bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of a toolkit to enhance care processes for people with a long-term neurological condition: a qualitative descriptive study
Authors: Sezier Ann , Mudge Suzie , Kayes Nicola , Kersten Paula , Payne Deborah , Harwood Matire , Potter Eden , Smith Greta , McPherson Kathryn M 
Published: June 2018

ObjectiveTo (A) explore perspectives of people with a long-term neurological condition, and of their family, clinicians and other stakeholders on three key processes: two-way communication, self-management and coordination of long-term care; and (B) use these data to develop a ‘Living Well Toolkit’, a structural support aiming to enhance the quality of these care processes.DesignThis qualitative descriptive study drew on the principles of participatory research. Data from interviews and focus groups with participants (n=25) recruited from five hospital, rehabilitation and community settings in New Zealand were analysed using conventional content analysis. Consultation with a knowledge-user group (n=4) and an implementation champion group (n=4) provided additional operational knowledge important to toolkit development and its integration into clinical practice.ResultsFour main, and one overarching, themes were constructed: (1)tailoring care:referring to getting to know the person and their individual circumstances; (2) involving others:representing the importance of negotiating the involvement of others in the person’s long-term management process; (3)exchanging knowledge:referring to acknowledging patient expertise; and (4)enabling:highlighting the importance of empowering relationships and processes. The overarching theme was: assume nothing. These themes informed the development of a toolkit comprising of two parts: one to support the person with the long-term neurological condition, and one targeted at clinicians to guide interaction and support their engagement with patients.ConclusionPerspectives of healthcare users, clinicians and other stakeholders were fundamental to the development of the Living Well Toolkit. The findings were used to frame toolkit specifications and highlighted potential operational issues that could prove key to its success. Further research to evaluate its use is now underway.
Is atrial fibrillation a risk factor for in-hospital cardiac arrest?: a Swedish retrospective cohort study
Authors: Ryden Alexander , Engdahl Johan , Claesson Andreas , Nordberg Per , Ringh Mattias , Hollenberg Jacob , Djärv Therese 
Published: June 2018

IntroductionAtrial fibrillation (AF) is associated with increased morbidity and mortality. Recent findings suggest that AF is also associated with out-of-hospital cardiac arrest. However, whether that association can be generalised to in-hospital cardiac arrests (IHCAs) is still unknown.AimsTo examine whether there is a stronger association with IHCA among hospitalised patients with AF compared with patients without AF.Materials and methodsAll adult patients admitted to the Karolinska University Hospital, Stockholm, Sweden during 2014–2015 were included. Data were drawn from their medical file and matched against the Swedish Registry for Cardiopulmonary Resuscitation. Patients who were documented as ever having the International Classification of Diseases, 10th revision code I48 prior to the current hospitalisation were categorised to the AF group and the remaining were categorised to the non-AF group. The primary outcome was occurrence of an IHCA.ResultsIn all, 102 416 patients were included. Among these, 10% had been diagnosed with AF and <1% (n=326) suffered from an IHCA, only 42 (13%) had a VF/VT. In a multivariable model adjusting for sex, age, CharlsonComorbidity Index score and whether the patients had been admitted electively or urgently, having AF was significantly associated with IHCA (OR 1.760; 95% CI 1.356 to 2.269; p<0.001).ConclusionsWithin this observational cohort study, patients with AF had a stronger association with IHCA than patients without AF. AF might be an independent risk factor for IHCA.
Does the architectural layout of a NICU affect alarm pressure? A comparative clinical audit of a single-family room and an open bay area NICU using a retrospective study design
Authors: Joshi Rohan , Straaten Henrica van , Mortel Heidi van de , Long Xi , Andriessen Peter , Pul Carola van 
Published: June 2018

ObjectivesTo determine differences in alarm pressure between two otherwise comparable neonatal intensive care units (NICUs) differing in architectural layout—one of a single-family room (SFR) design and the other of an open bay area (OBA) design.DesignRetrospective audit of more than 2000 patient days from each NICU cataloguing the differences in the number and duration of alarms for critical and alerting alarms, as well as the interaction of clinicians with the patient monitor.SettingTwo level 3 NICUs.ResultsA total of more than 150 000 critical and 1.2 million alerting alarms were acquired from the two NICUs. The number of audible alarms and the associated noise pollution varied considerably with the OBA NICU generating 44% more alarms per infant per day even though the SFR NICU generated 2.5 as many critical desaturation alarms per infant per day.ConclusionDifferences in the architectural layout of NICUs and the consequent differences in delays, thresholds and distribution systems for alarms are associated with differences in alarm pressure.
Psychometric evaluation of an interview-administered version of the Kessler 10-item questionnaire (K10) for measuring psychological distress in rural Bangladesh
Authors: Uddin Mohammed Nazim , Islam Fakir M Amirul , Al Mahmud Abdullah 
Published: June 2018

ObjectiveThe aim of this study was to translate, adapt and validate the Kessler 10-item questionnaire (K10) for measuring psychological distress in rural Bangladesh.DesignCohort study.SettingNarail district, Bangladesh.ParticipantsA random sample of 2425 adults of age 18–90 years was recruited.Outcome measureValidation of the K10 was the major outcome. Sociodemographic factors were measured to assess if the K10 needed adjustment for factors such as age or gender. The Rasch measurement model was used for the validation, and RUMM 2030 and SPSS V.24 software were used for analyses.ResultsInitial inspection of the total sample showed poor overall fit. A sample size of 300, which is more satiated for Rasch analysis, also showed poor overall fit, as indicated by a significant item–trait interaction (χ2= 262.27, df=40, p<0.001) and item fit residual values (mean=–0.25, SD=2.49). Of 10 items, five items were disordered thresholds, and seven items showed misfit, suggesting problems with the response format and items. After removing three items (‘feel tired’, ‘depressed’ and ‘worthless’) and changing the Likert scale categories from five to four categories, the remaining seven items showed ordered threshold. A revised seven-item scale has shown adequate internal consistency, with no evidence of multidimensionality, no differential item functioning on age and gender, and no signs of local dependency.ConclusionsAnalysis of the psychometric validity of K10 using the Rasch model showed that 10 items are not appropriate for measuring psychological distress in rural Bangladesh. A modified version of seven items (K7) with four response categories would provide a psychometrically more robust scale than the original K10. The study findings suggest repeating the K7 version in other remote areas for further validation can substantiate an efficient screening tool for measuring psychological distress among the general Bangladeshi population.
Hospitalisation and mortality outcomes of patients with comorbid COPD and heart failure: a systematic review protocol
Authors: Axson Eleanor L , Sundaram Varun , Bloom Chloe I , Bottle Alex , Cowie Martin R , Quint Jennifer K 
Published: June 2018

IntroductionChronic obstructive pulmonary disease (COPD) and heart failure (HF) often coexist in patients. Many studies have explored the short-term and long-term outcomes of patients with comorbid COPD and HF; however, there have been discrepancies in their findings.Methods and analysisIn this systematic review, MEDLINE and Embase will be searched using a prespecified search strategy. Randomised controlled trials and studies conducted in the general population that employ analytical or descriptive (longitudinal or case–control) study designs that report odds ratios (ORs), hazard ratios (HRs), or risk ratios (RRs) of mortality or hospitalisation, comparing patients with comorbid COPD and HF with patients with just COPD, will be selected. Screening by title and abstract, then full-text screening will be conducted by two reviewers. The Population, Exposure, Comparator, Outcomes, Study (PECOS) characteristics framework will be used to systemise the data extraction from selected studies. Study quality will be assessed using an adapted version of the Newcastle-Ottawa risk of bias tool. Data extraction and the risk of bias will also be conducted by two reviewers. Given sufficient homogeneity of selected studies, a meta-analysis will be conducted. Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria will be used to assess the quality of cumulative evidence.DisseminationWith this review, we hope to improve the understanding of clinical outcomes of patients with comorbid COPD and HF. We intend to publish the results of our review in a peer-reviewed journal and to present our findings at national and international meetings and conferences.PROSPERO registration numberCRD42018089534
No association between DNA methylation and COPD in never and current smokers
Authors: de Vries Maaike , van der Plaat Diana A , Vonk Judith M , Boezen H Marike 
Published: June 2018

IntroductionChronic obstructive pulmonary disease (COPD) is a progressive inflammatory lung disease with cigarette smoke as the main risk factor for its development. Since not every smoker develops COPD, other factors likely underlie differences in susceptibility to develop COPD. Here, we tested if DNA methylation may be such a factor by assessing the association between DNA methylation levels and COPD in never and current smokers from the general population.MethodsFor the current study, 1561 subjects were non-randomly selected from the LifeLines cohort study. We included 903 never smokers and 658 current smokers with and without COPD, defined as pre-bronchodilator forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) <70%. Subsequently, we performed robust regression analysis on whole blood DNA methylation levels of 420 938 CpG sites with COPD as outcome.ResultsNone of the CpG sites in both the never and the current smokers were genome-wide significantly associated with COPD. CpG site cg14972228 annotated toSIPAL3was most significant (p=5.66×10−6) in the never smokers, while CpG site cg08282037 annotated toEPS8L1was most significant (p=1.45×10−5) in the current smokers.ConclusionIn contrast to a previous, smaller study, we did not observe any significant association between DNA methylation levels and the presence of COPD, independent of smoking status. Apparently, DNA methylation studies are highly variable.
Mortality among diagnostic medical radiation workers in South Korea, 1996–2015
Authors: Lee Won Jin , Ko Seulki , Bang Ye Jin , Cha Eun Shil , Lee Kyoung-Mu 
Published: June 2018

ObjectivesTo evaluate the risk for all-cause and cause-specific mortality in diagnostic medical radiation workers in South Korea.MethodsThe study population included all diagnostic medical radiation workers enrolled in the National Dosimetry Registry (NDR) between 1996 and 2011. NDR data were linked with mortality data obtained from national registries through 2015. Standardised mortality ratios (SMRs) and relative standardised mortality ratios (rSMRs) were calculated for external comparison and for adjustment of the cohort’s overall healthiness.ResultsA total of 1099 deaths (974 in men and 125 in women) were reported from among 80 837 medical radiation workers. The SMRs for all causes of death were significantly lower than expected in both men (SMR 0.45, 95% CI 0.42 to 0.48) and women (SMR 0.49, 95% CI 0.41 to 0.58). No excesses were observed for any specific cause of death. The findings were similar by job title, calendar year of entry and year of birth. However, relative to all causes of death, mortality from all cancers (rSMR 1.60, 95% CI 1.41 to 1.82), leukaemia, colon cancer, stomach cancer and diseases of the circulatory system increased significantly among male workers. The results for female workers were limited due to small number of deaths; however, the rSMR for all cancers was significantly elevated (rSMR 1.70, 95% CI 1.17 to 2.46).ConclusionsThis cohort showed lower mortality among diagnostic medical radiation workers than in the general population. However, occupational factors may have been involved in the increased relative mortality for several causes of death.
Relationship Between Plasma 8‐OH‐Deoxyguanosine and Cardiovascular Disease and Survival in Type 2 Diabetes Mellitus: Results From the ADVANCE Trial
Authors: Thomas Merlin C. , Woodward Mark , Li Qiang , Pickering Raelene , Tikellis Christos , Poulter Neil , Cooper Mark E. , Marre Michel , Zoungas Sophia , Chalmers John ,   the ADVANCE Collaborative Group
Published: June 2018

Background

8‐Oxo‐2′‐deoxyguanosine (8‐oxo‐2′‐
dG
) is a biomarker of oxidative
DNA
damage that is associated with cardiovascular disease and premature mortality in the general population. Although oxidative stress has a proven role in cardiovascular complications in diabetes mellitus, evidence for a relationship between plasma 8‐oxo‐2′‐
dG
and major cardiovascular outcomes in diabetes mellitus is weak.

Methods and Results

A case‐cohort study was performed in 3766 participants with prevalent diabetes mellitus in the
ADVANCE
(Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation) trial (
ClinicalTrials.gov
number
NCT
00145925). The hazard ratios for mortality and major acute cardiovascular events were derived using Cox regression models. During a median of 5 years of follow‐up, 695 (18.4%) participants in this enriched cohort died (including 354 deaths from cardiovascular disease). Individuals with higher levels of 8‐oxo‐2′‐
dG
were more likely to die. After adjusting for cardiovascular disease risk factors, the hazard ratio for a 1‐SD increase in plasma 8‐oxo‐2′‐
dG
was 1.10 (95% confidence interval, 1.01–1.20;
P
=0.03). This was driven by an independent association between plasma 8‐oxo‐2′‐
dG
and cardiovascular death (hazard ratio, 1.23; 95% confidence interval, 1.10–1.37 [
P
<0.001]). By contrast, no association was seen between 8‐oxo‐2′‐
dG
and noncardiovascular disease death (of which cancer was the major single cause). 8‐Oxo‐2′‐
dG
was also not significantly associated with either nonfatal myocardial infarction or nonfatal stroke.

Conclusions

In adults with type 2 diabetes mellitus, increased levels of 8‐oxo‐2′‐
dG
are independently associated with all‐cause mortality and cardiovascular mortality in adults with longstanding type 2 diabetes mellitus who participated in the
ADVANCE
trial, consistent with the role of oxidative damage in the development and progression of cardiovascular decompensation in diabetes mellitus.

Clinical Trial Registration

URL
:
http://www.clinicaltrials.gov
. Unique identifier:
NCT
00145925.
Delphi Analysis of Science Gaps in the 2015 American Heart Association Cardiac Arrest Guidelines
Authors: Panchal Ashish R. , Cash Rebecca E. , Crowe Remle P. , Coute Ryan , Way David , Aufderheide Tom , Merchant Raina M. 
Published: June 2018

Background
Current cardiac arrest guidelines have limited high‐quality scientific evidence to support recommendations for care. The quality of scientific evidence on which guidelines are based may correlate with improved patient outcomes and meaningful survival. We sought to develop a prioritized list of knowledge gaps in resuscitation to assist researchers, policy makers, and funding agencies in their decision‐making process.

Methods and Results
A 4‐stage modified Delphi method was used with a panel of cardiac arrest experts. Experts addressed the prompt: “What are the top 3 gaps in knowledge involving cardiac arrest care that should be research priorities for National Institutes of Health/American Heart Association funding to have the greatest impact on public health?” Knowledge gaps were identified in the initial round, rated in a second round, and rank ordered in the third round, and they underwent final review and consensus (final round). The outcome was 10 knowledge gaps, with prioritization of the top 3 gaps. A total of 61 gaps, with 19 distinct themes, were identified by participants. The 10 knowledge gaps most likely to affect public health identified by the expert panel included, in order, the following: telecommunicator cardiopulmonary resuscitation, hemodynamic monitoring for goal‐directed resuscitation, reasons why bystanders fail to respond, optimization of postarrest care, out‐of‐hospital cardiac arrest identification and response, individualizing resuscitation strategies, predicting patients at risk, tools for neuroprognostication, optimal airway management, and optimizing educational strategies.

Conclusions
Ten priorities for cardiac arrest research were identified, but consensus was not reached on the prioritized top 3. Future research should address these gaps to potentially improve resuscitation guideline evidence quality.
Dietary Docosahexaenoic Acid Reduces Oscillatory Wall Shear Stress, Atherosclerosis, and Hypertension, Most Likely Mediated via an IL‐1–Mediated Mechanism
Authors: Alfaidi Mabruka A. , Chamberlain Janet , Rothman Alexander , Crossman David , Villa‐Uriol Maria‐Cruz , Hadoke Patrick , Wu Junxi , Schenkel Torsten , Evans Paul C. , Francis Sheila E. 
Published: June 2018

BackgroundHypertension is a complex condition and a common cardiovascular risk factor. Dietary docosahexaenoic acid (DHA) modulates atherosclerosis and hypertension, possibly via an inflammatory mechanism. IL‐1 (interleukin 1) has an established role in atherosclerosis and inflammation, although whetherIL‐1 inhibition modulates blood pressure is unclear.Methods and ResultsMale apoE−/−(apolipoprotein E–null) mice were fed either a high fat diet or ahigh fat dietplusDHA(300 mg/kg per day) for 12 weeks. Blood pressure and cardiac function were assessed, and effects ofDHAon wall shear stress and atherosclerosis were determined.DHAsupplementation improved left ventricular function, reduced wall shear stress and oscillatory shear at ostia in the descending aorta, and significantly lowered blood pressure compared with controls (119.5±7 versus 159.7±3 mm Hg,P<0.001, n=4 per group). Analysis of atheroma followingDHAfeeding in mice demonstrated a 4‐fold reduction in lesion burden in distal aortas and in brachiocephalic arteries (P<0.001, n=12 per group). In addition,DHAtreatment selectively decreased plaque endothelialIL‐1β (P<0.01).ConclusionsOur findings revealed that raised blood pressure can be reduced by inhibitingIL‐1 indirectly by administration ofDHAin the diet through a mechanism that involves a reduction in wall shear stress and local expression of the proinflammatory cytokineIL‐1β.
Lack of a Tricuspid Regurgitation Doppler Signal and Pulmonary Hypertension by Invasive Measurement
Authors: O'Leary Jared M. , Assad Tufik R. , Xu Meng , Farber‐Eger Eric , Wells Quinn S. , Hemnes Anna R. , Brittain Evan L. 
Published: June 2018

Background

Transthoracic echocardiography (
TTE
) is used to estimate pulmonary artery systolic pressure, but an adequate tricuspid regurgitation velocity (
TRV
) needed to calculate pulmonary artery systolic pressure is not always present. It is unknown whether the absence of a measurable
TRV
signifies normal pulmonary artery pressure.

Methods and Results

We extracted hemodynamic,
TTE
, and clinical data from Vanderbilt's deidentified electronic medical record in all patients referred for right heart catheterization between 1998 and 2014. Pulmonary hypertension (
PH
) was defined as mean pulmonary artery pressure ≥25 mm Hg. We examined the prevalence and clinical correlates of
PH
in patients without a reported
TRV
. We identified 1262 patients with a
TTE
within 2 days of right heart catheterization. In total, 803/1262 (64%) had a reported
TRV
, whereas 459 (36%) had no reported
TRV
. Invasively confirmed
PH
was present in 47% of patients without a reported
TRV
versus 68% in those with a reported
TRV
(
P
<0.001). Absence of a
TRV
yielded a negative predictive value for excluding
PH
of 53%. Right ventricular dysfunction, left atrial dimension, elevated body mass index, higher brain natriuretic peptide, diabetes mellitus, and heart failure were independently associated with
PH
among patients without a reported
TRV
.

Conclusions

PH
is present in almost half of patients without a measurable
TRV
who are referred for both
TTE
and right heart catheterization. Clinical and echocardiographic features of left heart disease are associated with invasively confirmed
PH
in subjects without a reported
TRV
. Clinicians should use caution when making assumptions about
PH
status in the absence of a measurable
TRV
on
TTE
.
The neo-Weberian state and the neodevelopmentalist strategies in Latin America: the case of Uruguay
Authors: Ramos Conrado , Milanesi Alejandro 
Published: June 2018

This article seeks to contribute to the development of the neo-Weberian theory of public administration by making it travel to the Latin American context. We argue that this model of public administration reform, identified in continental European states, tends to be present in some Latin American countries that have followed neodevelopmentalist models of economic development. The neo-Weberian political strategy promotes a public sector modernization that enhances its steering and coordination capacities which is functional to a neodevelopmental view that aims to rebuild the state’s central role in leading economic growth and social cohesiveness. Yet, the public management model that is implanted resembles an ‘imperfect’ neo-Weberianism due to the institutional deficiencies of these countries and the difficulties in providing a clear reform script. We provide this link by decoding the main outlines of the public management model in Uruguay in the context of the reforms implemented by the Frente Amplio. Points for practitioners The article demonstrates two central points. First, that the processes of public sector reform are usually linked to other broader development strategies and to calculations of political feasibility. This can explain to some extent the options taken by politicians. Second, public sector reforms are often a combination of multiple administrative doctrines. This poses the risk of being unsystematic, incoherent or even contradictory.
Attachment as a Core Feature of Resilience: A Systematic Review and Meta-Analysis
Authors: Darling Rasmussen Pernille , Storebø Ole Jakob , Løkkeholt Trine , Voss Line Gaunø , Shmueli-Goetz Yael , Bojesen Anders Bo , Simonsen Erik , Bilenberg Niels 
Published: June 2018

Background Research has pointed to secure attachment as a possible key factor of resilience in adulthood. Objective We aimed to investigate the role of secure attachment as a potential core feature in the properties of resilience. Methods We conducted a systematic review in accordance with PRISMA guidelines followed by a meta-analysis. Results Thirty-three studies were included in the review, and 10 of these, including 2305 subjects, were used for meta-analysis. The raw correlation coefficients ranged from .20 to .57, which indicated weak to moderate correlations between resilience and attachment. The synthesized correlation coefficients indicated that the correlations were significant and highly unlikely to be due to random variation. All studies are also reported on qualitatively. Conclusions In both of our meta-analyses and in the narratively reported studies, we found that secure attachment is associated with the presence of resilience.