bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evidence-based digital support during 1 year after an Interdisciplinary Pain Rehabilitation Programme for persons with chronic musculoskeletal pain to facilitate a sustainable return to work: a study protocol for a registry-based multicentre randomised controlled trial
Authors: Turesson Christina , Liedberg Gunilla , Vixner Linda , Lofgren Monika , Björk Mathilda 
Published: May 2022

IntroductionChronic musculoskeletal pain (CMSP) severely affects the individual’s quality of life, functioning and ability to work, and comes with significant societal costs for sick leave and productivity loss. After rehabilitation, patients with CMSP often experience lack of support when responsibility for the return-to-work process is taken over by the employer. Therefore, we aim to evaluate the effectiveness of a digital support (Sustainable WorkEr digital support for Persons with chronic Pain and their Employers (SWEPPE)) for promoting a sustainable return-to-work for persons with CMSP and to facilitate the employers’ supportive role and responsibilities in the process.Methods and analysisIn this registry-based multicentre randomised controlled trial, 360 patients with CMSP will be randomised to either receive the smartphone application SWEPPE (n=180) or to a control group (n=180). The intervention group will use SWEPPE for 1 year and the control group will not receive any intervention for return to work (RTW). Participants will be recruited from approximately 10 specialist and primary care level units connected to the Swedish National Quality Registry for Pain Rehabilitation providing Interdisciplinary Pain Rehabilitation Programmes (IPRP) for CMSP. Eligibility criteria are age 18–65 years and a need for support in RTW or continued support at work for creating a sustainable work situation. Baseline data will be collected when the participants have completed the IPRP. Final assessment will be performed after 12 months. The primary outcome will be a number of days with sickness cash benefit. Secondary outcomes and explanatory variables including important domains affected by CMSP such as health-related quality of life, functioning and work ability will be collected.Ethics and disseminationThe Swedish Ethics Review Board approved the study (Dnr 2020-01593, Dnr 2021-01854). The study findings will be disseminated through publication, national and international conferences, and meetings to be available for patients, healthcare providers or stakeholders.Trial registration numberNCT05058547.
Intercountry and intracountry variations in opinions of palliative care specialist physicians in Germany, Italy, Japan and UK about continuous use of sedatives: an international cross-sectional survey
Authors: Morita Tatsuya , Kawahara Takuya , Stone Patrick , Sykes Nigel , Miccinesi Guido , Klein Carsten , Stiel Stephanie , Hui David , Deliens Luc , Heijltjes Madelon T , Mori Masanori , Heckel Maria , Robijn Lenzo , Krishna Lalit , Rietjens Judith 
Published: May 2022

ObjectivesTo explore intercountry and intracountry differences in physician opinions about continuous use of sedatives (CUS), and factors associated with their approval of CUS.SettingsSecondary analysis of a questionnaire study.ParticipantsPalliative care physicians in Germany (N=273), Italy (N=198), Japan (N=334) and the UK (N=111).Primary and secondary outcome measuresPhysician approval for CUS in four situations, intention and treatment goal, how to use sedatives and beliefs about CUS.ResultsThere were no significant intercountry or intracountry differences in the degree of agreement with statements that (1) CUS is not necessary as suffering can always be relieved with other measures (mostly disagree); (2) intention of CUS is to alleviate suffering and (3) shortening the dying process is not intended. However, there were significant intercountry differences in agreement with statements that (1) CUS is acceptable for patients with longer survival or psychoexistential suffering; (2) decrease in consciousness is intended and (3) choice of neuroleptics or opioids. Acceptability of CUS for patients with longer survival or psychoexistential suffering and whether decrease in consciousness is intended also showed wide intracountry differences. Also, the proportion of physicians who agreed versus disagreed with the statement that CUS may not alleviate suffering adequately even in unresponsive patients, was approximately equal. Regression analyses revealed that both physician-related and country-related factors were independently associated with physicians’ approval of CUS.ConclusionVariations in use of sedatives is due to both physician- and country-related factors, but palliative care physicians consistently agree on the value of sedatives to aid symptom control. Future research should focus on (1) whether sedatives should be used in patients with longer survival or with primarily psychoexistential suffering, (2) understanding physicians’ intentions and treatment goals, (3) efficacy of different drugs and (4) understanding the actual experiences of patients receiving CUS.
Study protocol for the Shifting Weight using Intermittent Fasting in night shift workers (SWIFt) study: a three-arm randomised controlled trial comparing three weight loss strategies in night shift workers with obesity
Authors: Rogers Michelle , Coates Alison , Huggins Catherine E , Dorrian Jillian , Clark Angela B , Davis Corinne , Leung Gloria KW , Davis Rochelle , Phoi Yan Yin , Kellow Nicole J , Iacovou Marina , Yates Crystal L , Banks Siobhan , Sletten Tracey L , Bonham Maxine P 
Published: May 2022

IntroductionShift workers are at an increased risk of developing obesity and type 2 diabetes. Eating and sleeping out of synchronisation with endogenous circadian rhythms causes weight gain, hyperglycaemia and insulin resistance. Interventions that promote weight loss and reduce the metabolic consequences of eating at night are needed for night shift workers. The aim of this study is to examine the effects of three weight loss strategies on weight loss and insulin resistance (HOMA-IR) in night shift workers.Methods and analysisA multisite 18-month, three-arm randomised controlled trial comparing three weight loss strategies; continuous energy restriction; and two intermittent fasting strategies whereby participants will fast for 2 days per week (5:2); either during the day (5:2D) or during the night shift (5:2N). Participants will be randomised to a weight loss strategy for 24 weeks (weight loss phase) and followed up 12 months later (maintenance phase). The primary outcomes are weight loss and a change in HOMA-IR. Secondary outcomes include changes in glucose, insulin, blood lipids, body composition, waist circumference, physical activity and quality of life. Assessments will be conducted at baseline, 24 weeks (primary endpoint) and 18 months (12-month follow-up). The intervention will be delivered by research dietitians via a combination of face-to-face and telehealth consultations. Mixed-effect models will be used to identify changes in dependent outcomes (weight and HOMA-IR) with predictor variables of outcomes of group, time and group–time interaction, following an intention-to-treat approach.Ethics and disseminationThe study protocol was approved by Monash Health Human Research Ethics Committee (RES 19-0000-462A) and registered with Monash University Human Research Ethics Committee. Ethical approval has also been obtained from the University of South Australia (HREC ID: 202379) and Ambulance Victoria Research Committee (R19-037). Results from this trial will be disseminated via conference presentations, peer-reviewed journals and student theses.Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN-12619001035112).
Association between proton pump inhibitor use and risk of pneumonia in children: nationwide self-controlled case series study in Sweden
Authors: Wang Yun-Han , Svanström Henrik , Wintzell Viktor , Ludvigsson Jonas F , Pasternak Björn 
Published: May 2022

ObjectiveTo evaluate the association between use of proton pump inhibitors (PPIs) and risk of pneumonia in children.DesignNationwide register-based self-controlled case series study.SettingSweden, July 2006 to December 2016.ParticipantsChildren aged <18 years who were treated with PPIs and had a hospitalisation or hospital emergency care visit for pneumonia within 1 year before and 2 years after PPI initiation.Main outcomes and measuresThe primary analysis examined the risk of pneumonia during the risk period (ongoing PPI treatment), the pre-exposure period (≤30 days preceding PPI treatment) and the postexposure period (days 1–365 after PPI discontinuation), comparing to the unexposed period. Conditional Poisson regression was used to estimate incidence rate ratios (IRRs) and 95% CIs.ResultsA total of 2356 cases of pneumonia were included. Compared with the unexposed period, the risk of pneumonia was significantly increased during ongoing PPI treatment, with an adjusted IRR of 1.40 (95% CI 1.21 to 1.62). The risk of pneumonia was also increased in the pre-exposure period (adjusted IRR, 1.80, 95% CI 1.51 to 2.13), but not in the postexposure period (adjusted IRR 0.98, 95% CI 0.89 to 1.08). Dividing the risk period by time since treatment initiation, the increased risk of pneumonia was highest in the first 30 days (adjusted IRR 1.63, 95% CI 1.35 to 1.97), remained during days 31–90 (adjusted IRR 1.32, 95% CI 1.04 to 1.69), but waned in days ≥91 (IRR 1.06, 95% CI 0.79 to 1.41).Conclusions and relevanceAn increased risk of pneumonia was observed both immediately before and immediately after PPI initiation. This pattern of association can likely be explained by an underlying risk of pneumonia due to factors transiently present at the time around PPI initiation. Thus, our findings do not support a causal relationship between PPI use and risk of pneumonia.
Facilitators and barriers of infectious diseases surveillance activities: lessons from the Global Polio Eradication Initiative - a mixed-methods study
Authors: Osaghae Ikponmwosa , Agrawal Priyanka , Olateju Adetoun , Alonge Olakunle 
Published: May 2022

ObjectivesTo document lessons from the Global Polio Eradication Initiative (GPEI) by determining factors associated with successful surveillance programme globally as well as at national and subnational levels. The process of conducting surveillance has been previously recognised in the literature as important for the success of polio surveillance activities.DesignA cross-sectional survey with closed and open-ended questions.SettingsSurvey of persons involved in the implementation of surveillance activities under the GPEI at the global level and in seven low-income and middle-income countries.ParticipantsIndividuals (n=802) with ≥12 months of experience implementing surveillance objective of the GPEI between 1988 and 2019.Main outcome measures and methodsQuantitative and qualitative analyses were conducted. Logistic regression analyses were used to assess factors associated with implementation process as a factor for successful surveillance programme. Horizontal analysis was used to analyse qualitative free-text responses on facilitators and barriers identified for conducting surveillance activities successfully.ResultsOverall, participants who reported challenges relating to GPEI programme characteristics had 50% lower odds of reporting implementation process as a factor for successful surveillance (adjusted OR (AOR): 0.50, 95% CI: 0.29 to 0.85). Challenges were mainly perceptions of external intervention source (ie, surveillance perceived as ‘foreign’ to local communities) and the complexity of surveillance processes (ie, surveillance required several intricate steps). Those who reported organisational challenges were almost two times more likely to report implementation process as a factor for successful surveillance (AOR: 1.89, 95% CI: 1.07 to 3.31) overall, and over threefolds (AOR: 3.32, 95% CI: 1.14 to 9.66) at the national level.ConclusionsProgramme characteristics may have impeded the process of conducting surveillance under the GPEI, while organisational characteristics may have facilitated the process. Future surveillance programmes should be designed with inputs from local communities and frontline implementers.
Maternal childbirth experience and pain relief methods: a retrospective 7-year cohort study of 85 488 parturients in Finland
Authors: Joensuu Johanna , Saarijärvi Hannu , Rouhe Hanna , Gissler Mika , Ulander Veli-Matti , Heinonen Seppo , Torkki Paulus , Mikkola Tomi 
Published: May 2022

ObjectivesThe aim of this study was to analyse the relation between the used labour pain relief and childbirth experience measured by Visual Analogue Scale (VAS).DesignA retrospective cohort study.SettingChildbirth in five Helsinki University Hospital delivery units from 2012 to 2018.Primary outcome measureChildbirth experience measured by VAS and classified in three groups (negative VAS=1–5, positive VAS=6–8 and highly positive=9–10).ResultsThe use of epidural or non-epidural compared with non-medical pain relief methods decreased the likelihood to experience highly positive childbirth for primiparous (adjusted OR (aOR)EPIDURAL=0.64, 95% CI 0.57 to 0.73; and aORNON-EPIDURAL=0.76, 95% CI 0.66 to 0.87) and multiparous (aOREPIDURAL=0.90, 95% CI 0.84 to 0.97 and aORNON-EPIDURAL=0.80, 95% CI 0.74 to 0.86) parturients. The effects of epidural differed between primiparas and multiparas. In multiparas epidural was associated with decreased odds for experiencing negative childbirth compared with the non-medical group (aOR=0.70, 95% CI 0.57 to 0.87), while the effect of epidural was considered insignificant in primiparas (aOR=1.28, 95% CI 0.93 to 1.77).ConclusionWhile the use of medical—epidural and non-epidural—pain relief methods were not associated with odds for experiencing negative childbirth in primiparas, using epidural helps to avoid negative experience in multiparas. However, the odds for experiencing highly positive childbirth were decreased if the parturients used any medical pain relief for both primiparas and multiparas. Consequently, the effect of pain relief on the childbirth experience is strongly confounded by indication. Thus, the use of pain relief per se plays a limited role in the complex formation of the overall childbirth experience.
Prevalence of work-related musculoskeletal symptoms among tea garden workers in Bangladesh: a cross-sectional study
Authors: Kairi Tamal Kanti , Dey Sanghamitra 
Published: May 2022

ObjectivesOccupational health is still in the developmental stage in Bangladesh. There is a lack of focus on agricultural workers. Statistics on musculoskeletal symptoms (MSS) of any occupational group can assist in developing intervention and ergonomics-based prevention. This study aimed to assess work-related MSS among tea garden workers.SettingThis cross-sectional study was done in one tea garden in Moulvibazar district which has the highest number of gardens in Bangladesh.Design and participants346 tea garden workers were interviewed using the Nordic Musculoskeletal Questionnaire Extended Version 2. Workers 18–60 years of age and of both sexes were interviewed individually.Outcome measuresPrevalence of MSS among the tea garden workers, MSS in different body regions and MSS related informations. Sociodemographic and work-related factor associated with MSS.ResultsAmong the tea garden workers, 276 were female and 70 were male. The study showed 80.9% had symptoms in the past 12 months while 80.1% and 76.6% had in the past 4 weeks and on the day of the interview, respectively. Symptoms were most commonly reported at the shoulder (78.2%) followed by upper back (56.1%) and lower back (32.5%). Workers engaged with plucking operation were found to be significantly associated with symptoms compared with non-pluckers (p<0.05). Female workers were more likely to display symptoms in the neck (p<0.05) than male workers. Increased work hours were significantly associated with symptoms in the lower back (p<0.05). Overtime was responsible for symptoms in the elbow and hip/buttock (p<0.05). Statistics from relevant studies in India, Malaysia and Thailand were compared with the results of this study.ConclusionsThe prevalence of MSS among tea garden workers was found to be very high, and ergonomic interventions like reduction of weight load, job rotation and small breaks can reduce these symptoms.
How is recovery defined and measured in patients with low back pain? Protocol for a mixed study systematic review
Authors: Lukacs Michael J , Kowalski Katie L , Peters Nicole , Stanley Meagan , Rushton Alison B 
Published: May 2022

IntroductionThis protocol describes the methods for a mixed study systematic review aiming to explore the definitions and measurements of recovery in patients with low back pain, and how perspectives of recovery differ between patients and providers. This review will be the first to review the concept of recovery in patients with low back pain across both quantitative and qualitative literature.Methods and analysisThis protocol has been designed and reported in line with Preferred Reporting Items of Systematic Reviews and Meta-Analyses Protocols. The following databases will be electronically searched from database inception until 30 November 2021: Medline, EMBASE, CINAHL, Cochrane, PEDro. Grey literature will be searched for through targeted searching of ProQuest Dissertations and Theses and handsearching of the references of all included studies. Studies will be included if they include a patient population of >50% with low back pain (with or without leg pain), and mention the concept of recovery within the abstract, methods or results. The Mixed Methods Appraisal Tool will be used for quality assessment of both quantitative and qualitative included studies. Two independent reviewers will conduct the search, screen titles/abstracts and extract relevant data from full texts. Discrepancies between reviewers will be settled by a third reviewer with spinal pain expertise. For syntheses, thematic analysis will be used to analyse both qualitative and quantitative investigations to explore meanings, measurement and perspectives of recovery from a diverse evidence base. There is no clinical trial associated with this protocol.Ethics and disseminationThere are no ethical issues associated with this systematic review, and ethics approval was not required. Once completed, the results of this review will be published in a peer-reviewed journal within the realm of spinal pain to help guide future research inquiries.PROSPERO registration numberCRD42022295804.
Questioning the seasonality of SARS-COV-2: a Fourier spectral analysis
Authors: Cappi Riccardo , Casini Luca , Tosi Davide , Roccetti Marco 
Published: May 2022

ObjectivesTo investigate the hypothesis of a seasonal periodicity, driven by climate, in the contagion resurgence of COVID-19 in the period February 2020–December 2021.DesignAn observational study of 30 countries from different geographies and climates. For each country, a Fourier spectral analysis was performed with the series of the daily SARS-CoV-2 infections, looking for peaks in the frequency spectrum that could correspond to a recurrent cycle of a given length.SettingsPublic data of the daily SARS-CoV-2 infections from 30 different countries and five continents.ParticipantsOnly publicly available data were utilised for this study, patients and/or the public were not involved in any phase of this study.ResultsAll the 30 investigated countries have seen the recurrence of at least one COVID-19 wave, repeating over a period in the range 3–9 months, with a peak of magnitude at least half as large as that of the highest peak ever experienced since the beginning of the pandemic until December 2021. The distance in days between the two highest peaks in each country was computed and then averaged over the 30 countries, yielding a mean of 190 days (SD 100). This suggests that recurrent outbreaks may repeat with cycles of different lengths, without a precisely predictable seasonality of 1 year.ConclusionOur findings suggest that COVID-19 outbreaks are likely to occur worldwide, with cycles of repetition of variable lengths. The Fourier analysis of 30 different countries has not found evidence in favour of a seasonality that recurs over 1year period, solely or with a precisely fixed periodicity.
Managing Unusual Sensory Experiences in People with First-Episode Psychosis (MUSE FEP): a study protocol for a single-blind parallel-group randomised controlled feasibility trial
Authors: Dudley Robert , Dodgson Guy , Common Stephanie , O’Grady Lucy , Watson Florence , Gibbs Christopher , Arnott Bronia , Fernyhough Charles , Alderson-Day Ben , Ogundimu Emmanuel , Kharatikoopaei Ehsan , Patton Victoria , Aynsworth Charlotte 
Published: May 2022

IntroductionHallucinations (hearing or seeing things that others do not) are a common feature of psychosis, causing significant distress and disability. Existing treatments such as cognitive–behavioural therapy for psychosis (CBTp) have modest benefits, and there is a lack of CBTp-trained staff. Shorter, targeted treatments that focus on specific symptoms delivered by a non-specialist workforce could substantially increase access to treatment.Managing Unusual Sensory Experiences (MUSE) explains why people have hallucinations and helps the person to develop and use coping strategies to reduce distress. MUSE focuses only on hallucinations, and treatment is short (four to six, 1-hour sessions per week). It is a digital intervention, run on National Health Service (NHS) laptops, which provides information about hallucinations in an engaging way, using audio, video and animated content. Crucially, it is designed for use by non-specialist staff like community psychiatric nurses.Methods and analysisThe study is a two-arm feasibility randomised controlled trial comparing MUSE and treatment as usual (TAU) (n=40) to TAU alone (n=40), recruiting across two NHS Trusts, using 1:1 allocation and blind assessments before and after treatment (2 months) and at follow-up (3 months). Quantitative information on recruitment rates, adherence and completion of outcome assessments will be collected. Qualitative interviews will capture service users’ experience of therapy and clinicians’ experiences of the training and supervision in MUSE. Clinicians will also be asked about factors affecting uptake, adherence and facilitators/barriers to implementation. Analyses will focus on feasibility outcomes and provide initial estimates of intervention effects. Thematic analysis of the qualitative interviews will assess the acceptability of the training, intervention and trial procedures.Ethics and disseminationThe trial has received NHS Ethical and Health Research Authority approval. Findings will be disseminated directly to participants and services, as well as through peer-reviewed publications and conference presentations.Trial registration numberISRCTN16793301.