bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of rehabilitation measures in reintegration of children with brain tumours or leukaemia and their families after completion of cancer treatment: a study protocol
Authors: Peikert Mona Leandra , Inhestern Laura , Bergelt Corinna 
Published: August 2017

IntroductionFor ill children as well as for their parents and siblings, childhood cancer poses a major challenge. Little is known about the reintegration into daily life of childhood cancer survivors and their families. The aim of this prospective observational study is to further the understanding of the role of rehabilitation measures in the reintegration process of childhood leukaemia or brain tumour survivors and their family members after the end of cancer treatment.Methods and analysisThis prospective observational study consists of three study arms: a quantitative study in cooperation with three German paediatric oncological study registries (study arm 1), a quantitative study in cooperation with a rehabilitation clinic that offers a family-oriented paediatric oncological rehabilitation programme (study arm 2) and a qualitative study at 12-month follow-up including families from the study arms 1 and 2 (study arm 3). In study arm 1, children, parents and siblings are surveyed after treatment (baseline), 4–6 months after baseline measurement and at 12-month follow-up. In study arm 2, data are collected at the beginning and at the end of the rehabilitation measure and at 12-month follow-up. Families are assessed with standardised questionnaires on quality of life, emotional and behavioural symptoms, depression, anxiety, fear of progression, coping and family functioning. Furthermore, self-developed items on rehabilitation aims and reintegration into daily life are used. Where applicable, users and non-users of rehabilitation measures will be compared regarding the outcome parameters. Longitudinal data will be analysed by means of multivariate analysis strategies. Reference values will be used for comparisons if applicable. Qualitative data will be analysed using thematic analysis.Ethics and disseminationThis study has been approved by the medical ethics committee of the Medical Chamber of Hamburg. Data will be published in peer-reviewed journals and presented at conferences.
The benefits of hardware removal in patients with pain or discomfort after fracture healing of the ankle: a systematic review protocol
Authors: Thune Alexandra , Hagelberg Mårten , Nåsell Hans , Sköldenberg Olof 
Published: August 2017

IntroductionFor any orthopaedic surgeon working with trauma; ankle fractures are one of the most common injuries treated. The treatment of ankle fractures can be conservative, using external fixation, but more commonly the fractures are treated with open reduction and internal fixation. Residual pain and discomfort are common in patients after surgical treatment of fractures of the ankle. Sometimes it is difficult to determine whether the pain or discomfort is due to the implants left in situ or the primary injury itself. In many cases, the decision is made to remove the implants. Extraction of internal fixation material from the ankle is a common procedure in many orthopaedic clinics. There are no evidence-based guidelines or consensus regarding the effect of hardware removal from the ankle. The aim of this protocol is to describe the method that will be used to collect, describe and analyse the current evidence regarding hardware removal after fracture healing of the ankle.Methods and analysisWe will conduct a systematic review of studies that were published after 1967 regarding the benefits of hardware removal in patients with pain or discomfort after fracture healing of the ankle. Study selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. We will make a predefined search strategy and use it in several databases. We will include both randomised controlled trials (RCTs) and non-RCT studies. We will use descriptive statistics to summarise the studies collected. If more than one RCT is collected then a meta-analysis will be conducted. The quality of evidence will be assessed using Grading of Recommendations Assessment, Development and Evaluation guidelines.Ethics and disseminationNo ethics approval is required as no primary data will be collected. Once complete, the results will be made available by peer-reviewed publication.Trial registration numberPROSPERO registration number CRD42016039186
Equipping community pharmacy workers as agents for health behaviour change: developing and testing a theory-based smoking cessation intervention
Authors: Steed Liz , Sohanpal Ratna , James Wai-Yee , Rivas Carol , Jumbe Sandra , Chater Angel , Todd Adam , Edwards Elizabeth , Macneil Virginia , Macfarlane Fraser , Greenhalgh Trisha , Griffiths Chris , Eldridge Sandra , Taylor Stephanie , Walton Robert 
Published: August 2017

ObjectiveTo develop a complex intervention for community pharmacy staff to promote uptake of smoking cessation services and to increase quit rates.DesignFollowing the Medical Research Council framework, we used a mixed-methods approach to develop, pilot and then refine the intervention.MethodsPhase I: We used information from qualitative studies in pharmacies, systematic literature reviews and the Capability, Opportunity, Motivation—Behaviour framework to inform design of the initial version of the intervention.Phase II: We then tested the acceptability of this intervention with smoking cessation advisers and assessed fidelity using actors who visited pharmacies posing as smokers, in a pilot study.Phase III: We reviewed the content and associated theory underpinning our intervention, taking account of the results of the earlier studies and a realist analysis of published literature. We then confirmed a logic model describing the intended operation of the intervention and used this model to refine the intervention and associated materials.SettingEight community pharmacies in three inner east London boroughs.Participants12 Stop Smoking Advisers.InterventionTwo, 150 min, skills-based training sessions focused on communication and behaviour change skills with between session practice.ResultsThe pilot study confirmed acceptability of the intervention and showed preliminary evidence of benefit; however, organisational barriers tended to limit effective operation. The pilot data and realist review pointed to additional use of Diffusion of Innovations Theory to seat the intervention in the wider organisational context.ConclusionsWe have developed and refined an intervention to promote smoking cessation services in community pharmacies, which we now plan to evaluate in a randomised controlled trial.Trial registration numberUKCRN ID 18446, Pilot.
A cross-sectional study of travel patterns of older adults in the USA during 2015: implications for mobility and traffic safety
Authors: Shen Sijun , Koech Wilson , Feng Jing , Rice Thomas M , Zhu Motao 
Published: August 2017

BackgroundWith an ever increasing population of older adults (65+ years) in the USA, a better understanding of this population’s travel patterns is needed to improve travel mobility and transportation safety.ObjectiveIn this study, we described the travel patterns of older adults in the USA during 2015.MethodsTravel patterns of older adults (65–74 and 75+ years) were compared with younger adults (25–64 years) by frequency and proportion of daily trips. The daily trips of various age groups were estimated using the 2015 American Time Use Survey.ResultsThe percentage of daily travellers was 88% for adults (25–64 years), 75% for adults (65–74 years) and 68% for adults (75+ years). While the percentage of privately owned vehicle (POV) drivers and average time of driving POVs decreased, the percentage of POV passengers increased as adults aged. Females were less likely to drive POVs and had decreased average daily driving time, but they were more likely to ride in POVs as passengers and had longer average daily riding times than their male counterparts across all age groups. Older adults were more likely to travel in the mornings and early afternoons (from 8:00 to 15:59) while younger adults were more likely to travel in the late afternoons and early evenings (from 16:00 to 19:59).ConclusionsPOV use is the predominant mode of transit in the USA. As adults age, the percentages of daily travellers and POV drivers decrease. This pattern is more apparent among females than males. This study delineated travel patterns of older adults using a 2015 national survey, and the findings facilitate traffic systems designers and policy-makers to develop and implement initiatives to accommodate older adults’ mobility needs and improve traffic safety.
What is the prevalence of and associations with forced labour experiences among male migrants from Dolakha, Nepal? Findings from a cross-sectional study of returnee migrants
Authors: Mak Joelle , Abramsky Tanya , Sijapati Bandita , Kiss Ligia , Zimmerman Cathy 
Published: August 2017

ObjectivesGrowing numbers of people are migrating outside their country for work, and many experience precarious conditions, which have been linked to poor physical and mental health. While international dialogue on human trafficking, forced labour and slavery increases, prevalence data of such experiences remain limited.MethodsMen from Dolakha, Nepal, who had ever migrated outside of Nepal for work were interviewed on their experiences, from predeparture to return (n=194). Forced labour was assessed among those who returned within the past 10 years (n=140) using the International Labour Organization's forced labour dimensions: (1)unfree recruitment; (2)work and life under duress; and (3)impossibility to leave employer. Forced labour is positive if any one of the dimensions is positive.ResultsParticipants had worked in India (34%), Malaysia (34%) and the Gulf Cooperation Council countries (29%), working in factories (29%), as labourers/porters (15%) or in skilled employment (12%). Among more recent returnees (n=140), 44% experiencedunfree recruitment, 71%work and life under duressand 14%impossibility to leave employer. Overall, 73% experienced forced labour during their most recent labour migration.Forced labour was more prevalent among those who had taken loans for their migration (PR 1.23) and slightly less prevalent among those who had migrated more than once (PR 0.87); however the proportion of those who experienced forced labour was still high (67%). Age, destination and duration of stay were associated with only certain dimensions of forced labour.ConclusionForced labour experiences were common during recruitment and at destination. Migrant workers need better advice on assessing agencies and brokers, and on accessing services at destinations. As labour migration from Nepal is not likely to reduce in the near future, interventions and policies at both source and destinations need to better address the challenges migrants face so they can achieve safer outcomes.
Exploring newly qualified doctors' workplace stressors: an interview study from Australia
Authors: Tallentire Victoria R , Smith Samantha E , Facey Adam D , Rotstein Laila 
Published: August 2017

PurposePostgraduate year 1 (PGY1) doctors suffer from high levels of psychological distress, yet the contributory factors are poorly understood. This study used an existing model of workplace stress to explore the elements most pertinent to PGY1 doctors. In turn, the data were used to amend and refine the conceptual model to better reflect the unique experiences of PGY1 doctors.MethodFocus groups were undertaken with PGY1 doctors working at four different health services in Victoria, Australia. Transcripts were coded using Michie's model of workplace stress as the initial coding template. Remaining text was coded inductively and the supplementary codes were used to modify and amplify Michie's framework.ResultsThere were 37 participants in total. Key themes included stressors intrinsic to the job, such as work overload and long hours, as well as those related to the context of work such as lack of role clarity and relationships with colleagues. The main modification to Michie's framework was the addition of the theme of uncertainty. This concept related to most of the pre-existing themes in complex ways, culminating in an overall sense of anxiety.ConclusionsMichie's model of workplace stress can be effectively used to explore the stressors experienced by PGY1 doctors. Pervasive uncertainty may help to explain the high levels of psychological morbidity in this group. While some uncertainty will always remain, the medical education community must seek ways to improve role clarity and promote mutual respect.
Effectiveness of rehabilitation after a total hip arthroplasty: a protocol for an observational study for the comparison of usual care in the Netherlands versus Germany
Authors: Seeber Gesine H , Wijnen Annet , Lazovic Djordje , Bulstra Sjoerd K , Dietz Günter , van Lingen Christiaan P , Stevens Martin 
Published: August 2017

IntroductionOsteoarthritis is the most common joint disorder worldwide. Total hip arthroplasty (THA) is considered one of the most effective treatments for end-stage hip osteoarthritis. The number of THAs is expected to increase dramatically in the coming decades. Usual postoperative rehabilitation after primary THA differs between the German and the Dutch system. In the Netherlands, patients undergo fast-track surgery and are discharged into their home environment within a few days without receiving any aftercare. In Germany, patients stay in the hospital for about 12 days before being transferred to a rehabilitation centre for a period of 3 weeks. The superficially more cost-effective Dutch system of usual care after THA is judged critically in both countries due to suboptimal rehabilitation outcomes. The aim of this study is therefore to compare the Dutch with the German usual care rehabilitation after primary THA. It is hypothesised that the German procedure is more effective in terms of functional outcomes and patient satisfaction than the Dutch procedure and that in the long run the German approach is more cost-effective than the Dutch system.Methods and analysisMedical effectiveness will be assessed at four different time points by means of patient self-reported questionnaires and functional tests. Assessments include the Hip disability and Osteoarthritis Outcome Score, Patient Acceptable Symptom State, Short Form 36, EuroQol 5 Dimensions 3 Level Questionnaire, Timed Up & Go Test and Five Times Sit-to-Stand Test. Additionally, long-term economic aspects in both countries will be assessed from a societal perspective, to get a first impression on whether cutting costs for rehabilitation, as practised in the Netherlands, really disburdens the healthcare system efficiently.Ethics and disseminationThe study is approved by the Institutional Review Boards of both University Medical Center Groningen (METc2015/483) and Hannover Medical School (no 2874-2015) and will be conducted according to the principles of the Declaration of Helsinki (64th, 2013). The results of the study will be published in international peer-reviewed scientific journals. Patient data will be presented anonymously in any publication or scientific journal.Trial registration numberDRKS00011345; Pre-results.
Transformation of mortality in a remote Australian Aboriginal community: a retrospective observational study
Authors: Hoy Wendy E , Mott Susan Anne , McLeod Beverly June 
Published: August 2017

ObjectivesTo describe trends in ages and causes of death in a remote-living Australian Aboriginal group over a recent 50-year period.DesignA retrospective observational study, from 1960 to 2010, of deaths and people starting dialysis, using data from local clinic, parish, dialysis and birthweight registers.SettingA remote island community in the Top End of Australia’s Northern Territory, where a Catholic mission was established in 1911. The estimated Aboriginal population was about 800 in 1960 and 2260 in 2011.ParticipantsAll Aboriginal residents of this community whose deaths had been recorded.Outcome measuresAnnual frequencies and rates of terminal events (deaths and dialysis starts) by age group and cause of death.ResultsAgainst a background of high rates of low birth weight, 223 deaths in infants and children and 934 deaths in adults (age>15 years) were recorded; 88% were of natural causes. Most deaths in the 1960s were in infants and children. However, over time these fell dramatically, across the birthweight spectrum, while adult deaths progressively increased. The leading causes of adult natural deaths were chronic lung disease, cardiovascular disease and, more recently, renal failure, and rates were increased twofold in those of low birth weight. However, rates of natural adult deaths have been falling briskly since 1986, most markedly among people of age ≥45 years. The population is increasing and its age structure is maturing.ConclusionsThe changes in death profiles, the expression of the Barker hypothesis and the ongoing increases in adult life expectancy reflect epidemiological and health transitions of astonishing rapidity. These probably flow from advances in public health policy and healthcare delivery, as well as improved inter-sectoral services, which are all to be celebrated. Other remote communities in Australia are experiencing the same phenomena, and similar events are well advanced in many developing countries.
Outcome of revascularisation in stable coronary artery disease without ischaemia: a Danish registry-based follow-up study
Authors: Simonsen Jane Angel , Mickley Hans , Johansen Allan , Hess Søren , Thomassen Anders , Gerke Oke , Jensen Lisette O , Hallas Jesper , Vach Werner , Hoilund-Carlsen Poul F 
Published: August 2017

ObjectivesIn stable coronary artery disease (CAD), coronary revascularisation may reduce mortality of patients with a certain amount of left ventricular myocardial ischaemia. However, revascularisation does not always follow the guidance suggested by ischaemia testing. We compared outcomes in patients without ischaemia who had either revascularisation or medical treatment.Design and populationBased on registries, 1327 consecutive patients with normal myocardial perfusion scintigraphy (MPS) and 278 with fixed perfusion defects were followed for a median of 6.1 years. Most patients received medical therapy alone (Med), but 26 (2%) with a normal MPS and 15 (5%) with fixed perfusion defects underwent revascularisation (Revasc).Outcome measuresIncidence rates of all-cause death (ACD) and rates of cardiac death/myocardial infarction (CD/MI).ResultsWith a normal MPS, the ACD rate was 6.2%/year in the Revasc group versus 1.9%/year in the Med group (p=0.01); the CD/MI rates were 6.9%/year and 0.6%/year, respectively (p<0.00001). Results persisted after adjustment for predictors of revascularisation, in particular angina score, and in comparisons of matched Revasc and Med patients. With fixed defects, the ACD rate was 9.1%/year in the Revasc group and 6.7%/year in the Med group (p=0.44); the CD/MI rate was 5.0%/year versus 4.2%/year, respectively (p=0.69). If adjusted for angiographic variables or analysed in matched subsets, differences remained insignificant.ConclusionsWith normal MPS, revascularisation conferred a higher risk, even after adjustment for predictors of revascularisation. With fixed defects, the Revascversus Med difference was close to equipoise. Hence, in patients with stable CAD without ischaemia, we could not find evidence to justify exceptional revascularisation.
Value of light microscopy to diagnose urogenital gonorrhoea: a diagnostic test study in Indonesian clinic-based and outreach sexually transmitted infections services
Authors: Hananta I Putu Yuda , van Dam Alje P , Bruisten Sylvia Maria , van der Loeff Maarten Franciscus Schim , Soebono Hardyanto , Christiaan de Vries Henry John 
Published: August 2017

IntroductionGonorrhoea is a common sexually transmitted disease caused byNeisseria gonorrhoeae(Ng) infection. Light microscopy of urogenital smears is used as a simple tool to diagnose urogenital gonorrhoea in many resource-limited settings. We aimed to evaluate the accuracy of light microscopy to diagnose urogenital gonorrhoea as compared with a PCR-based test.MethodsIn 2014, we examined 632 male urethral and 360 endocervical smears in clinic-based and outreach settings in Jakarta, Yogyakarta and Denpasar, Indonesia. Using the detection of Ng DNA by a validated PCR as reference test, we evaluated the accuracy of two light microscopic criteria to diagnose urogenital gonorrhoea in genital smears: (1) the presence of intracellular Gram-negative diplococci (IGND) and (2) ≥5 polymorphonuclear leucocytes (PMNL)/oil-immersion field (oif) in urethral or ≥20 PMNL/oif in endocervical smears.ResultsIn male urethral smears, IGND testing had a sensitivity (95% CI), specificity (95% CI) and kappa±SE of 59.0% (50.1 to 67.4), 89.4% (86.3 to 91.9) and 0.49±0.04, respectively. For PMNL count, these were 59.0% (50.1 to 67.4), 83.7% (80.2 to 86.9) and 0.40±0.04, respectively. The accuracy of IGND in the clinic-based settings (72.0% (57.5 to 83.3), 95.2% (91.8 to 97.5) and 0.68±0.06, respectively) was better than in the outreach settings (51.2% (40.0 to 62.3), 83.4% (78.2 to 87.8) and 0.35±0.06, respectively). In endocervical smears, light microscopy performed poorly regardless of the setting or symptomatology, with kappas ranging from −0.09 to 0.24.ConclusionLight microscopy using IGND and PMNL criteria can be an option with moderate accuracy to diagnose urethral gonorrhoea among males in a clinic-based setting. The poor accuracy in detecting endocervical infections indicates an urgent need to implement advanced methods, such as PCR. Further investigations are needed to identify the poor diagnostic outcome in outreach services.
A cost-effectiveness comparison of the NICE 2015 and WHO 2013 diagnostic criteria for women with gestational diabetes with and without risk factors
Authors: Jacklin Paul Brian , Maresh Michael JA , Patterson Chris C , Stanley Katharine P , Dornhorst Anne , Burman-Roy Shona , Bilous Rudy W 
Published: August 2017

ObjectivesTo compare the cost-effectiveness (CE) of the National Institute for Health and Care Excellence (NICE) 2015 and the WHO 2013 diagnostic thresholds for gestational diabetes mellitus (GDM).SettingThe analysis was from the perspective of the National Health Service in England and Wales.Participants6221 patients from four of the Hyperglycaemia and Adverse Pregnancy Outcomes (HAPO) study centres (two UK, two Australian), 6308 patients from the Atlantic Diabetes in Pregnancy study and 12 755 patients from UK clinical practice.Primary and secondary outcome measures plannedThe incremental cost per quality-adjusted life year (QALY), net monetary benefit (NMB) and the probability of being cost-effective at CE thresholds of £20 000 and £30 000 per QALY.ResultsIn a population of pregnant women from the four HAPO study centres and using NICE-defined risk factors for GDM, diagnosing GDM using NICE 2015 criteria had an NMB of £239 902 (relative to no treatment) at a CE threshold of £30 000 per QALY compared with WHO 2013 criteria, which had an NMB of £186 675. NICE 2015 criteria had a 51.5% probability of being cost-effective compared with the WHO 2013 diagnostic criteria, which had a 27.6% probability of being cost-effective (no treatment had a 21.0% probability of being cost-effective). For women without NICE risk factors in this population, the NMBs for NICE 2015 and WHO 2013 criteria were both negative relative to no treatment and no treatment had a 78.1% probability of being cost-effective.ConclusionThe NICE 2015 diagnostic criteria for GDM can be considered cost-effective relative to the WHO 2013 alternative at a CE threshold of £30 000 per QALY. Universal screening for GDM was not found to be cost-effective relative to screening based on NICE risk factors.