bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experiences of individuals with rheumatoid arthritis interacting with health care and the use of a digital self-care application: a qualitative interview study
Authors: Viberg Johansson Jennifer , Blyckert Hanna , Schölin Bywall Karin 
Published: December 2023

ObjectivesOver the last few decades, there have been significant improvements in the treatment of rheumatoid arthritis (RA), with the development of new treatments and guidelines for teamwork and patient self-care and access to digital tools. This study aimed to explore the experiences of individuals with RA interacting with healthcare. It also looked at how a self-care application, an educational programme called the ‘healthcare encounter’, improved patient–doctor communication.DesignSemistructured interviews were conducted, and qualitative content analysis was performed.SettingThe potential participants, individuals with established, or under investigation for, RA diagnosis at rheumatology clinics in Sweden, were asked to participate in the study via a digital self-care application called the Elsa Science Self-care app.ParticipantsTen interviews were performed with participants from nine clinics following a meeting with the rheumatologist or other healthcare personnel between September 2022 and October 2022. Phrases, sentences or paragraphs referring to experiences from healthcare meetings and opinions about the digital programme were identified and coded. Codes that reflected similar concepts were grouped; subcategories were formulated, and categories were connected to their experiences and opinions.ResultsAmong our participants, three main categories emerged: the availability of healthcare, individual efforts to have a healthier life and personal interaction with healthcare. Participants described that the ‘healthcare encounter’ educational programme can be a source of information, which confirms, supports and creates a sense of control.ConclusionThe participants valued being seen and taking part in a dialogue when they had prepared themselves (observed symptoms over time and prepared questions). The implementation of digital self-care applications might need to be incorporated into the healthcare setting, so that both the patients and the healthcare personnel have a shared understanding. Collaboration is essential in this context.
Establishment and validation of a prediction model for myocarditis in Chinese children below 14 years old: a protocol for a retrospective cohort study
Authors: Wu Lifeng , Ji Weidan , Huang Yumao , Zeng Huanxuan , Chen Jie , Zou Yueling , Lin Weiguo , Lin Yuzhan 
Published: December 2023

IntroductionPaediatric myocarditis, a rare inflammatory disease, often presents without clear early symptoms. Although cardiac troponin I levels can aid in diagnosing myocarditis, they are not definitive indicators. Troponin I levels frequently fluctuate within and outside the reference range, potentially causing misinterpretations by clinicians. Although a negative troponin I result is valuable for excluding myocarditis, its specificity is low. Moreover, the clinical diagnosis of paediatric myocarditis is exceptionally challenging, and accurate early-stage diagnosis and treatment pose difficulties. Currently, the Dallas criteria, involving cardiac biopsy, serves as the gold standard for myocarditis diagnosis. However, this method has several drawbacks and is unsuitable for children, resulting in its limited use.Methods and analysisIn this study, we will employ multiple logistic regression analysis to develop a predictive model for early childhood myocarditis. This model will assess the patient’s condition at onset and provide the probability of a myocarditis diagnosis. Model performance will be evaluated for accuracy and calibration, and the results will be presented through receiver operating characteristic (ROC) curves and calibration plots. Clinical decision curve analysis, in conjunction with ROC curve analysis, will be employed to determine the optimal cut-off value and calculate the net clinical benefit value for assessing clinical effectiveness. Finally, internal model validation will be conducted using bootstrapping.Ethics and disseminationApproval from the Clinical Research Ethics Committee of The Third Affiliated Hospital of Wenzhou Medical University has been obtained. The research findings will be disseminated through presentations at scientific conferences and publication in peer-reviewed journals.
Self-Management Analysis in Chronic Conditions (SMACC) checklist: an international consensus-based tool to develop, compare and evaluate self-management support programmes
Authors: Moreels Timothy , Cruyt Ellen , De Baets Stijn , Andries Lore , Arts-Tielemans Magelien , Rodriguez-Bailon Maria , Bergström Aileen , Boete Kyara , Bormans Iris , Costa Ursula , Declercq Hanne , Dekelver Sari , Dekyvere Virginie , Delooz Eva , Engels Cynthia , Helderweirt Sam , Jarrey Mike , Lenaerts Anneleen , Leyman Anneleen , Lim Kee Hean , Meynen Louise , Satink Ton , Schoenmakers Freya , Senn Daniela , Slembrouck Lise , Van Meensel Emma , Vangenechten Dani , Van Paepeghem Bram , De Vriendt Patricia , Van de Velde Dominique 
Published: December 2023

ObjectivesThe Self-Management Analysis in Chronic Conditions (SMACC) checklist was developed as a guidance tool to support the development, comparison and evaluation of self-management support programmes for persons with a chronic condition. The checklist was based on a previously performed concept analysis of self-management. The aim of this study was to validate its content using an international Delphi study and to deliver a final version.DesignA two-round Delphi study was conducted between October 2022 and January 2023. Using the researchers’ networks, professionals with research or clinical expertise in self-management support and chronic conditions were recruited via online purposive snowball sampling. Participants were asked to score each item of the checklist (16 items total) on 3 content validity indicators: (1) clarity and comprehensibility, (2) relevance and importance and (3) degree of alignment with the overall goal of the checklist to promote adequate and comprehensive self-management support programmes. A consensus threshold of 75% agreement was used. The participants were also asked general questions about the checklist as a whole and were asked to provide feedback considering its refinement.ResultsFifty-four professionals with an average 14.5 years of experience participated in round 1, 48 with an average 12.5 years of experience participated in round 2. The majority of professionals were from Western Europe. For the majority of items consensus was reached after round 1. In round 2, 3 of the 4 remaining items reached consensus, 1 last item was retained based on highly recurring feedback.ConclusionsThe SMACC checklist was considered a valid and comprehensive tool to aid the development, evaluation and comparison of self-management support programmes. It was acknowledged as a useful instrument to supplement existing frameworks and was seen as feasible to implement in both research and clinical settings. Further validation in the field, with input from patients and peer experts, will be valuable.
Prevalence, awareness, treatment and control of dyslipidaemia and their determinants: results from a population-based survey of 60 283 residents in eastern China
Authors: Chen Yijia , Du Jinling , Zhou Nan , Song Yingqian , Wang Weiwei , Hong Xin 
Published: December 2023

ObjectivesTo investigate the prevalence, awareness, treatment and control of dyslipidaemia and its associated factors in eastern China.DesignCross-sectional study.SettingData were collected from the 2017 Nanjing Chronic Disease and Risk Factor Surveillance.ParticipantsThis study included 60 283 participants aged ≥18 years.Outcome measuresPrevalence of dyslipidaemia was defined as self-reported history of dyslipidaemia and/or the use of lipid-lowering medication, and/or meeting at least one of the following during on-site investigation: total cholesterol ≥6.2 mmol/L, triglyceride ≥2.3 mmol/L, low-density lipoprotein cholesterol ≥4.1 mmol/L and high-density lipoprotein cholesterol <1.0 mmol/L. Dyslipidaemia awareness was defined as the proportion of patients with dyslipidaemia who explicitly indicate their awareness of having a diagnosis of dyslipidaemia. Treatment was based on medication use among individuals with dyslipidaemia. Control was defined as having dyslipidaemia, receiving treatment and achieving serum lipid control to the standard level.AnalysisComplex weighting was used to calculate weighted prevalence. A two-level logistic regression model determined the influencing factors for dyslipidaemia prevalence, awareness, treatment and control.ResultsThe crude prevalence rate of dyslipidaemia was 28.4% (17 093 of 60 283). Among 17 093 patients with dyslipidaemia, the crude rates of awareness, treatment and control were 40.0% (n=6830), 27.5% (n=4695) and 21.9% (n=3736), respectively. The corresponding weighted prevalence rates were 29.8%, 41.6%, 28.9% and 22.9%. Older age (OR 2.03, 95% CI 1.82 to 2.23), urban residence (1.24, 1.19 to 1.31), higher education level (1.31, 1.21 to 1.42), current smoking (1.22, 1.15 to 1.29), alcohol consumption (1.20, 1.14 to 1.26), obesity (2.13, 1.99 to 2.29), history of hypertension (1.64, 1.56 to 1.71) and diabetes (1.92, 1.80 to 2.04) were identified as independent risk factors for dyslipidaemia (all p<0.001). Participants who were older, female, living in urban areas, had higher education levels, did not smoke or drink alcohol, had central obesity, had hypertension or had diabetes were more likely to be aware of their dyslipidaemia conditions, receive treatment and achieve serum lipid control to a standard level than their comparators (all p<0.05).ConclusionsThe prevalence of dyslipidaemia is relatively high in eastern China; however, awareness, treatment and control levels are relatively low.
Self-reported condom use among Washington State residents prior to and during the COVID-19 pandemic: a cross-sectional analysis of BRFSS data
Authors: Jewell Mary , Jampel Sonya M , Casagrande Mary Grace , Ásbjörnsdóttir Kristjana , Littman Alyson J 
Published: December 2023

ObjectivesCOVID-19 significantly impacted healthcare access and sexual behaviour, but little is known about how COVID-19 affected condom use. This study aimed to investigate whether self-reported condom use and sex in Washington State changed during pandemic restrictions compared with prepandemic.DesignCross-sectional survey data from the Behavioral Risk Factor Surveillance System.SettingWashington State.Participants11 684 participants aged 18–65.Primary and secondary outcome measuresThe primary outcome was changes in the prevalence of condom use by time of interview pre-COVID-19, before the Washington State lockdown (1 January 2019 to 23 March 2020, n=7708) and during COVID-19, after the first state lockdown (24 March 2020 to 31 December 2020, n=3976). The secondary outcome was changes in the prevalence of reported sex during the same periods. We assessed whether associations differed by rurality and HIV risk behaviour.ResultsCondom use was similar during COVID-19 (37.3%) compared with pre-COVID-19 (37.8%) (adjusted prevalence ratio (PR): 0.98, 95% CI 0.89, 1.01). Associations did not differ by rurality or HIV risk behaviour. Compared with pre-COVID-19 (83.0%), a smaller proportion of respondents reported having sex in the last 12 months during COVID-19 (80.5%), a relative decrease of 3% (PR: 0.97, 95% CI 0.96, 0.99; p<0.001).ConclusionsThe prevalence of reported sex declined during COVID-19, but condom use remained steady in Washington. As our reproductive health system faces increased challenges, these results may inform future sexual health services.
Cohort profile: COBLAnCE: a French prospective cohort to study prognostic and predictive factors in bladder cancer and to generate real-world data on treatment patterns, resource use and quality of life
Authors: Lebret Thierry , Bonastre Julia , Fraslin Aldéric , Neuzillet Yann , Droupy Stéphane , Rebillard Xavier , Vordos Dimitri , Guy Laurent , Villers Arnauld , Schneider Marc , Coloby Patrick , Lacoste Jean , Méjean Arnaud , Lacoste Jacques , Descotes Jean-Luc , Eschwege Pascal , Loison Guillaume , Blanché Hélène , Mariani Odette , Ghaleh Bijan , Mangin Anthony , Sirab Nanor , Groussard Karine , Radvanyi François , Allory Yves , Benhamou Simone 
Published: December 2023

PurposeBladder cancer is a complex disease with a wide range of outcomes. Clinicopathological factors only partially explain the variability between patients in prognosis and treatment response. There is a need for large cohorts collecting extensive data and biological samples to: (1) investigate gene-environment interactions, pathological/molecular classification and biomarker discovery; and (2) describe treatment patterns, outcomes, resource use and quality of life in a real-world setting.ParticipantsCOBLAnCE (COhort to studyBLAdderCancEr) is a French national prospective cohort of patients with bladder cancer recruited between 2012 and 2018 and followed for 6 years. Data on patient and tumour characteristics, treatments, outcomes and biological samples are collected at enrolment and during the follow-up.Findings to dateWe describe the cohort at enrolment according to baseline surgery and tumour type. In total, 1800 patients were included: 1114 patients with non-muscle-invasive bladder cancer (NMIBC) and 76 patients with muscle-invasive bladder cancer (MIBC) had transurethral resection of a bladder tumour without cystectomy, and 610 patients with NMIBC or MIBC underwent cystectomy. Most patients had a solitary lesion (56.3%) without basement membrane invasion (71.7% of Ta and/or Tis). Half of the patients with cystectomy were stage ≤T2 and 60% had non-continent diversion. Surgery included local (n=298) or super-extended lymph node dissections (n=11) and prostate removal (n=492). Among women, 16.5% underwent cystectomy and 81.4% anterior pelvectomy.Future plansCOBLAnCE will be used for long-term studies of bladder cancer with focus on clinicopathological factors and molecular markers. It will lead to a much-needed improvement in the understanding of the disease. The cohort provides valuable real-world data, enabling researchers to study various research questions, assess routine medical practices and guide medical decision-making.
Health service factors affecting the COVID-19 vaccination campaign in a Ghanaian metropolis: A qualitative exploratory study
Authors: Abraham Susanna Aba Aba , Amoah John Oti , Agyare Dorcas Frempomaa , Sekimpi Deogratias Kaheeru , Bosomtwe-Duker Diana , Druye Andrews Adjei , Osei Berchie Gifty , Obiri-Yeboah Dorcas 
Published: December 2023

ObjectiveThe study sought to explore the perspectives of vaccinators on the health system factors that impacted the COVID-19 vaccination campaign.DesignThe study employed an exploratory-descriptive qualitative design. Key-informants’ interviews were conducted using semi-structured guide to gather the data. Thematic analysis following the steps of Braun and Clark was conducted using ATLAS.ti software.SettingThe study setting was the Cape Coast Metropolis where the Central Regional Health Directorate is located. The Directorate initiates and implements policy decisions across the region. It is also the only metropolis in the region that recorded about 5970 of the total COVID-19 cases recorded in Ghana.ParticipantsEleven vaccinators who had been trained for the COVID-19 vaccination and had participated in the campaign for at least 6 months were purposively sampled through the Regional Public Health Unit.ResultsFour themes were derived from the data after analysis; ‘vaccine-related issues’; ‘staffing issues’; ‘organising and planning the campaign’ and ‘surveillance and response systems’. Subthemes were generated under each major theme. Our results revealed the health service promoted the COVID-19 vaccination campaign through public education and ensured access to COVID-19 vaccines through the use of community outreaches. Also, the health service ensured adequate logistics supply for carrying out the campaign as well as ensured vaccinators were adequately equipped for adverse incidence reporting and management. Dissatisfaction among COVID-19 vaccinators attributed to low remuneration and delays in receiving allowances as well as shortfalls in efforts at securing transportation and a conducive venue for the vaccination exercise also emerged. Other challenges in the vaccination campaign were attributed to poor data entry platforms and limited access to internet facilities.ConclusionThis study highlights the health system’s strategies and challenges during the COVID-19 vaccination campaign, emphasising the need for critical interventions to prevent low vaccination rates.
Long COVID in long-term care: a rapid realist review
Authors: Fyffe Ian , Sorensen Janice , Carroll Simon , MacPhee Maura , Andrews-Paul Alison , Crooks Valorie A , Freeman Shannon , Davison Karen , Walls Jennifer , Berndt Annette , Shams Benajir , Sivan Manoj , Mithani Akber 
Published: December 2023

ObjectivesThe goals of this rapid realist review were to ask: (a) what are the key mechanisms that drive successful interventions for long COVID in long-term care (LTC) and (b) what are the critical contexts that determine whether the mechanisms produce the intended outcomes?DesignRapid realist review.Data sourcesMedline, CINAHL, Embase, PsycINFO and Web of Science for peer-reviewed literature and Google for grey literature were searched up to 23 February 2023.Eligibility criteriaWe included sources focused on interventions, persons in LTC, long COVID or post-acute phase at least 4 weeks following initial COVID-19 infection and ones that had a connection with source materials.Data extraction and synthesisThree independent reviewers searched, screened and coded studies. Two independent moderators resolved conflicts. A data extraction tool organised relevant data into context-mechanism-outcome configurations using realist methodology. Twenty-one sources provided 51 intervention data excerpts used to develop our programme theory. Synthesised findings were presented to a reference group and expert panel for confirmatory purposes.ResultsFifteen peer-reviewed articles and six grey literature sources were eligible for inclusion. Eleven context-mechanism-outcome configurations identify those contextual factors and underlying mechanisms associated with desired outcomes, such as clinical care processes and policies that ensure timely access to requisite resources for quality care delivery, and resident-centred assessments and care planning to address resident preferences and needs. The underlying mechanisms associated with enhanced outcomes for LTC long COVID survivors were: awareness, accountability, vigilance and empathetic listening.ConclusionsAlthough the LTC sector struggles with organisational capacity issues, they should be aware that comprehensively assessing and monitoring COVID-19 survivors and providing timely interventions to those with long COVID is imperative. This is due to the greater care needs of residents with long COVID, and coordinated efficient care is required to optimise their quality of life.
Research priorities for children’s cancer: a James Lind Alliance Priority Setting Partnership in the UK
Authors: Aldiss Susie , Hollis Rachel , Phillips Bob , Ball-Gamble Ashley , Brownsdon Alex , Chisholm Julia , Crowther Scott , Dommett Rachel , Gower Jonathan , Hall Nigel J , Hartley Helen , Hatton Jenni , Henry Louise , Langton Loveday , Maddock Kirsty , Malik Sonia , McEvoy Keeley , Morgan Jessica Elizabeth , Morris Helen , Parke Simon , Picton Sue , Reed-Berendt Rosa , Saunders Dan , Stewart Andy , Tarplee-Morris Wendy , Walsh Amy , Watkins Anna , Weller David , Gibson Faith 
Published: December 2023

ObjectivesTo engage children who have experienced cancer, childhood cancer survivors, their families and professionals to systematically identify and prioritise research questions about childhood cancer to inform the future research agenda.DesignJames Lind Alliance Priority Setting Partnership.SettingUK health service and community.MethodsA steering group oversaw the initiative. Potential research questions were collected in an online survey, then checked to ensure they were unanswered. Shortlisting via a second online survey identified the highest priority questions. A parallel process with children was undertaken. A final consensus workshop was held to determine the Top 10 priorities.ParticipantsChildren and survivors of childhood cancer, diagnosed before age 16, their families, friends and professionals who work with this population.ResultsFour hundred and eighty-eight people submitted 1299 potential questions. These were refined into 108 unique questions; 4 were already answered and 3 were under active study, therefore, removed. Three hundred and twenty-seven respondents completed the shortlisting survey. Seventy-one children submitted questions in the children’s surveys, eight children attended a workshop to prioritise these questions. The Top 5 questions from children were taken to the final workshop where 23 questions in total were discussed by 25 participants (young adults, carers and professionals). The top priority was ‘can we find effective and kinder (less burdensome, more tolerable, with fewer short and long-term effects) treatments for children with cancer, including relapsed cancer?’ConclusionsWe have identified research priorities for children’s cancer from the perspectives of children, survivors, their families and the professionals who care for them. Questions reflect the breadth of the cancer experience, including diagnosis, relapse, hospital experience, support during/after treatment and the long-term impact of cancer. These should inform funding of future research as they are the questions that matter most to the people who could benefit from research.
Examining the extent, forms and factors influencing multiple job holding among medical doctors, professional nurses and rehabilitation therapists in two South African provinces: a cross-sectional study
Authors: Matiwane Busisiwe Precious , Blaauw Duane , Rispel Laetitia Chairmaine 
Published: December 2023

ObjectiveMultiple job holding (MJH), or working in more than one paid job simultaneously, is a common characteristic of health labour markets. The study examined the extent (prevalence), forms and factors influencing MJH among public sector medical doctors, professional nurses and rehabilitation therapists in two South African provinces.DesignA cross-sectional, analytical study.Setting29 public sector hospitals in the Gauteng and Mpumalanga provinces of South Africa.ParticipantsFull-time public sector medical doctors, professional nurses and rehabilitation therapists.ResultsWe obtained an overall response rate of 84.3%, with 486 medical doctors, 571 professional nurses and 340 rehabilitation therapists completing the survey. The mean age was 39.9±9.7 years for medical doctors, 43.7±10.4 years for professional nurses and 32.3±8.7 years for rehabilitation therapists. In the preceding 12 months, the prevalence of MJH was 33.7% (95% CI 25.8% to 42.6%) among medical doctors, 8.6% (95% CI 6.3% to 11.7%) among professional nurses and 38.7% (95% CI 31.5% to 46.5%) among rehabilitation therapists. Medical doctors worked a median of 20 (10–40) hours per month in their additional jobs, professional nurses worked 24 (12–34) hours per month and rehabilitation therapists worked 16 (8–28) hours per month. Private practice was the most prevalent form of MJH among medical doctors and rehabilitation therapists, compared with nursing agencies for professional nurses. MJH was significantly more likely among medical specialists (OR 4.3, p<0.001), married professional nurses (OR 2.4, p=0.022) and male rehabilitation therapists (OR 2.4, p=0.005).ConclusionThe high prevalence of MJH could adversely affect the care of public sector patients. The study findings should inform the review and revision of existing MJH policies.