bluuebunny/crossref_metadata_2025_split huggingface dataset:
Active & Safe Central: using a mixed-methods design and the RE-AIM framework to evaluate a sport and recreational injury prevention resource for practitioners in Canada
Authors: Richmond Sarah A. , Bruin Samantha , Black Amanda M , Pike Ian , Babul Shelina 
Published: January 2021

ObjectivesAn online, evidence-based resource was created to support the development of sport and recreational injury prevention programmes. The resource, called Active & Safe Central (www.activesafe.ca), provides evidence-based information across the public health approach for a number of sport and recreational activities. The objective of this project was to evaluate the perceived usefulness of Active & Safe Central as an educational tool.DesignA mixed-methods study design, guided by the RE-AIM (reach, effectiveness, adoption, implementation and maintenance) framework, was used to evaluate Active & Safe Central.SettingData were collected using an online survey, available to all users of the site, and focus groups (n=2) that took place in Vancouver and Toronto, Canada.ParticipantsSurvey respondents (n=87) were recruited online, including parents, coaches, youth and adult athletes, and teachers. Focus group participants (n=16) were key stakeholders and end users, recruited from academia, local health sectors, sport and recreational organisations, and not-for-profit injury prevention organisations.ResultsPost launch, there were 1712 users visiting the website 2306 times (sessions), with the majority representing new users, over returning users (87.5% and 12.5%, respectively). There were 6340 page visits, with the most popular pages including soccer, playgrounds and ice hockey. Active & Safe Central was reported as a credible source of evidence-based sport and recreational information and that the site would be recommended to others. Information collected from focus group participants was used to inform necessary adaptations to the online platform, including critical navigation issues, visualisations and interactivity. The major themes that emerged from focus group and survey data included increased awareness of injury prevention recommendations and that the recommendations would be used in one’s own sporting activity and/or practice.ConclusionsThe results of the evaluation suggest the tool is a useful resource for sport and recreational injury information that has significant potential to impact prevention practice.
KEPT-app trial: a pragmatic, single-blind, parallel, cluster-randomised effectiveness study of pelvic floor muscle training among incontinent pregnant women: study protocol
Authors: Sidik Sherina Mohd , Jaffar Aida , Foo Chai Nien , Muhammad Noor Azimah , Abdul Manaf Rosliza , Ismail Siti Irma Fadhilah , Alagirisamy Parwathi , Ahmad Fazlah Amalina Farhi , Suli Zailiza , Goodyear-Smith Felicity 
Published: January 2021

IntroductionPelvic floor muscle training (PFMT) strongly recommended to incontinent pregnant women. The Kegel Exercise Pregnancy Training-app trial is a multicentre cluster-randomised study aims to assess the effectiveness and its cost-effectiveness of the mobile app guidance in PFMT among incontinent pregnant women.Methods and analysis370 pregnant women (aged 18 years old and above) will be recruited with International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form. Ten clusters (primary care clinics) will be randomly assigned to either PFMT or usual care in a 1:1 ratio by an independent researcher (sealed envelope). The primary outcome will be urinary incontinence, and the secondary outcomes (quality of life; PFMT adherence, psychological status and mobile apps’ usability) will be assessed at four measurement time points (t0: baseline) and postintervention (t1: 4 weeks, t2: 8 weeks and t3: 8 weeks postnatal). T-test analysis will determine any significant differences at the baseline between the control and intervention groups. The mixed-model analysis will determine the effectiveness of the intervention at the population-average level for both the primary and secondary outcomes. For the cost-effectiveness analysis, expenditures during the study and 6 months after the intervention will be compared between the groups using the multiway sensitivity analysis. The recruitment planned will be in December 2020, and the planned end of the study will be in August 2021.Ethics and disseminationThis study protocol was approved by the Ethics Committee for Research Involving Human Subjects, Universiti Putra Malaysia (JKEUPM-2019–368) and Medical Research and Ethics Committee (MREC), Ministry of Health Malaysia, NMRR-19-412-47116 (IIR) with the ANZCTR registration. This study will obtain informed written consent from all the study participants. The results which conform with the Consolidated Standards of Reporting Trials and the Recommendations for Interventional Trials will be published for dissemination in peer-reviewed journals and conference proceedings.Trial registration numberACTRN12619000379112.
Key drivers of innovativeness appraisal for medicines: the Italian experience after the adoption of the new ranking system
Authors: Galeone Carlotta , Bruzzi Paolo , Jommi Claudio 
Published: January 2021

ObjectiveIn 2017, the Italian Medicines Agency (Agenzia Italiana del Farmaco, AIFA) introduced a standardised process to appraise innovativeness of medicines. Innovative medicines are provided speeder market access and dedicated funds. Innovativeness criteria are: unmet therapeutic need, added therapeutic value and quality of the evidence (Grading of Recommendations Assessment, Development and Evaluation method). We investigated the role played by these three criteria on the final decision aimed to understand how the new Italian innovativeness appraisal framework was implemented.DesignA desk research gathered AIFA’s appraisal reports on innovativeness and data analyses were conducted. No patients were directly involved in this study.Setting and participantsWe scrutinised all 77 appraisal reports available on AIFA’s website (2017–2020).Primary and secondary outcome measuresThe impact of the three domains on final decision was investigated through a series of univariate analyses.ResultsAmong 77 appraisal reports on innovativeness available, 49 (64%) and 28 (36%) were for oncology and non-oncology medicines, respectively. The appraisals were equally distributed among ‘fully innovative’ (36%), ‘conditionally innovative’ (30%) and ‘not innovative’ (34%). Added therapeutic value was the most important driver on innovativeness decision, followed by quality of the evidence. Drugs for rare diseases and with paediatric/mixed indications were appraised ‘innovative’ by a larger proportion, but no statistical significance was found.ConclusionsDespite some limitations, including the moderate number of appraisals, this paper provides an insight into the determinants of innovativeness appraisals for medicines in Italy and the accuracy of the appraisal process. This has important implications in terms of transparency and accountability in the prioritisation process applied to innovative medicines.
Long-term trends and regional variations of hypertension incidence in China: a prospective cohort study from the China Health and Nutrition Survey, 1991–2015
Authors: Luo Yunmei , Xia Fan , Yu Xuexin , Li Peiyi , Huang Wenzhi , Zhang Wei 
Published: January 2021

ObjectiveThe aim is to explore the trends of hypertension incidence and regional variations in China from 1991 to 2015.DesignA dynamic prospective cohort study.SettingChina Health and Nutrition Survey 1991–2015.Participants12 952 Chinese adults aged 18+ years.Primary outcome measuresIncident hypertension from 1993 to 2015.ResultsAge-standardised hypertension incidence increased from 40.8 per 1000 person-years (95% CI 38.3 to 43.4) between 1993 and 1997 to 48.6 (95% CI 46.1 to 51.0) between 2011 and 2015. The increasing trends were further supported by results from subsequent extended Cox proportional hazard model. In addition, results from the modelling analysis showed that individuals in eastern, central and northeastern China had greater risks of hypertension occurrence in comparison with their counterparts in western China.ConclusionHypertension incidence increased during the study period. The growth called for more attention on the health education and health promotion of individuals with great risks.
Orthopaedic medical examination for young amateur athletes: a repeated cross-sectional study from 2014 to 2018
Authors: Yokoe Takuji , Tajima Takuya , Yamaguchi Nami , Nagasawa Makoto , Ota Tomomi , Morita Yudai , Chosa Etsuo 
Published: January 2021

ObjectivesMedical examinations for adult elite athletes are performed all over the world, however, no studies in the relevant English literature have reported on orthopaedic medical examinations for young amateur athletes. The purpose of this study was to report the results of orthopaedic medical examinations of the spine and lower extremities in young amateur athletes.MethodsThis repeated cross-sectional study from 2014 to 2018 included a total of 323 young amateur athletes (age, 12–18 years) who were active in one of the following four sports: boxing, canoeing, weightlifting and track and field. The orthopaedic medical examination consisted of six assessments (physical examinations, the generalised joint laxity, muscle and joint tightness, static alignment and muscle volume of the lower extremities and the medial longitudinal arch of the foot). Questions regarding pain in the spine and lower extremities were also performed.ResultsAmong 323 young amateur athletes, 17 (5.3%) had received orthopaedic treatment at the time of the medical examination, with spondylolysis being the most common cause (29.4%, 5/17). Among 306 young athletes who had not received orthopaedic treatment, 61 (19.9%) had at least one positive finding in physical examinations or had pain in the spine or lower extremities. Anterior drawer test of the ankle and Kemp test for the spine accounted for 34% and 28% of positive findings, respectively. Low back pain and knee pain accounted for 58% and 16% of pain, respectively.ConclusionsThe present study showed that approximately one-fifth of young amateur athletes who had not received orthopaedic treatment had pain in the spine and lower extremities and positive findings in physical examinations that may require orthopaedic treatments. In addition to the early detection of injuries, orthopaedic medical examinations for young amateur athletes provide an opportunity to educate such athletes.
Impact of electronic health records on predefined safety outcomes in patients admitted to hospital: a scoping review
Authors: Subbe Christian Peter , Tellier Genevieve , Barach Paul 
Published: January 2021

ObjectivesReview available evidence for impact of electronic health records (EHRs) on predefined patient safety outcomes in interventional studies to identify gaps in current knowledge and design interventions for future research.DesignScoping review to map existing evidence and identify gaps for future research.Data sourcesPubMed, the Cochrane Library, EMBASE, Trial registers.Study selectionEligibility criteria: We conducted a scoping review of bibliographic databases and the grey literature of randomised and non-randomised trials describing interventions targeting a list of fourteen predefined areas of safety. The search was limited to manuscripts published between January 2008 and December 2018 of studies in adult inpatient settings and complemented by a targeted search for studies using a sample of EHR vendors. Studies were categorised according to methodology, intervention characteristics and safety outcome.Results from identified studies were grouped around common themes of safety measures.ResultsThe search yielded 583 articles of which 24 articles were included. The identified studies were largely from US academic medical centres, heterogeneous in study conduct, definitions, treatment protocols and study outcome reporting. Of the 24 included studies effective safety themes included medication reconciliation, decision support for prescribing medications, communication between teams, infection prevention and measures of EHR-specific harm. Heterogeneity of the interventions and study characteristics precluded a systematic meta-analysis. Most studies reported process measures and not patient-level safety outcomes: We found no or limited evidence in 13 of 14 predefined safety areas, with good evidence limited to medication safety.ConclusionsPublished evidence for EHR impact on safety outcomes from interventional studies is limited and does not permit firm conclusions regarding the full safety impact of EHRs or support recommendations about ideal design features. The review highlights the need for greater transparency in quality assurance of existing EHRs and further research into suitable metrics and study designs.
The Irish National Adverse Event Study-2 (INAES-2): longitudinal trends in adverse event rates in the Irish healthcare system
Authors: Connolly Warren , Rafter Natasha , Conroy Ronan M , Stuart Cornelia , Hickey Anne , Williams David J 
Published: January 2021

ObjectivesTo quantify the prevalence and nature of adverse events in acute Irish hospitals in 2015 and to assess the impact of the National Clinical Programmes and the National Clinical Guidelines on the prevalence of adverse events by comparing these results with the previously published data from 2009.Design and methodsA retrospective chart review of 1605 admissions to eight Irish hospitals in 2015, using identical methods to those used in 2009.ResultsThe percentage of admissions associated with one or more adverse events was unchanged (p=0.48) at 14% (95% CI=10.4% to 18.4%) in 2015 compared with 12.2% (95% CI=9.5% to 15.5%) in 2009. Similarly, the prevalence of preventable adverse events was unchanged (p=0.3) at 7.4% (95% CI=5.3% to 10.5%) in 2015 compared with 9.1% (95% CI=6.9% to 11.9%) in 2009. The incidence densities of preventable adverse events were 5.6 adverse events per 100 admissions (95% CI=3.4 to 8.0) in 2015 and 7.7 adverse events per 100 admissions (95% CI=5.8 to 9.6) in 2009 (p=0.23). However, the percentage of preventable adverse events due to hospital-associated infections decreased to 22.2% (95% CI=15.2% to 31.1%) in 2015 from 33.1% (95% CI=25.6% to 41.6%) in 2009 (p=0.01).ConclusionAdverse event rates remained stable between 2009 and 2015. The percentage of preventable adverse events related to hospital-associated infection decreased, which may represent a positive impact of the related national programmes and guidelines.
Barriers and facilitators to meeting recommended physical activity levels among new immigrant and refugee children in Saskatchewan, Canada
Authors: Lane Ginny , Nisbet Christine , Johnson Shanthi , Candow Darren , Chilibeck Philip D. , Vatanparast Hassan 
Published: January 2021

Newcomers are often healthy when they arrive in Canada, yet experience health declines shortly thereafter, possibly due to lifestyle changes. As part of the Healthy Immigrant Children study, this mixed-methods study aims to analyze possible predictors of physical activity among 300 newcomer children, and explore their lived experiences using a sub-sample of 19 parents and 24 service providers. Data collection involved questionnaires concerning socioeconomic status and physical activity, anthropometric measurements, and in-depth interviews. Participants aged 5 years and older largely met physical activity recommendations (82.9%), while none of the 3–4-year-olds did. Males were more active than females, especially among older ages. Many participants engaged in too much screen time (53.4–90.0%). Age and income predicted physical activity among males, while parents’ education level was the only significant predictor among females. Barriers to physical activity included: recreational physical activity being an unfamiliar concept, gender limitations, financial resources, safety concerns, and children’s preference for screen time. Schools played a central role in newcomer children’s health by providing accessible opportunities for physical activity. Newcomer families preferred to have their children involved in culturally relevant physical activities. Given the growing newcomer population, it is important to support active lifestyle practices among them. Novelty: About 83% of newcomer children aged 5 years and older met physical activity recommendations, while none of the 3–4-year-olds did. Age and income predicted males’ physical activity, while parents’ education level predicted females’ physical activity. Schools provide accessible opportunities for newcomer children to engage in physical activity.
ПЕРЕВAГИ І НЕДOЛІКИ ДИСТAНЦІЙНOГO НAВЧAННЯ В ЦІЛOМУ ТA ПРИ ВИВЧЕННІ ДИСЦИПЛІНИ «ГІСТOЛOГІЯ, ЦИТOЛOГІЯ ТA ЕМБРІOЛOГІЯ»
Authors: Shuturma O. Ya. , Kramar S. B. , Nebesna Z. M. , Getmanyuk I. B. 
Published: January 2021

Сучaсні реaлії життя вимaгaють ширoкoгo викoристaння дистaнційнoгo нaвчaння у ВНЗ Укрaїни, що має свoї перевaги тa недoліки. У стaтті описано oсoбливoсті виклaдaння дисципліни «Гістoлoгія, цитoлoгія тa ембріoлoгія» в умoвaх кaрaнтину. Бaгaтoрічний дoсвід викoристaння нoвітніх іннoвaційних технoлoгій у Тернoпільськoму нaціoнaльнoму медичнoму університеті імені І. Я. Гoрбaчевськoгo МОЗ України сприяв ефективній oргaнізaції дистaнційнoгo нaвчaння нa кaфедрі гістoлoгії тa ембріoлoгії. Викoристaння особистісного підхoду дo кoжнoгo студентa сприялo крaщoму зaсвoєнню нaвчaльнoгo мaтеріaлу. При викoнaнні індивідуaльних зaвдaнь студенти кoристувaлися мaтеріaлaми СДO Moodle ТНМУ, рекомендованими викладачем дoступними інтернет-джерелaми, друкoвaнoю літерaтурoю, щo дoзвoлилo їм oтримaти якісні та глибoкі знaння.
АНАЛІТИЧНА ХІМІЯ У ФАРМАЦЕВТИЧНІЙ ОСВІТІ УКРАЇНИ ТА ПОЛЬЩІ
Authors: Mykhalkiv M. M. , Ivanusa I. B. , Zahrychuk H. Ya. 
Published: January 2021

Аналітична хімія належить до базових дисциплін у фармацевтичній освіті. Вона є підґрунтям для подальшого вивчення таких дисциплін, як фармацевтична хімія, токсикологічна та судова хімія, стандартизація лікарських засобів тощо, та передбачає формування умінь застосування одержаних знань для вивчення спеціальних дисциплін та у професійній діяльності. Навички виконання якісного та кількісного аналізу хімічними й інструментальними методами вкрай необхідні для подальшого успішного засвоєння фізичної та колоїдної, органічної, біологічної, фармацевтичної, токсикологічної та судової хімії, технології ліків й інших спеціальних дисциплін.
У рамках проєкту “New and innovative teaching methods in pharmacy” доценти Тернопільського національного медичного університету імені І. Я. Горбачевського МОЗ України (ТНМУ) М. М. Михалків, І. Б. Івануса та Г. Я. Загричук відвідали Uniwersytet Medyczny w Lublinie. Ми мали можливість відвідати кафедри, на яких навчаються студенти фармацевтичного факультету, та поспілкуватися із професорсько-викладацьким складом цих кафедр щодо методик викладання дисциплін, у тому числі й аналітичної хімії, та познайомитися із напрямками їх наукових досліджень.
В Україні, відповідно до навчального плану підготовки здобувачів вищої освіти галузі знань 22 «Охорона здоровʼя», спеціальності 226 «Фармація, промислова фармація» (другий (магістерський) рівень вищої освіти), кваліфікації «Магістр фармації», аналітична хімія належить до нормативних навчальних дисциплін, а саме до циклу загальної підготовки. Дану дисципліну студенти вивчають на другому курсі навчання (3 та 4 семестри).
У Польщі, а саме в Люблінському медичному університеті до 2019 р. аналітичну хімію на фармацевтичному факультеті (спеціальність «Фармація») студенти вивчали також на другому курсі навчання (3 та 4 семестри), тоді як з 2019–2020 навчального року студенти вивчатимуть аналітичну хімію на першому курсі (2 семестр). Спільні підходи та відмінності у викладанні аналітичної хімії в Україні та Польщі наведено в даній статті.
Evaluation of Scoring Systems for Airway Management After Oral Cancer Surgery: A Retrospective Study
Authors: Abe Atsushi , Umemura Eri , Hayashi Hiroki , Ito Yu , Adachi Moriyasu 
Published: January 2021

Objective: Postoperative airway obstruction following oral cancer surgery is difficult to predict. Scoring systems used to assess the need for tracheotomy use risk factors as criteria. We aimed to examine whether these clinical scoring systems can predict airway obstruction following oral cancer surgery. Methods: We assessed 95 patients who underwent oral cancer surgery without tracheotomy under general anesthesia between January 2007 and April 2019. We reviewed multiple factors from the patients’ medical records, including age, sex, tumor site, body mass index, tumor stage, type of surgery, airway management method, Cameron and Gupta scores, and postoperative airway complications. Results: Tumors were located in the maxilla ( n = 14), buccal mucosa ( n = 13), mandible ( n = 14), floor of the mouth ( n = 6), and tongue ( n = 48). Twenty-seven patients (28.4%) were graded as Stage 1, 37 patients (38.9%) as Stage 2, 9 patients (9.5%) as Stage 3, and 3 (3.2%) patients as Stage 4. Nine patients (9.5%) had local recurrences, and ten patients (10.5%) had neck metastases. Postoperative oxygen administration alone failed to improve dyspnea in 4 patients (4.2%). The median Cameron scores between patients with and without airway trouble were not significantly different ( P = 0.226). However, a significant difference was observed in median Gupta scores between patients with and without airway trouble ( P = 0.01). We created a receiver operating characteristic curve to predict postoperative airway trouble based on the preoperative Gupta score; the area under the curve was 0.856 (95% confidence interval: 0.61-1). A Gupta score cutoff value of 3.0 had a sensitivity of 92.3% and specificity of 75.0%. Conclusions: Screening based on the Gupta score appears to be effective in predicting postoperative airway obstruction. We propose that this screening tool can be used to better plan tracheotomy and other airway management strategies during preoperative patient assessment.
The Immediate Effect of COVID-19 Policies on Social-Distancing Behavior in the United States
Authors: Abouk Rahi , Heydari Babak 
Published: January 2021

Objective Although anecdotal evidence indicates the effectiveness of coronavirus disease 2019 (COVID-19) social-distancing policies, their effectiveness in relation to what is driven by public awareness and voluntary actions needs to be determined. We evaluated the effectiveness of the 6 most common social-distancing policies in the United States (statewide stay-at-home orders, limited stay-at-home orders, nonessential business closures, bans on large gatherings, school closure mandates, and limits on restaurants and bars) during the early stage of the pandemic. Methods We applied difference-in-differences and event-study methodologies to evaluate the effect of the 6 social-distancing policies on Google-released aggregated, anonymized daily location data on movement trends over time by state for all 50 states and the District of Columbia in 6 location categories: retail and recreation, grocery stores and pharmacies, parks, transit stations, workplaces, and residences. We compared the outcome of interest in states that adopted COVID-19–related policies with states that did not adopt such policies, before and after these policies took effect during February 15–April 25, 2020. Results Statewide stay-at-home orders had the strongest effect on reducing out-of-home mobility and increased the time people spent at home by an estimated 2.5 percentage points (15.2%) from before to after policies took effect. Limits on restaurants and bars ranked second and resulted in an increase in presence at home by an estimated 1.4 percentage points (8.5%). The other 4 policies did not significantly reduce mobility. Conclusion Statewide stay-at-home orders and limits on bars and restaurants were most closely linked to reduced mobility in the early stages of the COVID-19 pandemic, whereas the potential benefits of other such policies may have already been reaped from voluntary social distancing. Further research is needed to understand how the effect of social-distancing policies changes as voluntary social distancing wanes during later stages of a pandemic.