bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding the uptake of virtual care for first and return outpatient appointments in child and adolescent mental health services: a mixed-methods study
Authors: Campbell Leslie Anne , Clark Sharon E , Chorney Jill , Emberly Debbie , Carrey NJ , Bagnell Alexa , Blenus Jaime , Daneff Miriam , Campbell John Charles 
Published: December 2023

ObjectiveTo describe patterns of virtual and in-person outpatient mental health service use and factors that may influence the choice of modality in a child and adolescent service.DesignA pragmatic mixed-methods approach using routinely collected administrative data between 1 April 2020 and 31 March 2022 and semi-structured interviews with clients, caregivers, clinicians and staff. Interview data were coded according to the Consolidated Framework for Implementation Research (CFIR) and examined for patterns of similarity or divergence across data sources, respondents or other relevant characteristics.SettingChild and adolescent outpatient mental health service, Nova Scotia, Canada.ParticipantsIWK Health clinicians and staff who had participated in virtual mental healthcare following its implementation in March 2020 and clients (aged 12–18 years) and caregivers of clients (aged 3–18 years) who had received treatment from an IWK outpatient clinic between 1 April 2020 and 31 March 2022 (n=1300). Participants (n=48) in semi-structured interviews included nine clients aged 13–18 years (mean 15.7 years), 10 caregivers of clients aged 5–17 years (mean 12.7 years), eight Community Mental Health and Addictions booking and registration or administrative staff and 21 clinicians.ResultsDuring peak pandemic activity, upwards of 90% of visits (first or return) were conducted virtually. Between waves, return appointments were more likely to be virtual than first appointments. Interview participants (n=48) reported facilitators and barriers to virtual care within the CFIR domains of ‘outer setting’ (eg, external policies, client needs and resources), ‘inner setting’ (eg, communications within the service), ‘individual characteristics’ (eg, personal attributes, knowledge and beliefs about virtual care) and ‘intervention characteristics’ (eg, relative advantage of virtual or in-person care).ConclusionsShared decision-making regarding treatment modality (virtual vs in-person) requires consideration of client, caregiver, clinician, appointment, health system and public health factors across episodes of care to ensure accessible, safe and high-quality mental healthcare.
Associations of academic environment, lifestyle, sense of coherence and social support with self-reported mental health status among dental students at a university in Brazil: a cross-sectional study
Authors: Silva Andréa Neiva da , Vettore Mario Vianna 
Published: December 2023

ObjectivesThe study evaluated the association of academic environment, lifestyle, sense of coherence (SOC) and social support with self-reported mental health status among dental students.DesignSecondary analysis of data from a cross-sectional, questionnaire-based survey conducted from August to October 2018.SettingDental school of a public-funded university in the south-eastern region of Brazil.Participants233 undergraduate dental students recruited across all years of the course.Outcome measuresSocioeconomic and demographic characteristics, city of origin and student’s academic semester were obtained through self-completed questionnaires. Perception of the academic environment (Dundee Ready Education Environment Measure (DREEM)), individual lifestyle (Individual Lifestyle Profile Questionnaire (ILPQ)), SOC (SOC Scale (SOC-13)), social support (Medical Outcomes Study Scale (MOS)), and depression, anxiety and stress (Depression, Anxiety and Stress Scale-21 (DASS-21)) were assessed using validated instruments. The relationships between variables were investigated through multivariable negative binomial regression to obtain the rate ratios (RRs) and 95% CIs.ResultsFemale sex was associated with greater scores of anxiety (RR 1.74, 95% CI 1.10 to 1.97) and stress (RR 1.52, 95% CI 1.12 to 2.06). Students who perceived a better academic environment and those reporting a greater SOC had a lower probability of depression, anxiety and stress. Furthermore, a favourable lifestyle was associated with lower depression scores (RR 0.99, 95% CI 0.97 to 0.99). Social support did not remain associated with depression, anxiety and stress after adjustment.ConclusionsThe present findings suggest that self-reported mental health status is associated with students’ sex, academic environment, SOC and lifestyle. Enhancing the educational environment and SOC, and promoting a healthy lifestyle may improve the psychological health of dental students.
Diet in relation to Metabolic, sleep and psychological health Status (DiMetS): protocol for a cross-sectional study
Authors: Poursalehi Donya , Shahdadian Farnaz , Hajhashemy Zahra , Lotfi Keyhan , Moradmand Zahra , Rouhani Parisa , Mohammadi Sobhan , Mokhtari Elahe , Saneei Parvane 
Published: December 2023

IntroductionMetabolic disturbances are of major health concerns in the world. In addition to their high prevalence, these disorders have substantial roles in developing other physical and mental diseases. Diet could have a considerable influence on managing the progression of these conditions and their consequent health-related effects. The aim of the ‘Diet in relation to Metabolic, sleep and psychological health Status’ Project is to explore the association of nutrition with metabolic, sleep and mental health, considering potential mediators including brain-derived neurotrophic factor (BDNF) and adropin.Methods and analysisThis cross-sectional study will be conducted on adults (20–65 years) working in schools of Isfahan, Iran. A multistage cluster random sampling method will be used to select participants. Anthropometric, body composition and biochemical values including fasting blood glucose, lipid profile, 25-hydroxy vitamin D, insulin, BDNF, adropin, malondialdehyde, superoxide dismutase, glutathione peroxidase, uric acid, creatinine and C reactive protein will be measured for each participant. National Cholesterol Education Program and Adult Treatment Panel III will be considered to define metabolic syndrome. Diet will be assessed through a validated Food Frequency Questionnaire. Furthermore, sleep status, mental health, quality of life, physical activity and demographic status of individuals will be assessed by validated questionnaires. The collected data will be analysed using appropriate statistical methods.Ethics and disseminationThe study protocol was approved by the local Ethics Committee of Isfahan University of Medical Sciences. All participants will provide written informed consent. Dissemination will be through conference presentations and publications in peer-reviewed journals.
Cohort study to characterise surgical site infections after open surgery in the UK’s National Health Service
Authors: Guest Julian F , Fuller Graham W , Griffiths Ben 
Published: December 2023

ObjectiveTo characterise surgical site infections (SSIs) after open surgery in the UK’s National Health Service.DesignRetrospective cohort analysis of electronic records of patients from Clinical Practice Research Datalink, linked with Hospital Episode Statistics’ secondary care datasets.SettingClinical practice in the community and secondary care.ParticipantsCohort of 50 000 adult patients who underwent open surgery between 2017 and 2022.Outcome measuresIncidence of SSI, clinical outcomes, patterns of care and costs of wound management.Results11% (5281/50 000) of patients developed an SSI a mean of 18.4±14.7 days after their surgical procedure, of which 15% (806/5281) were inpatients and 85% (4475/5281) were in the community after hospital discharge. The incidence of SSI varied according to anatomical site of surgery. The incidence also varied according to a patient’s risk and whether they underwent an emergency procedure. SSI onset reduced the 6 months healing rate by a mean of 3 percentage points and increased time to wound healing by a mean of 15 days per wound. SSIs were predominantly managed in the community by practice and district nurses and 16% (850/5281) of all patients were readmitted into hospital. The total health service cost of surgical wound management following SSI onset was a mean of £3537 per wound ranging from £2542 for a low-risk patient who underwent an elective procedure to £4855 for a high-risk patient who underwent an emergency procedure.ConclusionsThis study provides important insights into several aspects of SSI management in clinical practice in the UK that have been difficult to ascertain from surveillance data. Surgeons are unlikely to be fully aware of the true incidence of SSI and how they are managed once patients are discharged from hospital. Current SSI surveillance services appear to be under-reporting the actual incidence.
Shared decision-making improving efficacy in diarrhoea-dominant irritable bowel syndrome in Chinese outpatient setting: protocol of a prospective, randomised controlled trial
Authors: Song Kai , Fan Zhengyang , Chen Yang , Fei Guijun , Li Xiaoqing , Wu Dong 
Published: December 2023

IntroductionDiarrhoea-dominant irritable bowel syndrome (IBS-D) is a disorder with multiple pathogenesis; many people with IBS-D may have psychosocial issues which can make assessment and treatment more difficult. Routine treatment procedure might not always achieve the desired outcome. Therefore, patients may not be satisfied with the conventional experience and would like to be more involved in clinical decision-making. A shared decision-making (SDM) model, that requires patient participation, has been demonstrated to have a powerful effect on the diagnosis and treatment of other diseases, which improves patients’ compliance, satisfaction, thus refining the clinical outcome. However, there is no corresponding evidence in IBS-D. Herein, we hope to verify the effect of SDM through clinical studies, and we anticipate that SDM can improve the therapeutic effect in patients with IBS-D.MethodsThe study is a prospective, randomised, single-centre trial. 166 IBS-D outpatients who attend Peking Union Medical College Hospital will be allocated into routine treatment group and SDM group. The primary endpoint is the severity of bowel symptoms, measured by the IBS symptom severity scale. Secondary endpoints include impact of disease and quality of life, negative psychology and the evaluation of diagnosis and treatment process.Ethics and disseminationEthical approval has been obtained from the research ethics committee of Peking Union Medical College Hospital (I-23PJ470). This protocol has been approved by Chinese Clinical Trial Register (ChiCTR2300073681) in July 2023. The results of this trial will be published in an open-access way and disseminated among gastrointestinal physicians.Trial registration numberChinese Clinical Trial Register (ChiCTR2300073681).
Defining ‘therapeutic value’ of medicines: a scoping review
Authors: Glaus Camille E G , Kloeti Andrina , Vokinger Kerstin N 
Published: December 2023

ObjectivesIn recent years, discussions on the importance and scope of therapeutic value of new medicines have intensified, stimulated by the increase of prices and number of medicines entering the market. This study aims to perform a scoping review identifying factors contributing to the definition of the therapeutic value of medicines.DesignScoping review.Data sourcesWe searched the MEDLINE, CINAHL, Embase, Business Source Premier, EconLit, Regional Business News, Cochrane, Web of Science, Scope and Pool databases through December 2020 in English, German, French, Italian and Spanish.Eligibility criteriaStudies that included determinants for the definition of therapeutic value of medicines were included.Data extraction and synthesisData were extracted using the mentioned data sources. Two reviewers independently screened and analysed the articles. Data were analysed from April 2021 to May 2022.ResultsOf the 1883 studies screened, 51 were selected and the identified factors contributing to the definition of therapeutic value of medicines were classified in three categories: patient perspective, public health perspective and socioeconomic perspective. More than three-quarters of the included studies were published after 2014, with the majority of the studies focusing on either cancer disorders (14 of 51, 27.5%) or rare diseases (11 of 51, 21.6%). Frequently mentioned determinants for value were quality of life, therapeutic alternatives and side effects (all patient perspective), prevalence/incidence and clinical endpoints (all public health perspective), and costs (socioeconomic perspective).ConclusionsMultiple determinants have been developed to define the therapeutic value of medicines, most of them focusing on cancer disorders and rare diseases. Considering the relevance of value of medicines to guide patients and physicians in decision-making as well as policymakers in resource allocation decisions, a development of evidence-based factors for the definition of therapeutic value of medicines is needed across all therapeutic areas.
Incorporating usability evaluation into iterative development of an online platform to support research participation in Parkinson’s disease: a mixed methods protocol
Authors: Chapman Rebecca , Zeissler Marie-Louise , Meinert Edward , Mullin Stephen , Whipps Sue , Whipps John , Hockey Kate , Hockey Philip , Carroll Camille B 
Published: December 2023

IntroductionMany people with Parkinson’s (PwP) are not given the opportunity or do not have adequate access to participate in clinical research. To address this, we have codeveloped with users an online platform that connects PwP to clinical studies in their local area. It enables site staff to communicate with potential participants and aims to increase the participation of the Parkinson’s community in research. This protocol outlines the mixed methods study protocol for the usability testing of the platform.Methods and analysisWe will seek user input to finalise the platform’s design, which will then be deployed in a limited launch for beta testing. The beta version will be used as a recruitment tool for up to three studies with multiple UK sites. Usability data will be collected from the three intended user groups: PwP, care partners acting on their behalf and site study coordinators. Usability questionnaires and website analytics will be used to capture user experience quantitatively, and a purposive sample of users will be invited to provide further feedback via semistructured interviews. Quantitative data will be analysed using descriptive statistics, and a thematic analysis undertaken for interview data. Data from this study will inform future platform iterations.Ethics and disseminationEthical approval was obtained from the University of Plymouth (3291; 3 May 2022). We will share our findings via a ‘Latest News’ section within the platform, presentations, conference meetings and national PwP networks.
Acceptability of aspirin for cancer preventive therapy: a survey and qualitative study exploring the views of the UK general population
Authors: Lloyd Kelly E , Hall Louise H , Ziegler Lucy , Foy Robbie , Green Sophie M C , MacKenzie Mairead , Taylor David G , Smith Samuel G 
Published: December 2023

ObjectivesAspirin could be offered for colorectal cancer prevention for the UK general population. To ensure the views of the general population are considered in future guidance, we explored public perceptions of aspirin for preventive therapy.DesignWe conducted an online survey to investigate aspirin use, and awareness of aspirin for cancer prevention among the UK general population. We conducted semistructured interviews with a subsample of survey respondents to explore participants’ acceptability towards aspirin for cancer preventive therapy. We analysed the interview data using reflexive thematic analysis and mapped the themes onto the Theoretical Domains Framework, and the Necessity and Concerns Framework.SettingOnline survey and remote interviews.ParticipantsWe recruited 400 UK respondents aged 50–70 years through a market research company to the survey. We purposefully sampled, recruited and interviewed 20 survey respondents.ResultsIn the survey, 19.0% (76/400) of respondents were aware that aspirin can be used to prevent cancer. Among those who had previously taken aspirin, 1.9% (4/216) had taken it for cancer prevention. The interviews generated three themes: (1) perceived necessity of aspirin; (2) concerns about side effects; and (3) preferred information sources. Participants with a personal or family history of cancer were more likely to perceive aspirin as necessary for cancer prevention. Concerns about taking aspirin at higher doses and its side effects, such as gastrointestinal bleeding, were common. Many described wanting guidance and advice on aspirin to be communicated from sources perceived as trustworthy, such as healthcare professionals.ConclusionsAmong the general population, those with a personal or family history of cancer may be more receptive towards taking aspirin for preventive therapy. Future policies and campaigns recommending aspirin may be of particular interest to these groups. Multiple considerations about the benefits and risks of aspirin highlight the need to support informed decisions on the medication.
Accuracy of antibiotic concentrations in drug dispensing in neonates: a laboratory-based study
Authors: Zheng Li-Yuan , Gu Wei-Ping , Liang Na , Gao Li-Li , Guo Wen-Wen , Li Rui-Rui , Wang Xin , Hao Guo-Xiang , Van Den Anker John , Wu Yue-E , Zhao Wei 
Published: December 2023

BackgroundAntibacterial therapy plays a crucial role in neonatal infections. The efficacy of antibacterial agents is closely related to the actual dose given to neonates. So we evaluated factors potentially affecting the actual dose of intravenous antibiotics during dispensing process in neonates.MethodsMeropenem, cefoperazone/sulbactam and piperacillin/tazobactam with two strengths were used to evaluate three methods. Method A (MA) was diluted once and the volumes of 5% glucose for MAwere meropenem 4.00 mL, cefoperazone/sulbactam 3.00 mL, piperacillin/tazobactam 9.00 mL. Method B (MB) differed by doubling the volume of 5% glucose. The difference in method C (MC) involved diluting with 5% glucose twice. The concentrations were measured by high-performance liquid chromatography. Relative error (RE) was used to evaluate the preparation accuracy.ResultsThe RE values using MA/MB/MCwere: (1) meropenem 0.5 g: 15.1%, 8.0%, 10.4%; 0.25 g: 7.8%, 3.1%, 6.0%; (2) cefoperazone/sulbactam 1.5 g: 13.6%, 4.2%, 3.4%; 0.75 g: 8.8%, 3.5%, 4.0%; (3) piperacillin/tazobactam 4.5 g: 18.2%, 8.7%, 6.3%; 562.5 mg: 8.1%, 2.8%, 6.1%. MBwas better than MAin all three drugs. No difference in RE values was found between single and double dilution, except meropenem with 0.25 g. Using MB, meropenem and piperacillin/tazobactam with small drug strength had higher accuracy in preparation.ConclusionsMBwas suitable for neonatal drug dispensing because of its high accuracy and simple operation. Drugs with small strength were promoted due to the high accuracy.
Overview of road traffic injuries among migrant workers in Guangzhou, China, from 2017 to 2021
Authors: Yang Tengfei , Kong Jiangwei , Chen Xinzhe , Zeng Haotian , Zhou Nian , Yang Xingan , Miao Qifeng , Liao Xinbiao , Zhang Fu , Lan Fengchong , Wang Huijun , Li Dongri 
Published: December 2023

IntroductionThere are many migrant workers in China’s first-tier cities, but little is known about road safety. This paper systematically analysed road traffic injuries and risk factors among migrant workers in Guangzhou, China.MethodsRoad traffic crash data from 2017 to 2021 were obtained from the Guangzhou Public Security Traffic Management Integrated System. We plotted the crash network of road users in road traffic crashes and used logistic regression to analyse the risk factors for migrant workers of motorcycle and four-wheeled vehicle crashes. Moreover, the roles of migrant workers and control individuals as perpetrators in road traffic crashes were also analysed.ResultsBetween 2017 and 2021, 76% of road traffic injuries were migrant workers in Guangzhou. Migrant workers who were motorcyclist drivers most commonly experienced road traffic injuries. Crashes between motorcyclists and car occupants were the most common. The illegal behaviours of migrant worker motorcyclists were closely related to casualties, with driving without a licence only and driving without a licence and drunk driving accounting for the greatest number. Migrant workers were responsible for many injuries of other road users. Motorcycle drivers have a higher proportion of drunk driving.DiscussionMigrant workers play an important role in road traffic safety. They were both the leading source of road traffic injuries and the main perpetrators of road traffic crashes. Measures such as strict requirements for migrant workers to drive motorcycles with licences, prohibit drunk driving, greater publicity of road safety regulations, and combining compulsory education with punishment for illegal behaviours.
Disease activity and neonatal outcomes after exposure to natalizumab throughout pregnancy
Authors: Thiel Sandra , Litvin Nastassja , Haben Sabrina , Gold Ralf , Hellwig Kerstin 
Published: December 2023

BackgroundAfter natalizumab discontinuation severe relapses can occur despite pregnancy, but third trimester exposure is associated with neonatal haematological abnormalities (HA). The best time point for stopping natalizumab during pregnancy is unclear.MethodsProspective, observational cohort with 350 natalizumab exposed pregnancies from the German Multiple Sclerosis and Pregnancy Registry. Clinical disease activity and neonatal outcomes are compared between women with natalizumab discontinuation during (1st Trim-group) versus after the first trimester (maintaining-group) and for subgroup analysis before (<30-subgroup) or after (≥30-subgroup) the 30th gestational week (gw).ResultsBaseline characteristics did not significantly differ between the 1st Trim-group (n=179; median exposure duration: 2.60 gw, IQR 1.30–3.60) and the maintaining-group (n=171; median exposure duration: 30.9 gw, IQR 26.9–33.3). Fewer relapses occurred during pregnancy and the postpartum year in the maintaining-group (25.7%) compared with the 1st Trim-group (62.6%; p<0.001). Women in ≥30-subgroup had a significantly lower relapse risk in the first 6 months postpartum (relapse rate ratio: 0.36, 95% CI: 0.15 to 0.84). In total, 7.5% retained meaningful disability 12 months postpartum. No significant effect on neonatal outcomes were observed, but anaemia (OR: 2.62, 95% CI: 1.12 to 6.52) and thrombocytopaenia (OR: 2.64, 95% CI: 1.15 to 6.46) were significantly more common in the ≥30-subgroup. 21.8% of all neonates were born small for gestational age, independent of the timing of natalizumab discontinuation.ConclusionContinuing natalizumab during pregnancy after gw 30 decreases the relapse risk postpartum going along with a higher risk for HA in the newborns. These results add relevant knowledge as a basis for informed risk–benefit discussion.