bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding the scale and nature of avoidable healthcare-associated harm for prisoners in England: protocol for a retrospective cross-sectional study
Authors: Carson-Stevens Andrew , McFadzean Isobel Joy , Purchase Thomas , Gwyn Sioned , Hellard Stuart , Davies Kate , Ashcroft Darren M. , Avery Anthony , Campbell Stephen , Edwards Adrian , Flynn Sandra , Hewson Thomas , Ibrahim Saied , Jordan Melanie , Keers Richard N. , Millar Tim , Panagioti Maria , Sanders Caroline , Senior Jane , Stevenson Caroline , Thompson Ellie , Walter Florian , de Wet Carl , Wainwright Verity , Shaw Jenny 
Published: December 2024

IntroductionAround 1 in 20 patients experience avoidable healthcare-associated harm worldwide. Despite longstanding concerns, there is insufficient information available about the safety of healthcare for prisoners. To address this, this study will investigate the scale and nature of avoidable healthcare-associated harm for prisoners in England.MethodsWe will undertake a large retrospective cross-sectional study involving a case note review of patient healthcare records in 18 prisons in England. Prisons will be purposively sampled for maximum variation of characteristics based on prison category (open, local, training, high security, female), type (publicly and privately run) and prison population size, to sample approximately 15 000 patient records. We will focus on two samples: an enhanced risk sample of prisoners, considered to be at the most risk of healthcare-associated harm, and a random sample of prisoners excluded from the enhanced risk sample, to estimate the incidence of avoidable harm, and express this as ‘per 100 000 patients per year’. Avoidable harms will be characterised by type of incident(s), contributory incident(s), contributory factor(s), outcome(s) and severity of harm, prior to a thematic analysis of the relationships between those variables. Univariable and multivariable analyses will be conducted to identify factors associated with avoidable harm.Ethics and disseminationThe decision regarding participation by prisons within the study will be voluntary, and their consent to participate may be withdrawn at any time. We will not seek individual patient consent for the retrospective case note review of their records, but if patients respond to publicity about the project and inform us that they do not wish their records to be included, we will adhere to their wishes. We will produce a report for the Department of Health’s Policy Research Programme and several peer-reviewed publications. The study has been granted a favourable opinion by Wales Research Ethics Committee 3 (reference 19/WA/0291), Her Majesty’s Prison and Probation Service (reference 2019–332) and the Confidentiality Advisory Group (CAG) to access the medical records without individual consent under Section 251 of the National Health Service Act 2006 (reference 19/CAG/0214).
‘We are not trained to do clinical work’: security staff providing physical restraint for NGT feeding in English paediatric wards—a qualitative multi-informant study
Authors: Fuller Sarah , Sheridan Emerie , Tan Jacinta , Nicholls Dasha 
Published: December 2024

ObjectiveTo gain insights into the experience, and impact, of using security staff to facilitate physical restraints for nasogastric tube feeding.DesignA cross-sectional design using 39 individual interviews, three online focus groups and three written submissions involving young people with lived experience (PWLE), parents/carers, paediatric staff and security staff involved in nasogastric feeding under restraint in paediatric settings in England. Qualitative semistructured interviews were transcribed and thematically analysed.Participants53 individuals participated: seven security staff (all men); nine PWLE who experienced the intervention between the ages of 9 and 17 (all female); 20 parents (15 mothers, 5 fathers) and 20 paediatric staff (5 men, 15 women).ResultsRegarding the involvement of security staff, participants spoke in relation to two primary themes (1) short-term impact and (2) long-term impact. Short-term themes included that the intervention felt inappropriate and traumatic while also recognising its lifesaving nature and the fact that involving security guards preserved positive relationships with nursing staff. Longer-term themes included the development of trauma symptoms, while also acknowledging the skill development and improved professional relationships that could result from delivering the intervention.ConclusionsThis lifesaving clinical intervention can negatively impact security staff as much as the patient, parents/carers and paediatric staff. A prebrief and debrief should be seen as part of the ‘process’. Further research is needed to better understand what else can mitigate negative impacts.
Association between oral microbiome diversity and all-cause mortality: a longitudinal study of NHANES, 2009–2012
Authors: Yu Ju , Lin Bo , Zhang Zhanqiang , Chen Wanna , Lv Weiming , Zheng Liang 
Published: December 2024

ObjectiveThe study investigates the association between oral microbiome diversity and all-cause mortality.DesignPopulation-based cohort study.SettingUS National Health and Nutrition Examination Survey (2009–2010 and 2011–2012).ParticipantsA total of 8224 participants who had valid data on the oral microbiome diversity and survival through 31 December 2019 were included in this study.Primary and secondary outcome measuresOral microbiome diversity was measured using the observed number of amplicon sequence variant (ASV) and grouped into quartiles. Cox proportional hazards regression models were used to estimate the HR and 95% CI for all-cause mortality according to the quartiles of ASV number, adjusted for potential confounders.ResultsAmong the 8224 participants (mean (SD) age: 42.0 (15.1) years; 49.9% male; 37.2% white, 23.8% black, 27.2% Hispanic and 11.8% other race/ethnicity), the median follow-up time was 108 months (IQR, 95–120 months) and 429 (5.2%) deaths were identified. Participants with a higher ASV number were more likely to be poor, non-Hispanic black or Hispanic, uninsured and current smokers, more likely to have poor self-rated oral health and periodontitis and less likely to use dental floss. However, compared with the lowest quartile of the ASV number, a suggestive association was observed for the second quartile (HR=0.80, 95% CI: 0.60 to 1.08), a significant reduction in all-cause mortality was observed for the third (HR=0.55, 95% CI: 0.37 to 0.82) and the fourth (HR=0.58, 95% CI: 0.38 to 0.89) quartile. The dose–response association for all-cause mortality risk was curvilinear; the protective association plateaued when the number of ASVs was larger than 120.ConclusionDespite being linked to greater socioeconomic disadvantages and poorer oral health, higher oral microbiome diversity was significantly associated with a substantial reduction in all-cause mortality.
Factors influencing access, quality and utilisation of primary healthcare for patients living with hypertension in West Africa: a scoping review
Authors: Amarteyfio Kezia Naa Amerley Akosua , Bondzie Eugene Paa Kofi , Reichenberger Veronika , Afun Nana Efua Enyimayew , Cofie Albert Kofi Mensah , Agyekum Mary Pomaa , Lamptey Paul , Ansah Evelyn K , Agyepong Irene Akua , Mirzoev Tolib , Perel Pablo 
Published: December 2024

ObjectivesHypertension is one of the most prevalent non-communicable diseases in West Africa, which responds to effective primary care. This scoping review explored factors influencing primary care access, utilisation and quality for patients with hypertension in West Africa.DesignScoping review using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews.Data sourcesPublished literature from PubMed, Embase, Scopus, Cairn Info and Google Scholar, between 1 January 2000 and 31 December 2023.Eligibility criteriaSystematic reviews, observational studies and reports involving participants aged 18 years and above, written in English, French or Portuguese, were included. Clinical case series/case reports, short communications, books, grey literature, randomised control trials, clinical trials, quasi-experiments, conference proceedings and papers on gestational hypertension and pre-eclampsia were excluded.Data extraction and synthesisData from included studies were extracted onto an Excel spreadsheet and synthesised qualitatively using thematic analysis structured by the components of the overall review question.ResultsThe search yielded a total of 5846 studies, 45 papers were selected for full review and 16 papers were eventually included. Macro (contextual) barriers included economic, funding and geographical barriers. Meso (health system) factors include access to medications, tools, equipment and other supplies, out-of-pocket payments, availability of health insurance, health workers numbers, capacity and distribution. Micro (community and patient factors) barriers included financial barriers and limited knowledge, whereas facilitators included the availability of alternative providers and community and household support. These factors are interconnected and complex and should be addressed as a whole to reduce the burden of hypertension in West Africa.ConclusionMultiple complex and interrelated factors at contextual, health systems, community and patient levels act as barriers and enablers to access, utilisation and quality of primary care for hypertension in West Africa. Improving primary care and outcomes will, therefore, require multilevel multifaceted interventions.
Efficacy of susceptibility-guided quadruple therapy with antibiotic resistance using the string test coupled with quantitative PCR forHelicobacter pylorieradication: a protocol of a multicentre, open, randomised clinical trial
Authors: Cui Yi , Zhang Shenke , Hu Shuqin , Fei Sujuan , Yang Geliang 
Published: December 2024

IntroductionHelicobacter pyloriis a major health problem, with the high prevalence ofH. pyloriand the increasing antibiotic resistance rate in China. Antibiotic resistance is the main reason for the failure ofH. pylorieradication. This study aims to evaluate the efficacy and safety of susceptibility-guided quadruple therapy with antibiotic resistance using the string test coupled with quantitative PCR (qPCR) forH. pylorieradication.Methods and analysisThis is a multicentre, open, randomised clinical trial that will enroll 324 patients withH. pyloriinfection. Patients will be randomised to two groups for a 14-day treatment: Treatment group will be treated with proton pump inhibitor (PPI), bismuth with two different kinds of antibiotics susceptibly guided by string test coupled with qPCR, while control group will be treated empirically with PPI, bismuth with two different kinds of antibiotics. The types and dosages of bismuth, PPI and antibiotics administered in this trial are based on the 2022 Chinese Guidelines for the treatment ofH. pyloriinfection and the Sixth Chinese National Consensus Report on the management ofH. pyloriinfection. The primary endpoint is the eradication rate, while secondary endpoints include compliance, the incidence of adverse events and adverse drug reactions.Ethics and disseminationThis study was approved by the ethics committee of the Third People’s Hospital of Zhengzhou (No. 2024-04-001-K02). The results will be published in the appropriate peer-reviewed journal.Trial registration numberChiCTR2400082768.
Predictive accuracy of lactate albumin ratio for mortality in intensive care units: a nationwide cohort study
Authors: Suzuki Yasuhito , Aoki Yoshitaka , Shimizu Mikihiro , Nakajima Mikio , Imai Ryo , Okada Yohei , Mimuro Soichiro , Nakajima Yoshiki 
Published: December 2024

BackgroundThe lactate albumin ratio (LAR), a simple prognostic marker used in intensive care units (ICUs), combines lactate and serum albumin levels to predict patient outcomes. Despite its potential, the predictive accuracy of the LAR remains insufficiently explored. This study aimed to assess the usefulness of the LAR in predicting mortality among patients in the ICU.MethodsThis retrospective study conducted a secondary analysis of prospectively obtained clinical data from the Japanese Intensive Care Patient Database. We included all patients admitted to ICUs between 2015 and 2021, excluding those under the age of 16 years. The main outcome was in-hospital mortality. The LAR predictive value for this outcome was assessed by examining the area under the receiver operating characteristic curve and comparing it against prognostic indicators such as age, lactate, albumin and Sequential Organ Failure Assessment score. LAR shape was assessed using unrestricted spline curves, and the optimal cut-off value was identified from sensitivity and negative likelihood ratio. Subgroup analysis was used to evaluate the predictive accuracy of the LAR across different patient attributes and clinical scenarios.ResultsOf 2 34 774 cases analysed, in-hospital mortality was 8.8% (20 723 deaths). The LAR had an area under the curve of 0.761 (95%CI 0.757 to 0.765), indicating a fair predictive performance for in-hospital mortality. Unrestricted spline curves demonstrated that LAR can predict mortality through a monotonic positive dose–response relationship with 0.4 as the optimal cut-off value. In subgroup analysis, areas under the curve were significantly higher in subgroups defined by younger age, female sex, unplanned ICU admission, non-surgical patients, non-infectious patients, non-heart failure patients and lack of end-stage renal disease.ConclusionsThe LAR might be a useful predictor for screening mortality in ICU patients. However, further research to establish appropriate cut-off values for the LAR and identify the optimal target population is warranted.
Exploring perceptions of diabetes distress and its care in Japan: a qualitative study of patients and physicians
Authors: Akano Kyoko , Sugihara Taro 
Published: December 2024

ObjectivesThis study aimed to identify the obstacles preventing care of diabetes distress from being integrated into diabetes management, as perceived by both patients and healthcare professionals. By conducting interviews with people with type 2 diabetes (PWD) and physicians, this study aimed to gain insight into the current state of care for diabetes distress in diabetes management and propose targeted interventions to improve patients’ overall well-being and treatment outcomes.DesignThis qualitative study used semistructured interviews with patients and physicians. The interviews followed a guide with open-ended questions to gather detailed, reflective responses about participant experiences, perceptions and attitudes towards the research topic.SettingThis study targeted stakeholders in type 2 diabetes care in Japan.ParticipantsNine PWD and nine physicians participated in the interviews. The patients had been receiving treatment for more than 5 years, and the physicians had at least 1 year of clinical experience in diabetes treatment and had treated a minimum of five PWD per month. The physicians were recruited through snowball sampling.ResultsThis study uncovered four primary themes. Patients and physicians had differing perceptions of diabetes distress, with patients experiencing psychological challenges, such as anxiety over self-management and fluctuating blood glucose levels, while physicians focused on poor adherence and financial constraints. PWD often felt responsible for managing their condition, leading to self-blame and reluctance to seek emotional support from healthcare providers (HCPs). Physicians faced constraints in providing psychosocial support owing to limited resources and insufficient training. HCPs support affected patient motivation and clinic visits, with positive reinforcement and understanding fostering self-management, whereas one-sided guidance had negative effects. Patients frequently used self-tracking data to enhance their self-management and effectively communicate with HCPs. These data provided valuable insights for treatment planning and helped bridge gaps in the monthly laboratory results.ConclusionThis study highlights significant discrepancies between patients’ and physicians’ perceptions of diabetes distress. Effective communication and trust building are essential for addressing the psychological needs of patients. The integration of self-tracking data can enhance patient–HCP interactions and support better diabetes management. Addressing these gaps can improve care of diabetes distress in clinical practice, leading to better quality of life and treatment outcomes for PWD.
Respiratory rehabilitation techniques for patients with cystic fibrosis: a protocol for a systematic review and network meta-analysis
Authors: Lin Na , Wang Xinyu , Tang Yilong , Chen Xuefeng 
Published: December 2024

IntroductionCystic fibrosis (CF) is an autosomal recessive genetic disorder caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene, primarily affecting the respiratory and digestive systems. Respiratory rehabilitation techniques play a crucial role in managing pulmonary symptoms and maintaining lung function in CF patients. Although various techniques have been developed and applied, there is currently no globally recognised optimal respiratory rehabilitation regimen. This study intends to conduct a network meta-analysis to comprehensively evaluate and compare the effectiveness of different respiratory rehabilitation techniques in CF patients.Methods and analysisThe following key electronic bibliographic databases will be searched from inception to September 2024: Medline, Embase, Cochrane Library, Web of Science, CINAHL and Physiotherapy Evidence Database. We will include randomised controlled trials (RCTs) and quasi-RCTs that compare the efficacy of various respiratory rehabilitation techniques in CF patients, such as airway clearance techniques, exercise training and inspiratory muscle training. The primary outcomes will be lung function (forced expiratory volume in 1 s and forced vital capacity) and exercise capacity (VO2 max and 6 min walk test). Secondary outcomes will include quality of life, frequency of pulmonary exacerbations, hospitalisation rates and adverse events. If permitted, data will be synthesised using traditional pairwise meta-analysis and network meta-analysis, with the quality of evidence assessed using the Grading of Recommendations Assessment, Development and Evaluation approach.Ethics and disseminationEthical approval will not be required for this protocol. The results of the final review will be disseminated via peer-reviewed journals and conference presentations.PROSPERO registration numberCRD42024574551.
Follow-up of immediate postpartum intrauterine device insertion: a scoping review protocol
Authors: Herculano Thuany Bento , Amaral-Moreira Carolina de Freitas Alves , Bennini Júnior João Renato , Surita Fernanda G 
Published: December 2024

IntroductionThe intrauterine device (IUD) inserted immediately after delivery is a safe and effective measure for preventing unplanned pregnancies. Despite exhibiting a higher expulsion rate compared with later insertions, it proves cost-effective due to the high rate of continuity of the method. There is still a gap in the literature regarding the optimal strategy for monitoring these patients, whether it should be through clinical examination, ultrasound or both. The aim of this review is to map the available evidence regarding the proper clinical and ultrasound follow-up procedures of IUDs inserted immediately post partum.Methods and analysisUsing the well-established scoping review methodology outlined by the Joanna Briggs Institute, a five-stage review is outlined: (1) determining the research question, (2) search strategy, (3) inclusion criteria, (4) data extraction and (5) analysis and presentation of the results. The search strategy will be applied to nine databases reflecting empirical and grey literature. A two-step screening process will be used to determine eligibility of articles. To be included in the review, articles must describe how postpartum women (adolescents or adults) who had an IUD inserted immediately after birth (vaginal or caesarean) were followed up. All articles will be independently assessed for eligibility, and data from eligible articles will be extracted and charted using a standardised form. Extracted data will be analysed using narrative and descriptive analyses.Ethics and disseminationEthics approval is not required. The results will be disseminated to the health science community through professional networks, conference presentations and publication in a scientific journal.
Diagnosing and managing patients with heart failure with preserved ejection fraction: a consensus survey
Authors: Austin Rosalynn , Khair Eva , Blakeman Thomas , Hossain Muhammad Zakir , Sowden Emma , Chew-Graham Carolyn , Forsyth Faye , Deaton Christi 
Published: December 2024

AimAs heart failure (HF) with preserved ejection fraction (HFpEF) prevalence increases, it remains frequently underdiagnosed and poorly managed. Recent positive pharmacological trials have increased interest in HFpEF but challenges of diagnosis and management remain. The survey aim was to examine consensus between primary and secondary care providers regarding HFpEF diagnosis and management.MethodsAs part of a larger programme of work, survey questions were developed in an online format and piloted with healthcare providers (HCPs). The survey link was distributed via professional networks and social media. Analysis included frequencies of responses, comparison by main professional groups and thematic analysis free-text responses. A virtual workshop of HCPs was conducted to discuss and refine survey findings.ResultsHCPs (n=66) across the UK participated: 19 general practitioners (GPs), 20 HF specialist nurses (HFSN), 17 cardiologists and 10 others. Consensus was high (92%) that diagnosing the type of HF was very important and most favoured inclusion of HFpEF in Quality Outcome Framework indicators. No clear consensus was reached that ongoing management should be in primary care (47.5% of GPs, 35% of HFSN and 31.3% of cardiologists ‘somewhat agreed’). Opinions differed between GPs (52.3)% and specialists (HFSN 80% and cardiologists 81.3%) for practice nurses to be upskilled and assume HFpEF management. No HCPs reported any level of disagreement for HFSN management of HFpEF. Free-text comments highlighted resource barriers to HFpEF diagnosis and management and confirmed the need to develop better HFpEF services.ConclusionsConsensus was reached regarding importance of diagnosing HFpEF, but agreement on methods and responsibilities for diagnosis and management varied. Free-text comments identified HCPs concerns related to overwhelmed primary and secondary care services and lack of sufficient resources to meet existing patient demands. Creation of collaborative care pathways is needed to support the increasing number of older patients with HFpEF.Trial registration numberClinicalTrials. gov (reference number:NCT03617848).