bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perceived effect of financial risk protection by the Urban–Rural Resident Basic Medical Insurance Scheme: a mixed-methods study of rural residents in China
Authors: Jiang Huan , Zhao Miaomiao , Tian Guomei , Zhao Zihua , Ding Ding , Yin Mei 
Published: October 2021

ObjectivesIt is to explore the perceived financial risk protection effect of the Urban–Rural Resident Basic Medical Insurance Scheme (URRBMI) and its influencing factors to provide evidence to further improve the URRBMI.DesignIt is a cross-sectional survey.ParticipantsThis mixed-methods study is conducted in five provinces in rural China. Through stratified cluster random sampling, 1681 rural residents participate in a cross-sectional questionnaire survey (1657 valid questionnaires are retrieved). Thirty rural residents participate in in-depth interviews.Primary and secondary outcome measuresA multivariate logistic regression analysis is adopted to identify factors influencing respondents’ perceptions. Semistructured interviews are used to identify the reasons why some respondents believed the URRBMI to be ineffective.ResultsOverall, 77.5% of respondents believe that the URRBMI is effective. Respondents, who are older, have a higher household income, prefer primary health facilities and provide a higher rating for critical illness compensation and maximum compensatory payouts. They are more likely to give the URRBMI a higher effectiveness rating than their counterparts. Qualitatively, participants who believe the URRBMI to be ineffective list the following reasons: low outpatient service coverage, insufficient or undersupplied drugs and services in the insurance list, problems in the arrangement of deductibles and maximum compensatory payouts, provider-induced behaviour and increased healthcare service price.ConclusionsThis exploration focuses on the reasons why rural residents think the scheme is invalid, which are vital for policy reform. Policies should focus on benefits design and coverage, the assumption of a supervisory role, avoiding financial risk stemming from critical illness and cross-sectoral actions to strengthen the primary healthcare system and comprehensive social security wealth.
Behaviours of older adults and caregivers preparing for elective surgery: a virtually conducted mixed-methods research protocol to improve surgical outcomes
Authors: Norcott Alexandra , Chan Chiao-Li , Nyquist Linda , Bynum Julie P , Min Lillian , Fetters Michael D , DeJonckheere Melissa 
Published: October 2021

IntroductionOlder adults (age ≥65 years) are pursuing increasingly complex, elective surgeries; and, are at higher risk for intraoperative and postoperative complications. Patients and their caregivers frequently struggle with the postoperative recovery process at home, which may contribute to complications. We aim to identify opportunities to intervene during the preoperative period to improve postoperative outcomes by understanding the preparatory behaviours of older adults and their caregivers before a complex, elective surgery.Methods and analysisAs a result of the COVID-19 pandemic, we will conduct this study via telephone and videoconferencing. Using a multiphase mixed-methods research design, we will collect data on 10–15 patient–caregiver dyads from a pool of older adults (across a spectrum of cognitive abilities) scheduled for an elective colorectal surgery between 1 July 2020 and 30 May 2021. We will collect quantitative and qualitative data before (T1, T2) and after (T3, T4) surgery. Preoperatively, participants will each complete a cognitive assessment and a semi-structured qualitative interview that focuses on their preparatory behaviours (T1). They will then answer questionnaires about mood, self-efficacy and home environment (T2). Three weeks following hospital discharge, participants will complete another qualitative interview focusing on a comparison of preoperative and postoperative preparedness (T3). Researchers will also collect information about the patient’s medical conditions, the postoperative complications and healthcare utilisation from the patient’s chart 30 days following discharge (T4). We will code and conduct thematic analysis of the qualitative data to identify salient themes. Quantitative data will be analysed using basic descriptive statistics to characterise the participants. We will integrate the qualitative and quantitative findings using results from the quantitative scales to group participants and with use of joint display analysis.Ethics and disseminationEthics approval was obtained from the University of Michigan IRB. Study findings will be disseminated through peer-reviewed journals and presentations at conferences.
Protocol to test the efficacy and safety of frequent applications of skin electrical stimulation for Leber hereditary optic neuropathy: a single-arm, open-label, non-randomised prospective study
Authors: Ueda Kaori , Kurimoto Takuji , Takano Fumio , Murai Yusuke , Mori Sotaro , Sakamoto Mari , Nagai Takayuki , Yamada-Nakanishi Yuko , Nakamura Makoto 
Published: October 2021

IntroductionLeber hereditary optic neuropathy (LHON) is an acute or subacute inherited optic neuropathy caused by mitochondrial mutations. More than 90% of patients with LHON have one of three point mutations (ie, G3460A, G11778A and T14484C). We previously reported that a 12-week session of skin electrical stimulation (SES) with a 2-week interval significantly improved visual acuity and field tests 1 week after the last stimulation and without adverse effects in 10 cases of LHON carrying the mt DNA G11778A mutation. In the present study, we will examine the magnitude and persistence of the efficacy and presence or absence of adverse events using SES with a more frequent stimulation protocol.Methods and analysisThis study will be a single-arm, open-labelled, non-randomised clinical study that analyses 15 cases of LHON with G11778A mutation. All participants will take a portable SES device home and perform SES by themselves every other day for 12 weeks. The logarithm for the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA) at 1 week after the last SES will be measured as the primary outcome. LogMAR BCVA will be measured at four and 8 weeks after the last SES treatment. The Humphrey visual field sensitivity test using size V stimulation and critical fusion frequency at 1, 4 and 8 weeks after the last SES session will be secondary outcome measurements. Slit-lamp examination, optical coherence tomography and specular microscopy will also be performed to verify the safety of SES.Ethics and disseminationThe protocol was approved by the Institutional Review Board at Kobe University, Japan (Approval No.C190030). This study is in progress and deserves Pre-result. All documents communicating with the ethics committee will be reposited by the researcher. Modifications to the protocol will be reviewed by the ethics committee and implemented after approval. Data monitoring will be performed by a researcher who is not involved in the study every 6 months after approval. The research summary results will be registered in the Japan Registry of Clinical Trials (jRCTs) and made available to participants in accordance with the terms described in the documents. In addition, the results of this study will be presented at domestic and international meetings and published in peer-reviewed journals within a year after data is fixed.Trial registration numberjRCTs052200033.
Buteyko method for people with asthma: a protocol for a systematic review and meta-analysis
Authors: Mendonça Karla Morganna Pereira Pinto de , Collins Sean , Santos Tácito ZM , Chaves Gabriela , Leite Sarah , Santino Thayla Amorim , Monteiro Karolinne Souza 
Published: October 2021

IntroductionButeyko method is recommended as a non-pharmacological treatment for people with asthma. Although the worldwide interest in the Buteyko method, there is a paucity of studies gathering evidence to support its use. Therefore, we aim to conduct a systematic review and meta-analysis to assess the effects of the Buteyko method in children and adults with asthma.Methods and analysisWe will search on Cochrane Central Register of Controlled Trials, MEDLINE, Embase, US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov and WHO International Clinical Trials Registry Platform for studies focusing on the Buteyko method for children and adults with asthma. The searches will be carried out in September 2021 from database’s inception to the present. We will include randomised controlled trials comparing Buteyko method alone with asthma education or inactive control intervention. There will be no restriction on language. Primary outcomes include quality of life, asthma symptoms and adverse events/side effects. Two review authors will independently screen the studies for inclusion and extract data. We will assess the quality of the included studies using the ‘Risk of Bias’ tool. The certainty of the evidence will be assessed using the GRADE approach. Data synthesis will be conducted using Review Manager software. Reporting of the review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance and the Cochrane Handbook for Systematic Reviews of Interventions.Ethics and disseminationThis study will assess and provide evidence for the use of the Buteyko method in people with asthma. We will analyse secondary data and this does not require ethics approval. The findings will be published in peer-reviewed journals, at relevant conferences and will be shared in plain language in social media. Moreover, the findings of this review could guide the direction of healthcare practice and research.PROSPERO registration numberCRD42020193132.
Impact of COVID-19 restrictions on preschool children’s eating, activity and sleep behaviours: a qualitative study
Authors: Clarke Joanne , Kipping Ruth , Chambers Stephanie , Willis Kate , Taylor Hilary , Brophy Rachel , Hannam Kimberly , Simpson Sharon Anne , Langford Rebecca 
Published: October 2021

ObjectivesIn spring 2020, the first COVID-19 national lockdown placed unprecedented restrictions on the behaviour and movements of the UK population. Citizens were ordered to ‘stay at home’, only allowed to leave their houses to buy essential supplies, attend medical appointments or exercise once a day. We explored how lockdown and its subsequent easing changed young children’s everyday activities, eating and sleep habits to gain insight into the impact for health and well-being.DesignIn-depth qualitative interviews; data analysed using thematic analysis.SettingSouth West and West Midlands of England.ParticipantsTwenty parents (16 mothers; 4 fathers) of preschool-age children (3–5 years) due to start school in September 2020. Forty per cent of the sample were from Black, Asian or minority ethnic backgrounds and half lived in the most deprived areas.ResultsChildren’s activity, screen time, eating and sleep routines had been disrupted. Parents reported children ate more snacks, but families also spent more time preparing meals and eating together. Most parents reported a reduction in their children’s physical activity and an increase in screen time, which some linked to difficulties in getting their child to sleep. Parents sometimes expressed guilt about changes in activity, screen time and snacking over lockdown. Most felt these changes would be temporary, though others worried about re-establishing healthy routines.ConclusionsParents reported that lockdown negatively impacted on preschool children’s eating, activity and sleep routines. While some positive changes were identified, many participants described lack of routines, habits and boundaries which may have been detrimental for child health and development. Guidance and support for families during COVID-19 restrictions could be valuable to help maintain healthy activity, eating, screen time and sleeping routines to protect child health and ensure unhealthy habits are not adopted.
Study protocol for a randomised controlled clinical trial comparing desflurane-based versus propofol-based anaesthesia on postanaesthesia respiratory depression in patients with obstructive sleep apnoea after major abdominal surgery
Authors: Wu Huanghui , Yang Fei , Zhang Ran , Xue Haiyan , Yang Yongyong , Liao Ruizhe , Li Min , Wu Xiaozhi , Chen Dongsheng , Chen Guozhong , Gong Yi , Hou Lichao 
Published: October 2021

IntroductionPatients with obstructive sleep apnoea (OSA) are more sensitive to postanaesthesia respiratory depression. Whether different anaesthetic regimens (intravenous-based or inhalational-based general anaesthesia) affect the postanaesthesia respiratory depression is controversial. Although desflurane has been reported that presents favourable rapid recovery profile in special patients including whom with OSA, the strong clinical evidence of the benefit on postanaesthesia respiratory depression is far from being revealed. This study aims to fill this knowledge gap by investigating the postanaesthesia respiratory depression in postanaesthesia care unit (PACU) in patients with OSA after major abdominal surgery, followed by desflurane-based anaesthesia compared with propofol-based anaesthesia.Methods and analysisEight hundred and fifty-four patients with OSA scheduled for elective major abdominal surgery will be randomly 1:1 assigned to desflurane-based (n=427) or propofol-based anaesthesia (n=427) using a computer-generated randomisation scheme with permuted block size maintained by a centralised randomisation centre. Patients will be assessed before and a consecutive 3 days after their surgery according to the standardised tasks. Demographic data as well as surgical and anaesthesia information will be collected for the duration of the procedure. Incidence of postanaesthesia respiratory depression in PACU as well as anaesthesia recovery, emergence delirium, postoperative nausea and vomiting, rescue analgesia, duration of PACU and hospital stay, and any other adverse events will be assessed at the given study time point. Investigators performing postoperative follow-up are not involved in both anaesthesia implementation and postoperative care.Ethics and disseminationThis study protocol has been approved by the ethics board at Xiang’an Hospital of Xiamen University (XAHLL2019003). The results of this study will be published in a peer-review journal and presented at national conferences as poster or oral presentations. Participants wishing to know the results of this study will be contacted directly on data publication.Trial registration numberChiCTR2000031087.
Longitudinal trajectory of depression symptom severity and the influence of concussion history and physical function over a 19-year period among former National Football League (NFL) players: an NFL-LONG Study
Authors: Brett Benjamin L , Kerr Zachary Y , Walton Samuel R , Chandran Avinash , Defreese J D , Mannix Rebekah , Echemendia Ruben J , Meehan William P , Guskiewicz Kevin M , McCrea Michael 
Published: October 2021

ObjectiveThis study investigated the longitudinal course of depressive symptom severity over 19 years in former American football players and the influence of concussion history, contact sport participation and physical function on observed trajectories.MethodsFormer American football players completed a general health questionnaire involving demographic information, medical/psychiatric history, concussion/football history and validated measures of depression and physical function at three time points (2001, 2010 and 2019). Parallel process latent growth curve modelling tested associations between concussion history, years of football participation, and overall and change in physical function on the overall level and trajectory of depressive symptoms.ResultsAmong the 333 participants (mean(SD) age, 48.95 (9.37) at enrolment), there was a statistically significant, but small increase in depressive symptom severity from 2001 (48.34 (7.75)) to 2019 (49.77 (9.52)), slope=0.079 (SE=0.11), p=0.007. Those with greater concussion history endorsed greater overall depressive symptom severity, B=1.38 (SE=0.33), p<0.001. Concussion history, B<0.001 (SE=0.02), p=0.997 and years of participation, B<0.001 (SE=0.01), p=0.980, were not associated with rate of change (slope factor) over 19 years. Greater decline in physical function, B=−0.71 (SE=0.16), p<0.001, was predictive of a faster growth rate (ie, steeper increase) of depression symptom endorsement over time.ConclusionsConcussion history, not years of participation, was associated with greater depressive symptom severity. Neither factor was predictive of changes over a 19-year period. Decline in physical function was a significant predictor of a steeper trajectory of increased depressive symptoms, independent of concussion effects. This represents one viable target for preventative intervention to mitigate long-term neuropsychiatric difficulties associated with concussion across subsequent decades of life.
Dementia Early-Stage Cognitive Aids New Trial (DESCANT) of memory aids and guidance for people with dementia: randomised controlled trial
Authors: Clarkson Paul , Pitts Rosa , Islam Saiful , Peconi Julie , Russell Ian , Fegan Greg , Beresford Rebecca , Entwistle Charlotte , Gillan Vincent , Orrell Martin , Challis David , Chester Helen , Hughes Jane , Kapur Narinder , Roe Brenda , Malik Baber , Robinson Catherine 
Published: October 2021

BackgroundCommon memory aids for people with dementia at home are recommended. However, rigorous evaluation is lacking, particularly what guidance or support is valued.ObjectiveTo investigate effects of memory aids and guidance by dementia support practitioners (DSPs) for people in early-stage dementia through a pragmatic, randomised controlled trial.MethodsOf 469 people with mild-to-moderate dementia and their informal carers, 468 were randomised to a DSP with memory aids or to usual care plus existing dementia guide. Allocation was stratified by Trust/Health Board; time since first attendance at memory service; gender; age; and living with primary carer or not. Primary outcome was Bristol Activities of Daily Living Scale (BADLS) Score at 3 and 6 months (primary end-point). Secondary outcomes for people with dementia: quality of life (CASP-19; DEMQOL); cognition and functioning (Clinical Dementia Rating Scale; S-MMSE); capability (ICECAP-O); social networks (LSNS-R); and instrumental daily living activities (R-IDDD). Secondary outcomes for carers: psychological health (GHQ-12); sense of competence (SSCQ).ResultsDSPs were successfully trained, compliance was good and welcomed by participants. Mean 6 months BADLS Score increased to 14.6 (SD: 10.4) in intervention and 12.6 (SD: 8.1) in comparator, indicative of greater dependence in the activities of daily living. Adjusted between-group difference was 0.38 (95% CI: −0.89 to 1.65, p=0.56). Though this suggests greater dependency in the intervention group the difference was not significant. No differences were found in secondary outcomes.ConclusionsThis intervention did not maintain independence in the activities of daily living with no improvement in other outcomes for people with dementia or carers.Trial registration numberCurrent Controlled TrialsISRCTN12591717.
Measurement of the effects of lateral release
Authors: Quaile A. 
Published: October 2021

AbstractIn a prospective trial of 37 knees with anterior knee pain, 12 improved with conservative treatment. Twenty five knees in 23 patients required arthroscopy and lateral release. It was found that the clinical examination combined with skyline X-Rays gave a good assessment of these patients. The medial angle and the congruence angle were rarely abnormal but often showed improved centring after lateral release. It seems unlikely, however, that this is responsible for improved symptoms especially as the asymptomatic side frequently showed similar X-Ray changes.
The Royal Naval Medical Stores for Service Afloat: a prospective quantitative study
Authors: Dewar E. P. , Mitchell K. A. W. , Hett D. A. , Taylor R. B. 
Published: October 2021

AbstractThe contents of the scale of Medical Stores for Service Afloat must provide adequate quantities of drugs to allow proper patient care in a variety of situations often remote from specialist support. The overall make up of the scale is difficult to envisage outside the context for which it was conceived. This study was designed to assess the accuracy of the make up of the scale in three RN ships over a six-month period during a detached deployment. During this time the usage of all consumable items was specifically recorded and the outcome subjected to rigorous analysis in relation to the present scale. The results of the study indicate that in the case of both HMS Ark Royal (AR) and the two smaller ships HMS Edinburgh and HMS Sirius (ES) the quantities of drugs in the majority of cases are in excess of requirements. Of the 290 (AR) and 266 (ES) individual drugs 68% and 40% respectively could safely be reduced by varying amounts, whereas only 7.6% and 4.9% respectively needed to be increased. Furthermore, when these changes are costed the savings that result are £7806 for the AR scale and £1532 for the ES scale. Extrapolation of these figures across the surface fleet produces an overall saving on the costs of drugs of over £87,000.
Malignant Ameloblastoma? A case report and review of literature outlining problems in diagnosis and treatment
Authors: Matear D. W. , Crewe T. C. 
Published: October 2021

AbstractThis paper reviews the literature on the clinical and histological diagnosis of both malignant ameloblastoma and ameloblastic carcinoma. The problems of existing classifications are emphasised and guidelines as to clearer, simpler classification are suggested. The case history emphasises the need for a clear classification between malignant ameloblastoma and ameloblastic carcinoma.
Intensive Stress?? Caring under pressure
Authors: Watkinson G. E. 
Published: October 2021

AbstractThis article is based on a survey of the intensive care nursing staff at RNH Haslar and RNH Stonehouse. It examines individuals response to external stressors and was undertaken as part of a project for the Health Education Certificate Course. The survey took place during December 1989 and January 1990.The prime purpose of this research was to explore whether high levels of stress existed among nurses on the Intensive Care Unit (ICU) at RNH Haslar. If so, to discover the main causes of work-related stress, and in addition to examine how best to implement a nursing management strategy to enable those affected to cope with stress. However, the pilot study carried out at RNH Stonehouse allowed a change in tack, enabling not only a comparison between external stressors on similar units but providing a much broader insight.
Is perianal sepsis adequately managed? The results of a five year audit at Royal Naval Hospital Haslar
Authors: Parker S. J. , Dale R. F. 
Published: October 2021

AbstractA retrospective audit and postal questionnaire of 148 patients presenting with perianal sepsis confirms that the isolation of gut-related organisms remains a sensitive indicator of a perianal fistula. It did not confirm that the use of microbiological results affects the long term outcome for these patients. It suggests that early examination under anaesthetic and laying open of a fistula may not be necessary in all patients in which gut-related organisms are identified. There was no statistical difference in recurrence rates of perianal sepsis between those operated on by senior or junior surgeons, though there may have been selection bias in these patients.