articles. After applying all exclusion criteria, 14 articles on reproductive health remained for extraction. The articles provided data on the following aspects of youths’ reproductive health: frequency of condom use (eight articles), sexual risk behaviours other than lack of condom use (seven articles), and prevalence of sexually transmitted infections (three articles).ConclusionsThe literature on the reproductive health needs of youth undergoing reentry is extremely limited. Current intervention studies yield mixed but promising results and more intervention studies that address both pre-release reentry planning and the post-incarceration period are needed. Given incarcerated youths’ well-documented reproductive health disparities compared with non-incarcerated adolescents, the identified gaps represent important opportunities for future research and programmatic emphasis.
Early assessment with a virtual reality haptic simulator predicts performance in clinical practice
Authors: Al-Saud Loulwa M , Mushtaq Faisal , Mann Richard P , Mirghani Isra'a , Balkhoyor Ahmed , Harris Richard , Osnes Cecilie , Keeling Andrew , Mon-Williams Mark A , Manogue Michael 
Published: November 2019

BackgroundPrediction of clinical training aptitude in medicine and dentistry is largely driven by measures of a student’s intellectual capabilities. The measurement of sensorimotor ability has lagged behind, despite being a key constraint for safe and efficient practice in procedure-based medical specialties. Virtual reality (VR) haptic simulators, systems able to provide objective measures of sensorimotor performance, are beginning to establish their utility in facilitating sensorimotor skill acquisition, and it is possible that they may also inform the prediction of clinical performance.MethodsA retrospective cohort study examined the relationship between student performance on a haptic VR simulator in the second year of undergraduate dental study with subsequent clinic performance involving patients 2 years later. The predictive ability was tested against a phantom-head crown test (a traditional preclinical dental assessment, in the third year of study).ResultsVR scores averaged across the year explained 14% of variance in clinic performance, while the traditional test explained 5%. Students who scored highly on this averaged measure were ~10 times more likely to be high performers in the clinical crown test. Exploratory analysis indicated that single-trial VR scores did not correlate with real-world performance, but the relationship was statistically significant and strongest in the first half of the year and weakened over time.ConclusionsThe data demonstrate the potential of a VR haptic simulator to predict clinical performance and open up the possibility of taking a data-driven approach to identifying individuals who could benefit from support in the early stages of training.
Compact star in Tolman–Kuchowicz spacetime in the background of Einstein–Gauss–Bonnet gravity
Authors: Bhar Piyali , Singh Ksh. Newton , Tello-Ortiz Francisco 
Published: November 2019

Abstract
The present work is devoted to the study of anisotropic compact matter distributions within the framework of five-dimensional Einstein–Gauss–Bonnet gravity. To solve the field equations, we have considered that the inner geometry is described by Tolman–Kuchowicz spacetime. The Gauss–Bonnet Lagrangian $$\mathcal {L}_{GB}$$LGB is coupled to the Einstein–Hilbert action through a coupling constant, namely $$\alpha $$α. When this coupling tends to zero general relativity results are recovered. We analyze the effect of this parameter on the principal salient features of the model, such as energy density, radial and tangential pressure and anisotropy factor. These effects are contrasted with the corresponding general relativity results. Besides, we have checked the incidence on an important mechanism: equilibrium by means of a generalized Tolman–Oppenheimer–Volkoff equation and stability through relativistic adiabatic index and Abreu’s criterion. Additionally, the behavior of the subliminal sound speeds of the pressure waves in the principal directions of the configuration and the conduct of the energy-momentum tensor throughout the star are analyzed employing the causality condition and energy conditions, respectively. All these subjects are illuminated by means of physical, mathematical and graphical surveys. The M–I and the M–R graphs imply that the stiffness of the equation of state increases with $$\alpha $$α; however, it is less stiff than GR.
Memories of my early career in relativity physics
Authors: Trautman Andrzej , Salisbury Donald 
Published: November 2019

Abstract
This interview is focused on university studies and early career in relativity physics including thesis work under Leopold Infeld dealing with gravitational waves. Trautman’s recollections include the collaboration with Ivor Robinson and relationships with relevant personalities like Felix Pirani, Jerzy Plebanski, Roger Penrose and Peter Bergmann.
Effect of graphene lateral size on the microstructure and properties of graphene/copper composites
Authors: Zhang Dandan , Xiao Huaxing , Jiang Wei , Cao Xia , Ye Manyu , Huang Lu , Tang Tao 
Published: November 2019

Copper matrix composites reinforced with graphene nanoplatelets (GNPs) were prepared by vacuum hot pressing of ball milled mixtures of powders. Two grades of GNPs were used; one with average thickness of 2 nm and average lateral size of 6 [Formula: see text]m and another with much larger lateral size of 80 [Formula: see text]m. Microstructure and properties of as-prepared composites containing 10 vol.% GNPs were studied. The GNPs sheets are uniformly distributed and well aligned in the Cu matrix. The microstructure observation shows that the GNPs-2–6 exhibits a better dispersion in the Cu matrix than GNPs-2–80. The addition of fine GNPs-2–6 lead to [Formula: see text]31% higher tensile strength and approximately same electrical conductivity of the Cu matrix, while the GNPs-2–80/Cu composite only shows a [Formula: see text]15% increase of tensile strength and a lower electrical conductivity than the Cu matrix.
Effect of shielding gas flow rate on arc behaviors in GMAW with single cable-typed wire
Authors: Hu Qingxian , Zhang Lei , Pu Juan , Zhu Caichen 
Published: November 2019

A three-dimensional numerical model of arc in gas metal arc welding (GMAW) with single cable-typed wire was established based on the theory of arc physics. The influences of different shielding gas flow rates on the features of temperature field, velocity field and pressure field were investigated. The results showed that the maximum velocity of arc plasma along radial direction and the arc pressure on the surface of workpieces were increased obviously with the increase of the shielding gas flow rate, while the arc temperature was changed little. This phenomenon was mainly attributed to the increasing collisions between arc plasmas and the self-rotation action of cable-typed wires. The arc temperature at the tip of the cable-typed wire reached the maximum. The maximum flow velocity of arc plasma was located at the tip of wire (2–8 mm). The arc pressures in the central axis reached the maximum pressure. The simulation results were in agreement with the experimental results.