bluuebunny/crossref_metadata_2025_split huggingface dataset:
On Bore Dynamics and Pressure: RANS, Green-Naghdi, and Saint-Venant Equations
Authors: Liu Jiaqi , Hayatdavoodi Masoud , Ertekin R. Cengiz 
Published: September 2019

AbstractPropagation and impact of two- and three-dimensional bores generated by breaking of a water reservoir is studies by use of three theoretical models. These include the Reynolds-averaged Navier–Stokes (RANS) equations, the level I Green-Naghdi (GN) equations, and the Saint-Venant (SV) equations. Two types of bore generations are considered, namely, (i) bore generated by dam-break, where the reservoir water depth is substantially larger than the downstream water depth, and (ii) bore generated by an initial mound of water, where the reservoir water depth is larger but comparable to the downstream water depth. Each of these conditions corresponds to different natural phenomena. This study shows that the relative water depth plays a significant role on the bore shape, stability, and impact. Particular attention is given to the bore pressure on horizontal and vertical surfaces. The effect of fluid viscosity is studied by use of different turbulence closure models. Both two- and three-dimensional computations are performed to study their effect on bore dynamics. Results of the theoretical models are compared with each other and with available laboratory experiments. Information is provided on bore kinematics and dynamics predicted by each of these models. Discussion is given on the assumptions made by each model and differences in their results. In summary, SV equations have substantially simplified the physics of the problem, while results of the GN equations compare well with the RANS equations, with incomparable computational cost. RANS equations provide further details about the physics of the problem.
“Learning the Hard Way”: Understanding the Workplace Learning of Sports Coach Mentors
Authors: Leeder Thomas M. , Russell Kate , Beaumont Lee C. 
Published: September 2019

The purpose of this study was to understand the workplace learning of sports coach mentors. Semi-structured interviews were conducted with 18 coach mentors employed by a sport governing body (SGB) as part of a formalised mentoring programme. ‘Current’ coach mentors (n = 9) had been employed for a minimum of one year by the organisation and were all interviewed once. ‘New’ coach mentors (n = 9) were all interviewed twice, once at the start of their employment and once again 9 months later. Moreover, regional mentors (n = 8) who oversee the training and practice of the coach mentors participated in one focus group. Data were analysed thematically, with the sociology of Pierre Bourdieu and relevant workplace learning literature used to support the analytical process. The findings highlight how habitus structures coach mentors’ participation in learning opportunities afforded to them in the workplace. In addition, habitus and embodied capital will impact how coach mentors interact with and interpret mentor training, whilst influencing their level of engagement with other employees. It is argued SGB social fields are crucial in the production of promoted norms and ‘legitimate’ knowledge within workplaces, which subsequently influences mentor learning. Recommendations are made for critically transformative approaches to training coach mentors.
Scaffolding Women Coaches’ Development: A Program to Build Coaches’ Competence and Confidence
Authors: Allen Justine B. , Reid Colleen 
Published: September 2019

Research continues to demonstrate the underrepresentation of women coaches and that barriers outweigh support. The purpose of this practical article is to describe the process undertaken by a National Governing Body of Sport to deliver a learning and development program to support women hockey coaches in Scotland, the Women in Coaching program. Our aim is to share understanding about this example of good practice to provide insight and direction for change that can enhance the experiences and provisions of coach education and development for women coaches. First, we explain the use of scaffolding as a concept to capture the approach adopted in the program to bring together a range of learning situations (e.g., coach education, workshops, systematic observation of coaching practice, mentoring). We then describe and discuss the evidence gathered to inform program development (i.e., workforce analysis, interviews with coaches). Next the delivery of the program and assessment of its impact are discussed (i.e., pre-post self-perceptions, players’ perceptions, coaching behaviors, reflective survey). Finally we present best practices based on the lessons learned from our involvement with the program over the past six years.
How effective are ‘age’ tools at changing patient behaviour? A rapid review
Authors: Kulendrarajah Bavidra , Grey Adam , Nunan David 
Published: September 2019

BackgroundA common form of risk communication is to relay the relative risk (%) of an adverse outcome based on surrogate markers associated with the outcome. A novel way of communicating risk is through ‘effective age’ of a person or specific organ. These tools can be used to change patient behaviour.ObjectiveTo determine the effect of ‘effective age’ tools on patient behaviour as compared with more traditional methods of risk communication.Study selectionWe performed a search of the PubMed database up to February 2019 for systematic reviews and randomised controlled trials (RCT) that answered our question. Interventions were ‘effective age’ tools, comparators were usual care or alternative risk communication tools. Primary outcomes were behavioural change measures.FindingsWe included 1 overview of systematic reviews (level 1 evidence), 2 systematic reviews (level 1 evidence) and 13 RCTs (level 2 evidence). Both systematic reviews concluded the evidence base was not conclusive enough to make specific recommendations.Age tools assessed in the 13 RCTs were: ‘lung age’ (n=5), ‘heart age’ (n=3), ‘health age’ (n=2), ‘cardiovascular age’ (n=1), ‘body age’ (n=1) and ‘net present value’ (n=1). 7/13 (54%) RCTs demonstrated a clinical effect on behaviour change favouring the ‘age’ tool; 2/13 (15%) demonstrated a null effect; 4/13 (31%) favoured control.ConclusionsOur findings indicate that systematic review evidence needs updating. The evidence from RCTs on the effect of using age metrics on patient behaviour is poor. There is a need for high-quality trials to decrease uncertainty in the available evidence.
Understanding men’s psychological reactions and experience following a cardiac event: a qualitative study from the MindTheHeart project
Authors: Jbilou Jalila , Grenier Jean , Chomienne Marie-Helene , Talbot France , Tulloch Heather , D'Antono Bianca , Greenman Paul 
Published: September 2019

ObjectivesEmotional issues such as depression, anxiety and post-traumatic stress disorder are common following a cardiac event. Despite their high prevalence, they often go undiagnosed and research suggests that men in particular are at higher risk. Therefore, a better understanding of men’s experiences with a cardiac event and ensuing health services is key for adapting approaches that meet their needs. The aim of this study was to describe the self-reported emotional challenges that men face following a cardiac event and to understand their patterns of psychosocial adjustment.DesignQualitative study (focus groups and one-on-one interviews) using an interpretive phenomenal analysis.SettingClinical settings (cardiac departments in hospitals, cardiac rehabilitation programme and family medicine clinics) and in the community in three Canadian provinces.ParticipantsA total of 93 men participated in the study through 22 focus groups and 5 semi-structured interviews, none has been excluded based on comorbidities.ResultsFour major themes emerged: (1) managing uncertainty and adversity; (2) distancing, normalising and accepting; (3) conformity to traditional masculine norms and (4) social, literacy and communication challenges.ConclusionsHealthcare professionals caring for men following a cardiac event must be aware of the psychological and social adjustments that accompany the physical challenges. However, there is a lack of explicit guidelines, tools and clinical training in men-sensitive approaches. Further research is required to better inform clinical practices and healthcare services.
Trends in socioeconomic inequalities in self-rated health in Germany: a time-trend analysis of repeated cross-sectional health surveys between 2003 and 2012
Authors: Wachtler Benjamin , Hoebel Jens , Lampert Thomas 
Published: September 2019

ObjectivesThis study assessed the extent of educational and income inequalities in self-rated health (SRH) in the German adult population between 2003 and 2012 and how these inequalities changed over time.DesignRepeated cross-sectional health interview surveys conducted in 2003, 2009, 2010 and 2012.Setting and participantsThe study population was the German adult population aged 25–69, living in private households in Germany. In total 54 197 randomly selected participants (2003: 6890; 2009: 16 418; 2010: 17 145; 2012: 13 744) were included.Main outcome measuresSRH was assessed with one single question. Five answer categories were dichotomised into good (‘very good’ and ‘good’) versus poor (‘moderate’, ‘poor’, ‘very poor’) SRH. To estimate the extent of the correlation between absolute and relative inequalities in SRH on the one hand, and income and education on the other; slope indices of inequality (SII) and relative indices of inequality (RII) were estimated using linear probability and log-binomial regression models.ResultsThere were considerable and persisting educational and income inequalities in SRH in every survey year. Absolute educational inequalities were largely stable (2003: SII=0.25, 95% CI 0.21 to 0.30; 2012: 0.29, 95% CI 0.25 to 0.33; p trend=0.359). Similarly, absolute income inequalities were stable (2003: SII=0.22, 95% CI 0.17 to 0.27; 2012: SII=0.26, 95% CI 0.22 to 0.30; p trend=0.168). RII by education (2003: 2.53, 95% CI 2.11 to 3.03; 2012: 2.72, 95% CI 2.36 to 3.13; p trend=0.531) and income (2003: 2.09. 95% CI 1.75 to 2.49; 2012: 2.53, 95% CI 2.19 to 2.92; p trend=0.051) were equally stable over the same period.ConclusionsWe found considerable and persisting absolute and relative socioeconomic inequalities in SRH in the German adult population between 2003 and 2012, with those in lower socioeconomic position reporting poorer SRH. These findings should be a concern for both public health professionals and political decision makers.
Delivering the right information to the right person at the right time to facilitate deprescribing in hospital: a mixed methods multisite study to inform decision support design in Australia
Authors: Baysari Melissa T , Duong Mai , Zheng Wu Yi , Nguyen Amy , Lo Sarita , Ng Brendan , Ritchie Angus , Le Couteur David , McLachlan Andrew , Bennett Alexandra , Hilmer Sarah 
Published: September 2019

ObjectivesTo inform the design of electronic decision support (EDS) to facilitate deprescribing in hospitals we set out to (1) explore the current processes of in-hospital medicines review, deprescribing and communication of deprescribing decisions with the patient’s general practitioner (GP), (2) identify barriers to undertaking these tasks and (3) determine user preferences for EDS.DesignMultimethod, multisite study comprising observations, semistructured interviews and focus groups.SettingGeneral medicine, geriatric medicine and rehabilitation wards at six hospitals in two local health districts in Sydney, Australia and primary care practices in one primary healthcare district in Sydney, Australia.Participants149 participants took part in observations, interviews and focus groups, including 69 hospital doctors, 13 nurses, 55 pharmacists and 12 GPs.Main outcome measuresObservational data on who was involved in medicines review and deprescribing, when medicines review took place, and what artefacts (eg, forms) were used. Participants reported perceptions of medicines review, polypharmacy and deprescribing and preferences for EDS.ResultsDeprescribing, undertaken during medicines review, was typically performed by a junior doctor, following a decision to deprescribe by a senior doctor. Key barriers to deprescribing included a perception that deprescribing was not the responsibility of hospital doctors, a lack of confidence among junior doctors and pharmacists in broaching this topic with senior doctors and a lack of patient engagement in the deprescribing process. In designing EDS, the tools, likely to be used by junior doctors, pharmacists and nurses, should be available throughout the hospitalisation and should comprise non-interruptive evidence-based guidance on why and how to deprescribe.ConclusionsDeprescribing decisions are complex and influenced by multiple factors. The implementation of EDS alone is unlikely to address all barriers identified. To achieve sustained improvements in monitoring of polypharmacy and subsequent deprescribing, a multifaceted intervention is needed.
Non-medical determinants of perinatal health: protocol for a systematic review with meta-analysis
Authors: Daalderop Leonie A , de Groot Marjolein W , van der Meer Lindsey , Steegers Eric A P , Bertens Loes C M 
Published: September 2019

IntroductionResearch focusing on the associations between non-medical determinants and unfavourable perinatal health outcomes is increasing. Despite increasing knowledge on this theme, it still remains unclear to what extent social, environmental and lifestyle factors contribute to these unfavourable outcomes. Therefore, we aim to provide a systematic review, preferably with meta-analysis, in order to provide insight into the associations between non-medical determinants and perinatal mortality, preterm birth and being small for gestational age (SGA).Methods and analysisObservational studies performed in European countries studying the associations between non-medical determinants and unfavourable perinatal health outcomes will be included. Primary outcomes of interest are perinatal mortality, preterm birth and SGA. To retrieve potential eligible articles, a systematic literature search was performed in the following online databases on 5 October 2018: MEDLINE, Embase, Web of Science, Cochrane and Google Scholar. Additionally, a reference list check and citation search will be performed. Data of the included articles will be extracted using a standardised and piloted data extraction form. Risk of bias will be assessed using the Newcastle-Ottawa Scale. The study selection and data extraction process will be performed by two reviewers independently. Disagreements will be resolved through discussion with a third reviewer. The pooled effects will be calculated separately for each association found between one of the outcome measures and the non-medical determinants using a random effects model. Heterogeneity of the studies will be assessed using the I2statistic.Ethics and disseminationNo ethical approval is necessary for a systematic review with meta-analysis. The findings will be published in a peer-reviewed journal.PROSPERO registration numberCRD42018056105.
Development and validation of multivariable clinical diagnostic models to identify type 1 diabetes requiring rapid insulin therapy in adults aged 18–50 years
Authors: Lynam Anita , McDonald Timothy , Hill Anita , Dennis John , Oram Richard , Pearson Ewan , Weedon Michael , Hattersley Andrew , Owen Katharine , Shields Beverley , Jones Angus 
Published: September 2019

ObjectiveTo develop and validate multivariable clinical diagnostic models to assist distinguishing between type 1 and type 2 diabetes in adults aged 18–50.DesignMultivariable logistic regression analysis was used to develop classification models integrating five pre-specified predictor variables, including clinical features (age of diagnosis, body mass index) and clinical biomarkers (GADA and Islet Antigen 2 islet autoantibodies, Type 1 Diabetes Genetic Risk Score), to identify type 1 diabetes with rapid insulin requirement using data from existing cohorts.SettingUK cohorts recruited from primary and secondary care.Participants1352 (model development) and 582 (external validation) participants diagnosed with diabetes between the age of 18 and 50 years of white European origin.Main outcome measuresType 1 diabetes was defined by rapid insulin requirement (within 3 years of diagnosis) and severe endogenous insulin deficiency (C-peptide <200 pmol/L). Type 2 diabetes was defined by either a lack of rapid insulin requirement or, where insulin treated within 3 years, retained endogenous insulin secretion (C-peptide >600 pmol/L at ≥5 years diabetes duration). Model performance was assessed using area under the receiver operating characteristic curve (ROC AUC), and internal and external validation.ResultsType 1 diabetes was present in 13% of participants in the development cohort. All five predictor variables were discriminative and independent predictors of type 1 diabetes (p<0.001 for all) with individual ROC AUC ranging from 0.82 to 0.85. Model performance was high: ROC AUC range 0.90 (95% CI 0.88 to 0.93) (clinical features only) to 0.97 (95% CI 0.96 to 0.98) (all predictors) with low prediction error. Results were consistent in external validation (clinical features and GADA ROC AUC 0.93 (0.90 to 0.96)).ConclusionsClinical diagnostic models integrating clinical features with biomarkers have high accuracy for identifying type 1 diabetes with rapid insulin requirement, and could assist clinicians and researchers in accurately identifying patients with type 1 diabetes.
Examining the effects of low back pain and mental health symptoms on healthcare utilisation and costs: a protocol for a population-based cohort study
Authors: Wong Jessica J , Côté Pierre , Tricco Andrea C , Rosella Laura C 
Published: September 2019

IntroductionLow back pain (LBP) is a leading cause of disability associated with high healthcare utilisation and costs. Mental health symptoms are negative prognostic factors for LBP recovery; however, no population-based studies have assessed the joint effects of LBP and mental health symptoms on healthcare utilisation. This proposed study will characterise the health system burden of LBP and help identify priority groups to inform resource allocation and public health strategies. Among community-dwelling adult respondents of five cycles of the Canadian Community Health Survey (CCHS) in Ontario, we aim to assess the effect of self-reported LBP on healthcare utilisation and costs and assess whether this effect differs between those with and without self-reported mental health symptoms.Methods and analysisWe designed a dynamic population-based cohort study using linkages of survey and administrative data housed at ICES. The Ontario sample of CCHS (2003–2004, 2005–2006, 2007/2008, 2009/2010, 2011/2012; total of ~1 30 000 eligible respondents) will be used to define the cohort of adults with self-reported LBP with and without mental health symptoms. Healthcare utilisation and costs will be assessed by linking health administrative databases. Follow-up ranges from 6 to 15 years (until 31 March 2018). Sociodemographic (eg, age, sex, education) and health behaviour (eg, comorbidities, physical activity) factors will be considered as potential confounders. Poisson and linear (log-transformed) regression models will be used to assess the association between LBP and healthcare utilisation and costs. We will assess effect modification with mental health symptoms on the additive and multiplicative scales and conduct sensitivity analyses to assess the impact of misclassification and residual confounding.Ethics and disseminationThis study is approved by the University of Toronto Research Ethics Board. We will disseminate findings using a multifaceted knowledge translation strategy, including scientific conference presentations, publications in peer-reviewed journals and workshops with key knowledge users.
The association between nurse staffing levels and the timeliness of vital signs monitoring: a retrospective observational study in the UK
Authors: Redfern Oliver C , Griffiths Peter , Maruotti Antonello , Recio Saucedo Alejandra , Smith Gary B 
Published: September 2019

ObjectivesOmissions and delays in delivering nursing care are widely reported consequences of staffing shortages, with potentially serious impacts on patients. However, studies so far have relied almost exclusively on nurse self-reporting. Monitoring vital signs is a key part of nursing work and electronic recording provides an opportunity to objectively measure delays in care. This study aimed to determine the association between registered nurse (RN) and nursing assistant (NA) staffing levels and adherence to a vital signs monitoring protocol.DesignRetrospective observational study.Setting32 medical and surgical wards in an acute general hospital in England.Participants538 238 nursing shifts taken over 30 982 ward days.Primary and secondary outcome measuresVital signs observations were scheduled according to a protocol based on the National Early Warning Score (NEWS). The primary outcome was the daily rate of missed vital signs (overdue by ≥67% of the expected time to next observation). The secondary outcome was the daily rate of late vital signs observations (overdue by ≥33%). We undertook subgroup analysis by stratifying observations into low, medium and high acuity using NEWS.ResultsLate and missed observations were frequent, particularly in high acuity patients (median=44%). Higher levels of RN staffing, measured in hours per patient per day (HPPD), were associated with a lower rate of missed observations in all (IRR 0.983, 95% CI 0.979 to 0.987) and high acuity patients (0.982, 95% CI 0.972 to 0.992). However, levels of NA staffing were only associated with the daily rate (0.954, CI 0.949 to 0.958) of all missed observations.ConclusionsAdherence to vital signs monitoring protocols is sensitive to levels of nurse and NA staffing, although high acuity observations appeared unaffected by levels of NAs. We demonstrate that objectively measured omissions in care are related to nurse staffing levels, although the absolute effects are small.Study registrationThe data and analyses presented here were part of the larger Missed Care study (ISRCTN registration: 17930973).