bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of immigration-specific stress on safety attitudes: a national cross-sectional study on overseas qualified nurses in Japan
Authors: Chang Xinyi , Gu Xiuzhu 
Published: January 2025

BackgroundMany countries have addressed the global issue of nursing shortage by recruiting overseas nurses who are also qualified in the host country. Nevertheless, such nurses may encounter various obstacles in their personal and professional lives in the host country, leading to apprehensions about their perceptions of workplace safety in healthcare organisations.ObjectiveThis study investigated the current state of immigration-specific stress among overseas qualified nurses (OQNs) working in Japan and its impact on safety attitudes.SettingsInvitation letters with a Quick Response (QR) code for a survey were sent to 119 hospitals across Japan that accepted OQNs as per the Ministry of Health, Labour and Welfare. Additionally, the survey QR code was shared with OQN-specific social media groups.ParticipantsThe inclusion criteria were being born and having received basic nursing education outside Japan, passing the Japanese national nursing examination, and current employment in the Japanese healthcare organisations. Valid responses were received from 214 OQNs.MethodsData were collected via an online survey, including the Demands of Immigration Scale and Safety Attitudes Questionnaire-Short Form (SAQ-SF) to measure stress and safety attitudes evaluation, respectively. Spearman’s correlation analysis and a generalised linear model were used to analyse the relationship between immigration-specific stress and safety attitudes as perceived by OQNs.ResultsThe findings showed that various safety attitude dimensions were significantly impacted by stressors such as ‘Not at home’, ‘Occupation’ and ‘Discrimination’. Notably, ‘Occupation’ disadvantages perceived by OQNs significantly affected all the safety attitude dimensions, such as ‘Teamwork climate’ (B=−5.69, [−7.78, –3.60], p<0.001), ‘Job satisfaction’ (B=−9.38, [−12.32, –6.44], p<0.001) and ‘Stress recognition’ (B=5.86, [3.17, 8.54], p<0.001).ConclusionsThe findings underscore the significance of implementing effective strategies such as enhancing the sense of belonging, providing better career advancement prospects and opportunities and addressing workplace discrimination to improve safety attitudes among OQNs. These interventions are crucial for enhancing patient safety in Japan.
Enhancing patient engagement: the influence of an in-consult patient decision aid on shared decision-making for lung tumour radiation – protocol for the randomised trial ‘SDM Lung SBRT’
Authors: Fink Thomas Leth , Hansen Torben Frøstrup , Kristiansen Charlotte , Hansen Torben Schjødt , Thing Rune Slot , Timm Signe , Steffensen Karina Dahl 
Published: January 2025

IntroductionPatient engagement is continuously being promoted by patients as well as politicians and healthcare professionals. One way of increasing patient engagement is by using shared decision-making (SDM), which is a joint effort of clinicians and patients making decisions together.When planning stereotactic body radiation therapy (SBRT) for a lung tumour located close to the thoracic wall, there are conflicting interests between (1) delivering the highest possible dose to obtain local tumour control and (2) reducing the dose to the thoracic wall to decrease the risk of chest wall pain and rib fractures following treatment. The radiation oncologist often makes the choice of dose without any engagement of the patient. We believe that the patients should be engaged in such a decision.To explore this matter, we have designed a randomised trial, ‘SDM Lung SBRT’, for which we present our study protocol with a special focus on a patient decision aid (PtDA), which is being tested in this trial.Methods and analysisThis study includes patients with a lung tumour located ≤1 cm from the thoracic wall. Patients are randomised to have the primary consultation with or without use of the PtDA. Treatment options are a radiation dose of either 66 Gray (Gy) in three fractions, 45 Gy in three fractions or no treatment. The primary outcome is patient engagement in decision-making measured by the validated observer-rated OPTION-12 score. Secondary outcomes are patient-reported outcomes, quality of life and side effects following treatment.Ethics and disseminationAll patients give informed consent to participate. According to Danish legislation, ethical approval is not required for this study as studies using questionnaires, observations or other non-biological studies are not considered interventions according to the Committee Act. Results from this study will be presented at scientific meetings and published in English peer-reviewed journals.Trial registration numberClinicalTrials.gov (NCT04940936).
Comfortable knowing little about lymphoedema? A qualitative study of medical interns in Australia
Authors: Kruger Natalie , Plinsinga Melanie , Window Peter , Hayes Sandra , Bunzli Samantha 
Published: January 2025

ObjectivesKnowledgeable doctors are needed for timely assessment, diagnosis and management of lymphoedema. This qualitative study explored the thoughts and feelings of Australian interns (medical graduates in their first postgraduate year) towards (i) their understanding of the lymphatic system and lymphoedema, (ii) curricula pertaining to lymphoedema within their Australian medical degree and (iii) how they perceive that their understanding and medical training in lymphoedema influence their clinical practice.Study design and methodsQualitative semistructured interviews were conducted with interns employed within their first postgraduate year in Australia. Interviews were conducted via Microsoft Teams or telephone, video-recorded, transcribed verbatim and analysed using thematic analysis. Inductive (data-driven) codes identified in the data were organised into themes.ResultsThe overarching theme was one of ambivalence. Participants noted that they had knowledge gaps related to lymphoedema (theme 1), but were not concerned by them, as they did not consider lymphoedema a condition they were expected to know about at medical school or in clinical practice (theme 2). Furthermore, they questioned the relevance of lymphoedema to their role (theme 3) and they considered lymphoedema care to be the responsibility of others (theme 4).ConclusionThese findings suggest a discord between what interns in this study recall being taught about lymphoedema and what current literature suggests newly graduated doctors should know. Future research is needed to explore the extent to which these findings extend to the perceptions of more senior doctors and how these findings impact the unmet needs of people with lymphoedema in Australia.
Effect of a multimodal analgesia strategy on remifentanil daily consumption in mechanically ventilated adult ICU patients: study protocol for a randomised, placebo-controlled, double-blind, parallel-group clinical trial
Authors: Widehem Remy , Nicolet Camille , Delannoy Violaine , Barthelemi Laurie , Soulairol Ian , Lefrant Jean-Yves , Mura Thibault , Roger Claire 
Published: January 2025

IntroductionIntensive care unit (ICU) patients under mechanical ventilation experience mild-to-severe pain. International guidelines emphasise the importance and benefits of multimodal analgesia to minimise opioid consumption and its side effects. However, no recommendation about drugs or protocol has been formulated. The aim of the Opioid-Free Analgesia in Intensive Care Unit study is to assess the feasibility of a standardised multimodal analgesia strategy and its benefits following the impact of remifentanil sparing in ICU patients.Methods and analysis50 mechanically ventilated adult patients will be recruited in a randomised, placebo-controlled, double-blind, feasibility trial. In the interventional group, patients will receive a standardised multimodal analgesia, initially receiving nefopam and tramadol, implementing with ketamine if patients remain painful, and then implementing with remifentanil with escalating doses in case of insufficient analgesia. In the control group, patients will receive remifentanil, implementing doses gradually to achieve analgesia. The primary outcome will be the daily consumption of remifentanil between the 24th and 48th hour after inclusion. Secondary outcomes will include drug tolerance, mechanical ventilation duration, ICU and hospital length of stay, 28-day and 90-day mortalities and 90-day opioid consumption.Ethics and disseminationThe study protocol was accepted by the Nîmes University Hospital’s research committee, the French ethics committee (Institutional Review BoardOUEST IV) and the French National Agency for the Safety of Medicines and Health Products (ANSM).Trial registration numberClinicalTrials.gov:NCT05825560
Childhood violence exposure and its contributing factors in Indonesia: a secondary data analysis of the National Survey on Children and Adolescents’ Life Experience
Authors: Amalia Dwi Octa , Sabarinah Sabarinah , Siregar Kemal N , Hadi Ella Nurlaella 
Published: January 2025

ObjectivesChildhood violence exposure is a public health concern that has long-term impacts on health and well-being. This study aims to identify the factors contributing to childhood violence exposure.DesignThis study conducted a secondary data analysis to examine childhood violence exposure.SettingThe study uses the National Survey on Children and Adolescents’ Life Experience, a cross-sectional national survey conducted by the Indonesian Ministry of Women’s Empowerment and Child Protection in Indonesia in 2021.ParticipantsA total of 4903 children aged 13–17 years participated in the survey.Outcome measuresThe dependent variable was childhood violence exposure. The independent variables included gender, education level, occupation, living arrangement, orphan status, witnessing violence, marital status and residence. Descriptive statistics, χ2test and logistic regression were performed for analysis.ResultsThe research findings indicate that nearly half of the children are exposed to violence, with a prevalence rate of 46.2% (95% CI 43.6% to 48.8%), including physical (13.8%), emotional (41.6%) and sexual (6.9%) violence exposure. Factors associated with violence exposure include being a working children (OR 1.85; 95% CI 1.48 to 2.32), not living with biological parents (OR 1.25; 95% CI 1.02 to 1.54) and witnessing violence in the home or neighbourhood (OR 6.78; 95% CI 5.78 to 7.97), all of which increase the risk of childhood violence exposure.ConclusionsThe findings highlight the necessity to focus on vulnerable groups such as working children, those not living with biological parents and children exposed to violence in the home. Policies and practices should prioritise identifying these at-risk children and provide targeted support through community-based early detection and intervention programmes. Strengthening awareness among stakeholders, including parents, educators and community leaders, will be essential to effectively reduce childhood violence exposure. Future research should explore the practical application of early detection strategies to better support these vulnerable groups.
Antenatal pelvic floor muscle exercise intervention led by midwives in England to reduce postnatal urinary incontinence: APPEAL feasibility and pilot randomised controlled cluster trial
Authors: MacArthur Christine , Bick Debra , Salmon Victoria , Jones Ellie , Hay-smith Jean , Bishop Jonathan , Gkini Eleni , Hemming Karla , Webb Sara , Pearson Mark , Coleman Tim , Terry Rohini , Edwards Elizabeth , Frawley Helena , Oborn Eivor , Dean Sarah 
Published: January 2025

ObjectivesTo assess the feasibility of an intervention of midwifery support for antenatal pelvic floor muscle exercises (PFME) to prevent postnatal urinary incontinence (UI).DesignFeasibility and pilot cluster randomised controlled trial. Clusters were community midwifery teams.SettingCommunity maternity antenatal care.ParticipantsOne hundred seventy-five women; 186 midwives.InterventionMidwifery training and resources for midwives and women to support antenatal PFME. Control clusters continued standard care.OutcomesWomen reporting: that their midwife explained how to do PFME, PFME adherence and postpartum UI. Midwives reporting: pre-post-training PFME confidence, intervention acceptability. Fidelity of training delivery and implementation.ResultsNinety-five midwives in intervention clusters; 91 midwives in control clusters. Of 998 women sent questionnaires, 175 responded: 15.8% in intervention, 16.4% in control clusters. Women’s characteristics in both trial arms were similar and characteristics of respondents and non-respondents were similar. Sixty-five percent (95% CI 56.9% to 72.4%) of women in intervention clusters reported their midwife explained how to do PFME vs 38% (95% CI 24.6% to 51.2%) in control clusters. Fifty percent (95% CI 24.1% to 77.1%) of women in intervention clusters vs 38% (95% CI 12.4% to 67.1%) in control clusters reported doing enough PFME to potentially prevent UI. Fourty-four percent (95% CI 32.0% to 56.1%) of women in intervention clusters reported UI vs 54% (95% CI 42.2% to 65.8%) in control clusters.Intervention training was delivered with fidelity and received positively. Midwives reported improvements in PFME confidence/knowledge (median increase of at least 1 point on a 0–4 scale for each of eight questions). Midwives (26%) most frequently reported insufficient time as an implementation barrier.ConclusionsThis pilot trial produced consistent new findings that training and resourcing midwives to teach and support pregnant women to undertake PFME is acceptable and feasible for women and midwives. It increased the number of women who are informed about PFME, with potential to improve PFME adherence and reduce postpartum UI. Recent changes to the National Health Service perinatal pelvic healthcare means a full trial is not possible.Trial registration numberISRCTN10833250.
Understanding good communication in ambulance pre-alerts to the emergency department: findings from a qualitative study of UK emergency services
Authors: Sampson Fiona C , O’Hara Rachel , Long Jaqui , Coster Joanne 
Published: January 2025

ObjectivesPrehospital notifications (pre-alerts) enable emergency department (ED) staff to prepare for the arrival of patients requiring a time-critical response. Effective communication of the pre-alert is key to enabling the ED to prepare appropriately, but evidence on communication practices is lacking. We undertook qualitative research to understand how pre-alert communication may be improved to optimise the ED response for pre-alerted patients.Design, setting and participantsData collection took place within three UK Ambulance Services and six EDs between August 2022 and April 2023. We undertook semi-structured interviews with 34 ambulance and 40 ED staff and 156 hours non-participation observation of pre-alert practice (143 pre-alerts). Verbatim interview transcripts and observation notes were imported into NVivo and analysed using a thematic approach.ResultsWe identified significant variation in how pre-alerts were communicated that influenced how effectively information was transferred. Ambulance and ED staff demonstrated a shared recognition that pre-alerts need to be communicated concisely, but both received minimal training in how to give and receive pre-alerts. Efficient pre-alerting was influenced by clinician experience and seniority. ED and ambulance clinicians following different information-sharing formats sometimes led to interruptions, information loss and tensions, particularly when an early ‘headline’ clinical concern had not been shared. Ambulance clinicians sometimes questioned the appropriateness of their pre-alert when ED clinicians did not explain the rationale for not giving the expected response (that is, being accepted into a high-priority area of the ED). Additional sources of frustration included technological problems and poor communication of estimated time of arrival and caller/responder identities.ConclusionsUse of a shared format, including a headline ‘cause for concern’, may improve the clarity, usefulness and civility of pre-alerts, particularly when the clinician’s concern is not obvious from observations. Basic training on how to undertake pre-alerts for both ED and ambulance clinicians may improve understanding of the importance of pre-alert communication.Trial registration numberISRCTN12652860.
Prognostic impact of albuminuria in early-stage chronic kidney disease on cardiovascular outcomes: a cohort study
Authors: Yaqoob Khadija , Naderi Hafiz , Thomson Ross J , Aksentijevic Dunja , Jensen Magnus T , Munroe Patricia B , Petersen Steffen E , Aung Nay , Yaqoob Muhammed Magdi 
Published: January 2025

BackgroundThe impact of early-stage chronic kidney disease (CKD) on cardiovascular outcomes, particularly when albuminuria is present, remains unclear. This study examined the associations between early CKD (stages 1 and 2) with and without albuminuria and the incidence of major adverse cardiovascular events (MACEs), heart failure (HF) and all-cause mortality.MethodsA cohort of 456 015 participants from the UK Biobank was categorised by CKD stage using serum creatinine to calculate estimated glomerular filtration rate (eGFR) and urinary albumin-creatinine ratio (≥3 mg/mmol) to define albuminuria. Multivariable Cox proportional hazard models were applied to evaluate the associations between CKD stages and cardiovascular outcomes. Additionally, left ventricular mass (LVM), an intermediate cardiovascular risk marker, was assessed in a subset of participants using cardiovascular MRI.ResultsCompared with normal kidney function, the risk of adverse outcomes increased progressively with advancing CKD stages, except for stage 2 CKD without albuminuria. Stage 2 CKD with albuminuria was associated with higher risks of MACE (HR 1.32, 95% CI 1.25 to 1.38), HF (HR 1.79, 95% CI 1.67 to 1.92) and all-cause mortality (HR 1.51, 95% CI 1.44 to 1.58), comparable to stage 3A CKD without albuminuria. The presence of albuminuria significantly interacted with the relationships between CKD stages and outcomes. No significant differences in indexed LVM were observed between early-stage CKD with albuminuria and normal renal function.ConclusionsIn early-stage CKD, albuminuria is independently associated with increased risks of MACE, HF and mortality. These findings support the use of albuminuria over eGFR decline alone for cardiovascular risk stratification in early CKD.
Long-term effects of urban renewal on health and health inequalities: the Neighbourhoods Law in Barcelona, Spain
Authors: Mehdipanah Roshanak , Pérez Katherine , Palència Laia , Bushman Gregory , Heinze Justin , Borrell Carme 
Published: January 2025

IntroductionFew studies exist examining the long-term effects of urban renewal programmes on health. The purpose of this study is to examine the long-term effects of an urban renewal programme on the health and health inequality outcomes of residents living in the neighbourhoods intervened in Barcelona city by the Neighbourhoods Law (NL), while comparing them to a comparison group of non-intervention neighbourhoods with similar socioeconomic status.MethodsThe Barcelona Health Survey was used for studying changes in self-rated health, mental health, hypertension and meeting walking requirements set by the WHO in pre (2006) and post (2016) years of neighbourhoods intervened by the NL and a group of comparison neighbourhoods with similar socioeconomic characteristics. We used logistic regression models to examine pre–post differences in health outcomes within intervention or comparison neighbourhoods. A difference-in-difference regression was used to assess the overtime impact of the NL intervention on the health outcomes compared with the comparison groups. All models were adjusted by the highest education level attained and age.ResultsIn the intervention neighbourhoods, self-rated health improved for manual workers, hypertension dropped in men and more women met the walking requirements compared with similar groups in the comparison neighbourhoods. Across all groups, mental health worsened.ConclusionsOur study is among the first to examine the long-term effects of urban renewal programmes. Although there exist complexities in studying these long-term effects, they are critical to ensure urban renewal programmes continue to improve health and reduce inequality among residents.
Three-dimensional non-relativistic Hietarinta supergravity
Authors: Concha Patrick , Rodríguez Evelyn , Salgado Sebastián 
Published: January 2025

Abstract
In this work we present the non-relativistic regime of the Hietarinta gravity theory and its extension to supergravity. At the bosonic level, we derive the non-relativistic version of the Hietarinta model by employing a contraction process and addressing the non-degeneracy of the invariant metric. To incorporate supersymmetry, we apply the Lie algebra expansion method to obtain the non-relativistic formulation of

$${\mathcal {N}}=2$$

N
=
2

Hietarinta supergravity. Our results reveal that the non-relativistic Hietarinta theory encompasses the extended Bargmann (super)gravity as a special case, yet it differs significantly from other existing non-relativistic (super)gravity models. Furthermore, we generalize our analysis to include a cosmological constant term in the non-relativistic Hietarinta (super)gravity action and examine its effects on the torsion structure.
Perturbation to μ–τ symmetry using type I and type II seesaw mechanisms under SU(2)L×Δ(27)×Z2 flavor symmetry
Authors: Wilina Ph. , Singh N. Nimai 
Published: January 2025

We construct the neutrino mass matrix by using the [Formula: see text] flavor symmetry group and apply the perturbation to [Formula: see text]–[Formula: see text] symmetric neutrino mass matrix generated from type I seesaw mechanism with the contribution from type II seesaw. The symmetric neutrino mass matrix is obtained by transforming the right-handed neutrinos [Formula: see text] as [Formula: see text], SM Higgs doublets H as [Formula: see text], scalar singlet [Formula: see text] as [Formula: see text] under [Formula: see text](27) symmetry whereas contribution from type II is obtained by transforming the scalar triplet [Formula: see text] as 3 under [Formula: see text](27) symmetry. We obtain non-diagonal charged-lepton mass matrix by transforming scalar doublets [Formula: see text] as [Formula: see text], scalar singlet [Formula: see text] as [Formula: see text] under [Formula: see text](27) symmetry. The detailed numerical analysis is carried out by scanning the type II seesaw strength and other input parameters. The neutrino oscillation parameters are found to be consistent with the 3[Formula: see text] bound of the latest experimental neutrino oscillation data. The analysis also focuses on the Planck cosmological bound on the sum of the three absolute neutrino masses, [Formula: see text] [Formula: see text]eV. We obtain baryon asymmetry via lepton asymmetry for both normal and inverted hierarchy in agreement with the Planck bound on the baryon-to-photon ratio.