bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multiple psychological factors predict abdominal pain severity in children with irritable bowel syndrome
Authors: Hollier John M. , van Tilburg Miranda A. L. , Liu Yan , Czyzewski Danita I. , Self Mariella M. , Weidler Erica M. , Heitkemper Margaret , Shulman Robert J. 
Published: December 2018

AbstractBackgroundAnxiety and depression are implicated as contributors to abdominal pain in pediatric irritable bowel syndrome (IBS) but is unclear if this pain is associated with other psychological factors. The study objective was to test if the impact of anxiety or depression on IBS symptom severity is mediated by somatization and/or pain catastrophizing.MethodsWe utilized baseline data from local pediatric IBS clinical studies. Through mediation analysis, we assessed whether somatization or pain catastrophizing mediated (either independently or combined) the separate relationships of anxiety or depression with IBS abdominal pain severity.Key ResultsWe analyzed 261 participants. All psychological factors were positively correlated with one another and IBS abdominal pain severity. The association of anxiety with IBS abdominal pain was mediated by both somatization and pain catastrophizing in individual analyses (each mediated standardized coefficient [β] 0.11, CI 0.05‐0.18) and in multiple analysis (mediated standardized β 0.18, CI 0.09‐0.27). The association of depression with IBS abdominal pain was also mediated by somatization (mediated standardized β 0.08, CI0.02‐0.14) and pain catastrophizing (mediated standardized β 0.06, CI 0.01‐0.11) in individual analyses and in multiple analysis (mediated standardized β 0.19, CI 0.04‐0.19).Conclusions and InferencesSomatization and pain catastrophizing mediate the relationships between anxiety/depression and IBS abdominal pain severity. These findings suggest that somatization and pain catastrophizing may be better treatment targets than anxiety and depression. Clinicians should assess these psychological factors in pediatric IBS patients and refer for intervention to improve outcomes.
Identifying notions of environment in obesity research using a mixed‐methods approach
Authors: Elgaard Jensen Torben , Kleberg Hansen Anne K. , Ulijaszek Stanley , Munk Anders K. , Madsen Anders K. , Hillersdal Line , Jespersen Astrid P. 
Published: December 2018

SummaryThe recent rise of computation‐based methods in social science has opened new opportunities for exploring qualitative questions through analysis of large amounts of text. This article uses a mixed‐methods design that incorporates machine reading, network analysis, semantic analysis, and qualitative analysis of 414 highly cited publications on obesogenic environments between 2001 and 2015. The method produces an elaborate network map exhibiting five distinct notions of environment, all of which are currently active in the field of obesity research. The five notions are institutional, built, food, family, and bodily environments. The network map is proposed as a navigational tool both for policy actors who wish to coordinate efforts between a variety of stakeholders and for researchers who wish to understand their own research and research plans in light of different positions in the field. The final part of the article explores how the network map may also initiate a broader set of reflections on the configuration, differentiation, and coherence of the field of obesity research.
Exploring the Effects of a Single Rational Emotive Behavior Therapy Workshop in Elite Blind Soccer Players
Authors: Wood Andrew G. , Barker Jamie B. , Turner Martin , Thomson Peter 
Published: December 2018

Research examining the effects of rational emotive behavior therapy (REBT) on athletic performance is emerging. There is, however, a paucity of research exploring psychological interventions in specialized sport populations. The present study investigated the effects of a single REBT workshop, including intellectual and practical insight into the ABC(DE) framework, on psychological, physiological, and performance markers in an elite blind soccer team. From use of a within-participant pretest–posttest crossover design in an ecologically valid setting, data indicated small and immediate reductions in irrational beliefs, perceived helpfulness of preperformance anxiety, and physiological markers (i.e., systolic blood pressure) prior to a penalty-kick simulation. However, no substantial changes were shown in penalty-kick performance. In sum, although the findings elucidate some benefits of a single REBT workshop, the educational insight into the ABC(DE) framework was deemed insufficient for meaningful changes in outcome measures. Practical implications and recommendations for future researchers are discussed.
Structure of the posttranslational Sec protein-translocation channel complex from yeast
Authors: Itskanov Samuel , Park Eunyong 
Published: December 2018

Posttranslational translocon architecture
About a third of proteins are transported into endoplasmic reticulum by the universally conserved Sec61 protein-conducting channel. Itskanov and Park determined a cryo–electron microscopy structure of the Sec complex from yeast, which mediates posttranslational translocation of many secretory proteins across the endoplasmic reticulum membrane. The study reveals how Sec63 activates the Sec61 channel for substrate polypeptide insertion. The structure also explains the mutually exclusive binding of Sec63 and the ribosome to the channel.

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Evaluation of stakeholder views on peer review of NIHR applications for funding: a qualitative study
Authors: Turner Sheila , Bull Abby , Chinnery Fay , Hinks Jeremy , Mcardle Nicola , Moran Rebecca , Payne Helen , Woodford Guegan Eleanor , Worswick Louise , Wyatt Jeremy C 
Published: December 2018

ObjectivesInnovations resulting from research have both national and global impact, so selecting the most promising research studies to fund is crucial. Peer review of research funding applications is part of the selection process, and requires considerable resources. This study aimed to elicit stakeholder opinions about which factors contribute to and influence effective peer review of funding applications to the UK National Institute for Health Research (NIHR), and to identify possible minor improvements to current processes and any major changes or potential innovations to achieve a more efficient peer review process.DesignQualitative interviews with 30 stakeholders involved in the peer review process.ParticipantsParticipants were drawn from three NIHR coordinating centres and represented four types of stakeholders: board members with responsibility for making funding decisions, applicants, external peer reviewers and NIHR staff.MethodsAll interviews were conducted by telephone apart from three that were face to face with NIHR staff. Data were analysed using a thematic template method.ResultsThe responses from NIHR staff, board members and reviewers differed from those received from applicants. The first three groups focused on how well the process of peer review did or did not function. The applicants mentioned these points but in addition often reflected on how their personal application was assessed. Process improvements suggested included: developing a more proportionate review process; providing greater guidance, feedback, training, acknowledgement or incentives for peer reviewers; reducing the time commitment and amount of paperwork; and asking reviewers to comment on the importance, strengths and weaknesses of applications and flaws which are potentially ‘fixable’.ConclusionsOverall, participants were supportive of the need for peer review in evaluating applications for research funding. This study revealed which parts of the process are working well and are valued, and barriers, difficulties and potential areas for improvement and development.
Cost of oropharyngeal dysphagia after stroke: protocol for a systematic review
Authors: Marin Sergio , Serra-Prat Mateu , Ortega Omar , Clavé Pere 
Published: December 2018

IntroductionOropharyngeal dysphagia (OD) is a major disorder following stroke. OD can produce alterations in both the efficacy and safety of deglutition and may result in malnutrition, dehydration, frailty, respiratory infections and pneumonia. These complications can be avoided by early detection and treatment of OD in poststroke patients, and hospital stays, medication and mortality rates can be reduced. In addition to acute in-hospital costs from OD complications, there are other costs related to poststroke OD such as direct non-healthcare costs or indirect costs. The objective of this systematic review is to assess and summarise literature on the costs related to OD in poststroke patients.Methods and analysisA systematic review of studies on the cost of OD and its complications (aspiration, malnutrition, dehydration, aspiration pneumonia and death) in patients who had a stroke will be performed from the perspectives of the hospital, the healthcare system and/or the society. The main outcomes of interest are the costs related to poststroke OD. We will search MEDLINE, Embase and the National Health Service Economic Evaluation Database. Studies will be included if they are partial economic evaluation studies, studies that provide information on costs in adult (>17 years) poststroke patients with OD and/or its complications (malnutrition, dehydration, frailty, respiratory infections and pneumonia) or economic evaluation studies in which the cost of this condition has been estimated. Studies will be excluded if they refer to oesophageal dysphagia or OD caused by causes other than stroke. Main study information will be presented and summarised in tables, separately for studies that provide incremental costs attributable to OD or its complications and studies that report the effect of OD or its complications on total costs of stroke, and according to the perspective from which costs were measured.Ethics and disseminationThe results of this systematic review will be published in a peer-reviewed journal.PROSPERO registration numberCRD42018099977.
Rationale and design of a single-blind, randomised controlled trial of exercise training for managing learning and memory impairment in persons with multiple sclerosis
Authors: Sandroff Brian M , Motl Robert W , Bamman Marcus , Cutter Gary R , Bolding Mark , Rinker John R , Wylie Glenn R , Genova Helen , DeLuca John 
Published: December 2018

IntroductionThis randomised controlled trial (RCT) examines treadmill walking exercise training effects on learning and memory performance, hippocampal volume, and hippocampal resting-state functional connectivity in persons with multiple sclerosis (MS) who have objective impairments in learning new information.Methods and analysisForty fully ambulatory persons with MS who demonstrate objective learning and memory impairments will be randomly assigned into either the intervention or active control study conditions. The intervention condition involves supervised, progressive treadmill walking exercise training three times per week for a 3-month period. The active control condition involves supervised, progressive low-intensity resistive exercise that will be delivered at the same frequency as the intervention condition. The primary outcome will involve composite performance on neuropsychological learning and memory tests, and the secondary outcomes involve MRI measures of hippocampal volume and resting-state functional connectivity administered before and after the 3-month study period. Outcomes will be administered by treatment-blinded assessors using alternate test forms to minimise practice effects, and MRI data processing will be performed by blinded data analysts.Ethics and disseminationThis study has been approved by a university institutional review board. The primary results will be disseminated via peer-reviewed publications and the final data will be made available to third parties in applicable data repositories. If successful, the results from this study will eventually inform subsequent RCTs for developing physical rehabilitation interventions (ie, treadmill walking exercise training) for improving learning and memory and its relationship with hippocampal outcomes in larger samples of cognitively impaired persons with MS. The results from this early-phase RCT will further lay preliminary groundwork for ultimately providing clinicians and patients with guidelines for better using chronic treadmill walking exercise for improving cognition and brain health. This approach is paramount as learning and memory impairment is common, burdensome and poorly managed in MS.Trial registration numberNCT03319771; Pre-results.
Study protocol for a randomised controlled trial of humanoid robot-based distraction for venipuncture pain in children
Authors: Ali Samina , Sivakumar Mithra , Beran Tanya , Scott Shannon D , Vandermeer Ben , Curtis Sarah , Jou Hsing , Hartling Lisa 
Published: December 2018

IntroductionIntravenous insertion (IVI) is a very common procedure in the emergency department (ED). IVI is often painful and stressful for both children and their families. Currently, distraction therapy is not used as a standard of care for IVI in North America. We propose that interaction with a humanoid robot may effectively distract children during IVI thereby reducing their pain and distress.Methods and analysisThis randomised controlled superiority trial will be conducted in a Canadian paediatric ED. We plan to recruit 80 patients. Children will be eligible if they (1) are 6 to 11 years of age, (2) need an IVI, (3) are fully conscious and alert, (4) have sufficient knowledge of the English language to understand and complete the study assessments and (5) are accompanied by a legal guardian. Our primary objective is to compare patient-reported pain and distress with the use of distraction (via a humanoid robot) versus standard care in children. The primary outcomes will be (1) self-reported pain, as measured by the Faces Pain Scale—Revised and (2) observed distress, as measured by the Observational Scale of Behavioural Distress—Revised. Secondary outcomes will include (1) measuring parental anxiety, (2) examining the association between parental anxiety and child outcomes and (3) children’s degree of engagement with the humanoid robot via the Intrinsic Motivation Inventory tool. First enrolment occurred in April 2017 and is ongoing.Ethics and disseminationThis study has been approved by the Health Research Ethics Board (University of Alberta). Informed consent to participate will be obtained from all participants’ parents/guardian, in conjunction with assent from the participant themselves. This study data will be submitted for publication regardless of results. Purchase of the robot was facilitated through a Stollery Children’s Hospital Foundation donation. Recruitment costs are supported by the Women and Children’s Health Research Institute.Trial registration numberNCT02997631; Pre-results.
How is the audit of therapy intensity influencing rehabilitation in inpatient stroke units in the UK? An ethnographic study
Authors: Taylor Elizabeth , Jones Fiona , McKevitt Christopher 
Published: December 2018

ObjectivesOccupational therapy, physiotherapy and speech and language therapy are central to rehabilitation after a stroke. The UK has introduced an audited performance target: that 45 min of each therapy should be provided to patients deemed appropriate. We sought to understand how this has influenced delivery of stroke unit therapy.DesignEthnographic study, including observation and interviews. The theoretical framework drew on the work of Lipsky and Power, framing therapists as ‘street level bureaucrats’ in an ‘audit society’.SettingStroke units in three English hospitals.ParticipantsForty-three participants were interviewed, including patients, therapists and other staff.ResultsThere was wide variation in how therapy time was recorded and in decision-making regarding which patients were ‘appropriate for therapy’ or auditable. Therapists interpreted their roles differently in each stroke unit. Therapists doubted the validity of the audit results and did not believe their results reflected the quality of services they provided. Some assumed their audit results would inform commissioning decisions. Senior therapy leaders shaped priorities and practices in each therapy team. Patients were inactive outside therapy sessions. Patients differed regarding the quantity of therapy they felt they needed but consistently wanted to be more involved in decisions and treated as individuals.Conclusions and implicationsStroke unit therapy has different meanings in different hospitals. Measuring therapy time is problematic due to varied interpretations of ‘what counts’ and variation in reporting practices. Although stroke policy, guidelines and audit are potential tools of improvement, their benefits are not automatic. Their actual effects depend largely on the attitudes and values of local influential ‘street level leaders’. More work is needed to promote an integrated whole team approach to rehabilitation. Further research into contextual and human factors, including the roles and views of therapy leaders, would enable a better understanding of implementation of guidelines and service improvement.
Exploring patient safety in Swedish specialised home healthcare: an interview study with multidisciplinary teams and clinical managers
Authors: Lindblad Marléne , Flink Maria , Ekstedt Mirjam 
Published: December 2018

ObjectiveHome healthcare is the fastest growing arena in the healthcare system but patient safety research in this context is limited. The aim was to explore how patient safety in Swedish specialised home healthcare is described and adressed from multidisciplinary teams’ and clinical managers’ perspectives.DesignAn explorative qualitative study.SettingMultidisciplinary teams and clinical managers were recruited from three specialised home healthcare organisations in Sweden.MethodsNine focus group interviews with multidisciplinary teams and six individual interviews with clinical managers were conducted, in total 51 participants. The data were transcribed verbatim and analysed using qualitative content analysis.ResultsPatient safety was inherent in the well-established care ideology which shaped a common mindset between members in the multidisciplinary teams and clinical managers. This patient safety culture was challenged by the emerging complexity in which priority had to be given to standardised guidelines, quality assessments and management of information in maladapted communication systems and demands for required competence and skills. The multiple guidelines and quality assessments that aimed to promote patient safety from a macro-perspective, constrained the freedom, on a meso-level and micro-level, to adapt to challenges based on the care ideology.ConclusionPatient safety in home healthcare is dependent on adaptability at the management level; the team members’ ability to adapt to the varying conditions and on patients being capable of adjusting their homes and behaviours to reduce safety risks. A strong culture related to a patient’s value as a person where patients’ and families’ active participation and preferences guide the decisions, could be both a facilitator and a barrier to patient safety, depending on which value is given highest priority.
Reasons to stop drinking alcohol among patients with rheumatoid arthritis in Sweden: a mixed-methods study
Authors: Larsson Ingrid , Andersson Maria L E 
Published: December 2018

ObjectivesThe aims were to identify patients with rheumatoid arthritis (RA) who had stopped drinking alcohol and compare them with patients drinking alcohol, and to explore reasons for stopping drinking alcohol.DesignA sequential explanatory mixed methods design was used.SettingSix rheumatology clinics in Southern Sweden Better Anti-Rheumatic FarmacOTherapy cohort.ParticipantsA total of 1509 patients completed the questions about alcohol and were included in the study. 86 of these had stopped drinking alcohol and 72 responded to the open question and their answers were analysed with qualitative content analysis.Outcome measuresThe quantitative data were from a cross-sectional survey assessing disease severity, physical function (Health Assessment Questionnaire, HAQ) and health-related quality of life (EuroQol five dimensions, EQ5D), pain, fatigue, patient global assessment (PatGA) and lifestyle factors, for example, alcohol. The questions assessing alcohol included an open question ‘Why have you stopped drinking alcohol?’ResultsThe patients who stopped drinking alcohol were older (median (min-max) 69 (36–90) vs 66 (23–95), p=0.011), had worse HAQ (1.00 (0–2.75) vs 0.50 (0–3.00), p<0.001), worse EQ5D (0.69 (−0.02–1.00) vs 0.76 (−0.58–1.00), p<0.001) worse PatGA (5 (0–10) vs 3 (0–10), p<0.001), more pain (5 (0–10) vs 3 (0–10), p<0.001) and more fatigue (6 (0–10) vs 4 (0–10), p<0.001 compared with patients drinking alcohol. The qualitative content analysis revealed five categories describing reasons for patients with RA to stop drinking alcohol: illness and treatment; health and well-being; work and family; faith and belief; and dependences and abuse.ConclusionsThe patients who had stopped drinking had worse physical functioning and higher levels in pain-related variables. Most stopped drinking due to their illness or a desire to improve health.
Behaviour change interventions for the management of Raynaud’s phenomenon: a systematic literature review
Authors: Daniels Jo , Pauling John D , Eccleston Christopher 
Published: December 2018

ObjectivesRaynaud’s phenomenon (RP) is a significant cause of morbidity. Vasodilator medications cause unwanted adverse effects, with behavioural and lifestyle changes forming the mainstay of self-management; this is difficult to implement successfully. The objectives of this study were to evaluate the efficacy of behaviour change interventions for RP and identify learning points for future treatment development.DesignSystematic literature review and narrative synthesis of findings.Data sourcesEMBASE, MEDLINE, Cochrane and PsycINFO were searched for eligible studies on 22 August 2017.Eligibility criteriaRandomised controlled trials (RCTs) of behaviour change interventions with at least one control comparator arm.Data extraction and synthesisStudy selection, data extraction and risk of bias were assessed independently by two reviewers, reaching consensus with a third when necessary. Primary outcomes of interest included severity/impact, frequency and duration of RP episodes, pain, disability, adverse events and study withdrawal.ResultsOf 638 articles retrieved, eight studies fulfilled criteria for inclusion. Biofeedback was the active behaviour change treatment arm for seven studies, with one study reporting a behavioural intervention. Studies were published 1978–2002; six were USA-based studies, one German and one Swedish. Using Cochrane Risk of Bias assessment, studies were assessed to be overall at high risk of bias, with the exception of one large RCT. The total sample included 495 participants (study median=29), with a median age of 39.5 years and preponderance towards females (73%). Five studies reported significant effects in primary outcomes of interest; however, due to missing data, relative efficacy of interventions could not be reliably assessed.ConclusionsThere is no evidence to support or refute claims of the efficacy of behaviour change interventions for the management of RP. There remains a strong case for developing and testing behaviour change interventions that focus on self-management; however, theoretical development and advancement in trial quality is imperative to underpin future work.PROSPERO registration numberCRD42017049643.