bluuebunny/crossref_metadata_2025_split huggingface dataset:
Occupational burn-out, fatigue and stress in professional rescuers: a cross-sectional study in Kazakhstan
Authors: Vinnikov Denis , Kapanova Gulnara , Romanova Zhanna , Krugovykh Ilya , Kalmakhanov Sundetgali , Ualiyeva Aliya , Baigonova Kaini , Tulekov Zhangir , Ongarbaeva Damet 
Published: June 2022

ObjectivesTo find predictors of burn-out in a cohort of rescuers.DesignCross-sectional study.SettingRepublican Rescue Squad (N=105) and Republican Mudslide Rescue Service under the Ministry of Emergency Situations (N=480) in Almaty, Kazakhstan.ParticipantsIn total, we included 268 (80% men, median age 38 (IQR 22) years) rescuers from both organisations.Primary and secondary outcome measuresWe offered a questionnaire to rescuers, which included Maslach Burnout Inventory, quantifying emotional exhaustion (EX), cynicism (CY) and professional efficacy (PE) along with fatigue, stress and health-related quality of life (HRQL) tools.ResultsLower scores of HRQL (Physical Component Score (PCS) beta −0.04 (95% CI −0.06 to −0.02); Mental Component Score beta −0.03 (95% CI −0.05 to −0.01)), higher fatigue (Fatigue Severity Scale (FSS) score beta 0.03 (95% CI 0.03 to 0.04)) and stress (Perceived Stress Score-10 beta 0.04 (95% CI 0.02 to 0.06)) independently predicted greater EX. Lower PCS (beta −0.03 (95% CI −0.06 to −0.01)) and FSS (beta 0.02 (95% CI 0.01 to 0.03)) could predict more CY burn-out. In addition to stress, higher education (beta 0.86 (95% CI 0.40 to 1.32)) was positively associated with lower burn-out severity in PE domain.ConclusionsFatigue, stress and HRQL were associated with burn-out in rescuers. Addressing these predictors may help guide further interventions to reduce occupational burn-out.
Effectiveness of ‘Tackle Your Tics’, a brief, intensive group-based exposure therapy programme for children with tic disorders: study protocol of a randomised controlled trial
Authors: Heijerman-Holtgrefe Annet , Huyser Chaim , Verdellen Cara , van de Griendt Jolande , Beljaars Laura , Kan Kees-Jan , Lindauer Ramón , Cath Daniëlle , Hoekstra Pieter , Utens Lisbeth 
Published: June 2022

IntroductionThis paper outlines the study protocol for the Dutch Tackle Your Tics study in youth with tic disorders. Tourette syndrome and chronic tic disorders are prevalent neurodevelopmental disorders, placing considerable burden on youth and their families. Behavioural treatment is the first-line, evidence-based intervention for tic disorders, but tic reduction and availability remain relatively low. Patient associations stress the need for more accessible high-quality treatments, also focusing on improving quality of life. Therefore, the brief, intensive group-based treatment Tackle Your Tics was developed.Methods and analysisTackle Your Tics is a 4-day intensive and comprehensive group-based intervention for children and adolescents (9–17 years) with Tourette syndrome or a chronic tic disorder. The programme encompasses exposure and response prevention treatment and additional supporting components (coping strategies, relaxation exercises and parent support). To study the effectiveness of Tackle Your Tics and identify predictors/moderators at baseline, a single-blinded randomised controlled trial (n=104) is conducted, comparing Tackle Your Tics (n=52) with a waiting list condition lasting 3 months (n=52). Assessments are performed at similar time points for both groups: at baseline, after 4 weeks, and at 3 and 6 months of follow-up, on tic severity, quality of life and other psychosocial variables.Ethics and disseminationEthics approval has been obtained from the medical ethical committee of the Amsterdam Medical Centre (METC nr NL66340.018.18, v3 June 2020). Findings will be presented on national and international conferences, peer-reviewed scientific journals, patient organisation meetings and public media. Patient representatives are fully integrated as part of the research team. If Tackle Your Tics proves to be effective, it can expand evidence-based treatment possibilities for children and adolescents with tic disorders. Identifying the psychosocial predictors/moderators for the effectiveness of this intervention can provide personalised treatment advice in the future.Trial registration numberNL8052.
The relationship between the living lab approach and successful implementation of healthcare innovations: an integrative review
Authors: Zipfel Nina , Horreh Bedra , Hulshof Carel T J , de Boer Angela G E M , van der Burg-Vermeulen Sylvia J 
Published: June 2022

ObjectivesThe concept of living labs as a research method to enhance participation of end-users in the development and implementation process of an innovation, gained increasing attention over the past decade. A living lab can be characterised by five key components: user-centric, cocreation, real-life context, test innovation and open innovation. The purpose of this integrative literature review was to summarise the literature on the relationship between the living lab approach and successful implementation of healthcare innovations.MethodsAn integrative literature review searching PubMed, EMBASE, PsycINFO and Cinahl databases between January 2000 and December 2019. Studies were included when a living lab approach was used to implement innovations in healthcare and implementation outcomes were reported. Included studies evaluated at least one of the following implementation outcomes: acceptability, adoption, appropriateness, feasibility, fidelity, implementation cost, penetration or sustainability. Quality was assessed based on a tool developed by Hawker et al.ResultsOf the 1173 retrieved articles, 30 studies were included of which 11 of high quality. Most studies involved a combination of patients/public (N=23) and providers (N=17) as key stakeholders in the living lab approach. Living lab components were mostly applied in the development phase of innovations (N=21). The majority of studies reported on achievement of acceptability (N=22) and feasibility (N=17) in terms of implementation outcomes. A broader spectrum of implementation outcomes was only evaluated in one study. We found that in particular six success factors were mentioned for the added-value of using living lab components for healthcare innovations: leadership, involvement, timing, openness, organisational support and ownership.ConclusionsThe living lab approach showed to contribute to successful implementation outcomes. This integrative review suggests that using a living lab approach fosters collaboration and participation in the development and implementation of new healthcare innovations.PROSPERO registration numberCRD42020166895.
Detection of atrial fibrillation in primary care with radial pulse palpation, electronic blood pressure measurement and handheld single-lead electrocardiography: a diagnostic accuracy study
Authors: Verbiest-van Gurp Nicole , Uittenbogaart Steven B , Lucassen Wim A M , Erkens Petra M G , Knottnerus J André , Winkens Bjorn , Stoffers Henri E J H , van Weert Henk C P M 
Published: June 2022

ObjectiveTo determine the diagnostic accuracy of three tests—radial pulse palpation, an electronic blood pressure monitor and a handheld single-lead ECG device—for opportunistic screening for unknown atrial fibrillation (AF).DesignWe performed a diagnostic accuracy study in the intention-to-screen arm of a cluster randomised controlled trial aimed at opportunistic screening for AF in general practice. We performed radial pulse palpation, followed by electronic blood pressure measurement (WatchBP Home A) and handheld ECG (MyDiagnostick) in random order. If one or more index tests were positive, we performed a 12-lead ECG at shortest notice. Similarly, to limit verification bias, a random sample of patients with three negative index tests received this reference test. Additionally, we analysed the dataset using multiple imputation. We present pooled diagnostic parameters.Setting47 general practices participated between September 2015 and August 2018.ParticipantsIn the electronic medical record system of the participating general practices (n=47), we randomly marked 200 patients of ≥65 years without AF. When they visited the practice for any reason, we invited them to participate. Exclusion criteria were terminal illness, inability to give informed consent or visit the practice or having a pacemaker or an implantable cardioverter-defibrillator.OutcomesDiagnostic accuracy of individual tests and test combinations to detect unknown AF.ResultsWe included 4339 patients; 0.8% showed new AF. Sensitivity and specificity were 62.8% (range 43.1%–69.7%) and 91.8% (91.7%–91.8%) for radial pulse palpation, 70.0% (49.0%–80.6%) and 96.5% (96.3%–96.7%) for electronic blood pressure measurement and 90.1% (60.8%–100%) and 97.9% (97.8%–97.9%) for handheld ECG, respectively. Positive predictive values were 5.8% (5.3%–6.1%), 13.8% (12.2%–14.8%) and 25.2% (24.2%–25.8%), respectively. All negative predictive values were ≥99.7%.ConclusionIn detecting AF, electronic blood pressure measurement (WatchBP Home A), but especially handheld ECG (MyDiagnostick) showed better diagnostic accuracy than radial pulse palpation.Trial registration numberNetherlands Trial Register No. NL4776 (old NTR4914).
Emergency medicine physician supervision and mortality among patients receiving care from non-physician clinicians in a task-sharing model of emergency care in rural Uganda: a retrospective analysis of a single-centre training programme
Authors: Rice Brian , Pickering Ashley , Laurence Colleen , Kizito Prisca Mary , Leff Rebecca , Kisingiri Steven Jonathan , Ndyamwijuka Charles , Nakato Serena , Adriko Lema Felix , Bisanzo Mark 
Published: June 2022

ObjectivesTo assess the association between emergency medicine physician supervision and 3-day mortality for patients receiving care from non-physician clinicians in a task-sharing model of emergency care in rural Uganda.DesignRetrospective cohort analysis with multivariable logistic regression.SettingSingle rural Ugandan emergency unit.ParticipantsAll patients presenting for care from 2009 to 2019.InterventionsThree cohorts of patients receiving care from non-physician clinicians had three different levels of physician supervision: ‘Direct Supervision’ (2009–2010) emergency medicine physicians directly supervised all care; ‘Indirect Supervision’ (2010–2015) emergency medicine physicians were consulted as needed; ‘Independent Care’ (2015–2019) no emergency medicine physician supervision.Primary outcome measureThree-day mortality.Results38 033 ED visits met inclusion criteria. Overall mortality decreased significantly across supervision cohorts (‘Direct’ 3.8%, ‘Indirect’ 3.3%, ‘Independent’ 2.6%, p<0.001), but so too did the rates of patients who presented with ≥3 abnormal vitals (‘Direct’ 32%, ‘Indirect’ 19%, ‘Independent’ 13%, p<0.001). After controlling for vital sign abnormalities, ‘Direct’ and ‘Indirect’ supervision were both significantly associated with reduced OR for mortality (‘Direct’: 0.57 (0.37 to 0.90), ‘Indirect’: 0.71 (0.55 to 0.92)) when compared with ‘Independent Care’. Sensitivity analysis showed that this mortality benefit was significant for the minority of patients (17.2%) with ≥3 abnormal vitals (‘Direct’: 0.44 (0.22 to 0.85), ‘Indirect’: 0.60 (0.41 to 0.88)), but not for the majority (82.8%) with two or fewer abnormal vitals (‘Direct’: 0.81 (0.44 to 1.49), ‘Indirect’: 0.82 (0.58 to 1.16)).ConclusionsEmergency medicine physician supervision of emergency care non-physician clinicians is independently associated with reduced overall mortality. This benefit appears restricted to the highest risk patients based on abnormal vitals. With over 80% of patients having equivalent mortality outcomes with independent non-physician clinician emergency care, a synergistic model providing variable levels of emergency medicine physician supervision or care based on patient acuity could safely address staffing shortages.
Examining the impact of social stressor stimuli in eliciting physiological reactivity in children and adolescents with autism spectrum disorder: a systematic review and meta-analysis protocol
Authors: Wong Agnes S K , Burns Samantha , Woodruff Earl 
Published: June 2022

IntroductionStress is not experienced the same by everyone. Some individuals, such as individuals with autism spectrum disorder (ASD), are at risk of heightened sensitivity to stress responses. ASD is a neurodevelopmental disorder commonly characterised by deficits in social communication and social interaction. Among different stressor stimuli, social stressors are particularly worth our attention due to the social and communication challenges inherent in ASD. This study aims to systematically evaluate different social stressor stimuli in eliciting physiological reactivity in ASD, focusing on the children and adolescent population.Methods and analysisWe designed a study protocol for this study and submitted it to PROSPERO for systematic review registration. Any studies with children and adolescents with ASD between the ages of 0 and 18 in clinical and community settings will be included. All types of social stressor interventions will be included. The outcome of interest will include studies with physiological activity of the participants being measured, for example, measures related to autonomic functioning, electrodermal functioning and cortisol level. The primary literature sources will be across four electronic databases: MEDLINE, Embase, PsycInfo and CINAHL in August 2021. The second source of literature will be across grey literature, including ProQuest Dissertations & Theses Global and across clinical trial registries in August 2021. Hand searching of references will be performed on the reference lists of all included studies. Two volunteers pursuing postgraduate-level studies will independently search and screen potential studies for eligibility. Finally, all references considered by hand searching will be reviewed by two researchers. The methodological quality of the research will be assessed by adopting the quality assessment used by a previous study. The assessment consists of four primary categories: descriptive validity, internal validity, external validity and statistical conclusion validity.Ethics and disseminationNo ethical approval is required for this study. Results will be disseminated through conferences and publications in relevant peer-reviewed journals.PROSPERO registration numberCRD42021244039.
Cohort profile: Anhui Maternal–Child Health Study in China
Authors: Yin Jiaqian , Cao Yunxia , Liang Chunmei , Peng Xiaoqing , Xu Xiaofeng , Zhou Weiju , Khutan Ranjit , Tao Fang-Biao , Chen Ruoling 
Published: June 2022

PurposeThe Anhui Maternal–Child Health Study (AMCHS) aims to examine determinants of reproduction, pregnancy and postpartum maternal and child health outcomes in Chinese women who received assisted reproductive technology (ART).Study design and participantsAMCHS is an ongoing cohort study starting from May 2017. AMCHS recruits participants from all couples who sought ART treatment in the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China. The participants are interviewed to document baseline sociodemography, lifestyles, dietary intake and environmental exposure. Their clinical characteristics are obtained from hospital records. Samples of blood, follicular fluid and semen are collected at the clinic. Participants receive a standard long pituitary downregulation or a short protocol with an antagonist for the treatment. They are followed up from preconception to delivery, or discontinuation of ART treatment. Details of their children’s health are documented through a questionnaire focusing on developmental status and anthropometry measurement.Findings to dateUntil April 2021, AMCHS had recruited 2042 couples in the study. 111 women withdrew from the study and 19 failed to retrieve oocytes. Among the 1475 confirmed pregnancies, 146 had miscarriages or terminated their pregnancies, 9 had stillbirths and 263 were ongoing pregnancies. The implantation failure increased with maternal age; adjusted OR was 1.43 (95% CI 1.16 to 1.77) in the age of 31–35 years, 1.97 (95% CI 1.46 to 2.66) in 35–39 years and 6.52 (95% CI 3.35 to 12.68) in ≥40 years compared with those aged 20–30 years. Among the 1057 couples with successful ART who were followed up for delivering babies, 576 had their children examined at age 30–42 days, 459 at 6 months and 375 at 12 months.Future plansThe AMCHS will identify comprehensive risk factors for poor ART outcomes and explore potential interaction effects of multiple factors including sociopsychological aspects of environmental exposure, dietary intake and genetics on maternal and child health.
Effects of whole-body vibration training on lower limb motor function and neural plasticity in patients with stroke: protocol for a randomised controlled clinical trial
Authors: Zhang Mingkai , Wei Jianing , Wu Xueping 
Published: June 2022

IntroductionLower limb motor dysfunction is common in patients with stroke, and usually caused by brain neural connectivity disorder. Previous studies have shown that the whole-body vibration training (WBVT) significantly improves the lower limb motor function in patients with stroke and may promote nerve remodelling. The prior purpose of this study is to explore effects of WBVT on lower limb motor function and neuroplasticity in patients with stroke.MethodsA single-blind randomised controlled trial will be conducted. Sixty patients with stroke will be recruited and allocated randomly to WBVT, routine rehabilitation training (RRT) and control group (CG). The WBVT and RRT interventions will be implemented as five 25 min sessions weekly for continuous 12 weeks; the CG will remain daily habitual living styles and routine treatments, in community or hospital, and will also receive telephone follow-up and health-related lectures. Transcranial magnetic stimulation will be used to assess neural plasticity while lower limb motor function is assessed using indicators of strength, walking ability and joint activity. The assessments will be conducted at the period of baseline, week 6, week 12 as well as on 4 and 8 weeks, respectively, after intervention completion.Ethics and disseminationThis study has been approved by the Shanghai University of Sport Research Ethics Committee (102772021RT067) and will provide data on the effects of WBVT relative to RRT in terms of the improvement of stroke patients’ lower limb motor function and neural plasticity. The results of this study will be disseminated via publications in peer-reviewed journals and presentations at international conference.Trial registration numberChiCTR2200055143.
Factors associated with cancer treatment delay: a protocol for a systematic review and meta-analysis
Authors: Morrill Kristin E , Robles-Morales Rogelio , Lopez-Pentecost Melissa , Martínez Portilla Raigam J , Saleh Ahlam A , Skiba Meghan B , Riall Taylor S , Austin Jessica D , Hirschey Rachel , Jacobs Elizabeth T , Spotleson Lena , Hanna Timothy P 
Published: June 2022

IntroductionTreatment delays are significantly associated with increased mortality risk among adult cancer patients; however, factors associated with these delays have not been robustly evaluated. This review and meta-analysis will evaluate factors associated with treatment delays among patients with five common cancers.Methods and analysisScientific databases including Ovid MEDLINE, Elsevier Embase, EBSCOhost CINAHL Plus Full Text, Elsevier Scopus and ProQuest Dissertations and Theses Global will be searched to identify relevant articles published between January 2000 and October 2021. Research articles published in the USA evaluating factors associated with treatment delay among breast, lung, prostate, cervical or colorectal adult cancer patients will be included. The primary outcome of the meta-analysis will be the pooled adjusted and unadjusted odds of treatment delay for patient, disease, provider and system-level factors defined according to specified time intervals. The secondary outcomes will be mean or median treatment delay for each cancer site according to first treatment and the influence of factors on the pooled mean treatment delay for each cancer site (via meta-regression analyses). Results from qualitative and mixed-methods studies will be narratively synthesised. Three reviewers will independently screen records generated from the search and two reviewers will independently extract data following a consensus agreement. Statistical heterogeneity will be assessed with a standard I2 test and funnel plots will be conducted to evaluate publication bias. Risk of bias will be assessed independently by two authors using validated tools according to the article’s study design.Ethics and disseminationFormal ethical approval is not required because the work is being carried out on publicly accessible studies. The findings of this review will be disseminated through a peer-reviewed scientific journal, academic conferences, social media, and key stakeholders.PROSPERO registration numberCRD42021293131.
Web-based interventions for pregnant women with gestational diabetes mellitus: a systematic review and meta-analysis protocol
Authors: Guo Pingping , Jin Yin , Xiang Zhenzhen , Chen Dan Dan , Xu Ping , Wang Xiaojuan , Zhang Wei , Mao Minna , Zheng Qiong , Feng Suwen 
Published: June 2022

IntroductionGestational diabetes mellitus (GDM) is one of the most prevalent diseases during pregnancy, which is closely associated with many short-term and long-term maternal and neonatal complications and can incur heavy financial burden on both families and society. Web-based interventions have been used to manage GDM because of the advantages of high accessibility and flexibility, but their effectiveness has remained inconclusive. This systematic review and meta-analysis aims to comprehensively investigate the multidimensional effectiveness of web-based interventions for pregnant women with GDM, thereby aiding implementation decisions in clinical settings.Methods and analysisThis systematic review protocol strictly adheres to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. Six electronic databases (PubMed, Web of Science, Cochrane Central Register of Controlled Trials, Embase, CINAHL and PsycINFO) will be comprehensively searched from their inception to 26 January 2022 to identify randomised controlled trials and controlled clinical trials regarding the efficacy of web-based interventions for pregnant women with GDM on glycaemic control, behavioural outcomes, cognitive and attitudinal outcomes, mental health, maternal and neonatal clinical outcomes, and medical service utilisation and costs. Two reviewers will independently conduct the study selection, data extraction and quality assessment. The methodological quality of included studies will be assessed using the Effective Public Health Practice Project assessment tool. The overall meta-analyses for each of the interested outcomes will be performed if the outcome data are sufficient and provides similar effect measures, as well as subgroup analyses for glycaemic control indicators based on the different types of intervention format, interactivity and technology. We will conduct a qualitative synthesis for studies that cannot be quantitatively synthesised.Ethics and disseminationEthics approval is not required for this review as no human participants will be involved. The results will be disseminated via a peer-reviewed journal or an academic conference.PROSPERO registration numberCRD42022296625.