bluuebunny/crossref_metadata_2025_split huggingface dataset:
Making Every Contact Count: health professionals’ experiences of integrating conversations about Snacktivity to promote physical activity within routine consultations – a qualitative study
Authors: Krouwel Matthew , Greenfield Sheila , Sanders James P , Gokal Kajal , Chalkley Anna , Griffin Ryan A , Parretti Helen , Jolly Kate , Skrybant Magdalena , Biddle Stuart , Greaves Colin , Esliger Dale W , Sherar Lauren B , Edwardson Charlotte , Yates Thomas , Maddison Ralph , Frew Emma , Mutrie Nanette , Ives Natalie , Tearne Sarah , Daley Amanda J 
Published: October 2024

ObjectiveHelping people to change their health behaviours is becoming a greater feature within the role of health professionals, including through whole system initiatives such as Making Every Contact Count. Health services provide an ideal setting to routinely promote health behaviours, including physical activity. Snacktivity is a novel approach that promotes small bouts of physical activity (activity snacks) throughout the day. This study explored health professionals’ initial experiences of delivering a Snacktivity intervention to promote physical activity within routine health consultations. A further aim was to investigate health professionals’ ability/fidelity in delivering the Snacktivity intervention to their patients.DesignSemistructured interviews (n=11) and audio recording of consultations (n=46).Setting and participantsHealthcare professionals from a variety of specialisms who delivered the Snacktivity intervention within patient consultations.ResultsAnalyses revealed two higher-level themes of interest: (1) health professionals’ conceptualisation of Snacktivity (subthemes: observations/reflections about patients’ understanding, engagement and enthusiasm for delivering the Snacktivity intervention) and (2) health professionals’ understanding of Snacktivity and experience in delivering the intervention (subthemes: delivering Snacktivity; limitations, challenges and possible improvements). Consultation audio recordings demonstrated health professionals delivered the Snacktivity intervention with high levels of fidelity. Health professionals were proficient and supportive of delivering the Snacktivity intervention within consultations although practical barriers to implementation such as time constraints were raised, and confidence in doing so was mixed.ConclusionsHealth professionals were proficient and supportive of delivering the Snacktivity intervention within consultations. The primary barrier to implementation was the time to deliver it, however, gaining greater experience in the intervention and improving behaviour change counselling skills may reduce this barrier.Trial registration numberISRCTN64851242.
Assessment of bleeding events in patients receiving DOACs with or without statins to treat venous thromboembolism: insights from the RIETE registry
Authors: Del Giorno Rosaria , Mazzolai Lucia , Keller Sanjiv , Siniscalchi Carmine , Lopez-Jimenez Luciano , Ballaz Aitor , Montenegro Ana Cristina , Otero Remedios , Rashidi Farid , Monreal Manuel 
Published: October 2024

ObjectiveTo evaluate the impact of coadministering statins with direct oral anticoagulants (DOACs) on the risk of major bleeding events in patients with venous thromboembolism (VTE).DesignObservational cohort analysis based on a multicentre international registry.SettingData were extracted from the Registro Informatizado de Enfermedad TromboEmbolica Registry, which involves 205 centres across 27 countries.ParticipantsA total of 73 659 patients diagnosed with VTE were classified based on their anticoagulant therapy (DOACs) versus low-molecular-weight heparin (LMWH) or vitamin K antagonists (VKAs) and concurrent use of statins.MethodsMultivariable Cox proportional hazards models adjusted for confounding variables to assess the risk of major bleeding events stratified by the type of anticoagulant use and statin use.ResultsFrom October 2013 to February 2023, 73 659 patients were recruited: 2573 were statin users on DOACs, 14 090 were statin users on LMWH or VKA therapy, 10 088 were non-statin users on DOACs and 46 908 were non-statin users on LMWH or VKA therapy. Statin users were 10 years older and more likely to have hypertension, diabetes, renal failure or prior artery disease. During anticoagulation (median, 187 days), 1917 patients (2.6%) suffered major bleeding. Rates of major bleeding per 100 patient-years were 2.33 (95% CI 1.72 to 3.09), 3.75 (95% CI 3.43 to 4.10), 1.39 (95% CI 1.13 to 1.69) and 3.10 (95% CI 2.93 to 3.27), respectively. On multivariable analysis, patients treated with DOACs had a significantly lower risk of major bleeding compared with those on LMWH or VKA therapy (adjusted HR 0.59; 95% CI 0.48 to 0.74). The adjusted HR in statin users versus non-users was 1.03 (95% CI 0.92 to 1.14), while in statin users on DOACs versus the rest of patients, it was 1.18 (95% CI 0.79 to 1.76).ConclusionsIn patients with VTE receiving statins, long-term anticoagulation with DOACs was associated with a reduced risk of major bleeding, regardless of the statin use. These findings support the safety profile of DOACs over VKAs or LMWH in the management of VTE in patients requiring statins.
Care gaps among people presenting to the hospital following self-harm: observational study of three emergency departments in England
Authors: Steeg Sarah , Bickley Harriet , Clements Caroline , Quinlivan Leah M , Barlow Steven , Monaghan Elizabeth , Naylor Fiona , Smith Jonathan , Mughal Faraz , Robinson Catherine , Gnani Shamini , Kapur Navneet 
Published: October 2024

ObjectivesThis study aims to examine the proportions of patients referred to mental health, social and voluntary, community and social enterprise (VCSE) services and general practice and to assess care gaps among people presenting to the hospital following self-harm.DesignPopulation-based observational study. Data were extracted from hospital records.SettingThree emergency departments (EDs) in Manchester, UK.Participants26 090 patients aged 15+ years who presented to participating EDs following self-harm and who received a psychosocial assessment by a mental health specialist.Primary and secondary outcome measuresPrimary outcome measures are as follows: care gaps, estimated from the proportion of patients with evidence of social and mental health needs with no new or active referral to mental health, social and VCSE services. Secondary outcome measures are as follows: proportions of referrals by groups of patients, estimated mental health and social needs of patients. Indicators of mental health and social need were developed with academic clinicians (psychiatrist, general practitioner and social worker) and expert lived experience contributors.Results96.2% (25 893/26 909) of individuals were estimated as having mental health needs. Among this group, 29.9% (6503/21 719) had no new or active referral to mental health services (indicating a care gap). Mental healthcare gaps were greater in men and those who were aged under 35 years, from a black, South Asian or Chinese ethnic group, living in the most deprived areas and had no mental health diagnosis, or alcohol, substance misuse, anxiety or trauma-related disorder. 52.8% (14 219/26 909) had social needs, with care gaps greater for men, individuals aged 45–64 and those who were unemployed or had a diagnosed mental disorder.ConclusionsCare gaps were higher among hospital-presenting groups known to have increased risks of suicide: men, those in middle age, unemployed individuals and those misusing substances. Improved access to mental health, social and VCSE services and general practice care is vital to reduce inequities in access to self-harm aftercare.
Effectiveness of psychological interventions for carers of patients with severe mental illness (SMI): a systematic review
Authors: Ali Syed , Tallent Jacqueline , Sambrook Harry , MacInnes Douglas , Kinane Catherine 
Published: October 2024

ObjectivesInterventions for carers of patients with severe mental illness (SMI) are effective in improving patient outcomes. This review examined the effectiveness of psychological interventions or support designed to help carers of patients with SMI.DesignA systematic review of randomised controlled trials (RCTs) was conducted. Study selection, data abstraction and risk of bias assessments were independently conducted and duplicated. The reporting of this review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.Data sourcesCINAHL, CENTRAL, EMBASE, Medline and PsycINFO were searched from inception to 30 April 2024.Eligibility criteriaOnly studies using an RCT were considered. All other research designs were excluded. The included population was carers over 18 caring for a patient with SMI. Any psychological, psychosocial or psychoeducational interventions were included. Patients under 18, diagnosed with dementia or learning disabilities comorbidity, were excluded.Data extraction and synthesisStudy characteristics and outcome data (mean and SD) for each included study were collected. Review Manager (RevMan) was used to manage the data. Meta-analysis was not considered appropriate due to the heterogeneity of the included studies. The results were presented as a narrative synthesis.ResultsThis review included 3869 participants from 32 RCTs and demonstrated a beneficial effect of psychological interventions for carers. Psychoeducation was widely used and the most evaluated intervention for carers.ConclusionsPsychological interventions for carers are beneficial in helping to reduce negative outcomes and enhance positive outcomes. Future research could focus on exploring the impact of interventions on less evaluated outcomes such as depressive and anxiety symptoms.PROSPERO registration numberCRD42021233181.
Level of option B+PMTCT drug adherence with male partner involvement and associated factors among breastfeeding women until 18 months in North Gojjam Zone, Amhara region, Northwest Ethiopia, 2022: a multicentre cross-sectional study
Authors: Belachew Tegegne Wale , Mitiku Assefa Kebie , Tegegne Dagnaw Mersha , Yimer Tigist Seid , Mekuriaw Begizew Yimenu , Mengistu Temesgen Dessie , Aynekulu Getahun Tadele , Ferede Wassie Yazie 
Published: October 2024

BackgroundAdherence to option B+antiretroviral therapy medication is crucial for the effective implementation of the Prevention of Mother-to-Child Transmission (PMTCT) programme. Ethiopia has adopted the WHO’s target of achieving over 95% adherence. However, research conducted in southern Ethiopia found that only 81.4% of women adhered to option B+medication, which reflects a poor level of adherence and remains a concern.ObjectiveThe objective of the study was to assess the level of option B+PMTCT drug adherence and associated factors among women who were breast feeding for up to 18 months in government health facilities of North Gojjam Zone, Amhara region, Northwest Ethiopia, 2022DesignAn institution-based cross-sectional study was conducted.SettingThe study was carried out in hospitals located in the North Gojjam Zone of Northwest Ethiopia.ParticipantsThe study was conducted with 223 HIV-positive women who were breast feeding for up to 18 months, from 1 March 2022 to 30 April 2022.Primary and secondary outcomesThe primary outcome was to assess the level of option B+PMTCT drug adherence, while the secondary outcome was to identify factors associated with option B+PMTCT drug adherence among HIV-positive women who were breast feeding for up to 18 months. Associations between variables were analysed using both bivariate and multivariable logistic regression models, with a p<0.05 considered statistically significant at the 95% confidence level.ResultsA total of 223 participants were included, yielding a response rate of 97.8%. The adherence to option B+PMTCT drugs was 62.8%. The type of health facility (adjusted OR, AOR=0.17 (95% CI: 0.008 to 0.35)), partner support involvement (AOR=3.03 (95% CI: 1.12 to 9.13)) and the time taken to reach the facility from home (AOR=6.34 (95% CI: 2.92 to 13.75)) were significantly associated with the level of option B+PMTCT drug adherence.ConclusionOption B+PMTCT drug adherence was lower than the recommended level. The type of health facility, partner support and the time required to travel from home to the facility were factors associated with adherence to option B+PMTCT medication. Support from a partner is crucial for improving adherence to option B+medication.
Impact of urban greening on population health in sub-Saharan Africa: a scoping review protocol
Authors: Ansah Edward Wilson , Antiri Ebenezer Oduro , Awuah Hilary Konadu , Salu Promise , Adoripore John , Boakye Anthony Edward 
Published: October 2024

IntroductionThe rate of urbanisation in sub-Saharan Africa (SSA) has increased remarkably, with the urban population expected to double by 2050. This rapid urbanisation, industrialisation and climate change pose serious public health challenges resulting from increased heat waves and other environmental changes. Urban greening holds promise as a climate change mitigation and adaptation strategy, leading to biodiversity conservation and enhancing the physical, mental and social well-being of the population.Methods and analysisThis scoping review aims to identify and synthesise studies that investigated the availability and utilisation of green spaces, the factors that affect the utilisation of green spaces as well as the health impacts of urban greening in SSA. A systematic search will be conducted across multiple databases (MEDLINE, PubMed, JSTOR, SCOPUS and Green FILE) and grey literature sources for papers published up to 2024, in line with established scoping review frameworks. The data will be charted and extracted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, Extension for Scoping Reviews. We will further synthesise and use thematic analysis to fully understand the relationship between urban greening and population health in SSA.Ethics and disseminationEthical approval will not be required because primary data will not be collected for the study. The results of this study come from published articles, which are publicly available. The results of the review will be submitted to a peer-reviewed journal for publication and presented at workshops and conferences.RegistrationThe scoping review protocol has been registered on the Open Science Frameworkhttps://osf.io/nfh68.
Virtual reality-guided mindfulness intervention to enhance psychosocial well-being in caregivers of end-stage kidney disease patients: protocol for a mixed-methods pilot randomised controlled trial
Authors: Shankar Ravi , Hong Wei Zhen , Bundele Anjali , Si Koh Pei , Mukhopadhyay Amartya 
Published: October 2024

IntroductionCaregivers of patients with end-stage kidney disease (ESKD) face significant challenges that contribute to caregiver burden, negatively impacting their psychosocial well-being. Virtual-reality (VR)-guided mindfulness interventions have shown promise in reducing stress, anxiety and depression in various populations.Methods and analysisThis pilot study aims to evaluate the efficacy and feasibility of a VR-guided mindfulness intervention for ESKD caregivers. A single-centre, single-blind, parallel-group pilot randomised controlled trial will be conducted. Thirty ESKD caregivers will be randomly allocated to either the VR-guided mindfulness intervention group or the sham VR control group. The intervention group will receive a 6 week home-based VR-guided mindfulness programme, while the control group will view relaxing nature videos without mindfulness content. Participants will be assessed at baseline, post-intervention (6 weeks) and follow-up (12 weeks) using validated questionnaires for caregiver burden (Zarit Burden Interview (ZBI)), stress, anxiety, depression (Depression Anxiety Stress Scale-21 (DASS-21)), quality of life (36-Item Short Form Health Survey (SF-36)) and mindfulness (Five Facet Mindfulness Questionnaire (FFMQ)). Feasibility outcomes include accrual rates, retention, adherence, questionnaire completion and side effect rates. Semi-structured interviews will explore participants’ experiences with the intervention.Ethics and disseminationThe study has been approved by the NHG Domain Specific Review Board (Reference: 2024–3940-APP1). The results of this pilot study will be reported in peer-reviewed open-access journals and shared with participants and stakeholders.Trial registrationNCT06479200.
Ventilator performances for non-invasive ventilation: a bench study
Authors: Caillard Christian , Fresnel Emeline , Artaud-Macari Elise , Cuvelier Antoine , Tamion Fabienne , Patout Maxime , Girault Christophe 
Published: October 2024

IntroductionA wide range of recent ventilators, dedicated or not, is available for non-invasive ventilation (NIV) in respiratory or intensive care units (ICU). We conducted a bench study to compare their technical performances.MethodsVentilators, including five ICU ventilators with NIV mode on, two dedicated NIV ventilators and one transport ventilator, were evaluated on a test bench for NIV, consisting of a 3D manikin head connected to an ASL 5000 lung model via a non-vented mask. Ventilators were tested according to three simulated lung profiles (normal, obstructive, restrictive), three levels of simulated air leakage (0, 15, 30 L/min), two levels of pressure support (8, 14 cmH2O) and two respiratory rates (15, 25 cycles/min).ResultsThe global median Asynchrony Index (AI) was higher with ICU ventilators than with dedicated NIV ventilators (4% (0; 76) vs 0% (0; 15), respectively; p<0.05) and different between all ventilators (p<0.001). The AI was higher with ICU ventilators for the normal and restrictive profiles (p<0.01) and not different between ventilators for the obstructive profile. Auto-triggering represented 43% of all patient-ventilator asynchrony. Triggering delay, cycling delay, inspiratory pressure-time product, pressure rise time and pressure at mask were different between all ventilators (p<0.01). Dedicated NIV ventilators induced a lower pressure-time product than ICU and transport ventilators (p<0.01). There was no difference between ventilators for minute ventilation and peak flow.ConclusionDespite the integration of NIV algorithms, most recent ICU ventilators appear to be less efficient than dedicated NIV ventilators. Technical performances could change, however, according to the underlying respiratory disease and the level of air leakage.
Patient perspectives on knowledge gaps in hypersensitivity pneumonitis
Authors: Varadarajan Janani , Edgar Armani , O'Beirne Ronan , Paul Tessy K , Krishnan Jamuna K , Kaner Robert , Safford Monika M , Aronson Kerri 
Published: October 2024

ObjectivesResponding to prior research findings that lack of knowledge about their disease impacted patients’ quality of life, the objective of this study was to identify and prioritise information gaps about hypersensitivity pneumonitis (HP) from the perspective of patients living with the disease.DesignThis study used the nominal group technique, a semiquantitative and qualitative method to identify stakeholder priorities.SettingVirtual group sessions were conducted in an academic medical centre in the USA.Participants21 patients diagnosed with HP participated in this study. Participants were eligible if they spoke English and had access to the internet and were excluded if they had cognitive impairment.ResultsThe patient statements were grouped into seven themes that were prioritised by participants in the following order: (1) natural history and prognosis; (2) current treatment options and therapeutic research; (3) epidemiology and aetiology of HP; (4) living well with HP; (5) origin and management of symptoms; (6) identifying and mitigating exposures and (7) methods of educating patients, clinicians and others about HP.ConclusionsThis study provides an understanding of patients’ prioritisation of knowledge gaps in HP to inform targeted educational interventions and provide avenues for future research.
Digital biomarkers for psoriatic arthritis: a qualitative focus group study on patient-perceived opportunities and barriers
Authors: de Groot Patty , Wagenaar Wendy , Foolen Jasper , Tchetverikov Ilja , Goekoop-Ruiterman Yvonne P.M. , Vis Marijn , Kok Marc R. , Coates Laura C. , Luime Jolanda J. 
Published: October 2024

ObjectivesThe widespread adoption of wearables, for example, smartphones and smartwatches in the daily lives of the general population, allows passive monitoring of physiological and behavioural data in the real world. This qualitative study explores the perspective of psoriatic arthritis (PsA) patients towards these so-called digital biomarkers (dBMs).MethodsAs part of a Design Thinking approach, six focus groups were conducted involving 27 PsA patients. The semistructured topic guide included disease activity, coping strategies, care needs, and potential advantages and disadvantages of dBMs. Thematic analysis followed an abductive coding method.ResultsPsA daily permeates patients’ lives, both physically and mentally. Participants discussed how their lives are focused on minimising the impact of the disease on their daily routines. Their attempts to gain control over their disease highly depend on trial and error. Flare-ups are related to physiological as well as behavioural micro and macro changes. Understanding these changes could enable the detection of (early) flare. Participants elicited pros and cons of the use of dBMs, discussed their intended use and made practical remarks. This led to three main themes: ‘Perceived dBM opportunities’, ‘Mapping Disease activity’ and ‘Perceived dBM barriers and pitfalls’.ConclusionPsA patients are receptive to dBMs for tracking the disease symptoms. Disease activity is regarded multifaceted and thus, dBMs should include a broad range of features to truly reflect the disease activity status. Reducing the time of trial and error in learning to manage the disease is regarded beneficial. Establishing and maintaining the relationship with their attending physicians is a prerequisite, even if remote patient monitoring becomes an alternative for some physical hospital visits.