bluuebunny/crossref_metadata_2025_split huggingface dataset:
Putting Self-Management in the Context of Community-Dwelling American Indians Living With Type 2 Diabetes
Authors: Jones Jacqueline , Goins R. Turner , Schure Mark , Winchester Blythe , Bradley Vickie 
Published: December 2019

Purpose The purpose of this qualitative descriptive study was to examine the National Standards for Diabetes Self-Management Education and Support (DSMES) defined diabetes self-care behaviors (healthy eating, being active, taking medication, monitoring, problem solving, reducing risk, and healthy coping) in the context of older community-dwelling American Indians (AIs). Methods Secondary theme analysis of transcribed semistructured qualitative interview data from 28 participants in the Native Elder Care Study aged >60 years identified factors that influence the DSMES self-care behaviors in the context of community-dwelling AIs. Results Four themes that characterized barriers, facilitators, and opportunities for DSMES to support self-care behaviors included community food security, care partners in self-care, community opportunities for diabetes support, and blending of both health worlds. Conclusion Tribal communities have contemporary strengths and cultural traditions that can be activated to enhance diabetes self-management education and support. Diabetes educators can work in tandem with community health representatives to strengthen the social and community support within which individual AIs with type 2 diabetes mellitus live. Community-based participatory research with AI caregivers, dyads, families, youth, and Indian Health Service clinicians may help to improve tribal food policy and school health initiatives, as well as develop intergenerational interventions for modeling effective diabetes self-management.
‘Take more laxatives was their answer to everything’: A qualitative exploration of the patient, carer and healthcare professional experience of constipation in specialist palliative care
Authors: Hasson Felicity , Muldrew Deborah , Carduff Emma , Finucane Anne , Graham-Wisener Lisa , Larkin Phil , Mccorry Noleen , Slater Paul , McIlfatrick Sonja 
Published: December 2019

Background: Constipation is a major problem for many older adults, more so for those who are receiving specialist palliative care. However, limited research reports the subjective experiences of constipation, despite evidenced differences between the healthcare professional and patient/carer perspective. Aim: The main aim of this study is to explore the experience of how constipation is assessed and managed within specialist palliative care from the patient, carer and healthcare professional perspective. Design: Exploratory, qualitative design, utilising focus groups and interviews, and analysed using thematic analysis. Setting/participants: Six focus groups with 27 healthcare professionals and semi-structured interviews with 13 patients and 5 family caregivers in specialist palliative care units across three regions of the United Kingdom. Results: Constipation impacted physically, psychologically and socially on patients and families; however, they felt staff relegated it on the list of importance. Lifestyle modifications implemented at home were not incorporated into their specialist palliative care plan within the hospice. Comparatively, healthcare professionals saw constipation solely as a physical symptom. Assessment focused on the physical elements of constipation, and management was pharmacologically driven. Healthcare professionals reported patient embarrassment as a barrier to communicating about bowel care, whereas patients wanted staff to initiate communication and discuss constipation openly. Conclusion: Assessment and management of constipation may not yet reflect the holistic palliative care model. A focus on the pharmacological management may result in lifestyle modifications being underutilised. Healthcare professionals also need to be open to initiate communication on bowel care and consider non-pharmacological approaches. It is important that patients and families are supported in self-care management, alongside standardised guidelines for practice and for healthcare professionals to facilitate this.
Knowledge of School-Going Adolescents About the Oral Effects of Tobacco Usage in Ibadan, Southwest Nigeria
Authors: Lawal Folake B. , Fagbule Omotayo F. 
Published: December 2019

Background The individual knowledge of the effects of tobacco usage on health plays an important role in its uptake. Tobacco consumption usually starts during adolescence, and lack of knowledge about the oral problems of tobacco usage probably plays a role in it. Aim To determine the knowledge of adolescents about the effect of tobacco usage on oral health. Methods A cross-sectional study was conducted among 1,465 adolescents aged 12 to 20 years who attended senior secondary schools in a major city in Nigeria. Data were obtained through a semistructured questionnaire. Data obtained were analyzed with SPSS. Results The mean age of respondents was 15.2 (±1.4) years. Only 40 (2.7%) of them used tobacco at the time of study and 992 (67.7%) said that tobacco usage has effect(s) on oral health. The main effects mentioned were mouth odor: 338 (34.1%); teeth discoloration: 297 (29.9%); tooth decay: 138 (13.9%); damage to teeth: 72 (7.3%); lip discoloration: 39 (3.9%); and oral cancer: 11 (1.1%). It was found that female respondents (72.1%, odds ratio = 1.4, confidence interval = 1.1–1.7, p =  .005); those aged 12 to 15 years (73.6%, odds ratio = 2.0, confidence interval = 1.6–2.5, p < .001); and children of skilled workers (73.4%, odds ratio = 1.9, confidence interval = 1.2–3.0, p =  .008) were more likely to mention that tobacco has adverse effect(s) on oral health. Conclusion Although two thirds of the students knew that tobacco usage has effects on oral health, there were gross inadequacies in the knowledge and misconceptions about those effects.
Serum and follicular fluid levels of serotonin, kisspeptin, and brain-derived neurotrophic factor in patients undergoing in vitro fertilization: an observational study
Authors: Bódis József , Sulyok Endre , Kőszegi Tamás , Prémusz Viktória , Várnagy Ákos , Koppán Miklós 
Published: December 2019

Objective This study aimed to examine the effect of interactions between serotonin (5-HT), brain-derived neurotrophic factor (BDNF), and kisspeptin on the reproductive potential in women receiving in vitro fertilization (IVF). Methods Paired serum and follicular fluid (FF) samples were obtained from 30 consecutive patients receiving IVF. Primary and secondary outcome measures were the rate of chemical/clinical pregnancy and the number of mature oocytes and embryos, respectively. Serum and FF 5-HT, BDNF, kisspeptin, and platelet-activating factor (PAF) levels were measured by enzyme-linked immunosorbent assay. Results In response to ovarian hyperstimulation, serum 5-HT and kisspeptin levels significantly increased, whereas serum BDNF and PAF levels remained unchanged. These factors were detected in FF, but they were unrelated to serum levels. FF 5-HT and BDNF levels were positively correlated. Serum kisspeptin levels were negatively correlated with FF BDNF and serum and FF PAF levels. Women who were pregnant had significantly lower FF BDNF levels compared with women who were not pregnant (21.96±12.75 vs 47.63±52.90 µg/mL). Multivariate stepwise linear regression and logistic regression analyses showed that only 5-HT and kisspeptin improved IVF outcome. Conclusions This study indicates a role of serotoninergic mechanisms in success of IVF, but the contribution of interacting neuropeptides requires additional investigation.
Clinical features and sex differences in pediatric post-traumatic headache: A retrospective chart review at a Boston area concussion clinic
Authors: McEvoy Haley , Borsook David , Holmes Scott A 
Published: December 2019

Background Often concussion/mTBI triggers a chronic headache syndrome called persistent post-traumatic headache (P-PTH) that can last from months to years post-injury, and produce significant disruption of childhood education, social interaction and development. Although prevalent and highly disabling, P-PTH is underrepresented in headache and pain research and lacks clear definition and pathophysiology. Clinical presentation of P-PTH frequently resembles that of other headache disorders, like migraine, yet the pathophysiological mechanisms are distinct and not fully understood, making the disorder difficult to treat in the clinical setting. Methods In a retrospective analysis of 1506 pediatric patients attending Boston Children’s Hospital clinics, demographic trends, symptom features, and the influence of sex on clinical presentation of PTH are presented. We compare clinical characteristics of P-PTH with a published cohort of migraine patients to evaluate the clinical features that are unique to P-PTH. Results Findings show that despite equivalent representation of sex in the clinic, P-PTH is expressed more in females than males and is weighted towards somatic symptoms. Relative to migraine, PTH is less associated with a family history of headache. Conclusions The ability to identify persons with PTH can help manage risk factors and identify persons likely to develop persistent post-concussion symptoms.
Quantification of photophobia in visual snow syndrome: A case-control study
Authors: Eren Ozan E , Ruscheweyh Ruth , Straube Andreas , Schankin Christoph J 
Published: December 2019

Objective To quantify photophobia in visual snow syndrome (VSS), a debilitating migraine-associated visual disturbance manifesting with continuous “TV snow-like” flickering dots in the entire visual field and additional visual symptoms, such as photophobia. Methods Photophobia was compared between 19 patients with VSS and 19 controls matched for age, sex, migraine and aura using the Leiden Visual Sensitivity Scale (L-VISS). Results Patients with VSS had an increased L-VISS-score compared to matched controls [(22.2 ± 5.9 vs. 4.4 ± 4.8; ANOVA, factors VSS and comorbid migraine: Main effect for VSS (F = 100.70; p < 0.001), but not for migraine (F < 0.01; p = 1.00) or the interaction (F = 1.93; p = 0.16)]. An L-VISS-score of 14 identified VSS with a sensitivity and specificity of 95% (Receiver Operating Characteristic analysis, 0.986 ± 0.014, p ≤ 0.001). Conclusion Patients with VSS suffer continuously from photophobia at a level similar to chronic migraineurs during attacks. Although migraine and VSS share dysfunctional visual processing, patients with VSS might be more severely affected.
Faecal occult blood test and colonoscopy use in Portugal: Results from the National Health Survey 2014
Authors: Khan Haseeb , Shaaban Nabil , Peleteiro Bárbara 
Published: December 2019

Objectives Given the recent implementation of regional colorectal cancer screening programs in Portugal, understanding patterns of faecal occult blood test and colonoscopy use is essential to improve its control. We aimed to describe the use of both tests and to identify factors associated with its non- and under-use. Methods A sample of 7208 subjects aged 50–74 from the National Health Survey 2014 was examined. Previous experience of faecal occult blood test and colonoscopy was classified as never or ever; ever-users, who had last undergone these tests more than 2 or 10 years before, respectively, were considered under-users. We computed age- and education-adjusted prevalence ratios and corresponding 95% confidence intervals for non- and under-use. Results Of the individuals in the screening age range, 36.9% had never undergone either test. The prevalence of non-use was 50.7% and 62.2% for faecal occult blood test and colonoscopy, and 27.4% and 6.0% of subjects under-used each test, respectively. The lowest prevalence of non- and under-use was found in the Norte region. Low socioeconomic status and unhealthy lifestyles were significantly associated with low testing; greater use was observed for those having more recent contact with healthcare services. Conclusions This study identifies patterns of colorectal cancer screening use, with regional disparities that have not yet been reduced by the implementation of organised screening programmes.
Mapping the prison mental health service workforce in Australia
Authors: Davidson Fiona , Clugston Bobbie , Perrin Michelle , Williams Megan , Heffernan Edward , Kinner Stuart A 
Published: December 2019

Objective: The rapidly growing number of people in prison in Australia, combined with the high prevalence of mental disorder in this population, results in high demand for mental health services in prison settings. Despite their critical role as part of a national mental health response, prison mental health services (PMHS) in Australia have been poorly characterised. In this paper, we describe findings of the first national survey of PMHS in Australia. Methods: We distributed a survey to key representatives of PMHS in all Australian states and territories in 2016. Results: Our method constitutes a replicable process for quantifying and comparing PMHS in Australia. We describe the structure, governance and staffing models in seven jurisdictions. When compared against international recommendations, only one Australian jurisdiction (the ACT) is funded to provide services at a level equivalent to mental health services provided in the community. Conclusion: Prison mental health services in Australia are delivered by a complex mix of government, private sector and non-government services. Services appear to be severely under-resourced when compared with the available benchmarks.
The Climate Action Simulation
Authors: Rooney-Varga Juliette N. , Kapmeier Florian , Sterman John D. , Jones Andrew P. , Putko Michele , Rath Kenneth 
Published: December 2019

Background. We describe and provide an initial evaluation of the Climate Action Simulation, a simulation-based role-playing game that enables participants to learn for themselves about the response of the climate-energy system to potential policies and actions. Participants gain an understanding of the scale and urgency of climate action, the impact of different policies and actions, and the dynamics and interactions of different policy choices. Intervention. The Climate Action Simulation combines an interactive computer model, En-ROADS, with a role-play in which participants make decisions about energy and climate policy. They learn about the dynamics of the climate and energy systems as they discover how En-ROADS responds to their own climate-energy decisions. Methods. We evaluated learning outcomes from the Climate Action Simulation using pre- and post-simulation surveys as well as a focus group. Results. Analysis of survey results showed that the Climate Action Simulation increases participants’ knowledge about the scale of emissions reductions and policies and actions needed to address climate change. Their personal and emotional engagement with climate change also grew. Focus group participants were overwhelmingly positive about the Climate Action Simulation, saying it left them feeling empowered to make a positive difference in addressing the climate challenge. Discussion and Conclusions. Initial evaluation results indicate that the Climate Action Simulation offers an engaging experience that delivers gains in knowledge about the climate and energy systems, while also opening affective and social learning pathways.
Positive Association Between Serum Levels of High-Sensitivity C-Reactive Protein and Depression/Anxiety in Female, but Not Male, Patients With Type 2 Diabetes Mellitus
Authors: Yang Qian-Qian , Shao Di , Li Jie , Yang Chun-Ling , Fan Min-Hua , Cao Feng-Lin 
Published: December 2019

Purpose: Patients with Type 2 diabetes (T2D) have increased risk of depression and anxiety. Evidence suggests that a heightened inflammatory state may contribute to this association. Females experience more depression and higher inflammation levels than males. This study compared associations of serum high-sensitivity C-reactive protein (hs-CRP) levels with symptoms of depression and anxiety between men and women with Type 2 diabetes mellitus (T2DM). Method: Cross-sectional data including demographic and disease characteristics, symptoms of depression and anxiety, clinical data, and laboratory values were collected from 392 patients with T2DM recruited from a general hospital in Shandong Province, China. We evaluated associations between serum hs-CRP level and symptoms of depression and anxiety in males and females separately using multiple linear regressions and χ2 tests for trend. Results: Sex moderated the association between serum hs-CRP level and symptoms of depression ( B = .112 [ SE = 0.049]; p = .022) and anxiety ( B = .137 [ SE = 0.053]; p = .011). Among females, hs-CRP level was positively associated with depression ( B = .034, 95% confidence interval [CI] = [.006, .061]; p = .016, false discovery rate [FDR]-adjusted p = .020) and anxiety ( B = .041, 95% CI [.011, .071], p = .007, FDR-adjusted p = .007). Positive trends indicated a higher prevalence of clinically significant symptoms of depression and anxiety in higher serum hs-CRP categories in females. No associations were found in males. Conclusion: Findings demonstrate that associations between serum hs-CRP level and symptoms of depression and anxiety in patients with T2D are sex-specific, with only females demonstrating a significant positive association.
Contemporary utilization patterns and outcomes of thrombolytic administration for ischemic stroke among patients with cancer
Authors: Owusu-Guha Jocelyn , Guha Avirup , Miller P Elliott , Pawar Sumeet , Dey Amit K , Ahmad Tariq , Attar Hatim , Awan Farrukh T , Mitchell Darrion , Desai Nihar R , Addison Daniel 
Published: December 2019

Background Thrombolytic therapy significantly improves outcomes among patients with acute ischemic stroke. While cancer outcomes have dramatically improved, the utilization, safety, and mortality outcomes of patients with cancer who receive thrombolytic therapy for acute ischemic stroke are unknown. Methods Using a national database, we identified all hospitalizations for acute ischemic stroke requiring thrombolytic therapy between 2003 and 2015. Patients with contraindications to thrombolytic therapy were excluded. Following propensity score matching for comorbidity burden, trends in thrombolytic therapy use and its effect on in-hospital mortality, intracranial or all-cause bleeding, and the combined endpoint of mortality and all-cause bleeding, by presence/absence of cancer were evaluated. We also evaluated 30- and 90-day readmission rates post-thrombolytic therapy administration. Results We identified 237,687 acute ischemic stroke hospitalizations requiring thrombolytic therapy, of which 26,328 (11%) had an underlying cancer. Over the study period, thrombolytic therapy use increased across all acute ischemic stroke admissions, irrespective of cancer presence (12.4/1000 in 2003 to 81.1/1000 in 2015, P < 0.0001). However, thrombolytic therapy utilization differed by cancer presence (4.8% cancer vs.·5.1% non-cancer, P = 0.001). There was no difference in intracranial bleeding (9.6% vs. 9.7%), all-cause bleeding (13.2% vs. 13.2%), or in-hospital mortality (7.6% vs. 7.2%). While there was no difference in 30-day readmission rates by cancer presence (24% vs. 29%, P = 0.40), at 90-days, cancer patients saw higher readmission rates (17.2% vs. 13.3%, P = 0.02). Conclusions Contemporary thrombolytic therapy use for acute ischemic stroke has risen, irrespective of presence of cancer. Yet, patients with comorbid cancer appear to see lower rates of thrombolytic therapy use for acute ischemic stroke, despite no difference in the rate of intracranial bleeding or mortality after adjustment for comorbidities.
Systematic review and network meta-analysis of the efficacy and safety of glycopyrrolate/formoterol fumarate metered dose inhaler in comparison with other long-acting muscarinic antagonist/long-acting β2-agonist fixed-dose combinations in COPD
Authors: Siddiqui Mohd Kashif , Shukla Pragya , Jenkins Martin , Ouwens Mario , Guranlioglu Deniz , Darken Patrick , Biswas Mousumi 
Published: December 2019

Background: Dual bronchodilation with a long-acting muscarinic antagonist (LAMA)/long-acting β2-agonist (LABA) fixed-dose combination (FDC) is an established treatment strategy for chronic obstructive pulmonary disease (COPD). The relative efficacy and safety of glycopyrrolate/formoterol fumarate metered dose inhaler (GFF MDI 18/9.6 μg) in patients with moderate-to-very severe COPD, compared with other licensed LAMA/LABA FDCs, was investigated using an integrated Bayesian network meta-analysis (NMA). Methods: A systematic literature review and subsequent screening process identified randomized controlled trials of ⩾10 weeks’ duration that enrolled patients aged ⩾40 years with moderate-to-very severe COPD and included at least one LAMA/LABA FDC or open LAMA + LABA treatment arm. NMAs were conducted for outcomes including change from baseline in forced expiratory volume in 1 s (FEV1), St George’s Respiratory Questionnaire (SGRQ), and transition dyspnea index (TDI) parameters, annualized rate of exacerbations, use of rescue medication, adverse events, and all-cause withdrawals. Meta-regression and sensitivity analyses accounted for heterogeneity across studies. Results: In total, 29 studies including 34,617 patients contributed to the NMA for efficacy or safety outcomes at week 24 or exacerbations. For all LAMA/LABA FDCs with data available, significantly greater improvements in FEV1 [trough, peak, and area under the curve (AUC)0–4], SGRQ total score and TDI focal score at week 24, and annualized rate of moderate-to-severe exacerbations, were observed versus placebo. Where indirect comparisons were possible, differences between GFF MDI and other LAMA/LABA FDCs were small relative to established margins of clinical relevance, and not statistically significant. The safety and tolerability profile of GFF MDI was consistent with other LAMA/LABA FDCs and placebo. The results of the meta-regression were generally similar to the base case. Conclusions: GFF MDI demonstrated comparable efficacy and safety outcomes to other LAMA/LABA FDCs. Personalization of treatment choice within the class on the basis of other factors such as patient preference may be appropriate.