bluuebunny/crossref_metadata_2025_split huggingface dataset:
Work‐related stress among health professionals in Swiss acute care and rehabilitation hospitals—A cross‐sectional study
Authors: Peter Karin Anne , Hahn Sabine , Schols Jos M. G. A. , Halfens Ruud J. G. 
Published: May 2020

AbstractAims and objectivesThis study aimed to identify significant work stressors associated with stress symptoms, job satisfaction, intention to leave and health‐related outcomes among health professionals.BackgroundThe workforce shortage of health professionals is a current concern, and a reduction of work‐related stress is thus essential for retaining health professionals. Studies on the extent of work‐related stress in different health professions are limited.MethodsThe research was conducted with a cross‐sectional study encompassing 26 randomly selected acute care and rehabilitation hospitals. The sample consisted of 3,398 health professionals. The study was undertaken in accordance with the STROBE checklist for observational studies.ResultsWork–private life conflicts were significantly associated with health professionals' stress symptoms, job satisfaction, intention to leave the organisation and profession, their general health status, burnout symptoms and quality of sleep. Also, opportunities for development and the behaviour of the direct line manager (e.g. quality of leadership, unfair behaviour, rewards given) along with various profession‐specific stressors were the important predictors revealed.ConclusionsThis study shows the high relevance of preventing and reducing work–private life conflicts, enhancing leadership qualities as well as opportunities for development among health professionals working in acute care and rehabilitation hospitals. Also, differences between health professions should be taken into consideration in developing strategies for reducing stress at work.Relevance to clinical practiceThe results of this study are particularly relevant for health professional leaders and reveal the urgent need in hospital practice for effective strategies to improve health professionals' work–private life balance, opportunities for development and quality of leadership.
Comparative evaluations of single‐item pain‐intensity measures in cancer patients: Numeric rating scale vs. verbal rating scale
Authors: Kim Hee‐Ju , Jung Sun‐Ok 
Published: May 2020

AbstractAims and ObjectivesTo evaluate the psychometric quality of two single‐item pain‐intensity measures: the Numeric Rating Scale (NRS) and the Verbal Rating Scale (VRS).BackgroundMeasuring pain intensity is a vital step in initiating symptom management and evaluating the effectiveness of interventions with cancer patients. Single‐item pain‐intensity measures of the NRS and VRS format have been evaluated to be acceptable for use in clinical practice and research; however, evidence to choose one over the other, as a standardised pain‐assessment format, is insufficient.DesignDescriptive correlational study. The study was guided and reported following the STROBE guideline.MethodsData accrued at two time points during cancer treatment with a total of 249 patients treated in a Korean University Hospital. Two single‐item measures were constructed to assess pain intensity over 1 week. The Brief Pain Inventory (BPI; pain intensity subscale and interference subscale) and the functional assessment of chronic illness therapy‐fatigue were the criterion. Convergent and concurrent validity were tested with Pearson's correlations.ResultsIn the convergent‐validity evaluation of the cross‐sectional association with the BPI, the NRS showed a much higher level of association than the VRS (0.81 versus 0.61). In convergent validity with a longitudinal association with the BPI, the NRS score change had a much higher level of association (0.61 versus 0.37). In concurrent‐validity evaluation, the NRS and VRS showed similar levels of associations with fatigue (−0.48 versus −0.49). Yet, the NRS showed statistically higher levels of correlation with functional limitations than the VRS (0.55 versus 0.42), comparable to the concurrent validity of the BPI.ConclusionThe NRS showed higher validity than VRS when assessing overall pain intensity over the past week.Relevance to Clinical NursingPain assessment is a vital role of nurses in caring for patients with cancer. Current study findings support the use of the single‐item NRS pain measure to assess global pain intensity over the past week.
Brain MRI Diffusion Encoding Direction Number Affects Tract‐Based Spatial Statistics Results in Multiple Sclerosis
Authors: Kincses Bálint , Spisák Tamás , Faragó Péter , Király András , Szabó Nikoletta , Veréb Dániel , Kocsis Krisztián , Bozsik Bence , Tóth Eszter , Vécsei László , Kincses Zsigmond Tamás 
Published: May 2020

ABSTRACTBACKGROUND AND PURPOSEDiffusion tensor imaging (DTI) is a promising approach to detect the underlying brain pathology. These alterations can be seen in several diseases such as multiple sclerosis. Tract‐based spatial statistics (TBSS) is an easy to use and robust way for analyzing diffusion data. The effect of acquisition parameters of DTI on TBSS has not been evaluated, especially the number of diffusion encoding directions (NDED), which is directly proportional with scan time.METHODSWe analyzed a large set of DTI data of healthy controls (N = 126) and multiple sclerosis patients (N = 78). The highest NDED (60 directions) was reduced and a tensor calculation was done separately for every subset. We calculated the mean and standard deviation of DTI parameters under the white matter mask. Moreover, the FMRIB Software Library TBSS pipeline was used on DTI images with 15, 30, 45, and 60 directions to compare differences between groups. Mean DTI parameters were compared between groups as a function of NDED.RESULTSThe mean value of FA and AD decreased with increasing number of directions. This was more pronounced in areas with smaller FA values. RD and MD were constant. The skeleton size reduced with elevating NDED along with the number of significant voxels. The TBSS analysis showed significant differences between groups throughout the majority of the skeleton and the group difference was associated with NDED.CONCLUSIONOur results suggested that results of TBSS depended on the NDED, which should be considered when comparing DTI data with varying protocols.
Nursing students' perspectives on the inclusion of course content on lesbian, gay, bisexual, and transgender health in the nursing curriculum: A descriptive qualitative study
Authors: Ercan‐Şahin Nilay , Aslan Funda 
Published: May 2020

AbstractThe aim of the study was to examine nursing students' perspectives on why and how course contents on lesbian, gay, bisexual, and transgender health should be included in the nursing curriculum. This was a descriptive qualitative study. A purposive sample was used, and 17 students participated. Thematic analyses revealed four themes: “The need for knowledge and awareness”; “Communication”; “The need for practice‐based learning”; and “Inclusion of course contents on lesbian, gay, bisexual and transgender health in the nursing curriculum”. Almost all the students reported that the proportion of the course content that had been allocated to lesbian, gay, bisexual, and transgender health was inadequate and emphasized that it is necessary to improve both the theoretical and practical components of the nursing curriculum.
Effect of the occupational environment of parents on cryptorchidism
Authors: Mitsui Takahiko , Araki Atsuko , Miyashita Chihiro , Ito Sachiko , Kitta Takeya , Moriya Kimihiko , Shinohara Nobuo , Takeda Masayuki , Kishi Reiko ,   Japan Environment and Children’s Study Group*
Published: May 2020

AbstractBackgroundThe early detection and treatment of cryptorchidism are necessary to preserve male fertility. This study aimed to assess the effect of parents’ occupational environment on the incidence of cryptorchidism in their sons.MethodsThe study enrolled 51 316 newborn males, whose mothers were recruited in the Japan Environment and Children’s Study. We analyzed cryptorchidism incidence in male newborns according to 14 categories of occupation of their parents. We also analyzed the effect of the mother’s occupational environment during gestation, including working and night‐shift work, on cryptorchidism incidence. Information on occupations was obtained from self‐administered questionnaires. Cryptorchidism was identified through a survey at birth or 1 month after birth using medical records.ResultsCryptorchidism was identified in 305 male infants (0.59%) at birth or 1 month after birth. Weight, height, head circumference, and chest circumference at birth were significantly lower in male infants with cryptorchidism than in those without the condition. Gestational age was also shorter in mothers whose infants developed cryptorchidism. Moreover, maternal age at delivery and smoking during gestation also had an effect on cryptorchidism incidence. However, multivariate analysis of the 14 categories of occupation of parents during gestation showed no significant effect on cryptorchidism incidence in their male infants.ConclusionsThis study revealed that the work environment of parents did not significantly affect the incidence of cryptorchidism in their sons. However, this study might have underestimated mild and transient cases of cryptorchidism. Further studies are necessary to investigate the risk factors of cryptorchidism in relation to parents’ occupation.
First pediatric organ donation after circulatory determination of death in Singapore: Facing challenges in the absence of a local practice guideline
Authors: Thong Wen Yi , Chong Poh Heng , Koh Pei Lin , Loh Will Ne‐Hooi , Tay Stacey Kiat‐Hong 
Published: May 2020

AbstractPediatric organ donation represents only a low proportion of overall organ donation in many parts of world, unable to match the needs for pediatric organ transplantation. Pediatric organ donation after circulatory determination of death (DCD) is increasingly explored in pediatric transplantation, as it increases the availability of organ grafts. A 6‐year‐old Caucasian boy with a history of arteriovenous malformation presented with a catastrophic intracranial bleed, resulting in severe brainstem dysfunction despite maximal medical and surgical measures. He did not fulfill the criteria for brain death, which must be met for pediatric organ donation in Singapore. Due to parental request, his organs were donated after withdrawal of life support and determination of death by circulatory criteria. Pediatric organ DCD poses many challenges in the pediatric population, especially in the absence of a local practice guideline. We present the first case of a pediatric organ DCD that has occurred in Singapore. Further work is needed, particularly in establishing a national policy for pediatric organ DCD and increasing overall awareness and acceptance toward pediatric organ donations.
Massive transfusion protocols in paediatric trauma population: A systematic review
Authors: Kinslow Kyle , McKenney Mark , Boneva Dessy , Elkbuli Adel 
Published: May 2020

AbstractBackgroundOur main objective was to review the literature to answer the following questions regarding paediatric massive transfusion (PMT) protocols: (a) How is PMT defined?; (b) Which blood product ratios have been investigated, and what is their effect on outcomes?; and (c) What evidence exists regarding PMT outcomes?MethodsThe PRISMA guidelines were used. We searched PubMed, Google Scholar, Cochrane Library, EMBASE, Wiley Online Library and Ovid. Articles were screened for inclusion based on relevance to PMT. Articles were assessed for study design, presence of established/tested PMT, PMT definition, PMT activation criteria and Transfusion Ratios for the final determination of article inclusion.ResultsOur search produced 3213 articles, with 33 included for final review. Existing definitions of PMT are based on volume administered/kg but vary in timeframe criteria (over 4 hours vs 24 hours). Some studies have investigated “high” balanced transfusion ratios as seen in adults (1:1 FFP:pRBC), with a few showing statistically significant improvement in paediatric mortality vs lower ratios. PMT protocol implementation has not been shown to consistently reduce paediatric trauma mortality across multiple centres. However, other operational aspects, such as reduced time to first transfusion, are apparent benefits.ConclusionsThere is poor consensus over the definition of PMT. Definitions that involve early recognition have the most promise for practice and future studies. Evidence supporting an optimal blood product ratio in PMT is also lacking but trends towards supporting balanced approaches. Implementation of PMT protocols has been limited in showing significant improvement of overall paediatric trauma mortality but may reduce associated morbidity.
Association of vitamin B12deficiency in people with type 2 diabetes on metformin and without metformin: a multicenter study, Karachi, Pakistan
Authors: Miyan Zahid , Waris Nazish 
Published: May 2020

ObjectiveTo assess the prevalence of vitamin B12deficiency in people with type 2 diabetes mellitus (T2DM) on metformin and without metformin.MethodologyBetween May 2018 and January 2019, this prospective multicenter observational study recruited participants from seven centers in four provinces of Pakistan (Sindh, Punjab, Baluchistan and Khyber Pakhtunkhwa). Participants with T2DM treated with metformin for >2 years and those not on metformin underwent assessment of hemoglobin, vitamin B12, homocysteine and diabetic neuropathy (vibration perception threshold (VPT) >15V) and painful diabetic neuropathy (Douleur Neuropathique 4 (DN4) ≥4) and Diabetic Neuropathy Symptom (DNS) score ≥1.ResultsOf 932 subjects, 645 (69.2%) were treated with metformin, while 287 (30.8%) were not on metformin. Overall, B12deficiency (<200 pg/mL) was significantly higher in metformin users of 25 (3.9%), compared with non-metformin users of 6 (2.1%), while B12insufficiency (200–300 pg/mL) was significantly lower in metformin users of 117 (18.4%) compared with non-metformin users of 80 (27.9%). Subjects with B12deficiency and insufficiency with hyperhomocysteinemia (≥15) were found in 19 (76%) µmol/L and 69 (60.5%) µmol/L in metformin users compared with 6 (100%) µmol/L and 57 (73.1%) μmol/L in non-metformin users, respectively. VPT>25 and DN4 score ≥4 were significantly higher in B12-deficient metformin users compared with non-metformin users. Similarly, DNS score ≥1 was non-significantly higher in B12-deficient metformin users compared with non-metformin users.ConclusionThis study shows that vitamin B12insufficiency was frequently found in our population and may progress into B12deficiency. It is also associated with neuropathy in subjects on metformin. Further interventional studies to assess the benefit of B12treatment on painful neuropathy in patients on metformin may be warranted. B12levels may be checked in people with T2DM using metformin for >2 years.
Risk factors for genital infections in people initiating SGLT2 inhibitors and their impact on discontinuation
Authors: McGovern Andrew P , Hogg Michael , Shields Beverley M , Sattar Naveed A , Holman Rury R , Pearson Ewan R , Hattersley Andrew T , Jones Angus G , Dennis John M 
Published: May 2020

IntroductionTo identify risk factors, absolute risk, and impact on treatment discontinuation of genital infections with sodium-glucose co-transporter-2 inhibitors (SGLT2i).Research design and methodsWe assessed the relationship between baseline characteristics and genital infection in 21 004 people with type 2 diabetes initiating SGLT2i and 55 471 controls initiating dipeptidyl peptidase-4 inhibitors (DPP4i) in a UK primary care database. We assessed absolute risk of infection in those with key risk factors and the association between early genital infection and treatment discontinuation.ResultsGenital infection was substantially more common in those treated with SGLT2i (8.1% within 1 year) than DPP4i (1.8%). Key predictors of infection with SGLT2i were female sex (HR 3.64; 95% CI 3.23 to 4.11) and history of genital infection; <1 year before initiation (HR 4.38; 3.73 to 5.13), 1–5 years (HR 3.04; 2.64 to 3.51), and >5 years (HR 1.79; 1.55 to 2.07). Baseline HbA1c was not associated with infection risk for SGLT2i, in contrast to DPP4i where risk increased with higher HbA1c. One-year absolute risk of genital infection with SGLT2i was highest for those with a history of prior infection (females 23.7%, males 12.1%), compared with those without (females 10.8%, males 2.7%). Early genital infection was associated with a similar discontinuation risk for SGLT2i (HR 1.48; 1.21–1.80) and DPP4i (HR 1.58; 1.21–2.07).ConclusionsFemale sex and history of prior infection are simple features that can identify subgroups at greatly increased risk of genital infections with SGLT2i therapy. These data can be used to risk-stratify patients. High HbA1c is not a risk factor for genital infections with SGLT2i.
10-Valent pneumococcal non-typeable H. influenzae protein D conjugate vaccine (PHiD-CV10) versus 13-valent pneumococcal conjugate vaccine (PCV13) as a booster dose to broaden and strengthen protection from otitis media (PREVIX_BOOST) in Australian Aboriginal children: study protocol for a randomised controlled trial
Authors: Oguoma Victor M , Wilson Nicole , Mulholland Kim , Santosham Mathuram , Torzillo Paul , McIntyre Peter , Smith-Vaughan Heidi , Balloch Anne , Chatfield Mark , Lehmann Deborah , Binks Michael J , Chang Anne , Carapetis Jonathan , Krause Vicki , Andrews Ross , Snelling Tom , Licciardi Paul , Morris Peter , Leach Amanda Jane 
Published: May 2020

IntroductionStreptococcus pneumoniae and non-typeable Haemophilus influenzae (NTHi) are major otitis media pathogens that densely co-colonise the nasopharynx and infect the middle ear of Australian Aboriginal infants from very early in life. Our co-primary hypotheses are that at 18 months of age infants receiving 10-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine (PHiD-CV10) compared with those receiving 13-valent pneumococcal conjugate vaccine (PCV13) as a booster at 12 months of age will have higher antibody levels to Haemophilus influenzae protein D and that infants receiving PCV13 will have higher antibody levels to PCV13-only serotypes 3, 6A and 19A.Methods and analysesOur randomised controlled trial will enrol 270 Aboriginal children at 12 months of age to a booster dose of either PHiD-CV10 or PCV13. Children who completed the three-dose primary course schedules of PHiD-CV10 at 2, 4, 6 months of age; PCV13 at 2, 4, 6 months of age; or a combination schedule of PHiD-CV10 at 1, 2, 4 months of age plus PCV13 at 6 months of age are eligible. The co-primary assessor-blinded outcomes when the infants are 18 months of age are as follows: (a) IgG geometric mean concentration (GMC) and proportion with IgG ≥100 EU/mL for protein D, and (b) IgG GMC and the proportion with IgG ≥0.35 µg/mL for pneumococcal serotypes 3, 6A and 19A. Secondary immunogenicity comparisons of six primary and booster dose schedules of 10 shared serotypes at 18 months of age, nasopharyngeal carriage, all forms of otitis media, hearing loss and developmental milestones at 18, 24, 30 and 36 months of age will be reported.Ethics and disseminationEthics committees of NT Department of Health, Menzies, WA Department of Health and WA Aboriginal Health approved the study. Results will be presented to communities, at conferences and published in peer-reviewed journals.Trial registration numberNCT01735084.
The Copenhagen Primary Care Laboratory Pregnancy (CopPreg) database
Authors: Janbek Janet , Kriegbaum Margit , Grand Mia Klinten , Specht Ina Olmer , Lind Bent Struer , Andersen Christen Lykkegaard , Heitmann Berit Lilienthal 
Published: May 2020

PurposeThe Copenhagen Primary Care Laboratory Pregnancy (CopPreg) database was established based on data from The Danish Medical Birth Register and the Copenhagen Primary Care Laboratory (CopLab) database. The aim was to provide a biomedical and epidemiological data resource for research in early disease programming (eg, parental clinical biomarker levels and pregnancy/ birth outcomes or long-term health in the offspring).ParticipantsThe cohort consisted in total of 203 608 women (with 340 891 pregnancies) who gave birth to 348 248 children and with 200 590 related fathers. In this paper, we focused on women and fathers who had clinical test requisitions prior to and during pregnancy, and on all children. Thus, the cohort in focus consisted of 203 054 pregnancies with requisitions on 147 045 pregnant women, 39 815 fathers with requisitions during periconception and 65 315 children with requisitions.Findings to dateIn addition to information on pregnancy and birth health status and general socio-demographic data, over 2.2 million clinically relevant test results were available for pregnancies with requisitions, over 1.5 million for children and over 600 000 test results were available for the fathers with requisitions during periconception. These were ordered by general practitioners in the primary care setting only and included general blood tests, nutritional biomarkers (macronutrients and micronutrients) and hormone tests. Information on tests related to infections, allergies, heart and lung function and sperm analyses (fathers) were also available.Future plansThe CopPreg database provides ready to use and valid data from already collected, objectively measured and analysed clinical tests. With several research projects planned, we further invite national and international researchers to use this vast data resource. In a coming paper, we will explore and discuss the indication bias in our cohort.
Hypothetical interventions and risk of myocardial infarction in a general population: application of the parametric g-formula in a longitudinal cohort study—the Tromsø Study
Authors: Wilsgaard Tom , Vangen-Lønne Anne Merete , Mathiesen Ellisiv , Løchen Maja-Lisa , Njølstad Inger , Heiss Gerardo , Danaei Goodarz 
Published: May 2020

ObjectivesThe aim of this study was to use the parametric g-formula to estimate the 19-year risk of myocardial infarction (MI) under hypothetical interventions on six cardiovascular risk factors.Design and settingA populations-based cohort study with repeated measurements, the Tromsø Study.Primary outcome measureMyocardial infarction.ParticipantsWe estimated the relative and absolute risk reduction under feasible and intensive risk reduction strategies for smoking, physical activity, alcohol drinking, body mass index, total serum cholesterol and systolic blood pressure in 14 965 men and women with 19 years of follow-up (1994–2013).ResultsThe estimated 19-year risk of MI under no intervention was 7.5% in individuals with baseline mean age 49.3 years (range 25–69). This risk was reduced by 30% (95% CI 19% to 39%) under joint feasible interventions on all risk factors, and 70% (60%, 78%) under a set of more intensive interventions. The most effective interventions were lowering of total cholesterol to 5.18 mmol/L and lowering of systolic blood pressure to 120 mm Hg (33% and 37% lower MI risk, respectively). The absolute risk reductions were significantly larger in men, in older participants, in smokers and in those with low education.ConclusionModification of population levels of cardiovascular risk factors could have prevented close to one-third of the cases of MI in the municipality of Tromsø during 19 years of follow-up.