bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does the white coat influence satisfaction, trust and empathy in the doctor–patient relationship in the General and Family Medicine consultation? Interventional study
Authors: Marques Caetano Carreira Leonor , Dinis Sara , Correia António , Pereira António , Belo Regina , Madanelo Inês , Brito David , Gomes Rita , Monteiro Luís , Correia Gil , Maia Conceição , Marques Tiago , Sousa Raquel , Abreu Diogo , Matias Catarina , Constantino Liliana , Rosendo Inês 
Published: December 2021

ObjectivesTo understand the influence of the white coat on patient satisfaction, opinions about medical clothing, perception about confidence, empathy and medical knowledge and the satisfaction and comfort level of physicians in consultation.SettingAn interventional study was conducted with a representative sample of the population attending primary care in central Portugal.ParticipantsThe sample was composed by 286 patients divided into two groups exposed or not to a doctor wearing a white coat. The first and last patients in consultation every day for 10 consecutive days were included.InterventionsEvery other day the volunteer physicians consulted with or without the use of a white coat. At the end of the consultation, a questionnaire was distributed to the patient with simple questions with a Likert scale response, the Portuguese version of the ‘Trust in physician’ scale and the Jefferson Scale of Patient Perceptions of Physician Empathy - Portuguese Version (JSPPPE-VP scale). A questionnaire was also distributed to the physician.OutcomesPlanned and measured primary outcomes were patient satisfaction, trust and perception about empathy and secondary outcomes were opinion about medical clothing, satisfaction and comfort level of physicians in consultation.ResultsThe sample was homogeneous in terms of sociodemographic variables. There were no statistically significant differences between the groups in terms of satisfaction, trust, empathy and knowledge perceived by the patients. There were differences in the opinion of the patients about the white coat, and when the physician was wearing the white coat this group of patients tended to think that this was the only acceptable attire for the physician (p<0.001). But when the family physician was in consultation without the white coat, this group of patients tended to agree that communication was easier (p=0.001).ConclusionsThere was no significant impact of the white coat in patient satisfaction, empathy and confidence in the family physician.Trial registration numberClinicalTrials.gov ID number:NCT03965416.
Can a collective-impact initiative improve well-being in three US communities? Findings from a prospective repeated cross-sectional study
Authors: Riley Carley , Roy Brita , Lam Veronica , Lawson Kerianne , Nakano Lauren , Sun Jacqueline , Contreras Erika , Hamar Brent , Herrin Jeph 
Published: December 2021

IntroductionCommunities are seeking to learn if and how they can improve the well-being of their residents. We therefore examined the impact of a community-led, collective-impact initiative, deployed through Blue Zones Project by Sharecare, aimed at improving health and well-being in one set of US communities.MethodsWe used data from cross-sectional surveys of the Well-Being Index (2010–2017) to assess how the Life Evaluation Index (LEI) in Hermosa Beach, Manhattan Beach and Redondo Beach in California (Beach Cities) changed over time and how this change compares with change for similar cities (Beach Cities-like) and for the USA as a whole. We examined types of interventions, perceived impacts, and relationships between intervention type and change in LEI.ResultsThe Beach Cities experienced greater increases in LEI than Beach Cities-like communities and the nation. The entire portfolio of interventions was positively associated with change in LEI in the Beach Cities (+1.12, p=0.012), with process-oriented interventions most closely associated with improvement.ConclusionsCommunity-led collective action that leverages community engagement and activation, strategic use of programming and large-scale built-environment and policy change can improve health and well-being at scale.
Utility of a personalisedBronchiectasisActionManagementPlan (BAMP) for children with bronchiectasis: protocol for a multicentre, double-blind parallel, superiority randomised controlled trial
Authors: Marchant Julie M , Chang Anne B , Schutz Kobi L , Versteegh Lesley , Cook Anne , Roberts Jack , Morris Peter S , Yerkovich Stephanie T , McCallum Gabrielle B 
Published: December 2021

IntroductionBronchiectasis is no longer considered rare or irreversible in children, yet it remains relatively under-researched and neglected in respiratory health globally. Bronchiectasis (including chronic suppurative lung disease) causes substantial morbidity for patients and significant impact on caregivers, especially during acute respiratory exacerbations. In other chronic respiratory diseases (eg, asthma), empowering consumers with an individualised plan for management of acute exacerbations improves clinical outcomes. However, in the absence of any such data specific to bronchiectasis, action management plans are rarely currently used in children or adults with bronchiectasis. We hypothesise that providing an individualised bronchiectasis action management plan (BAMP) to children with bronchiectasis reduces non-scheduled doctor consultations, compared with not having a BAMP.Methods and analysisThis multicentre, parallel, double-blind, randomised trial involving three urban Australian hospitals commenced in June 2018 and will include 198 children, aged <19 years with bronchiectasis who had 2 or more exacerbations in the previous 18 months. Children will be randomised to having an individualised BAMP or standard care (a decoy clinic letter). Primary caregivers will then be followed up monthly for 12 months. The primary outcome is the rate of acute non-scheduled doctor visits for respiratory exacerbations by 12 months. The main secondary outcomes are cough-specific quality of life scores at 6 and 12 months, overall exacerbation rate over 12 months, and proportion of children who received timely influenza vaccination by 30 May annually.Ethics and disseminationThe Human Research Ethics Committees of the Northern Territory Department of Health and Menzies School of Heath Research and Queensland Children’s Hospital approved the study. The results of the trial will be submitted for publication and the BAMP made available free online.Trial registration numberAustralia and New Zealand Clinical Trials Register ACTRN12618000604202.
Is neighbourhood income inequality associated with maternal mental health? A longitudinal analysis of pregnant and new mothers living in Calgary, Alberta
Authors: Lowe Samuel AJ , McDonald Sheila , Senthilselvan Ambikaipakan , Nykiforuk Candace IJ , Chari Radha , Pabayo Roman 
Published: December 2021

ObjectivesRising income inequality is a potential risk factor for poor mental health, however, little work has investigated this link among mothers. Our goal was to determine if neighbourhood-level income inequality was associated with maternal mental health over time.DesignSecondary data analysis using a retrospective cohort study design.Setting and participantsData from the All Our Families (AOF) ongoing cohort study in the city of Calgary (Canada) were used, with our sample including 2461 mothers. Participant data were collected at six time points from 2008 to 2014, corresponding to <25 weeks of pregnancy to 3 years post partum. AOF mothers were linked to 196 geographically defined Calgary neighbourhoods using postal code information and 2006 Canada Census data.Main outcome measuresAnxiety symptoms measured using the Spielberger State Anxiety Inventory, and depressive symptoms measured using the Edinburgh Postnatal Depression Scale and the Centre for Epidemiologic Studies-Depression Scale.ResultsMultilevel regression modelling was used to quantify the associations between neighbourhood-level income inequality and continuous mental health symptoms over time. For anxiety symptoms, the interaction term between neighbourhood Gini and time was significant (β=0.0017, 95% CI=0.00049 to 0.0028, p=0.005), indicating an excess rate of change over time. Specifically, a SD increase in Gini (Z-score) was associated with an average monthly rate increase in anxiety symptom scores of 1.001% per month. While depressive symptom scores followed similar longitudinal trajectories across levels of income inequality, we did not find significant evidence for an association between inequality and depressive symptoms. There was no evidence of a cross-level interaction between inequality and household income on either outcome.ConclusionIncome inequality within neighbourhoods appears to adversely impact the mental health trajectories of pregnant and new mothers. Further research is needed to understand the mechanisms that explain this relationship, and how interventions to reduce income inequality could benefit mental health.
Accuracy of CT texture analysis for differentiating low-grade and high-grade renal cell carcinoma: systematic review and meta-analysis
Authors: Yu Wei , Liang Gao , Zeng Lichuan , Yang Yang , Wu Yinghua 
Published: December 2021

ObjectivesThis study aimed to assess the accuracy of CT texture analysis (CTTA) for differentiating low-grade and high-grade renal cell carcinoma (RCC).DesignSystematic review and meta-analysis.Data sourcesPubMed, Cochrane Library, Embase, Web of Science, OVID Medline, Science Direct and Springer were searched to identify the included studies.Eligibility criteria for including studiesClinical studies that report about the accuracy of CTTA in differentiating low-grade and high-grade RCC.MethodsMultiple databases were searched to identify studies from their inception to 20 October 2021. Two radiologists independently extracted data from the primary studies. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic OR (DOR) were calculated to assess CTTA performance. The summary receiver operating characteristic (SROC) curve was plotted, and the area under the curve (AUC) was calculated to evaluate the accuracy of CTTA in grading RCC.ResultsThis meta-analysis included 11 studies, with 1603 lesions observed in 1601 patients. Values of the pooled sensitivity, specificity, PLR, NLR, DOR were 0.79 (95% CI 0.73 to 0.84), 0.84 (95% CI 0.81 to 0.87), 5.1 (95% CI 4.0 to 6.4), 0.24 (95% CI 0.19 to 0.32) and 21 (95% CI 13 to 33), respectively. The SROC curve showed that the AUC was 0.88 (95% CI 0.84 to 0.90). Deeks’ test found no significant publication bias among the studies (p=0.42).ConclusionsThe findings of this meta-analysis suggest that CTTA has a high accuracy in differentiating low-grade and high-grade RCC. A standardised methodology and large sample-based study are necessary to certain the diagnostic accuracy of CTTA in RCC grading for clinical decision making.
Anaesthesia Choice for Creation of Arteriovenous Fistula (ACCess) study protocol : a randomised controlled trial comparing primary unassisted patency at 1 year of primary arteriovenous fistulae created under regional compared to local anaesthesia
Authors: Macfarlane Alan JR , Kearns Rachel J , Clancy Marc James , Kingsmore David , Stevenson Karen , Jackson Andrew , Mark Patrick , Aitken Margaret , Moonesinghe Ramani , Vindrola-Padros Cecilia , Gaianu Lucian , Pettigrew Gavin , Motallebzadeh Reza , Karydis Nikolaos , Vesey Alex , Singh Rita , Muniraju Thalakunte , Suttie Stuart , McConnachie Alex , Wetherall Kirsty , El-Boghdadly Kariem , Hogg Rosemary , Thomson Iain , Nangalia Vishal , Aitken Emma 
Published: December 2021

IntroductionArteriovenous fistulae (AVF) are the ‘gold standard’ vascular access for haemodialysis. Universal usage is limited, however, by a high early failure rate. Several small, single-centre studies have demonstrated better early patency rates for AVF created under regional anaesthesia (RA) compared with local anaesthesia (LA). The mechanistic hypothesis is that the sympathetic blockade associated with RA causes vasodilatation and increased blood flow through the new AVF. Despite this, considerable variation in practice exists in the UK. A high-quality, adequately powered, multicentre randomised controlled trial (RCT) is required to definitively inform practice.Methods and analysisThe Anaesthesia Choice for Creation of Arteriovenous Fistula (ACCess) study is a multicentre, observer-blinded RCT comparing primary radiocephalic/brachiocephalic AVF created under regional versus LA. The primary outcome is primary unassisted AVF patency at 1 year. Access-specific (eg, stenosis/thrombosis), patient-specific (including health-related quality of life) and safety secondary outcomes will be evaluated. Health economic analysis will also be undertaken.Ethics and disseminationThe ACCess study has been approved by the West of Scotland Research and ethics committee number 3 (20/WS/0178). Results will be published in open-access peer-reviewed journals within 12 months of completion of the trial. We will also present our findings at key national and international renal and anaesthetic meetings, and support dissemination of trial outcomes via renal patient groups.Trial registration numberISRCTN14153938.SponsorNHS Greater Glasgow and Clyde GN19RE456, Protocol V.1.3 (8 May 2021), REC/IRAS ID: 290482.
Effect of computerised, knowledge-based, clinical decision support systems on patient-reported and clinical outcomes of patients with chronic disease managed in primary care settings: a systematic review
Authors: El Asmar Marie line , Dharmayat Kanika I , Vallejo-Vaz Antonio J , Irwin Ryan , Mastellos Nikolaos 
Published: December 2021

ObjectivesChronic diseases are the leading cause of disability globally. Most chronic disease management occurs in primary care with outcomes varying across primary care providers. Computerised clinical decision support systems (CDSS) have been shown to positively affect clinician behaviour by improving adherence to clinical guidelines. This study provides a summary of the available evidence on the effect of CDSS embedded in electronic health records on patient-reported and clinical outcomes of adult patients with chronic disease managed in primary care.Design and eligibility criteriaSystematic review, including randomised controlled trials (RCTs), cluster RCTs, quasi-RCTs, interrupted time series and controlled before-and-after studies, assessing the effect of CDSS (vs usual care) on patient-reported or clinical outcomes of adult patients with selected common chronic diseases (asthma, chronic obstructive pulmonary disease, heart failure, myocardial ischaemia, hypertension, diabetes mellitus, hyperlipidaemia, arthritis and osteoporosis) managed in primary care.Data sourcesMedline, Embase, CENTRAL, Scopus, Health Management Information Consortium and trial register clinicaltrials.gov were searched from inception to 24 June 2020.Data extraction and synthesisScreening, data extraction and quality assessment were performed by two reviewers independently. The Cochrane risk of bias tool was used for quality appraisal.ResultsFrom 5430 articles, 8 studies met the inclusion criteria. Studies were heterogeneous in population characteristics, intervention components and outcome measurements and focused on diabetes, asthma, hyperlipidaemia and hypertension. Most outcomes were clinical with one study reporting on patient-reported outcomes. Quality of the evidence was impacted by methodological biases of studies.ConclusionsThere is inconclusive evidence in support of CDSS. A firm inference on the intervention effect was not possible due to methodological biases and study heterogeneity. Further research is needed to provide evidence on the intervention effect and the interplay between healthcare setting features, CDSS characteristics and implementation processes.PROSPERO registration numberCRD42020218184.
Hyperkalaemia prevalence, recurrence and treatment in patients on haemodialysis in China: protocol for a prospective multicentre cohort study (PRECEDE-K)
Authors: Ni Zhaohui , Jin Haijiao , Lu Renhua , Zuo Li , Yu Weimin , Ren Yuqing , Yang Qiongqiong , Xiao Jie , Zhang Qinghong , Zhang Lihong , Zhang Xinzhou , Chen Qinkai , Chen Chaosheng , Shao Guojian , Luo Qun , Yao Li , Qin Shuguang , Peng Hui , Zhao Qing 
Published: December 2021

IntroductionHyperkalaemia (HK) is a potentially life-threatening electrolyte imbalance associated with several adverse clinical outcomes and is common in patients with kidney failure. However, there is no evidence on the occurrence, recurrence and treatment of HK in patients on haemodialysis (HD) in China.Methods and analysisThe HK Prevalence, Recurrence, and Treatment in Haemodialysis Study is a prospective, multicentre, observational, cohort study being conducted across 15–18 sites in China. Approximately 600 patients with end-stage kidney disease on HD are anticipated to be enrolled and will be followed up for 24 weeks. Patients will be in the long interdialytic interval (LIDI) at enrolment and will receive follow-up care every 4 weeks in LIDI for pre-dialysis and post-dialysis (at enrolment only) serum potassium measurements. To obtain pre-dialysis serum potassium levels in the short interdialytic interval (SIDI), a follow-up visit will be performed in the SIDI during the first week. Information on concomitant medications, blood gas analysis and biochemistry measurements will be obtained at enrolment and at each follow-up visit. The primary endpoint will be the proportion of patients experiencing HK (defined as serum potassium level >5.0 mmol/L) at the study enrolment or during the 24-week follow-up. The key secondary endpoint will be the proportion of patients experiencing HK recurrence (defined as any HK event after the first HK event) within 1–6 months (if applicable) during the 24-week follow-up, including enrolment assessment.Ethics and disseminationThis study has been approved by Shanghai Jiaotong University School of Medicine, Renji Hospital Ethics Committee (2020-040). Other participating subcentres must also obtain ethics committee approval prior to the start of the study. The Good Clinical Practice regulations shall be strictly followed during the test implementation. Amendments to the protocol will be reviewed by the ethics committees. Written informed consent will be obtained from all participants before collection of any patient data and patient information. The findings of this study will be disseminated through peer-reviewed publications and conference presentations.Trial registration numberClinicalTrials.gov Registry (NCT04799067).
Exploring the evidence for the effectiveness of health interventions for COVID-19 targeting migrants: a systematic review protocol
Authors: Mondello Stefania , Visalli Carmela , Kobeissy Firas , Cacciani Laura , Cruciani Fabio , D'Amato Stefania , Di Napoli Anteo , Giorgi Rossi Paolo , Milli Caterina , Petrelli Alessio , Silvestri Caterina , Cernigliaro Achille , Scondotto Salvatore 
Published: December 2021

IntroductionOwing to their inherent vulnerabilities, the burden of COVID-19 and particularly of its control measures on migrants has been magnified. A thorough assessment of the value of the interventions for COVID-19 tailored to migrants is essential for improving their health outcomes as well as promoting an effective control of the pandemic. In this study, based on evidence from primary biomedical research, we aimed to systematically identify health interventions for COVID-19 targeting migrants and to assess and compare their effectiveness. The review will be conducted within a programme aimed at defining and implementing interventions to control the COVID-19 pandemic in Italy, funded by the Italian Ministry of Health and conducted by a consortium of Italian regional health authorities.Methods and analysesData sources will include the bibliographic databases MEDLINE, Embase, LOVE Platform COVID-19 Evidence, and Cochrane Central Register of Controlled Trials. Eligible studies must evaluate health interventions for COVID-19 in migrants. Two independent reviewers will screen articles for inclusion using predefined eligibility criteria, extract data of retained articles and assess methodological quality by applying the Cochrane Risk of Bias tool. Disagreements will be resolved through consensus or arbitrated by a third reviewer if necessary. In synthesising the evidence, we will structure results by interventions, outcomes and quality. Where studies are sufficiently homogenous, trial data will be pooled and meta-analyses will be performed. Data will be reported according to methodological guidelines for systematic review provided by the Cochrane Collaboration and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.Ethics and disseminationThis is a review of existing literature, and ethics approval is not required. We will submit results for peer-review publication and present at relevant conferences. The review findings will be included in future efforts to develop evidence-informed recommendations, policies or programmatic actions at the national and regional levels and address future high-quality research in public health.
Respiratory symptoms and lung function in patients treated for pulmonary tuberculosis in Malawi: a prospective cohort study
Authors: Nightingale Rebecca , Chinoko Beatrice , Lesosky Maia , Rylance Sarah J , Mnesa Bright , Banda Ndaziona Peter Kwanjo , Joekes Elizabeth , Squire Stephen Bertel , Mortimer Kevin , Meghji Jamilah , Rylance Jamie 
Published: December 2021

RationalePulmonary tuberculosis (PTB) can cause post-TB lung disease (PTLD) associated with respiratory symptoms, spirometric and radiological abnormalities. Understanding of the predictors and natural history of PTLD is limited.ObjectivesTo describe the symptoms and lung function of Malawian adults up to 3 years following PTB-treatment completion, and to determine the evolution of PTLD over this period.MethodsAdults successfully completing PTB treatment in Blantyre, Malawi were followed up for 3 years and assessed using questionnaires, post-bronchodilator spirometry, 6 min walk tests, chest X-ray and high-resolution CT. Predictors of lung function at 3 years were identified by mixed effects regression modelling.Measurement and main resultsWe recruited 405 participants of whom 301 completed 3 years follow-up (mean (SD) age 35 years (10.2); 66.6% males; 60.4% HIV-positive). At 3 years, 59/301 (19.6%) reported respiratory symptoms and 76/272 (27.9%) had abnormal spirometry. The proportions with low FVC fell from 57/285 (20.0%) at TB treatment completion to 33/272 (12.1%), while obstruction increased from and 41/285 (14.4%) to 43/272 (15.8%) at 3 years. Absolute FEV1and FVC increased by mean 0.03 L and 0.1 L over this period, but FEV1decline of more than 0.1 L was seen in 73/246 (29.7%). Higher spirometry values at 3 years were associated with higher body mass index and HIV coinfection at TB-treatment completion.ConclusionSpirometric measures improved over the 3 years following treatment, mostly in the first year. However, a third of PTB survivors experienced ongoing respiratory symptoms and abnormal spirometry (with accelerated FEV1decline). Effective interventions are needed to improve the care of this group of patients.