bluuebunny/crossref_metadata_2025_split huggingface dataset:
Formative mixed-method multicase study research to inform the development of a safer sex and healthy relationships intervention in further education (FE) settings: the SaFE Project
Authors: Young Honor , Turney Catherine , White James , Lewis Ruth , Bonell Christopher 
Published: July 2019

ObjectivesSexual health includes pleasurable, safe, sexual experiences free from coercion, discrimination and violence. In the UK, many young people’s experiences fall short of this definition. This study aimed to inform the development of a safer sex and healthy relationships intervention for those aged 16–19 years studying in further education (FE) settings.DesignA formative mixed-method multicase study explored if and how to implement four components within a single intervention.SettingSix FE settings in England and Wales and one sexual health charity participated between October and July 2015.ParticipantsFocus groups with 134 FE students and 44 FE staff, and interviews with 11 FE managers and 12 sexual health charity staff, first explored whether four candidate intervention components were acceptable and could have sustained implementation. An e-survey with 2105 students and 163 staff then examined potential uptake and acceptability of components shortlisted in the first stage. Stakeholder consultation was then used to refine the intervention.InterventionInformed by a review of evidence of effective interventions delivered in other settings, four candidate intervention components were identified which could promote safer sex and healthy relationships among those aged 16–19 years: 1) student-led sexual health action groups; 2) on-site sexual health and relationships services; 3) staff safeguarding training about sexual health and relationships and 4) sex and relationships education.ResultsOn-site sexual health and relationships services and staff safeguarding training about sexual health and relationships were key gaps in current FE provision and welcomed by staff, students and health professionals. Sex and relationships education and student-led sexual health action groups were not considered acceptable.ConclusionsThe SaFE intervention, comprising on-site sexual health and relationships services and staff safeguarding training in FE settings, may have potential promoting sexual health among FE students. Further optimisation and refinement with key stakeholders is required before piloting via cluster randomised controlled trial.
Understanding variation in unplanned admissions of people aged 85 and over: a systems-based approach
Authors: Wilson Andrew , Baker Richard , Bankart John , Banerjee Jay , Bhamra Ran , Conroy Simon , Kurtev Stoyan , Phelps Kay , Regen Emma , Rogers Stephen , Waring Justin 
Published: July 2019

AimTo examine system characteristics associated with variations in unplanned admission rates in those aged 85+.DesignMixed methods.SettingPrimary care trusts in England were ranked according to changes in admission rates for people aged 85+ between 2007 and 2009, and study sites selected from each end of the distribution: three ‘improving’ sites where rates had declined by more than 4% and three ‘deteriorating’ sites where rates had increased by more than 20%. Each site comprised an acute hospital trust, its linked primary care trust/clinical commissioning group, the provider of community health services and adult social care.ParticipantsA total of 142 representatives from these organisations were interviewed to understand how policies had been developed and implemented. McKinsey’s 7S framework was used as a structure for investigation and analysis.ResultsIn general, improving sites provided more evidence of comprehensive system focused strategies backed by strong leadership, enabling the development and implementation of policies and procedures to avoid unnecessary admissions of older people. In these sites, primary and intermediate care services appeared more comprehensive and better integrated with other parts of the system, and policies in emergency departments were more focused on providing alternatives to admission.ConclusionsHealth and social care communities which have attenuated admissions of people aged 85+ prioritised developing a shared vision and strategy, with sustained implementation of a suite of interventions.
Classification tree model of the personal economic burden of dementia care by related factors of both people with dementia and caregivers in Japan: a cross-sectional online survey
Authors: Nakabe Takayo , Sasaki Noriko , Uematsu Hironori , Kunisawa Susumu , Wimo Anders , Imanaka Yuichi 
Published: July 2019

ObjectiveThe purpose of this study was to clarify the microlevel determinants of the economic burden of dementia care at home in Japanese community settings by classifying them into subgroups of factors related to people with dementia and their caregivers.DesignA cross-sectional online survey.Participants4313 panels of Japanese research company who fulfilled the following criteria: (1) aged 30 years or older, (2) non-professional caregiver of someone with dementia, (3) caring for only one person with dementia and (4) having no conflicts of interest with advertising or marketing research entities.Primary outcome measuresInformal care costs and out-of-pocket payments for long-term care (LTC) services.ResultsFrom 4313 respondents, only 1383 caregivers in community-settings were included in this analysis. We conducted a χ² automatic interaction detection analysis to identify the factors related to each cost (informal care costs and out-of-pocket payments for LTC services) divided into subcategories. In the resultant classifications, informal care cost was mainly related to caregivers’ employment status. When caregivers acquired family care leave, informal care costs were the highest. On the other hand, out-of-pocket payments for LTC were related to care-need levels and family economic status. Activities of Daily Living and Instrumental Activities of Daily Living functions such as bathing, toileting and cleaning were related to all costs.ConclusionThis study clarified the difference in dementia care costs between classified subgroups by considering the combination of the situations of both people with dementia and their caregivers. Informal care costs were related to caregivers’ employment and cohabitation status rather to the situations of people with dementia. On the other hand, out-of-pocket payments for LTC services were related to care-need levels and family economic status. These classifications will be useful in understanding which situation represents a greater economic burden and helpful in improving the sustainability of the dementia care system in Japan.
Implementation of the Symptom Navi © Programme for cancer patients in the Swiss outpatient setting: a study protocol for a cluster randomised pilot study (Symptom Navi© Pilot Study)
Authors: Bana Marika , Ribi Karin , Kropf-Staub Susanne , Zürcher-Florin Sabin , Näf Ernst , Manser Tanja , Bütikofer Lukas , Rintelen Felix , Peters Solange , Eicher Manuela 
Published: July 2019

IntroductionSelf-management interventions show promising results on symptom outcomes and self-management behaviours. The Symptom Navi© Programme (SN©P) is a nurse-led intervention supporting patients’ symptom self-management during anticancer treatment. It consists of written patient information (Symptom Navi© Flyers (SN©Flyers)), semistructured consultations and a training manual for nurses.Methods and analysisThis pilot study will evaluate the implementation of the SN©P based on the Reach Effectiveness—Adoption Implementation Maintenance framework at Swiss outpatient cancer centres. We will use a cluster-randomised design and randomise the nine participating centres to the intervention or usual care group. We expect to include 140 adult cancer patients receiving first-line systemic anticancer treatment. Trained nurses at the intervention clusters will provide at least two semistructured consultations with the involvement of SN©Flyers. Outcomes include patients’ accrual and retention rates, patient-reported interference of symptoms with daily functions, symptom burden, perceived self-efficacy, quality of nursing care, nurse-reported facilitators and barriers of adopting the programme, nurses’ fidelity of providing the intervention as intended, and patients’ safety (patients timely reporting of severe symptoms). We will use validated questionnaires for patient-reported outcomes, focus group interviews with nurses and individual interviews with oncologists. Linear mixed models will be used to analyse patient-reported outcomes. Focus group and individual interviews will be analysed by thematic analysis.Ethics and disseminationThe Symptom Navi© Pilot Study has been reviewed and approved by Swiss Ethic Committee Bern (KEK-BE: 2017–00020). Results of the study will be disseminated in peer-reviewed journal and at scientific conferences.Trial registration numberNCT03649984; Pre-results.
The extent of public awareness, understanding and use of the Global Solar UV index as a worldwide health promotion instrument to improve sun protection: protocol for a systematic review
Authors: Lehmann Maria , Heinitz Maria , Uter Wolfgang , Pfahlberg Annette B , Gefeller Olaf 
Published: July 2019

Introduction(Over)exposure to ultraviolet radiation is a major risk factor for skin cancer. The Global Solar Ultraviolet Index (UVI) was introduced by the WHO and partner organisations in 1995 as a simple measure of the intensity of solar UV radiation, providing guidance for the population to use appropriate sun protective measures. Little is known about the impact of the UVI on actual sun protection behaviour. Our systematic review aims to assess global levels of awareness, understanding and use of the UVI as prerequisites for the preventive effectiveness of this public health tool.Methods and analysisSystematic searches will be performed in 10 electronic literature databases including Medline, Scopus and Web of Science–Core Collection, two clinical trials registries and at least two grey literature databases (OpenGrey, Bielefeld Academic Search Engine). Additional literature sources will be retrieved using hand search of reference lists of included studies and snowballing methods. We will include studies with all types of quantitative study designs and participants reporting on at least one outcome in the three main categories (i) awareness, (ii) understanding and (iii) use of the UVI. We will assess the risk of bias within studies with an abbreviated version of the AXIS tool, designed specifically for cross-sectional studies. As we expect large heterogeneity in outcomes, we will conduct a narrative synthesis of results instead of a meta-analysis.Ethics and disseminationEthical approval and patient consent are not required as this is a systematic review based on published studies. The results of this study will be published in an international peer-reviewed journal.Prospero registration numberCRD42018093693.
Patient reporting of complications after surgery: what impact does documenting postoperative problems from the perspective of the patient using telephone interview and postal questionnaires have on the identification of complications after surgery?
Authors: Woodfield John , Deo Priya , Davidson Ann , Chen Tina Yen-Ting , van Rij Andre 
Published: July 2019

ObjectivesTo identify the frequency of postoperative complications, including problems identified by patients and complications occurring after discharge from hospital. To identify how these impact on quality of life (QoL) and the patient’s perception of the success of their treatment.DesignData from three prospective sources: surgical audit, a telephone interview (2 weeks after discharge) and a patient-focused questionnaire (2 months after surgery) were retrospectively analysed.SettingDunedin Hospital, Dunedin, New Zealand.ParticipantsOf the 500 patients, 100 undergoing each of the following types of surgeries: anorectal, biliary, colorectal, hernia and skin.Primary and secondary outcome measuresThe primary outcomes were complications and the 36-item Short Form Health Survey (SF-36). Secondary outcomes included the patient’s ratings of their treatment and a questionnaire-derived patient satisfaction score.Results226 patients reported a complication; there were 344 separate complications and 411 reports of complications (16% of complications were reported on more than one occasion). The audit, telephone interview and questionnaire captured 12.6%, 36.3% and 51% of the 411 reports, respectively. Patients with complications had a lower SF-36 Physical Composite Summary (PCS) score (48.5 vs 43.9, p=0.021) and a lower Patient Satisfaction Score (85.6 vs 74.6, p<0.001). Rating of information received, care received, symptoms experienced, QoL and satisfaction with surgery were all significantly worse for patients with complications. On linear regression analysis, surgical complications, American Society of Anaesthesiologists score and age all made a similar contribution to the SF-36 PCS score, with standardised beta coefficients between 0.19 and 0.21.ConclusionsFollowing surgery, over 40% of patients experienced complications. The QoL and satisfaction score were significantly less than for those without complications. The majority of complications were diagnosed after discharge from hospital. Taking more notice of the patient perspective helps us to identify problems, to understand what is important to them and may suggest ways to improve perioperative care.
How should health policy and practice respond to the increased genetic risk associated with close relative marriage? results of a UK Delphi consensus building exercise
Authors: Salway Sarah , Yazici Edanur , Khan Nasaim , Ali Parveen , Elmslie Frances , Thompson Julia , Qureshi Nadeem 
Published: July 2019

Objectives(1) To explore professional and lay stakeholder views on the design and delivery of services in the area of consanguinity and genetic risk. (2) To identify principles on which there is sufficient consensus to warrant inclusion in a national guidance document. (3) To highlight differences of opinion that necessitate dialogue. (4) To identify areas where further research or development work is needed to inform practical service approaches.DesignDelphi exercise. Three rounds and one consensus conference.SettingUK, national, web-based and face-to-face.ParticipantsRecruitment via email distribution lists and professional networks. 42 participants with varied professional and demographic backgrounds contributed to at least one round of the exercise. 29 people participated in statement ranking across both rounds 2 and 3.ResultsOver 700 individual statements were generated in round 1 and consolidated into 193 unique statements for ranking in round 2, with 60% achieving 80% or higher agreement. In round 3, 74% of statements achieved 80% or higher agreement. Consensus conference discussions resulted in a final set of 148 agreed statements, providing direction for both policy-makers and healthcare professionals. 13 general principles were agreed, with over 90% agreement on 12 of these. Remaining statements were organised into nine themes: national level leadership and coordination, local level leadership and coordination, training and competencies for healthcare and other professionals, genetic services, genetic literacy, primary care, referrals and coordination, monitoring and evaluation and research. Next steps and working groups were also identified.ConclusionsThere is high agreement among UK stakeholders on the general principles that should shape policy and practice responses in this area: equity of access, cultural competence, coordinated inter-agency working, co-design and empowerment and embedded evaluation. The need for strong national leadership to ensure more efficient sharing of knowledge and promotion of more equitable and consistent responses across the country is emphasised.
Trace evidence examination using laboratory and synchrotron X-ray diffraction techniques
Authors: Raven Mark D. , Fitzpatrick Robert W. , Self Peter G. 
Published: July 2019

Abstract
In a 2007 homicide in Western Australia, small (<0.5 mm diameter) red brick fragments and soil were identified on the victim's clothing (mainly bra), body (mainly hair) and vehicle. A comparative study of the mineralogy and morphology of the red brick fragments with red bricks from the paved area in front of the victim's house was undertaken by traditional laboratory X-ray diffraction (XRD) using low background Si wafer holders and a 0.5 mm focusing monocapillary attachment. Whilst significant similarities were observed between the two datasets, peak overlaps and poor resolution prevented a specific provenance to be determined. Additional analyses using the superior intensity and resolution of synchrotron XRD that was conducted at the Australian Synchrotron quantified the mineralogy of polycrystalline minerals (cristobalite and mullite) in the small brick fragments. These data established that the brick fragments could not be distinguished from the driveway bricks and were clearly shown to be different to a range of other possible sources.
The trial was before a judge only and he concluded that the mineralogy data from the small brick fragments on the victim's clothing and the bricks from her front driveway indicated that she was initially attacked in her front yard and not at Kings Park where her body was buried.
ДІАГНОСТИКА ТА КОРЕКЦІЯ МАГНІЄВОГО ДЕФІЦИТУ У ВАГІТНИХ ІЗ ОБТЯЖЕНИМ ГІНЕКОЛОГІЧНИМ АНАМНЕЗОМ
Authors: Andriichuk T. P. , Senchuk A. Ya. , Martynova D. A. 
Published: July 2019

Мета дослідження – виокремлення пацієнток із клінічними ознаками дефіциту магнію серед вагітних із групи ризику розвитку прееклампсії і вивчення ефективності застосування в них препаратів магнію для профілактики прееклампсії.
Матеріали та методи. Нами здійснені обстеження і комплексна пероральна магнієва профілактика пізнього гестозу у 100 вагітних (I група) із групи ризику виникнення цього ускладнення вагітності. Результати порівнювали із даними спостереження за 50-ма вагітними (II група) з групи ризику виникнення прееклампсії, яким до профілактичного комплексу пероральні препарати магнію не додавали. Контрольну групу (КГ) склали 50 здорових жінок із фізіологічним перебігом вагітності. Наявність дефіциту магнію визначали за результатами вивчення даних опитування, зафіксованих у розробленій нами анкеті для дослідження дефіциту магнію у вагітних. Магнієву монопрофілактику прееклампсії здійснювали такими препаратами:

Магнію оксид легкий 342 мг і магнію карбонат легкий 670 мг, що відповідає 365 мг іонів Mg++ – по 1 шипучій таблетці на добу переривчастими курсами – у 10–12; 22–26; 30–32 тижні вагітності.
Мікрогранульований порошок магнію оксид, 535 мг, що відповідає 300 мг магнію і магнію оксиду легкого 403,0–435,2 мг, що відповідає іонам магнію 243 мг. Препарати призначали з 10 тижнів протягом усієї вагітності по 1 таблетці 1 раз на добу.

Результати дослідження та їх обговорення. Результати профілактичного застосування пероральних препаратів магнію показали високу ефективність, нешкідливість і гарну переносимість запропонованої терапії порівняно із загальноприйнятими підходами (протокол МОЗ). У групі вагітних, які використовували препарати магнію (I група), значно меншою була частота загрози переривання вагітності та плацентарної дисфункції. Ефективність профілактики прееклампсії становила 96,0 % у I групі і тільки 68,0 % у групі пацієнток, яким профілактика прееклампсії здійснювалась за протоколом (II група).
Висновки. Визначено, що пацієнтки із групи ризику розвитку прееклампсії потребують призначення препаратів магнію, корекції способу життя та харчування. Профілактичний прийом препаратів магнію пацієнтками з групи ризику розвитку прееклампсії є високоефективним, нешкідливим і гарно переноситься. Ефективність профілактики прееклампсії становить 96,0 %.
ОСОБЛИВОСТІ ПЕРЕБІГУ МУКОВІСЦИДОЗУ В ДІТЕЙ ТЕРНОПІЛЬСЬКОЇ ОБЛАСТІ
Authors: Boyarchuk O. R. , Kosovska V. O. , Kosovska T. M. 
Published: July 2019

Мета дослідження – встановити особливості клінічного перебігу муковісцидозу в дітей Тернопільської області.
Матеріали та методи. Проведено ретроспективний аналіз історій хвороб 15 дітей Тернопільської області, хворих на муковісцидоз. Оглянуто 5 дітей під час їх перебування у стаціонарі.
Результати дослідження та їх обговорення. Ідеальними можна вважати виявлення хворих на муковісцидоз під час неонатального скринінгу і початок лікування одразу ж після встановлення діагнозу навіть за відсутності клінічних проявів. Діагноз муковісцидозу в усіх пацієнтів підтверджено в Західноукраїнському спеціалізованому дитячому медичному центрі. При дослідженні генотипу було виявлено різні види мутацій, але найчастіше траплялась мутація F508del/F508del. Ми ви­значили, що більшість дітей досягла десятирічного віку. Час встановлення діагнозу муковісцидозу був різний: до 1 року – в 2 дітей (13,3 %), від 2 до 5 років – у 5 дітей (33,3 %), від 5 до 10 років – у 8 дітей (53,4 %). Встановлено, що, чим пізніше у хворого діагностують захворювання, тим тяжчий його перебіг і нижча ефективність лікування. У цих дітей відмічали багаторазові рецидиви запальних процесів у бронхах – у 10 хворих (66,6 %), додаткових пазухах носа – в 5 (33,3 %), порушень функції підшлункової залози – у 15 (100,0 %), розвиток резистентності патогенної мікрофлори до антибіотиків – у 15 (100,0 %). Тому в цих дітей лікування ускладнювалось і, відповідно, ефективність його знижувалась. Майже в половини пацієнтів, а саме у 7 (46,6 %), внаслідок тривалої гіпоксії виявлено деформацію пальців і нігтів у вигляді «барабанних паличок» та «годинникових скелець». Легеневу гіпертензію діагностовано в 4 пацієнтів (26,6 %). Деформацію грудної клітки (бочкоподібна, розширена в передньо-задньому розмірі) відмічено в 7 дітей (46,6 %). Холестатичний гепатит виявлено в 5 хворих (33,3 %). Порушення толерантності до глюкози діагностовано у 2 дітей (13,3 %).
Висновки. У структурі хворих на муковісцидоз дітей Тернопільської області переважають дівчатка та мешканці сільської місцевості. На сьогодні більша частина дітей області з муковісцидозом (53,3 %) досягла віку старше 10 років. У дітей нашого регіону переважає мутація F508del/F508del (66,7 %). У більшості дітей (53,4 %) захворювання було діагностовано після 5 років. У дебюті хвороби найчастіше спостерігали затяжні обструктивні бронхіти (66,7 %) та порушення функції підшлункової залози (100,0 %). Серед ускладнень переважали кісткові деформації, ознаки хронічної гіпоксії та висока частота інфікування золотистим стафілококом (73,3 %) і синьогнійною паличкою (46,7 %). Необхідно збільшити настороженість щодо діагностики муковісцидозу на ранніх стадіях для покращення якості й подовження тривалості життя дітей.