bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reliability and validity of the Turkish version of the Individual-Level Abortion Stigma Scale: a methodological study
Authors: Cetinkaya Aynur , Özmen Dilek , Uyar Fatma , Tayhan Ali 
Published: April 2019

ObjectivesThe aim of this study was to assess the reliability and validity of the Turkish version of the Individual-Level Abortion Stigma Scale.SettingThree hospitals affiliated to Public Hospitals Union General Secretariat in Manisa, a city located in Western Turkey.DesignThis was a methodological study.ParticipantsA total of 230 women aged 22–49 years who previously underwent abortion and volunteered to participate in the study.Primary and secondary outcome measuresData analysis was performed using the SPSS and LISREL software. The Content Validity Index was calculated based on the values obtained from expert opinions. In the reliability analysis, Cronbach’s alpha values were calculated for the overall scale and its subscales. To test the stability of the scale over time, the scale was readministered to 30 women in the study 15 days later and the test–retest values (Pearson’s correlation coefficients) were determined. In the validity analysis, the exploratory and confirmatory factor analyses were performed. In the exploratory factor analysis, the principal component analysis was performed using the varimax rotation and the factor loading of the scale was examined. Confirmatory factor analysis was performed to investigate the item-factor construct of the scale.ResultsThe Content Validity Index was calculated as 0.86. The Cronbach’s alpha values ranged between 0.83 and 0.94. The item-total correlation coefficients ranged between 0.36 and 0.72, and the test–retest reliability was 0.96 for the overall scale and its subscales (p<0.05). The total variance revealed by five factors was 75%. Confirmatory factor analysis of the scale revealed an acceptable compliance level (root mean square error of approximation=0.092, χ2/df=2.91, Goodness of Fit Index=0.831, Comparative Fit Index=0.928, p<0.001).ConclusionsThe results suggest that this scale has the potential for use in research and clinical settings to measure abortion stigma among women.
From pain treatment to opioid dependence: a qualitative study of the environmental influence on codeine use in UK adults
Authors: Kinnaird Emma , Kimergård Andreas , Jennings Stacey , Drummond Colin , Deluca Paolo 
Published: April 2019

ObjectivesTo investigate the views and experiences of people who use codeine in order to describe the ‘risk environment’ capable of producing and reducing harm.DesignThis was a qualitative interview study. Psychological dependence on codeine was measured using the Severity of Dependence Scale. A cut-off score of 5 or higher indicates probable codeine dependence.SettingParticipants were recruited from an online survey and one residential rehabilitation service.Participants16 adults (13 women and 3 men) from the UK who had used codeine in the last 12 months other than as directed or as indicated. All participants began using codeine to treat physical pain. Mean age was 32.7 years (SD=10.1) and mean period of codeine use was 9.1 years (SD=7.6).ResultsParticipants’ experiences indicated that they became dependent on codeine as a result of various environmental factors present in a risk environment. Supporting environments to reduce risk included: medicine review of repeat prescribing of codeine, well-managed dose tapering to reduce codeine consumption, support from social structures in form of friends and online and access to addiction treatment. Environments capable of producing harm included: unsupervised and long-term codeine prescribing, poor access to non-pharmacological pain treatments, barriers to provision of risk education of codeine related harm and breakdown in structures to reduce the use of over the counter codeine other than as indicated.ConclusionThe study identified microenvironments and macroenvironments capable of producing dependence on codeine, including repeat prescribing and unsupervised use over a longer time period. The economic environment was important in its influence on the available resources for holistic pain therapy in primary care in order to offer alternative treatments to codeine. Overall, the goal is to create an environment that reduces risk of harm by promoting safe use of codeine for treatment of pain, while providing effective care for those developing withdrawal and dependence.
A prospective, cross-sectional study to establish age-specific reference intervals for neonates and children in the setting of clinical biochemistry, immunology and haematology: the HAPPI Kids study protocol
Authors: Hoq Monsurul , Karlaftis Vicky , Mathews Susan , Burgess Janet , Donath Susan M , Carlin John , Monagle Paul , Ignjatovic Vera 
Published: April 2019

IntroductionThe clinical interpretation of laboratory tests is reliant on reference intervals. However, the accuracy of a reference interval is dependent on the selected reference population, and in paediatrics, the ability of the reference interval to reflect changes associated with growth and age, as well as sex and ethnicity. Differences in reagent formulations, methodologies and analysers can also impact on a reference interval. To date, no direct comparison of reference intervals for common analytes using different analysers in children has been published. The Harmonising Age Pathology Parameters in Kids (HAPPI Kids) study aims to establish age-appropriate reference intervals for commonly used analytes in the routine clinical care of neonates and children, and to determine the feasibility of paediatric reference interval harmonisation by comparing age-appropriate reference intervals in different analysers for multiple analytes.Methods and analysisThe HAPPI Kids study is a prospective cross-sectional study, collecting paediatric blood samples for analysis of commonly requested biochemical, immunological and haematological tests. Venous blood samples are collected from healthy premature neonates (32–36 weeks of gestation), term neonates (from birth to a maximum of 72 hours postbirth) and children aged 30 days to ≤18 years (undergoing minor day surgical procedures). Blood samples are processed according to standard laboratory procedures and, if not processed immediately, stored at –80°C. A minimum of 20 samples is analysed for every analyte for neonates and then each year of age until 18 years. Analytical testing is performed according to the standard operating procedures used for clinical samples. Where possible, sample aliquots from the same patients are analysed for an analyte across multiple commercially available analysers.Ethics and disseminationThe study protocol was approved by The Royal Children’s Hospital, Melbourne, Ethics in Human Research Committee (34183 A). The study findings will be published in peer-reviewed journals and shared with clinicians, laboratory scientists and laboratories.
Determinants of undergoing thyroid cancer screening in Korean women: a cross-sectional analysis from the K-Stori 2016
Authors: Cho Ha Na , Choi Eunji , Seo Da Hea , Park Boyoung , Park Sohee , Cho Juhee , Kim Sue , Park Yeong-Ran , Rhee Yumie , Choi Kui Son 
Published: April 2019

ObjectivesThyroid cancer is the most common cancer among Korean women. Studies suggest that the incidence of thyroid cancer might be associated with overdiagnosis resulting from thyroid cancer screening. The objective of this study was to identify the determinants of participation in thyroid cancer screening in Korean women.MethodsData were obtained from the 2016 Korean Study of Women’s Health-Related Issues, a nationwide cross-sectional survey of women according to the reproductive life cycle. A total of 8697 cancer-free women of ages between 20 and 79 years were included for analysis. Multivariable logistic regression analysis was applied to analyse factors associated with adherence to thyroid cancer screening based on Andersen’s health behavioural model.ResultsOver the last 2 years, the rate of thyroid cancer screening was 39.2%. In multivariable models, older age, higher household income, high school education level and higher perceived risk of cancer were positively associated with thyroid cancer screening participation. Moreover, women who underwent cervical cancer screening (adjusted OR [aOR] 3.67; 95% CI 2.90 to 4.64) and breast cancer screening (aOR 10.91; 95% CI 8.41 to 14.14) had higher odds of attending thyroid cancer screening than women who did not attend cancer screening.ConclusionsThese findings highlight the need to increase awareness of different recommendations on screening for various cancers to improve cost-effectiveness and to prevent unnecessary treatments.
Exploring the impact, response and preparedness to water-related natural disasters in the Barisal division of Bangladesh: a mixed methods study
Authors: Jagnoor Jagnoor , Rahman Aminur , Cullen Patricia , Chowdhury Fazlul Kader , Lukaszyk Caroline , Baset Kamran ul , Ivers Rebecca 
Published: April 2019

ObjectivesTo investigate the impact of natural disasters on communities in the Barisal division of Bangladesh, exploring community approaches to disaster preparedness and mitigation.SettingCommunities in all districts of the Barisal division of Bangladesh.ParticipantsQuantitative data were collected through a cross-sectional household survey (n=9263 households; n=38 981 individuals). Qualitative data were collected through in-depth interviews (n=7) and focus group discussions (n=23) with key informants.Outcome measuresQuantitative research recorded features of natural disaster events from the previous 5 years, documenting risk factors that increase vulnerability to disaster, use of disaster warning systems and evacuation processes. Qualitative research investigated disaster risk perceptions, experiences during and following disaster, and disaster preparedness practices.ResultsThe survey response rate was 94.7%. Exposure to disaster in the last 5 years was high (82%) with flooding and cyclones considered the greatest threats. Awareness of evacuation processes was low; and only 19% of respondents evacuated their homes at the time of disaster. Drowning during disaster was the primary concern (87%), followed by debt, livestock and crop loss (78%). The qualitative findings indicated prevailing fatalistic perceptions towards natural disasters among community. The consequences of disasters included significant loss of livelihoods and exposure to infections due to poor sanitation. There was also insufficient support for the most vulnerable, particularly women, children and the elderly. Although several community preparedness and practices existed, there was a lack of response to early warning systems. Barriers to disaster response and resilience included financial insecurities, loss of livelihoods and cultural concerns regarding women’s privacy.ConclusionsCritical to achieving disaster resilience is increased government investment in infrastructure and systems-level responses that empower communities. Further research can support this by addressing community challenges to promoting disaster resilience and how to leverage existing community strengths to implement locally owned solutions.
Evaluating costs and health consequences of sick leave strategies against pandemic and seasonal influenza in Norway using a dynamic model
Authors: Edwards Christina Hansen , Tomba Gianpaolo Scalia , Sonbo Kristiansen Ivar , White Richard , de Blasio Birgitte Freiesleben 
Published: April 2019

ObjectivesTo quantify population-level health and economic consequences of sick leave among workers with influenza symptoms.InterventionsCompared with current sick leave practice (baseline), we evaluated the health and cost consequences of: (1) increasing the proportion of workers on sick leave from 65% (baseline) to 80% or 90%; (2) shortening the maximum duration from symptom onset to sick leave from 4 days (baseline) to 2 days, 1.5 days, 1 day and 0.5 days; and (3) combinations of 1 and 2.MethodsA dynamic compartmental influenza model was developed using Norwegian population data and survey data on employee sick leave practices. The sick leave interventions were simulated under 12 different seasonal epidemic and 36 different pandemic influenza scenarios. These scenarios varied in terms of transmissibility, the proportion of symptomatic cases and illness severity (risk of primary care consultations, hospitalisations and deaths). Using probabilistic sensitivity analyses, a net health benefit approach was adopted to assess the cost-effectiveness of the interventions from a societal perspective.ResultsCompared with current sick leave practice, sick leave interventions were cost-effective for 31 (65%) of the pandemic scenarios, and 11 (92%) of the seasonal scenarios. Economic benefits from sick leave interventions were greatest for scenarios with low transmissibility, high symptomatic proportions and high illness severity. Overall, the health and economic benefits were greatest for the intervention involving 90% of sick workers taking sick leave within one-half day of symptoms. Depending on the influenza scenario, this intervention resulted in a 44.4%–99.7% reduction in the attack rate. Interventions involving sick leave onset beginning 2 days or later, after the onset of symptoms, resulted in economic losses.ConclusionsPrompt sick leave onset and a high proportion of sick leave among workers with influenza symptoms may be cost-effective, particularly during influenza epidemics and pandemics with low transmissibility or high morbidity.
Comparative long-term effectiveness and safety of primary bariatric surgeries in treating type 2 diabetes mellitus in adults: a protocol for systematic review and network meta-analysis of randomised controlled trials
Authors: Ding Li , Zhuo Chuanjun , Fan Yuxin , Zhang Yalan , Li Hui , Qi Dongwang , Tang Shaofang , Cui Jingqiu , He Qing , Liu Ming 
Published: April 2019

IntroductionBariatric surgeries are effective in treating obesity related comorbidities, including type 2 diabetes mellitus. More robust evidence is needed to facilitate choice of procedure. In this systemic review, we aim to investigate the comparative long-term effectiveness in inducing remission of type 2 diabetes, halting diabetic complications, reducing mortality and the safety of conventional and emerging bariatric surgeries.Methods and analysisDatabases including Cochrane Central Register, EMBASE, MEDLINE and clinical trial registries will be searched for randomised controlled trials with at least 3 years of follow-up, including direct and/or indirect evidence regarding primary bariatric surgeries in overweight or obese adults with type 2 diabetes mellitus, from inception of each database to 2019, with no language or publication type limits imposed. Dual selection of studies, data extraction and risk of bias assessments will be performed. Primary outcomes include full diabetes remission, composite outcome of full or partial diabetes remission and adverse event profiles. Secondary outcomes include anthropometric measurements, cardiovascular risk factor burden, medication burden, diabetic complications and all-cause mortality. Given sufficient homogeneity, network meta-analyses will be performed in a random-effects model based on the Bayesian framework, while assessing for consistency between direct and indirect estimates. Heterogeneities of studies will be explored through meta-regression analysis, and robustness of findings will be checked by sensitivity analysis, and an alternative method under a frequentist framework. All statistical analysis and graphical presentations will be conducted by R software V.3.3.3 (The R Project for Statistical Computing). The overall quality of the evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluation criteria for each outcome.Ethics and disseminationEthics approval is not required as individual patient data will not be included. This review will be subject for publication in a peer reviewed journal.PROSPERO registration numberCRD42018110775.
Impact of co-occurring hearing and visual difficulties in childhood on educational outcomes: a longitudinal cohort study
Authors: Hill Matilda , Hall Amanda , Williams Cathy , Emond Alan M 
Published: April 2019

BackgroundMild hearing and visual difficulties are common in childhood, and both may have implications for educational achievement. However, the impact of co-occurring common hearing and visual difficulties in childhood is not known.ObjectiveTo determine the prevalence and impact of co-occurring common hearing and visual difficulties of childhood on educational outcomes in primary and secondary school.MethodsThe sample was drawn from the Avon Longitudinal Study of Parents and Children, a longitudinal birth cohort study in England. The exposures were hearing and visual difficulties at age 7 (defined as conductive hearing loss or otitis media with effusion, and amblyopia, strabismus or reduced visual acuity, respectively). The outcomes measured were achievement of level 4 or above at Key Stage 2 (KS2) in English, Maths and Science, respectively, at age 11, and attainment of five or more General Certificate of Secondary Education (GCSEs) at grades A*–C at age 16. Multiple logistic regression models assessed the relationship between hearing and visual difficulties and educational outcomes, adjusting for potential confounding factors.Results2909 children were included in the study; 261 had hearing difficulties, 189 had visual difficulties and 14 children had co-occurring hearing and visual difficulties. Children with co-occurring hearing and visual difficulties were less likely to achieve the national target at KS2 compared with children with normal hearing and vision, even after adjustment for confounding factors (OR 0.30, CI 0.15 to 0.61 for KS2 English). Differences in IQ, behaviour, attention and social cognition did not account for this relationship. The impact of co-occurring hearing and visual difficulties on GCSE results was explained largely by poor performance at KS2.ConclusionsCo-occurring hearing and visual difficulties in childhood have an enduring negative impact on educational outcomes. Identification of affected children and early intervention in primary school is essential.
Tai Chi for heart attack survivors: qualitative insights
Authors: Conboy Lisa , Krol Julie , Tomas Jose , Yeh Gloria Y , Wayne Peter , Salmoirago-Blotcher Elana 
Published: April 2019

ObjectivesCardiac rehabilitation (CR) programmes are standard of care for patients following a coronary event. While such exercise-based secondary prevention programme do offer benefits, they are used by less than 30% of eligible patients and attrition within these programmes is high. This project is a nested qualitative assessment of a pilot programme considering Tai Chi (TC) as an alternative to CR. We hypothesised that TC may overcome several key barriers to CR.MethodsA semistructured focus group agenda was used to assess three key domains of feasibility: (1) patients’ experiences, (2) reasons/barriers for not having attended CR and (3) any improvements in physical activity and other secondary outcomes (quality of life, weight, sleep). A thematic analysis was used to better understand the key concepts.ResultsThis high-risk group of patients reported that they enjoyed TC exercise, and felt confident and safe doing it. TC practice was reported to support other types of physical activity allowing for a generalisation of positive effects.DiscussionThis analysis is consistent with published reports of TC practice improving mood and psychological well-being. Qualitative methods allowed us to find emergent experiential reports of behaviour change factors found in established behaviour change theories.
PP14 The feasibility and acceptability of a novel low tech intervention to improve pre-hospital data recording for pre-alert and handover to the emergency department
Authors: Fitzpatrick David , Maxwell Douglas , Craigie Alan 
Published: April 2019

BackgroundPoor communication during patient handover is recognised internationally as a root cause of a significant proportion of preventable deaths. Data used in handover is not always easily recorded using ambulance based tablets, particularly in time-critical cases. Paramedics have therefore developed pragmatic workarounds (writing on gloves or scrap paper) to record these data. However, such practices can conflict with policy, data recorded can be variable, easily lost and negatively impact on handover quality.AimsTo measure the feasibility and acceptability of a novel, low-tech intervention introduced to support clinical information recording and delivery during pre-alert and handover. The intervention consisted of a reusable card with pre-alert/handover mnemonic and corresponding text boxes for data entry via pen.MethodsA pre and post-test design was used. Paramedics (n=69) based at one city ambulance Station received the intervention. Pre-and post-test measures (12 weeks post-introduction) focussed on paramedic acceptability and utility of intervention, ED staff (n=99) perceptions of handover quality, and proportions of clinical variables documented by ED staff during pre-alert.ResultsTwenty-five (36%) paramedics responded to an intervention acceptability questionnaire. Most felt both the pre-alert (n=23 [92%]) and handover (n=18 [72%]) components of the card were ‘useful’ or ‘very useful’. Nineteen (76%) used the card to record clinical information, almost all (n=23 [92%]) felt it ‘useful’ to ‘very useful’ in supporting pre-alert. Similarly, 65% (n=16) stated they ‘often’ or ‘always’ used the card during handover. For pre-alert information there were improvements in the provision of 8/11 (72.7%) clinical variables measured. Results from the post-test survey evaluating ED staff (n=37 [37%]) perceptions of handover demonstrated perceived improvements in 3/5 domains measured (p<0.05).ConclusionThis novel low-tech intervention was highly acceptable to paramedic participants, improving their data recording and information exchange processes. Further, well conducted studies are required to test the impact of this intervention on information exchange processes.