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The users were able to run autoEF and autoMAPSE in most patients. The feasibility for obtaining accepted images (score of ≥2) with automatic measurements ranged from 50% to 91%. The feasibility was lowest for novices and highest for experts for both autoEF and autoMAPSE (p≤0.001). Large coefficients of variation and wide coefficients of repeatability indicate moderate agreement. The corresponding intraclass correlations (ICC) were moderate to good (ICC 0.51-0.85) for intra-rater and poor (ICC 0.35-0.51) for inter-rater analyses. The findings of modest to poor agreement and reliability were not explained by the experience of the users alone.
Novices, intermediate and expert users were able to record four-chamber views for automatic assessment of autoEF and autoMAPSE using HUD devices. The modest feasibility, agreement and reliability suggest this should not be implemented into clinical practice without further refinement and clinical evaluation.
NCT03547076.
NCT03547076.
An impoverished medical workforce is a global phenomenon, which can impact patient care significantly. Greater flexibility in working patterns is one approach policy-makers adopt to address this issue, and the expansion of less than full-time (LTFT) working forms part of this. Studies suggest that LTFT working has the potential to improve recruitment and retention by aligning with how doctors increasingly want to balance their careers with other commitments and interests. What is less well understood are the influencing factors and outcomes related to LTFT working among doctors. This protocol outlines the methodology for a systematic review that will evaluate existing knowledge on LTFT working in the medical profession.
The Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines will be followed. Embase, MEDLINE, PsycINFO, Health Management Information Consortium, Web of Science, Cochrane Library, Healthcare Administration, and Applied Social Sciences Index and Abstracts will be searched for studies published up to March 2022. Unpublished literature from EThos and ProQuest Dissertations & Theses Global will also be searched. Bibliographic searching, citation searching and handsearching will be used to retrieve additional papers. Authors will be contacted for data or publications if necessary. Two independent reviewers will undertake study screening, data extraction and quality assessment, with disagreements resolved by consensus or by a third reviewer if necessary. Data synthesis will be by narrative synthesis and meta-analysis if possible.
The proposed study does not require ethical approval; however, it forms part of a larger body of research on the impact of LTFT working on the medical workforce for which ethics approval has been granted by the Research Ethics Committee at University College London. Findings will be published in a peer-reviewed journal and will be presented at national and international conferences.
CRD42022307174.
CRD42022307174.
We investigated associations between multiple sociodemographic characteristics (sex, age, occupational social class, education and ethnicity) and self-reported healthcare disruptions during the early stages of the COVID-19 pandemic.
Coordinated analysis of prospective population surveys.
Community-dwelling participants in the UK between April 2020 and January 2021.
Over 68 000 participants from 12 longitudinal studies.
Self-reported healthcare disruption to medication access, procedures and appointments.
Prevalence of healthcare disruption varied substantially across studies between 6% and 32% reported any disruption, with 1%-10% experiencing disruptions in medication, 1%-17% experiencing disruption in procedures and 4%-28% experiencing disruption in clinical appointments. Females (OR 1.27; 95% CI 1.15 to 1.40; I
=54%), older persons (eg, OR 1.39; 95% CI 1.13 to 1.72; I
=77% for 65-75 years vs 45-54 years) and ethnic minorities (excluding white minorities) (OR 1.19; 95% CI 1.05 to 1.35; I
=0% vs white) were more likely to report healthcare disruptions. Those in a more disadvantaged social class were also more likely to report healthcare disruptions (eg, OR 1.17; 95% CI 1.08 to 1.27; I
=0% for manual/routine vs managerial/professional), but no clear differences were observed by education. We did not find evidence that these associations differed by shielding status.
Healthcare disruptions during the COVID-19 pandemic could contribute to the maintenance or widening of existing health inequalities.
Healthcare disruptions during the COVID-19 pandemic could contribute to the maintenance or widening of existing health inequalities.
To assess HIV testing uptake and its determinants among adolescents and young adults.
Cross-sectional design involving analysis of 2016 Demographic and Health Survey data.
Nationally representative survey of Burundi.
A total of 7218 young women and 2860 young men were included.
We estimated the proportion of adolescent (15-19 years) and young adult (20-24 years) women and men who had tested for HIV and received results in the 12 months preceding the survey. Multivariable logistic models for determining predictors of HIV testing uptake were fitted among respondents aged 15-24 regardless of sexual activity in the 12 months before the survey and separately among a subset that reporting having had sex in the 12 months preceding the survey.
An estimated 27.1% (95% CI 25.8% to 28.4%) women and 16.6% (95% CI 15.1% to 18.1%) men had tested for HIV and received results in the 12 months preceding the survey. The proportion was more than twice as high among those aged 20
24 years compared with 15
19 years,entive services in Burundi.
The current study aimed to assess the level of nicotine dependence and its influencing factors among daily smokers in Zhejiang, China.
The 2020 Global Adult Tobacco Survey was conducted in Zhejiang, China.
1244 daily smokers aged ≥15 years.
Respondents were asked questions regarding their age, sex, residence, education level, occupation, household income, age of starting daily smoking and nicotine dependence.
The findings revealed that 17.4% of daily smokers were highly dependent on nicotine, and the mean Fagerström Test for Nicotine Dependence score of daily smokers was (3.1±2.4). Age, educational level, occupation and age of starting daily smoking had significant effects on high nicotine dependence, whereas residence, sex and yearly household income were not significant factors. Compared with the age group ≥60 years, the proportion of respondents with a higher nicotine dependence level was lower in the age group of 15-39 years (OR=0.45). Daily smokers with a higher education level had a lower nicoed persons and those with lower education levels.
There is limited research focused explicitly on understanding how commercial actors use different forms of power to influence policy decision making in Thailand. This study aimed to identify how the food industry has used structural, instrumental and discursive power to influence policy on restricting food marketing in Thailand.
Qualitative study using in-depth semistructured interviews SETTINGS Thailand.
The interviews were conducted with 20 participants (of a total of 29 invited actors) from government, civil society, technical experts, international organisation and the food and advertising industry. Interview data were identified in the transcripts and analysed using abductive methods.
Non-commercial actors perceived the commercial actors' structural power (its economic influence and structurally privileged position) as central to understanding the government having not implemented policy to restrict food marketing. The commercial actors' instrumental power was observed through sponsorship, campairguments and institutional processes used to enhance commercial actors' ability to shape the policy decision for nutrition, public opinion and the broader regulatory environment. The findings help governments and other stakeholders to anticipate industry efforts to counter policy. The findings also suggest the need for governance structures that counter industry power, including comprehensive monitoring and enforcement in policy implementation.
Many children in developing countries grow up in environments that lack stimulation, leading to deficiencies in early years of development. Several efficacy trials of early childhood care and education (ECCE) programmes have demonstrated potential to improve child development; evidence on whether these effects can be sustained once programmes are scaled is much more mixed. This study evaluates whether an ECCE programme shown to be effective in an efficacy trial maintains effectiveness when taken to scale by the Government of Ghana (GoG). The findings will provide critical evidence to the GoG on effectiveness of a programme it is investing in, as well as a blueprint for design and scale-up of ECCE programmes in other developing countries, which are expanding their investment in ECCE programmes.
This study is a cluster randomised controlled trial, in which the order that districts receive the programme is randomised. A minimum sample of 3240 children and 360 schools will be recruited across 72 district schoon (21361/001), Yale University (2000031549) and Ghanaian Health Service Ethics Review Committee (028/09/21). Results will be made available to participating communities, funders, the wider public and other researchers through peer-reviewed journals, conference presentations, social and print media and various community/stakeholder engagement activities.
ISRCTN15360698, AEARCTR-0008500.
ISRCTN15360698, AEARCTR-0008500.
Sociodemographic predictors of employee alcohol use are well established in the literature, but knowledge about associations between workplace factors and alcohol use is less explored. The aim of this study was to explore whether workplace factors were associated with employee alcohol use (consumption and alcohol-related problems).
Cross-sectional study. Linear and binary logistic regression analyses.
Heterogeneous sample of employees (workers and supervisors) from 22 companies across geographical locations and work divisions in Norway.
Employees (N=5388) responded on survey items measuring workplace factors and alcohol use.
Data on alcohol use were collected with the Alcohol Use Disorders Identification Test (AUDIT). selleck Consumption was measured with the AUDIT-C (the first three items), and alcohol-related problems were operationalised as a sum score of 8 or higher on the full 10-item AUDIT.
Higher levels of alcohol consumption were associated with more liberal workplace drinking social norms (b=1.37edictor of both consumption and alcohol-related problems. Results suggest that some workplace factors may play a role in explaining employee alcohol consumption, although the predictive ability of these factors was limited. This study points to the importance of drinking social norms, workplace drinking culture and leadership for understanding employee alcohol use.
Using a surrogate endpoint as a substitute for a primary patient-relevant outcome enables randomised controlled trials (RCTs) to be conducted more efficiently, that is, with shorter time, smaller sample size and lower cost. However, there is currently no consensus-driven guideline for the reporting of RCTs using a surrogate endpoint as a primary outcome; therefore, we seek to develop SPIRIT (Standard Protocol Items Recommendations for Interventional Trials) and CONSORT (Consolidated Standards of Reporting Trials) extensions to improve the design and reporting of these trials. As an initial step, scoping and targeted reviews will identify potential items for inclusion in the extensions and participants to contribute to a Delphi consensus process.
The scoping review will search and include literature reporting on the current understanding, limitations and guidance on using surrogate endpoints in trials. Relevant literature will be identified through (1) bibliographic databases; (2) grey literature; (3) handsearching of reference lists and (4) solicitation from experts.
Homepage: https://www.selleckchem.com/products/ew-7197.html
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