bluuebunny/crossref_metadata_2025_split huggingface dataset:
A model for the provision of integrated perinatal and infant mental health services in regional settings
Authors: Lee Vivian Wing Woon , Newman Louise Kathryn 
Published: July 2018

Objective: This paper aims to describe current approaches in Victoria to the development of perinatal and infant mental health services in regional areas. Method: The paper outlines the significance of perinatal mental disorder for maternal wellbeing and impact on infant development, and describes the model of care at the Agnes Unit. Results: The Agnes Unit has been established as a residential therapeutic unit offering short-term treatment that focusses on promoting parental mental health, parenting sensitivity and the parent-infant relationship. Conclusions: A coordinated and integrated approach with focus on early intervention is needed to deliver perinatal and infant mental health services. Services need to focus on the infant and parent-infant relationship in addition to parental mental health.
“It’s very humbling”: The Effect Experienced by Those Who Facilitate a Legacy Project Session Within Palliative Care
Authors: Collins Andrew 
Published: July 2018

Objectives: The creative arts can be utilized within palliative care to facilitate the creation of a legacy project, an object which will reflect the unique experiences and interests of the creator. This can be bestowed to a loved one, thereby providing an opportunity to leave something tangible behind. However, there is a paucity of evidence exploring the impact experienced by those who facilitate the legacy generation session. Methods: “From The HEart” is a volunteer operated program that offers creative arts based legacy projects to palliative care patients. Five volunteers were interviewed to understand their personal experiences. Emphasis was placed on any perceived positive or negative impact from this work, and if a self-care program would be required. Interviews were transcribed verbatim into a textual document which was coded by the principal investigator using inductive content analysis to derive overarching themes. Results: Five themes emerged from the data: “providing a benefit”, “internal validation”, “it's all been positive”, “self-awareness”, and “if you need support”. All facilitators reported positive experiences, which provided internal validation or confirmation that this work was personally significant to this group. Self-care practises emerged as important, but group activities would only be warranted if requirements couldn't be meet through individual self-care practises. Significance of Results: This study provides confirmation that facilitators do not report any negative experiences while assisting a palliative care client in creating a legacy project. These activities can provide meaning while working in the field of palliative care.
Determining optimal poststroke exercise: Study protocol for a randomized controlled trial investigating therapeutic intensity and dose on functional recovery during stroke inpatient rehabilitation
Authors: Klassen Tara D , Dukelow Sean P , Bayley Mark T , Benavente Oscar , Hill Michael D , Krassioukov Andrei , Liu-Ambrose Teresa , Pooyania Sepideh , Poulin Marc J , Yao Jennifer , Eng Janice J 
Published: July 2018

Rationale A top priority in stroke rehabilitation research is determining the appropriate exercise dose to optimize recovery. Although more intensive rehabilitation very early after stroke may be deleterious to recovery, inpatient rehabilitation, occurring after acute care, may be a more appropriate setting to assess therapeutic dose on neurological recovery. Hypothesis Individuals receiving higher intensity and dose exercise programs will yield greater improvements in walking ability over usual inpatient physical therapy care. Methods and design Seventy-five individuals across seven inpatient rehabilitation sites in Canada will be randomized into one of three treatment programs, each 5 days/week, for four weeks and monitored for exertion (heart rate) and repetitions (step count). Study outcomes The primary outcome measure is the 6 min walk and secondary outcomes include functional independence, cognitive, and quality-of-life measures. Outcome data will be assessed at four time points. Summary This trial will contribute to our knowledge of the therapeutic intensity and dose necessary to maximize functional recovery at a very important stage of rehabilitation and neural recovery poststroke.
Management of occult obscure gastrointestinal bleeding patients based on long-term outcomes
Authors: Kunihara Sayoko , Oka Shiro , Tanaka Shinji , Tsuboi Akiyoshi , Otani Ichiro , Chayama Kazuaki 
Published: July 2018

Background: There is no consensus regarding the management of occult obscure gastrointestinal bleeding (OGIB) patients without a confirmed bleeding source. This study aimed to consider the management of occult OGIB patients based on their long-term outcomes. Methods: We retrospectively enrolled 357 consecutive occult OGIB patients (203 men; mean age: 59.7 years) who underwent capsule endoscopy (CE) at Hiroshima University Hospital, Japan and were followed up for more than 12 months (mean follow-up period; 50.2 months). Patients were divided into three groups as follows: Group A consisted of 98 of 157 patients who had positive findings and indication for treatment, Group B consisted of 59 of 157 patients who had positive findings but no indication for treatment, and Group C consisted of 200 patients who had negative small-bowel findings. We examined the rate of positive CE findings, detection rate and details of bleeding sources, overt bleeding rate, the rate of anemia exacerbation, 5-year anemia exacerbation rate, and overall survival rate. Results: The positive CE findings rate was 44% (157/357) and detection rate of bleeding source was 27% (98/357). The details of Group A were as follows: angioectasia ( n = 61), nonspecific ulceration ( n = 10), nonsteroidal anti-inflammatory drug-induced ulcer ( n = 8), and others ( n = 19). The details of Group B were as follows: erythema ( n = 31), angioectasia ( n = 25), and others ( n = 3). There were no patients with overt bleeding in Group B. Although six patients had anemia exacerbation in Group B, they had angioectasia without a bleeding source. Conclusion: The long-term outcomes of occult OGIB patients were good. Occult OGIB patients without bleeding source lesions may not require follow-up CE.
Engagement features judged by excessive drinkers as most important to include in smartphone applications for alcohol reduction: A mixed-methods study
Authors: Perski Olga , Baretta Dario , Blandford Ann , West Robert , Michie Susan 
Published: July 2018

Objective Engagement with smartphone applications (apps) for alcohol reduction is necessary for their effectiveness. This study explored (1) the features that are ranked as most important for engagement by excessive drinkers and (2) why particular features are judged to be more important for engagement than others. Methods Two studies were conducted in parallel. The first was a focus group study with adult excessive drinkers, interested in reducing alcohol consumption using an app ( ngroups = 3). Participants individually ranked their top 10 features from a pre-specified list and subsequently discussed their rankings. The second was an online study with a new sample ( n = 132). Rankings were analysed using the intraclass correlation coefficient (ICC) to assess the level of agreement between raters for each study. Qualitative data were analysed using inductive thematic analysis. Results There was low agreement between participants in their rankings, both in the focus groups (ICC = 0.15, 95% confidence interval (CI) = 0.03–0.38) and the online sample (ICC = 0.11, 95% CI = 0.06–0.23). ‘Personalisation’, ‘control features’ and ‘interactive features’ were most highly ranked in the focus groups. These were expected to elicit a sense of benefit and usefulness, adaptability, provide motivational support or spark users’ interest. Results from the online study partly corroborated these findings. Conclusion There was little agreement between participants, but on average, the features judged to be most important for inclusion in smartphone apps for alcohol reduction were personalisation, interactive features and control features. Tailoring on users’ underlying psychological needs may promote engagement with alcohol reduction apps.
Effect of Anterior Glenoid Labral Tears and Glenoid Bone Loss at the NFL Combine on Future NFL Performance
Authors: Murphy Colin P. , Frangiamore Salvatore J. , Mannava Sandeep , Sanchez Anthony , Beiter Evan R. , Whalen James M. , Price Mark D. , LaPrade Robert F. , Provencher Matthew T. 
Published: July 2018

Background: Anterior glenohumeral instability is a common abnormality in the young, athletic population, especially in those participating in contact or collision sports. Purpose: To examine the effect of anterior labral tears, their associated injuries, and their management on future National Football League (NFL) performance. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review of all NFL Combine participants from 2009 to 2015 was performed using medical and imaging reports compiled at the NFL Combine. These notes and images were reviewed and analyzed for involved structures, associated injuries, and evidence of previous surgical interventions. The respective NFL draft position, number of NFL games played, number of NFL games started, and NFL snap percentage for each player’s first 2 seasons were collected and compared with a control group and within subgroups. Results: Of the 2285 players at the NFL Combine between 2009 and 2015, there were 206 (9%) anterior labral tears confirmed by magnetic resonance imaging, 20 of which were bilateral, for a total of 226 affected shoulders. There were 908 players who fit the criteria for inclusion in the control group. Overall, there were no significant differences between players with anterior labral tears and the control players in terms of draft position ( P = .259), games played in their first 2 NFL seasons ( P = .391), games started in their first 2 NFL seasons ( P = .486), or snap percentage in their first ( P = .268) and second ( P = .757) NFL seasons. In general, sustaining a concomitant injury with an anterior labral tear (superior labrum from anterior to posterior [SLAP] tear, glenoid bone loss, Hill-Sachs lesion, rotator cuff tear, humeral avulsion of the glenohumeral ligament, and anterior tear combined with posterior tear) negatively affected a player’s NFL draft position when compared with those with an isolated anterior labral tear ( P = .003). There was no significant difference between operative and nonoperative management for anterior labral tears in terms of any performance metric. Conclusion: A history of anterior labral tears was not significantly associated with future NFL performance. While players with isolated injuries were drafted significantly earlier than those with concomitant injuries, combined injuries did not affect players’ games played, games started, or snap percentage in their first 2 NFL seasons. Glenoid bone loss did significantly decrease draft position; however, the severity of bone loss did not affect draft position, and there were no significant associations between glenoid bone loss and games played, games started, or snap percentage.
Supporting Caregivers in Pregnancy: A Qualitative Study of Their Activities and Roles
Authors: Anders Shilo , Aaron Hannah , Jackson Gretchen Purcell , Novak Laurie L 
Published: July 2018

Background: The significant role of lay caregivers has been explored in chronic and acute illnesses. In pregnancy, caregivers’ (eg, the baby’s father, friends, and family) roles in promoting the health of the mother and baby are not well understood. Objective: We characterize the activities and roles of pregnancy caregivers and offer opportunities for engaging this important group. Method: We conducted interviews with 29 pregnancy caregivers. Interview transcripts were analyzed inductively, resulting in a coding scheme of actions and roles that pregnancy caregivers perform. Results: The most common actions and roles included searching for information (97%), accompanying patients to medical appointments (69%), and being a source of emotional support (76%). Identified actions and roles fit a patient work framework, including work types identified by Corbin and Strauss: illness, everyday life, biographical, articulation, and invisible. Conclusion: The patient work framework can be employed to describe the activities and roles of pregnancy caregivers. We have contributed new insights into the experiences of pregnancy caregivers and recommendations for educational and technological interventions.
Femininity and female sexual desires in “The Lang Women”: an analysis using Halliday’s theory on transitivity
Authors: Nguyen Thu Hanh 
Published: July 2018

AbstractsThis article deals with the linguistic representation of and the relationship between femininity and female desires and needs in Masters’ short story “The Lang Women”. Based on Halliday’s theory of systemic functional linguistics, particularly Transitivity, this story is examined for what it can tell us about how Masters represents and explores female desires and needs in her work. In particular the article focuses on Carrie’s consideration of her own physical attributes. The article also discusses Masters’ view of the relationship between femininity and female sexual desires and how Masters’ work can be read as a common on debates about female sexuality and its depiction current at the time of her writing. The article then claims that through female sexuality women can expand their self, agency and social status.
Long-Term Links between Physical Activity and Sleep Quality
Authors: SEMPLONIUS THALIA , WILLOUGHBY TEENA 
Published: July 2018

ABSTRACT

Purpose
Findings from cross-sectional research indicate that the relationship between sleep quality and physical activity is mixed. For research that does indicate a significant association, the interpretation of the finding most often is that physical activity leads to better sleep, or less frequently, that better sleep leads to more involvement in physical activity (see sleep deprivation studies). Cross-sectional studies, however, are not able to assess the direction of these effects, and experimental studies have tested only one direction of the effects. Longitudinal studies, with their focus on temporal order, are needed to specifically examine the link between sleep and physical activity as well as the direction of effects. The current study had three goals: to examine 1) the longitudinal relationship between sleep and physical activity, 2) the direction of effects, and 3) whether emotion regulation mediates the relationship between sleep and physical activity.

Methods
Participants included a sample of 827 (M
age at baseline = 19.04 yr, SD = 0.92 yr, 73.88% female) students at a university in Southwestern Ontario, who took part in a larger longitudinal survey that started in their first year of university. Participants were surveyed annually for 3 yr (2011, 2012, 2013; retention, 83.9%). Measures assessed sleep quality, physical activity, emotion regulation, and involvement in sports clubs.

Results
A cross-lagged autoregressive path analysis revealed that sleep quality indirectly predicted increased high-, moderate-, and low-intensity physical activity over time through its positive effect on emotion regulation. Moderate levels of physical activity indirectly predicted sleep quality over time through emotion regulation.

Conclusions
Overall, there appears to be support for a bidirectional relationship between sleep and physical activity over time (at least for moderate physical activity) but only indirectly through emotion regulation.
Association of Sickle Cell Trait and Hemoglobin S Percentage with Physical Fitness
Authors: WEBBER BRYANT J. , UPTEGRAFT COLBY C. , NYE NATHANIEL S. , O’Connor Francis G. 
Published: July 2018

ABSTRACT

Purpose
This study aimed to determine the association between sickle cell trait (SCT) as a binary variable and hemoglobin S percentage as a stratified categorical variable with aerobic and anaerobic fitness.

Methods
This retrospective cohort study included all recruits who entered US Air Force Basic Training between January 2009 and December 2014. Fitness parameters among recruits with and without SCT were compared using a standardized fitness assessment of a 1.5-mile timed run, 1 min of push-ups, and 1 min of sit-ups. Performance was further compared by stratifying those with SCT by their hemoglobin S percentage (20%–29.99%, 30%–39.99%, and ≥40%).

Results
Of all recruits (N = 210,461) who entered training during the surveillance period, 2161 (1.0%) had SCT. After adjusting for age, sex, race, body mass index, and ambient temperature while conducting the fitness assessment, recruits with SCT were slower on their initial run than their peers without SCT by a mean (standard error) of 9.4 s (2.6 s) (P < 0.001) and completed 0.5 (0.3) fewer push-ups (P < 0.05); sit-up completion was statistically equivalent between the two groups. When retested 6 wk later, recruits with SCT improved their run time by a margin of 4.3 s (2.1 s) over their counterparts without SCT (P < 0.05). Baseline physical fitness was largely consistent across strata of hemoglobin S percentages; increased percentages were modestly correlated with faster run times (R
2 = 0.374) and fewer push-ups (R
2 = 0.339).

Conclusions
As compared with their peers, recruits with SCT had slightly inferior aerobic fitness and similar anaerobic fitness at the outset of basic training, and gaps further narrowed over 6 wk of training. Stratifying recruits by their hemoglobin S percentage did not dramatically change the strength or direction of association.
Influence of Vitamin D Supplementation by Sunlight or Oral D3 on Exercise Performance
Authors: CARSWELL ALEXANDER T. , OLIVER SAMUEL J. , WENTZ LAUREL M. , KASHI DANIEL S. , ROBERTS ROSS , TANG JONATHAN C. Y. , IZARD RACHEL M. , JACKSON SARAH , ALLAN DONALD , RHODES LESLEY E. , FRASER WILLIAM D. , GREEVES JULIE P. , WALSH NEIL P. 
Published: July 2018

ABSTRACT

Purpose
To determine the relationship between vitamin D status and exercise performance in a large, prospective cohort study of young men and women across seasons (study 1). Then, in a randomized, placebo-controlled trial, to investigate the effects on exercise performance of achieving vitamin D sufficiency (serum 25(OH)D ≥ 50 nmol·L−1) by a unique comparison of safe, simulated-sunlight and oral vitamin D3 supplementation in wintertime (study 2).

Methods
In study 1, we determined 25(OH)D relationship with exercise performance in 967 military recruits. In study 2, 137 men received either placebo, simulated sunlight (1.3× standard erythemal dose in T-shirt and shorts, three times per week for 4 wk and then once per week for 8 wk) or oral vitamin D3 (1000 IU·d−1 for 4 wk and then 400 IU·d−1 for 8 wk). We measured serum 25(OH)D by high-pressure liquid chromatography tandem mass spectrometry and endurance, strength and power by 1.5-mile run, maximum dynamic lift and vertical jump, respectively.

Results
In study 1, only 9% of men and 36% of women were vitamin D sufficient during wintertime. After controlling for body composition, smoking, and season, 25(OH)D was positively associated with endurance performance (P ≤ 0.01, ΔR
2 = 0.03–0.06, small f2
effect sizes): 1.5-mile run time was ~half a second faster for every 1 nmol·L−1 increase in 25(OH)D. No significant effects on strength or power emerged (P > 0.05). In study 2, safe simulated sunlight and oral vitamin D3 supplementation were similarly effective in achieving vitamin D sufficiency in almost all (97%); however, this did not improve exercise performance (P > 0.05).

Conclusions
Vitamin D status was associated with endurance performance but not strength or power in a prospective cohort study. Achieving vitamin D sufficiency via safe, simulated summer sunlight, or oral vitamin D3 supplementation did not improve exercise performance in a randomized-controlled trial.
Shaping the Future of Research: A perspective from early career researchers in Vancouver, Canada
Authors: Clark Peter G.K. , McCoy James M. , Chik Jenny H.L. , HajiHosseini Azadeh , Lasalle Manuel , Kent Brianne A. , Vogt Stefanie L. 
Published: July 2018

Future of Research is an organization dedicated to championing, engaging, and empowering early career researchers (ECRs). The organization was founded in 2014 and has since inspired other groups to advocate for a more equitable and sustainable research enterprise. Here we report the findings of the Future of Research Vancouver Symposium. The goals of the Vancouver symposium were to ascertain the perspective of ECRs in Canada and to outline pathways to a sustainable future for Canadian research. The symposium had two sessions. The first session was a series of talks that were intended to prepare attendees with an informed understanding of several perspectives in the science enterprise, with a particular focus on the Canadian system. The second session was a series of interactive workshops to identify the greatest challenges facing ECRs in Canada and to propose solutions. The results of the workshops illuminated three main themes for the challenges facing Canadian ECRs: funding, mentorship, and the divide between academia and other sectors. These themes are similar to those discussed at the Future of Research symposiums in the United States, emphasizing that these issues are not isolated to Canada; however, Canadian policies are trailing behind the progress being made in other countries.
Circulating Proenkephalin, Acute Kidney Injury, and Its Improvement in Patients with Severe Sepsis or Shock
Authors: Caironi Pietro , Latini Roberto , Struck Joachim , Hartmann Oliver , Bergmann Andreas , Bellato Valentina , Ferraris Sandra , Tognoni Gianni , Pesenti Antonio , Gattinoni Luciano , Masson Serge 
Published: July 2018

Abstract

BACKGROUND
Acute kidney injury (AKI) occurs in many critically ill patients and is associated with high mortality. We examined whether proenkephalin could predict incident AKI and its improvement in septic patients.

METHODS
Plasma proenkephalin A 119–159 (penKid) was assayed in 956 patients with sepsis or septic shock enrolled in the multicenter Albumin Italian Outcome Sepsis (ALBIOS) trial to test its association with incident AKI, improvement of renal function, need for renal replacement therapy (RRT), and mortality.

RESULTS
Median [Q1–Q3] plasma penKid concentration on day 1 [84 (20–159) pmol/L[ was correlated with serum creatinine concentration (r = 0.74); it was higher in patients with chronic renal failure and rose progressively with the renal Sequential Organ Failure Assessment subscore. It predicted incident AKI within 48 h (adjusted odds ratio, 3.3; 95% CI, 2.1–5.1; P &lt; 0.0001) or 1 week [adjusted hazard ratio, 2.1 (1.7–2.8); P &lt; 0.0001] and future RRT during the intensive care unit stay [odds ratio, 4.0 (3.0–5.4)]. PenKid was also associated with improvements in renal function in patients with baseline serum creatinine &gt;2 mg/dL, both within the next 48 h [adjusted odds ratio, 0.31 (0.18–0.54), P &lt; 0.0001] and 1 week [0.23 (0.12–0.45)]. The time course of penKid concentrations predicted AKI and 90-day mortality.

CONCLUSIONS
Early measurement and the trajectory of penKid predict incident AKI, improvement of renal function, and the need for RRT in the acute phase after intensive care unit admission during sepsis or septic shock. PenKid measurement may be a valuable tool to test early therapies aimed at preventing the risk of AKI in sepsis.