bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vocational and psychosocial predictors of medical negligence claims among Australian doctors: a prospective cohort analysis of the MABEL survey
Authors: Bradfield Owen M , Bismark Marie , Scott Anthony , Spittal Matthew 
Published: June 2022

ObjectiveTo understand the association between medical negligence claims and doctors’ sex, age, specialty, working hours, work location, personality, social supports, family circumstances, self-rated health, self-rated life satisfaction and presence of recent injury or illness.Design and settingProspective cohort study of Australian doctors.Participants12 134 doctors who completed the Medicine in Australia: Balancing Employment and Life survey between 2013 and 2019.Primary outcome measureDoctors named as a defendant in a medical negligence claim in the preceding 12 months.Results649 (5.35%) doctors reported being named in a medical negligence claim during the study period. In addition to previously identified demographic factors (sex, age and specialty), we identified the following vocational and psychosocial risk factors for claims: working full time (OR=1.48, 95% CI 1.13 to 1.94) or overtime hours (OR 1.70, 95% CI 1.29 to 2.23), working in a regional centre (OR 1.69, 95% CI 1.37 to 2.08), increasing job demands (OR 1.16, 95% CI 1.04 to 1.30), low self-rated life satisfaction (OR 1.43, 95% CI 1.08 to 1.91) and recent serious personal injury or illness (OR 1.40, 95% CI 1.13 to 1.72). Having an agreeable personality was mildly protective (OR 0.91, 95% CI 0.83 to 1.00). When stratified according to sex, we found that working in a regional area, low self-rated life satisfaction and not achieving work–life balance predicted medical negligence claims in male, but not female, doctors. However, working more than part-time hours and having a recent personal injury or illness predicted medical negligence claims in female, but not male, doctors. Increasing age predicted claims more strongly in male doctors. Personality type predicted claims in both male and female doctors.ConclusionsModifiable risk factors contribute to an increased risk of medical negligence claims among doctors in Australia. Creating more supportive work environments and targeting interventions that improve doctors’ health and well-being could reduce the risk of medical negligence claims and contribute to improved patient safety.
Protocol for a scoping review of the use of information and communication technology platforms for the delivery and utilisation of transgender healthcare
Authors: Cui Jialiang , Prankumar Sujith Kumar , Wong Horas TH , Addo Isaac Yeboah , Tumwine Christopher , Noor Muhammad Naveed 
Published: June 2022

IntroductionIn recent years, there has been strong interest in making digital health and social tools more accessible, particularly among vulnerable and stigmatised groups such as transgender people. While transgender people experience unique physical, mental and sexual health needs, not much is currently known about the extent to which they use information and communication technologies such as short messaging service and videoconferencing to access health services. In this paper, we discuss our protocol for a scoping review of the literature about the delivery and utilisation of digitally mediated health services for transgender populations.Methods and analysisThis scoping review of the provision and experience of telemedicine among transgender people will follow the methodological framework developed by Arksey and O’Malley. The search will be conducted using three online databases, namely PubMed, CINAHL and Scopus, with additional literature explored using Google Scholar to identify grey literature. Relevant English-language studies will be shortlisted after completing a title and abstract review based on defined inclusion criteria. Following that, a final list of included studies will be compiled after a full-text review of the shortlisted articles has been completed. To enable the screening process, a team of researchers will be assigned refereed publications explicitly referring to the provision and experience of transgender healthcare through telemedicine. Screening performed independently will then collaboratively be reviewed to maintain consistency.Ethics and disseminationThe research is exempt from ethics approval since our analysis is based on extant research into the use of digital technologies in providing healthcare to transgender people. The results of this study will be disseminated through peer-reviewed academic publications and presentations. Our analysis will guide the design of further research and practice relating to the use of digital communication technologies to deliver healthcare services to transgender people.
Clinicodemographic profile and predictors of poor outcome in hospitalised COVID-19 patients: a single-centre, retrospective cohort study from India
Authors: Tiwari Lokesh , Gupta Prakriti , N Yankappa , Banerjee Amrita , Kumar Yogesh , Singh Prashant K , Ranjan Alok , Singh C M , Singh Prabhat Kumar 
Published: June 2022

ObjectivesPrimary objective was to study the clinicodemographic profile of hospitalised COVID-19 patients at a tertiary-care centre in India. Secondary objective was to identify predictors of poor outcome.SettingSingle centre tertiary-care level.DesignRetrospective cohort study.ParticipantsConsecutively hospitalised adults patients with COVID-19.Primary and secondary outcome measuresPrimary outcome variable was in-hospital mortality. Covariables were known comorbidities, clinical features, vital signs at the time of admission and on days 3–5 of admission, and initial laboratory investigations.ResultsIntergroup differences were tested using χ2 or Fischer’s exact tests, Student’s t-test or Mann-Whitney U test. Predictors of mortality were evaluated using multivariate logistic regression model. Out of 4102 SARS-CoV-2 positive patients admitted during 1-year period, 3268 (79.66%) survived to discharge and 834 (20.33%) died in the hospital. Mortality rates increased with age. Death was more common among males (OR 1.51, 95% CI 1.25 to 1.81). Out of 261 cases analysed in detail, 55.1% were in mild, 32.5% in moderate and 12.2% in severe triage category. Most common clinical presentations in the subgroup were fever (73.2%), cough/coryza (65.5%) and breathlessness (54%). Hypertension (45.2%), diabetes mellitus (41.8%) and chronic kidney disease (CKD; 6.1%) were common comorbidities. Disease severity on admission (adjusted OR 12.53, 95% CI 4.92 to 31.91, p<0.01), coagulation defect (33.21, 3.85–302.1, p<0.01), CKD (5.67, 1.08–29.64, p=0.04), high urea (11.05, 3.9–31.02, p<0.01), high prothrombin time (3.91, 1.59–9.65, p<0.01) and elevated ferritin (1.02, 1.00–1.03, p=0.02) were associated with poor outcome on multivariate regression. A strong predictor of mortality was disease progression on days 3–5 of admission (adjusted OR 13.66 95% CI 3.47 to 53.68).ConclusionCOVID-19 related mortality in hospitalised adult patients at our center was similar to the developed countries. Progression in disease severity on days 3–5 of admission or days 6–13 of illness onset acts as ‘turning point’ for timely referral or treatment intensification for optimum use of resources.
Integration of planetary health in undergraduate and postgraduate medical education: protocol for a scoping review
Authors: Moloo Husein , Selvam Rajajee , Seguin Nieve , Zhang Lisa , Lacaille-Ranger Ariane , Sikora Lindsey , McIsaac Daniel I 
Published: June 2022

IntroductionDespite climate change being recognised as the greatest health threat of the 21st century, current medical education curricula do not reflect the urgency of the climate crisis. Preparing for climate-related health repercussions requires educational institutions to disseminate planetary health knowledge in a systematic way. We sought to evaluate the extent of the literature on the inclusion of planetary health in undergraduate and postgraduate medical education to guide curricular development.Methods and analysisA scoping review is being undertaken with a search strategy developed with a health sciences librarian. The search strategy was run on the following databases from inception to 22 June 2021: Medline, Embase, APA PsycINFO, CINAHL, Global Health, Scopus. This scoping review is being conducted as per methodology that has been previously outlined. Studies that discuss the implementation of planetary health education within undergraduate and postgraduate medical education will be included, whether they discuss formal inclusion or supplemental courses. To supplement our database search, data from the Health and Environment Adaptive Task Force’s National Report on Planetary Health Education, the Planetary Health Report Card and the Association for Medical Education in Europe Consensus Statement on Planetary Health and Education for Sustainable Healthcare will be included. As we anticipate varying methodologies, the data analysis will consist of both a quantitative and a qualitative component. Outcomes will be categorised within the domains of the Planetary Health Education Framework, which incorporates concepts of systems thinking, social justice and interconnection within nature as they apply to education for planetary health.Ethics and disseminationAs no intervention or patient recruitment will be required, research ethics board approval is not applicable. We plan to disseminate our results via publication in a peer-reviewed journal or conference presentation.Trial registration numberThis protocol has been registered in Open Science Framework (10.17605/OSF.IO/7M6GZ).
Effectiveness of the self-fatigue assessment in guiding early postoperative ambulation in gynaecological oncology patients: study protocol for a randomised controlled trial
Authors: Du Qian , Chen Bo , Xu Shaoyong , He Hong , Qin Xiaomin , Kang Tongting , Wang Xu , Huang Xiaojie 
Published: June 2022

IntroductionEnhanced recovery after surgery (ERAS) guidelines strongly recommends that patients be in early postoperative ambulation within 24 hours. This study aims to assess the effectiveness and safety of the self-fatigue assessment method to guide patients’ early postoperative ambulation.Methods and analysisThis is a single-centre, randomised, open, parallel-controlled trial. Five hundred and fifty-two patients who meet the inclusion criteria for gynaecological oncology surgery are randomly assigned in a 1:1 ratio to either a self-fatigue assessment group (study group) or a fixed activity distance assessment group (control group). The fixed activity distance group adopts a fixed early postoperative ambulation distance to guide the patient’s activity, while the self-fatigue assessment group uses the Borg Exercise Scale to assess the patient’s fatigue and stops activity when the fatigue level reaches 5–6. The primary outcome measure is the time to first postoperative flatus. Secondary outcome measures are the time to first bowel movement, the incidence of moderate to severe bloating, the incidence of bowel obstruction or venous thromboembolism, the incidence of adverse events (nausea, vomiting, dizziness), patient satisfaction, sleep quality scores, patient compliance with activities, hospital costs and days in hospital.Ethics and disseminationThis study was approved by the Independent Ethics Committee of Xiangyang Central Hospital affiliated with Hubei University of Arts and Sciences and registered with the China Clinical Trials Registry in May 2021. The results of the trial will be disseminated through open access peer-reviewed journals and abstracts will be submitted to relevant national and international conferences.Trial registration numberCTR2100046035.
Health systems analysis and evaluation of the barriers to availability, utilisation and readiness of sexual and reproductive health services in COVID-19-affected areas: a WHO mixed-methods study protocol
Authors: Kouanda Seni , Nahyuha Chomi Eunice , Kim Caron , Jen Sothornwit , Bahamondes Luis , Cecatti Jose Guilherme , Lumbiganon Pisake , Emefa Modey , Brizuela Vanessa , Kuganantham Hamsadvani , Seuc Armando Humberto , Ali Moazzam 
Published: June 2022

IntroductionCOVID-19 has led to an unprecedented increase in demand on health systems to care for people infected, necessitating the allocation of significant resources, especially medical resources, towards the response. This, compounded by the restrictions on movement instituted may have led to disruptions in the provision of essential services, including sexual and reproductive health (SRH) services. This study aims to assess the availability of contraception, comprehensive abortion care, sexually transmitted infection prevention and treatment and sexual and gender-based violence care and support services in local health facilities during COVID-19 pandemic. This is a standardised generic protocol designed for use across different global settings.Methods and analysisThis study adopts both quantitative and qualitative methods to assess health facilities’ SRH service availability and readiness, and clients’ and providers’ perceptions of the availability and readiness of these services in COVID-19-affected areas. The study has two levels: (1) perceptions of clients (and the partners) and healthcare providers, using qualitative methods, and (2) assessment of infrastructure availability and readiness to provide SRH services through reviews, facility service statistics for clients and a qualitative survey for healthcare provider perspectives. The health system assessment will use a cross-sectional panel survey design with two data collection points to capture changes in SRH services availability as a result of the COVID-19 epidemic. Data will be collected using focus group discussions, in-depth interviews and a health facility assessment survey.Ethics and disseminationEthical approval for this study was obtained from the WHO Scientific and Ethics Review Committee (protocol ID CERC.0103). Each study site is required to obtain the necessary ethical and regulatory approvals that are required in each specific country.
Effectiveness of a personal health coaching intervention (diabetescoach) in patients with type 2 diabetes: protocol for an open-label, pragmatic randomised controlled trial
Authors: Hohberg Vivien , Kreppke Jan-Niklas , Kohl Jan , Seelig Eleonora , Zahner Lukas , Streckmann Fiona , Gerber Markus , König Daniel , Faude Oliver 
Published: June 2022

IntroductionThe widespread prevalence of type 2 diabetes (T2D) not only influences patients’ daily lives but also has an economic impact on society. Increasing physical activity and a healthy diet can delay the progression of T2D. Although there are evidence-based recommendations on diet and physical activity, patients with T2D have difficulties implementing them. An appropriate lifestyle intervention can address this problem.Methods and analysisThis study is based on the need to develop an intervention that helps patients to establish behavioural changes in order to achieve glycaemic control. The intervention will be evaluated in a monocentric, open-label, pragmatic, two-arm randomised controlled trial with a sample ratio of 1:1 and a parallel design. This superiority study will be conducted in Switzerland. All enrolled patients (n=90) will receive the standard medical treatment for T2D. The intervention group will receive personal health coaching by telephone and access to a smartphone and web application for 1 year. The control group will receive access to the application for 1 year and a one-time written diet and exercise recommendation. The primary outcomes are objectively measured physical activity and glycated haemoglobin. Secondary outcomes are self-reported physical activity, nutrition, cognitive mediators of changes in sport-related behaviour, blood values, medication and nutritional supplements, anthropometric data, quality of life, neuropathy and cost-effectiveness. All outcomes will be measured at baseline, at 27 weeks after inclusion and at 54 weeks after inclusion. The recruitment of participants and the measurements will be completed after 2 years. Linear mixed-effects models will be applied for each outcome variable to analyse the intervention effects.Ethics and disseminationThis study was approved by the Ethics Committee North-western and Central Switzerland in February 2021 (ref: 2020-02755). All participants will be required to provide written informed consent. The results will be published in international peer-reviewed journals.Trial registration numberISRCTN79457541.
COVID-19 among staff and their family members of a healthcare research institution in Bangladesh between March 2020 and April 2021: a test-negative case–control study
Authors: Mahfuz Mustafa , Alam Md Ashraful , Fahim Shah Mohammad , Hasan S M Tafsir , Sarmin Monira , Das Subhasish , Mostafa Ishita , Parveen Shahana , Rahman Mustafizur , Arifeen Shams E , Clemens John D , Ahmed Tahmeed 
Published: June 2022

ObjectiveTo identify factors associated with COVID-19 positivity among staff and their family members of icddr,b, a health research institute located in Bangladesh.SettingDhaka, Bangladesh.ParticipantsA total of 4295 symptomatic people were tested for SARS-CoV-2 by reverse-transcription PCR between 19 March 2020 and 15 April 2021. Multivariable logistic regression was done to identify the factors associated with COVID-19 positivity by contrasting test positives with test negatives.ResultForty-three per cent of the participants were tested positive for SARS-CoV-2. The median age was high in positive cases (37 years vs 34 years). Among the positive cases, 97% were recovered, 2.1% had reinfections, 24 died and 41 were active cases as of 15 April 2021. Multivariable regression analysis showed that age more than 60 years (adjusted OR (aOR)=2.1, 95% CI 1.3 to 3.3; p<0.05), blood group AB (aOR=1.5, 95% CI 1.1 to 2; p<0.05), fever (aOR=3.1, 95% CI 2.6 to 3.7; p<0.05), cough (aOR=1.3, 95% CI 1.1 to 1.6; p<0.05) and anosmia (aOR=2.7, 95% CI 1.3 to 5.7; p<0.05) were significantly associated with higher odds of being COVID-19 positive when compared with participants who were tested negative.ConclusionsThe study findings suggest that older age, fever, cough and anosmia were associated with COVID-19 among the study participants.
Making space for patients’ preferences in precision medicine: a qualitative study exploring perspectives of patients with rheumatoid arthritis
Authors: Bywall Karin Schölin , Johansson Jennifer Viberg , Erlandsson Inger , Heidenvall Marie , Lason Marta , Appel Esbensen Bente 
Published: June 2022

ObjectivePrecision medicine in rheumatoid arthritis (RA) creates new opportunities to involve patients in early identification of accurate indicators of health trajectories. The aim of this study was to explore patient perspectives on patient-centredness in precision medicine for RA treatment.DesignSemistructured interviews were conducted to explore patients’ perspectives on a new personalised approach to RA treatment. The interview guide was developed together with patient research partners and health care professionals.SettingAn invitation to the interviews was sent through a mobile application. The interviews were one-on-one, using an interview guide with open-ended questions. Interviews were conducted digitally (October 2020–February 2021) via Zoom or telephone, depending on each participant’s preferences.ParticipantsPatients with RA (N=12) were purposively recruited. Patients were eligible if they had an RA diagnosis, were aged 18–80 years, and understood and expressed themselves in Swedish. Participants and researchers did not know each other prior to the interviews.ResultsParticipants expressed desires and needs for patients to have an active role in precision medicine by making shared treatment decisions together with a healthcare professional. In order for that to work, patients need information on potential treatment options, an ability to express their preferences, an individual treatment plan and identification of personal treatment goals. Patients also identified two requirements of healthcare professional in precision medicine: a safe environment to express personal matters and two-way communication with healthcare professionals.ConclusionCommunication between patients and healthcare professionals needs to be more focused on patients’ individual treatment preferences and expressed needs, in order to increase patient-centredness in treatment decisions, so shared decision-making can become a reality. More research is needed to design multifaceted implementation strategies to support patients and healthcare professionals to increase patient-centredness throughout treatment personalisation.
Application of the new ‘XU-line’ in the dynamic ultrasonographic evaluation of the spatial displacement of anterior cervical tissues for airway management: protocol for a prospective observational study
Authors: Wang Yujie , Mao Mingfeng , Zhou Yang , Shi Wanrui , Xu Mao 
Published: June 2022

IntroductionPatients with cervical spondylosis have a high incidence of difficult airway, and unpredicted difficult intubation may be life-threatening. Traditional predictors and imaging data may suggest a difficult airway, but these data have limited predictive value, with low sensitivity and specificity. Ultrasonography is a non-irradiating, reproducible, inexpensive and simple tool that provides good imaging of the cervical soft tissue for airway assessment. This study will use the new ‘XU-line’ in the dynamic ultrasonographic airway evaluation of the spatial displacement of the anterior cervical tissues to determine whether preoperative ultrasonographic assessment of the neck anatomy can predict difficult airway.Methods and analysisThis prospective, observational study will be conducted in a single centre. Four hundred and eleven patients scheduled for anterior cervical decompression and fusion under general anaesthesia will be recruited. The parallel trunk reference line through the mentum is defined as the XU-line, and the spatial displacement of the anterior cervical soft tissue relative to the XU-line at six anatomical levels in the transverse plane and two distances in the sagittal plane will be measured on ultrasonography with the patient in the supine position and the sniff position. The spatial displacement distances of soft tissue structures relative to the XU-line will be compared between the ‘easy intubation’ and ‘difficult intubation’ groups (in accordance with the Cormack-Lehane classification). Receiver operating characteristic curves will be used to determine the sensitivity and specificity of the ‘difficulty prediction capability’ of each ultrasonographic and physical measurement. Multiple logistic regression analysis will be performed to determine the independent predictors of difficult intubation.Ethics and disseminationEthical approval for this study has been obtained from the Peking University Third Hospital Medical Science Research Ethics Committee. The results of this study will be disseminated via a peer-reviewed publication and national and international conferences and workshops.Trial registration numberChiCTR2000034446.