bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disparities of infant and neonatal mortality trends in Greece during the years of economic crisis by ethnicity, place of residence and human development index: a nationwide population study
Authors: Siahanidou Tania , Dessypris Nick , Analitis Antonis , Mihas Constantinos , Evangelou Evangelos , Chrousos George , Petridou Eleni 
Published: August 2019

ObjectiveTo study trends of infant mortality rate (IMR) and neonatal mortality rate in Greece during the period 2004–2016 and explore the role of sociodemographic factors in the years of crisis.DesignNationwide individual data for live births and infant (0–11 months) deaths provided by the Hellenic Statistical Authority were examined using Poisson, joinpoint regression and interrupted time series (ITS) analyses.SettingGreece.ParticipantsAll infant deaths (n=4862) over the 13-year period, of which 87.2% were born to Greek mothers, and respective live births.Main outcome measuresEvolution of IMR (0–364 days), early (<7 days) neonatal mortality rate (ENMR), late (7–27 days) neonatal mortality rate (LNMR) and post neonatal (28–364 days) mortality rate (PNMR) trends, by maternal nationality, place of residence and Human Development Index (HDI).ResultsBy Poisson regression, overall, during the study period, among infants of Greek mothers, IMR and PNMR declined significantly (−0.9%; 95% CI −1.7% to −0.1% and −1.6%; −3.0% to −0.2% annually, respectively), although differentially by place of residence (IMRurban: −2.1%; −2.9% to −1.3%, IMRrural: +10.6%; 7.6% to 13.6%). By contrast, among infants of non-Greek mothers, the low starting IMR/ENMR/LNMR/PNMR increased significantly (max ENMR:+12.5%; 8.6% to 16.5%) leading to a non-significant time–trend pattern overall in Greece. The inverse associations of HDI with IMR, ENMR and PNMR were restricted to Greek mothers’ infants. Joinpoint regression analyses among Greek mothers’ infants indicated non-significant increasing trends of IMR and ENMR following the crisis (+9.3%, 2012–2016, p=0.07 and +10.2%, 2011–2016, p=0.06, respectively). By contrast, the high (+17.1%; 8.1% to 26.9%, p=0.002) IMR increases among non-Greek infants were restricted to 2004–2011 and equalised to those of Greek mothers’ infants thereafter. ITS analyses in preset years (2008, 2010, 2012) identified significantly increasing trends in IMR, LNMR and PNMR after 2012, and in ENMR after 2010, among Greek mothers’ infants.ConclusionsHDI and rural residence were significantly associated with IMR. The strongly decreasing IMR trends among Greek-mothers’ infants were stagnated after a lag time of ~4 years of crisis approximating the previously sharply increasing trends among non-Greeks.
Patient journey following lumbar discectomy surgery: protocol for a single-centre qualitative analysis of the patient rehabilitation experience (DiscJourn)
Authors: White Louise , Heneghan Nicola R , Furtado Navin , Masson Annabel , Rushton Alison B 
Published: August 2019

IntroductionLumbar discectomy is a widely used surgical procedure internationally with the majority of patients experiencing significant benefit. However, approximately 20% of patients report suboptimal functional recovery and quality of life. The impact and meaning of the surgical experience from the patients’ perspective are not fully understood. Furthermore, there is limited evidence guiding postoperative management with significant clinical practice variation and it is unclear if current postoperative support is valued, beneficial or meets patients’ needs and expectations. This study aims to address the evidence gap by moving beyond current knowledge to gain insight into the lived experiences relating to patients’ lumbar discectomy surgery journey. Results will inform more meaningful and specific care, thus, enhance rehabilitation and outcomes.Methods and analysisA qualitative investigation using interpretative phenomenology analysis (IPA) will provide a flexible inductive research approach. A purposive sample (n=20) of patients undergoing primary discectomy will be recruited from one UK NHS secondary care centre. Semi-structured interviews will be conducted postsurgery discharge. A topic guide, developed from the literature and our previous work with input from two patient co-investigators, will guide interviews with the flexibility to explore interesting or patient-specific points raised. Providing longitudinal data, patients will keep weekly diaries capturing experiences and change over time throughout 12 months following surgery. A second interview will be completed 1 year postsurgery with its topic guide informed by initial findings. This combination of patient interviews and diaries will capture patients’ attitudes and beliefs regarding surgery and recovery, facilitators and barriers to progress, experiences regarding return to activities/function and interactions with healthcare professionals. The rich density of data will be thematically analysed in accordance with IPA, supported by NVivo software.Ethics and disseminationEthical approval has been granted by the London-Bloomsbury Research Ethics Committee (18/LO/0459; IRAS 241345). Conclusions will be disseminated through conferences and peer-reviewed journals.
Area level impacts on emergency hospital admissions of the integrated care and support pioneer programme in England: difference-in-differences analysis
Authors: Keeble Eilís , Bardsley M , Durand Mary Alison , Hoomans Ties , Mays Nicholas 
Published: August 2019

ObjectiveTo examine whether any differential change in emergency admissions could be attributed to integrated care by comparing pioneer and non-pioneer populations from a pre-pioneer baseline period (April 2010 to March 2013) over two follow-up periods: to 2014/2015 and to 2015/2016.DesignDifference-in-differences analysis of emergency hospital admissions from English Hospital Episode Statistics.SettingLocal authorities in England classified as either pioneer or non-pioneer.ParticipantsEmergency admissions to all NHS hospitals in England with local authority determined by area of residence of the patient.InterventionWave 1 of the integrated care and support pioneer programme announced in November 2013.Primary outcome measureChange in hospital emergency admissions.ResultsThe increase in the pioneer emergency admission rate from baseline to 2014/2015 was smaller at 1.93% and significantly different from that of the non-pioneers at 4.84% (p=0.0379). The increase in the pioneer emergency admission rate from baseline to 2015/2016 was again smaller than for the non-pioneers but the difference was not statistically significant (p=0.1879).ConclusionsIt is ambitious to expect unequivocal changes in a high level and indirect indicator of health and social care integration such as emergency hospital admissions to arise as a result of the changes in local health and social care provision across organisations brought about by the pioneers in their early years. We should treat any sign that the pioneers have had such an impact with caution. Nevertheless, there does seem to be an indication from the current analysis that there were some changes in hospital use associated with the first year of pioneer status that are worthy of further exploration.
Effect of computerised cognitive training on cognitive outcomes in mild cognitive impairment: a systematic review and meta-analysis
Authors: Zhang Haifeng , Huntley Jonathan , Bhome Rohan , Holmes Benjamin , Cahill Jack , Gould Rebecca L , Wang Huali , Yu Xin , Howard Robert 
Published: August 2019

ObjectivesTo determine the effect of computerised cognitive training (CCT) on improving cognitive function for older adults with mild cognitive impairment (MCI).DesignSystematic review and meta-analysis.Data sourcesPubMed, Embase, Web of Science and the Cochrane Library were searched through January 2018.Eligibility criteriaRandomised controlled trials comparing CCT with control conditions in those with MCI aged 55+ were included.Data extraction and synthesisTwo independent reviewers extracted data and assessed the risk of bias. Effect sizes (Hedges’ g and 95% CIs) were calculated and random-effects meta-analyses were performed where three or more studies investigated a comparable intervention and outcome. Heterogeneity was quantified using the I2statistic.Results18 studies met the inclusion criteria and were included in the analyses, involving 690 participants. Meta-analysis revealed small to moderate positive treatment effects compared with control interventions in four domains as follows: global cognitive function (g=0.23, 95% CI 0.03 to 0.44), memory (g=0.30, 95% CI 0.11 to 0.50), working memory (g=0.39, 95% CI 0.12 to 0.66) and executive function (g=0.20, 95% CI −0.03 to 0.43). Statistical significance was reached in all domains apart from executive function.ConclusionsThis meta-analysis provides evidence that CCT improves cognitive function in older people with MCI. However, the long-term transfer of these improvements and the potential to reduce dementia prevalence remains unknown. Various methodological issues such as heterogeneity in outcome measures, interventions and MCI symptoms and lack of intention-to-treat analyses limit the quality of the literature and represent areas for future research.
Cost-effectiveness of physical activity interventions in adolescents: model development and illustration using two exemplar interventions
Authors: Gc Vijay S , Suhrcke Marc , Atkin Andrew J , van Sluijs Esther , Turner David 
Published: August 2019

ObjectiveTo develop a model to assess the long-term costs and health outcomes of physical activity interventions targeting adolescents.DesignA Markov cohort simulation model was constructed with the intention of being capable of estimating long-term costs and health impacts of changes in activity levels during adolescence. The model parameters were informed by published literature and the analysis took a National Health Service perspective over a lifetime horizon. Univariate and probabilistic sensitivity analyses were undertaken.SettingSchool and community.ParticipantsA hypothetical cohort of adolescents aged 16 years at baseline.InterventionsTwo exemplar school-based: a comparatively simple, after-school intervention and a more complex multicomponent intervention compared with usual care.Primary and secondary outcome measuresIncremental cost-effectiveness ratio as measured by cost per quality-adjusted life year gained.ResultsThe model gave plausible estimates of the long-term effect of changes in physical activity. The use of two exemplar interventions suggests that the model could potentially be used to evaluate a number of different physical activity interventions in adolescents. The key model driver was the degree to which intervention effects were maintained over time.ConclusionsThe model developed here has the potential to assess long-term value for money of physical activity interventions in adolescents. The two applications of the model indicate that complex interventions may not necessarily be the ones considered the most cost-effective when longer-term costs and consequences are taken into account.
Variability in the burden of disease estimates with or without age weighting and discounting: a methodological study
Authors: Egunsola Oluwaseun , Raubenheimer Jacques , Buckley Nicholas 
Published: August 2019

ObjectivesThis study examines the impact of the type of method used on the estimation of the burden of diseases.DesignComparison of methods of estimating disease burden.SettingFour metrics of burden of disease estimation, namely, years of potential life lost (YPLL), non-age weighted years of life lost (YLL) without discounting and YLL with uniform or non-uniform age weighting and discounting were used to calculate the burden of selected diseases in three countries: Australia, USA and South Africa.ParticipantsMortality data for all individuals from birth were obtained from the WHO database.OutcomesThe burden of 10 common diseases with four metrices, and the relative contribution of each disease to the overall national burden when each metric is used.ResultsThere were variations in the burden of disease estimates with the four methods. The standardised YPLL estimates were higher than other methods of calculation for diseases common among young adults and lower for diseases common among the elderly. In the three countries, discounting decreased the contributions of diseases common among younger adults to the total burden of disease, while the contributions of diseases of the elderly increased. After discounting with age weighting, there were no distinct patterns for diseases of the elderly and young adults in the three countries.ConclusionsGiven the variability in the estimates of the burden of disease with different approaches, there should be transparency regarding the type of metric used and a generally acceptable method that incorporates all the relevant social values should be developed.
Theory-based electronic learning intervention to support appropriate antibiotic prescribing by nurses and pharmacists: intervention development and feasibility study protocol
Authors: Courtenay Molly , Lim Rosemary , Deslandes Rhian , Ferriday Rebecca , Gillespie David , Hodson Karen , Reid Nicholas , Thomas Neil , Chater Angel 
Published: August 2019

IntroductionNurse and pharmacist independent prescribers manage patients with respiratory tract infections and are responsible for around 8% of all primary care antibiotic prescriptions. A range of factors influence the prescribing behaviour of these professionals, however, there are no interventions available specifically to support appropriate antibiotic prescribing behaviour by these groups. The aims of this paper are to describe (1) the development of an intervention to support appropriate antibiotic prescribing by nurse and pharmacist independent prescribers and (2) an acceptability and feasibility study designed to test its implementation with these prescribers.Method and analysisDevelopment of intervention:a three-stage, eight-step method was used to identify relevant determinants of behaviour change and intervention components based on the Behaviour Change Wheel. The intervention is an online resource comprising underpinning knowledge and an interactive animation with a variety of open and closed questions to assess understanding.Acceptability and feasibility of intervention:nurse and pharmacist prescribers (n=12–15) will use the intervention. Evaluation includes semi-structured interviews to capture information about how the user reacts to the design, delivery and content of the intervention and influences on understanding and engagement, and a pre-post survey to assess participants’ perceptions of the impact of the intervention on knowledge, confidence and usefulness in terms of application to practice. Taking an initial inductive approach, data from interview transcripts will be coded and then analysed to derive themes. These themes will then be deductively mapped to the Capability, Opportunity, Motivation-Behaviour model. Descriptive statistics will be used to analyse the survey data, and trends identified.Ethics and disseminationEthical approval for the study has been provided by the School of Healthcare Sciences Research Governance and Ethics Committee, Cardiff University. The findings will be disseminated via publication in peer-reviewed journals and through conference presentations.
Study protocol for ‘The Project About Loneliness and Social networks (PALS)’: a pragmatic, randomised trial comparing a facilitated social network intervention (Genie) with a wait-list control for lonely and socially isolated people
Authors: Band Rebecca , Ewings Sean , Cheetham-Blake Tara , Ellis Jaimie , Breheny Katie , Vassilev Ivaylo , Portillo Mari Carmen , Yardley Lucy , Blickem Christian , Kandiyali Rebecca , Culliford David , Rogers Anne 
Published: August 2019

IntroductionLoneliness and social isolation have been identified as significant public health concerns, but improving relationships and increasing social participation may improve health outcomes and quality of life. The aim of the Project About Loneliness and Social networks (PALS) study is to assess the effectiveness and cost-effectiveness of a guided social network intervention within a community setting among individuals experiencing loneliness and isolation and to understand implementation of Generating Engagement in Network Involvement (Genie) in the context of different organisations.Methods and analysisThe PALS trial will be a pragmatic, randomised controlled trial comparing participants receiving the Genie intervention to a wait-list control group. Eligible participants will be recruited from organisations working within a community setting: any adult identified as socially isolated or at-risk of loneliness and living in the community will be eligible. Genie will be delivered by trained facilitators recruited from community organisations. The primary outcome will be the difference in the SF-12 Mental Health composite scale score at 6-month follow-up between the intervention and control group using a mixed effects model (accounting for clustering within facilitators and organisation). Secondary outcomes will be loneliness, social isolation, well-being, physical health and engagement with new activities. The economic evaluation will use a cost-utility approach, and adopt a public sector perspective to include health-related resource use and costs incurred by other public services. Exploratory analysis will use a societal perspective, and explore broader measures of benefit (capability well-being). A qualitative process evaluation will explore organisational and environmental arrangements, as well as stakeholder and participant experiences of the study to understand the factors likely to influence future sustainability, implementation and scalability of using a social network intervention within this context.Ethics and disseminationThis study has received NHS ethical approval (REC reference: 18/SC/0245). The findings from PALS will be disseminated widely through peer-reviewed publications, conferences and workshops in collaboration with our community partners.Trial registration numberISRCTN19193075
Prevalence and factors associated with suicide among medical professionals in low/middle-income countries: a systematic review protocol
Authors: Rukundo Godfrey Zari , Byakwaga Helen , Kinengyere Alison , Bapolisi Achille Mwira , Betancourt Miriela , Akena Dickens 
Published: August 2019

IntroductionA number of studies in low/middle-income countries (LMICs) have reported varying prevalence of suicide among medical professionals with low rates. This may be because of the methods used in suicide assessment and the stigma associated with it. For this study, the prevalence of suicidal ideation, attempt and completed suicide, as well as the factors associated with suicidality and methods used during suicidal acts, will be documented.Methods and analysisStudies published in peer-reviewed journals in which the prevalence and factors associated with suicidal ideation, attempt and completion among medical professionals in LMICs will be included. The Cochrane Library (CENTRAL), PsychINFO, PubMed and Embase will be systematically searched. We will search for all the papers available in the databases up to March 31 2019. Methodological quality of the articles will be assessed using the quality in prognostic studies tool. The risk of bias of the articles will be assessed using Cochrane risk of bias assessment tool for non-randomised studies. In the event of no statistical heterogeneity, a meta-analysis of the findings will be conducted.Ethics and disseminationEthical permission will not be required since this work does not involve the use of participant data that can be used to identify individuals. Findings from this study will be available for clinicians and other medical professionals, scientists and policy makers. On request, a data set of the study can be provided.Trial registration numberCRD42018095990.
A population-based retrospective study comparing cancer mortality between Moluccan migrants and the general Dutch population: equal risk 65 years after immigration?
Authors: van der Wal Junus M. , Bodewes Adee , Agyemang Charles , Kunst Anton 
Published: August 2019

ObjectiveTo test the hypothesis that cancer mortality rates among the Moluccan–Dutch, the oldest non-Western migrant group to arrive in the Netherlands after the Second World War, are similar to those in the general Dutch population.DesignPopulation-based retrospective study.SettingData from the national cause of death registry in the Netherlands and municipal registries.ParticipantsUsing historic records containing family names of all Moluccan–Dutch who arrived in the Netherlands in 1951, we identified 81 591 Moluccan–Dutch persons in the national cause of death registry of the Netherlands. The reference group consisted of 15 866 538 persons of the general Dutch population.Outcome measuresMortality data were linked to demographic data from municipal registries. We calculated all-cancer and cancer-specific mortality and measured differences between the two groups using Poisson regression, adjusting for sex, age and area socioeconomic status. We conducted a sub-analysis for the first-generation and second-generation Moluccan–Dutch.ResultsThere was no difference in all-cancer mortality between Moluccan–Dutch and the general Dutch population. Mortality was higher among Moluccan–Dutch for liver, cervix and corpus uteri cancers, but lower for stomach, oesophagus, kidney and nervous system cancers. For most cancers, mortality risk as compared with the general Dutch population varied between different generations of Moluccan–Dutch.ConclusionsSeveral decades after migration, the Moluccan–Dutch show similar all-cancer mortality, but different cancer-specific mortality rates, when compared with the general Dutch population.