bluuebunny/crossref_metadata_2025_split huggingface dataset:
Variation in cervical and breast cancer screening coverage in England: a cross-sectional analysis to characterise districts with atypical behaviour
Authors: Massat Nathalie J , Douglas Elaine , Waller Jo , Wardle Jane , Duffy Stephen W 
Published: July 2015

ObjectivesReducing cancer screening inequalities in England is a major focus of the 2011 Department of Health cancer outcome strategy. Screening coverage requires regular monitoring in order to implement targeted interventions where coverage is low. This study aimed to characterise districts with atypical coverage levels for cervical or breast screening.DesignObservational study of district-level coverage in the English Cervical and Breast screening programmes in 2012.SettingEngland, UK.ParticipantsAll English women invited to participate in the cervical (age group 25–49 and 50–64) and breast (age group 50–64) screening programmes.OutcomesRisk adjustment models for coverage were developed based on district-level characteristics. Funnel plots of adjusted coverage were constructed, and atypical districts examined by correlation analysis.ResultsVariability in coverage was primarily explained by population factors, whereas general practice characteristics had little independent effect. Deprivation and ethnicity other than white, Asian, black or mixed were independently associated with poorer coverage in both screening programmes, with ethnicity having the strongest effect; by comparison, the influence of Asian, black or mixed ethnic minority was limited. Deprivation, ethnicity and urbanisation largely accounted for the lower cervical screening coverage in London. However, for breast screening, being located in London remained a strong negative predictor. A subset of districts was identified as having atypical coverage across programmes. Correlates of deprivation in districts with relatively low adjusted coverage were substantially different from overall correlates of deprivation.DiscussionThese results inform the continuing drive to reduce avoidable cancer deaths in England, and encourage implementation of targeted interventions in communities residing in districts identified as having atypically low coverage. Sequential implementation to monitor the impact of local interventions would help accrue evidence on ‘what works’.
A questionnaire survey exploring healthcare professionals’ attitudes towards teamwork and safety in acute care areas in South Korea
Authors: Kim Sung Eun , Kim Chan Woong , Lee Sang Jin , Oh Je Hyeok , Lee Dong Hoon , Lim Tae Ho , Choi Hyuk Joong , Chung Hyun Soo , Ryu Ji Yeong , Jang Hye Young , Choi Yoon Hee , Kim Su Jin , Jung Jin Hee 
Published: July 2015

ObjectivesAlthough human factors are important in terms of patient safety, there have been very few reports on the attitudes of healthcare professionals working in acute care settings in South Korea. In the present study, we investigated the attitudes of such professionals, their cultures and their management systems.DesignA questionnaire survey with 65 items covering nine themes affecting patient safety. Nine themes were compared via a three-or-more-way analysis of variance, with interaction, followed by multiple comparisons among several groups.SettingIntensive care units, emergency departments and surgical units of nine urban hospitals.Participants592 nurses and 160 physicians.InterventionNone.Outcome measuresMean scores using a five-point scale and combined response scores for each of the nine themes.ResultsThe mean score for information-sharing was the highest (3.78±0.49) and that for confidence/assertion was the lowest (2.97±0.34). The mean scores for teamwork, error management, work value, organisational climate, leadership, stress and fatigue level, and error/procedural compliance were intermediate. Physicians showed lower scores in leadership and higher scores in information-sharing than nurses. Respondents with 24 months or less of a clinical career showed higher scores in leadership, stress and fatigue, and error scores and lower scores in work value than more experienced respondents.ConclusionsOur results suggest that medical personnel in Korea are relatively reluctant to disclose error or assert their different opinions with others. Many did not adequately recognise the negative effects of fatigue and stress, attributed errors to personal incompetence, and error-management systems were inadequate. Discrepancies in leadership and information-sharing were evident between professional groups, and leadership, stress, fatigue level, work value and error scores varied with the length of work experience. These can be used as baseline data to establish training programmes for patient safety in Korea.
‘Seizure First Aid Training’ for people with epilepsy who attend emergency departments, and their family and friends: study protocol for intervention development and a pilot randomised controlled trial
Authors: Noble AJ , Marson AG , Tudur-Smith C , Morgan M , Hughes DA , Goodacre S , Ridsdale L 
Published: July 2015

IntroductionPeople with chronic epilepsy (PWE) often make costly but clinically unnecessary emergency department (ED) visits. Offering them and their carers a self-management intervention that improves confidence and ability to manage seizures may lead to fewer visits. As no such intervention currently exists, we describe a project to develop and pilot one.Methods and analysisTo develop the intervention, an existing group-based seizure management course that has been offered by the Epilepsy Society within the voluntary sector to a broader audience will be adapted. Feedback from PWE, carers and representatives from the main groups caring for PWE will help refine the course so that it addresses the needs of ED attendees. Its behaviour change potential will also be optimised. A pilot randomised controlled trial will then be completed. 80 PWE aged ≥16 who have visited the ED in the prior 12 months on ≥2 occasions, along with one of their family members or friends, will be recruited from three NHS EDs. Dyads will be randomised to receive the intervention or treatment as usual alone. The proposed primary outcome is ED use in the 12 months following randomisation. For the pilot, this will be measured using routine hospital data. Secondary outcomes will be measured by patients and carers completing questionnaires 3, 6 and 12 months postrandomisation. Rates of recruitment, retention and unblinding will be calculated, along with the ED event rate in the control group and an estimate of the intervention's effect on the outcome measures.Ethics and disseminationEthical approval: NRES Committee North West—Liverpool East (Reference number 15/NW/0225). The project's findings will provide robust evidence on the acceptability of seizure management training and on the optimal design of a future definitive trial. The findings will be published in peer-reviewed journals and presented at conferences.Trial registration numberISRCTN13 871 327.
Safety culture in long-term care: a cross-sectional analysis of the Safety Attitudes Questionnaire in nursing and residential homes in the Netherlands
Authors: Buljac-Samardzic Martina , van Wijngaarden Jeroen DH , Dekker–van Doorn Connie M 
Published: July 2015

ObjectiveThe first objective was to investigate if the Safety Attitudes Questionnaire (SAQ) is appropriate to measure the safety attitude of caregivers in nursing and residential homes, and second, to compare safety attitude of these caregivers with available data of caregivers in other settings (ie, inpatients, intensive care unit (ICU) and ambulatory care).MethodsUsing a cross-sectional survey methodology, we obtained completed SAQ surveys from 521 caregivers (response rate of 53%) working in nine units in nine different nursing and residential homes in The Netherlands. Exploratory factor and Cronbach's alpha measures were used to analyse the psychometric properties of the SAQ. A correlation matrix was performed to study the relationship among the SAQ dimensions. A t test was performed to test significant differences between our sample and the benchmark settings.ResultsThe factor analyses and calculated Cronbach's alphas (α=0.56–0.80) for this sample confirmed the robustness of the SAQ scales. There was a high positive correlation between teamwork climate, job satisfaction, perceptions of management, safety climate and working conditions (r=0.31 to 63), but stress recognition had a negative correlation with each of the other dimensions (r=−0.13 to −0.18). Overall, the scores from the nursing and residential homes differed significantly from the benchmark settings.ConclusionsThe findings in this study confirmed that the SAQ could also be used in the nursing and residential homes setting. However, stress recognition in nursing and residential homes setting does not seem to be one of the dimensions of the safety attitude construct. Furthermore, Dutch nursing and residential homes have significantly higher scores on most dimensions of the SAQ compared with US inpatient units and comparable scores to ICUs (Dutch and US) and ambulatory services.
What do patients say about emergency departments in online reviews? A qualitative study
Authors: Kilaru Austin S , Meisel Zachary F , Paciotti Breah , Ha Yoonhee P , Smith Robert J , Ranard Benjamin L , Merchant Raina M 
Published: July 2015

BackgroundPatients have adopted web-based tools to report on the quality of their healthcare experiences. We seek to examine online reviews for US emergency departments (EDs) posted on Yelp, a popular consumer ratings website.MethodsWe conducted a qualitative analysis of unstructured, publicly accessible reviews for hospitals available onhttp://www.yelp.com. We collected all reviews describing experiences of ED care for a stratified random sample of 100 US hospitals. We analysed the content of the reviews using themes derived from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) inpatient care survey. We also used modified grounded theory to iteratively code the text of the reviews, identifying additional themes specific to emergency care. The data were double-coded, and discrepancies were evaluated to ensure consensus.ResultsOf the 1736 total reviews, 573 (33%) described patient experiences involving the ED. The reviews contained several themes assessed by the HCAHPS survey, including communication with nurses, communication with doctors, and pain control. The reviews also contained key themes specific to emergency care: waiting and efficiency; decisions to seek care in the ED; and events following discharge, including administrative difficulties.ConclusionsThese exploratory findings suggest that online reviews for EDs contain similar themes to survey-based assessments of inpatient hospital care as well as themes specific to emergency care. Consumer rating websites allow patients to provide rapid and public feedback on their experience of medical care. Web-based platforms may offer a novel strategy for assessing patient-centred quality in emergency care.
Implementation of HIV treatment as prevention strategy in 17 Canadian sites: immediate and sustained outcomes from a 35-month Quality Improvement Collaborative
Authors: Clarke Christina M , Cheng Tessa , Reims Kathleen G , Steinbock Clemens M , Thumath Meaghan , Milligan Robert Sam , Barrios Rolando 
Published: July 2015

BackgroundRapid scale-up of effective antiretroviral therapy (ART) is required to meet global targets to eliminate new HIV infections and AIDS-related deaths. Yet, gaps persist in all nations striving for these targets. In the intervention setting of British Columbia (BC), Canada, where ART is publicly funded, 73% of HIV-diagnosed were on ART in 2011, and only 49% were achieving viral suppression.MethodsAn observational case descriptive study of HIV care sites in BC recruited to participate in a 35-month Breakthrough Series Quality Improvement Collaborative and sustainability network. Sites collected four quality indicators, qualitative change descriptions and implemented the chronic care model (CCM) and HIV care and treatment guidelines. Two reviewers assigned monthly implementation scores to evaluate site progress (January 2011–2012). All quality indicators were pooled and analysed using probability-based run chart rules.ResultsSeventeen teams with a pooled median population of 2296 HIV patients joined the initiative. Comprehensive CCM implementation and evidence of improvement was achieved by 29% of sites (implementation score of 4.0 or higher on 5.0 scale). Evidence of sustained improvement was observed for patient engagement (88.8–90.4%), ART uptake among patients unequivocally in need (92.9–94.8%), and ART uptake (≥6 months) and achieving viral suppression (57.3–78.4%) (all p<0.05).ConclusionsThis study shows evidence of sustained improvements in HIV care processes and treatment outcomes for an estimated population of 2296 HIV patients in 17 BC sites. Overall success points to opportunities for other high-income countries seeking to improve HIV health outcomes.
Changing an ingrained culture: Improving the safety of oxygen therapy at University Hospitals Bristol NHS Foundation Trust
Authors: Gatter Michelle , Dixon Giles , Wall Josh , Mew Ed 
Published: July 2015

AbstractOxygen is one of the most commonly administered drugs in UK hospitals. Our quality improvement project aimed to increase the safety of oxygen therapy at University Hospitals Bristol NHS Foundation Trust. We aimed to increase the rate of oxygen prescribing and increase the percentage of nurses signing appropriately for oxygen titration and administration. We hypothesised this would result in a higher percentage of patients achieving their appropriate oxygen saturations.Our project ran on several acute medical and surgical wards. We tested several interventions with a plan, do, study, act method of continuous data collection. We firstly focussed on the education of junior doctors and then the wider multi-disciplinary team with a trust-wide “safety focus”. We utilised patient safety systems already in place in the hospital, such as the clinical risk register and incident reporting system. We also trialled an intervention that was successfully implemented by another group in a different trust in the UK.Oxygen prescription increased from 44.4% to 76.9% over the duration of the project. Appropriate nursing signatures increased from 26.6% to 60%. The number of patients achieving appropriate target saturations rose from 61.8% to 76.7%. The most successful interventions were the trust safety briefing and oxygen safety hangers.Our project has showed the importance of integrating new projects within safety schemes already available. Persistence and careful intervention are key to changing strongly engrained cultures in large organisations. Interventions that have proved to be successful in other trusts can be implemented to enact change.
Association between patterns of leisure time physical activity and asthma control in adult patients
Authors: Bacon Simon L , Lemiere Catherine , Moullec Gregory , Ninot Gregory , Pepin Véronique , Lavoie Kim L 
Published: July 2015

BackgroundPhysical activity has been shown to have various health benefits in patients with asthma, especially in children. However, there are still limited data on the nature of the association between physical activity and asthma control in adults.ObjectiveThe objective of the current study was to determine the nature of the association between physical activity and asthma control, with particular emphasis on the intensity of the activity and seasonal variations.Methods643 adult patients with objectively confirmed asthma (mean age (SD)=53 (15) years, 60% women) were interviewed by telephone. Patients completed the asthma control questionnaire (ACQ), the asthma quality of life questionnaire, and a 1-year physical activity recall questionnaire to assess leisure time physical activity (LTPA).ResultsTotal LTPA was related to control (β (95% CI)=−0.013 (−0.030 to 0.006)), with those doing recommended levels of LTPA being nearly 2.5 times more likely to have good control compared with inactive patients. Analysis of seasonal exercise habits found that winter LTPA (β=−0.027 (−0.048 to −0.006)) was more strongly associated with ACQ scores than summer LTPA (β=−0.019 (−0.037 to −0.001)). Adjustment for age, sex, season of assessment, inhaled corticosteroid (ICS) dose, body mass index, and current smoking status reduced the strength of the relationships.ConclusionsData indicate that higher levels of LTPA are associated with better levels of asthma control in adult patients with asthma, and that this seems to be more pronounced among asthmatics who do the recommended levels of exercise.
Palliative care for cirrhosis: a UK survey of health professionals’ perceptions, current practice and future needs
Authors: Low Joseph , Vickerstaff Victoria , Davis Sarah , Bichard Julia , Greenslade Lynda , Hopkins Katherine , Marshall Aileen , Thorburn Douglas , Jones Louise 
Published: July 2015

ObjectiveTo determine the knowledge and practice patterns of a UK cohort of relevant healthcare professionals (HCPs) about delivering palliative care in cirrhosis, and to inform priorities for future research.DesignAn on-line questionnaire survey with closed and open responses.SettingHCPs identified from the mailing list of special interest groups in hepatology and gastroenterology (liver), general practice and specialist palliative care (SPC) across the UK.ResultsOf the 6181 potential contacts identified, 517 HCPs responded. Most believed a role exists for SPC in caring for people with cirrhosis, but many SPC HCPs felt ill prepared to provide good care to those facing death. Further training was needed in managing liver-related symptoms, symptom control and end of life issues. All HCP groups wished to increase community provision of palliative care support, but many general practitioners felt unable to manage advanced cirrhosis in the community. There were differences in the optimal trigger for SPC referral with liver HCPs less likely to refer at symptom deterioration. Prognostication, symptom management and service configuration were key areas identified for future research.ConclusionsAll who responded acknowledged the role of SPC in caring for those dying with cirrhosis and need for further training to improve confidence and enable joint working between SPC, general practice and liver teams. Low response rates make it difficult to generalise these findings, which require further validation.
Detection of aneurysmal subarachnoid hemorrhage 3 months after initial bleeding: evaluation of T2* and FLAIR MR sequences at 3 T in comparison with initial non-enhanced CT as a gold standard
Authors: Mulé Sébastien , Soize Sébastien , Benaissa Azzedine , Portefaix Christophe , Pierot Laurent 
Published: July 2015

ObjectiveTo investigate the ability of T2* and fluid-attenuated inversion recovery (FLAIR) MR sequences to detect hemosiderin deposition 3 months after aneurysmal subarachnoid hemorrhage (SAH) in comparison with early non-enhanced CT (NECT) as a gold standard.Materials and methodsFrom September 2008 through May 2013, patients with aneurysmal SAH were included if a NECT less than 24 h after the onset of symptoms showed a SAH, and MRI, including T2* and FLAIR sequences, was performed 3 months later. All aneurysms were treated endovascularly. NECT and MR sequences were blindly analyzed for the presence of SAH (NECT) or hemosiderin deposition (MRI). When positive, details of the spatial distribution of SAH or hemosiderin deposits were noted. Sensitivities were calculated for each patient. Sensitivities, specificities, and positive predictive values (PPVs) were calculated for each location.ResultsForty-nine patients (mean age 52.9 years) were included. Bleeding-related patterns were identified in 43 patients (87.8%) on T2* and 10 patients (20.4%) on FLAIR. T2* was highly predictive of the location of the initial hemorrhage, especially in the Sylvian cisterns (PPVs 95% and 100%) and the anterior interhemispheric fissure (PPV 90%).ConclusionsThe T2* sequence can detect and localize a previous SAH a few months after aneurysmal bleeding.
Canine adipose‐derived stromal cell viability following exposure to synovial fluid from osteoarthritic joints
Authors: Kiefer Kristina M. , O'Brien Timothy D. , Pluhar Elizabeth G. , Conzemius Michael 
Published: July 2015

IntroductionStem cell therapy used in clinical application of osteoarthritis in veterinary medicine typically involves intra‐articular injection of the cells, however the effect of an osteoarthritic environment on the fate of the cells has not been investigated.Aims and ObjectivesAssess the viability of adipose derived stromal cells following exposure to osteoarthritic joint fluid.Materials and MethodsAdipose derived stromal cells (ASCs) were derived from falciform adipose tissue of five adult dogs, and osteoarthritic synovial fluid (SF) was obtained from ten patients undergoing surgical intervention on orthopedic diseases with secondary osteoarthritis. Normal synovial fluid was obtained from seven adult dogs from an unrelated study. ASCs were exposed to the following treatment conditions: culture medium, normal SF, osteoarthritic SF, or serial dilutions of 1:1 to 1:10 of osteoarthritic SF with media. Cells were then harvested and assessed for viability using trypan blue dye exclusion.ResultsThere was no significant difference in the viability of cells in culture medium or normal SF. Significant differences were found between cells exposed to any concentration of osteoarthritic SF and normal SF and between cells exposed to undiluted osteoarthritic SF and all serial dilutions. Subsequent dilutions reduced cytotoxicity.ConclusionsOsteoarthritic synovial fluid in this ex vivo experiment is cytotoxic to ASCs, when compared with normal synovial fluid. Current practice of direct injection of ASCs into osteoarthritic joints should be re‐evaluated to determine if alternative means of administration may be more effective.
KAT6B Is a Tumor Suppressor Histone H3 Lysine 23 Acetyltransferase Undergoing Genomic Loss in Small Cell Lung Cancer
Authors: Simó-Riudalbas Laia , Pérez-Salvia Montserrat , Setien Fernando , Villanueva Alberto , Moutinho Catia , Martínez-Cardús Anna , Moran Sebastian , Berdasco Maria , Gomez Antonio , Vidal Enrique , Soler Marta , Heyn Holger , Vaquero Alejandro , de la Torre Carolina , Barceló-Batllori Silvia , Vidal August , Roz Luca , Pastorino Ugo , Szakszon Katalin , Borck Guntram , Moura Conceição S. , Carneiro Fátima , Zondervan Ilse , Savola Suvi , Iwakawa Reika , Kohno Takashi , Yokota Jun , Esteller Manel 
Published: July 2015

Abstract
Recent efforts to sequence human cancer genomes have highlighted that point mutations in genes involved in the epigenetic setting occur in tumor cells. Small cell lung cancer (SCLC) is an aggressive tumor with poor prognosis, where little is known about the genetic events related to its development. Herein, we have identified the presence of homozygous deletions of the candidate histone acetyltransferase KAT6B, and the loss of the corresponding transcript, in SCLC cell lines and primary tumors. Furthermore, we show, in vitro and in vivo, that the depletion of KAT6B expression enhances cancer growth, while its restoration induces tumor suppressor–like features. Most importantly, we demonstrate that KAT6B exerts its tumor-inhibitory role through a newly defined type of histone H3 Lys23 acetyltransferase activity. Cancer Res; 75(18); 3936–45. ©2015 AACR.