bluuebunny/crossref_metadata_2025_split huggingface dataset:
Orthodontic incisor retraction caused changes in the soft tissue chin area: a retrospective study
Authors: Lu Wenxin , Zhang Xu , Mei Li , Wang Pengfei , He Jiarong , Li Yu , Zhao Zhihe 
Published: April 2020

Abstract
Background
To investigate the area and morphological changes around the soft tissue chin after orthodontic incisor retraction.

Methods
Fifty-nine female adults with bimaxillary protrusion requiring extraction of four premolars were included in the study. Cephalograms were taken before (T0) and after (T1) orthodontic treatment. The soft tissue changes, including the area, thickness and morphology were measured. Paired-t tests were performed for statistical comparisons. Pearson correlation analyses and backward multivariate regression analyses were used to identify the relationship between the soft tissue changes and incisor retraction.

Results
Following the incisor retractions (5.35 ± 1.79 mm and 4.42 ± 1.62 mm for the upper and lower, respectively), there was a significant increase in the soft tissue thickness of L1c-LL (0.64 ± 1.67 mm, P = 0.025) and Pog-Pog’ (0.44 ± 1.10 mm, P = 0.022), and a significant decrease in the soft tissue thickness of B-B′ (1.21 ± 1.34 mm, P <  0.01). Changes in the area of soft tissue chin and lower lip were not statistically significant (P > 0.05). Pearson coefficient between the thickness changes of B-B′ and the retraction of lower incisors was − 0.376. The multiple correlations between the soft tissue thickness changes and incisor retractions were Y = 1.02–0.42a + 0.42b for L1c-LL, and Y = 0.17–0.31b for B-B′.

Conclusions
The orthodontic incisor retraction could cause soft tissue thickness changes (i.e. an increase in L1c-LL and Pog-Pog’ and a decrease in B-B′) without area changes.
Prevalence and correlates of bullying in physiotherapy education in Nigeria
Authors: Mbada Chidozie Emmanuel , Ogunseun Idowu Phebean , Fasuyi Francis Oluwafunso , Adegbemigun Oluwafemi David , Fatoye Clara Toyin , Idowu Opeyemi Ayodiipo , Johnson Olubusola Esther , Odole Adesola Christiana , Okonji Adaobi Margaret , Kaka Bashir , Fatoye Francis 
Published: April 2020

AbstractBackgroundBullying is an unexpressed part and parcel of medical education but it is largely unexplored in physiotherapy. This study assessed the prevalence and socio-demographic correlates of bullying in physiotherapy education in Nigeria.MethodsTwo hundred and nineteen clinical physiotherapy students from three purposively selected Federal Universities in Nigeria participated in this study. Following a cross-sectional design, the Students Perception of Professor Bullying Questionnaire (SPPBQ) was used to obtain information on bullying. The SPPBQ includes a working definition of lecturer bullying followed by other sections inquiring about lecturers bullying experiences. Data was collected on socio-demographic characteristics, bullying experiences and availability of adequate policy and support on bullying. Descriptive and inferential statistics were used analyze data. Alpha level was set atp < 0.05.ResultsLifetime and point prevalence of bullying in physiotherapy education were 98.6 and 99.1%. 94.5% of the respondents had witnessed physiotherapy students bullying and there was a 100% rate of ‘no attempt’ to stop a physiotherapy lecturer from bullying. 38.4 and 44.7% of the respondents believed there was adequate school policy and support available on bullying. There was no significant association between bullying and each of age (휒2 = 0.117,p = 0.943), gender (휒2 = 0.001,p = 0.974), level of study (휒2 = 0.000,p = 0.995) and any specific university (휒2 = 1.343,p = 0.511).ConclusionThere is high lifetime and point prevalence of bullying in physiotherapy education in Nigeria, which are largely unchallenged or redressed. Being a clinical physiotherapy student ordinarily predisposes to bullying without necessary contributions of intrinsic and extrinsic factors.
Selecting top candidates for medical school selection interviews- a non-compensatory approach
Authors: Shulruf Boaz , O’Sullivan Anthony , Velan Gary 
Published: April 2020

Abstract
Background
Medical schools apply a range of selection methods to ensure that admitted students succeed in the program. In Australia, selection tools typically include measures of academic achievement (e.g. the Australian Tertiary Admission Rank – ATAR) and aptitude tests (e.g. the Undergraduate Medicine and Health Sciences Admissions Test – UMAT). These are most commonly used to determine which applicants are invited for additional selection processes, such as interviews. However, no previous study has examined the efficacy of the first part of the selection process. In particular, are compensatory or non-compensatory approaches more effective in evaluating the outcomes of cognitive and aptitude tests, and do they affect the demographics of students selected for interview?

Methods
This study utilised data from consecutive cohorts of mainstream domestic students who applied to enter the UNSW Medicine program between 2013 to 2018. A compensatory ranked selection model was compared with a non-compensatory ranked model. Initially, ATAR marks and UMAT scores for each applicant were ranked within each cohort. In the compensatory model, the mean of the ATAR and UMAT ranks were used to determine the outcome. In the non-compensatory model, the lowest rank of ATAR and UMAT determined the outcome for each applicant. The impact of each model on the gender and socioeconomic status of applicants selected to interview was evaluated across all cohorts.

Results
The non-compensatory ranked selection model resulted in substantially higher ATAR and UMAT thresholds for invitation to interview, with no significant effect on the socioeconomic status of the selected applicants.

Conclusions
These results are important, demonstrating that it is possible to raise the academic threshold for selection to medicine without having any negative impact on applicants from low socioeconomic backgrounds. Overall, the evidence gathered in this study suggests that a non-compensatory model is preferable for selecting applicants for medical student selection interview.
Development and psychometric evaluation of a new tool for measuring the attitudes of patients with progressive neurological diseases to ethical aspects of end-of-life care
Authors: Bužgová Radka , Kozáková Radka 
Published: April 2020

AbstractBackgroundKnowing the opinions of patients with Progressive Neurological Diseases (PNDs) and their family members on end-of-life care can help initiate communication and the drawing up of a care plan. The aim of this paper is to describe the creation and psychometric properties of the newly developed APND-EoLC questionnaire (theAttitudes of Patients with Progressive Neurological Disease to End of Life Carequestionnaire).MethodsFollowing focus group discussion, four main areas of interest were identified: patients’ and family members’ attitudes towards end-of-life care, factors influencing decisions about treatment to prolong patients’ life, concerns and fears regarding dying, and opinions on the system of care. The created questions were divided into domains based on factor analysis and psychometric properties were evaluated by sample of 209 patients with PND and 118 their family members.ResultsThe final version of the scale contains a total of 28 questions divided into six domains (end-of-life control, keeping patients alive, trust in doctors/treatment, trust in social support, sense of suffering, and dependence/loss of control) and five individual questions determining views of the care system with specified response options. Construct validity was verified by confirmatory factor analysis for each evaluated area individually. Appropriate psychometric properties were identified in the questionnaire.ConclusionsThe APND-EoLC questionnaire can be recommended for use in both research and clinical practice.
Perspectives regarding privacy in clinical research among research professionals from the Arab region: an exploratory qualitative study
Authors: Adarmouch Latifa , Felaefel Marwan , Wachbroit Robert , Silverman Henry 
Published: April 2020

Abstract
Background
Protecting the privacy of research participants is widely recognized as one of the standard ethical requirements for clinical research. It is unknown, however, how research professionals regard concepts of privacy as well as the situations in the research setting that require privacy protections. The aim of this study was to explore the views of research professionals from Arab countries regarding concepts and scope of privacy that occur in clinical research.

Methods
We adopted an exploratory qualitative approach by the use of focus group discussions. We recruited individuals involved in research from Egypt and Morocco. We analyzed focus group data via a constant comparison approach, which consisted of close reading of the transcribed interviews followed by coding and then determining themes and subthemes.

Results
Between August 2016 and July 2018, we conducted nine focus group discussions. Respondents discussed several privacy issues that occurred before the research began (e.g., recruitment practices); during research (e.g., data collection and physical exams), and after the research (e.g., secondary use of data and data sharing). Respondents revealed their perspectives of patients towards privacy in the clinical and research settings and mentioned that patients are more likely to permit access to their privacy in the clinical setting compared with research setting due to the existence of benefits and trust in clinical care. Respondents also recommended training regarding data protections for individuals involved in research.

Conclusions
Our study shows that research professionals discussed a range of privacy issues that are present during the different stages of research. We recommend 1) development of standards regarding privacy protections during recruitment efforts; 2) additional training for individuals involved in research regarding best practices with data security in secondary research; 3) a quantitative study involving investigators and REC members to determine their knowledge, attitudes and practices regarding privacy issues that occur in research; and 4) a quantitative study involving patients to elicit their views regarding their privacy concerns in research.
Relationship of patient safety culture with factors influencing working environment such as working hours, the number of night shifts, and the number of days off among healthcare workers in Japan: a cross-sectional study
Authors: Hayashi Ryosuke , Fujita Shigeru , Iida Shuhei , Nagai Yoji , Shimamori Yoshiko , Hasegawa Tomonori 
Published: April 2020

Abstract
Background
Patient safety culture is defined as a product of individual and group values, attitudes, perceptions, competencies, and patterns of behavior that determine the commitment to, and the style and proficiency of, an organization’s health and safety management. Factors influencing healthcare workers’ working environment such as working hours, the number of night shifts, and the number of days off may be associated with patient safety culture, and the association pattern may differ by profession. This study aimed to examine the relationship between patient safety culture and working environment.

Methods
Questionnaire surveys were conducted in 2015 and 2016. The first survey was conducted in hospitals in Japan to investigate their patient safety management system and activities and intention to participate in the second survey. The second survey was conducted in 40 hospitals; 100 healthcare workers from each hospital answered a questionnaire that was the Japanese version of the Hospital Survey on Patient Safety Culture for measuring patient safety culture. The relationship of patient safety culture with working hours in a week, the number of night shifts in a month, and the number of days off in a month was analyzed.

Results
Response rates for the first and second surveys were 22.4% (731/3270) and 94.2% (3768/4000), respectively. Long working hours, numerous night shifts, and few days off were associated with low patient safety culture. Despite adjusting the working hours, the number of event reports increased with an increase in the number of night shifts. Physicians worked longer and had fewer days off than nurses. However, physicians had fewer composites of patient safety culture score related to working hours, the number of night shifts, and the number of days off than nurses.

Conclusions
This study suggested a possibility of improving the patient safety culture by managing the working environment of healthcare workers. High number of night shifts may lead to high number of event reports. Working hours, the number of night shifts, and the number of days off may differently influence patient safety culture in physicians and nurses.
The nature and activity of liaison mental services in acute hospital settings: a multi-site cross sectional study
Authors: Saraiva Sonia , Guthrie Elspeth , Walker Andrew , Trigwell Peter , West Robert , Shuweidi Farag , Crawford Mike , Fossey Matt , Hewison Jenny , Murray Carolyn Czoski , Hulme Claire , House Allan 
Published: April 2020

Abstract
Background
To describe the clinical activity patterns and nature of interventions of hospital-based liaison psychiatry services in England.

Methods
Multi-site, cross-sectional survey. 18 acute hospitals across England with a liaison psychiatry service. All liaison staff members, at each hospital site, recorded data on each patient they had face to face contact with, over a 7 day period. Data included location of referral, source of referral, main clinical problem, type of liaison intervention employed, staff professional group and grade, referral onto other services, and standard assessment measures.

Results
A total of 1475 face to face contacts from 18 hospitals were included in the analysis, of which approximately half were follow-up reviews. There was considerable variation across sites, related to the volume of Emergency Department (ED) attendances, number of hospital admissions, and work hours of the team but not to the size of the hospital (number of beds). The most common clinical problems were co-morbid physical and psychiatric symptoms, self-harm and cognitive impairment. The main types of intervention delivered were diagnosis/formulation, risk management and advice. There were differences in the type of clinical problems seen by the services between EDs and wards, and also differences between the work conducted by doctors and nurses. Almost half of the contacts were for continuing care, rather than assessment. Eight per cent of all referrals were offered follow up with the LP team, and approximately 37% were referred to community or other services.

Conclusions
The activity of LP services is related to the flow of patients through an acute hospital. In addition to initial assessments, services provide a wide range of differing interventions, with nurses and doctors carrying out distinctly different roles within the team. The results show the volume and diversity of LP work. While much clinical contact is acute and confined to the inpatient episode, the LP service is not defined solely by an assessment and discharge function; cases are often complex and nearly half were referred for follow up including liaison team follow up.
Effects of a rehabilitation program for individuals with chronic spinal cord injury in Shanghai, China
Authors: Chang Fengshui , Zhang Qi , Xie Haixia , Yang Yuhui , Sun Mei , Wu Airong , Wu Jinghua , Chen Gang , Shen Feng , Li Chengyue , Lu Jun 
Published: April 2020

Abstract
Background
Specialized Institution-Based Rehabilitation (SIBR) is the cornerstone of care and treatment for individuals with spinal cord injury, but most people with chronic spinal cord injury (CSCI) living in China have no SIBR experience after acute care hospital discharge. In 2009, an SIBR facility was set up in Shanghai (China) to fill this important gap in care. The purpose of the study was to evaluate the effectiveness of an integrated rehabilitation training program among individuals with CSCI living in Shanghai.

Methods
A within-subject pre-posttest design was used to evaluate the SIBR. The sample included 455 individuals ≥1 year post-SCI, who were older than 18 years of age and were enrolled in a rehabilitation center in Shanghai, China, between 2013 and 2019. The data included individuals’ sociodemographic and injury characteristics, and twenty-three indicators were used as outcome measurements to evaluate basic life skills and their applications in family and social life. Multivariate linear regression was conducted to determine which factors might have influenced the effectiveness of the SIBR.

Results
All basic life skills and their applications in family and social life were improved, but with variations across socio-demographics. Female individuals with CSCI had better outcomes in basic life skills than did males. In terms of basic life skills and their applications in family and social life, individuals with a low level (thoracic or lumbosacral) of injury achieved more significant functional gains than those with a higher level (cervical). The baseline score was also a relevant factor in functional outcome.

Conclusions
Even for individuals with a long SCI history, SIBR training can improve basic life skills and the applications of those skills in family and social life settings.
The effects of enhanced primary healthcare interventions on primary care providers’ job satisfaction
Authors: Wong Wen Jun , Mohd Norzi Aisyah , Ang Swee Hung , Chan Chee Lee , Jaafar Faeiz Syezri Adzmin , Sivasampu Sheamini 
Published: April 2020

Abstract
Background
In response to the rising burden of cardiovascular risk factors, the Malaysian government has implemented Enhanced Primary Healthcare (EnPHC) interventions in July 2017 at public clinic level to improve management and clinical outcomes of type 2 diabetes and hypertensive patients. Healthcare providers (HCPs) play crucial roles in healthcare service delivery and health system reform can influence HCPs’ job satisfaction. However, studies evaluating HCPs’ job satisfaction following primary care transformation remain scarce in low- and middle-income countries. This study aims to evaluate the effects of EnPHC interventions on HCPs’ job satisfaction.

Methods
This is a quasi-experimental study conducted in 20 intervention and 20 matched control clinics. We surveyed all HCPs who were directly involved in patient management. A self-administered questionnaire which included six questions on job satisfaction were assessed on a scale of 1–4 at baseline (April and May 2017) and post-intervention phase (March and April 2019). Unadjusted intervention effect was calculated based on absolute differences in mean scores between intervention and control groups after implementation. Difference-in-differences analysis was used in the multivariable linear regression model and adjusted for providers and clinics characteristics to detect changes in job satisfaction following EnPHC interventions. A negative estimate indicates relative decrease in job satisfaction in the intervention group compared with control group.

Results
A total of 1042 and 1215 HCPs responded at baseline and post-intervention respectively. At post-intervention, the intervention group reported higher level of stress with adjusted differences of − 0.139 (95% CI -0.266,-0.012; p = 0.032). Nurses, being the largest workforce in public clinics were the only group experiencing dissatisfaction at post-intervention. In subgroup analysis, nurses from intervention group experienced increase in work stress following EnPHC interventions with adjusted differences of − 0.223 (95% CI -0.419,-0.026; p = 0.026). Additionally, the same group were less likely to perceive their profession as well-respected at post-intervention (β = − 0.175; 95% CI -0.331,-0.019; p = 0.027).

Conclusions
Our findings suggest that EnPHC interventions had resulted in some untoward effect on HCPs’ job satisfaction. Job dissatisfaction can have detrimental effects on the organisation and healthcare system. Therefore, provider experience and well-being should be considered before introducing healthcare delivery reforms to avoid overburdening of HCPs.
Equity and efficiency of maternal and child health resources allocation in Hunan Province, China
Authors: Huang Minyuan , Luo Dan , Wang Zhanghua , Cao Yongmei , Wang Hua , Bi Fengying , Huang Yunxiang , Yi Luxi 
Published: April 2020

Abstract
Background
A reasonable allocation of health resources is often characterized by equity and high efficiency. This study aims to evaluate the equity and efficiency of maternal and child health (MCH) resources allocation in Hunan Province, China.

Methods
Data related to MCH resources and services was obtained from the Hunan maternal and child health information reporting and management system. The Gini coefficient and data envelopment analysis (DEA) were employed to evaluate the equity and efficiency of MCH resources allocation, respectively.

Results
The MCH resources allocation in terms of demographic dimension were in a preferred equity status with the Gini values all less than 0.3, and the Gini values for each MCH resources’ allocation in terms of the geographical dimension ranged from 0.1298 to 0.4256, with the highest values in the number of midwives and medical equipment (≥ CNY 10,000), which exceeds 0.4, indicating an alert of inequity. More than 40% regions in Hunan were found to be relatively inefficient with decreased return to scale in the allocation of MCH resources, indicating those inefficient regions were using more inputs than needed to obtain the current output levels.

Conclusions
The equity of MCH resources by population size is superior by geographic area and the disproportionate distribution of the number of medical equipment (≥ CNY 10,000) and midwives between different regions was the main source of inequity. Policy-makers need to consider the geographical accessibility of health resources among different regions to ensure people in different regions could get access to available health services. More than 40% of regions in Hunan were found to be inefficient, with using more health resources than needed to produce the current amount of health services. Further investigations on factors affecting the efficiency of MCH resources allocation is still needed to guide regional health plans-making and resource allocation.