bluuebunny/crossref_metadata_2025_split huggingface dataset:
National health and economic impact of a lifestyle program to prevent type 2 diabetes mellitus in Germany: a simulation study
Authors: Ogurtsova Katherine , Laxy Michael , Emmert-Fees Karl , Dintsios Charalabos-Markos , Zhang Ping , Icks Andrea 
Published: October 2024

IntroductionTo examine the long-term health and economic impact of a lifestyle diabetes prevention program in people with high risk of developing type 2 diabetes in Germany.Research design and methodsWe assessed the lifetime cost-effectiveness of a 2-year pragmatic lifestyle program for preventing type 2 diabetes targeting German adults aged 35–54 and 55–74 years old with hemoglobin A1c (HbA1c) from 6.0% to 6.4%. We used the Centers for Disease Control and Prevention RTI Diabetes Cost-Effectiveness Model to run a simulation on the program effectiveness. We estimated incremental health benefits in quality-adjusted life years (QALYs) and costs using an established simulation model adapted to the German context, from a healthcare system and societal perspective. The cost-effectiveness of the program was measured by incremental cost-effectiveness ratios (ICERs) in cost per QALY. We projected the number of type 2 diabetes cases prevented by participation rate if the program was implemented nationwide.ResultsThe lifestyle program would result to more QALYs and higher costs. The lifetime ICERs were 14 690€ (35–54 years old) and 14 372€ (55–74 years old) from a healthcare system perspective and cost saving (ICER=−3805€) and cost-effective (ICER=4579€), respectively, from a societal perspective. A total of 10 527 diabetes cases would be prevented over lifetime if the program was offered to all eligible people nationwide and 25% of those would participate in the program.ConclusionsImplementing the lifestyle intervention for people with HbA1c from 6.0% to 6.4% could be a cost-effective at standard willingness to pay level strategy for type 2 diabetes prevention. The intervention in the younger cohort could be cost saving from a societal perspective. The successful implementation of a lifestyle-based diabetes prevention program could be an important component of a successful National Diabetes Strategy in Germany.
SoundMind Trial: a study protocol for a randomised controlled trial for online acceptance and commitment therapy and sound therapy for tinnitus
Authors: Huang Xiaoling , Tang Dongmei , Sun Shan , Li Huawei 
Published: October 2024

IntroductionTinnitus is a common ailment that affects 10%–15% of adults worldwide. Comorbidities associated with tinnitus often include hearing loss, emotional distress and sleep disorders, with insomnia being a common issue among patients with tinnitus. Audiological and psychological approaches are typically used to treat chronic subjective tinnitus, with the combination of sound therapy and cognitive–behavioural therapy-based counselling having the strongest evidence for effectiveness. Acceptance and commitment therapy (ACT) has also shown promising effects in reducing the impact of tinnitus when delivered in groups or online. However, there is a lack of evidence on the effects of combining ACT with sound therapy for patients with tinnitus-related insomnia. Therefore, this study aims to compare the efficacy of internet-delivered ACT combined with sound therapy versus sound therapy alone for tinnitus in a superiority, two-arm randomised controlled trial.Methods and analysisA total of 164 patients with chronic subjective tinnitus and insomnia will be randomised to receive internet-delivered guided self-help tinnitus treatment based on ACT combined with tailored sound therapy or tailored sound therapy alone. The primary outcome is the variation in Tinnitus Handicap Inventory scores observed 2 months after randomisation between the two study groups. Secondary outcomes will include insomnia severity, sleep parameters, tinnitus loudness, tinnitus acceptance, depression and anxiety. The outcomes will be assessed at 2, 3 and 6 months post randomisation.Ethics and disseminationThe study is approved by the review board and ethics committee of the Eye and ENT Hospital of Fudan University (approval number: 2023066-1). The findings will be disseminated through presentations at relevant conferences and peer-reviewed publications.Trial registration numberNCT05963542.
Satisfaction and preference for home delivery pharmaceutical services among patients attending primary care settings in Qatar during COVID-19 pandemic: a cross-sectional study
Authors: Alam Muhammad Tanveer , Veettil Shajitha Thekke , Krishnan Jeyaram Illiayaraja , Alsalmi Reena Ghazi , Jacob Jinsy , Mousa Aly Tamer , Sakallah Samah Auni Mesbah , Mahmood Shafqat , Al Nuaimi Ahmed 
Published: October 2024

ObjectivesDuring the COVID-19 epidemic, due to the high risk associated with travel and group gatherings, the Ministry of Public Health in Qatar introduced home delivery of pharmaceutical services. This study aims to investigate the satisfaction and preferences of patients who used the new home delivery services provided by health centres (HCs).Study designA cross-sectional study was conducted using an exploratory questionnaire to assess patients’ preferences for pharmaceutical delivery services.SettingsPrimary care.ParticipantsA convenient sample of 604 adults who used the pharmaceutical delivery services was recruited. The study tool measured satisfaction with a set of 11 service evaluation criteria on a Likert scale of 5 grades. The score ranged between 1 for highly dissatisfied and 5 for highly satisfied. A quantitative summary satisfaction score was calculated by summing the satisfaction rating for home delivery on the 11 service evaluation criteria. The final score was adjusted to a maximum of 100 for ease of understanding.ResultsResults showed that 45.5% of participants were highly satisfied with the overall quality of the home delivery service. Furthermore, 58.9% were willing to recommend the service to others, while only 30.9% considered the delivery cost to be reasonable. Among the factors associated with satisfaction was nationality, where Qatari nationals had a significantly higher mean satisfaction score (89%) compared with expatriates (79.5%).OutcomeThe satisfaction score exhibited a significant positive trend with age and educational level. Factors such as gender, the time required to access the HCs, frequency of requesting pharmacy service and income categories did not show a significant difference in the satisfaction score.ConclusionThe home delivery service is a promising addition to primary care. It may play a crucial role in enhancing accessibility for the beneficiaries reducing unnecessary visits to HCs in the future.
The chronic wound characterisation study and biobank: a study protocol for a prospective observational cohort investigation of bacterial community composition, inflammatory responses and wound-healing trajectories in non-healing wounds
Authors: Iversen Anne Kristine Servais , Lichtenberg Mads , Fritz Blaine Gabriel , Díaz-Pinés Cort Isabel , Al-Zoubaidi Dania Firas , Gottlieb Hans , Kirketerp-Møller Klaus , Bjarnsholt Thomas , Jakobsen Tim Holm 
Published: October 2024

IntroductionChronic wounds affect 1%–2% of the global population, with rising incidence due to ageing and lifestyle-related diseases. Bacterial biofilms, found in 80% of chronic wounds, and scattered single-cell bacteria may hinder healing. Microbes are believed to negatively impact healing by exacerbating inflammation and host immune response.Methods and analysisThe primary objective of the chronic wound characterisation (CWC) study is to investigate chronic wounds through a prospective observational cohort study exploring bacterial community composition, inflammatory responses and the influence of bacteria on wound-healing trajectories. The CWC study will be investigated through two cohorts: thepredictiveandin-depth.Thepredictive cohortincludes patients with a chronic wound scheduled for mechanical debridement. The debrided material will be collected for dual RNA sequencing and 16s ribosomal RNA gene sequencing, as well as samples for microbial culturing and a photo to assess the wound. Clinical data is recorded, and healing and/or other clinical endpoints are established through medical records.Thein-depth cohortincludes and follows patients undergoing split-thickness skin grafting. Extensive sampling (ESwabs, biopsies, tape strips, debrided material and a sample of the skin graft) will be performed on surgery and patients will be seen at two follow-up visits. Samples will be analysed through culturing and next-generation sequencing methods. A biobank will be established comprising longitudinal clinical samples and clinical data.Ethics and disseminationThe study has been approved by the board of health ethics, Capital Region of Denmark, under protocol number H-20032214. The study findings will be disseminated through peer-reviewed publications and showcased at both national and international conferences and meetings within the domains of microbiology, wound healing and infection.
Developing the ‘Life Threads’ approach to support families after traumatic brain injury in UK community settings: protocol for a qualitative prefeasibility study
Authors: Whiffin Charlotte Jane , Ellis-Hill Caroline , Norman Alyson , Lee Morag , Singh Parmjeet Kaur , Clark-Wilson Jo , Daisley Audrey , Felles Natasha Yasmin , Holloway Mark , Rose Sara , Gracey Fergus 
Published: October 2024

IntroductionTraumatic brain injury (TBI) brings about inevitable and significant changes for family members. Mental health effects for family members are well documented but there are significant gaps in support options across services. Here, we describe our protocol for a study that seeks to investigate the potential for a narrative, creative approach, the ‘Life Threads’ approach, as a low intensity, accessible means of support that can be applied across service contexts.MethodsWe will recruit 20 family members of someone who sustained a TBI from services in an area of the UK with a diverse demographic. Family members will be provided with the ‘Life Threads’ approach materials and guided in their use. The study is planned to run from March 2023 to July 2024.AnalysisCollection of data on potential usefulness, feasibility and acceptability will be through focus groups and individual interviews. Transcripts will be analysed using reflexive thematic analysis, conducted within a relativist, constructivist orientation.Ethics and disseminationEthical approvals have been sought and gained (Nottingham 1 Research Ethics Committee, 23/EM/0185, 4 September 2023), and the study has been registered with ISRCTN. As a research team, we are guided by our own personal, professional and research experiences of TBI which we will consider reflexively throughout the research process. Results will be disseminated in collaboration with our patient and public involvement group through open peer-reviewed journal publication and scientific conference, with lay summaries shared via recruitment sites.Trial registration numberISRCTN17392794.
Diabetic health literacy and associated factors among patients with diabetes attending follow-up in public hospitals of Northeastern Ethiopia: a multicentre cross-sectional study
Authors: Nigussie Elda Mekonnen , Demeke Mekasha Getnet , Adane Tigist Demssew , Mengistu Bethelehem Taye , Goshu Abel Tibebu , Dessie Yihenew Ayehu , Worku Birhan Getye , Asefa Eyosiyas Yeshialem 
Published: October 2024

ObjectiveTo assess the magnitude of diabetic health literacy (DHL) and associated factors among diabetes patients attending follow-up at public hospitals in Northeastern Ethiopia.DesignAn institution-based cross-sectional study was conducted from 24 May to 24 June 2022.SettingDiabetic clinics of four public hospitals in Northeastern Ethiopia.Participants611 adult diabetes patients who have been undergoing follow-up care for at least 6 months were systematically selected. Patients who were unable to communicate, were critically ill and with gestational diabetes mellitus were excluded from the study.OutcomesDHL was assessed using a 15-item tool developed from existing literature.ResultsOf all the participants, 300 (49.1%) had low, 174 (28.5%) moderate and 137 (22.4%) had high DHL levels. The significant factors impacting DHL included age (<40 years old: AOR=3.48, 95% CI=2.11–5.77; 40–60 years: AOR=2.79, 95% CI=1.75–4.46), low education (AOR=0.29, 95% CI=0.16–0.56 for those who can’t read and write; AOR=0.41, 95% CI=0.23–0.74 for those who can read and write; AOR=0.45, 95% CI=0.27–0.76 for primary education), exposure to diabetic education (AOR=1.84, 95% CI=1.31–2.58), having ≥2 information sources (AOR=2.28, 95% CI=1.57–3.32), moderate social support (AOR=1.94, 95% CI=1.32–2.87), strong social support (AOR=2.73, 95% CI=1.75–4.26) and urban residence (AOR=1.65, 95% CI=1.14–2.39).ConclusionThe study showed that less than a quarter of the patients have high DHL, with almost half having low levels of DHL. Tailoring health education programmes to diverse educational levels, incorporating multiple information sources and fostering social support networks could enhance DHL.
Emerging lessons from experiences at transitions in care among hospitalised patients with cancer with postdischarge frequent emergency department use: a qualitative study using linked clinical and patient-reported interview data from Quebec, Canada
Authors: Kurteva Siyana , Nassar Nabil , Tamblyn Robyn 
Published: October 2024

BackgroundWhile teamwork is essential to providing high-quality patient-centred care, challenges in interprofessional collaboration and decision-making in hospital settings are common, especially for patients with cancer. The purpose of this qualitative study was to identify emerging themes and potential challenges related to hospital discharge experiences among patients hospitalised for cancer who became frequent emergency department (ED) users postdischarge.MethodsA cohort of patients with cancer discharged from an academic health centre in Montreal (Canada) between October 2014 and November 2016 was assembled. Using health administrative claims from the provincial universal healthcare programme, frequent ED (FED) users were identified as patients who had a ≥4 ED visits in the year following hospital discharge. Qualitative analysis of transcripts from semistructured telephone interviews conducted with patients 25–30 days’ postdischarge was used for in-depth exploratory analyses to characterise hospital discharge experiences and transition process from the hospital to the community.ResultsOverall, 182 (14.5%) of 1253 patients with cancer who became FED users were included in this study. The mean age was 69.1 (SD=11.5), 59.9% (n=109) were male, and the most frequent cancers were 80 (43.9%) respiratory and 52 (28.6%) upper digestive cancer. Content analyses revealed six emerging themes from the FED patient interviews. Overall, these included (1) incomplete communication of information, (2) hospital discharge planning, (3) coordinating care among team members, (4) follow-up with outpatient providers, (5) monitoring and managing symptoms after discharge and (6) enlisting help of social and community supports.ConclusionsUsing integrated data from clinical, administrative claims and patient interviews, this study provided insights into the challenges related to hospital discharge experiences and transition into community among hospitalised patients with cancer with FED use. Application of our findings could assist in hospital discharge preparation and improvement in healthcare delivery and health outcomes.Trial registration numberNCT01179867.
Treatments, medical expenses and complications of hospital outpatient healthcare associated with stroke in patients with diabetes in China: a retrospective analysis of the Beijing Municipal Medical Insurance Database
Authors: Zeng Yi , Liang SiTing , Wang Hanming , Zeng JiaDong , Luo Ying , Wang Weihao , Qiao JingTao , Fan Jingwen , Zhang Zhen , Guo Lixin 
Published: October 2024

ObjectivesDiabetes is closely associated with risk of stroke and its adverse sequelae. Approximately 20%–33% of patients with stroke have diabetes. In China, however, it is unclear how stroke affects healthcare utilisation, medications and complications among people with diabetes. This study aimed to analyse the clinical characteristics, treatment options, medical expenses and complications of hospital outpatient healthcare associated with stroke in patients with diabetes in China.DesignA retrospective, multicentre, observational study.SettingBeijing Municipal Medical Insurance Database, with data from 2016 to 2018.ParticipantsThe study included patients with diabetes whose data included 2016–2018 outpatient medication records and who had Beijing medical insurance. Patients who did not have continuous prescription records for more than 2 months were excluded from the analysis. In total, 2 853 036 people with diabetes were included, and patients who had and did not have a stroke were compared.ResultsIn our study, 19.75%–22.30% of patients with diabetes suffered from stroke between 2016 and 2018. The average annual medical cost for a patient diagnosed with diabetes is ¥9606.65, and the cost increases to ¥13 428.39 when diabetes was combined with stroke; thus, stroke increases the medical cost for patients with diabetes by 39.78% (p<0.0001). Among patients with diabetes who had a stroke, 4.76 medications were used (1.8 hypoglycaemic drugs and 2.97 non-hypoglycaemic drugs); these numbers were significantly greater than for patients with diabetes who did not have a stroke receiving both hypoglycaemic drugs and non-hypoglycaemic drugs (p<0.0001). Among patients with diabetes who did not have a stroke, 3.58 medications were used (1.66 hypoglycaemic drugs and 1.92 non-hypoglycaemic drugs). Patients with diabetes who had a stroke also had significantly greater incidences of diabetic peripheral neuropathy, diabetic kidney disease, diabetic retinopathy and diabetic angiopathy than those who did not have a stroke (p<0.0001). These drugs and costs increased with the number of complications (p<0.0001). The increased medical costs for each specific complication are also listed. We also analysed the medical costs and medication regimens stratified by sex, age group and complications.ConclusionsStroke is associated with a significant increase in complications and medications for patients with diabetes and greatly adds to the economic burden of these patients. Early identification of stroke risk factors in patients with diabetes, as well as targeted poststroke diabetes management, is crucial from a socioeconomic perspective for a comprehensive management and treatment of stroke in patients with diabetes.
Exploring the decision-making experience of elderly diabetes patients regarding their health-seeking behaviour: a descriptive qualitative study
Authors: Du Qiu Hui , Yang Jin Hong , Zhang Zi Chen , Li Shao Bo , Liu Yu Qin , Li Yu Min , Yang You , Jia Hong Hong 
Published: October 2024

BackgroundDiabetes has emerged as a critical global public health issue. The burden of diabetes is escalating in developing countries, including China. For individuals with diabetes, making informed and rational decisions regarding health-seeking behaviour is crucial to prevent or delay the occurrence of complications. However, prevalent irrational health-seeking behaviours among Chinese patients with diabetes have led to a low treatment rate of only 32.2%. In this study, we explore the subjective experiences of elderly patients with diabetes related to their decision-making experience for seeking healthcare, providing valuable insights for targeted intervention, and provide theoretical basis for establishing an efficient medical and health service system.MethodsA qualitative study using descriptive phenomenology research methodology was adopted to explore the decision-making experience of elderly diabetes patients in seeking healthcare services. A purposive sampling approach, specifically maximum variation sampling, was employed to conduct semistructured in-depth interviews with 11 eligible participants between January and February 2023. Data analysis was carried out using QSR Nvivo 12.0 software and Colaizzi’s seven-step analysis method.ResultsFour themes emerged: ‘lack of disease risk perception and negative coping styles’, ‘ huge medical and economic burden’, ‘lack of family and social support’ and ‘Dissatisfaction with medical services’.ConclusionThe health-seeking behavioural decision-making level of elderly diabetic patients is relatively low. Medical and healthcare professionals should formulate targeted intervention measures aimed at improving their disease cognition level, changing their coping styles and enhancing their health-seeking behavioural decision-making level to improve their health outcomes. Meanwhile, policymakers should plan and allocate medical resources in a targeted manner based on the needs and expectations of patients.
An expert consensus on the most effective components of integrated motivational interviewing and cognitive behavioural therapy for lifestyle behaviour change: protocol for an online modified Delphi study
Authors: Barrett Stephen , Begg Stephen , Dunford Ashley , O'Halloran Paul , Rodda Kane , Denniss Emily , Breckon Jeff , Kingsley Michael 
Published: October 2024

IntroductionBehaviour change interventions are advocated as a key approach to manage behavioural risk factors such as insufficient physical activity, poor diet and smoking. Integrated motivational interviewing and cognitive behavioural therapy (MI-CBT) interventions have become increasingly popular to promote behaviour change; however, there is a lack of agreement as to what constitutes necessary components of MI-CBT interventions for lifestyle behaviour change. The primary objective of this study is to use a consensus method to develop guidelines to design and deliver MI-CBT interventions for lifestyle behaviour change.MethodsA three-round modified Delphi study will be conducted with an expert, international panel of clinicians and researchers. An online survey will be developed from assessments of key MI-CBT literature and practice guides to identify commonly used components of individually delivered MI and CBT interventions. In each round, participants will rate the extent to which they agree with each component using a Likert scale. Responses from Rounds 1 and 2 will be presented to participants in subsequent rounds. Responses will be represented using bar graphs and include the median and IQR of participants’ responses. To encourage consensus, participants will be asked to consider the group responses before finalising their opinion to the statements. If at least 80% of the experts agree to a statement in Rounds 2 or 3, it will be included in a final list of necessary statements.DiscussionThis modified Delphi process will help transparency in the design and implementation of MI-CBT interventions. The consensus statement will also help reporting and comparability among effectiveness studies for MI-CBT intervention studies, and help inform research, policy and practice.Ethics and disseminationEthical approval has been granted by the La Trobe University Human Research Ethics Committee (approval number HEC24066). The results will be disseminated via peer-reviewed publications, conferences and international professional associations.