bluuebunny/crossref_metadata_2025_split huggingface dataset:
Individual-level characteristics associated with oral HIV test acceptability among Peruvian men who have sex with men and transgender women: a cross-sectional study
Authors: Flores Juan A , Brown Brandon , León Segundo R , Sánchez Hugo , Galea Jerome T 
Published: March 2018

ObjectivesPeruvian men who have sex with men (MSM) and transgender women (TGW) are highly vulnerable to HIV infection (HIV), but stigma, access issues and fear of venipuncture hamper testing. The oral HIV test—which uses oral fluids and provides results in 20 minutes—could reduce these barriers. The objective of this study was to determine the acceptability of the oral HIV test and the individual-level factors associated with its acceptability among MSM and TGW.MethodsWe conducted a cross-sectional secondary analysis among Peruvian MSM and TGW attending a community-based health centre between February 2012 and February 2013 to determine the individual-level factors associated with oral HIV test acceptability.ResultsOf 334 participants, 88% were MSM and 12% TGW. Overall, 85% of participants indicated their acceptability of the oral HIV test. Acceptability was higher in MSM than TGW (85.7% vs 80.0%) but this difference was not significant. Factors associated with acceptability in MSM were: tertiary or higher education (prevalence ratio (PR)=1.18, 95% CI 1.06 to 1.32 and PR=1.16, 95% CI 1.03 to 1.30, respectively); sex with drug use (PR=1.19, 95% CI 1.05 to 1.36); believing that HIV is transmitted by saliva (PR=1.20, 95% CI 1.08 to 1.33); and potential use of the oral test at home (PR=1.56, 95% CI 1.32 to 1.85). The only factor associated with lower acceptability was having had first anal intercourse between 14 and 19 years of age (PR=0.89, 95% CI 0.80 to 0.98).ConclusionsWe identified the individual factors associated with oral HIV test acceptability among Peruvian MSM and TGW. Expanded use of the oral HIV test to increase testing rates among Peruvian MSM and TGW is recommended.Trial registration numberNCT01387412, post-results.
Weekly variations in feelings of trust predict incident STI within a prospective cohort of adolescent women from a US city
Authors: Matson Pamela A , Fortenberry J Dennis , Chung Shang-en , Gaydos Charlotte A , Ellen Jonathan M 
Published: March 2018

ObjectivesFeelings of intimacy, perceptions of partner concurrency (PPC) and perceptions of risk for an STD (PRSTD) are meaningful and dynamic attributes of adolescent sexual relationships. Our objective was to examine whether variations in these STI-associated feelings and perceptions predicted incident Chlamydia trachomatis and/or Neisseriagonorrhoeae infection within a prospective cohort of urban adolescent women.MethodsA cohort of clinic-recruited women aged 16–19 completed daily surveys on feelings and risk perceptions about each current sex partner on a smartphone continuously for up to 18 months. Urine was tested for C. trachomatis and N. gonorrhoeae every 3 months. Daily responses were averaged across the week. As overall means for trust, closeness and commitment were high, data were coded to indicate any decrease in feelings from the previous week. PRSTD and PPC were reverse coded to indicate any increase from the previous week. An index was created to examine the cumulative effect of variation in these feelings and perceptions. Generalised linear models were used to account for correlation among repeated measures within relationships.ResultsFor each week that there was a decrease in trust, there was a 45% increase in the risk of being infected with an STI at follow-up (relative risk (RR) 1.45, 95% CI 1.18 to 1.78, P=0.004). Neither a decrease in closeness or commitment, nor an increase in PRSTD or PPC was associated with an STI outcome. Cumulatively, the index measure indicated that a change in an additional feeling or perception over the week increased the odds of an STI by 14% (RR 1.14, 95% CI 1.02 to 1.29, P=0.026).ConclusionsA decrease in feelings of trust towards a main partner may be a more sensitive indicator of STI risk than PRSTD, PPC or commitment. The next generation of behavioural interventions for youth will need strategies to address feelings of intimacy within adolescent romantic relationships.
Remote Limb Ischemic Preconditioning Attenuates Cerebrovascular Depression During Sinusoidal Galvanic Vestibular Stimulation via α
1
‐Adrenoceptor–Protein Kinase Cε–Endothelial NO Synthase Pathway in Rats
Authors: McBride Devin W. , Reis Cesar , Zhang John H. , Applegate Richard , Tang Jiping 
Published: March 2018

Background

Vasovagal syncope (
VVS
) is characterized by hypotension and bradycardia followed by lowering of cerebral blood flow. Remote limb ischemic preconditioning (
RIPC
) is well documented to provide cardio‐ and neuroprotection as well as to improve cerebral blood flow. We hypothesized that
RIPC
will provide protection against
VVS
‐induced hypotension, bradycardia, and cerebral hypoperfusion. Second, because endothelial nitric oxide synthase has been reported as a mediator of cerebral blood flow control, we hypothesized that the mechanism by which
RIPC
primes the vasculature against
VVS
is via the α
1
‐adrenoceptor–protein kinase Cε–endothelial nitric oxide synthase pathway.

Methods and Results

We utilized sinusoidal galvanic vestibular stimulation in rats as a model of
VVS
.
RIPC
attenuated the lowerings of mean arterial pressure, heart rate, and cerebral blood flow caused by sinusoidal galvanic vestibular stimulation, as well as improving behavior during, and recovery after, stimulation.
RIPC
induced elevated serum norepinephrine, increased expression of brain α
1
‐adrenoceptors, and reduced brain expression of norepinephrine transporter 1. Antagonizing adrenoceptors and norepinephrine transporter 1 prevented
RIPC
protection of cerebral perfusion during sinusoidal galvanic vestibular stimulation.

Conclusions

Taken together, this study indicates that
RIPC
may be a potential therapy that can prevent
VVS
pathophysiology, decrease syncopal episodes, and reduce the injuries associated with syncopal falls. Furthermore, the α
1
‐adrenoceptor–protein kinase Cε–endothelial nitric oxide synthase pathway may be a therapeutic target for regulating changes in cerebral blood flow.
Coffee Consumption and Coronary Artery Calcium Score: Cross‐Sectional Results of ELSA‐Brasil (Brazilian Longitudinal Study of Adult Health)
Authors: Miranda Andreia M. , Steluti Josiane , Goulart Alessandra C. , Benseñor Isabela M. , Lotufo Paulo A. , Marchioni Dirce M. 
Published: March 2018

Background

Available evidence for the relationship between coffee intake and subclinical atherosclerosis is limited and inconsistent. This study aimed to evaluate the association between coffee consumption and coronary artery calcium (
CAC
) in
ELSA
‐Brasil (Brazilian Longitudinal Study of Adult Health).

Methods and Results

This cross‐sectional study is based on baseline data from participants of the
ELSA
‐Brasil cohort. Only participants living in São Paulo, Brazil, who underwent a
CAC
measurement (n=4426) were included. Coffee consumption was collected using a food frequency questionnaire.
CAC
was detected with computed tomography and expressed as Agatston units.
CAC
was further categorized as an Agatson score ≥100 (CAC ≥100). In multiple logistic regression analysis considering intake of coffee and smoking status interaction, significant inverse associations were observed between coffee consumption (>3 cups/d) and
CAC
≥100 (odds ratio [OR]: 0.85 [95% confidence interval, 0.58–1.24] for ≤1 cup/d;
OR
: 0.73 [95% confidence interval, 0.51–1.05] for 1–3 cups/d;
OR
: 0.33 [95% confidence interval, 0.17–0.65] for >3 cups/d). Moreover, there was a statistically significant interaction effect for coffee consumption and smoking status (
P
=0.028 for interaction). After stratification by smoking status, the analysis revealed a lower
OR
of coronary calcification in never smokers drinking >3 cups/d (
OR
: 0.37 [95% confidence interval, 0.15–0.91]), whereas among current and former smokers, the intake of coffee was not significantly associated with coronary calcification.

Conclusions
Habitual consumption of >3 cups/d of coffee decreased odds of subclinical atherosclerosis among never smokers. The consumption of coffee could exert a potential beneficial effect against coronary calcification, particularly in nonsmokers.
Police‐Recorded Crime and Disparities in Obesity and Blood Pressure Status in Chicago
Authors: Tung Elizabeth L. , Wroblewski Kristen E. , Boyd Kelly , Makelarski Jennifer A. , Peek Monica E. , Lindau Stacy Tessler 
Published: March 2018

Background
The purpose of this study was to examine associations between several types of police‐recorded crime (violent, nonviolent, and homicide) and cardiometabolic health (obesity and elevated blood pressure [BP]), and to determine if associations were modified by age and sex.

Methods and Results
We analyzed cross‐sectional data (N=14 799 patients) from 3 primary care clinics at an academic medical center in Chicago, IL. Patient‐level health data were obtained from the electronic health record (June 1, 2014–May 31, 2015), including body mass index and BP, and linked to the City of Chicago Police Data Portal. Geocoded crime counts were aggregated to census tract and calculated as the annual crime rate per 1000 population. Generalized linear mixed models were used to assess obesity and BP status as a function of crime rate quartile, controlling for patient, clinic, and neighborhood characteristics. Median violent crime rates in each quartile ranged from 15 to 84 per 1000 population. Median age was 56 years (interquartile range, 38–72 years); 42% of patients were obese and 33% had elevated BP. Compared with patients living in the lowest quartile, patients living in the highest quartile for violent crime had 53% higher adjusted odds of obesity (95% confidence interval, 1.15–2.03) and 25% higher adjusted odds of elevated BP (95% confidence interval, 1.01–1.56). In subanalyses examining homicide, a relatively rare event, exposure was not associated with obesity and was inconsistently associated with elevated BP.

Conclusions
In a densely populated, high‐poverty region in Chicago, recurrent exposure to high rates of violent crime was consistently associated with obesity and elevated BP, but rare exposure to homicide was not.
Gayby Baby – From the politics of representation to the politics of care
Authors: Skattebol Jennifer , Newell Maya 
Published: March 2018

Background: Real life stories can enable audiences to empathise with the experiences of marginalised groups and communities and are extremely powerful tools in struggles for equality. High-quality documentary research can convey the life experiences of marginalised peoples in ways that are recognisable to them and which further their struggle for equality. Often, marginalised people are represented by ‘filmmakers’ eager to capitalise on the affect produced by detailed renditions of everyday political struggles. However, film-makers are rarely trained in how to empower participants to understand film-making and distribution processes. These understandings and dialogic processes are important if participants are to have a real say in how they are represented. Process: In 2011, Maya Newell and Charlotte Mars began to develop an observational feature documentary Gayby Baby (2015) focused on same-sex families, for the first time revealing the child’s perspective on debates concerning Lesbian, Gay, Bisexual, Trans, Intersex, Queer and their children’s equality. They were interested in empowering participants to have a real say in the film. Jen Skattebol’s family was one of the four families featured in the film. This shared activist experience grounds the authors’ discussion of ethical care in representative practices. Discussion: Recently, documentary film-making and academic research has seen the emergence of a new value system that measures success in terms of ‘impact’ in the public sphere. This developing interest amplifies the ethical issues involved in representational work and raises new questions concerning the implications of subject participation in the development of resources that aim to improve health and well-being in broad political terms. This article sketches out the contours of a more ethical form of social impact making that grew out of kitchen table conversations between documentary subject and maker – the researched and researcher. Ethical frameworks of care need to be recalibrated in line with the issues foregrounded by burgeoning social impact agendas.
Perceived self-efficacy in B-cell non-Hodgkin lymphomas: Qualitative outcomes in patient-directed education
Authors: Howson Alexandra , Turell Wendy , Roc Anne 
Published: March 2018

Objective: Perceived self-efficacy (PSE) is considered a foundation for effective self-care in the context of chronic disease and illness. In order to improve patient and caregiver knowledge about self-care in B-cell non-Hodgkin’s lymphoma (NHL), we designed and delivered an online, patient-focused education activity. Educational impact on PSE was evaluated using a mixed quantitative/qualitative methodology. We report here on the qualitative characteristics of self-efficacy. Methods: We interviewed participants using open-ended questions based on a semi-structured interview guide. Interviews were audio-recorded and transcribed verbatim, and analysed using constant comparative method with software support (NVivo for Mac 11, QSR International). Results: In all, 12 people diagnosed with B-cell NHL were interviewed. Descriptive analysis showed that participants were able to summarise key education messages about B-cell NHL presented in the programme. Key themes linked to self-care knowledge and practice included normalisation of self-care, learning the hard way, everyone is different and being prepared. Participants described four key strategies linked to the notion of ‘being prepared’: (1) asking questions, (2) building relationships with oncologists, (3) developing/maintaining a philosophy of life, and (4) connecting with others. These themes provide context for the experience of PSE and may also reflect beliefs that have implications for self-efficacy education. Conclusions: Interview data affirm PSE as a foundation of self-care and identify beliefs underpinning PSE. A dominant belief of ‘being prepared’ was sustained by four strategies that education content reinforced. Educators can use these insights to strengthen self-efficacy education interventions for patients with B-cell NHL and other types of cancer.
Explaining variation in perceived managerial autonomy and direct politicization in European public sectors
Authors: Van de Walle Steven 
Published: March 2018

Public sector reforms aimed at ‘making the managers manage’ granted public managers autonomy and tried to depoliticize the administration. There is substantial variation in the degree of direct politicization and in managerial autonomy. This article tests four sets of hypotheses to explain variation in perceptions of direct politicization and managerial autonomy in European public sectors. Data from a new survey in 15 countries among several thousand top public sector managers in central government are used. Findings show that variation in perceived direct politicization and managerial autonomy is partially determined by the formal status of an organization as an agency, and the hierarchical position of the manager within the organization. Managers from very large organizations also experience more autonomy, but organization size has no impact on perceived politicization. The policy field within which the respondent’s organization is situated has mixed effects. The article also finds that the models are better at explaining the variation in perceived managerial autonomy than that in direct politicization. Points for practitioners The article shows that top public managers in European central administration perceive different levels in the extent to which politicians try to influence senior-level appointments, as well as in the extent of management autonomy that they have. These differences in perception are mainly explained by whether or not they work in an agency, as well as by the hierarchical position that they occupy within the organization.
A Diabetes Mobile App With In-App Coaching From a Certified Diabetes Educator Reduces A1C for Individuals With Type 2 Diabetes
Authors: Kumar Shefali , Moseson Heidi , Uppal Jaspreet , Juusola Jessie L. 
Published: March 2018

Purpose There are currently many diabetes apps available, but there is limited evidence demonstrating clinical impact. The purpose of this study is to evaluate the impact of a diabetes mobile app with in-app coaching by a certified diabetes educator on glycemic control for individuals with type 2 diabetes. Methods A 12 week-long single-arm intent-to-treat trial evaluated the impact of a diabetes mobile app and coaching program (One Drop | Mobile With One Drop | Experts), which facilitated tracking of self-care and included an in-app diabetes education program, on A1C for individuals with type 2 diabetes and an A1C ≥7.5% (58 mmol/mol). An online study platform (Achievement Studies, Evidation Health Inc, San Mateo, CA) was used to screen, consent, and enroll participants; collect study data; and track participants’ progress throughout the study. Baseline and study end A1C measurements as well as questionnaire data from participants were collected. Results Participants (n = 146) were 52 ± 9 years old, 71% female, 25% black or Hispanic, diagnosed with diabetes for 11 ± 7 years, and with a mean baseline A1C of 9.87% ± 2.0 (84 mmol/mol). In adjusted repeated measures models, mean A1C improved by −0.86% among study completers (n = 127), −0.96% among active users of the app and coaching program (n = 93), and −1.32% among active users with a baseline A1C ≥9.0% (75 mmol/mol) (n = 53). Conclusions This program was associated with a clinically meaningful and significant reduction in A1C and can potentially increase access to effective diabetes self-management education and support for individuals with diabetes.
Cost Analysis of a High Support Housing Initiative for Persons with Severe Mental Illness and Long-Term Psychiatric Hospitalization
Authors: Rudoler David , de Oliveira Claire , Jacob Binu , Hopkins Melonie , Kurdyak Paul 
Published: March 2018

Objective: The objective of this article was to conduct a cost analysis comparing the costs of a supportive housing intervention to inpatient care for clients with severe mental illness who were designated alternative-level care while inpatient at the Centre for Addiction and Mental Health in Toronto. The intervention, called the High Support Housing Initiative, was implemented in 2013 through a collaboration between 15 agencies in the Toronto area. Method: The perspective of this cost analysis was that of the Ontario Ministry of Health and Long-Term Care. We compared the cost of inpatient mental health care to high-support housing. Cost data were derived from a variety of sources, including health administrative data, expenditures reported by housing providers, and document analysis. Results: The High Support Housing Initiative was cost saving relative to inpatient care. The average cost savings per diem were between $140 and $160. This amounts to an annual cost savings of approximately $51,000 to $58,000. When tested through sensitivity analysis, the intervention remained cost saving in most scenarios; however, the result was highly sensitive to health system costs for clients of the High Support Housing Initiative program. Conclusions: This study suggests the High Support Housing Initiative is potentially cost saving relative to inpatient hospitalization at the Centre for Addiction and Mental Health.
Comparison of the Basal View and a Previously Standardized Cleft Lip Rating Scale
Authors: Klein Gabriel M. , Dhawan Arjun , Laskowski Robert A. , Peredo Andrew L. , Kelly Raymond , Gelfand Mark A. , Khan Sami U. , Bui Dui T. , Dagum Alexandar B. 
Published: March 2018

Objectives: Numerous scales assessing the aesthetics of cleft lip repair exist. Most, including the Asher-McDade scale, use frontal and lateral views, while neglecting a basal view. We believe this view is important for properly assessing the aesthetics of repair. In this study, we evaluate the basal view in comparison to the Asher-McDade scale. Methods: This scale was based on progressive columellar shortening and alar flaring/slumping. A panel of 4 plastic surgeons applied the basal and Asher-McDade scales to pictures of patients with repaired unilateral cleft lip in 56 multiethnic participants aged 5 years to 18 years; images were scored from 1 to 5 (best). Statistical analysis was done via Spearman correlation. Results: Scores from plastic surgeons correlated strongly for each view. There was moderate correlation for the basal view with both nasal form and deviation scores ( P < .05). As expected, there were no strong correlations between the basal view and vermillion border or profile. Discussion: The Asher-McDade scale has been used to evaluate cleft lift repairs but is limited due to its subjective nature. The basal view scale grades these repairs by using a scale of progressive columellar shortening and alar flaring/slumping, which provides an opportunity for quantification and standardization. Our results show that the basal view correlates with the Asher-McDade scale among raters, thus providing an objective and validated measure of cleft lip repair.
Bilateral simultaneous primary choroidal melanomas: Treated with palladium-103 plaque radiation
Authors: Maheshwari Abhilasha , Finger Paul T 
Published: March 2018

Purpose: To provide a clinical description of a case of bilateral choroidal melanoma in a patient treated with palladium-103 (103Pd) plaque brachytherapy. Methods: An 81-year-old man presented with choroidal melanoma in both eyes. In consideration of tumor sizes and locations, treatment involved insertion of 103Pd radioactive plaque in the right eye followed by the left at an interval of 2 months. Results: At 1-year follow-up, bilateral local control has been associated with apical tumor height regression, and visual acuity has been preserved (20/20 in the right eye and 20/25 in the left). Exudative subretinal fluid has resolved. There has been no metastasis. Conclusion: Bilateral choroidal melanomas are rare, reported to be either simultaneous or sequential as well as treatable. In this case, we were able to achieve tumor regression and preserve visual acuity in both eyes after plaque brachytherapy.