BMC research notes
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Randomized Controlled Trial
Prevention of haematoma progression by tranexamic acid in intracerebral haemorrhage patients with and without spot sign on admission scan: a statistical analysis plan of a pre-specified sub-study of the TICH-2 trial.
We present the statistical analysis plan of a prespecified Tranexamic Acid for Hyperacute Primary Intracerebral Haemorrhage (TICH)-2 sub-study aiming to investigate, if tranexamic acid has a different effect in intracerebral haemorrhage patients with the spot sign on admission compared to spot sign negative patients. The TICH-2 trial recruited above 2000 participants with intracerebral haemorrhage arriving in hospital within 8 h after symptom onset. They were included irrespective of radiological signs of on-going haematoma expansion. Participants were randomised to tranexamic acid versus matching placebo. In this subgroup analysis, we will include all participants in TICH-2 with a computed tomography angiography on admission allowing adjudication of the participants' spot sign status. ⋯ Primary outcome will be the ability of tranexamic acid to limit absolute haematoma volume on computed tomography at 24 h (± 12 h) after randomisation among spot sign positive and spot sign negative participants, respectively. Within all outcome measures, the effect of tranexamic acid in spot sign positive/negative participants will be compared using tests of interaction. This sub-study will investigate the important clinical hypothesis that spot sign positive patients might benefit more from administration of tranexamic acid compared to spot sign negative patients. Trial registration ISRCTN93732214 ( http://www.isrctn.com ).
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Observational Study
National report on aggressions to physicians in Spain 2010-2015: violence in the workplace-ecological study.
Aggressions against health staff is a phenomenon that is not widely studied worldwide. To date, there is no national study analyzing this situation in Spain. Our objective is to describe and analyze aggressions to physicians of the whole Spanish territory in the period 2010-2015, through an observational analytical study by conglomerates (ecological) with all aggressions to physicians identified by the 52 official medical associations of Spain over 6 years of study. ⋯ There were 2419 aggressions on physicians, 51% on men. Primary care is the area that concentrates more incidents (54%) and the public sector is the most affected (89%). A third of the assaults were concentrated on professionals aged 46-55 years old. Cumulative incidence decreased from 20 aggressions × 10,000 physicians in 2010 to 15 × 10,000 physicians in 2015. The importance and seriousness of the problem of aggressions against physicians is verified through notifications to the registry. The collection method is different from others based on surveys, and therefore the figures are significantly lower than other studies. The scant denunciation by attacked physicians in Spain makes deceiving the real dimensions of the phenomenon.
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The present study was aimed at assessing the validity and the reliability of the Sinhala version of the Utrecht Work Engagement Scale-Student Version (UWES-S) among collegiate cycle students in Sri Lanka. ⋯ The 17-item UWES-S was translated to Sinhala and the judgmental validity was assessed by a multi-disciplinary panel of experts. Construct validity of the UWES-S was appraised by using multi-trait scaling analysis and exploratory factor analysis (EFA) on data obtained from a sample of 194 grade thirteen students in the Kurunegala district, Sri Lanka. Reliability of the UWES-S was assessed by using internal consistency and test-retest reliability. Except for item 13, all other items showed good psychometric properties in judgemental validity, item-convergent validity and item-discriminant validity. EFA using principal component analysis with Oblimin rotation, suggested a three-factor solution (including vigor, dedication and absorption subscales) explaining 65.4% of the total variance for the 16-item UWES-S (with item 13 deleted). All three subscales show high internal consistency with Cronbach's α coefficient values of 0.867, 0.819, and 0.903 and test-retest reliability was high (p < 0.001). Hence, the Sinhala version of the 16-item UWES-S is a valid and a reliable instrument to assess work engagement among collegiate cycle students in Sri Lanka.
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The present study applied the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement to observational studies published in prestigious occupational medicine and health journals. ⋯ A total of 60 articles was evaluated. All sub-items were reported in 63.74% (95% confidence interval [CI], 56.24-71.24%), not reported in 29.70% (95% CI, 20.2-39.2%), and not applicable in 6.56% (95% CI, 4.86-8.26%) of the studies. Of the 45 sub-items investigated in this survey, eight were reported 100% of the time, 13 were addressed in more than 90% of the articles, 22 were included in more than 75% of the studies, and 27 sub-items were applied in more than 50% of the articles published in the journals included in this study.
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The manufacturers of electronic cigarettes (e-cigarettes) are actively marketing their product through electronic and social media. Undergraduate medical students are expected to have better knowledge and awareness as they directly interact with patients in their training, The purpose of this study is therefore, to determine knowledge, use and perception regarding e-cigarettes among medical students from Sindh, Pakistan. ⋯ A cross-sectional study was conducted between 1st July and 30th September 2016 at five different medical colleges situated in the second largest province of Sindh, Pakistan. The data was collected through a structured, self-administered questionnaire. Of the 500 students, the mean age was 21.5 ± 1.7 years and 58% were females. Over (65.6%) students were aware of e-cigarettes, 31 (6.2%) reported having used e-cigarettes, of whom 6 (1.2%) self-reported daily use. Users of conventional tobacco products were significantly more likely to have heard of e-cigarettes (87.6% vs 51.6%, p < 0.001) and having used them (13.9% vs 1.3%, p < 0.001). On multivariable logistic regression analysis we found a strong association of e-cigarette use with consumption of conventional cigarettes [OR: 10.6, 95% CI 3.6-30.8, p < 0.001], use of smokeless tobacco products [OR: 7.9, 95% CI 2.7-23.4, p < 0.001] however a weak association was observed for Shisha use [OR: 3.05, 95% CI 0.9-9.6, p = 0.05].