bluuebunny/crossref_metadata_2025_split huggingface dataset:
Influence of Texture Evolution on Mechanical and Damping Properties of SiC/Li2ZrO3/Al Composite Through Friction Stir Processing
Authors: Singh Subhash , Pal Kaushik 
Published: November 2019

AbstractIn this study, parent aluminum (Al), silicon carbide (SiC) reinforced Al, zirconia (ZrO2) coated SiC reinforced Al, and lithium zirconate spinel (Li2ZrO3, LZO) encapsulated SiC incorporated Al metal matrix composites were processed via friction stir processing (FSP) technique to observe the influence of grain refinement on mechanical and damping properties. Electron backscattered diffraction (EBSD) analysis were conducted for detailed and deep understanding of possible mechanism and microstructure at longitudinal cross sections of the samples. Further, the room temperature mechanical properties and thermal cyclic (−100 to 400 °C) damping performance of the friction stir processed composites were studied. The results obtained in this investigation show that storage modulus of pristine Al, SiC reinforced Al, ZrO2 coated SiC reinforced Al, and LZO coated SiC reinforced Al were improved by a factor of 1.09, 1.17, 1.09, and 1.38, respectively, after FSP. Additionally, the ultimate tensile strength (UTS) and hardness of the friction stir processed SiC/Li2ZrO3/Al composite were improved by a factor of 1.08 and 1.11, respectively, after FSP was compared with an unprocessed composite.
Daily life participation in childhood chronic disease: a qualitative study
Authors: Nap-van der Vlist Merel M , Kars Marijke C , Berkelbach van der Sprenkel Emma E , Nijhof Linde N , Grootenhuis Martha A , van Geelen Stefan M , van der Ent Cornelis K , Swart Joost F , van Royen-Kerkhof Annet , van Grotel Martine , van de Putte Elise M , Nijhof Sanne L 
Published: November 2019

ObjectiveOpportunities to participate in daily life have improved considerably for children with chronic disease. Nevertheless, they still face challenges associated with their ever-present illness affecting every aspect of their lives. To best help these children, we aimed to assess the child’s own perspective on participation and the main considerations that affect participation in a stable phase of disease.MethodsQualitative study design was applied. Semistructured, indepth interviews were conducted and analysed by a general inductive approach using constant comparison, coding and categorisation. Children 8–18 years old with a chronic disease were recruited from a cohort study involving cystic fibrosis, autoimmune disease and post-treatment paediatric cancer.Results31 of the 56 (55%) invited patients participated. From the perspective of children with chronic disease, participation is considered more than merely engaging in activities; rather, they view having a sense of belonging, the ability to affect social interactions and the capacity to keep up with peers as key elements of full participation. Some children typically placed a higher priority on participation, whereas other children typically placed a higher priority on their current and/or future needs, both weighing the costs and benefits of their choices and using disclosure as a strategy.ConclusionsEnabling full participation from the child’s perspective will help realise patient-centred care, ultimately helping children self-manage their participation. Caregivers can stimulate this participation by evaluating with children how to achieve a sense of belonging, active involvement and a role within a peer group. This requires active collaboration between children, healthcare providers and caregivers.
The role of education in the association between self-rated health and levels of C-reactive protein: a cross-sectional study in rural areas of China
Authors: Tu Raoping , Pan Kuan-Yu , Cai Guoxi , Yamamoto Taro , Wang Hui-Xin 
Published: November 2019

ObjectivesThis study aims to examine the association between self-rated health (SRH) and levels of C-reactive protein (CRP) among adults aged 45 to 101 years old in rural areas of China, and to explore the role of education in the association.DesignCross-sectional study.SettingThe study population was derived from two databases in China: Nanping project (NP) and the China Health and Retirement Longitudinal Study (CHARLS).ParticipantsThere were 646 participants from a rural area of Nanping (NP) and 8555 rural participants from a national representative sample of China (CHARLS).MethodsCRP was measured using a high sensitivity sandwich enzyme immunoassay in the NP and immunoturbidimetric assay in the CHARLS. SRH was assessed by SRH questionnaires and categorised into good and poor. Education was measured by the maximum years of schooling and dichotomised into illiterate and literate. Multivariate linear regression models were used to study the associations.ResultsCompared to people with good SRH, those with poor SRH had higher levels of CRP in NP (β=0.16, 95% CI −0.02 to 0.34) and in CHARLS (β=0.07, 95% CI 0.02 to 0.11) after adjusting for potential confounders. Similar findings were observed in the pooled population (β=0.08, 95% CI 0.03 to 0.12), especially in men (β=0.13, 95% CI 0.06 to 0.20) and in literate people (β=0.12, 95% CI 0.06 to 0.18).ConclusionPoor SRH may be a predicator of elevated levels of CRP among middle-aged and older people in rural areas, especially in men and literate people.
Decomposition of the US black/white inequality in premature mortality, 2010–2015: an observational study
Authors: Kiang Mathew V , Krieger Nancy , Buckee Caroline O , Onnela Jukka Pekka , Chen Jarvis T 
Published: November 2019

ObjectiveDecompose the US black/white inequality in premature mortality into shared and group-specific risks to better inform health policy.SettingAll 50 US states and the District of Columbia, 2010 to 2015.ParticipantsA total of 2.85 million non-Hispanic white and 762 639 non-Hispanic black US-resident decedents.Primary and secondary outcome measuresThe race-specific county-level relative risks for US blacks and whites, separately, and the risk ratio between groups.ResultsThere is substantial geographic variation in premature mortality for both groups and the risk ratio between groups. After adjusting for median household income, county-level relative risks ranged from 0.46 to 2.04 (median: 1.03) for whites and from 0.31 to 3.28 (median: 1.15) for blacks. County-level risk ratios (black/white) ranged from 0.33 to 4.56 (median: 1.09). Half of the geographic variation in white premature mortality was shared with blacks, while only 15% of the geographic variation in black premature mortality was shared with whites. Non-Hispanic blacks experience substantial geographic variation in premature mortality that is not shared with whites. Moreover, black-specific geographic variation was not accounted for by median household income.ConclusionUnderstanding geographic variation in mortality is crucial to informing health policy; however, estimating mortality is difficult at small spatial scales or for small subpopulations. Bayesian joint spatial models ameliorate many of these issues and can provide a nuanced decomposition of risk. Using premature mortality as an example application, we show that Bayesian joint spatial models are a powerful tool as researchers grapple with disentangling neighbourhood contextual effects and sociodemographic compositional effects of an area when evaluating health outcomes. Further research is necessary in fully understanding when and how these models can be applied in an epidemiological setting.
Needlestick prevention devices: data from hospital surveillance in Piedmont, Italy—comprehensive analysis on needlestick injuries between healthcare workers after the introduction of safety devices
Authors: Ottino Maria Chiara , Argentero Andrea , Argentero Pier Angelo , Garzaro Giacomo , Zotti Carla Maria 
Published: November 2019

ObjectiveNeedlestick and sharps injuries (NSIs) involving healthcare workers (HCWs) are worldwide under surveillance since long time; the implementation of the European Directive 32/2010 regarding the mandatory use of safety-engineered devices (SEDs) seems to have reduced the number of these accidents. Our surveillance investigated the frequency and the modality of SED-related NSIs in the Piedmont region to verify changes in the epidemiology of these events.MethodsWe analysed the exposure records of NSIs, device usage data and structural data of 42 acute care hospitals and compared conventional and safety devices. We calculated the accident rates per 100 000 needles and, as a measure of SED efficacy, the relative risk between the use of safety and non-safety devices with a 95% CI. We also described the dynamics of the NSIs and the most involved professional groups of HCWs, procedures and devices.ResultsTotal and specific device accident rates for 100 000 needles were lower with the use of SEDs. In 2015–2016, there were 1640 NSIs, with a decreasing absolute number during the observation period; 18% were SEDs related. Half of the total accidents with SEDs occurred in the patient’s room, and nurses were involved in 78% of the cases. The most involved devices were the butterfly needles and peripheral venous catheters, and the most involved procedures were venous sampling (40%) and phlebotherapy (16%). The exposures occurred mostly during the procedure, and 45% of the SED-related injuries occurred during the disposal of the device; 92% of the SEDs involved had a manual activation mechanism.ConclusionIn agreement with the results of other European studies, our results show that SEDs reduce the risk of percutaneous exposure of HCWs, but in introducing SEDs, we must select those with a higher level of safety (with a passive activation mechanism) and improve the healthcare staff training programmes.
Implementation and refinement of a community health nurse model of support for people experiencing homelessness in Australia: a collaborative approach
Authors: Goeman Dianne , Howard Jane , Ogrin Rajna 
Published: November 2019

ObjectiveTo implement, refine and evaluate an assertive community health nurse (CHN) model of support for people experiencing or at risk of homelessness that aims to improve their access to health and social care services.MethodsParticipants were recruited between 30 August 2013 and 31 October 2015, including clients residing in a Victorian southern Melbourne metropolitan suburb, who registered with the CHN and stakeholders from local service provider organisations engaging with the CHN. A collaborative approach using demographic data collected from client records to identify need and measure the time clients took to engage and access services, qualitative data gathered during Stakeholder Advisory Group meetings and feedback from face-to-face interviews with service organisation representatives informed refinement of the CHN model.ResultsThirty-nine clients (22 Female, mean age 50±11 years) participated. Clients engaged with services after an average of seven CHN visits. Eighteen clients independently accessed services after approximately 9 weeks, including medical and housing services. Client need and feedback from 20 stakeholders and three community nurses contributed to refining the model to ensure it met local needs and informed the necessary organisational framework, the CHN role and the attributes, knowledge and the skills required.ConclusionA collaborative CHN model of support for people at risk of or experiencing homelessness has been articulated. Evaluation of the role demonstrated increased client engagement with health and community services and social activities. Additionally, the CHN assisted other service providers in their delivery of care to this very complex client group.
Healthy lifestyle behaviour and risk of long-duration troublesome neck pain among men and women with occasional neck pain: results from the Stockholm public health cohort
Authors: Bohman Tony , Holm Lena W , Hallqvist Johan , Pico-Espinosa Oscar J , Skillgate Eva 
Published: November 2019

ObjectivesThe effect of a healthy lifestyle on the prognosis of neck pain is unknown. This study aimed to investigate if a healthy lifestyle behaviour influences the risk of long-duration troublesome neck pain among men and women with occasional neck pain.DesignLongitudinal cohort study.SettingsGeneral population, and a subsample of the working population, in Stockholm County, Sweden.ParticipantsThis study involved 5342 men and 7298 women, age 18 to 84, from the Stockholm Public Health Cohort, reporting occasional neck pain at baseline in 2006.MeasuresBaseline information about leisure physical activity, smoking, alcohol consumption and consumption of fruits and vegetables were dichotomised into recommendations for healthy/not healthy behaviour. The exposure, a healthy lifestyle behaviour, was categorised into four levels according to the number of healthy behaviours (HB) met. Generalised linear models were applied to assess the exposure on the outcome long-duration troublesome neck pain (activity-limiting neck pain ≥2 days/week during the past 6 months), at follow-up in 2010.ResultsThe adjusted risk of long-duration troublesome neck pain decreased with increasing adherence to a healthy lifestyle behaviour among both men and women (trend test: p<0.05). Compared with the reference category, none or one HB, the risk decreased by 24% (risk ratio 0.76, 95% CI 0.58 to 0.98) among men and by 34% (0.66, 0.54 to 0.81) among women, with three or four HBs. The same comparison showed an absolute reduction of the outcome by 3% in men (risk difference −0.03, 95% CI −0.05 to −0.01) and 5% in women (-0.05,–0.08 to −0.03). Similar results were found in the working population subsample.ConclusionAdhering to a healthy lifestyle behaviour decreased the risk of long-duration troublesome neck pain among men and women with occasional neck pain. The results add to previous research and supports the importance of promoting a healthy lifestyle behaviour.
Effectiveness of prehabilitation for patients undergoing orthopaedic surgery: protocol for a systematic review and meta-analysis
Authors: Punnoose Anuj , Weiss Ori , Khanduja Vikas , Rushton Alison B 
Published: November 2019

IntroductionUndergoing major surgery can induce physical and functional decline. Prehabilitation programmes aim to improve physical fitness and function preoperatively and could enhance postoperative recovery and outcomes. Prehabilitation interventions have been utilised across a range of orthopaedic populations of all ages and can be multimodal in nature. The aim of this study is to evaluate the effectiveness of prehabilitation for patients undergoing orthopaedic surgery including day surgery procedures. It will also investigate the components of prehabilitation to understand optimum duration and frequency of programmes.Methods/designSystematic review and meta-analysis designed in accordance with Preferred
Reporting Items for Systematic Review and Meta-Analysis Protocols. A comprehensive electronic search will be performed in MEDLINE, CINAHL, AMED, Embase, PEDro and Cochrane CENTRAL databases in order to identify randomised control trials published between January 2000 to 25 March 2019. ISI Web of Science, System for information on grey literature and the European Union clinical trials registry will identify studies that are underway or unpublished. Two independent reviewers will carry out the searches, study selection (title and abstract and full text stages), data extraction, risk of bias assessment (Cochrane Risk of Bias tool 2.0) and evaluation of overall strength of evidence. Meta-analyses will be used for data which demonstrates homogeneity, otherwise a narrative synthesis will be performed for groups of studies of high heterogeneity (I2 >50%). The overall strength of the body of evidence will be assessed using Grading of Recommendations Assessment, Development and Evaluation.Ethics and disseminationThis study raises no ethical issues. This study aims to identify the effectiveness of prehabilitation interventions and may assist clinicians in determining which components, duration, frequency and the method of delivery would form the most effective prehabilitation intervention for patients undergoing an orthopaedic surgical procedure. The findings will be disseminated through publication in a peer-reviewed journal and conference presentations.PROSPERO registration numberCRD42019123268.
Are there gender disparities in symptom presentation or triage of patients with chest discomfort at primary care out-of-hours services? An observational study
Authors: van der Meer Manon G. , Appelman Yolande , Rutten Karlijn H.G. , van der Graaf Yolanda , Nathoe Hendrik M. , Doevendans Pieter A. , Smit Michelle , Verheij Emmy , Botermans Anne , Rutten Frans H. 
Published: November 2019

ObjectivesPrevious hospital-based studies have suggested delayed recognition of acute coronary syndrome (ACS) in women. We wanted to assess differences in symptom presentation or triage among women and men who contacted primary care out-of-hours services (OHS) for chest discomfort.DesignRetrospective observational study.SettingPrimary care OHS.Participants276 women and 242 men with chest discomfort who contacted a primary care OHS in the Netherlands in 2013 and 2014.Main outcome measuresDifferences between women and men regarding symptom presentation and urgency allocation.Results8.4% women and 14.0% men had ACS. Differences in symptoms between patients with and without ACS were in general small, for both women and men. In women with ACS compared with women without ACS, mean duration of telephone calls was discriminative; 5.22 (SD 2.53) vs 7.26 (SD 3.11) min, p value=0.003. In men, radiation of pain (89.3% vs 54.9%, p value=0.011) was discriminative for ACS, and stabbing chest pain (3.7% vs 24.0%, p value=0.014) for absence of ACS . Women and men with chest discomfort received similar high urgency allocation (crude and adjusted OR after correction for ACS and age; 1.03 (95% CI 0.72 to 1.48) and 1.04 (95% CI 0.72 to 1.52), respectively). Women with ACS received a high urgency allocation in 22/23 (95.7%) and men with ACS in 30/34 (88.2%), p value=0.331.ConclusionsDiscriminating ACS in patients with chest discomfort who contacted primary care OHS is difficult in both women and men. Women and men with chest discomfort received similar high urgency allocation.
Cardiopulmonary resuscitation level of knowledge among allied health university students in Jordan: a cross-sectional study
Authors: Oteir Alaa O , Almhdawi Khader A , Kanaan Saddam F , Alwidyan Mahmoud T , Williams Brett 
Published: November 2019

ObjectiveTo explore the level of cardiopulmonary resuscitation (CPR) knowledge among allied health professions (AHPs) students and its associated factors.MethodsThis is a cross-sectional study assessing CPR knowledge among AHP students. A multidisciplinary expert panel designed a survey, which then was piloted to 20 potential participants. The survey had two sections, including demographics and knowledge questions. Knowledge questions scores ranged from 0 to 10, where 10 indicates all questions were answered correctly.ResultsA total of 883 students completed the surveys and were included in the study. The mean age was 21 years (±1.6) and the majority were females (73.1%). A total of 693 (78.5%) students did not receive previous CPR training and the top barriers to receiving CPR training were unawareness of training opportunities and a lack of time. Participants had a mean CPR knowledge score of 3.9 (±1.7) out of 10 maximum potential points. Trained participants had a higher mean score compared with the untrained (4.6 (±1.6) vs 3.8 (±1.6), p<0.001). Previous training (adjusted β=0.6; 95% CI 0.2 to 0.9; p<0.001) and being in the physical therapy programme (adjusted β=0.5; 95% CI 0.1 to 0.8; p=0.01) were associated with higher knowledge.ConclusionThere is poor knowledge of CPR among AHP students including trained individuals. Efforts to increase the awareness of CPR should target students and professionals who are highly likely to encounter patients requiring CPR. Compulsory training courses, shorter training periods as well as recurrent and regular refreshing courses and use of various media devices are recommended.
Support Needs Approach for Patients (SNAP) tool: a validation study
Authors: Gardener A Carole , Ewing Gail , Mendonca Silvia , Farquhar Morag 
Published: November 2019

ObjectivesPatient-identified need is key to delivering holistic, supportive, person-centred care, but we lack tools enabling patients to express what they need to manage life with a long-term condition. The Support Needs Approach for Patients (SNAP) tool was developed to enable patients with advanced chronic obstructive pulmonary disease (COPD) identify and express their unmet support needs to healthcare professionals (HCPs), but its validity is unknown. This study aimed to establish face, content and criterion validity of the SNAP tool.DesignTwo-stage mixed-methods study involving patients with advanced COPD and their carers. Stage 1: Face and content validity assessed though focus groups involving patients and carers considering appropriateness, relevance and completeness of the SNAP tool. Data were analysed using conventional content analysis. Stage 2: Content and criterion validity assessed in a postal survey through patient self-completion of the SNAP tool and disease impact measures (Chronic Respiratory Questionnaire, COPD Assessment Test, and Hospital Anxiety and Depression Scale). Content validity assessed using summary statistics; criterion validity via correlations between tool items and impact measures.Settings and participantsTwo hundred and forty patients and carers participated. Stage 1 patient and informal carer participants were recruited from two primary care practices and Stage 2 patients from 28 practices. Participating practices located in the East of England were recruited via the NIHR Clinical Research Network: Eastern.ResultsPatients and carers found the tool patient-friendly and comprehensive, with potential clinical utility. No tool items were redundant. Clear correlations were found between tool items and the majority of items in the impact measures.ConclusionsThe SNAP tool has good face, content and criterion validity. It has potential to support the delivery of holistic, supportive, person-centred care by enabling patients to identify and express their unmet support needs to HCPs.