bluuebunny/crossref_metadata_2025_split huggingface dataset:
Malnutrition and its association with readmission and death within 7 days and 8–180 days postdischarge in older patients: a prospective observational study
Authors: Sharma Yogesh , Miller Michelle , Kaambwa Billingsley , Shahi Rashmi , Hakendorf Paul , Horwood Chris , Thompson Campbell 
Published: May 2024

ObjectiveThe relationship between admission nutritional status and clinical outcomes following hospital discharge is not well established. This study investigated whether older patients’ nutritional status at admission predicts unplanned readmission or death in the very early or late periods following hospital discharge.Design, setting and participantsThe study prospectively recruited 297 patients ≥60 years old who were presenting to the General Medicine Department of a tertiary care hospital in Australia. Nutritional status was assessed at admission by using the Patient-Generated Subjective Global Assessment (PG-SGA) tool, and patients were classified as either nourished (PG-SGA class A) or malnourished (PG-SGA classes B and C). A multivariate logistic regression model was used to adjust for other covariates known to influence clinical outcomes and to determine whether malnutrition is a predictor for early (0–7 days) or late (8–180 days) readmission or death following discharge.Outcome measuresThe impact of nutritional status was measured on a combined endpoint of any readmission or death within 0–7 days and between 8 and 180 days following hospital discharge.ResultsWithin 7 days following discharge, 29 (10.5%) patients had an unplanned readmission or death whereas an additional 124 (50.0%) patients reached this combined endpoint within 8–180 days postdischarge. Malnutrition was associated with a significantly higher risk of combined endpoint of readmissions or death both within 7 days (OR 4.57, 95% CI 1.69 to 12.37, P<0.001) and within 8–180 days (OR 1.98, 95% CI 1.19 to 3.28, P=0.007) following discharge and this risk remained significant even after adjustment for other covariates.ConclusionsMalnutrition in older patients at the time of hospital admission is a significant predictor of readmission or death both in the very early and in the late periods following hospital discharge. Nutritional state should be included in future risk prediction models.Trial registration numberACTRN No. 12614000833662; Post-results.
Social support in maintaining mental health and quality of life among community-dwelling older people with functional limitations in Malaysia: a population-based cross-sectional study
Authors: Balqis-Ali Nur Zahirah , Fun Weng Hong 
Published: May 2024

ObjectiveThis study aimed to examine the mediation role of perceived social support in the relationship between functional limitations, depressive symptoms and quality of life among older people in Malaysia.SettingThe Malaysian National Health Morbidity Survey 2018: Elderly Health was a cross-sectional health community survey among adults aged 50 and above.Participants3977 community-dwelling older Malaysians aged 60 and above.Outcome measuresFunctional limitations were defined as personal activities of daily living (PADL) and instrumental activities of daily living (IADL), tested in separate paths in all analyses. PADL was measured using the Barthel Index, while IADL was measured using the Lawton and Brody scale. Perceived social support, depressive symptoms and quality of life were measured using the Duke Social Support Index, Geriatric Depression Scale-14 and Control, Autonomy, Self-Realisation and Pleasure-19 tools. We used mediation analysis through structural equation modelling to explore the role of perceived social support.ResultsPerceived social support mediated the relationship between PADL and IADL with depressive symptoms, with the indirect effects at −0.079 and −0.103, respectively (p<0.001). Similarly, perceived social support mediated the relationship between PADL and IADL with quality of life, with the indirect effects at 0.238 and 0.301, respectively (p<0.001). We performed serial multiple mediation analysis and found that perceived social support and depressive symptoms mediated the path between PADL and IADL with quality of life, with the indirect effects at 0.598 and 0.747, respectively (p<0.001). The relationship between functional limitations and all outcomes remained significant in all mediation analyses.ConclusionThe present study provides evidence that perceived social support relieves the influence of functional limitations on depressive symptoms and declining quality of life among older people. Therefore, it is imperative to establish a social support system to improve the overall well-being of older people.
Nurses’ and midwives’ experiences of clinical supervision in practice: a scoping review protocol
Authors: Gill-Meeley Nicola , Hernon Orlaith , Cuddihy Ciaran , Frawley Timothy , Smyth Siobhan 
Published: May 2024

ObjectiveTo outline and examine what evidence exists related to nurses’ and midwives’ experiences of participating in clinical supervision.IntroductionThe practice of clinical supervision is increasingly prevalent in nursing and midwifery, yet disparity remains in relation to professionals’ understanding and experience of this clinical support and how it is implemented in practice. This scoping review will identify the available evidence and gaps in knowledge that exist in relation to nurses’ and midwives’ experience of this practice and examine how the various forms are defined in the literature.Methods and analysisComprehensive searches of CINAHL Complete, MEDLINE (EBSCO), PsycINFO (EBSCO), Embase, Scopus and the Cochrane Library will be carried out. Grey literature will also be searched and all results will be screened independently by two reviewers using identified inclusion and exclusion criteria. All empirical data that identify and report nurses’ and midwives’ experiences of clinical supervision will be included in the review. Studies that include other health and social care professionals will be excluded where the nursing and midwifery cohort is not reported independently. Data from all relevant studies will be extracted using a validated adapted data extraction form. Our review will be guided by the Joanne Briggs Institute Methodology and findings will be guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols Extension for Scoping Reviews statement.Ethics and disseminationThis review does not require ethical approval. Our dissemination strategy includes peer-reviewed publication, presentation and conferences and sharing through stakeholder networks.
PRESOLRE: study protocol for a primary school-based, cluster randomised controlled trial of three sun exposure risk prevention strategies on Reunion Island
Authors: Dugast Charline , Bruneau Léa , Fianu Adrian , Ferdynus Cyril , Boussaid Karim , Vuichard Juliette , Duloutre Floreana , Dumez Jessica , Sultan-Bichat Nathalie , Bertolotti Antoine 
Published: May 2024

IntroductionReunion Island, a French overseas department, is located in the southern hemisphere, close to the Capricorn tropic. This island has a multicultural and multiethnic population of 860 000 inhabitants, a quarter of whom are at high risk of developing skin cancer due to intense ultraviolet radiation. Melanoma is responsible for the majority of skin cancer deaths. The early prevention of melanoma is based on sun protection in childhood, but French regulations are not adapted to the environmental conditions of this tropical region.The main objective of our study is to evaluate the effectiveness of three sun protection programs conducted in Reunionese primary schools through a pupil knowledge questionnaire.Methods and analysisPRESOLRE is an interventional, open-label, cluster-randomised controlled trial, in four parallel arms, that is being conducted throughout 2022–2023 on Reunion Island. The trial design assumes an escalation interventional effect using: first, a control arm without proposed intervention (arm 1); second, an arm whose classes are encouraged to use the validated educational programme ‘Living With the Sun’ (LWS) (arm 2); third, an arm whose classes are encouraged to use both ‘LWS’ combined with ‘Mission Soleil Réunion’s sun protection awareness programme (arm 3); fourth, an arm benefiting from an intervention similar to arm 3, combined with the distribution of hats, sunglasses and sun creams (arm 4). In all, 1780 pupils from 18 classes of 20 pupils, on average, will be included. Randomisation applies to the classes of pupils (so defined as clusters). The primary outcome is based on the proportion of correct answers to the knowledge questions after the awareness programme, compared between the four arms using a linear mixed model with random intercept.Ethics and disseminationThe study obtained ethics approval in 2022 (ID: 2022-A00350-43). Results will be published in peer-reviewed journals.Trial registration numberNCT05367180.
Restore and Rebuild (R&R): a protocol for a phase 2, randomised control trial to compare R&R as a treatment for moral injury-related mental health difficulties in UK military veterans to treatment as usual
Authors: Williamson Victoria , Murphy Dominic , Bonson Amanda , Biscoe Natasha , Leightley Daniel , Aldridge Vicky , Greenberg N 
Published: May 2024

BackgroundExposure to potentially morally injurious events is increasingly recognised as a concern across a range of occupational groups, including UK military veterans. Moral injury-related mental health difficulties can be challenging for clinicians to treat and there is currently no validated treatment available for UK veterans. We developed Restore and Rebuild (R&R) as a treatment for UK veterans struggling with moral injury-related mental health difficulties. This trial aims to examine whether it is feasible to conduct a pilot randomised controlled trial (RCT) of R&R treatment compared with a treatment-as-usual (TAU) control group.MethodsWe will use a feasibility single-blind, single-site RCT design. The target population will be UK military veterans with moral injury-related mental health difficulties. We will recruit N=46 veteran patients who will be randomly allocated to R&R (n=23) or TAU (n=23). Patients randomised to R&R will receive the 20-session one-to-one treatment, delivered online. Veterans allocated to TAU, as there are currently no manualised treatments for moral injury-related mental health problems available, will receive the one-to-one treatment (online) typically provided to veterans who enter the mental health service for moral injury-related mental health difficulties. We will collect outcome measures of moral injury, post-traumatic stress disorder (PTSD), alcohol misuse, common mental disorders and trauma memory at pretreatment baseline (before randomisation), end of treatment, 12 weeks and 24 weeks post-treatment. The primary outcome will be the proportion of patients who screen positive for PTSD and moral injury-related distress post-treatment.Ethics and disseminationThis trial will establish whether R&R is feasible, well-tolerated and beneficial treatment for veterans with moral injury-related mental health difficulties. If so, the results of the trial will be widely disseminated and R&R may improve access to effective care for those who struggle following moral injury and reduce the associated negative consequences for veterans, their families and wider society.Trial registration numberISRCTN99573523.
Prognostic factors for the development of upper limb dysfunctions after breast cancer: the UPLIFT-BC prospective longitudinal cohort study protocol
Authors: De Groef An , Vets Nieke , Devoogdt Nele , Smeets Ann , Van Assche Dieter , Emmerzaal Jill , Dams Lore , Verbeelen Kaat , Fieuws Steffen , Baets Liesbet De 
Published: May 2024

IntroductionUpper limb (UL) dysfunctions are highly prevalent in people after breast cancer and have a great impact on performing activities in daily living. To improve care, a more comprehensive understanding of the development and persistence of UL dysfunctions is needed. Therefore, the UPLIFT-BC study will primarily examine the prognostic value of different factors at the body functions and structures, environmental and personal level of the International Classification of Functioning, Disability and Health (ICF) framework at 1-month post-surgery for persisting UL dysfunctions at 6 months after finishing cancer treatment.Methods and analysisA prospective longitudinal cohort study, running from 1-week pre-surgery to 6 months post-local cancer treatment, is performed in a cohort of 250 women diagnosed with primary breast cancer. Different potentially prognostic factors to UL dysfunctions, covering body functions and structures, environmental and personal factors of the ICF, are assessed pre-surgically and at different time points post-surgery. The primary aim is to investigate the prognostic value of these factors at 1-month post-surgery for subjective UL function (ie, QuickDASH) at 6 months post-cancer treatment, that is, 6 months post-radiotherapy or post-surgery (T3), depending on the individuals’ cancer treatment trajectory. In this, factors with relevant prognostic value pre-surgery are considered as well. Similar analyses are performed with an objective measure for UL function (ie, accelerometry) and a composite score of the combination of subjective and objective UL function. Second, in the subgroup of participants who receive radiotherapy, the prognostic value of the same factors is explored at 1-month post-radiotherapy and 6 months post-surgery. A forward stepwise selection strategy is used to obtain these multivariable prognostic models.Ethics and disseminationThe study protocol was approved by the Ethics Committee of UZ/KU Leuven (reference number s66248). The results of this study will be published in peer-reviewed journals and will be presented at several research conferences.Trial registration numberNCT05297591.
Effect of a 3D-printed reconstruction automated matching system for selecting the size of a left double-lumen tube: a study protocol for a prospective randomised controlled trial
Authors: Li Lantao , Zhu Yihao , Yin Feng , Yu Hong , Wang Huaiming , Xu Yi , Fei Fei , Liu Wusong , Duan Bowen , Wang Fei , Jia Ying , Zhang Hongwei 
Published: May 2024

IntroductionLung isolation is primarily accomplished using a double-lumen tube (DLT) or bronchial blocker. A precise and accurate size of the DLT is a prerequisite for ensuring its accurate placement. Three-dimensional (3D) reconstruction technology can be used to accurately reproduce tracheobronchial structures to improve the accuracy of DLT size selection. Therefore, we have developed automatic comparison software for 3D reconstruction based on CT data (3DRACS). In this study, we aimed to evaluate the efficiency of using 3DRACS to select the DLT size for endobronchial intubation in comparison with using the ‘blind’ DLT intubation method to determine the DLT size, which is based on height and sex.Methods and analysisThis is a prospective, single-centre, double-blind randomised controlled trial. In total, 200 patients scheduled for lung resection using a left DLT will be randomly allocated to the 3D group or the control group at a 1:1 ratio. A 3DRACS will be used for the 3D group to determine the size of the DLT, while in the case of the control group, the size of the DLT will be determined according to patient height and sex. The primary outcome is the success rate of placement of the left DLT without fibreoptic bronchoscopy (FOB). The secondary outcomes include the following: successful intubation time, degree of pulmonary atrophy, grade of airway injury, oxygenation during one-lung ventilation, postoperative sore throat and hoarseness, and number of times FOB is used.Ethics and disseminationEthical approval has been obtained from our local ethics committee (approval number: SCCHEC-02-2022-155). Written informed consent will be obtained from all participants before randomisation, providing them with clear instructions about the purpose of the study. The results will be disseminated through peer-reviewed publications and conferences.Trial registration numberNCT06258954.
33 The legacy of the northern ireland conflict in palliative care
Authors: O’Hara Brendan 
Published: May 2024

IntroductionUnderstanding the impact of the Northern Ireland ‘Troubles’/‘conflict’ on a particular area of health care – palliative care – which has received little, if any, previous research focus. The research was carried out for a dissertation submitted in partial fulfilment for the degree of Master of Philosophy.Aim(s)To investigate how the legacy of the Northern Ireland conflict may be encountered by professionals providing palliative care. To investigate how the distinct context of Northern Ireland has impacted on palliative care practice.MethodInterviews were carried out with nine professionals with experience and interest in the provision of support to people living with a terminal illness.Participants reflected experience from voluntary and statutory services and across a wide geography of Northern Ireland. Participants included: three nurses; two doctors; a social worker; a chaplain; a complementary therapist and a welfare officer.ResultsThis research opened up a dialogue between the disciplines of peacebuilding and palliative care. The impact of the Troubles has had an effect on the delivery of palliative care, through the attitudes and influences on those who provide the care and those they care for.ConclusionThe influences of the religious divide, the silencing, and the traumas of the past are not something that the care giver is apart from - they are very much influenced by them. The sensitivities around the Catholic/Protestant divide, the silencing, and restricting opportunities to talk about ‘Troubles’-related trauma, could prevent people from having appropriate palliative care.
54 Improving assessment of pain in palliative care
Authors: Hall Gusa , Gregory Amanda 
Published: May 2024

BackgroundEvidence has shown it is essential within palliative care that pain assessment is consistent, effective and documented in order to achieve high quality pain control.1AimThe aim of this project was to implement a validated pain assessment tool into clinical practice at an independent hospice.MethodA systematic literature review with databases AHMED, MEDLINE, PsychINFO, CINAHL and EMBASE to identify validated pain assessment tools was conducted. This was followed by a retrospective audit of 40 clinical records, measured against the Hospice UK pain management audit tool as a percentage of compliance.Results6 publications (from 500) met the systematic literature review inclusion criteria and identified 11 pain assessment tools. Analysis of the literature concurred with the European Association of Palliative Care recommendations in the use of the multi-dimensional Brief Pain Inventory (BPI) as a pain assessment tool within palliative care. The results of the audit highlighted inconsistencies in documentation of pain assessment across clinical settings and between clinicians. The inpatient unit scored a higher percentage of compliance in the three main audit categories.ConclusionThe results indicated that pain assessment and management is not documented consistently particularly within the community setting. Evidence from the systematic literature review highlighted that the adoption of a set process in conjunction with the BPI pain assessment tool will ensure essential elements of pain assessment are consistently addressed and documented to improve pain control. The Hospice is in the process of implementing the BPI and pain assessment subsequently will be reaudited.Reference. Fayers, P., Hjermstad, M., Klepstad, P., Loge, J., Caraceni, A., Hanks, G., Borchgrevink, P. and Kaasa, S. (2011). The dimensionality of pain: Palliative care and chronic pain patients differ in their reports of pain intensity and pain interference. Pain, 152(7), pp.1608–1620.
Dating apps as health allies? Examining the opportunities and challenges of dating apps as partners in public health
Authors: Garcia-Iglesias Jaime , Heaphy Brian , Mowlabocus Sharif , Yodovich Neta , Nagington Maurice , Patton Karissa , Atherton Sophie , Ford Andrea 
Published: May 2024

In recent years, dating apps have become important allies in public health. In this paper, we explore the implications of partnering with dating apps for health promotion. We consider the opportunities and challenges inherent in these collaborations, paying special attention to privacy, trust, and user care in a digital environment.Despite their potential as targeted health promotion tools, dating apps raise significant ethical concerns, including the commodification of user data and privacy breaches, which highlight the complexities of blending healthcare initiatives with for-profit digital platforms. Furthermore, the paper delves into issues of discrimination, harassment and unequal access within these apps, factors which can undermine public health efforts.We develop a nuanced framework, emphasising the development of transparent data policies, the decoupling of content moderation from health initiatives and a commitment to combat discrimination. We underscore the importance of embedding app-based health initiatives within broader care pathways, ensuring comprehensive support beyond the digital domain. This essay offers vital insights for public health practitioners, app developers and policymakers navigating the intersection of digital innovation and healthcare.
Digital interventions for STI and HIV partner notification: a scoping review
Authors: Woodward Charlotte , Bloch Sonja , McInnes-Dean Amelia , Lloyd Karen C , McLeod Julie , Saunders John , Flowers Paul , Estcourt Claudia S , Gibbs Jo 
Published: May 2024

Background
Partner notification (PN) is key to the control of sexually transmitted infections (STIs) and human immunodeficiency virus (HIV). Digital interventions have been used to facilitate PN. A scoping review was conducted to describe the interventions used, user preferences and acceptability of digital PN interventions from patient and partner perspectives.

Methods
A systematic literature search was conducted of eight databases for articles published in English, available online with digital PN outcome data. Articles were assessed using the Mixed Methods Appraisal Tool. Quantitative and qualitative data were synthesised and analysed using thematic analysis.

Results
Twenty-six articles met the eligibility criteria. Articles were heterogeneous in quality and design, with the majority using quantitative methods. Nine articles focused solely on bacterial STIs (five on syphilis; four on chlamydia), one on HIV, two on syphilis and HIV, and 14 included multiple STIs, of which 13 included HIV. There has been a shift over time from digital PN interventions solely focusing on notifying partners, to interventions including elements of partner management, such as facilitation of partner testing and treatment, or sharing of STI test results (between index patients and tested sex partners). Main outcomes measured were number of partners notified (13 articles), partner testing/consultation (eight articles) and treatment (five articles). Relationship type and STI type appeared to affect digital PN preferences for index patients with digital methods preferred for casual rather than established partner types. Generally, partners preferred face-to-face PN.

Conclusion
Digital PN to date mainly focuses on notifying partners rather than comprehensive partner management. Despite an overall preference for face-to-face PN with partners, digital PN could play a useful role in improving outcomes for certain partner types and infections. Further research needs to understand the impact of digital PN interventions on specific PN outcomes, their effectiveness for different infections and include health economic evaluations.