bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing the effectiveness of a comprehensive menstrual health intervention program in Ugandan schools (MENISCUS): process evaluation of a pilot intervention study
Authors: Nalugya Ruth , Tanton Clare , Hytti Laura , Kansiime Catherine , Nakuya Kevin , Namirembe Prossy , Nakalema Shamira , Neema Stella , Alezuyo Connie , Namuli Musoke Saidat , Torondel Belen , Francis Suzanna C. , Ross David A. , Bonell Chris , Seeley Janet , Weiss Helen A. 
Published: April 2020

Abstract
Background
Poor menstrual health and hygiene (MHH) is a globally recognised public health challenge. A pilot study of an MHH intervention was conducted in two secondary schools in Entebbe, Uganda, over 9 months. The intervention included five components delivered by the implementing partner (WoMena Uganda) and the research team: (i) training teachers to implement government guidelines for puberty education, (ii) a drama skit to reduce stigma about menstruation, (iii) training in use of a menstrual kit (including re-usable pads), (iv) guidance on pain relief methods including provision of analgesics and (v) improvements to school water, sanitation and hygiene (WASH) facilities. The aim of the process evaluation was to examine implementation, context and possible causal pathways.

Methods
We collected information on fidelity, dose, reach, acceptability, context and mechanisms of impact using (i) quantitative survey data collected from female and male students in year 2 of secondary school (ages 13–21; 450 at the baseline and 369 at endline); (ii) qualitative data from 40 in-depth interviews with parents, teachers and female students, and four focus group discussions with students, stratified by gender; (iii) data from unannounced visits checking on WASH facilities throughout the study; and (iv) routine data collected as part of the implementation. Quantitative data were used primarily to assess fidelity, dose and reach. Qualitative data were used primarily to assess acceptability, context and possible mechanisms.

Results
Both schools received all intervention elements that were delivered by the research team and implementing partner. The drama skit, menstrual kit and pain management intervention components were delivered with fidelity. Intervention components that relied on school ownership (puberty education training and WASH improvements) were not fully delivered. Overall, the intervention was acceptable to participants. Multilevel contextual factors including schools’ social and physical environment, and family, cultural and social factors influenced the acceptability of the intervention in the school setting. The intervention components reinforced one another, as suggested in our theoretical framework.

Conclusion
The intervention was feasible to deliver and acceptable to the schools and students. We propose a full-scale cluster-randomised trial to evaluate the intervention, adding a school-based MHH leadership group to address issues with school ownership.

Trial registration
ClinicalTrials.gov NCT04064736. Registered August 22, 2019, retrospectively registered.
Being a front-line dentist during the Covid-19 pandemic: a literature review
Authors: Fallahi Hamid Reza , Keyhan Seied Omid , Zandian Dana , Kim Seong-Gon , Cheshmi Behzad 
Published: April 2020

AbstractCoronavirus is an enveloped virus with positive-sense single-stranded RNA. Coronavirus infection in humans mainly affects the upper respiratory tract and to a lesser extent the gastrointestinal tract. Clinical symptoms of coronavirus infections can range from relatively mild (similar to the common cold) to severe (bronchitis, pneumonia, and renal involvement). The disease caused by the 2019 novel coronavirus (2019-nCoV) was called Covid-19 by the World Health Organization in February 2020. Face-to-face communication and consistent exposure to body fluids such as blood and saliva predispose dental care workers at serious risk for 2019-nCoV infection. As demonstrated by the recent coronavirus outbreak, information is not enough. During dental practice, blood and saliva can be scattered. Accordingly, dental practice can be a potential risk for dental staff, and there is a high risk of cross-infection. This article addresses all information collected to date on the virus, in accordance with the guidelines of international health care institutions, and provides a comprehensive protocol for managing possible exposure to patients or those suspected of having coronavirus.
Thickening-upward cycles in deep-marine and deep-lacustrine turbidite lobes: examples from the Clare Basin and the Ordos Basin
Authors: Zhang Lei-Fu , Dong Da-Zhong 
Published: April 2020

AbstractDeep-marine and deep-lacustrine reservoirs have been targets for conventional and unconventional oil and gas exploration and development for decades. Thickening-upward cycles in the deep-marine Carboniferous Ross Sandstone Formation outcrops in western Ireland and the deep-lacustrine Triassic Yanchang Formation outcrops in southeast Ordos Basin have been investigated and correlated in this study. Typical thickening-upward cycles consisting of, from bottom to top: (1) laminated shales/shales with interbedded siltstone beds; (2) interbedded sandstones/siltstones and mudstones; (3) structureless massive sandstones, are well recognized in these outcrops and are interpreted as turbidite lobes. A continuously prograding lobe-element model is proposed to explain the repeated stacking of thickening-upward cycles. Thickening-upward cycles developed within deep-marine and deep-lacustrine environments are highly comparable in many aspects, such as sedimentary structures, sheet-like geometries and amalgamation features. A frequent and strong degree of amalgamation is developed within the massive sandstone at the top of each thickening-upward cycle, suggesting a layer-by-layer depositional manner. Field observations and comparison with deep-marine counterparts support the occurrence of turbidity flows in the Yanchang Formation, Ordos Basin.
Fiber optic sensing technologies potentially applicable for hypersonic wind tunnel harsh environments
Authors: Qiu Huacheng , Min Fu , Yang Yanguang 
Published: April 2020

AbstractAdvanced sensing techniques are in big demand for applications in hypersonic wind tunnel harsh environments, such as aero(thermo)dynamics measurements, thermal protection of aircraft structures, air-breathing propulsion, light-weighted and high-strength materials, etc. In comparison with traditional electromechanical or electronic sensors, the fiber optic sensors have relatively high potential to work in hypersonic wind tunnel, due to the capability of responding to a wide variety of parameters, high resolution, miniature size, high resistant to electromagnetic and radio frequency interferences, and multiplexing, and so on. This article has classified and summarized the research status and the representative achievement on the fiber optic sensing technologies, giving special attention to the summary of research status on the popular Fabry-Perot interferometric, fiber Bragg gratings and (quasi) distributed fiber optic sensors working in hypersonic wind tunnel environment, and discussed the current problems in special optical fiber sensing technologies. This article would be regarded as reference for the researchers in hypersonic wind tunnel experiment field.
Child psychiatry: a model for specific goals for in-patient treatment linked to resources and limitations in out-patient treatment
Authors: Wilkinson Simon R. 
Published: April 2020

SummaryI present a rationale for two different types of in-patient child psychiatric unit: 24/7 intensive units and 24/5 child and family units. Intensive units address safety requirements. The developing personality of young people is at the centre of in-patient approaches on the child and family units. This requires attachment-informed practice. Families must always be involved and placement of units must facilitate their participation. The primary skill characterising these units is use of the milieu for therapy and combining this with family therapy. In other words, nurses and allied professionals need to be the dominant force in unit development, under the reflective guidance of consultants and clinical psychologists.
Feasibility and utility of enhanced sleep management on in-patient psychiatry wards
Authors: Novak Chloe , Packer Emma , Paterson Alastair , Roshi Ambrina , Locke Rosie , Keown Patrick , Watson Stuart , Anderson Kirstie N. 
Published: April 2020

Aims and methodSleep disturbance is common in psychiatry wards despite poor sleep worsening mental health. Contributory factors include the ward environment, frequent nightly checks on patients and sleep disorders including sleep apnoea. We evaluated the safety and feasibility of a package of measures to improve sleep across a mental health trust, including removing hourly checks when safe, sleep disorder screening and improving the ward environment.ResultsDuring the pilot there were no serious adverse events; 50% of in-patients were able to have protected overnight sleep. Hypnotic issuing decreased, and feedback from patients and staff was positive. It was possible to offer cognitive–behavioural therapy for insomnia to selected patients.Clinical implicationsMany psychiatry wards perform standardised, overnight checks, which are one cause of sleep disruption. A protected sleep period was safe and well-tolerated alongside education about sleep disturbance and mental health. Future research should evaluate personalised care rather than blanket observation policies.
Protective Effects of Dietary Intake of Antioxidants and Treatment-Related Toxicity in Childhood Leukemia: A Report From the DALLT Cohort
Authors: Ladas Elena J. , Blonquist Traci M. , Puligandla Maneka , Orjuela Manuela , Stevenson Kristen , Cole Peter D. , Athale Uma H. , Clavell Luis A. , Leclerc Jean-Marie , Laverdiere Caroline , Michon Bruno , Schorin Marshall A. , Greene Welch Jennifer , Asselin Barbara L. , Sallan Stephen E. , Silverman Lewis B. , Kelly Kara M. 
Published: April 2020

PURPOSE The benefits and risks of supplementation with antioxidants during cancer therapy have been a controversial area. Few studies have systematically evaluated dietary intake of antioxidants with toxicity and survival in childhood cancer. We sought to determine the role of dietary intake of antioxidants on rates of infections, mucositis, relapse, and disease-free survival during induction and postinduction phases of therapy among children and adolescents with acute lymphoblastic leukemia (ALL). PATIENTS AND METHODS We enrolled 794 children in a prospective clinical trial for treatment of ALL. Dietary intake was prospectively evaluated by a food frequency questionnaire. The association between dietary intake of antioxidants and treatment-related toxicities and survival were evaluated with the Benjamini-Hochberg false discovery rate (q) and logistic regression and the Kaplan-Meier method, respectively. RESULTS Dietary surveys were available for analysis from 614 (77%), and 561 (71%) participants at diagnosis and at end of induction, respectively. Of 513 participants who completed the dietary surveys at both time points, 120 (23%) and 87 (16%) experienced a bacterial infection and 22 (4%) and 55 (10%) experienced mucositis during the induction or postinduction phases of treatment, respectively. Increased intake of dietary antioxidants was associated with significantly lower rates of infection and mucositis. No association with relapse or disease-free survival was observed. Supplementation was not associated with toxicity, relapse, or survival. CONCLUSION Consumption of antioxidants through dietary intake was associated with reduced rates of infection or mucositis, with no increased risk of relapse or reduced survival. Dietary counseling on a well-balanced diet that includes an array of antioxidants from food sources alone may confer a benefit from infections and mucositis during treatment of childhood ALL.
Acute effects of Zamzam water on blood pressure and heart rate variability
Authors: Latif Rabia , Majeed Farrukh , Al Sunni Ahmed , K ALamrie Rahmah Mohammed , Al Naimi Shaykhah Nasser 
Published: April 2020

Objective: There is a lack of studies exploring the effects of Zamzam water on human physiology. The present study determined the effects of Zamzam water on blood pressure and heart rate variability (HRV).
Methods: This comparative interventional study was conducted at the Department of Physiology, of our university in March 2018. A total number of 97 female subjects drank 500 ml of either Zamzam water or mineral water in one minute. Finometer Pro and PowerLab (ADInstrumentsR) with ECG electrodes through bioamplifier and attached finger pulse transducer were used to collect data at the baseline (for five minutes), during (for one minute) and after the drink (for five minutes). Paired and uunpaired student’s t-test, one-way ANCOVA and one-way repeated measure ANOVA were used for analysis. Blood pressure parameters were followed minute by minute and HRV parameters were compared as a 5-minute of baseline segment to 5-minute post drink segment.
Results: Within-the-group comparison exhibited significant increases in blood pressure parameters (systolic, diastolic, pulse and mean arterial pressure), over a 5-minute post-drinking period in both groups. Zamzam water caused a significant increase in SDRR (an indication of overall HRV) and RMSSD (an indication of vagal activity) as compared to baseline.
Conclusion: Both drinks cause a significant increase in systolic, diastolic, pulse and mean arterial pressure within five minutes post-drinking period. Zamzam water produce a significant increase in cardiac vagal tone but has no effect on cardiac sympathetic activity. Mineral water has no significant effect on both, cardiac vagal and sympathetic activity.
doi: https://doi.org/10.12669/pjms.36.4.1755
How to cite this:Latif R, Majeed F, Al-Sunni A, ALamrie RMK, AlNaimi SN. Acute effects of Zamzam water on blood pressure and heart rate variability. Pak J Med Sci. 2020;36(4):755-760. doi: https://doi.org/10.12669/pjms.36.4.1755
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Στάσεις εκπαιδευτικών που διδάσκουν σε Δομές Υποδοχής και Εκπαίδευσης Προσφύγων (ΔΥΕΠ) απέναντι στην εκπαίδευση προσφύγων μαθητών
Authors: Μαλιγκούδη Χριστίνα , Τσαουσίδης Αναστάσιος 
Published: April 2020

Ο θεσμός των Δομών Υποδοχής και Εκπαίδευσης Προσφύγων (ΔΥΕΠ) αποτελεί μία από τις βασικότερες δομές εκπαίδευσης των προσφύγων στην Ελλάδα εκ μέρους της ελληνικής πολιτείας. Οι εκπαιδευτικοί που εργάζονται σε αυτές έρχονται καθημερινά αντιμέτωποι με πολλές εκπαιδευτικές προκλήσεις, αλλά παράλληλα, και οι μαθητές που φοιτούν σε αυτές, λαμβάνουν σημαντικότατα κοινωνικά, ψυχολογικά και γνωστικά ερεθίσματα. Συνεπώς, οι στάσεις των εκπαιδευτικών που διδάσκουν στις ΔΥΕΠ απέναντι στην εκπαίδευση των προσφύγων μαθητών, είναι καλό να αναδειχτούν και να μελετηθούν, καθώς επηρεάζουν πρωτίστως τους μαθητές. Για την παρούσα έρευνα επιλέχτηκε η ποιοτική μεθοδολογική προσέγγιση, στο πλαίσιο της οποίας εφαρμόστηκε η ημι-δομημένη συνέντευξη. Οι συμμετέχοντες της έρευνας ήταν δώδεκα εκπαιδευτικοί των κλάδων ΠΕ70-Δάσκαλοι, ΠΕ60-Νηπιαγωγοί και ΠΕ02-Φιλόλογοι που εργάστηκαν το σχολικό έτος 2018-19 σε ΔΥΕΠ που υπάγονται σε σχολεία των Διευθύνσεων Πρωτοβάθμιας Εκπαίδευσης των περιφερειών της Κεντρικής Μακεδονίας, Ανατολικής Μακεδονίας, Αττικής και Στερεάς Ελλάδας. Η επεξεργασία των συνεντεύξεων επιχειρεί να εξετάσει τις ρητές αλλά και άρρητες πεποιθήσεις τους απέναντι σε ζητήματα διγλωσσίας, ετερότητας, χρήσης της μητρικής γλώσσας κ.λπ.
Effectiveness of non-pharmacological falls prevention interventions for people with Multiple Sclerosis, Parkinson’s Disease and stroke: protocol for an umbrella review
Authors: O'Malley Nicola , Clifford Amanda M. , Comber Laura , Coote Susan 
Published: April 2020

Background: Falls are common among people with neurological diseases and are associated with many negative physical, psychosocial and economic consequences. Implementation of single diagnosis falls prevention interventions is currently problematic due to lack of participants and resources. Given the similarities in falls risk factors across stroke, Parkinson’s Disease (PD) and Multiple Sclerosis (MS), the development of an intervention designed for mixed neurological populations seems plausible and may provide a solution to current implementation challenges. This umbrella review aims to summarise the totality of evidence regarding the effectiveness of non-pharmacological falls prevention interventions for people with MS, PD and stroke and to identify the commonalities and differences between interventions that are effective for each disease to inform the development of an intervention for mixed diagnoses. Methods: This umbrella review will be conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Electronic databases and grey literature will be searched. Systematic reviews of randomised controlled trials (RCTS) and studies investigating the effects of non-pharmacological falls prevention interventions on falls outcomes among people with MS, PD and stroke will be included. Methodological quality of included reviews will be assessed using the Assessment of Multiple Systematic Reviews 2 tool. The Grading of Recommendations Assessments, Development and Evaluation framework will be used to rate the quality of evidence. A summary of evidence table and narrative synthesis will be utilised to clearly indicate the findings. Discussion: This umbrella review presents a novel and timely approach to synthesise existing falls literature to identify effective non-pharmacological interventions for people with MS, PD and stroke. Of importance, this umbrella review will use a robust methodology to explore the key differences and similarities in effective interventions for individuals with these neurological diseases to facilitate the development of an intervention for mixed neurological groups.
Long-term survival after endoscopic vein harvest for coronary artery bypass grafting
Authors: Kirmani BH , Power S , Zacharias J 
Published: April 2020

Introduction Endoscopic vein harvest is the technique of choice in North America, where it constitutes 80% of conduit harvest for coronary artery bypass grafting. The UK has much lower rates, despite demonstrable perioperative benefits. Concerns about patency and long-term survival are often cited as reasons for poor uptake and evidence in the literature thus far has only addressed mid-term outcomes. We sought to identify the long-term survival of patients undergoing endoscopic vein harvest compared with a contemporaneous cohort of open vein harvest. Materials and methods This was a retrospective cohort study of all consecutive patients undergoing isolated coronary artery bypass grafting at a single institution between 2007 and 2017. All-cause long-term mortality was compared using Kaplan–Meier curves and log-rank analysis. Results A total of 7,527 patients undergoing coronary artery bypass grafting (1,029 receiving endoscopic vein harvest) were studied. The groups were well matched for preoperative characteristics, except that there were more patients with triple-vessel disease and good left-ventricular function in the endoscopic vein harvest group. There was no statistically significant difference in the long-term survival (p = 0.23). At five years (median follow-up), survival was 86.1% (95% confidence interval 85.3–87.0) in the open vein harvest group compared with 85.5% (95% confidence interval 82.8–88.2) in the endoscopic vein harvest group. Discussion and conclusion Endoscopic vein harvest does not affect long-term survival in an unselected population. The contraindications for minimally invasive vein harvest in coronary artery bypass grafting are increasingly diminishing.
Significance of a positive sentinel lymph node biopsy in staging for distant metastasis in breast cancer: are current guidelines relevant?
Authors: Hubbard TJE , Ives C 
Published: April 2020

Introduction In breast cancer, early identification of distant metastasis changes management. Current guidelines recommend radiological staging in patients with a preoperative positive axilla; no guidelines address a preoperative negative axilla with subsequent positive sentinel lymph node biopsy. This study investigates whether current guidelines adequately identify distant metastasis in a positive sentinel lymph node biopsy population that had radiological staging. Materials and methods Patients diagnosed with primary breast cancer between 1 January 2013 and 1 October 2017 with a positive sentinel lymph node biopsy and subsequent radiological staging from a single unit were included. A systematic search identified relevant guideline criteria, against which patients were audited. Results A total of 330 patients with positive sentinel lymph node biopsy were identified; 227 (69%) had radiological staging postoperatively with computed tomography (5.3%), bone scan (2.6%) and both (92%) which identified 8/227 (3.5%) patients had distant metastasis. Patients with distant metastasis (DMp) compared with those without distant metastasis (NDMp) were associated with poorly differentiated tumours (DMp 62% vs NDMp 28%; p = 0.037), high-grade ductal carcinoma in situ (DMp 75% vs NDMp 39%; p = 0.043) and increased mean invasive tumour size (DMp 37mm vs NDMp 24mm; p = 0.014). Binomial logistic regression did not identify any characteristics to predict distant metastasis in staged patients (chi-squared p = 0.162). Two guidelines used postoperative results to inform radiological staging decision; 68/227 (30%) of staged patients met these guideline criteria, five of eight patients with distant metastasis did not meet current guideline criteria for radiological staging. Discussion Over 50% of patients with distant metastasis did not meet current guideline criteria for radiological staging and would have remained undiagnosed if current guidelines were followed. This study had an acceptable detection rate of 3.5% for distant metastasis. We therefore recommend radiological staging in all patients with positive sentinel lymph node biopsy.