bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of hallux rigidus (HARD trial): study protocol of a prospective, randomised, controlled trial of arthrodesis versus watchful waiting in the treatment of a painful osteoarthritic first metatarsophalangeal joint
Authors: Miettinen Mikko , Rämö Lasse , Lähdeoja Tuomas , Sirola Timo , Sandelin Henrik , Ponkilainen Ville , Repo Jussi P 
Published: August 2021

IntroductionHallux rigidus is a common problem of pain and stiffness of the first metatarsophalangeal joint (MTPJ) caused mainly by degenerative osteoarthritis. Several operative techniques have been introduced for the treatment of this condition without high-quality evidence comparing surgical to non-surgical care. In this trial, the most common surgical procedure, arthrodesis, will be compared with watchful waiting in the management of hallux rigidus.Methods and analysisNinety patients (40 years or older) with symptomatic first MTPJ osteoarthritis will be randomised to arthrodesis or watchful waiting in a ratio of 1:1. The primary outcome will be pain during walking, assessed using the 0–10 Numerical Rating Scale (NRS) at 1 year after randomisation. The secondary outcomes will be pain at rest (NRS), physical function (Manchester-Oxford Foot Questionnaire), patient satisfaction in terms of the patient-acceptable symptom state, health-related quality of life (EQ-5D-5L), activity level (The Foot and Ankle Ability Measure Sports subscale), use of analgesics or orthoses and the rate of complications. Our null hypothesis is that there will be no difference equal to or greater than the minimal important difference of the primary outcome measure between arthrodesis and watchful waiting. Our primary analysis follows an intention-to-treat principle.Ethics and disseminationThe study protocol has been approved by the Ethics Committee of Helsinki and Uusimaa Hospital District, Finland. Written informed consent will be obtained from all the participants. We will disseminate the findings of this study through peer-reviewed publications and conference presentations.Protocol version21 June 2021 V.2.0.Trial registration numberNCT04590313.
UK veterans’ mental health and well-being before and during the COVID-19 pandemic: a longitudinal cohort study
Authors: Sharp Marie-Louise , Serfioti Danai , Jones Margaret , Burdett Howard , Pernet David , Hull Lisa , Murphy Dominic , Wessely Simon , Fear Nicola T 
Published: August 2021

ObjectiveTo investigate the impact of the COVID-19 pandemic on the health and well-being of UK ex-service personnel (veterans) before and during the pandemic, and to assess associations of COVID-19 experiences and stressors with mental health, alcohol use and loneliness.DesignAn additional wave of data was collected from a longitudinal cohort study of the UK Armed Forces.SettingOnline survey June–September 2020.ParticipantsCohort members were included if they had completed a questionnaire at phase 3 of the King’s Centre for Military Health Research health and well-being study (2014–2016), had left the Armed Forces after regular service, were living in the UK, had consented to follow-up and provided a valid email address. Invitation emails were sent to N=3547 with a 44% response rate (n=1562).Primary outcome measuresCommon mental health disorders (CMDs) (measured using the General Health Questionnaire, 12 items—cut-off ≥4), hazardous alcohol use (measured using the Alcohol Use Disorder Identification Test, 10 items—cut off ≥8) and loneliness (University of California, Los Angeles, Loneliness Scale— 3 items-cut-off ≥6).ResultsVeterans reported a statistically significant decrease in hazardous drinking of 48.5% to 27.6%, while CMD remained stable (non-statistically significant increase of 24.5% to 26.1%). 27.4% of veterans reported feelings of loneliness. The COVID-19 stressors of reporting difficulties with family/social relationships, boredom and difficulties with health were statistically significantly associated with CMD, hazardous drinking and loneliness, even after adjustment for previous mental health/hazardous alcohol use.ConclusionsOur study suggests a COVID-19 impact on veterans’ mental health, alcohol use and loneliness, particularly for those experiencing difficulties with family relationships. Veterans experienced the pandemic in similar ways to the general population and in some cases may have responded in resilient ways. While stable levels of CMD and reduction in alcohol use are positive, there remains a group of veterans who may need mental health and alcohol treatment services.
Workforce safety in the remote health sector of Australia: a scoping review
Authors: Wright Laura Kimberly , Jatrana Santosh , Lindsay David 
Published: August 2021

ObjectivesTo scope the evidence surrounding workplace health and safety risks for the remote health workforce in Australia and to collate the recommendations to address those risks.DesignA five-stage scoping review framework refined by Cooperet alwas used for this review. Informit Health Collection, Ovid Emcare, Medline, Web of Science Core Collection, ProQuest and the grey literature were searched in October 2020 using a combination of key words derived from the eligibility criteria. No date restriction was placed on the search. Title and abstract screening, full-text review and data extraction were performed by three reviewers. Data were analysed by the lead author using qualitative thematic analysis.Eligibility criteriaArticles were eligible for inclusion if they were published research or industry reports, focused on safety for the remote health workforce in Australia, identified hazards/safety risks or recommendations to reduce risk, and were written in English.ResultsThe search yielded 312 articles, of which 18 met the inclusion criteria. A wide range of hazards/safety risks and recommendations were identified within the literature, which related to safety culture, isolation, safe environment, and education and training. Some recommendations, such as the use of a risk management approach, good post-incident support, safer clinics and accommodation, and improved access to education and training, had been discussed in the literature for over a decade, with a high level of agreement regarding their importance. Two articles briefly evaluated the impact of some recommendations.ConclusionWhile many recommendations have been developed to improve the safety of the remote health workforce in Australia, there is little evidence of their implementation and evaluation. As many remote health professionals report ongoing or worsening workplace safety issues, there is an urgent need for the implementation and evaluation of the workforce safety strategies recommended in the literature and required by legislation.
Preventing adverse cardiac events (PACE) in chronic obstructive pulmonary disease (COPD): study protocol for a double-blind, placebo controlled, randomised controlled trial of bisoprolol in COPD
Authors: Martin Allison , Hancox Robert J , Chang Catherina L , Beasley Richard , Wrobel Jeremy , McDonald Vanessa , Dobler Claudia C , Yang Ian A , Farah Claude S , Cochrane Belinda , Hillis Graham S , Scowcroft Caroline Polak , Aggarwal Ashutosh , Di Tanna Gian Luca , Balicki Grace , Galgey Shane , Jenkins Christine 
Published: August 2021

IntroductionHeart disease in chronic obstructive pulmonary disease (COPD) is a common but neglected comorbidity. Patients with COPD are frequently excluded from clinical trials of treatments aimed at reducing cardiac morbidity and mortality, which has led to undertreatment of cardiovascular disease in patients with COPD. A particular concern in COPD is the underuse of beta (β)-blockers. There is observational evidence that cardioselective β-blockers are safe and may even reduce mortality risk in COPD, although some evidence is conflicting. There is an urgent need to answer the research question: Are cardioselective β-blockers safe and of benefit in people with moderately severe COPD? The proposed study will investigate whether cardioselective β-blocker treatment in patients with COPD reduces mortality and cardiac and respiratory morbidity.Methods and analysesThis is a double-blind, randomised controlled trial to be conducted in approximately 26 sites in Australia, New Zealand, India, Sri Lanka and other countries as required. Participants with COPD will be randomised to either bisoprolol once daily (range 1.25–5 mg, dependent on tolerated dose) or matched placebo, in addition to receiving usual care for their COPD over the study duration of 24 months.The study will enrol 1164 participants with moderate to severe COPD, aged 40–85 years. Participants will be symptomatic from their COPD and have a postbronchodilator forced expiratory volume in 1 s (FEV1) ≥30% and ≤70% predicted and a history of at least one exacerbation requiring systemic corticosteroids, antibiotics or both in the prior 24 months.Ethics and disseminationThe study protocol has been approved by the Sydney Local Health District Human Research Ethics Committee at The Concord Repatriation General Hospital.Trial registration numbersNCT03917914; CTRI/2020/08/027322.
Determining the skills needed by frontline NHS staff to deliver quality improvement: findings from six case studies
Authors: Wright David , Gabbay John , Le May Andrée 
Published: August 2021

BackgroundPrevious studies have detailed the technical, learning and soft skills healthcare staff deploy to deliver quality improvement (QI). However, research has mainly focused on management and leadership skills, overlooking the skills frontline staff use to improve care. Our research explored which skills mattered to frontline health practitioners delivering QI projects.Study designWe used a theory-driven approach, informed by communities of practice, knowledge-in-practice-in-context and positive deviance theory. We used case studies to examine skill use in three pseudonymised English hospital Trusts, selected on the basis of Care Quality Commission rating. Seventy-three senior staff orientation interviews led to the selection of two QI projects at each site. Snowball sampling obtained a maximally varied range of 87 staff with whom we held 122 semistructured interviews at different stages of QI delivery, analysed thematically.ResultsSix overarching ‘Socio-Organisational Functional and Facilitative Tasks’ (SOFFTs) were deployed by frontline staff. Several of these had to be enacted to address challenges faced. The SOFFTs included: (1) adopting and promulgating the appropriate organisational environment; (2) managing the QI rollercoaster; (3) getting the problem right; (4) getting the right message to the right people; (5) enabling learning to occur; and (6) contextualising experience. Each task had its own inherent skills.ConclusionOur case studies provide a nuanced understanding of the skills used by healthcare staff. While technical skills are important, the ability to judge when and how to use wider skills was paramount. The provision of QI training and fidelity to the improvement programme may be less of a priority than the deployment of SOFFT skills used to overcome barriers. QI projects will fail if such skills and resources are not accessed.
Contribution of men who have sex with men (MSM) attending due to contact tracing to the diagnoses of HIV, syphilis and gonorrhoea in MSM from a clinic-based population
Authors: Samarasekara Keshinie , Ringshall Miriam , Parashar Kuhuk , Pickering Alice , Buss Zoe , Nichols Kayleigh , Devlin John , Fitzpatrick Colin , Williams Deborah , Richardson Daniel 
Published: August 2021

ObjectivesRates of HIV, syphilis and gonorrhoea have increased over the past 20 years in men who have sex with men (MSM). Contact tracing strategies have increased the number of MSM attending clinics as sexual contacts. Understanding the outcomes of contact tracing could inform future public health policies to reduce the burden of STIs in MSM.MethodWe aimed to describe the contribution of MSM attending as notified sexual contacts of patients with HIV, syphilis and gonorrhoea to the overall diagnoses of HIV, syphilis and gonorrhoea in MSM in a cross-sectional study. We collected data on all MSM diagnosed with HIV, syphilis and gonorrhoea in 2019 and evaluated which of these MSM were tested due to attending as a sexual contact.ResultsSexual contacts of HIV, syphilis and gonorrhoea contributed to 20% (95% CI=17.3% to 23.7%) of all diagnoses of HIV (3 of 30, 10%), syphilis (28 of 183, 15%) or gonorrhoea (98 of 420, 23%) in the study period. Asymptomatic sexual contacts contributed to 12% (95% CI=9.6% to 14.9%) of all diagnoses of HIV (3 of 30, 10%), syphilis (16 of 183, 9%) and gonorrhoea (57 of 420, 14%). The proportion of MSM diagnosed with gonorrhoea attending as sexual contacts of gonorrhoea (21%) was significantly greater than MSM diagnosed with HIV, attending as sexual contacts of HIV (3%) or MSM diagnosed with syphilis, attending as a sexual contact of syphilis (4%) (p<0.001). Furthermore, the proportion of MSM diagnosed with syphilis, attending as a sexual contact of another STI (11%) was significantly greater than MSM diagnosed with HIV, attending as a contact of another STI (7%) or MSM diagnosed with gonorrhoea, attending as a sexual contact of another STI (2%) (p<0.001).ConclusionContact tracing contributes significantly to the overall diagnoses of HIV, syphilis and gonorrhoea including asymptomatic sexual contacts in our population. Further efforts to increase the yield from contact tracing may continue to reduce the burden of HIV, syphilis and gonorrhoea within sexual networks of MSM.
Study on the Correlation between Nonalcoholic Fatty Liver and Metabolic Syndrome Based on Magnetic Resonance Diffusion-Weighted Imaging
Authors: Liu Xiaoyu , Yao Zining , Li Nan , Gao Kai , Zhu Sheng 
Published: August 2021

This paper explores the relationship between magnetic resonance diffusion-weighted imaging of nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome (MS), as well as the study of diffusion-weighted imaging, spectral imaging, and low density of nonalcoholic fatty liver correlation between serum concentration of lipoprotein cholesterol (LDL-C). This collection is from February 2018 to May 2018 in hospital as 39 cases of nonalcoholic fatty liver patients in the observation group and 39 patients in the control group with the same period of physical examination. All patients underwent magnetic resonance spectroscopy imaging, magnetic resonance diffusion-weighted imaging examination, and serum LDL-C test, compared the results of the two groups, and analysed the correlation between magnetic resonance spectroscopy imaging and magnetic resonance diffusion-weighted imaging examination results and LDL-C. The results showed that the prevalence of NAFLD was 12.33%, and the prevalence of NAFLD and MS was 3.47%. Magnetic resonance spectroscopy observation parameter group and the control group had statistically significant difference when compared (

P

< 0.05). Difference was statistically significant (

P

< 0.01). In conclusion, nonalcoholic fatty liver DWI and MR spectroscopy is closely related to LDL-C targets, quantitatively and noninvasively reflects the body’s fat metabolism, and can provide more extensive clinical diagnosis of nonalcoholic fatty liver. NAFLD is closely related to MS. The mutual aggravation and mutual promotion in the pathogenesis of the two should arouse enough attention and comprehensive prevention and treatment.
O ovo da serpente? Fundamentos e variações da crítica ao componente conservador das "Jornadas de junho" de 2013
Authors: Lima Pedro Luiz , Hajime Mateus 
Published: August 2021

A fortuna das interpretações sobre junho de 2013, salvo relevantes exceções, parece-nos ter sido acometida por infrutífera polarização. De um lado, a ênfase nos aspectos positivos das mobilizações permanece aquém de construir uma plausível relação entre os eventos de 2013 e seus desdobramentos na arena político-institucional do país, tratando junho como evento alheio à reação conservadora que se lhe seguiu. De outro lado, a ênfase no polo negativo faz crer que ora se tratariam de manifestações com alto grau de superficialidade, como meros eventos performáticos e miméticos de uma forma global de mobilização; ora se trataria do gatilho de uma reação conservadora cuja retórica genérica sobre corrupção e patriotismo seria sintoma de uma pulsão fascista, anti-institucional, anti-representação e, no limite, anti-democrática. Buscaremos identificar fundamentos e variações de algumas destas interpretações, em chave negativa, sobre o caráter conservador de junho de 2013 – menos para restituir imediatamente alguma verdade intrínseca que tais interpretações revelariam, e mais para entender como a polifonia e os antagonismos no interior deste restrito campo interpretativo apontariam, mesmo dados os limites de sua unilateralidade, para um momento crucial da efetiva contradição do fenômeno histórico em questão.
Sexualization of Sharīʿa: Application of Islamic Criminal (Ḥudūd) Laws in Pakistan
Authors: Abbasi Muhammad Zubair 
Published: August 2021

Abstract
In 1979, General Zia ul-Haq promulgated the Hudood Ordinances to provide Islamic punishments for several offenses, but the prosecution for extra-marital sex (zinā) has been disproportionately higher. Based on the analysis of reported judgments, I argue that the higher rate of prosecutions for zinā was a direct result of new laws. Despite carrying the name “Hudood”, these Ordinances specified several taʿzīr offenses with the objective of ensuring prosecutions. By incorporating ḥadd and taʿzīr offenses for zinā, the Zina Ordinance blurred the distinction between consensual sex and rape, and thus exposed victim women, who reported rape, to prosecution for consensual sex. The Qazf Ordinance, which might have curbed the filing of false accusations of zinā, encouraged them by providing the complainants the defense of good faith. The number of zinā cases has decreased after the reform of the Zina Ordinance and the Qazf Ordinance under the Protection of Women Act, 2006.
The State and the Minority Group: Land Rights between the State and Kpaduma Indigenous Group in Abuja, Federal Capital Territory (fct), Nigeria
Authors: Bamidele Seun , Idowu Olusegun Oladele 
Published: August 2021

Abstract
The politics of land rights and low or high intensity protest in the twenty-first century has produced several land-related protesters with a variety of strategies. This study focuses on the challenges of urbanization as it affects the Kpaduma community in Abuja, Federal Capital Territory (fct), Nigeria. Kpaduma, an indigenous group, has a history of protest at various times with the government over its ancestral land. The last protest in 2016 brought massive destruction of settlements and forced displacement. Quite a number of works have been written on the land protests, with particular reference to their causes and consequences. However, the post-protests situation, particularly regarding the tense relationship and urbanization process in the locality, is yet to be sufficiently explored. This study investigates the state of relations between the government and Kpaduma as well as the urbanization processes in the country’s capital after the forced displacement of Kpaduma.
The Devadasis, Dance Community of South India: A Legal and Social Outlook
Authors: Shankar Shreya , Ganesan Pranav 
Published: August 2021

Abstract
The devadasi community of south India are originators of a popular dance form called bharatanatyam. This paper explores several dimensions of this community including legal and social angles. A misjudged and misunderstood community, the modern-day devadasi’s circumstances can be described as fraught with social disabilities ranging from a lack of economic opportunities and the resultant poverty to an increased propensity for delinquency. The paper presents an unbiased view of the history of the devadasi system that attempts to use a varied range of sources so as to paint a clear narrative. The paper proposes a mechanism to move forward through truth commissions as a form of restorative justice that is likely to help both policymakers as well as artists.
Protestant Children, Missions and Education in the British World
Authors: Morrison Hugh 
Published: August 2021

Abstract
The British Protestant children’s missionary movement of the nineteenth and early- to mid-twentieth century was an educational movement, wherein philanthropy and pedagogy went hand in hand. Bringing an educational lens to bear on this group provides a more cohesive interpretive framework by which to make sense of the various elements than hitherto has been considered. As such, the Protestant children’s missionary movement emerges historically as a much more complex entity than simply a means of raising money or cramming heads full of knowledge. Across a range of geographic settings it acted as: a key site of juvenile religious and identity formation; a defining vehicle for the creation and maintenance of various types or scales of community (local, denominational, emotional, regional, national or global); a movement within which civic and religious messages were emphatically conflated (especially with respect to nation and empire); and in which children both participated in imperial or quasi-global networks of information exchange (especially as consumers of missionary periodicals) and became informed, active and responsive agents of missionary support in their own right.
Impact of the mean state on El Niño induced western North Pacific anomalous anticyclone during its decaying summer in AMIP models
Authors: Wang Xieyuan , Li Tim , He Chao 
Published: August 2021

AbstractThrough the diagnosis of 29 Atmospheric Model Inter-comparison Project (AMIP) experiments from the CMIP5 inter-comparison project, we investigate the impact of the mean state on simulated western North Pacific anomalous anticyclone (WNPAC) during El Niño decaying summer. The result indicates that the inter-model difference of the JJA mean precipitation in the Indo-western Pacific warm pool is responsible for the difference of the WNPAC. During the decaying summer of an Eastern Pacific (EP) type El Niño, a model that simulates excessive mean rainfall over the western North Pacific (WNP) reproduces a stronger WNPAC response, through an enhanced local convection-circulation-moisture feedback. The intensity of the simulated WNPAC during the decay summer of a Central Pacific (CP) type El Niño, on the other hand, depends on the mean precipitation over the tropical Indian Ocean. The distinctive WNPAC-mean precipitation relationships between the EP and CP El Niño result from different anomalous SST patterns in the WNP. While the local SST anomaly plays an active role in maintaining the WNPAC during the EP El Niño, it plays a passive role during the CP El Niño. As a result, only the mean-state precipitation/moisture field in the tropical Indian Ocean modulates the circulation anomaly in the WNP in the latter case.