bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between physician characteristics and practice-level uptake of paediatric virtual mental healthcare: a population-based study
Authors: Saunders Natasha Ruth , Stukel Therese A , Strauss Rachel , Fu Longdi , Guan Jun , Cohen Eyal , Vigod Simone , Guttmann Astrid , Kurdyak Paul , Toulany Alene 
Published: July 2023

ObjectiveTo examine physician factors associated with practice-level uptake of virtual mental healthcare for children and adolescents.Design, setting and participantsA population-based data linkage study of a cohort of all physicians (n=12 054) providing outpatient mental healthcare to children and adolescents (aged 3–17 years, n=303 185) in a single-payer provincial health system in Ontario, Canada from 1 July 2020 to 31 July 2021.ExposuresPhysician characteristics including gender, age, specialty, location of training, practice region, practice size and overall and mental health practice size.Main outcomesPractice-level proportion of outpatient virtual care provided: (1) mostly in-person (<25% virtual care), (2) hybrid (25%–99% virtual care) or (3) exclusively virtual (100% virtual care). Multinomial logistic regression models tested the association between practice-level virtual care provided and physician characteristics.ResultsAmong physicians, 1589 (13.2%) provided mostly in-person mental healthcare with 8714 (67.8%) providing hybrid care, and 2291 (19.0%) providing exclusively virtual care. The provision of exclusive virtual care (vs mostly in-person) was associated with female sex (adjusted OR (aOR) 1.97, 95% CI 1.70 to 2.27 (ref: male)), foreign training (aOR 1.27, 95% CI 1.07 to 1.50 (ref: Canadian-trained)), family physicians (aOR 2.05, 95% CI 1.56 to 2.69 (ref: psychiatrist)) and reversely associated with large practice size (aOR 0.32, 95% CI 0.25 to 0.40 (ref smallest quintile)). Mostly in-person care was associated with older age physicians (71+ years) and practice outside the Toronto region.Conclusions and relevanceIn a single-payer universal healthcare system that remunerates physicians using the same fee structure for in-person and virtual outpatient care, there is heterogeneity in utilisation of virtual care that is associated with provider factors. This practice variation, with limited evidence on effectiveness and appropriate contexts for virtual care use, suggests there may be opportunity for further outcomes research and guidance on appropriate context for paediatric virtual mental healthcare delivery.
Proof of concept of prehabilitation: a combination of education and behavioural change, to promote physical activity in people with fibromyalgia
Authors: Courel-Ibáñez Javier , Estévez-López Fernando , Hughes Ciara , Adams Nicola , Fullen Brona M , Davison Gareth , Montgomery Ashley , Cramp Fiona , Maestre Cristina , Martin Denis , McVeigh Joseph G 
Published: July 2023

ObjectivesTo establish proof of concept of a prehabilitation intervention, a combination of education and behavioural change, preceding a physical activity programme in people with fibromyalgia (FM).SettingsOpen-label, feasibility clinical trial.ParticipantsEleven people with FM (10 women).InterventionsThe prehabilitation intervention consisted of 4 weeks, 1 weekly session (~1 to 1.5 hours), aimed to increase self-efficacy and understand why and how to engage in a gentle and self-paced physical activity programme (6 weeks of walking with telephone support).Primary and secondary outcome measuresPrimary outcome was the acceptability and credibility of the intervention by means of the Credibility/Expectancy Questionnaire. Secondary outcomes comprised scales to measure FM severity, specific symptoms and sedentary behaviour. An exit interview was conducted to identify the strengths and weaknesses and barriers to the intervention.ResultsOne participant dropped out due to finding the walking programme excessively stressful. Participants expected the intervention would improve their symptoms by 22%–38% but resulted in 5%–26% improvements. Participants would be confident in recommending this intervention to a friend who experiences similar problems. The interviews suggested that the fluctuation of symptoms should be considered as an outcome and that the prehabilitation intervention should accomodate these fluctuation. Additional suggestions were to incorporate initial interviews (patient-centred approach), to tailor the programmes to individuals’ priorities and to offer a variety of physical activity programmes to improve motivation.ConclusionsThis feasibility study demonstrated that our novel approach is acceptable to people with FM. Future interventions should pay attention to flexibility, symptoms fluctuation and patients support.Trial registration numberNCT03764397.
Burdens of non-communicable disease attributable to metabolic risk factors in Australia, 1990–2019: joinpoint regression analysis of the Global Burden of Disease Study
Authors: Kibret Kelemu Tilahun , Backholer Kathryn , Peeters Anna , Tesfay Fisaha , Nichols Melanie 
Published: July 2023

BackgroundLong-term and comparative assessments of trends in non-communicable disease (NCD) burden attributable to metabolic risk are sparse. This study aimed to assess burdens and trends of NCD attributable to metabolic risk factors in Australia, 1990–2019.DesignPopulation-based observational study.Settings and data sourceData were extracted from the Global Burden of Disease Study 2019 for Australia and trends in NCD burden attributable metabolic risks were estimated using the joinpoint regression model.Main outcome measuresNCD deaths and disability-adjusted life-years (DALYs) attributed to metabolic risk factors, 1990–2019.ResultsResults indicate a 1.1% yearly increase in exposure to combined metabolic risk factors from 1990 to 2019. Between 1990 and 2019, the estimated absolute number of deaths from NCDs attributed to combined metabolic risks increased by 17.0%. However, metabolic risk-related NCD burdens in Australia decreased between 1990 and 2019. In 2019, 34.0% of NCD deaths and 20.0% of NCD DALYs were attributed to metabolic risk factors, compared with 42.9% and 24.4%, respectively, in 1990. In 2019, cardiovascular diseases (CVDs), neoplasms and chronic kidney diseases were the most common NCD deaths attributed to metabolic risks. High body mass index accounted for the highest proportion of diabetes deaths (47.0%) and DALYs (58.1%) as well as chronic kidney disease deaths (35.4%) and DALYs (39.7%). Similarly, high systolic blood pressure contributed to a high proportion of chronic kidney disease deaths (60.9%) and DALYs (53.2%), and CVDs deaths (44.0%) and DALYs (46.0%).ConclusionWhile the contribution of metabolic risk factors to the burden of NCDs has declined from 1990 to 2019, their role in NCD death and disability remains a challenge as the prevalence of these risk factors has increased. Prevention strategies should focus on metabolic risks particularly high body mass index and high systolic blood pressure to substantially reduce NCD burdens.
Methods to derive composite indicators used for quality and safety measurement and monitoring in healthcare: a scoping review protocol
Authors: McDonnell Thérèse , Cosgrove Grainne , Hogan Emma , Martin Jennifer , McNicholas Triona , O'Dowd Marcella , Rizoaica Florina , McAuliffe Eilish 
Published: July 2023

IntroductionComposite indicators of quality and safety in healthcare summarise performance across multiple indicators into a single performance measure. Composite indicators can identify domains and drivers of quality, improve the ability to detect differences, aid prioritisation for quality improvement and facilitate decision making about future healthcare needs. However, the use of composite indicators can be controversial, particularly when used to rank healthcare providers. Many of the concerns around transparency, appropriateness and uncertainty may be addressed by a robust and transparent development and review process.The aim of this scoping review is to describe methodologies used at each of the stages of development of composite indicators of quality and safety in healthcare. This review will provide those tasked with developing or reviewing composite indicators with a valuable consolidated analysis of a substantial and wide-ranging literature.Methods and analysisThe framework proposed by the Joanna Briggs Institute and enhancements proposed by Peterset al(2015, 2017, 2020) will be used in conducting this scoping review, and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews will guide the reporting. Grey literature and peer-reviewed documents will be in-scope. Electronic databases (PubMed, Embase, CINAHL, ABI/INFORM and SafetyLit) will be searched, and publications will be screened by two reviewers. Discussion, policy and guidance publications will be included if they discuss any aspect of the methods used in the development of a composite indicator of quality or safety in a healthcare setting. The search period ranges from 1 January 2000 to 31 December 2022. Data extraction will capture information on 11 stages of composite indicator development, augmenting a 10-stage framework developed by the European Commission Joint Research Centre.Ethics and disseminationEthical approval is not required. Review findings will be published in a peer-reviewed journal and presented at scientific conferences.
CASCADIA: a prospective community-based study protocol for assessing SARS-CoV-2 vaccine effectiveness in children and adults using a remote nasal swab collection and web-based survey design
Authors: Babu Tara M , Feldstein Leora R , Saydah Sharon , Acker Zachary , Boisvert Cassandra L , Briggs-Hagen Melissa , Carone Marco , Casto Amanda , Cox Sarah N , Ehmen Brenna , Englund Janet A , Fortmann Stephen P , Frivold Collrane J , Groom Holly , Han Peter D , Kuntz Jennifer L , Lockwood Tina , Midgley Claire M , Mularski Richard A , Ogilvie Tara , Reich Sacha L , Schmidt Mark A , Smith Ning , Starita Lea , Stone Jeremy , Vandermeer Meredith , Weil Ana A , Wolf Caitlin R , Chu Helen Y , Naleway Allison L 
Published: July 2023

IntroductionAlthough SARS-CoV-2 vaccines were first approved under Emergency Use Authorization by the Food and Drug Administration in late 2020 for adults, authorisation for young children 6 months to <5 years of age did not occur until 2022. These authorisations were based on clinical trials, understanding real-world vaccine effectiveness (VE) in the setting of emerging variants is critical. The primary goal of this study is to evaluate SARS-CoV-2 VE against infection among children aged >6 months and adults aged <50 years.MethodsCASCADIA is a 4-year community-based prospective study of SARS-CoV-2 VE among 3500 adults and paediatric populations aged 6 months to 49 years in Oregon and Washington, USA. At enrolment and regular intervals, participants complete a sociodemographic questionnaire. Individuals provide a blood sample at enrolment and annually thereafter, with optional blood draws every 6 months and after infection and vaccination. Participants complete weekly self-collection of anterior nasal swabs and symptom questionnaires. Swabs are tested for SARS-CoV-2 and other respiratory pathogens by reverse transcription-PCR, with results of selected pathogens returned to participants; nasal swabs with SARS-CoV-2 detected will undergo whole genome sequencing. Participants who test positive for SARS-CoV-2 undergo serial swab collection every 3 days for 21 days. Serum samples are tested for SARS-CoV-2 antibody by binding and neutralisation assays.AnalysisThe primary outcome is SARS-CoV-2 infection. Cox regression models will be used to estimate the incidence rate ratio associated with SARS-CoV-2 vaccination among the paediatric and adult population, controlling for demographic factors and other potential confounders.Ethics and disseminationAll study materials including the protocol, consent forms, data collection instruments, participant communication and recruitment materials, were approved by the Kaiser Permanente Interregional Institutional Review Board, the IRB of record for the study. Results will be disseminated through peer-reviewed publications, presentations, participant newsletters and appropriate general news media.
How is food variety conceptualised and measured as a diet quality indicator in developed settings? Protocol for a systematic scoping review
Authors: Chan Sara , Mozaffari Hadis , Conklin Annalijn Ida 
Published: July 2023

ObjectivesDietary diversity (DD) is a pillar of healthy eating guidance and can be used to assess diet quality. Despite being an established nutrition concept, many inconsistencies in its definition and measurement exist and meanings vary across the development spectrum. This protocol outlines a research trajectory, whereby a scoping review will be undertaken to illustrate and map the methodological approaches that have been utilised to measure diversity as a marker of diet quality in the general population. It seeks to determine the most common and less used methodological approaches to measure DD in the diet of healthy adults.Methods and analysisScoping review of peer-reviewed and grey literature from five bibliographic databases, supplemented by handsearching of reviews and reference lists. Search terms will include DD, food variety, mixed diet, balanced diet and food group variety. Eligible articles must include a measure for DD as an indicator of diet quality in the general population living in developed settings. Two independent reviewers will screen titles or abstracts, and read full-texts. Consensus will resolve any disagreements on study eligibility with a third reviewer consulted if needed. Data will be extracted using a standardised evidence table and analysed using a narrative synthesis approach. Data will be managed using Covidence.Ethics and disseminationNo ethics is required for this study using public documents. Results will be disseminated through peer-reviewed papers and scientific conferences.DiscussionThis scoping review will help to map, classify and assess the methodological approaches used in the nutrition literature to measure DD as a diet quality indicator. We anticipate a wide range of DD measures and expect to identify the most prevalent DD measures used to assess diet quality. Our findings will inform standardisation to improve future research on this nutritional concept.
Newcastle 1000 (NEW1000) Study: an Australian population-based prospective pregnancy cohort study design and protocol
Authors: Grace Tegan , Fisher Joshua , Wang Carol , Valkenborghs Sarah R , Smith Roger , Hirst Jonathan J , Mattes Joerg , Murphy Vanessa E , Pennell Craig E 
Published: July 2023

IntroductionMultiple cohort studies have been established to investigate the impact of early life factors on development and health outcomes. In Australia the majority of these studies were established more than 20 years ago and, although longitudinal in nature, are inherently susceptible to socioeconomic, environmental and cultural influences which change over time. Additionally, rapid leaps in technology have increased our understanding of the complex role of gene–environment interactions in life course health, highlighting the need for new cohort studies with repeated biological sampling and in-depth phenotype data across the first 1000 days of life from conception.Methods and analysisThe Newcastle 1000 (NEW1000) Study, based in the regional city of Newcastle, New South Wales, was developed after an extensive consultation process involving 3 years of discussion with key stakeholders and healthcare consumer organisations and seven healthcare consumer workshops. This prospective population-based pregnancy cohort study will recruit 500 families per year for 5 years, providing detailed, longitudinal, multisystem phenotyping, repeated ultrasound measures and serial sample collection to investigate healthcare consumer identified health outcomes of priority. Stage 1 will involve recruitment of pregnant participants and their partners at 14 weeks gestation, with dense phenotype data and biological samples collected at 14, 20, 28 and 36 weeks gestation and serial ultrasound measures at 20, 28, 36 and 40 weeks, with postpartum follow-up at 6 weeks and 6 months. Biological samples will be used for biomarker discovery and sequencing of the genome, transcriptome, epigenome, microbiome and metabolome.Ethics and disseminationEthics approval was obtained from Hunter New England Local Health District Ethics Committee (2020/ETH02881). Outcomes will be published in peer-reviewed journals, disseminated to participants through the NEW1000 website, presented at scientific conferences, and written reports to local, state and national government bodies and key stakeholders in the healthcare system to inform policy and evidence-based practice.
Traditional healers working with primary care and mental health for early intervention in psychosis in young persons: protocol for the feasibility cluster randomised controlled trial
Authors: Farooq Saeed , Sheikh Saima , Dikomitis Lisa , Haq Mian Mukhtar Ul , Khan Abdul Jalil , Sanauddin Noor , Ali Malik Wajid , Ali Johar , Khan Muhammad Firaz , Chaudhry Imran , Husain Nusrat , Gul Muhammad , Irfan Muhammad , Andrews Gabrielle , Kaistha Prachi , Shah Syed Muhammad Uzair , Azeemi Ishfaq , Hamid Shumaila , Minhaz Aaliya , Mallen Christian , Lewis Martyn 
Published: July 2023

ObjectivesIn low/middle-income countries (LMICs), more than half of patients with first-episode psychosis initially seek treatment from traditional and religious healers as their first care. This contributes to an excessively long duration of untreated psychosis (DUP). There is a need for culturally appropriate interventions to involve traditional and spiritual healers to work collaboratively with primary care practitioners and psychiatrists through task-shifting for early detection, referral and treatment of first episode of psychosis.MethodsTo prevent the consequences of long DUP in adolescents in LMICs, we aim to develop and pilot test a culturally appropriate and context-bespoke intervention.TraditionalHEalers working with primary care and mentalHealth for early interventiOn inPsychosis in young pErsons (THE HOPE) will be developed using ethnographic and qualitative methods with traditional healers and caregivers. We will conduct a randomised controlled cluster feasibility trial with a nested qualitative study to assess study recruitment and acceptability of the intervention. Ninety-three union councils in district Peshawar, Pakistan will be randomised and allocated using a 1:1 ratio to either intervention arm (THE HOPE) or enhanced treatment as usual and stratified by urban/rural setting. Data on feasibility outcomes will be collected at baseline and follow-up. Patients, carers, clinicians and policymakers will be interviewed to ascertain their views about the intervention. The decision to proceed to the phase III trial will be based on prespecified stop–go criteria.Ethics and disseminationEthical approval has been obtained from Keele University Ethical Review Panel (ref: MH210177), Khyber Medical University Ethical Review Board (ref: DIR/KMU-EB/IG/001005) and National Bioethics Committee Pakistan (ref no. 4-87/NBC-840/22/621). The results of THE HOPE feasibility trial will be reported in peer-reviewed journals and academic conferences and disseminated to local stakeholders and policymakers.Trial registration numberISRCTN75347421.
What does social cognition look like in everyday social functioning in Huntington’s disease? A protocol for a scoping review to explore and synthesise knowledge about social cognition alongside day-to-day social functioning of people with Huntington’s disease
Authors: Fisher Alexandra , Lavis Anna , Greenfield Sheila , Rickards Hugh 
Published: July 2023

IntroductionSocial cognition is problematic in Huntington’s disease (HD). Despite the observations of clinicians and families, there is minimal empirical literature about how it presents in daily life and the impact on social functioning. This protocol forms the basis of a scoping review to synthesise both the quantitative knowledge and qualitative experiences of the HD community so that a visual and narrative map can address what is known and what is not known for the benefit of the community and clinicians and academics alike.Methods and analysesAn umbrella scoping review of previous work and a scoping review of newer studies of social cognition and social functioning will be undertaken. The electronic databases PubMed, Medline, PsycINFO, Web of Science, Scopus, Embase and CINAHL will be searched to identify eligible studies from starting from 2003 to June 2023. A grey literature search and grey data search will also be undertaken. Quality appraisal of the included documents will use the Critical Appraisal Skills Programme and Authority, Accuracy, Coverage, Objectivity, Date, Significance checklists. A data charting table will be used for data extraction, with analysis of qualitative data using the framework method. The review findings will be presented in a visual form and in a narrative summary.Ethics and disseminationEthical review is not usually required as scoping reviews are produced via secondary data analysis, however, this protocol includes the use of grey data from a charity web forum and so in line with best practice for internet mediated research ethical review was sought and approved (STEM Ethical Review Committee, University of Birmingham-ERN_21-1028A). Review findings will be shared with service users and disseminated through a peer-reviewed publications, conference presentations and hosted via the website of the patient association charity the HD Association.
Study protocol for data to suppression (D2S): a cluster-randomised, stepped-wedge effectiveness trial of a reporting and capacity-building intervention to improve HIV viral suppression in housing and behavioural health programmes in New York City
Authors: Irvine Mary K , Abdelqader Faisal , Levin Bruce , Thomas Jacinthe , Avoundjian Tigran , Peterson Meghan , Zimba Rebecca , Braunstein Sarah L , Robertson McKaylee M , Nash Denis 
Published: July 2023

IntroductionWith progress in the ‘diagnose’, ‘link’ and ‘retain’ stages of the HIV care continuum, viral suppression (VS) gains increasingly hinge on antiretroviral adherence among people with HIV (PWH) retained in care. The Centers for Disease Control and Prevention estimate that unsuppressed viral load among PWH in care accounts for 20% of onward transmission. HIV intervention strategies include ‘data to care’ (D2C)—using surveillance to identify out-of-care PWH for follow-up. However, most D2C efforts target care linkage, not antiretroviral adherence, and limit client-level data sharing to medical (versus support-service) providers. Drawing on lessons learnt in D2C and successful local pilots, we designed a ‘data-to-suppression’ intervention that offers HIV support-service programmes surveillance-based reports listing their virally unsuppressed clients and capacity-building assistance for quality-improvement activities. We aimed to scale and test the intervention in agencies delivering Ryan White HIV/AIDS Programme-funded behavioural health and housing services.Methods and analysisTo estimate intervention effects, this study applies a cross-sectional, stepped-wedge design to the intervention’s rollout to 27 agencies randomised within matched pairs to early or delayed implementation. Data from three 12-month periods (pre-implementation, partial implementation and full implementation) will be examined to assess intervention effects on timely VS (within 6 months of a report listing the client as needing follow-up for VS). Based on projected enrolment (n=1619) and a pre-implementation outcome probability of 0.40–0.45, the detectable effect size with 80% power is an OR of 2.12 (relative risk: 1.41–1.46).Ethics and disseminationThis study was approved by the New York City Department of Health and Mental Hygiene’s institutional review board (protocol: 21–036) with a waiver of informed consent. Findings will be disseminated via publications, conferences and meetings including provider-agency representatives.Trial registration numberNCT05140421.