bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of three diagnostic strategies for suspicion of pulmonary embolism: planar ventilation-perfusion scan (V/Q), CT pulmonary angiography (CTPA) and single photon emission CT ventilation-perfusion scan (SPECT V/Q): a protocol of a randomised controlled trial
Authors: Le Pennec Romain , Le Roux Pierre-Yves , Robin Philippe , Couturaud Francis , Righini Marc , Le Gal Grégoire , Salaun Pierre-Yves 
Published: May 2024

IntroductionPulmonary embolism (PE) is a challenge to diagnose and when missed, exposes patients to potentially fatal recurrent events. Beyond CT pulmonary angiography (CTPA) and planar ventilation/perfusion (V/Q) scan, single photon emission CT (SPECT) V/Q emerged a new diagnostic modality of scintigraphic acquisition that has been reported to improve diagnostic performances. To date, no management outcome study or randomised trial evaluated an algorithm based on SPECT V/Q for PE diagnosis. We present the design of a randomised multicentre, international management study comparing SPECT V/Q with validated strategies.Material and methodsWe will include a total of 3672 patients with suspected PE requiring chest imaging, randomised into three different groups, each using a different diagnostic strategy based on SPECT V/Q, CTPA and planar V/Q scan. Randomisation will be unbalanced (2:1:1), with twice as many patients in SPECT V/Q arm (n=1836) as in CTPA and planar V/Q arms (n=918 in each). Our primary objective will be to determine whether a diagnostic strategy based on SPECT V/Q is non-inferior to previously validated strategies in terms of diagnostic exclusion safety as assessed by the 3-month risk of thromboembolism in patients with a negative diagnostic workup. Secondary outcomes will be the proportion of patients diagnosed with PE in each arm, patients requiring additional tests, the incidence of major and clinically relevant non-major bleeding and the incidence and cause of death in each arm.Ethics and disseminationThis trial is funded by a grant from Brest University Hospital and by INVENT. The study protocol was approved by Biomedical Research Ethics Committee. The investigator or delegate will obtain signed informed consent from all patients prior to inclusion in the trial. Our results will inform future clinical practice guidelines and solve the current discrepancy between nuclear medicine guidelines and clinical scientific society guidelines.Trial registration numberNCT02983760
Low back pain management in primary healthcare: findings from a scoping review on models of care
Authors: Duarte Susana Tinoco , Moniz Alexandre , Costa Daniela , Donato Helena , Heleno Bruno , Aguiar Pedro , Cruz Eduardo B 
Published: May 2024

IntroductionModels of care (MoCs) describe evidence-informed healthcare that should be delivered to patients. Several MoCs have been implemented for low back pain (LBP) to reduce evidence-to-practice gaps and increase the effectiveness and sustainability of healthcare services.ObjectiveTo synthesise research evidence regarding core characteristics and key common elements of MoCs implemented in primary healthcare for the management of LBP.DesignScoping review.Data sourcesSearches on MEDLINE (PubMed), EMBASE, Cochrane Central Register of Controlled Trials, PEDro, Scopus, Web of Science and grey literature databases were conducted.Eligibility criteriaEligible records included MoCs implemented for adult LBP patients in primary healthcare settings.Data extraction and synthesisData extraction was carried out independently by two researchers and included a summary of the studies, the identification of the MoCs and respective key elements, concerning levels of care, settings, health professionals involved, type of care delivered and core components of the interventions. Findings were investigated through a descriptive qualitative content analysis using a deductive approach.Results29 studies reporting 11 MoCs were included. All MoCs were implemented in high-income countries and had clear objectives. Ten MoCs included a stratified care approach. The assessment of LBP patients typically occurred in primary healthcare while care delivery usually took place in community-based settings or outpatient clinics. Care provided by general practitioners and physiotherapists was reported in all MoCs. Education (n=10) and exercise (n=9) were the most common health interventions. However, intervention content, follow-ups and discharge criteria were not fully reported.ConclusionsThis study examines the features of MoCs for LBP, highlighting that research is in its early stages and stressing the need for better reporting to fill gaps in care delivery and implementation. This knowledge is crucial for researchers, clinicians and decision-makers in assessing the applicability and transferability of MoCs to primary healthcare settings.
Coproduction of accessible digital mental health supports in partnership with young people from marginalised backgrounds: a scoping review protocol
Authors: Kealy Carmen , Potts Courtney , Mulvenna Maurice D , Donohoe Gary , O'Neill Siobhan , Barry Margaret M 
Published: May 2024

IntroductionDespite the evidence supporting the value of digital supports for enhancing youth mental health services, there is a lack of guidance on how best to engage with young people in coproduction processes during the design and evaluation of these technologies. User input is crucial in digital mental health, especially for disadvantaged, vulnerable and marginalised young people as they are often excluded from coproduction. A scoping review of international literature written in English will explore the coproduction processes with marginalised young people in digital mental health supports, from mental health promotion to targeted interventions. The review is guided by the research question: what are the most appropriate coproduction processes for engaging young people, especially marginalised young people, in the different stages of designing and evaluating digital mental health supports? The review aims to map and summarise the evidence, inform the overall research project and address the knowledge gaps.Methods and analysisThe scoping review uses Arksey and O’Malley’s framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols Extension for Scoping Reviews. From 22–24 October 2023, PubMed, Scopus, EBSCO, ASSIA, Web of Science, Ovid MEDLINE, Cochrane database, Embase, Google Scholar, ProQuest, OAIster and BASE will be systematically searched. Papers from 2021 onwards with a range of study designs and evidence that illustrate engagement with marginalised young people (aged 16–25) in the design, implementation and evaluation of digital technologies for young people’s mental health will be considered for inclusion. At least two reviewers will screen full texts and chart data. The results of this review will be summarised quantitatively through numerical counts of included literature and qualitatively through a narrative synthesis.Ethics and disseminationEthical approval is not required. Results will be disseminated through publications in peer-reviewed journals.Trial registration numberThis scoping review protocol has been registered with the Open Science Framework (https://osf.io/9xhgv).
Risk-adjusted trend in national inpatient fall rates observed from 2011 to 2019 in acute care hospitals in Switzerland: a repeated multicentre cross-sectional study
Authors: Bernet Niklaus S , Everink Irma H J , Hahn Sabine , Müller Marianne , Schols Jos M G A 
Published: May 2024

ObjectivesThis study aimed to investigate whether a significant trend regarding inpatient falls in Swiss acute care hospitals between 2011 and 2019 could be confirmed on a national level, and whether the trend persists after risk adjustment for patient-related fall risk factors.DesignA secondary data analysis was conducted based on annual multicentre cross-sectional studies carried out between 2011 and 2019.SettingAll Swiss acute care hospitals were obliged to participate in the surveys. Except for emergency departments, outpatient wards and recovery rooms, all wards were included.ParticipantsAll inpatients aged 18 or older who had given their informed consent and whose data were complete and available were included.Outcome measureWhether a patient had fallen in the hospital was retrospectively determined on the survey day by asking patients the following question: Have you fallen in this institution in the last 30 days?ResultsBased on data from 110 892 patients from 222 Swiss hospitals, a national inpatient fall rate of 3.7% was determined over the 9 survey years. A significant linear decreasing trend (p=0.004) was observed using the Cochran-Armitage trend test. After adjusting for patient-related fall risk factors in a two-level random intercept logistic regression model, a significant non-linear decreasing trend was found at the national level.ConclusionsA significant decrease in fall rates in Swiss hospitals, indicating an improvement in the quality of care provided, could be confirmed both descriptively and after risk adjustment. However, the non-linear trend, that is, an initial decrease in inpatient falls that flattens out over time, also indicates a possible future increase in fall rates. Monitoring of falls in hospitals should be maintained at the national level. Risk adjustment accounts for the observed increase in patient-related fall risk factors in hospitals, thus promoting a fairer comparison of the quality of care provided over time.
Research priorities for the management of major trauma: an international priority setting partnership with the James Lind Alliance
Authors: Bretherton Christopher Patrick , Hirst Robert , Gacaferi Hamez , Gower Jonathan , Exell Lauren , Johnston Scott , Martin Shan , Leech Caroline , Hilton Catherine , Battle Ceri , Axelrod Daniel , Vallier Heather , Van Embden Daphne , Stockton David J , Cole Elaine , Williams Julia , Johnson Louise , Laubscher Maritz , Webb Melissa , Braude Philip , Norris Sarah , Bell Steve , Maqungo Sithombo , Griffin Xavier Luke 
Published: May 2024

ObjectiveThe objective of this study is to determine research priorities for the management of major trauma, representing the shared priorities of patients, their families, carers and healthcare professionals.Design/settingAn international research priority-setting partnership.ParticipantsPeople who have experienced major trauma, their carers and relatives, and healthcare professionals involved in treating patients after major trauma. The scope included chest, abdominal and pelvic injuries as well as major bleeding, multiple injuries and those that threaten life or limb.MethodsA multiphase priority-setting exercise was conducted in partnership with the James Lind Alliance over 24 months (November 2021–October 2023). An international survey asked respondents to submit their research uncertainties which were then combined into several indicative questions. The existing evidence was searched to ensure that the questions had not already been sufficiently answered. A second international survey asked respondents to prioritise the research questions. A final shortlist of 19 questions was taken to a stakeholder workshop, where consensus was reached on the top 10 priorities.ResultsA total of 1572 uncertainties, submitted by 417 respondents (including 132 patients and carers), were received during the initial survey. These were refined into 53 unique indicative questions, of which all 53 were judged to be true uncertainties after reviewing the existing evidence. 373 people (including 115 patients and carers) responded to the interim prioritisation survey and 19 questions were taken to a final consensus workshop between patients, carers and healthcare professionals. At the final workshop, a consensus was reached for the ranking of the top 10 questions.ConclusionsThe top 10 research priorities for major trauma include patient-centred questions regarding pain relief and prehospital management, multidisciplinary working, novel technologies, rehabilitation and holistic support. These shared priorities will now be used to guide funders and teams wishing to research major trauma around the globe.
Patterns and clinical outcomes of childhood poisoning presenting to a children’s emergency department in Yenagoa, Nigeria: a 10-year retrospective study
Authors: Areprekumor Tare-Ebi , Joboy-Okei Evi , Amadin Nathan Osamwentin , Kalu Shedrach Uka 
Published: May 2024

IntroductionBackground: Childhood poisoning, characterised by exposure to toxic substances, poses a global health concern with variations across regions. Despite the importance of having current information about childhood acute poisoning in our region, there is a noticeable gap in such research in our local context. Regularly reviewing the agents responsible for poisoning in our locale is essential for devising prevention strategies and treatment approaches. This study aimed to examine the patterns and outcomes of childhood poisoning at the Children’s Emergency Department of the Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria.MethodsA retrospective cross-sectional study was conducted, analysing cases of childhood poisoning in the Children’s Emergency Ward, presenting from January 2013 to December 2022. Sociodemographic data, types of poisoning agents, home interventions, clinical features and outcomes were extracted from medical records.ResultsOf 9389 admissions, 81 (0.8%) cases were admitted for childhood poisoning, but only 69 cases were analysed (total n=69). Children aged under 5 years (52.2%) and who were males (59.4%) were mostly involved. Organophosphates (21.7%) and kerosene (20.3%) were common poisoning agents, often accidental (72.5%) and occurring at home (94.2%). Delayed hospital presentation (>2 hours) was common (68.1%). Vomiting (72.5%) and drooling saliva (56.5%) were prevalent symptoms. Hydration (60.9%) was the main hospital intervention, while antidotes were infrequently used (15.9%). Mortality was 8.7%, predominantly due to kerosene ingestion in young children.ConclusionOrganophosphate and kerosene poisoning are the most common in this facility. Enforcement challenges persist, emphasising the importance of safe storage practices and improved poison control measures. Addressing resource constraints for antidote availability and increasing awareness are vital for effective management and prevention.
When to reinvite initially ineligible populations for targeted lung cancer screening?
Authors: Goodley Patrick , Crosbie Philip A J , Sperrin Matthew , Merchant Zoe , Booton Richard , Balata Haval 
Published: May 2024

IntroductionTargeted low-dose CT lung cancer screening reduces lung cancer mortality. England’s Targeted Lung Health Check programme uses risk prediction tools to determine eligibility for biennial screening among people with a smoking history aged 55–74. Some participants initially ineligible for lung cancer screening will later become eligible with increasing age and ongoing tobacco exposure. It is, therefore, important to understand how many people could qualify for reinvitation, and after how long, to inform implementation of services.MethodsWe prospectively predicted future risk (using Prostate, Lung, Colorectal and Ovarian trial’s risk model (PLCOm2012) and Liverpool Lung Project version 2 (LLPv2) risk models) and time-to-eligibility of 5345 participants to estimate how many would become eligible through the course of a Lung Health Check screening programme for 55–74 years.ResultsApproximately a quarter eventually become eligible, with those with the lowest baseline risks unlikely to ever become eligible. Time-to-eligibility is shorter for participants with higher baseline risk, increasing age and ongoing smoking status. At a PLCOm2012threshold ≥1.51%, 68% of those who continue to smoke become eligible compared with 18% of those who have quit.DiscussionPredicting which participants may become eligible, and when, during a screening programme can help inform reinvitation strategies and service planning. Those with risk scores closer to the eligibility threshold, particularly people who continue to smoke, will reach eligibility in subsequent rounds while those at the lowest risk may be discharged from the programme from the outset.
1 Supporting family carers in best interest decision-making in dementia care at the end of life: findings from a cluster randomised control trial
Authors: Brazil Kevin , Carter Gillian , Cardwell Chris , Clarke Mike , Hudson Peter , Froggatt Katherine , McLaughlin Dorry , Passmore Peter , Kernohan W George 
Published: May 2024

BackgroundDementia is a leading cause of death worldwide. Often, people with moderate to advanced dementia are admitted to nursing homes for specialist care. When a person with dementia no longer has the capacity to make decisions about their care, nursing home staff, in combination with family members, may have to make decisions based on a person’s best interests. Family carers often report feeling unprepared to participate in these decisions. Advance Care Planning (ACP) can support family carers in best interest decision-making on goals of care at the end of life. However, given its relative importance, the prevalence of ACP in dementia care is poor. This study set out to examine the effectiveness of an intervention designed to facilitate ACP with family carers.MethodsA paired cluster randomised controlled trial was employed. The intervention comprised: a trained facilitator; family education; family meetings; documentation of ACP decisions; and intervention orientation for GPs and nursing home staff. Twenty-four nursing homes with a dementia nursing category located in Northern Ireland, UK participated. Family carers of nursing home residents classified as having dementia and judged as not having decisional capacity to participate in ACP discussions were invited to take part. Participants completed postal questionnaires prior to receiving the intervention or usual care and again, six weeks later.Results12 nursing homes were allocated to each group, 11 from intervention and 12 from usual care were analysed. The primary outcome was family carer uncertainty in decision-making about the care of the resident as measured by the Decisional Conflict Scale (DCS). There was evidence of a reduction in total DCS score in the intervention group compared with the usual care group (−10.5, 95% confidence interval −16.4 to −4.7; p<0.001).ConclusionsThe ACP was effective in reducing family carer uncertainty in decision-making concerning the care of their family member and improving perceptions of quality of care in nursing homes. Implications for clinicians and policy makers include the need to recognise the importance of family carer education and improving communication between family carers and formal care providers.
21 Exploring the effectiveness of a mindfulness-based intervention for staff in a palliative care setting
Authors: Hill Rebecca C , Graham-Wisener Lisa , Finucane Anne , Kavanagh Michele , McCorry Noleen K , Donnelly Michael , Dempster Martin 
Published: May 2024

IntroductionPalliative care staff engage in emotional and stressful work; however, research is yet to offer any insights as to what types of psychosocial intervention can effectively improve staff psychological well-being (Hill, Dempster, Donnelly, & McCorry, 2016).AimsThis research aims to evaluate the effectiveness of a Mindfulness-Based Intervention (MBI), which was condensed to make it more feasible for staff to attend, to improve the psychological well-being of palliative care staff.MethodsThe effectiveness of the intervention was evaluated quantitatively, using four psychological measures taken at baseline, post-intervention, and at follow-up with the intervention group; these measures were also taken at the same three time-points with a comparison group for comparison purposes.Qualitative data was collected through interviews with intervention participants and then thematic analysis was used to garner information on the feasibility, acceptability, and effectiveness of the intervention.ResultsParticipants in the intervention group had significant improvements in resilience (P =<0.001), self-compassion (p=0.003), and mindfulness (p=0.019), whereas the comparison group had no significant improvements on these outcomes.Initial qualitative findings indicate staff found the mindfulness course a positive experience with some describing a big impact on their personal and/or working life and others describing that they’d taken something away - usually a preferred meditation that they could use a self-care tool but also a more balanced perspective on their thinking.ConclusionThis research suggests a condensed MBI can effectively improve staff psychological well-being; furthermore, findings can inform future development of MBIs for this setting.References. Hill RC, Dempster M, Donnelly M, McCorry NK. Improving the wellbeing of staff who work in palliative care settings: A systematic review of psychosocial interventions. Palliative Medicine2016;30(9):825–833.. Neff KD, The development and validation of a scale to measure self-compassion. Self and identity2003;2(3):223–250.
22 Barriers and facilitators to implementing the carer support needs assessment toolin a community palliative care setting
Authors: Horseman Zoe , Milton Libby , Finucane Anne 
Published: May 2024

IntroductionFamily carers play a central role in community-based palliative care. However, caring for a terminally ill person puts the carer at increased risk of physical and mental morbidity, which is detrimental for both carer and patient (Williams & McCorkle, 2011). The validated Carer Support Needs Assessment Tool (CSNAT) provides a comprehensive measure of carer support needs and is intended for use in community palliative care (Ewing & Grande, 2013). The CSNAT creates an opportunity for carers to discuss their needs with healthcare professionals, facilitating the provision of appropriate support. A recent audit demonstrated poor use of the CSNAT in a Scottish community specialist palliative care service despite training and support.AimTo identify barriers and facilitators to implementation of the CSNAT in a community specialist palliative care service.MethodsA qualitative study was undertaken, involving interviews with 12 palliative care nurse specialists from two community nursing teams in Lothian, Scotland. Data was audio-recorded, transcribed and thematically analysed using a framework approach.ResultsData analysis is in progress. The results will identify factors which enable and prevent the use of the CSNAT in a community palliative care setting. Recommendations for improving the acceptability of the CSNAT will be developed.ConclusionFindings from this study have the potential to enhance engagement with the CSNAT, make it more congruent with current nursing practice, and improve the experience of carers of people approaching the end-of-life.References. Ewing G, Brundle C, Payne S, Grande G. The carer support needs assessment tool (CSNAT) for use in palliative care and end of life care at home: A validation study. Journal of Pain and Symptom Management 2013;46(2013):395–405.. Williams A, Mccorkle R. Cancer family caregivers during the palliative, hospice and bereavement phases: a review of the descriptive psychological literature.Palliative and supportive care2011;9:315–325.