bluuebunny/crossref_metadata_2025_split huggingface dataset:
How Central Support Built Capacity to Deliver a Health Promoting Intervention for Older Adults
Authors: Gould Joanie Sims , McKay Heather , Franke Thea 
Published: December 2020

Abstract
Background: A number of conceptual frameworks guide implementation and scale-up of evidence based (health promoting) interventions (EBIs). However, few studies delve into these frameworks to describe aspects of the delivery system--such as capacity building--that support successful scale-up. A standardized approach to capacity building is needed to develop new strategies and transfer successful strategies to new settings. Therefore, our objectives were to describe: (1) implementation strategies adopted by the central support system to build practitioners’ capacity to implement and scale-up a health promoting intervention (Choose to Move (CTM)), and (2) elements within capacity building strategies deemed essential to effectively implement CTM in diverse community contexts.Methods:﻿ CTM is a flexible, scalable, community-based health promoting physical activity (PA) and social connectedness intervention for older adults. In 2018-2020, eight health and social service societies, rural or remote municipalities, or community based organizations delivered CTM programs (n=22) that served older adults (n=322). We conducted in depth interviews with delivery partners (n=23), and a focus group with the central support system (n= 4) to assess key elements within capacity building strategies.Results: Capacity building strategies that delivery partners adopted were site selection/marketing, training, tools, technical assistance, peer networking, assessment and feedback. Essential elements that emerged within capacity building strategies were: a support system champion, activity coach skills, self efficacy and confidence; interactive assistance to answer questions and clarify materials. Key elements of central support that emerged were helping organizations-- adapt and tailor the EBI, leverage resources and strategies, maintain fidelity to the EBI, develop partnerships, train and monitor, learn from peers, increase awareness of older adult needs, increase PA programs for older adults and inform future organizational practices and processes. Central support provided a sounding board to organizations and were more successful if they were familiar with delivery partner resources and values, created buy-in and planned ahead.Conclusion: There is a key role for capacity building under the stewardship of central support units to promote implementation success. More clearly described capacity-building strategies that are designed and delivered to support implementation and scale-up would serve to advance the field, in future.
Care to Quit: A Stepped Wedge Cluster Randomised Controlled Trial to Implement Best Practice Smoking Cessation Care in Cancer Centres
Authors: Paul Christine L , Warren Graham , Vinod Shalini , Meiser Bettina , Stone Emily , Barker Daniel , White Kate , McLennan James , Day Fiona , McCarter Kristen , McEnallay Melissa , Tait Jordan , Canfell Karen , Weber Marianne , Segan Catherine 
Published: December 2020

Abstract
BackgroundCigarette smoking in people with cancer is associated with negative treatment related outcomes including increased treatment toxicity and complications, medication side effects, decreased performance status and morbidity. Evidence based smoking cessation care is not routinely provided to patients with cancer. The purpose of this study is to determine the effectiveness of a smoking cessation implementation intervention on abstinence from smoking in people diagnosed with cancer.MethodsA stepped wedge cluster randomized design will be used. All sites begin in the control condition providing treatment as usual. In a randomly generated order, sites will move to the intervention condition. Based on the Theoretical Domains Framework, implementation of Care to Quit will include i) building the capability and motivation of a critical mass of key clinical staff and identifying champions; and ii) identifying and implementing cessation care models/pathways. 2160 patients with cancer (diagnosed in the prior six months), aged 18+, who report recent combustible tobacco use (past 90 days or in the 30 days prior to cancer diagnosis) and are accessing anti-cancer therapy, will be recruited at nine sites. Assessments will be conducted at baseline and 7-month follow-up. The primary outcome will be 6-month abstinence from smoking. Secondary outcomes include biochemical verification of abstinence from smoking, duration of quit attempts, tobacco consumption, nicotine dependence, variables, provision and receipt of smoking cessation care, mental health and quality of life and cost effectiveness of the intervention. DiscussionThis study will implement best practice smoking cessation care in cancer centres and has the potential for wide dissemination. Trial registrationThe trial is registered with ANZCTR (www.anzctr.org.au): ACTRN (submitted, awaiting approval due to ANZCTR delays) prior to the accrual of the first participant and will be updated regularly as per registry guidelines.
Association Between Physical Activity Level and Cardiovascular Risk Factors in Adolescents Living with Type 1 Diabetes: A Cross-sectional Study
Authors: Wu Nana , Bredin Shannon , Jamnik Veronica , Koehle Michael , Guan Yanfei , Shellington Erin , Li Yongfeng , Li Jun , Warburton Darren 
Published: December 2020

Abstract
Background: Type 1 diabetes (T1D) is associated with a high risk of cardiovascular disease (CVD) and an increased rate of premature mortality from CVD. Regular physical activity can improve overall health and wellbeing and plays an important role in primary and secondary prevention of CVD. Methods: This cross-sectional study assessed cardiovascular risk factors, physical activity, and fitness (and their associations) in young individuals living with T1D and healthy controls. Primary outcomes included blood pressure, lipid profiles, and physical activity (accelerometry). We included a total of 48 individuals living with T1D and 19 healthy controls, aged 12 to 17 years. Statistical differences between groups were determined with chi-square, independent-samples t-tests or analysis of covariance. The associations between aerobic fitness, daily physical activity variables and cardiovascular risk factors were assessed with univariate and multivariate linear regression analysis.Results: In comparison to healthy controls, youth living with T1D showed higher levels of total cholesterol (4.03 ± 0.81 vs. 3.14 ± 0.67 mmol·L-1, p = 0.001), low-density lipoprotein cholesterol (LDL-C) (2.31 ± 0.72 vs. 1.74 ± 0.38 mmol·L-1, p = 0.035), and triglycerides (0.89 ± 0.31 vs. 0.60 ± 0.40 mmol·L-1 p = 0.012), and lower maximal oxygen power (VO2max) (35.48 ± 8.72 vs. 44.43 ± 8.29 mL·kg-1·min-1, p = 0.003), total physical activity counts (346.87 ± 101.97 vs. 451.01 ± 133.52 counts·min-1, p = 0.004), metabolic equivalents (METs) (2.09 ± 0.41 vs. 2.41 ± 0.60 METs, p = 0.033), moderate to vigorous intensity physical activity (MVPA), and the percentage of time spent in MVPA. The level of HDL-C was positively associated with METs (β = 0.29, p = 0.030, model R2 = 0.17), and the level of triglycerides was negatively associated with physical activity counts (β = -0.001, p = 0.018, model R2 = 0.205) and METs (β = -0.359, p = 0.015, model R2 = 0.208) in persons living with T1D. Conclusions:Youth with T1D, despite their young age and short duration of diabetes, present early signs of CVD risk, as well as low physical activity levels and cardiorespiratory fitness compared to healthy controls. Regular physical activity is associated with a beneficial cardiovascular profile in T1D, including improvements in lipid profile. Thus, physical activity participation should be widely promoted in youth living with T1D.
Intubation is Safe in Respiratory Failure Associated with Septic Shock: An Observational Study
Authors: Yang Ting , Shen Yongchun , Park John G. , Schulte Phillip J , Hanson Andrew C , Herasevich Vitaly , Dong Yue , Bauer Philippe R 
Published: December 2020

Abstract
BackgroundAcute respiratory failure associated with sepsis contributes to higher in-hospital mortality. Intubation and invasive mechanical ventilation is a common rescue procedure. However, the 2016 International Guidelines for Management of Sepsis and Septic Shock does not provide any recommendation on indication nor timing of intubation. Timely intubation may improve outcome. The decision to intubate those patients is often hampered by the fear of further hemodynamic deterioration following intubation. MethodsThis study aimed at evaluating the impact of timely intubation on outcome in sepsis associated respiratory failure. We conducted an ancillary analysis of a prospective registry od adult ICU patients with septic shock admitted to the medical ICU in a tertiary medical center, between April 30th, 2014 and December 31st, 2017. All cases of sepsis with lactate >4 mmol/L, mean arterial pressure <65 mmHg, or vasopressor use after 30 mL/kg fluid boluses and suspected or confirmed infection. Patients who remained hospitalized at 24 hours following sepsis onset were separated into intubated and non-intubated groups. The primary outcome was hospital mortality. Univariate and multivariable analyses were used, adjusted for admission characteristics and stabilization of shock within 6 hours. In a secondary analysis, time-dependent propensity score matching was used to match intubated and non-intubated patients.ResultsWe identified 345 (33%) patients intubated within 24 hours and 707 (67%) not intubated. Intubated patients were younger, transferred more often from an outside facility, had higher severity of illness scores, more lung infection, achieved blood pressure goals more often but less often lactate normalization within 6 hours. The crude in-hospital mortality was higher, 89 (26%) vs. 82 (12%), p<0.001, as were ICU mortality, and ICU and hospital length of stay. After adjustment, intubation showed no effect on hospital mortality but fewer hospital-free days through day 28. After 1:1 propensity score matching, there was no difference in hospital mortality, but fewer hospital-free days in the intubated group. ConclusionsIntubation within 24 hours of sepsis onset was safe and not associated with hospital mortality, but was associated with less 28-day hospital-free days. Intubation should not be discouraged in appropriate patients with septic shock.
Enhancing health care professionals’ knowledge of childhood sexual abuse through self-assessment: A realist review
Authors: Adisa Olumide , Allen Katherine , Tyrrell Katie 
Published: December 2020

Abstract
Background

Healthcare professionals (HCPs) are well-placed to facilitate disclosures by child sexual abuse/exploitation (CSA/E) survivors and promote timely access to specialist support. However, research with HCPs shows that many are reluctant to enquire about abuse and feel underprepared to deal with disclosures. Self-assessment offers a participatory approach that may be employed as part of a suite of educational interventions to increase HCP knowledge and confidence. As a complex intervention involving multiple steps and actors, its effectiveness is contingent on organisational contexts. Realist reviews offer a theory-driven and contextually sensitive approach for understanding the mechanisms of change that generate specific outcomes, enabling reviewers to identify generalisable insights on how and why programmes work.
Methods

We adopted a realist approach to answer the following questions: how are CSA/E self-assessment tools currently being used by HCPs, what does ‘good practice’ in the use of such tools look like, under what circumstances are existing tools effective, and why? Guided by Pawson’s 5 stages, we conducted a realist review of abuse-related self-assessment tools for HCPs. Following preliminary scoping of the literature, we developed an initial programme theory which informed our search strategy and theoretical framework.
Results

25 items met criteria for data extraction, and relevant contexts (C), mechanisms (M) and outcomes (O) were identified and mapped. Eight of these were included in the final synthesis. We identified two key ‘families’ of abuse-related self-assessment for healthcare contexts: PREMIS, a validated survey instrument to assess HCP knowledge, confidence and practice in relation to domestic violence and abuse (DVA); Trauma-informed practice/care (TIP/C) organisational self-assessment protocols. Two revised programme theories were formulated: 1. Individual self-assessment can promote organisational accountability 2. Organisational self-assessment can increase the coherence and sustainability of changes in practice.
Conclusions

Our review contributes to the evidence base on improving healthcare responses to CSA/E survivors, illustrating that self-assessment tools or protocols specifically designed to improve HCP responses to adult survivors of CSA/E remain under-developed and under-studied. Refined programme theories developed during synthesis regarding DVA and TIP/C related tools or protocols suggest areas for CSA/E-specific future research with stakeholders and service users.
Risk Factors of Pancreatitis after Percutaneous Transhepatic Biliary Stent Implantation in Patients with Distal Malignant Biliary Obstruction
Authors: Jia Nan , Chang Zhihui , Liu Zhaoyu 
Published: December 2020

Abstract
Purpose Percutaneous transhepatic biliary stent implantation (PTBS) has been widely used in the treatment of malignant obstructive jaundice (MBO)，which is an effective palliative therapy. The goal of the research was to explore the risk factors of postoperative pancreatitis in patients who had received PTBS.Materials and Methods This study retrospectively included 248 patients with distal malignant biliary obstruction (DMBO) who received PTBS from 2014 to 2019. The risk factors of postoperative pancreatitis such as clinical characteristics, laboratory and stent variables were evaluated by logistic regression analysis.Results Pancreatitis occurred in 51 (20%) patients, all of whom were mild pancreatitis. Multivariate analysis showed that stent implantation across the duodenal papilla, preoperative (within 3 days) administration of proton pump inhibitors (PPIs) were independent risk factors that related to pancreatitis (OR =13.242, 95% CI: 1.729–101.405; P = 0.013; OR =2.113, 95% CI: 1.024–4.36; P = 0.043, respectively), while preoperative administration of antibiotics was a protective factor (OR =0.466, 95% CI: 0.226–0.961; P = 0.039).Conclusion Patients with DMBO who underwent PTBS across the duodenal papilla were more likely to developing postoperative pancreatitis. Preoperative (within 3 days) administration of PPIs was also an independent risk factor for postoperative pancreatitis. Furthermore, preoperative administration of antibiotics may lower the risk of pancreatitis.
Correlation of [18F] FDG-PET/CT with dosimetry data: recurrence pattern after radiotherapy for head and neck carcinoma
Authors: Pisani Carla , Vigna Luca , Mastroleo Federico , Loi Gianfranco , Amisano Valentina , Masini Laura , Deantonio Letizia , Valletti Paolo Aluffi , Sacchetti Gian Mauro , Krengli Marco 
Published: December 2020

Abstract
ObjectiveTo analyze the pattern of failure in relation to pre-treatment [18F] FDG-PET/CT uptake in head and neck squamous cell carcinoma (HNSCC) patients treated with definitive radio-chemotherapy (RT-CHT).Methods and MaterialsFrom 2012 to 2016, 87 HNSCC patients treated with definitive RT-CHT, with intensity modulated radiation therapy with simultaneous integrated boost (IMRT-SIB), underwent pre-treatment [18F] FDG-PET/CT (PETpre), and MRI/CT for radiotherapy (RT) planning purposes. Patients with local recurrence, received [18F] FDG-PET/CT, (PETrec) at the time of the discovery of recurrence. In these patients, the biological target volume (BTV), BTVpre and BTVrec were segmented on PET images by means of an adaptive thresholding algorithm. The overlapping volume between BTVpre and BTVrec (BTVpre&rec) was generated and the dose coverage of BTVrec and BTVpre&rec was checked on the planning CT using the D99 and D95 dose metrics. The recurrent volume was defined as: ‘‘In-Field (IF)’’, ‘‘Extending Outside the Field (EOF)’’ or ‘‘Out-of-Field (OF)’’ if D95 was respectively equal or higher than 95%, D95 was between 95% and 20% or the D95 was less than 20% of prescribed dose.ResultsWe found 10/87 patients (11.5%) who had recurrence at primary site. Mean BTVpre was 13.1 cc (4.6-37.4 cc), while the mean BTVrec was 4.3 cc (1.1-12.7 cc). Two recurrences resulted 100% inside BTVpre, 4 recurrences were mostly inside (61%-91%) and 4 recurrences were marginal to BTVpre (33-1%). At dosimetric analysis, six recurrences (60%) were IF, 3 (30%) EOF and one (10%) OF. The mean D99 of the overlapping volumes BTVpre&rec was 68.1Gy (66.5-69.2 Gy), considering a prescription dose of 70 Gy to the planning target volume (PTV). ConclusionOur study shows that the recurrence may originate from the volume with the highest FDG-signal. Results support the hypothesis that an intensification of the dose on these volumes could be helpful to prevent local relapse.
Comparison of Diaphragmatic Paralysis, Respiratory Function and Postoperative Pain After Interscalene Brachial Plexus Block With a Reduction Dose of Levobupivacaine 0.25% 10 ml Versus 20 ml Undergoing Arthroscopic Shoulder Surgery: Study Protocol for the Randomized, Controlled and Double-blinded REDOLEV Study.
Authors: Oliver-Fornies Pablo , Lahuerta Pablo Ortega , Gomez Roberto Gomez , Pellicer Inmaculada Gonzalo , Gutierrez Leticia Oliden , Cabeza Jose Vinuales , Ligorit Lucia Gallego , Melgar Carlos Edgardo Orellana 
Published: December 2020

Abstract
Background: Arthroscopic shoulder surgery involves dynamic and severe postoperative pain. Interscalene brachial plexus block provides adequate analgesia, but the spread of local anaesthetics administered causes a phrenic nerve block that entrains a nonnegligible incidence of hemidiaphragmatic paralysis acute.The main objective of this trial is to compare the hemidiaphragmatic paralysis after interscalene brachial plexus block in arthroscopic shoulder surgery, between a standard volume (20 ml) and a low volume (10 ml) of 0.25% levobupivacaine.Methods: This is a comparative, prospective, single-center, double-blind, two-arm randomized controlled trial. Forty-eight patients will be included. The primary end-point is to determine the hemidiaphragmatic paralysis incidence diagnosed by the diaphragmatic thickness ratio in ultrasound. The secondary endpoints are as follows: (1) hemidiaphragmatic paralysis incidence diagnosed by forced vital capacity and (2) forced expiratory volume at 1 second decrease in spirometry; (3) hemidiaphragmatic paralysis incidence diagnosed by using diaphragmatic excursion decrease in ultrasound; (4) postoperative pain regarding 24-hour morphine intravenous total consumption and (5) time to first analgesic consumption of patient-controlled analgesia pump; and (6) postoperative harm between the two trial arms.Discussion: This trial would demonstrate that low-volume interscalene brachial plexus block decreases hemidiaphragmatic paralysis in arthroscopic shoulder surgery by using spirometry and ultrasound and would not provide inferior postoperative analgesia according to opioid requirements of postoperative patient-controlled analgesia in comparison to the standard volume used in current practice.Trial registration: EudraCT and Spanish Trial Register (REec) registration number: 2019-003855-12 (Registered on 07 January 2020). ClinicalTrials.gov identification number: NCT04385966 (Retrospectively registered on 08 May 2020). Ethics Committee approval: EC19/093 (18 Dic 2019).
Impact of Sofosbuvir and Daclastavir on Health-related Quality of Life in Patients Co-infected With Hepatitis C and Human Immunodeficiency Virus
Authors: Yunihastuti Evy , Amelia Fhadilla , Hapsari Arini Ika , Wicaksana Bramantya , Natali Veritea , Widhani Alvina , Sulaiman Andri Sanityoso , Karjadi Teguh Harjono 
Published: December 2020

Abstract
BackgroundWe conducted a real-life study of health-related quality of life (HRQoL) transformation before and 12 weeks after sofosbuvir and daclatasvir therapy in HCV/HIV co-infected patients. Factors related to the significant changes of each HRQoL domain were also evaluated.MethodsA prospective study was performed in the HIV integrated clinic at Cipto Mangunkusumo Hospital, Jakarta. HCV/HIV co-infected patients who started sofosbuvir and daclatasvir from government free DAA program in 2017-2019. WHOQoL-HIV BREF and RAND SF-36 questionnaires were recorded at baseline and post-treatment week 12. Results145 patients with mean age of 37.8 years (SD=4.2) were included in the analysis. Most of patients were male (89%), previous IVDU (89%), active smoker (50.4%) and non-cirrhosis (80%). SVR12 was achieved in 95.5% of patients. Sofosbuvir and daclatasvir treatments showed positive impacts on 4 domains of WHOQoL-HIV BREF and 3 domains of SF-36. Predicting factors of significant increase in each domain were: male and normal body mass index (BMI) for level of independence (RR 4.01,95% CI 1.09-14.74 and 4.80,95% CI 1.79-12.81); higher HCV-RNA for overall perception of QoL (RR 0.42,95% CI 0.18-0.94); non-smoking status for overall perception of health (RR 0.32,95% CI 0.15-0.66); male and fibrosis stage 0-1 for general health (6.21,95% CI 1.69-22.88 and 2.86,95% CI 1.16-7.00). Spiritual/personal belief decline was predicted by non-smoking status (RR 0.49,95% CI 0.24-0.98). Treatment success was not associated with any changes of HR-QoL.ConclusionsHCV/HIV co-infected patients were successfully treated with sofosbuvir and daclatasvir and experienced improvement of HRQoL 12 weeks after treatment completion.
Transient Dynamical-Thermal-Optical System Modeling and Simulation
Authors: Hahn Luzia , Eberhard Peter 
Published: December 2020

Abstract
In modern high resolution optical systems like astronomical telescopes or lithographic objectives, performance degradations can be caused by various disturbances. Holistic optical system simulation is required to predict the performance or the high precision systems. In this paper a method for transient dynamical-thermal-optical system modeling and simulation is introduced. Thereby, elastic deformation, rigid body motion, and mechanical stresses due to dynamical excitation are calculated using elastic multibody system simulation and temperature changes are determined using thermal finite element analysis. The deformation, the motion, and the mechanically and thermally induced stress index changes are then considered in a gradient-index ray tracing. Finally, the presented method is applied in a dynamical-thermal single lens system.