bluuebunny/crossref_metadata_2025_split huggingface dataset:
Burnout, coping strategies and help-seeking in general practitioners: a two-wave survey study in Denmark
Authors: Pedersen Anette Fischer , Vedsted Peter 
Published: February 2022

ObjectiveWork pressure remains an issue among general practitioners (GPs). Nevertheless, GPs rarely seek help for symptoms of burnout. The aim of this study was to examine whether burnout level was associated with coping strategies and help-seeking behaviour during time pressure.DesignA two-wave nationwide survey (2016 and 2019) based on questionnaire data from 1059 GPs.SettingPrimary care in Denmark.MethodsBurnout was measured by the Maslach Burnout Inventory (MBI), whereas coping strategies and help-seeking behaviour were measured by questions developed for the study. A composite score of quartile points was calculated for the three subscales of the MBI subscales. A score ≥9 was categorised as high level of burnout, and the composite score of 2019 was used as outcome. Data were analysed with logistic regression adjusted for sex, age and composite burnout score in 2016.ResultsHigh scores in 2016 on four key factors were associated with increased risk of high composite burnout score in 2019. These factors were compromising work (ORadjusted=2.27, 95% CI=1.45 to 3.56), postponing decisions (ORadjusted=1.53, 95% CI=1.04 to 2.24), delaying tasks (ORadjusted=1.61, 95% CI=1.16 to 2.25) and reducing breaks (ORadjusted=1.46, 95% CI=1.01 to 2.11) during time pressure. A lower risk of high composite burnout score was seen in 2019 in GPs who had sought help compared with GPs who did not seek help despite a perceived need (ORadjusted=0.59, 95% CI=0.35 to 0.97).ConclusionCertain coping strategies used in 2016 were associated with increased risk of high burnout score in 2019, whereas lower risk of high burnout was seen in the GPs seeking help. These findings are relevant to reduce burnout rates among GPs.
Strategies prescribers and pharmacists use to identify and mitigate adverse drug reactions in inpatient and outpatient care: a cognitive task analysis at a US Veterans Affairs Medical Center
Authors: Nguyen Khoa Anh , Militello Laura G , Ifeachor Amanda , Arthur Karen J , Glassman Peter A , Zillich Alan J , Weiner Michael , Russ-Jara Alissa L 
Published: February 2022

ObjectiveTo develop a descriptive model of the cognitive processes used to identify and resolve adverse drug reactions (ADRs) from the perspective of healthcare providers in order to inform future informatics effortsSettingInpatient and outpatient care at a tertiary care US Veterans Affairs Medical Center.ParticipantsPhysicians, nurse practitioners and pharmacists who report ADRs.OutcomesDescriptive model and emerging themes from interviews.ResultsWe conducted critical decision method interviews with 10 physicians and 10 pharmacists. No nurse practitioners submitted ADR incidents. We generated a descriptive model of an ADR decision-making process and analysed emerging themes, categorised into four stages: detection of potential ADR, investigation of the problem’s cause, risk/benefit consideration, and plan, action and follow-up. Healthcare professionals (HCPs) relied on several confirmatory or disconfirmatory cues to detect and investigate potential ADRs. Evaluating risks and benefits of related medications played an essential role in HCPs' pursuits of solutionsConclusionsThis study provides an illustrative model of how HCPs detect problems and make decisions regarding ADRs. The design of supporting technology for potential ADR problems should align with HCPs' real-world cognitive strategies, to assist fully in detecting and preventing ADRs for patients.
Premature mortality in early-intervention mental health services: a data linkage study protocol to examine mortality and morbidity outcomes in a cohort of help-seeking young people
Authors: McHugh Catherine , Song Yun Ju Christine , Zmicerevska Natalia , Crouse Jacob , Nichles Alissa , Wilson Chloe , Ho Nicholas , Iorfino Frank , Skinner Adam , Scott Elizabeth M , Hickie Ian B 
Published: February 2022

IntroductionUnderstanding the risk of premature death from suicide, accident and injury and other physical health conditions in people seeking healthcare for mental disorders is essential for delivering targeted clinical interventions and secondary prevention strategies. It is not clear whether morbidity and mortality outcomes in hospital-based adult cohorts are applicable to young people presenting to early-intervention services.Methods and analysisThe current data linkage project will establish the Brain and Mind Patient Research Register–Mortality and Morbidity (BPRR-M&M) database. The existing Brain and Mind Research Institute Patient Research Register (BPRR) is a cohort of 6743 young people who have accessed primary care-based early-intervention services; subsets of the BPRR contain rich longitudinal clinical, neurobiological, social and functional data. The BPRR will be linked with the routinely collected health data from emergency department (ED), hospital admission and mortality databases in New South Wales from January 2010 to November 2020. Mortality will be the primary outcome of interest, while hospital presentations will be a secondary outcome. The established BPRR-M&M database will be used to establish mortality rates and rates of ED presentations and hospital admissions. Survival analysis will determine how time to death or hospital presentation varies by identified social, demographic and clinical variables. Bayesian modelling will be used to identify predictors of these morbidity and mortality outcomes.Ethics and disseminationThe study has been reviewed and approved by the human research ethics committee of the Sydney Local Health District (2019/ETH00469). All data will be non-identifiable, and research findings will be disseminated through peer-reviewed journals and scientific conference presentations.
Lactogenic hormones in relation to maternal metabolic health in pregnancy and postpartum: protocol for a systematic review
Authors: Rassie Kate Louise , Giri Rinky , Melder Angela , Joham Anju , Mousa Aya , Teede Helena J 
Published: February 2022

IntroductionMaternal metabolic disease states (such as gestational and pregestational diabetes and maternal obesity) are reaching epidemic proportions worldwide and are associated with adverse maternal and fetal outcomes. Despite this, their aetiology remains incompletely understood. Lactogenic hormones, namely, human placental lactogen (hPL) and prolactin (PRL), play often overlooked roles in maternal metabolism and glucose homeostasis during pregnancy and (in the case of PRL) postpartum, and have clinical potential from a diagnostic and therapeutic perspective. This paper presents a protocol for a systematic review which will synthesise the available scientific evidence linking these two hormones to maternal and fetal metabolic conditions/outcomes.Methods and analysisMEDLINE (via OVID), CINAHL and Embase will be systematically searched for all original observational and interventional research articles, published prior to 8 July 2021, linking hPL and/or PRL levels (in pregnancy and/or up to 12 months postpartum) to key maternal metabolic conditions/outcomes (including pre-existing and gestational diabetes, markers of glucose/insulin metabolism, postpartum glucose status, weight change, obesity and polycystic ovary syndrome). Relevant fetal outcomes (birth weight and placental mass, macrosomia and growth restriction) will also be included. Two reviewers will assess articles for eligibility according to prespecified selection criteria, followed by full-text review, quality appraisal and data extraction. Where possible, meta-analysis will be performed; otherwise, a narrative synthesis of findings will be presented.Ethics and disseminationFormal ethical approval is not required as no primary data will be collected. The results will be published in a peer-reviewed journal and presented at conference meetings, and will be used to inform future research directions.PROSPERO registration numberCRD42021262771.
Can patiromer allow for intensified renin–angiotensin–aldosterone system blockade with losartan and spironolactone leading to decreased albuminuria in patients with chronic kidney disease, albuminuria and hyperkalaemia? An open-label randomised controlled trial: MorphCKD
Authors: Mårup Frederik Husum , Peters Christian Daugaard , Christensen Jeppe Hagstrup , Birn Henrik 
Published: February 2022

IntroductionChronic kidney disease (CKD) is associated with significantly increased morbidity and mortality. No specific treatment of the underlying condition is available for the majority of patients, but ACE-inhibitors (ACE-I) and angiotensin II-receptor blockers (ARB) slows progression in albuminuric CKD. Adding a mineralocorticoid receptor-antagonist (MRA) like spironolactone has an additive effect. However, renin–angiotensin–aldosterone system (RAAS)-blockade increases the risk of hyperkalaemia which is exacerbated by the presence of CKD. Thus, hyperkalaemia may prevent optimal use of RAAS-blockade in some patients.This project hypothesises that adding a potassium binder (patiromer) allows for improved RAAS-blockade including the use of MRA, thereby reducing albuminuria in patients with albuminuric CKD where full treatment is limited by hyperkalaemia.If successful, the study may lead to improved treatment of this subgroup of patients with CKD. Furthermore, the study will examine the feasibility of potassium binders in patients with CKD.Methods and analysisAn open-label, randomised controlled trial including 140 patients with estimated glomerular filtration rate (eGFR) 25–60 mL/min/1.73 m2, a urinary albumin/creatinine ratio (UACR) >500 mg/g (or 200 mg/g if diabetes mellitus) and a current or two previous plasma-potassium >4.5 mmol/L. Patients who develop hyperkaliaemia >5.5 mmol/L during a run-in phase, in which RAAS-blockade is intesified with the possible addition of spironolactone, are randomised to 12-month treatment with maximal tolerated ACE-I/ARB and spironolactone with or without patiromer.The primary endpoint is the difference in UACR measured at randomisation and 12 months compared between the two groups. Secondary endpoints include CKD progression, episodes of hyperkalaemia, blood pressure, eGFR, markers of cardiovascular disease, diet and quality of life.Ethics and disseminationThis study is approved by The Central Denmark Region Committees on Health Research Ethics (REFNO 1-10-72-110-20) and is registered in the EudraCT database (REFNO 2020-001595-15). Results will be presented in peer-reviewed journals, at meetings and at international conferences.
Concurrent changes in physical activity and body mass index among 66 852 public sector employees over a 16-year follow-up: multitrajectory analysis of a cohort study in Finland
Authors: Tiusanen Roosa , Saltychev Mikhail , Ervasti Jenni , Kivimäki Mika , Pentti Jaana , Stenholm Sari , Vahtera Jussi 
Published: February 2022

ObjectivesTo identify concurrent developmental trajectories of physical activity and body mass index (BMI) over time.DesignProspective cohort study, repeated survey.SettingCohort study in Finland.Participants66 852 public sector employees, who have been followed up for 16 years.Outcome measuresShapes of trajectories of changes in physical activity and BMI.ResultsAt baseline, mean age was 44.7 (SD 9.4) years, BMI 25.1 (SD 4.1) kg/m2 and physical activity 27.7 (SD 24.8) MET hours/week. Four clusters of concurrent BMI and physical activity trajectories were identified: (1) normal weight (BMI <25 kg/m2) and high level of physical activity (30–35 MET hours/week), (2) overweight (BMI 25–30 kg/m2) and moderately high level of physical activity (25–30 MET hours/week), (3) obesity (BMI 30–35 kg/m2) and moderately low level of physical activity (20–25 MET hours/week) and (4) severe obesity (BMI >35 kg/m2) and low level of physical activity (<20 MET hours/week). In general, BMI increased and physical activity decreased during the follow-up. Decline in physical activity and increase in BMI were steeper among obese respondents with low level of physical activity.ConclusionsChanges in BMI and physical activity might be interconnected. The results may be of interest for both clinicians and other stakeholders with respect to informing measures targeting increasing physical activity and controlling weight, especially among middle-aged people. Additionally, the information on the established trajectories may give individuals motivation to change their health behaviour.
Efficacy of probucol on cognitive function in Alzheimer’s disease: study protocol for a double-blind, placebo-controlled, randomised phase II trial (PIA study)
Authors: Lam Virginie , Clarnette Roger , Francis Roslyn , Bynevelt Michael , Watts Gerald , Flicker Leon , Orr Carolyn F , Loh Poh , Lautenschlager Nicola , Reid Christopher M , Foster Jonathan K , Dhaliwal Satvinder S , Robinson Suzanne , Corti Emily , Vaccarezza Mauro , Horgan Ben , Takechi Ryusuke , Mamo John 
Published: February 2022

IntroductionPreclinical, clinical and epidemiological studies support the hypothesis that aberrant systemic metabolism of amyloid beta (Aβ) in the peripheral circulation is causally related to the development of Alzheimer’s disease (AD). Specifically, recent studies suggest that increased plasma concentrations of lipoprotein-Aβ compromise the brain microvasculature, resulting in extravasation and retention of the lipoprotein-Aβ moiety. The latter results in an inflammatory response and neurodegeneration ensues. Probucol, a historic cholesterol-lowering drug, has been shown in murine models to suppress lipoprotein-Aβ secretion, concomitant with maintaining blood–brain-barrier function, suppressing neurovascular inflammation and supporting cognitive function. This protocol details the probucol in Alzheimer’s study, a drug intervention trial investigating if probucol has potential to attenuate cognitive decline, delay brain atrophy and reduce cerebral amyloid burden in patients with mild-to-moderate AD.Methods and analysisThe study is a phase II, randomised, placebo-controlled, double-blind single-site clinical trial held in Perth, Australia. The target sample is 314 participants with mild-to-moderate AD. Participants will be recruited and randomised (1:1) to a 104-week intervention consisting of placebo induction for 2 weeks followed by 102 weeks of probucol (Lorelco) or placebo. The primary outcome is changed in cognitive performance determined via the Alzheimer’s Disease Assessment Scales-Cognitive Subscale test between baseline and 104 weeks. Secondary outcomes measures will be the change in brain structure and function, cerebral amyloid load, quality of life, and the safety and tolerability of Lorelco, after a 104week intervention.Ethics and disseminationThe study has been approved by the Bellberry Limited Human Research Ethics Committee (approval number: HREC2019-11-1063; Version 4, 6 October 2021). Informed consent will be obtained from participants prior to any study procedures being performed. The investigator group will disseminate study findings through peer-reviewed publications, key conferences and local stakeholder events.Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12621000726853).
Type 2 diabetes and risk of diverticular disease: a Danish cohort study
Authors: Wittström Felix , Skajaa Nils , Bonnesen Kasper , Pedersen Lars , Ekholm Ola , Strate Lisa , Erichsen Rune , Sørensen Henrik Toft 
Published: February 2022

ObjectivesTo investigate the association between type 2 diabetes and risk of diverticular disease. Unlike previous studies, which have found conflicting results, we aimed to distinguish between diabetes types and adjust for modifiable risk factors.DesignObservational cohort study.SettingPopulation-based Danish medical databases, covering the period 2005–2018.ParticipantsRespondents of the 2010 or the 2013 Danish National Health Survey, of which there were 15 047 patients with type 2 diabetes and 210 606 patients without diabetes.Primary and secondary outcome measuresHazard ratios (HRs) for incident hospital diagnosis of diverticular disease adjusted for survey year, sex, age, body mass index (BMI), physical activity intensity, smoking behaviour, diet and education based on Cox regression analysis. As latency may affect the association between type 2 diabetes and diverticular disease, patients with type 2 diabetes were stratified into those with <2.5, 2.5–4.9 and ≥5 years duration of diabetes prior to cohort entry.ResultsFor patients with and without diabetes the incidence rates of diverticular disease were 0.76 and 0.54 events per 1000 person years, corresponding to a crude HR of 1.08 (95% CI 1.00 to 1.16) and an adjusted HR of 0.88 (95% CI 0.80 to 0.96). The HR was lower among patients with ≥5 years duration of diabetes (adjusted HR: 0.76, 95% CI 0.67 to 0.87) than among those with 2.5–4.9 years or <2.5 years duration.ConclusionWe found that patients with type 2 diabetes had a higher incidence rate of diverticular disease compared with patients without diabetes. However, after adjustment for modifiable risk factors, driven by BMI, type 2 diabetes appeared to be associated with a slightly lower risk of diverticular disease. Lack of adjustment for BMI may partially explain the conflicting findings of previous studies.
Genomic testing for children with interstitial and diffuse lung disease (chILD): parent satisfaction, understanding and health-related quality of life
Authors: Kelada Lauren , Wakefield Claire , Vidic Nada , Armstrong David S , Bennetts Bruce , Boggs Kirsten , Christodoulou John , Harrison Joanne , Ho Gladys , Kapur Nitin , Lindsey-Temple Suzanna , McDonald Tim , Mowat David , Schultz André , Selvadurai Hiran , Tai Andrew , Jaffe Adam 
Published: February 2022

ObjectiveResearch is needed to determine best practice for genomic testing in the context of child interstitial or diffuse lung disease (chILD). We explored parent’s and child’s health-related quality of life (HRQoL), parents’ perceived understanding of a genomic testing study, satisfaction with information and the study and decisional regret to undertake genomic testing.MethodsParents of children with diagnosed or suspected chILD who were enrolled in a genomic sequencing study were invited to complete questionnaires pretesting (T1) and after receiving the result (T2).ResultsParents’ (T1, n=19; T2, n=17) HRQoL was lower than population norms. Study satisfaction (T1) and perceived understanding (T2) were positively correlated (rs=0.68, p=0.014). Satisfaction with information (T1 and T2) and decisional regret (T2) were negatively correlated (T1 rs=−0.71, p=0.01; T2 rs=−0.56, p=0.03). Parents reported wanting more frequent communication with staff throughout the genomic sequencing study, and greater information about the confidentiality of test results.ConclusionsUnderstanding of genomic testing, satisfaction with information and participation and decisional regret are inter-related. Pretest consultations are important and can allow researchers to explain confidentiality of data and the variable turnaround times for receiving a test result. Staff can also update parents when there will be delays to receiving a result.
Association between age at onset of overweight and risk of hypertension across adulthood
Authors: Li Weijian , Fang Wei , Huang Zegui , Wang Xianxuan , Cai Zefeng , Chen Guanzhi , Wu Weiqiang , Chen Zhichao , Wu Shouling , Chen Youren 
Published: February 2022

ObjectiveThe aim of this study was to examine the association between age at onset of overweight and incident hypertension.MethodsWe analysed 4742 participants with new-onset overweight from the Kailuan study between 2006 and 2015 and and 4742 age-matched and sex-matched controls selected randomly from the same cohort but with normal weight. Participants were compared with respect to subsequent risk of hypertension, with sub-HR calculated with the Fine and Gray model, according to age of onset of overweight.ResultsOver a mean follow-up period of 5.17 years, 1642 overweight participants (34.6%) and 1293 normal-weight controls (27.3%) were subsequently diagnosed with hypertension. The median age at onset of overweight was 49.1 years. Compared with normal-weight controls, the multivariable-adjusted sub-HR for hypertension among participants with onset of overweight at 18–39 years of age, 40–49 years of age, 50–59 years of age and ≥60 years of age was 1.38 (95% CI 1.11 to 1.72), 1.27 (95% CI 1.09 to 1.49), 1.23 (95% CI 1.09 to 1.38) and 1.14 (95% CI 0.99 to 1.32), respectively. Onset of overweight in each age range was significantly associated with increased risk of hypertension, except for the group with onset at ≥60 years of age. The risk increased with each decade of attenuation of age at onset, peaking at 18–39 years of age.ConclusionsYounger age at onset of overweight across adulthood was associated with significantly increased risk of hypertension, with the highest relative risk among participants with onset of overweight at 18–39 years of age.
Detecting contagious spreading of urban innovations on the global city network
Authors: Kitzmann Niklas H. , Romanczuk Pawel , Wunderling Nico , Donges Jonathan F. 
Published: February 2022

AbstractOnly a fast and global transformation towards decarbonization and sustainability can keep the Earth in a civilization-friendly state. As hotspots for (green) innovation and experimentation, cities could play an important role in this transition. They are also known to profit from each other’s ideas, with policy and technology innovations spreading to other cities. In this way, cities can be conceptualized as nodes in a globe-spanning learning network. The dynamics of this process are important for society’s response to climate change and other challenges, but remain poorly understood on a macroscopic level. In this contribution, we develop an approach to identify whether network-based complex contagion effects are a feature of sustainability policy adoption by cities, based on dose-response contagion and surrogate data models. We apply this methodology to an exemplary data set, comprising empirical data on the spreading of a public transport innovation (Bus Rapid Transit Systems) and a global inter-city connection network based on scheduled flight routes. Although our approach is not able to identify detailed mechanisms, our results point towards a contagious spreading process, and cannot be explained by either the network structure or the increase in global adoption rate alone. Further research on the role of a city’s abstract “global neighborhood” regarding its policy and innovation decisions is thus both needed and promising, and may connect with research on social tipping processes. The methodology is generic, and can be used to compare the predictive power for innovation spreading of different kinds of inter-city network connections, e.g. via transport links, trade, or co-membership in political networks.
Educación internacional: las nuevas tecnologias y la gestión creativa como motor de cambios
Authors: Hidalgo Andrea , Herrera Elizabeth Colorado 
Published: February 2022

Este texto sistematiza experiências educacionais que geram oportunidades de internacionalização para alunos do Ensino Superior do Brasil e da Argentina. Propostas da Unesco sobre competências essenciais no século 21 reconhecem linguagens e novas tecnologias nos processos de troca. O trabalho relata experiências, atravessadas pela gestão criativa, realizadas antes e durante a pandemia.
PALAVRAS-CHAVE: Educação Superior. Internacionalização. Línguas.