bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and risk factors of hyperuricaemia in non-obese Chinese: a single-centre cross-sectional study
Authors: Wang Jinghua , Chen Yishu , Chen Shenghui , Wang Xinyu , Zhai Haoliang , Xu Chengfu 
Published: June 2022

ObjectivesHyperuricaemia is closely related to metabolic diseases and is receiving increasing attention from all over the world. This study aimed to investigate the prevalence and factors associated with hyperuricaemia in non-obese Chinese population.DesignRetrospective cross-sectional study.SettingA large general hospital that can provide health check-ups in Hangzhou, China.ParticipantsA total of 5731 apparently healthy Chinese adults (2349 men and 3382 women) who took their health check-ups during the year of 2019. Exclusion criteria: (1) those with body mass index ≥24 kg/m2; (2) those with incomplete anthropometric and biochemical data; (3) those with a history of malignancy and (4) those under urate-lowering treatment.Primary and secondary outcome measuresThe prevalence and factors associated with hyperuricaemia in non-obese Chinese adults.ResultsOf the 5731 non-obese subjects enrolled, 538 (9.4%) were identified as having hyperuricaemia, specifically 16.3% in men and 4.6% in women. The prevalence of hyperuricaemia markedly increased in women aged above 50 years. The prevalence of hyperuricaemia was significantly higher in metabolically unhealthy participants with normal weight than in metabolically healthy participants with normal weight. Participants with hyperuricaemia showed a higher prevalence of metabolic syndrome and fatty liver disease than participants with normouraemia. Age, waist circumference, estimated glomerular filtration rate, blood urea nitrogen, excessive drinking and fatty liver were associated with hyperuricaemia in both genders.ConclusionThe prevalence of hyperuricaemia was 9.4% in non-obese Chinese adults. Non-obese participants with hyperuricaemia also showed multiple metabolic disorders. We suggest that clinicians pay attention to serum uric acid level in non-obese patients.
Interventions to promote the implementation of pressure injuries prevention measures in nursing homes: a scoping review protocol
Authors: Yang Long-Fei , Liu Yan-Ling , Wu Chun-Tao , Ni Cui-Ping , Liu Yu 
Published: June 2022

IntroductionCurrently, various guidelines and documents on the prevention of pressure injuries have been published, but there are many serious lags in the actual practice in nursing homes. So some interventions are required to promote the implementation of normative practices. There was a review of preventive interventions for pressure injuries in long-term care facilities, but there is no systematic review of how to promote the implementation of preventive measures. This review aims to summarise interventions that promote the implementation of pressure injuries prevention measures in nursing homes, explore the research scope and gaps in this field and provide evidence and striving direction for global nursing homes to improve existing preventive behaviours.Methods and analysisThis scoping review will combine the Arksey and O’Malley framework with further clarification and advice of the scoping review by Levac et al as methodological guidance. Systematic retrieval of relevant literature databases, grey literature and references included studies will be conducted. Two reviewers will screen titles and abstracts independently, and then screen the full text of potentially relevant articles to determine final inclusion. After that, two reviewers will extract data based on a predesigned data extraction table independently. Inductive analysis and narrative analysis will be used to collate, summarise and report the results. Finally, managers of nursing homes in China will be consulted for additional information and their viewpoints on the research findings.Ethics and disseminationSince the scoping review is a secondary analysis of the literature, there is no need to apply for ethical approval. Our goal is to share the results with key stakeholders to help them find the direction of effort and improve clinical practice. Therefore, dissemination plans include publication in international journals and sharing it at conferences to inform more healthcare workers about the scope and gaps of the studies.
Characteristics of serum lipid levels in patients with hypertension: a hospital-based retrospective descriptive study
Authors: Wu Heming , Yu Zhikang , Huang Qingyan 
Published: June 2022

BackgroundDyslipidaemia is different among patients with hypertension in different populations. The serum lipid profiles among Hakka patients with hypertension in southern China are still unclear.Methods35 448 patients with hypertension were enrolled in this study from January 2016 to October 2020, and their serum lipids were analysed.ResultsLow high-density lipoprotein-cholesterol (HDL-C) (29.9%) accounted for the highest proportion in dyslipidaemia, followed by high triglyceride (TG) (20.7%), high total cholesterol (TC) (14.0%) and high low-density lipoprotein-cholesterol (LDL-C) (7.9%) in all subjects. The largest proportion of dyslipidaemia types was independent low HDL-C (12.7%). The proportion of low HDL-C was 15.5% in non-elderly men, 6.4% in non-elderly women, 16.7% in elderly men and 8.5% in elderly women, respectively. The largest proportion of dyslipidaemia types was independent high TG in non-elderly female patients (13.7%) and elderly patients (8.9%). The results showed that higher LDL-C, TC and TG levels in non-elderly patients than elderly patients. TG, TC and LDL-C levels decreasing with the increasing age, the differences were statistically significant. The levels of TG, TC, HDL-C and LDL-C in women were higher than in men among various age groups. Homocysteine level was increasing with increasing age.ConclusionsSerum lipid levels varied in different groups according to age and sex in patients with hypertension. Dyslipidaemia is more common in non-elderly patients than elderly. TG, TC and LDL-C levels were higher in female patients than male.
Harm minimisation for self-harm: a cross-sectional survey of British clinicians’ perspectives and practices
Authors: Haris Aishah Madinah , Pitman Alexandra , Mughal Faraz , Bakanaite Evelina , Morant Nicola , Rowe Sarah L 
Published: June 2022

ObjectiveHarm minimisation for self-harm is an alternative to preventive strategies and focuses on maximising safety when self-harming. We explored the views of clinicians on harm minimisation for self-harm to describe reported use and acceptability in clinical practice.DesignA cross-sectional study using an online survey consisting of fixed-choice and open-ended questions.SettingPrimary and secondary care practices in England, Scotland and Wales.ParticipantsSnowball sampling of UK-based clinicians (n=90; 67% female) working with people who self-harm and who have or have not previously recommended harm minimisation methods to patients.ResultsOf the 90 clinicians sampled, 76 (84%) reported having recommended harm minimisation techniques to people in their care who self-harm. Commonly recommended techniques were snapping rubber bands on one’s wrist and squeezing ice. Other techniques, such as teaching use of clean instruments when self-harming, were less likely to be recommended. Perceived client benefits included harm reduction and promotion of the therapeutic relationship. Perceived potential limitations of a harm minimisation approach for self-harm were (a) potential worsening of self-harm outcomes; (b) ethical reservations; (c) doubts about its effectiveness and appropriateness; and (d) lack of training and clear policies within the workplace.ConclusionsIn our sample of UK-based clinicians in various settings, harm minimisation for self-harm was broadly recommended for clients who self-harm due to perceived client benefits. However, future policies on harm minimisation must address clinicians’ perceived needs for training, well-defined guidelines, and clear evidence of effectiveness and safety to mitigate some clinician concerns about the potential for further harm.
Behavioral factors associated with SARS-CoV-2 infection. Results from a web-based case-control survey in the Capital Region of Denmark
Authors: Cajar Mille Dybdal , Tan Florence Chia Chin , Boisen Mogens Karsboel , Krog Sebastian Moretto , Nolsoee Rúna , Collatz Christensen Helle , Andersen Mikkel Porsborg , Moeller Amalie Lykkemark , Gerds Thomas Alexander , Pedersen-Bjergaard Ulrik , Lindegaard Birgitte , Kristensen Peter Lommer , Christensen Thomas Broe , Torp-Pedersen Christian , Lendorf Maria Elisabeth 
Published: June 2022

ObjectiveTo study the association between behavioural factors and incidence rates of SARS-CoV-2 infection.DesignCase–control web-based questionnaire study.SettingQuestionnaire data were collected in the Capital Region of Denmark in December 2020 when limited restrictions were in place, while the number of daily SARS-CoV-2 cases increased rapidly.Participants8913 cases of laboratory-confirmed SARS-CoV-2 infection were compared with two groups of controls: (1) 34 063 individuals with a negative SARS-CoV-2 test from the same date (negative controls, NCs) and 2) 25 989 individuals who had never been tested for a SARS-CoV-2 infection (untested controls, UC). Controls were matched on sex, age, test date and municipality.ExposureActivities during the 14 days prior to being tested positive for SARS-CoV-2 or during the same period for matched controls and precautions taken during the entire pandemic.Main outcomes and measuresSARS-CoV-2 infection incidence rate ratios (IRR).ResultsResponse rate was 41.4% (n=93 121). Using public transportation, grocery shopping (IRR: NC: 0.52; UC: 0.63) and outdoor sports activities (NC: 0.75; UC: 0.96) were not associated with increased rate of SARS-CoV-2 infection. Most precautions, for example, using hand sanitizer (NC: 0.79; UC: 0.98), physical distancing (NC: 0.79; UC: 0.82) and avoiding handshakes (NC: 0.74; UC: 0.77), were associated with a lower rate of infection. Activities associated with many close contacts, especially indoors, increased rate of infection. Except for working from home, all types of occupation were linked to increased rate of infection.ConclusionsIn a community setting with moderate restrictions, activities such as using public transportation and grocery shopping with the relevant precautions were not associated with an increased rate of SARS-CoV-2 infection. Exposures and activities where safety measures are difficult to maintain might be important risk factors for infection. These findings may help public health authorities tailor their strategies for limiting the spread of SARS-CoV-2.
Refreshing medical students’ intravenous-cannulation skills: a blinded observer three-arm randomised comparison of mental imagery, part-task trainer simulation and written instructions
Authors: Berger-Estilita Joana , Blülle Rafael , Stricker Daniel , Balmer Mathias , Greif Robert , Berendonk Christoph 
Published: June 2022

IntroductionIntravenous cannulation is a core competence in medicine, but is considered challenging to learn. This study investigates the effectiveness of three educational strategies used to refresh the intravenous cannulation skills of first-year medical students: mental imagery, part-task trainer simulation and written instructions.Materials and methodsIn this single-centre randomised controlled trial, first-year medical students were assigned to one of three different refresher tutorials on intravenous cannulation. Six months after their compulsory 4 hour instructor-led intravenous-cannulation course, each student was randomised to a 6 min self-learning tutorial: a mental imagery audioguide session, hands-on intravenous cannulation on a part-task trainer or reading written instructions.Immediately after the refresher tutorials, trained evaluators who were blinded to the randomised group assessed the students’ performance. Each evaluator completed a 15-item standardised checklist in an Objective Structured Clinical Examination (OSCE) station for intravenous cannulation. We performed a descriptive analysis of the data and a one-way analysis of variance. Additionally, we investigated the influence of previous intravenous cannulation experience on the total OSCE score.Results and discussionOn analysing the 309 students’ results, we did not find differences in the total rating of the performance (in percentage) between the three groups at the OSCE station (mental imagery group: 72.0%±17.9%; part-task trainer group: 74.4%±15.6%; written instructions group: 69.9%±16.6%, p=0.158). Multiple linear regression showed a small but statistically significant effect of students’ previous intravenous cannulation experience on OSCE performance. With the same outcome, written instructions and mental imagery had a better return on effort, compared with resource-intensive hands-on training with part-task trainers.ConclusionA single, short refresher seems to have a limited effect on intravenous-cannulation skills in first-year medical students. Less resource-intensive interventions, such as written instructions or mental imagery, are effective compared with hands-on part-task trainer simulation for refreshing this simple but important skill.Trial registration numberAEARCTR-0008043.
Mixed-methods evaluation of a behavioural intervention package to identify and amend incorrect penicillin allergy records in UK general practice
Authors: Wanat Marta , Santillo Marta , Galal Ushma , Davoudianfar Mina , Bongard Emily , Savic Sinisa , Savic Louise , Porter Catherine , Fielding Joanne , Butler Christopher C , Pavitt Sue , Sandoe Jonathan , Tonkin-Crine Sarah 
Published: June 2022

ObjectivesAbout 6% of the UK general practice population has a record of a penicillin allergy but fewer than 10% of these are likely to be truly allergic. In the ALABAMA (Allergy Antibiotics and Microbial resistance) feasibility trial, primary care patients with penicillin allergy were randomised to penicillin allergy assessment pathway or usual care to assess the effect on health outcomes. A behavioural intervention package was developed to aid delabelling. This study aimed to investigate patients’ and clinicians’ views of penicillin allergy testing (PAT).DesignWe conducted a mixed-methods process evaluation embedded within the ALABAMA trial, which included a clinician survey, a patient survey (at baseline and follow-up) and semistructured interviews with patients and clinicians.SettingsThe study was conducted in primary care, as part of the feasibility stage of the ALABAMA trial.ParticipantsPatients and primary care clinicians.ResultsClinicians (N=53; 52.2%) were positive about PAT and its potential value but did not have previous experience of referring patients for a PAT and were unsure whether patients would take penicillin after a negative allergy test. Patients (N=36; 46%) were unsure whether they were severely allergic to penicillin and did not fear a severe allergic reaction to penicillin. Clinician interviews showed that they were already aware of the benefit of PAT. Interviews with patients suggested the importance of safety as patients valued having numerous opportunities to address their concerns about safety of the test.ConclusionsThis study highlights the positive effects of the ALABAMA behavioural intervention for both patients and clinicians.Trial registration numberNCT04108637; ISRCTN20579216; Pre-results.
Impact of leadership behaviour on physician well-being, burnout, professional fulfilment and intent to leave: a multicentre cross-sectional survey study
Authors: Mete Mihriye , Goldman Charlotte , Shanafelt Tait , Marchalik Daniel 
Published: June 2022

ObjectiveTo examine how perceived leadership behaviours affect burnout, professional fulfilment and intent to leave the organisation among physicians.DesignAnonymous cross-sectional survey study from November 2016 to October 2018.Setting12 036 attending and resident physicians at 11 healthcare organisations participating in the Physician Wellness Academic Consortium (PWAC) were surveyed to assess burnout and professional fulfilment and their drivers.ParticipantsA sample of 5416 attending physicians with complete data on gender, specialty, leadership, burnout and professional fulfilment.Main outcomes and measuresThe leadership behaviour of each physician’s supervisor was assessed using the Mayo Clinic Participatory Management Leadership Index and categorised in tertiles. Multivariable logistic regression analyses examined the effect of leadership behaviour rating of each physician’s supervisor on burnout, professional fulfilment and intent to leave controlling for gender and specialty.ResultsThe response rate was 45% across 11 institutions. Half of the respondents were female. Professional fulfilment increased with increasing tertiles of leadership behaviour rating (19%, 34%, 47%, p<0.001). The odds of professional fulfilment were 5.8 times higher (OR=5.8, 95% CI: 5.1 to 6.59) for physicians in the top tertile compared with those in the lowest tertile. Physicians in the top tertile were also 48% less likely to be burned out (OR=0.52, 95% CI: 0.45 to 0.61) and reported 66% lower intent to leave (OR=0.34, 95% CI: 0.26 to 0.44). Individuals who rated their supervisor’s leadership in upper tertiles relative to lower tertiles exhibited lower levels of burnout (18% vs 35% vs 47%, p<0.001), and intent to leave (16% vs 24% vs 50% p<0.001).ConclusionPerceived leadership behaviours have a strong relationship with burnout, professional fulfilment and intent to leave among physicians. Organisations should consider leadership development as a potential vehicle to improve physician wellness and prevent costly physician departures.
Trends in sedentary behaviour and associated factors among adults in Mongolia: results from national cross-sectional surveys in 2009, 2013 and 2019
Authors: Pengpid Supa , Peltzer Karl 
Published: June 2022

ObjectiveThe study aimed to evaluate trends in the prevalence and correlates of sedentary behaviour (SB) in people aged 15–64 years from 2009 to 2019 in Mongolia.DesignRepeat population-based cross-sectional study.SettingNationally representative sample of persons living in the general community aged 15–64 years in Mongolia.ParticipantsThe sample included 17 780 people (15–64 years) who participated in Mongolia STEPS surveys 2009, 2013 or 2019.Primary and secondary outcome measures: self-reportedSB, along with physical measurements, health status and health behaviour, and sociodemographic covariates. Multinomial logistic regression calculated OR with 95% CI for moderate and high SB, with low SB as reference category.ResultsAcross study years, the proportion of low (<4 hours) SB was 62.3%, moderate (4–<8 hours) SB was 26.4% and high (≥8 hours) SB was 11.3%. Compared to the survey year 2009, in the survey years 2013 and 2019, high SB increased significantly, while moderate SB increased in the survey year 2013 but not in 2019. Urban residence was positively associated with moderate and high SB. Male sex and higher education were positively associated with moderate SB. Current tobacco use, current heavy alcohol use, and obesity class II were positively and high physical activity was negatively associated with moderate and/or high SB. Belonging to the Khalkha ethnic group and hypertension increased the odds of moderate or high SB in 2019 and 2013, respectively. Age, higher number of adults household members and inadequate fruit and vegetable intake were not associated with moderate or high SB.ConclusionMore than 1 in 10 people aged 15 years and older engaged in high SB. Several sociodemographic and health variables associated with moderate and/or high SB were identified that can help guide public interventions.
Real-time seizure detection in paediatric intensive care patients: the RESET child brain protocol
Authors: Waak Michaela , Gibbons Kristen , Sparkes Louise , Harnischfeger Jane , Gurr Sandra , Schibler Andreas , Slater Anthony , Malone Stephen 
Published: June 2022

IntroductionApproximately 20%–40% of comatose children with risk factors in intensive care have electrographic-only seizures; these go unrecognised due to the absence of continuous electroencephalography (EEG) monitoring (cEEG). Utility of cEEG with high-quality assessment is currently limited due to high-resource requirements. New software analysis tools are available to facilitate bedside cEEG assessment using quantitative EEG (QEEG) trends. The primary aim of this study is to describe accuracy of interpretation of QEEG trends by paediatric intensive care unit (PICU) nurses compared with cEEG assessment by neurologist (standard clinical care) in children at risk of seizures and status epilepticus utilising diagnostic test statistics. The secondary aims are to determine time to seizure detection for QEEG users compared with standard clinical care and describe impact of confounders on accuracy of seizure detection.Methods and analysisThis will be a single-centre, prospective observational cohort study evaluating a paediatric QEEG programme utilising the full 19 electrode set. The setting will be a 36-bed quaternary PICU with medical, cardiac and general surgical cases. cEEG studies in PICU patients identified as ‘at risk of seizures’ will be analysed. Trained bedside clinical nurses will interpret the QEEG. Seizure events will be marked as seizures if >3 QEEG criteria occur. Post-hoc dedicated neurologists, who remain blinded to the QEEG analysis, will interpret the cEEG. Determination of standard test characteristics will assess the primary hypothesis. To calculate 95% (CIs) around the sensitivity and specificity estimates with a CI width of 10%, the sample size needed for sensitivity is 80 patients assuming each EEG will have approximately 9 to 18 1-hour epochs.Ethics and disseminationThe study has received approval by the Children’s Health Queensland Human Research Ethics Committee (HREC/19/QCHQ/58145). Results will be made available to the funders, critical care survivors and their caregivers, the relevant societies, and other researchers.Trial registration numberAustralian New Zealand Clinical Trials Registry (ANZCTR) 12621001471875.