bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors influencing the length of hospital stay among patients resident in Blackpool admitted with COPD: a cross-sectional study
Authors: Agboado Gabriel , Peters Jonathan , Donkin Lynn 
Published: September 2012

ObjectivesTo identify the differential effects of patient, health service, temporal and geographic factors on length of stay (LOS) for chronic obstructive pulmonary disease (COPD)-related admissions.DesignWe used stratified Cox proportional hazard model to evaluate the association between LOS and patient, health service, temporal and geographical factors.SettingPatients resident in Blackpool, North West England, admitted to the local hospital with COPD.ParticipantsWe used the Admitted Patient Care General Episode Commissioning Dataset for the period 1 April 2005–31 March 2010. We analysed records of admission spells among patients resident in Blackpool aged 40 years or older admitted with a primary diagnosis of COPD.ResultsThere were 2410 admissions meeting the inclusion criteria over the period. These admissions were attributed to 1172 COPD patients, an average of 2.06 admissions per patient. The median LOS was 6 days (95% CI 6 to 6) while the mean was 9.8 days (95% CI 9.1 to 10.5). Patients were 22% more likely to be discharged earlier in 2009/2010 compared with 2005/2006 (adjusted HR 1.22; p=0.0100). LOS was associated with socioeconomic deprivation with those in the most deprived areas being 35% less likely to be discharged earlier compared with those from the least deprived areas (adjusted HR 0.65; p=0.0010).ConclusionsLOS among COPD patients have reduced over the period of the study. Age, deprivation, Charlson index, specialty of admission and cause of exacerbations were independently associated with LOS. Though there were no significant associations between LOS and season of admission and distance from hospital, there were significant variations in LOS associated with these variables based on selected patient characteristics.
Development of an economic model to assess the cost-effectiveness of hawthorn extract as an adjunct treatment for heart failure in Australia
Authors: Ford Emily , Adams Jon , Graves Nicholas 
Published: September 2012

ObjectiveAn economic model was developed to evaluate the cost-effectiveness of hawthorn extract as an adjunctive treatment for heart failure in Australia.MethodsA Markov model of chronic heart failure was developed to compare the costs and outcomes of standard treatment and standard treatment with hawthorn extract. Health states were defined by the New York Heart Association (NYHA) classification system and death. For any given cycle, patients could remain in the same NYHA class, experience an improvement or deterioration in NYHA class, be hospitalised or die. Model inputs were derived from the published medical literature, and the output was quality-adjusted life years (QALYs). Probabilistic sensitivity analysis was conducted. The expected value of perfect information (EVPI) and the expected value of partial perfect information (EVPPI) were conducted to establish the value of further research and the ideal target for such research.ResultsHawthorn extract increased costs by $1866.78 and resulted in a gain of 0.02 QALYs. The incremental cost-effectiveness ratio was $85 160.33 per QALY. The cost-effectiveness acceptability curve indicated that at a threshold of $40 000 the new treatment had a 0.29 probability of being cost-effective. The average incremental net monetary benefit (NMB) was −$1791.64, the average NMB for the standard treatment was $92 067.49, and for hawthorn extract $90 275.84. Additional research is potentially cost-effective if research is not proposed to cost more than $325 million. Utilities form the most important target parameter group for further research.ConclusionsHawthorn extract is not currently considered to be cost-effective in as an adjunctive treatment for heart failure in Australia. Further research in the area of utilities is warranted.
Barriers to the uptake of evidence from systematic reviews and meta-analyses: a systematic review of decision makers’ perceptions
Authors: Wallace John , Nwosu Bosah , Clarke Mike 
Published: September 2012

ObjectiveTo review the barriers to the uptake of research evidence from systematic reviews by decision makers.Search strategyWe searched 19 databases covering the full range of publication years, utilised three search engines and also personally contacted investigators. Reference lists of primary studies and related reviews were also consulted.Selection criteriaStudies were included if they reported on the views and perceptions of decision makers on the uptake of evidence from systematic reviews, meta-analyses and the databases associated with them. All study designs, settings and decision makers were included. One investigator screened titles to identify candidate articles then two reviewers independently assessed the quality and the relevance of retrieved reports.Data extractionTwo reviewers described the methods of included studies and extracted data that were summarised in tables and then analysed. Using a pre-established taxonomy, the barriers were organised into a framework according to their effect on knowledge, attitudes or behaviour.ResultsOf 1726 articles initially identified, we selected 27 unique published studies describing at least one barrier to the uptake of evidence from systematic reviews. These studies included a total of 25 surveys and 2 qualitative studies. Overall, the majority of participants (n=10 218) were physicians (64%). The most commonly investigated barriers were lack of use (14/25), lack of awareness (12/25), lack of access (11/25), lack of familiarity (7/25), lack of usefulness (7/25), lack of motivation (4/25) and external barriers (5/25).ConclusionsThis systematic review reveals that strategies to improve the uptake of evidence from reviews and meta-analyses will need to overcome a wide variety of obstacles. Our review describes the reasons why knowledge users, especially physicians, do not call on systematic reviews. This study can inform future approaches to enhancing systematic review uptake and also suggests potential avenues for future investigation.
Lung Injury Prevention with Aspirin (LIPS-A): a protocol for a multicentre randomised clinical trial in medical patients at high risk of acute lung injury
Authors: Kor Daryl Jon , Talmor Daniel S , Banner-Goodspeed Valerie M , Carter Rickey E , Hinds Richard , Park Pauline K , Gajic Ognjen , Gong Michelle N 
Published: September 2012

IntroductionAcute lung injury (ALI) is a devastating condition that places a heavy burden on public health resources. Although the need for effective ALI prevention strategies is increasingly recognised, no effective preventative strategies exist. The Lung Injury Prevention Study with Aspirin (LIPS-A) aims to test whether aspirin (ASA) could prevent and/or mitigate the development of ALI.Methods and analysisLIPS-A is a multicentre, double-blind, randomised clinical trial testing the hypothesis that the early administration of ASA will result in a reduced incidence of ALI in adult patients at high risk. This investigation will enrol 400 study participants from 14 hospitals across the USA. Conditional logistic regression will be used to test the primary hypothesis that early ASA administration will decrease the incidence of ALI.Ethics and disseminationSafety oversight will be under the direction of an independent Data and Safety Monitoring Board (DSMB). Approval of the protocol was obtained from the DSMB prior to enrolling the first study participant. Approval of both the protocol and informed consent documents were also obtained from the institutional review board of each participating institution prior to enrolling study participants at the respective site. In addition to providing important clinical and mechanistic information, this investigation will inform the scientific merit and feasibility of a phase III trial on ASA as an ALI prevention agent. The findings of this investigation, as well as associated ancillary studies, will be disseminated in the form of oral and abstract presentations at major national and international medical specialty meetings. The primary objective and other significant findings will also be presented in manuscript form. All final, published manuscripts resulting from this protocol will be submitted to Pub Med Central in accordance with the National Institute of Health Public Access Policy.
Transmissibility of the 2009 H1N1 pandemic in remote and isolated Canadian communities: a modelling study
Authors: Mostaço-Guidolin Luiz C , Bowman Chris S , Greer Amy L , Fisman David N , Moghadas Seyed M 
Published: September 2012

ObjectivesDuring the first wave of the 2009 influenza pH1N1, disease burden was distributed in a geographically heterogeneous fashion. It was particularly high in some remote and isolated Canadian communities when compared with urban centres. We sought to estimate the transmissibility (the basic reproduction number) of pH1N1 strain in some remote and isolated Canadian communities.DesignA discrete time susceptible-exposed-infected transmission model was fit to infection curves simulated from laboratory-confirmed case counts for pH1N1 on each day. The sampling from Poisson distribution was used to estimate the basic reproduction number, R0, of pH1N1 during the spring wave for five different communities in Manitoba and Nunavut, Canada, where remote and isolated communities experienced a high incidence of infection, and high rates of hospitalisation and intensive care unit admission.SettingRemote and isolated communities in Northern Manitoba, Nunavut, and the largest urban centre (Winnipeg) in the province of Manitoba, Canada.ResultsUsing published values of the exposed and infectious periods specific to H1N1 infection, corresponding to the average generation time of 2.78 days, we estimated a mean value of 2.26 for R0(95% CI 1.57 to 3.75) in a community located in northern Manitoba. Estimates of R0for other communities in Nunavut varied considerably with higher mean values of 3.91 (95% CI 3.08 to 4.87); 2.03 (95% CI 1.50 to 3.19); and 2.45 (95% CI 1.68 to 3.44). We estimated a lower mean value of 1.57 (95% CI 1.35 to 1.87) for R0in the Winnipeg health region, as the largest urban centre in Manitoba.ConclusionsInfluenza pH1N1 appears to have been far more transmissible in rural and isolated Canadian communities than other large urban areas. The differential severity of the pandemic in these regions may be explained partly by differential transmissibility, and suggests the need for more nuanced, targeted or population-specific control strategies in Canada.
What's in a name generator? Choosing the right name generators for social network surveys in healthcare quality and safety research
Authors: Burt Ronald S , Meltzer David O , Seid Michael , Borgert Amy , Chung Jeanette W , Colletti Richard B , Dellal George , Kahn Stacy A , Kaplan Heather C , Peterson Laura E , Margolis Peter 
Published: September 2012

BackgroundInterest in the use of social network analysis (SNA) in healthcare research has increased, but there has been little methodological research on how to choose the name generators that are often used to collect primary data on the social connection between individuals for SNA.ObjectiveWe sought to determine a minimum set of name generators sufficient to distinguish the social networks of a target population of physicians active in quality improvement (QI).MethodsWe conducted a pilot survey including 8 name generators in a convenience sample of 25 physicians active in QI to characterize their social networks. We used multidimensional scaling to determine what subset of these name generators was needed to distinguish these social networks.ResultsWe found that some physicians maintain a social network organized around a specific colleague who performed multiple roles while others maintained highly differentiated networks. We found that a set of 5 of the 8 name generators we used was needed to distinguish the networks of these physicians.ConclusionsBeyond methodology for selecting name generators, our findings suggest that QI networks may require 5 or more generators to elicit valid sets of relevant actors and relations in this target population.
The accident and emergency department questionnaire: a measure for patients’ experiences in the accident and emergency department
Authors: Bos Nanne , Sizmur Steve , Graham Chris , van Stel Henk F 
Published: September 2012

BackgroundThe National Health Service National Patient Survey Programme systematically gathers patients’ experiences about the care they have recently received. Prioritising quality improvement activities in the accident and emergency (A&E) department requires that survey outcomes are meaningful and reliable. We aimed to determine which method of obtaining summary scores for the A&E department questionnaire optimally combined good interpretability with robust psychometric characteristics.MethodsA&E department questionnaire data from 151 hospital trusts were analysed, covering 49 646 patients. Three methods of grouping and summarising items of the questionnaire were compared: principal components analysis (PCA); Department of Health dimensions; sections according to the patient's journey through the A&E department. The patient-level reliability of summary scores was determined by Cronbach's α coefficients (threshold: α>0.70), construct validity by Pearson's correlation coefficients, and the discriminative capacity by intra-class correlation coefficients (ICCs) and reliability of A&E-level mean scores.ResultsThe PCA provided the best score reliability on six clear and interpretable composites: waiting time; doctors and nurses; your care and treatment; hygiene; information before discharge; overall. The discriminative power of the concepts was comparable for the three methods, with ICCs between 0.010 and 0.061. A&E sample sizes were adequate to obtain good to excellent reliability of A&E-level mean scores.ConclusionsThe A&E department questionnaire is a valid and reliable questionnaire to assess patients’ experiences with the A&E. The discriminative power of six summary scores offers a reliable comparison of healthcare performance between A&Es to increase patient centredness and quality of care.
Re-screeningChlamydia trachomatispositive subjects: a comparison of practices between an STI clinic, general practitioners and gynaecologists
Authors: Dukers-Muijrers Nicole H T M , van Liere Genevieve A F S , Hoebe Christian J P A 
Published: September 2012

ObjectivesRe-screening after an initial positive test is a highly effective strategy to identify newChlamydia trachomatispositive cases. Here, we evaluate adherence to international re-screening guidelines and the re-screening positive rates among sexual healthcare providers.MethodsPassive retrospective cohort data were obtained from our STI clinic (South Limburg, Netherlands) and from the public laboratory that performs the majority ofC trachomatistests (September 2006–September 2010) conducted in the eastern South Limburg area. We assessed trends in re-screening after 3–12 months among young (16–25-year-old) and older women and men and evaluated differences between providers using multivariate regression analyses.ResultsThe positive rates inC trachomatisscreening varied from 2–9% depending on the type of provider. At the STI clinic, subsequent re-screening was performed in 33% (382/1144) of patients, and 19% of re-screening cases were positive (74/382). Similar rates were observed for gynaecologists (re-screening 30%, 54/178; re-screening positive rate 15%, 8/51); re-screening rates were lower for general practitioners (23%, 144/625, p<0.01), but the positive rate in re-screening was similar (17%, 25/144). At the STI clinic, the re-screening rate was higher for older females (p<0.01) and older males (p<0.01) than for young females. The re-screening rate for young male patients increased over time (p=0.04). General practitioners re-screened young women more often than young (p<0.01) and older (p<0.01) men.ConclusionsPositive rates were high for all care providers when re-screening patients. However, re-screening practices are suboptimal and differ between providers, arguing for improved adherence to currentC trachomatiscontrol guidelines.
Repeat genitalChlamydia trachomatistesting rates in young adults in England, 2010
Authors: Woodhall Sarah C , Atkins Janice L , Soldan Kate , Hughes Gwenda , Bone Angie , Gill O Noel 
Published: September 2012

ObjectivesTo explore patterns of repeat chlamydia testing among young people in England and factors associated with testing positive at repeat test.MethodsWe analysed chlamydia testing among 15 to 24-year-olds in England in a single calendar year (2010) using data from the genitourinary medicine clinic activity dataset (GUMCAD) and tests reported through the National Chlamydia Screening Programme (NCSP). Case records were linked using patient clinic numbers (GUMCAD), or by matching date of birth, gender and postcode (NCSP). Individuals could not be linked between datasets. The incidence of repeat testing was estimated using survival analysis. Risk factors for testing positive at repeat test were explored using multivariable logistic regression.Results1 235 058 tests in the NCSP dataset and 502 095 in GUMCAD were included. The incidence of repeat testing was 18.4 and 26.1 per 100 person years in the NCSP dataset and GUMCAD respectively. Among NCSP repeat tests, the proportion testing positive was higher in those reporting recent change of sexual partner (adjusted OR males 1.44; females 1.52), and among those with a positive compared to a negative baseline test (adjusted OR males 2.57; females 1.95).ConclusionsWe observed moderate levels of repeat testing within a year. Considering the frequency of partner change among young people, more could be done to encourage re-testing upon change of sexual partner. Increasing re-testing following a positive test could probably identify unresolved or repeat infections that may otherwise go untreated. Work to establish the optimum approach to repeat testing in England is now warranted.
Genital warts in men: a large population-based cross-sectional survey of Danish men
Authors: Munk Christian , Nielsen Ann , Liaw Kai-Li , Kjaer Susanne Krüger 
Published: September 2012

ObjectivesTo estimate the occurrence of and risk factors associated with genital warts in Danish menMethodsWe conducted a cross-sectional, questionnaire-based study among almost 23 000 men aged 18–45 years, randomly sampled from the general population of Denmark. Data was collected on self-reported clinically diagnosed genital warts, and various lifestyle habits.ResultsEver having had clinically diagnosed genital warts was reported by 7.9% of the men. The median age at first occurrence was 22 years. Genital warts within the previous 12 months were reported by 0.92% of the men, with a peak of 1.83% among men aged 21–24 years. The likelihood of reporting genital warts was strongly correlated with the lifetime number of sex partners (OR 8.0; 95% CI 6.0 to 10.8 for ≥15 partners vs 1–2 partners). Other factors associated with an increased risk for genital warts included ever having smoked and having had other sexually transmitted infections.ConclusionsAlmost 8% of Danish men aged 18–45 years reported having had a diagnosis of genital warts. The results provide baseline information for developing and monitoring prevention strategies against genital warts, such as vaccination against human papillomavirus types 6 and 11.
Estimating the population size of men who have sex with men: a modified Laska, Meisner and Siegel procedure taking into account internet populations
Authors: Chen Hao , Zhang Yanhui , Tan Hongzhuan , Lin Dan , Chen Mengshi , Chen Niannian , Bao Yugang , Wen Shiwu 
Published: September 2012

ObjectivesMen who have sex with men (MSM) are an at-risk population for HIV/AIDS.Accurately estimating the size of MSM is important to monitor the HIV/AIDS epidemic and to implement HIV/AIDS prevention in the MSM population. None of the current methods for MSM population size estimation is satisfactory, especially for internet samples. We try to use the modified Laska, Meisner and Siegel (LMS) method to estimate the size of MSM in tangible venues and internet virtual venues.MethodsLaska, Meisner and Siegel developed an unbiased estimator for the size of a population in a single venue based on a single sample (LMS method). In this study, we modified the LMS method for the estimation of population size of MSM (LMS* procedure). Specially, we integrated the MSM size of traditional tangible venue with internet virtual venue. Currently, the latter is an important source of socialisation for MSM population. To do this, we added a few parameters to the original LMS method. Then we applied the LMS* procedure to estimate the size of MSM in Changsha, the capital city of the Chinese Province of Hunan.ResultsThe LMS* procedure handled the complexity of socialisation among MSM population well. According to the LMS* procedure, the total number of MSM was 65 657 (95% CI 57 922 to 73 388), constituting a proportion of 5.43% (95% CI 4.79% to 6.07%) in the sexually active male population (15–64-year-olds) in Changsha.ConclusionsWe conclude that the LMS* procedure is suitable for the estimation of a hard-to-reach population, such as MSM, in tangible venues and internet virtual venues.
Sexual behaviour and less frequent bathing are associated with higher human papillomavirus incidence in a cohort study of uncircumcised Kenyan men
Authors: Backes Danielle M , Snijders Peter J F , Hudgens Michael G , Bailey Robert C , Bogaarts Martijn , Agot Kawango , Agingu Walter , Moses Stephen , Meijer Chris J L M , Smith Jennifer S 
Published: September 2012

ObjectivesData on the acquisition of human papillomavirus (HPV) infection in men are limited, especially from developing regions including Africa. The objective of this study was to characterise and determine the risk factors of HPV acquisition among a cohort of uncircumcised men participating in a randomised controlled trial (RCT) of male circumcision in Kisumu, Kenya.MethodsPenile exfoliated cell specimens were collected at baseline, 6- and 12-month follow-up visits from the glans/coronal sulcus and shaft of men enrolled in the control arm of the RCT between 2002 and 2005. All participants were HIV seronegative, aged 17–24 years at baseline and remained uncircumcised over follow-up. Specimens were tested with GP5+/6+ PCR to detect 44 HPV types. Parametric frailty models were used to assess risk factors of HPV incidence.ResultsThe median age of 966 participants was 20 years. The median follow-up time was 12.1 months. The incidence rate (IR) of any HPV infection was 49.3/1000 person-months with HPV16 having the highest IR (10.9/1000 person-months). The strongest risk factors for overall HPV incidence were bathing less frequently than daily (adjusted HR=2.6; 95% CI 1.0 to 6.5) and having ≥2 female sexual partners in the past year (adjusted HR=1.6; 95% CI 1.2 to 2.1).ConclusionsHPV IRs were notably high in this cohort of high-risk, uncircumcised men from Kisumu, Kenya, with the number of sexual partners and bathing frequency being the strongest risk factors.