bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acupuncture as analgesia for non-emergent acute non-specific neck pain, ankle sprain and primary headache in an emergency department setting: a protocol for a parallel group, randomised, controlled pilot trial
Authors: Kim Kun Hyung , Ryu Ji Ho , Park Maeng Real , Kim Yong In , Min Mun Ki , Park Yong Myeon , Kim Yu Ri , Noh Seung Hee , Kang Min Joo , Kim Young Jun , Kim Jae Kyu , Lee Byung Ryul , Choi Jun Yong , Yang Gi Young 
Published: June 2014

IntroductionThis study aims to assess the feasibility of acupuncture as an add-on intervention for patients with non-emergent acute musculoskeletal pain and primary headache in an emergency department (ED) setting.Methods and analysisA total of 40 patients who present to the ED and are diagnosed to have acute non-specific neck pain, ankle sprain or primary headache will be recruited by ED physicians. An intravenous or intramuscular injection of analgesics will be provided as the initial standard pain control intervention for all patients. Patients who still have moderate to severe pain after the 30 min of initial standard ED management will be considered eligible. These patients will be allocated in equal proportions to acupuncture plus standard ED management or to standard ED management alone based on computer-generated random numbers concealed in opaque, sealed, sequentially numbered envelopes. A 30 min session of acupuncture treatment with manual and/or electrical stimulation will be provided by qualified Korean medicine doctors. All patients will receive additional ED management at the ED physician's discretion and based on each patient's response to the allocated intervention. The primary outcome will be pain reduction measured at discharge from the ED by an unblinded assessor. Adverse events in both groups will be documented. Other outcomes will include the patient-reported overall improvement, disability due to neck pain (only for neck-pain patients), the treatment response rate, the use of other healthcare resources and the patients’ perceived effectiveness of the acupuncture treatment. A follow-up telephone interview will be conducted by a blinded assessor 72±12 h after ED discharge.Ethics and disseminationWritten informed consent will be obtained from all participants. The study has been approved by the Institutional Review Boards (IRBs). The results of this study will guide a full-scale randomised trial of acupuncture in an ED context.Trial registration numberClinicalTrials.gov:NCT02013908.
Insurance claims data: a possible solution for a national sports injury surveillance system? An evaluation of data information against ASIDD and consensus statements on sports injury surveillance
Authors: Åman Malin , Forssblad Magnus , Henriksson-Larsén Karin 
Published: June 2014

BackgroundBefore preventive actions can be suggested for sports injuries at the national level, a solid surveillance system is required in order to study their epidemiology, risk factors and mechanisms. There are guidelines for sports injury data collection and classifications in the literature for that purpose. In Sweden, 90% of all athletes (57/70 sports federations) are insured with the same insurance company and data from their database could be a foundation for studies on acute sports injuries at the national level.ObjectiveTo evaluate the usefulness of sports injury insurance claims data in sports injury surveillance at the national level.MethodA database with 27 947 injuries was exported to an Excel file. Access to the corresponding text files was also obtained. Data were reviewed on available information, missing information and dropouts. Comparison with ASIDD (Australian Sports Injury Data Dictionary) and existing consensus statements in the literature (football (soccer), rugby union, tennis, cricket and thoroughbred horse racing) was performed in a structured manner.ResultComparison with ASIDD showed that 93% of the suggested data items were present in the database to at least some extent. Compliance with the consensus statements was generally high (13/18). Almost all claims (83%) contained text information concerning the injury.ConclusionsRelatively high-quality sports injury data can be obtained from a specific insurance company at the national level in Sweden. The database has the potential to be a solid base for research on acute sports injuries in different sports at the national level.
Clinical characteristics and short-term outcomes in patients with elevated admission systolic blood pressure after acute ST-elevation myocardial infarction: a population-based study
Authors: Huang Bi , Yang Yanmin , Zhu Jun , Liang Yan , Tan Huiqiong 
Published: June 2014

ObjectivePrognostic value of lower admission systolic blood pressure (SBP) in patients with acute myocardial infarction has been confirmed, but the impact of elevated admission SBP on short-term outcomes has been evaluated only by a limited number of studies and they have reported conflicting results. The aim of our study was to investigate the characteristics and short-term outcomes in patients with elevated admission SBP after ST-elevation myocardial infarction (STEMI).DesignA population-based, observational study.SettingThe multicentre registry in China.ParticipantsA total of 7510 consecutive patients with STEMI were registered. Patients were divided into three groups according to admission SBP: normal admission SBP (100–139 mm Hg), modestly elevated admission SBP (140–179 mm Hg) and excessively elevated admission SBP (≥180 mm Hg). The primary outcomes were 7-day and 30-day all-cause mortality, major adverse cardiac events (MACE) and bleeding rate.ResultsOf 6591 patients, 4182 (63.5%) had normal admission SBP, 2187 (33.2%) modestly elevated admission SBP and 222 (3.4%) excessively elevated admission SBP. Patients with elevated admission SBP had a high-risk profile, such as were more likely to be older, with more concomitant cardiovascular morbidities, presenting with more events of anterior myocardial infarction and less reperfusion treatment. However, 7-day and 30-day all-cause mortality, MACE and bleeding rate were comparable among groups (all p>0.05). Survival curves and MACE curves were similar among groups (p=0.377 and 0.375, respectively). After multivariate adjustment, elevated admission SBP was not associated with increased risk of short-term death and bleeding, and MACE was comparable with normal admission SBP.ConclusionsAlthough those with elevated admission SBP after STEMI were at a higher risk for cardiovascular events, they did not have poorer short-term outcomes compared with patients with normal admission SBP.
A population-based cross-sectional study of barriers to uptake of eye care services in South India: the Rapid Assessment of Visual Impairment (RAVI) project
Authors: Marmamula Srinivas , Khanna Rohit C , Shekhar Konegari , Rao Gullapalli N 
Published: June 2014

ObjectiveTo assess the barriers to uptake of eye care services among those with avoidable impairment in the population aged ≥40 years in the South Indian state of Andhra Pradesh.DesignCross-sectional study.SettingCommunity setting.ParticipantsOf 7800 participants recruited from one urban and two rural locations using a two-stage cluster random sampling methodology, 7378 (95%) were examined. Eye examinations were conducted using a rapid assessment protocol. Visual impairment (VI) was defined as presenting visual acuity <6/18 in the better eye. For the purpose of this study, VI caused due to cataract or uncorrected refractive error was considered avoidable VI. A validated questionnaire was used to collect information on barriers for uptake of services among those who had avoidable VI.Primary outcomeBarriers to uptake of services among those with avoidable VI.ResultsThe prevalence of avoidable VI was 11.8% (95% CI 11.0% to 12.5%; n=868). Among these, 71.1% (n=617) individuals reported ‘person-related’ barriers whereas 28.9% (n=251) individuals reported ‘service-related’ barriers to uptake of services. Among the ‘person-related’ barriers, the leading barrier was ‘lack of perceived need’ (61.1%; n=377) for reasons such as old age, good vision in the other eye. This was followed by ‘no one to accompany’ (20.3%; n=125). Of the 251 individuals who had ‘service-related’ barriers, lack of affordability was the major barrier (76.1%; n=191) followed by lack of accessibility (12.7%; n=32). Over 11% (n=28) of the individuals were advised to wait for cataract surgery.ConclusionsPerson-related barriers are more common than service-related barriers in Andhra Pradesh. As the barriers trend more towards ‘person-related’ phenomenon such as person's attitude and ‘felt need’ to improve vision, newer and much intensive awareness campaigns are needed to bring about an attitudinal/behavioural change among individuals to improve the uptake of services.
Long-term clinical outcomes after deployment of femoral vascular closure devices in coronary angiography and percutaneous coronary intervention: an observational single-centre registry follow-up
Authors: Lee Stephen Wai-Luen , Tam Chor-Cheung , Wong Ka-Lam , Kong Shun-Ling , Yung See-Yue , Wong Yiu-Tung , Chiu Suk-Yee , Lam Cheung-Chi , Chan Ki-Wan , Chan Hon-Wah 
Published: June 2014

ObjectivesThere are few data evaluating the long-term effect of femoral vascular closure devices (FCDs) on patients’ clinical outcome. We aim to evaluate the incidence of peripheral vascular disease (PVD) in patients who received FCD following its deployment in coronary angiography and percutaneous coronary intervention (PCI) procedures.Design and settingObservational study of a single-centre registry.ParticipantsFrom June 2000 to September 2004, 265 patients who received FCD after coronary angiography and PCIs were enrolled on the study.Outcome measuresClinical follow-up (using Rutherford's categories of claudication), ankle brachial index (ABI) and duplex ultrasound of femoral arteries (using the non-accessed side as control) were performed to evaluate the presence of PVD.ResultsThe mean follow-up interval was 3320±628 days. 1 patient (0.4%) suffered from grade 2 claudication and another (0.4%) suffered from grade 1 claudication. The mean ABIs of the accessed side and non-accessed side were 1.06±0.13 and 1.08±0.11, respectively (p=0.17). For duplex ultrasound, the mean common femoral artery peak systolic velocities of the accessed side and non-accessed side were 87.4±22.3 and 87.7±22.1 cm/s, respectively (p=0.73); the mean superficial femoral artery peak systolic velocities of the accessed side and non-accessed side were 81.4±20.1 and 81.31±17.8 cm/s, respectively (p=0.19).ConclusionsThe use of FCD after a coronary angiogram and PCI is safe and does not increase the long-term risk of PVD.
Passive smoking at home is a risk factor for community-acquired pneumonia in older adults: a population-based case–control study
Authors: Almirall Jordi , Serra-Prat Mateu , Bolíbar Ignasi , Palomera Elisabet , Roig Jordi , Hospital Imma , Carandell Eugenia , Agustí Mercè , Ayuso Pilar , Estela Andreu , Torres Antoni ,   the Study Group of Community-Acquired Pneumonia in Catalan Countries (PACAP)
Published: June 2014

ObjectiveTo assess whether passive smoking exposure at home is a risk factor for community-acquired pneumonia (CAP) in adults.SettingA population-based case-control study was designed in a Mediterranean area with 860 000 inhabitants >14 years of age.Participants1003 participants who had never smoked were recruited.Primary and secondary outcome measuresRisk factors for CAP, including home exposure to passive smoking, were registered. All new cases of CAP in a well-defined population were consecutively recruited during a 12-month period.MethodsA population-based case-control study was designed to assess risk factors for CAP, including home exposure to passive smoking. All new cases of CAP in a well-defined population were consecutively recruited during a 12-month period. The subgroup of never smokers was selected for the present analysis.ResultsThe study sample included 471 patients with CAP and 532 controls who had never smoked. The annual incidence of CAP was estimated to be 1.14 cases×10–3inhabitants in passive smokers and 0.90×10−3in non-passive smokers (risk ratio (RR) 1.26; 95% CI 1.02 to 1.55) in the whole sample. In participants ≥65 years of age, this incidence was 2.50×10−3in passive smokers and 1.69×10−3in non-passive smokers (RR 1.48, 95% CI 1.08 to 2.03). In this last age group, the percentage of passive smokers in cases and controls was 26% and 18.1%, respectively (p=0.039), with a crude OR of 1.59 (95% CI 1.02 to 2.38) and an adjusted (by age and sex) OR of 1.56 (95% CI 1.00 to 2.45).ConclusionsPassive smoking at home is a risk factor for CAP in older adults (65 years or more).
Effect of a redesigned fracture management pathway and ‘virtual’ fracture clinic on ED performance
Authors: Vardy J , Jenkins P J , Clark K , Chekroud M , Begbie K , Anthony I , Rymaszewski L A , Ireland A J 
Published: June 2014

ObjectivesCollaboration between the orthopaedic and emergency medicine (ED) services has resulted in standardised treatment pathways, leaflet supported discharge and a virtual fracture clinic review. Patients with minor, stable fractures are discharged with no further follow-up arranged. We aimed to examine the time taken to assess and treat these patients in the ED along with the rate of unplanned reattendance.DesignA retrospective study was undertaken that covered 1 year before the change and 1 year after. Prospectively collected administrative data from the electronic patient record system were analysed and compared before and after the change.SettingAn ED and orthopaedic unit, serving a population of 300 000, in a publicly funded health system.Participants2840 patients treated with referral to a traditional fracture clinic and 3374 patients managed according to the newly redesigned protocol.Outcome measuresTime for assessment and treatment of patients with orthopaedic injuries not requiring immediate operative management, and 7-day unplanned reattendance.ResultsWhere plaster backslabs were replaced with removable splints, the consultation time was reduced. There was no change in treatment time for other injuries treated by the new discharge protocol. There was no increase in unplanned ED attendance, related to the injury, within 7 days (p=0.149). There was a decrease in patients reattending the ED due to a missed fracture clinic appointment.ConclusionsThis process did not require any new time resources from the ED staff. This process brought significant benefits to the ED as treatment pathways were agreed. The pathway reduced unnecessary reattendance of patients at face-to-face fracture clinics for a review of stable, self-limiting injuries.
Effect of exercise on anthropometric measures and serum lipids in older individuals: a systematic review and meta-analysis
Authors: Kuhle Carol L , Steffen Mark W , Anderson Paul J , Murad Mohammad Hassan 
Published: June 2014

ObjectivesOverweight and obesity are increasing in individuals over age 60 years. This systematic review quantifies the effect of exercise on body mass index (BMI), waist circumference (WC) and lipids in overweight and obese individuals over the age of 60 years.SettingsNine randomised controlled trials conducted in Brazil, Great Britain, Iceland, Japan and the USA compared aerobic and/or resistance exercise with a control group.ParticipantsFinal analysis reviewed 1166 participants over the age of 60 years for 3–9 months.Primary outcome measuresThis study reviewed the effects of exercise on BMI, WC and low-density lipoprotein (LDL).ResultsExercise produced a significant reduction in BMI (−1.01 kg/m2, 95% CI −2.00 to −0.01) and WC (−3.09 cm, 95% CI −4.14 to −2.04) but not LDL cholesterol (−0.31 mg/dL, 95% CI −0.81 to 0.19). Analyses revealed substantial heterogeneity likely due to the type and intensity of exercise. Data on adverse effects were minimal. The overall level of evidence is moderate due to imprecision and heterogeneity.ConclusionsExercise in overweight and obese older individuals improves anthropometric measures such as BMI and WC. The effect of exercise on serum lipids is unclear.
A hard pill to swallow: a qualitative study of women's experiences of adjuvant endocrine therapy for breast cancer
Authors: Harrow Alison , Dryden Ruth , McCowan Colin , Radley Andrew , Parsons Mark , Thompson Alastair M , Wells Mary 
Published: June 2014

ObjectiveTo explore women's experiences of taking adjuvant endocrine therapy as a treatment for breast cancer and how their beliefs about the purpose of the medication, side effects experienced and interactions with health professionals might influence adherence.DesignQualitative study using semistructured, one-to-one interviews.Setting2 hospitals from a single health board in Scotland.Participants30 women who had been prescribed tamoxifen or aromatase inhibitors (anastrozole or letrozole) and had been taking this medication for 1–5 years.ResultsWomen clearly wished to take their adjuvant endocrine therapy medication as prescribed, believing that it offered them protection against breast cancer recurrence. However, some women missed tablets and did not recognise that this could reduce the efficacy of the treatment. Women did not perceive that healthcare professionals were routinely or systematically monitoring their adherence. Side effects were common and impacted greatly on the women’s quality of life but did not always cause women to stop taking their medication, or to seek advice about reducing the side effects they experienced. Few were offered the opportunity to discuss the impact of side effects or the potential options available.ConclusionsAlthough most women in this study took adjuvant endocrine therapy as prescribed, many endured a range of side effects, often without seeking help. Advice, support and monitoring for adherence are not routinely offered in conventional follow-up settings. Women deserve more opportunity to discuss the pros, cons and impact of long-term adjuvant endocrine therapy. New service models are needed to support adherence, enhance quality of life and ultimately improve survival. These should ideally be community based, in order to promote self-management in the longer term.
How common are symptoms? Evidence from a New Zealand national telephone survey
Authors: Petrie Keith J , Faasse Kate , Crichton Fiona , Grey Andrew 
Published: June 2014

ObjectiveTo assess the frequency of symptoms in a general population sample over the previous week and the associations between symptom reporting and demographic factors, medical visits and medication use.DesignA representative general population sample (n=1000) was recruited using random digit dialling. Participants were asked whether they had experienced any of a list of 46 symptoms in the previous 7 days and if so, whether the symptom was mild, moderate or severe. Demographic data and information on medical visits and medication use were also collected.ResultsSymptom reporting was very common. The median number of symptoms reported by participants in the previous week was 5 with only 10.6% of participants reporting no symptoms. The five most common symptoms in the previous 7 days were: back pain (38%), fatigue (36%), headache (35%), runny or stuffy nose (34%) and joint pain (34%). The five symptoms rated highest in terms of severity were sexual difficulties, vomiting, tremor, suicidal thoughts and sleep problems. Symptom reporting was significantly positively associated with medical visits in the previous year and current medication taking. Women reported a significantly greater number of symptoms. We found no significant association between age or household size and symptom reporting.ConclusionsThis population-based study found that symptoms are more commonly experienced in the general population than previously estimated and are strongly associated with healthcare visits. Appreciation of the high prevalence of symptoms may help normalise the experience of symptom reports among the general population.
Maternal urinary iodine concentration in pregnancy and children's cognition: results from a population-based birth cohort in an iodine-sufficient area
Authors: Ghassabian Akhgar , Steenweg-de Graaff Jolien , Peeters Robin P , Ross H Alec , Jaddoe Vincent W , Hofman Albert , Verhulst Frank C , White Tonya , Tiemeier Henning 
Published: June 2014

ObjectiveReports from populations with an insufficient iodine intake suggest that children of mothers with mild iodine deficiency during pregnancy are at risk for cognitive impairments. However, it is unknown whether, even in iodine-sufficient areas, low levels of iodine intake occur that influence cognitive development in the offspring. This study investigated the association between maternal low urinary iodine concentration (UIC) in pregnancy and children's cognition in a population-based sample from a country with an optimal iodine status (the Netherlands).Setting and participantsIn 1525 mother–child pairs in a Dutch multiethnic birth cohort, we investigated the relation between maternal UIC<150 μg/g creatinine, assessed <18 weeks gestation and children's cognition.Outcomes measuresNon-verbal IQ and language comprehension were assessed during a visit to the research centre using Dutch test batteries when the children were 6 years.ResultsIn total, 188 (12.3%) pregnant women had UIC<150 μg/g creatinine, with a median UIC equal to 119.3 μg/g creatinine. The median UIC in the group with UIC>150 μg/g creatinine was 322.9 μg/g and in the whole sample 296.5 μg/g creatinine. There was a univariate association between maternal low UIC and children's suboptimum non-verbal IQ (unadjusted OR=1.44, 95% CI 1.02 to 2.02). However, after adjustment for confounders, maternal low UIC was not associated with children's non-verbal IQ (adjusted OR=1.33, 95% CI 0.92 to 1.93). There was no relation between maternal UIC in early pregnancy and children's language comprehension at 6 years.ConclusionsThe lack of a clear association between maternal low UIC and children's cognition probably reflects that low levels of iodine were not frequent and severe enough to affect neurodevelopment. This may result from the Dutch iodine fortification policy, which allows iodised salt to be added to almost all processed food and emphasises the monitoring of iodine intake in the population.