bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of bilateral salpingo-oophorectomy with all cause and cause specific mortality: population based cohort study
Authors: Cusimano Maria C , Chiu Maria , Ferguson Sarah E , Moineddin Rahim , Aktar Suriya , Liu Ning , Baxter Nancy N 
Published: December 2021

AbstractObjectivesTo determine if bilateral salpingo-oophorectomy, compared with ovarian conservation, is associated with all cause or cause specific death in women undergoing hysterectomy for non-malignant disease, and to determine how this association varies with age at surgery.DesignPopulation based cohort study.SettingOntario, Canada from 1 January 1996 to 31 December 2015, and follow-up to 31 December 2017.Participants200 549 women (aged 30-70 years) undergoing non-malignant hysterectomy, stratified into premenopausal (<45 years), menopausal transition (45-49 years), early menopausal (50-54 years), and late menopausal (≥55 years) groups according to age at surgery; median follow-up was 12 years (interquartile range 7-17).ExposuresBilateral salpingo-oophorectomy versus ovarian conservation.Main outcomes measuresThe primary outcome was all cause death. Secondary outcomes were non-cancer and cancer death. Within each age group, overlap propensity score weighted survival models were used to examine the association between bilateral salpingo-oophorectomy and mortality outcomes, while adjusting for demographic characteristics, gynaecological conditions, and comorbidities. To account for comparisons in four age groups, P<0.0125 was considered statistically significant.ResultsBilateral salpingo-oophorectomy was performed in 19%, 41%, 69%, and 81% of women aged <45, 45-49, 50-54, and ≥55 years, respectively. The procedure was associated with increased rates of all cause death in women aged <45 years (hazard ratio 1.31, 95% confidence interval 1.18 to 1.45, P<0.001; number needed to harm 71 at 20 years) and 45-49 years (1.16, 1.04 to 1.30, P=0.007; 152 at 20 years), but not in women aged 50-54 years (0.83, 0.72 to 0.97, P=0.018) or ≥55 years (0.92, 0.82 to 1.03, P=0.16). Findings in women aged <50 years were driven largely by increased non-cancer death. In secondary analyses identifying a possible change in the association between bilateral salpingo-oophorectomy and all cause death with advancing age at surgery, the hazard ratio gradually decreased during the menopausal transition and remained around 1 at all ages thereafter.ConclusionIn this observational study, bilateral salpingo-oophorectomy at non-malignant hysterectomy appeared to be associated with increased all cause mortality in women aged <50 years, but not in those aged ≥50 years. While caution is warranted when considering bilateral salpingo-oophorectomy in premenopausal women without indication, this strategy for ovarian cancer risk reduction does not appear to be detrimental to survival in postmenopausal women.
Changes in respiratory diseases in South Korea during the COVID-19 pandemic: an interrupted time series study
Authors: Mun Seog-Kyun , Yang Bo Ram , Chang Munyoung 
Published: December 2021

IntroductionIn South Korea, non-pharmaceutical interventions such as mask-wearing, hand washing and social distancing were strictly implemented to prevent the spread of COVID-19 after a national crisis alert was raised to the highest level early in the pandemic (23 February 2020). We aimed to investigate changes in the occurrence of respiratory diseases at the national level after the COVID-19 outbreak.MethodsThe study period was from 1 January to 1 August 2019 (213 days) and from 1 January to 31 July 2020 (213 days). Based on the National Health Insurance Service data, we analysed changes in the numbers of patients treated for respiratory diseases. The changes in the numbers of individuals using public transportation and visiting the theatre were investigated to assess the effect of social distancing after the national crisis alert was raised. Differences in daily cumulative numbers (DDCNs) in 2020 were calculated as follows: (daily cumulative number in 2020)–(cumulative number for that day in 2019). A change over time in DDCNs of <0 was taken as indication that the numbers decreased from 2019 to 2020. Segmented regression analyses were performed using generalised least squares method to identify changes in trends of DDCNs of patients treated for respiratory diseases and individuals using public transportation and visiting the theatre.ResultsAfter the national crisis alert was raised to the highest level, DDCNs of patients treated for respiratory diseases, individuals using public transportation, and those visiting the theatre exhibited a significant daily decline by 53.18 per 10 000 inhabitants (95% CI −65.86 to −40.49), 48.19 per 1000 inhabitants (95% CI −62.05 to −34.32) and 25.30 per 5000 inhabitants (95% CI −36.30 to −14.30), respectively, compared with before the national crisis alert was raised.ConclusionNon-pharmaceutical interventions to prevent the spread of COVID-19 significantly reduce the incidence of respiratory diseases.
Retrospective study of patterns of vitamin D testing and status at a single institution paediatric orthopaedics and sports clinics
Authors: Mahan Susan , Ackerman Kathryn , DiFazio Rachel , Miller Patricia , Feldman Lanna , Sullivan Nicholas , Glotzbecker Michael , Holm Ingrid A 
Published: December 2021

Objective(s)There has been a recent increase in awareness of the importance of bone health in children treated by paediatric orthopaedic and sports medicine providers. The purpose of this study was to assess our utilisation of 25 hydroxy vitamin D (25(OH)Vit D) testing in the past 10 years, and to evaluate the level of 25(OH)Vit D sufficiency in various populations of patients seen.DesignThis is a single site, retrospective medical record review study.SettingThe study took place at a single large, private, paediatric level 1 trauma teaching hospital in the Northeast USA.ParticipantsOur internal medical records query system identified all patients who have had 25(OH)Vit D testing in the past 10 years, from 1 January 2009 to 31 December 2018. All patients included were seen on an outpatient basis at our Orthopaedic clinics.InterventionsNo interventions for strict research, however, eligible patients have had 25(OH)Vit D testing during their standard of care treatment.Main outcome measure(s)The varying number of 25(OH)Vit D testing that occurred over the study time period within Orthopaedic groups, and by Vit D levels as sufficient, insufficient and deficient. 25(OH)Vit D sufficiency was ≥30 ng/mL, insufficiency <30 ng/mL and deficiency were <20 ng/mL. Patients were stratified and analysed.ResultsBetween 2009 and 2018, there were 4426 patients who had 25(OH)Vit D testing. Vitamin D testing increased significantly (p<0.001) in the past 10 years. 43% of patients had sufficient 25(OH)Vit D levels, 41% had insufficient levels and 15% had deficient levels.ConclusionMore frequent testing has led to an increased identification of patients with insufficient and deficient 25(OH)Vit D levels. We found over 50% of patients tested were found to have 25(OH)Vit D levels under 30 ng/mL. There should be an increased awareness of patients with orthopaedic problems who may present with 25(OH) insufficiency.
Top 10 (plus 1) research priorities for expectant families and those with children to age 24 months in Alberta, Canada: results from the Family Research Agenda Initiative Setting (FRAISE) priority setting partnership project
Authors: Brockway Meredith Lee , Keys Elizabeth , Bright Katherine Stuart , Ginn Carla , Conlon Leslie , Doane Stephanie , Wilson Jacqueline , Tomfohr-Madsen Lianne , Benzies Karen 
Published: December 2021

ObjectiveThe study objective was to identify the top 10 research priorities for expectant parents and caregivers of children up to age 24 months.DesignA priority setting partnership using a modified James Lind Alliance approach was implemented. First, a core steering committee was formed, consisting of 17 parents, clinicians and community agency representatives. Second, through in-person collaboration with steering committee members, we developed and distributed a survey to identify research priorities across 12 topics. In total, 596 participants consented and 480 completed the survey. Survey responses were grouped and themed into codes during a consensus-building workshop with steering committee members (n=18). Research and practice experts were consulted to provide feedback on which themes had already been researched. An in-person (n=21) workshop was used to establish the top 34 priorities, which were circulated to the broader steering committee (n=25) via an online survey. Finally, the core steering committee members (n=18) met to determine and rank a top 10 (plus 1) list of research priorities.SettingThis study was conducted in Alberta, Canada.ParticipantsExpectant parents and caregivers of children up to age 24 months.ResultsSurvey results provided 3232 responses, with 202 unique priorities. After expert feedback and steering committee consensus, a list of 34 priorities was moved forward for final consideration. The final top 10 (plus 1) research priorities included three priorities on mental health/relationships, two priorities on each of access to information, immunity and child development, and one priority on each of sleep, pregnancy/labour and feeding. Selecting 11 instead of 10 priorities was based on steering committee consensus.ConclusionsThe findings will direct future maternal–child research, ensuring it is rooted in parent-identified priorities that represent contemporary needs. To provide meaningful outcomes, research in these priority areas must consider diverse socioeconomic backgrounds and experiences.
Assessing effective mask use by the public in two countries: an observational study
Authors: Atzema Clare L , Mostarac Ivona , Button Dana , Austin Peter C , Javidan Arshia P , Wintraub Lauren , Li Allen , Patel Raumil V , Lee Daniel Dongjoo , Latham Nathaniel P , Latham Eric A , Brown Patrick C M , Somogyi Rita D , Chang Alex , Nguyen Huong , Buerk Sara , Chen Bin , Zimmerman Tristen , Funari Trevor , Colbert Cameron , Kea Bory 
Published: December 2021

ObjectivesDuring the COVID-19 pandemic wearing a mask in public has been recommended in some settings and mandated in others. How often this advice is followed, how well, and whether it inadvertently leads to more disease transmission opportunities due to a combination of improper use and physical distancing lapses is unknown.DesignCross-sectional observational study performed in June–August 2020.SettingEleven outdoor and indoor public settings (some with mandated mask use, some without) each in Toronto, Ontario, and in Portland, Oregon.ParticipantsAll passers-by in the study settings.Outcome measuresMask use, incorrect mask use, and number of breaches (ie, coming within 2 m of someone else where both parties were not properly masked).ResultsWe observed 36 808 persons, the majority of whom were estimated to be aged 31–65 years (49%). Two-thirds (66.7%) were wearing a mask and 13.6% of mask-wearers wore them incorrectly. Mandatory mask-use settings were overwhelmingly associated with mask use (adjusted OR 79.2; 95% CI 47.4 to 135.1). Younger age, male sex, Torontonians, and public transit or airport settings (vs in a store) were associated with lower adjusted odds of wearing a mask. Mandatory mask-use settings were associated with lower adjusted odds of mask error (OR 0.30; 95% CI 0.14 to 0.73), along with female sex and Portland subjects. Subjects aged 81+ years (vs 31–65 years) and those on public transit and at the airport (vs stores) had higher odds of mask errors. Mask-wearers had a large reduction in adjusted mean number of breaches (rate ratio (RR) 0.19; 95% CI 0.17 to 0.20). The 81+ age group had the largest association with breaches (RR 7.77; 95% CI 5.32 to 11.34).ConclusionsMandatory mask use was associated with a large increase in mask-wearing. Despite 14% of them wearing their masks incorrectly, mask users had a large reduction in the mean number of breaches (disease transmission opportunities). The elderly and transit users may warrant public health interventions aimed at improving mask use.
Benefits and drawbacks of videoconferencing for collaborating multidisciplinary teams in regional oncology networks: a scoping review
Authors: van Huizen Lidia S , Dijkstra Pieter U , van der Werf Sjoukje , Ahaus Kees , Roodenburg Jan LN 
Published: December 2021

IntroductionVarious forms of videoconferenced collaborations exist in oncology care. In regional oncology networks, multidisciplinary teams (MDTs) are essential in coordinating care in their region. There is no recent overview of the benefits and drawbacks of videoconferenced collaborations in oncology care networks. This scoping review presents an overview of videoconferencing (VC) in oncology care and summarises its benefits and drawbacks regarding decision-making and care coordination.DesignWe searched MEDLINE, Embase, CINAHL (nursing and allied health) and the Cochrane Library from inception to October 2020 for studies that included VC use in discussing treatment plans and coordinating care in oncology networks between teams at different sites. Two reviewers performed data extraction and thematic analyses.ResultsFifty studies were included. Six types of collaboration between teams using VC in oncology care were distinguished, ranging from MDTs collaborating with similar teams or with national or international experts to interactions between palliative care nurses and experts in that field. Patient benefits were less travel for diagnosis, better coordination of care, better access to scarce facilities and treatment in their own community. Benefits for healthcare professionals were optimised treatment plans through multidisciplinary discussion of complex cases, an ability to inform all healthcare professionals simultaneously, enhanced care coordination, less travel and continued medical education. VC added to the regular workload in preparing for discussions and increased administrative preparation.DiscussionBenefits and drawbacks for collaborating teams were tied to general VC use. VC enabled better use of staff time and reduced the time spent travelling. VC equipment costs and lack of reimbursement were implementation barriers.ConclusionVC is highly useful for various types of collaboration in oncology networks and improves decision-making over treatment plans and care coordination, with substantial benefits for patients and specialists. Drawbacks are additional time related to administrative preparation.
Impact of COVID-19 lockdown on the incidence and patterns of toxic exposures and poisoning in Jordan: a retrospective descriptive study
Authors: Raffee Liqaa , Daradkeh Hamza M , Alawneh Khaled , Al-Fwadleh Aida I , Darweesh Moath , Hammad Nouran H , Almasarweh Sami A 
Published: December 2021

ObjectivesTo describe the effect of the COVID-19 lockdown in Jordan (21 March 2020–21 May 2020) on the incidence and patterns of toxic exposures and poisoning as compared with the same period from the previous year (21 March 2019–21 May 2019).DesignA retrospective descriptive study.MethodsCall data sourced from Pharmacy One Poison Center from the lockdown period (21 March 2020–21 May 2020) and the same period during 2019 (21 March 2019–21 May 2019) were revised. In addition, a database was established and analysed.ResultsWe noticed that not only did calls increased, but there was also a noticeable change in call patterns. Calls increased by 91% (544 vs 285 calls) during the lockdown period. Drugs were the most common among types of exposure, and the most prevalent route of exposure was ingestion. There was a notable increase in ocular exposure by 550% (13 vs 2 cases). The majority of exposures were at home and there were no occupational exposures. We found an increase in household cleaner exposure among males and an increase in alcohol exposure in females. Children aged below 5 years are the most affected. Even though there is an increase in the total number of cases, severe cases decreased.ConclusionThe lockdown effect on rates of toxic exposures was prominent, whether through the increase in calls or the change in patterns. As people spent more time at home, their exposure to toxic agents increased. Furthermore, cleaning recommendations led to the misuse of cleaning and disinfectant products, increasing exposures related to abating the COVID-19 infection.
Identifying conducive contexts and working mechanisms of sedentary behaviour interventions in older adults: a realist review protocol as part of the ‘Stand UP Seniors’ project
Authors: Compernolle Sofie , Van Dyck Delfien , Vanhove Kenneth , Chastin Sebastien F M , Lauwerier Emelien , Cardon Greet 
Published: December 2021

IntroductionLifestyle behaviours, including sedentary behaviour, have been listed as key modifiable factors to promote healthy ageing. Sedentary behaviour is ubiquitous in older adults and has a strong link with age-related functional declines and chronic health conditions. Although several interventions have been developed aimed at the reduction of sedentary behaviour in older adults, little in-depth information is available on how these complex interventions work in different contexts. Therefore, the aim of our study was to unpack the mechanisms of how existing interventions aimed at the reduction of older adults’ sedentary behaviour work or fail to work in particular contexts in order to optimise the development and implementation of future sedentary behaviour interventions.Methods and analysisA realist review will be conducted as a first part of the Stand UP Seniors (SUPS) project and will be structured as follows: (1) defining the scope of the review, (2) searching and appraising the evidence, (3) extracting data and synthesising the results, and (4) drawing conclusions and formulating recommendations. The result of this iterative process will be a final programme theory that can be used to identify which context triggers which mechanism, and in turn might elicit which outcome. The final programme theory will be used to inform the second and the third parts of the SUPS project, which are, respectively, the development and evaluation of a sedentary behaviour intervention in older adults.Ethics and disseminationEthical approval is not required for the review. Dissemination of the realist review results, including the final programme theory, will occur through peer-reviewed publications and presentations at relevant conferences. The peer-reviewed realist review will be prepared according to the Realist and Meta-narrative Evidence Synthesis: Evolving Standards publication standards for realist syntheses.PROSPERO registration numberCRD42021248795.
Process evaluation protocol of a cluster randomised trial for a scalable solution for delivery of Diabetes Self-Management Education in Thailand (DSME-T)
Authors: Papachristou Nadal Iliatha , Aramrat Chanchanok , Jiraporncharoen Wichuda , Pinyopornpanish Kanokporn , Wiwatkunupakarn Nutchar , Quansri Orawan , Rerkasem Kittipan , Srivanichakorn Supattra , Techakehakij Win , Wichit Nutchanath , Pateekhum Chanapat , Birk Nick , Ngetich Elisha , Khunti Kamlesh , Hanson Kara , Kinra Sanjay , Angkurawaranon Chaisiri 
Published: December 2021

IntroductionType 2 diabetes mellitus is a major global challenge, including for Thai policy-makers, as an estimated 4 million people in Thailand (population 68 million) have this condition. Premature death and disability due to diabetes are primarily due to complications which can be prevented by good risk factor control. Diabetes Self-Management Education (DSME) programmes provide patients with diabetes with the necessary knowledge and skills to effectively manage their disease. Currently, a trial is being conducted in Thailand to evaluate the effectiveness, defined as HbA1c<7 at 12 months after enrolment, of a culturally tailored DSME in Thailand. A process evaluation can provide further interpretation of the results from complex interventions as well as insight into the success of applying the programme into a broader context.Methods and analysisThe aim of the process evaluation is to understand how and why the intervention was effective or ineffective and to identify contextually relevant strategies for future successful implementation. For the process evaluation, the design will be a mixed-method study collecting data from nurse providers, and village health volunteers (community health workers) as well as patients. This will be conducted using observations, interviews and focus groups from the three purposively selected groups at the beginning and end of trial. Quantitative data will be collected through surveys conducted at the beginning, during 6-month follow-up, and at the end of trial. The mixed-methods analysis will be triangulated to assess differences and similarities across the various data sources. The overall effectiveness of the intervention will be examined using multilevel analysis of repeated measures.Ethics and disseminationStudy approved by the Chiang Mai University Research Ethics Committee (326/2018) and the London School of Hygiene & Tropical Medicine (16113/RR/12850). Results will be published in open access, peer-reviewed scientific journals.Trial registration numberNCT03938233.
Impact of a multifaceted and multidisciplinary intervention on pain, agitation and delirium management in an intensive care unit: an experience of a Canadian community hospital in conducting a quality improvement project
Authors: Ma Zechen , Camargo Penuela Mercedes , Law Madelyn , Joshi Divya , Chung Han-Oh , Lam Joyce Nga Hei , Tsang Jennifer LY 
Published: December 2021

BackgroundClinical guidelines suggest that routine assessment, treatment, and prevention of pain, agitation, and delirium (PAD) is essential to improving patient outcomes as delirium is associated with increased mortality and morbidity. Despite the well-established improvements on patient outcomes, adherence to PAD guidelines is poor in community intensive care units (ICU). This quality improvement (QI) project aims to evaluate the impact of a multifaceted and multidisciplinary intervention on PAD management in a Canadian community ICU and to describe the experience of a Canadian community hospital in conducting a QI project.MethodsA ten-member PAD advisory committee was formed to develop and implement the intervention. The intervention consisted of a multidisciplinary rounds script, poster, interviews, visual reminders, educational modules, pamphlet and video. The 4-week intervention targeted nurses, family members, physicians, and the multidisciplinary team. An uncontrolled, before-and-after study methodology was used. Adherence to PAD assessment guidelines by nurses was measured over a 6-week pre-intervention and over a 6-week post-intervention periods.ResultsData on 430 and 406 patient-days (PD) were available for analysis during the pre- and post- intervention periods, respectively. The intervention did not improve the proportion of PD with guideline compliance to the assessment of pain (23.4% vs. 22.4%, p=0.80), agitation (42.9% vs. 38.9%, p=0.28), nor delirium (35.2% vs. 29.6%, p=0.10) by nurses.DiscussionThe implementation of a multifaceted and multidisciplinary intervention on PAD assessment did not result in significant improvements in guideline adherence in a community ICU. Barriers to knowledge translation are apparent at multiple levels including the personal level (low completion rates on educational modules), interventional level (under-collection of data), and organisational level (coinciding with hospital accreditation education). Our next steps include reintroduction of education modules using organisation approved platforms, updating existing ICU policy, updating admission order sets, and conducting audit and feedback.