bluuebunny/crossref_metadata_2025_split huggingface dataset:
Children’s views on postsurgical pain in recovery units in Norway: A qualitative study
Authors: Smeland Anja Hetland , Rustøen Tone , Næss Torgun , Nybro Lill , Lundeberg Stefan , Reinertsen Hanne , Diseth Trond H. , Twycross Alison 
Published: January 2019

AbstractAims and objectivesTo explore children's postsurgical experiences with pain and pain management in the recovery unit.BackgroundChildren's pain is underestimated and undertreated. Untreated pain can cause unnecessary suffering, increased complication risks and may lead to chronic pain. Research exploring children's experiences with postoperative pain and pain management is limited.DesignA qualitative, exploratory study. The study complied with the Consolidated Criteria for Reporting Qualitative Research (COREQ).MethodsChildren (N = 20), 8–16 years old, took part in semi‐structured interviews about their experiences with pain and postoperative pain management while they were in a recovery unit. Data were collected at two university hospitals in Norway. Content analysis was used to analyse the data.ResultsThree themes emerged from the interviews: “children's experiences of what felt unpleasant and painful,” “children's experiences with pain management” and “children's recommendations for future pain management”. About half of the children reported moderate to severe pain while in the recovery unit and they did not always tell their nurses when they had pain. They also reported experiencing pain in places other than their surgical wounds and stated that nausea and vomiting felt unpleasant and painful. The children indicated that pain medications and the use of nonpharmacological methods helped them cope with their pain and provided several recommendations about how to improve pain management.ConclusionPaediatric postoperative pain management remains suboptimal. The children in our study provided useful information about their pain experiences, how to improve pain management and explained why they did not tell their nurses when they were in pain.Relevance to clinical practiceThese findings should direct further improvements in paediatric postoperative pain management, such as increased use of pain assessment tools and preparatory information, as well as more appropriate administration of pain medications.
Factors associated with glycaemic control in patients with diabetes mellitus: A systematic literature review
Authors: Cheng Ling Jie , Wang Wenru , Lim Suan Tee , Wu Vivien Xi 
Published: January 2019

AbstractObjectivesTo perform a systematic review search and critically review the empirical evidence concerning the factors affecting glycaemic control in patients with type 1 or 2 diabetes mellitus.BackgroundPrevious primary studies have investigated the factors associated with glycaemic control among patients with type 1 or 2 diabetes, but attempts to amalgamate these evidences have been methodologically limited. Hence, a robust review of the evidence is essential to explore factors that can be addressed to promote good glycaemic control in patients with diabetes.DesignMixed‐method systematic review using the Preferred Reporting Items for Systematic review and Meta‐Analysis 2009 flow diagram, integrating evidence from qualitative and quantitative studies (see Supporting Information File S1).MethodsA systematic review of the literature published between 2006–2017 was conducted in seven electronic databases (CINAHL, MEDLINE, Scopus, EMBASE, PsycINFO, PubMed and ScienceDirect) using the search terms “diabetes mellitus,” “glycemic control,” “self‐concept,” “knowledge,” “self‐efficacy,” “empowerment,” “race,” “ethnicity,” “duration,” “medication,” “obesity” and “comorbidity.”ResultsA total of 1,582 articles were initially retrieved, and 24 of these articles were included in this systematic literature review. The overall empirical evidence suggested that higher socio‐economic status, greater dietary knowledge, and higher self‐efficacy and empowerment improve glycaemic control among patients with diabetes mellitus.ConclusionsThis review presented the factors associated with glycaemic control that may pose significant socio‐economic problems to most nations worldwide and impede development nationally, regionally and even globally. Greater emphasis needs to be placed on implementing lifestyle changes on a societal level to stem the tide of the epidemic.Relevance to Clinical PracticeThere is a need to implement self‐management initiatives, that incorporate dietary knowledge, to empower patients with diabetes in their own care. Future public health policy must be geared towards increasing the capability of dealing with the rising incidence of diabetes and implementing primary prevention.
Introducing early‐phase medical students to clinical paediatrics using simulation and a flipped‐classroom
Authors: Uther Penelope , Van Munster Kerri‐Anne , Briggs Nancy , O'Neill Susan , Kennedy Sean 
Published: January 2019

AimBoth simulation and the flipped‐classroom improve learning outcomes in medical education, with evidence emerging that they are effective in combination (‘flipped‐simulation’). Previous studies evaluating simulation in paediatrics have assessed efficacy for senior students. This study aimed to assess whether using flipped‐simulation in early‐phase medical student education would show similar benefits.MethodsA flipped‐simulation session was introduced into the earliest phase of the University of New South Wales Sydney's undergraduate medical program. A pre‐test‐post‐test study design was used to assess short‐term knowledge gains with an eight‐item quiz administered before and after students attended the session. A retrospective cohort design was used to assess long‐term knowledge retention, with student scores from a 10‐item quiz administered at the second‐phase paediatric course orientation, compared between a group that completed the flipped‐simulation course and a group that attended an alternative play‐based session. Additional survey data regarding student satisfaction were gathered.ResultsStudents demonstrated short‐term knowledge gains: mean test scores improved from the pre‐test to post‐test (3.4 ± 1.5 vs. 6.0 ± 1.3, P < 0.001). Students attending the flipped‐simulation course retained knowledge more effectively in the longer term: mean test scores of students who completed the flipped‐simulation session were significantly higher than those who attended the alternative play‐based session (4.4 ± 1.9 vs. 3.4 ± 1.8, P < 0.001). Survey data demonstrated high student confidence in practical skills.ConclusionCombining simulation and the flipped‐classroom is effective for early‐phase medical students, with improved knowledge over the short and long term, and high student satisfaction.
Presentation and outcomes in hypertrophic pyloric stenosis: An 11‐year review
Authors: Vinycomb Toby I , Laslett Kirby , Gwini Stella M , Teague Warwick , Nataraja Ramesh M 
Published: January 2019

AimTo evaluate the trend in presentation and postoperative outcomes of infants with hypertrophic pyloric stenosis (HPS) over the last decade.MethodsThis was a multicentre retrospective study in two tertiary paediatric centres between 2005 and 2015 inclusive. Participants included 626 infants who underwent a pyloromyotomy for HPS. We collected data on presentation features (age, weight, clinical signs, blood gas results, ultrasound findings) and postoperative outcomes (length of stay (LOS), complications, time to first postoperative feed).ResultsNo trend was identified during the study period with regards to age, weight, biochemical findings (pH, chloride, base excess) or pre‐operative ultrasound measurements. There was a downtrend in the number of palpated tumours over time, with a mean of 36% of tumours clinically palpated. Pyloric wall thickness had a moderate association with LOS in patients admitted for >8 days (correlation = 0.4752) but had a weak negative association with shorter lengths of stay (≤8 day, correlation = −0.094). Overall, median time to first feed was 7.80 h and improved yearly during the study period (hazard ratio = 1.07).ConclusionsPatients presenting with HPS are not being identified at an earlier age or with fewer biochemical derangements, in contrast to our initial perceptions. Subsequently, biochemical derangements can still play an important role in the diagnosis of HPS, and attention needs to be given to fluid management and electrolyte correction in all patients with HPS.
A randomized controlled trial of bedtime music for insomnia disorder
Authors: Jespersen Kira Vibe , Otto Marit , Kringelbach Morten , Van Someren Eus , Vuust Peter 
Published: January 2019

SummaryMusic is often used as a self‐help tool to alleviate insomnia. To evaluate the effect of bedtime music listening as a strategy for improving insomnia, we conducted an assessor‐blinded randomized controlled trial. Fifty‐seven persons with insomnia disorder were included and randomized to music intervention (n = 19), audiobook control (n = 19) or a waitlist control group (n = 19). The primary outcome measure was the Insomnia Severity Index. In addition, we used polysomnography and actigraphy to evaluate objective measures of sleep, and assessed sleep quality and quality of life. The results showed no clear effect of music on insomnia symptoms as the group × time interaction only approached significance (effect size = 0.71, p = .06), though there was a significant improvement in insomnia severity within the music group. With regard to the secondary outcomes, we found a significant effect of the music intervention on perceived sleep improvement and quality of life, but no changes in the objective measures of sleep. In conclusion, music listening at bedtime appears to have a positive impact on sleep perception and quality of life, but no clear effect on insomnia severity. Music is safe and easy to administer, but further research is needed to assess the effect of music on different insomnia subtypes, and as an adjunctive or preventive intervention.
Perspectives from the Edge: Chaplains in Greater Boston, 1945–2015
Authors: Cadge Wendy , Wang Katherine , Rowe Mary 
Published: January 2019

AbstractWe follow Bender et al.’s (Religion on the Edge: De‐Centering and Recentering the Sociology of Religion) call to study religion “on the edge” by looking at the work of chaplains, religious professionals who work outside of congregations. Rather than studying chaplains within a single type of institution—the military, healthcare, or other sectors—we shift the unit of analysis to geography, asking where chaplains in Greater Boston worked between 1945 and the present. Based on coverage in theBoston Globe, we find that chaplains, mostly men, worked across Greater Boston between 1945 and 2015. The majority were Catholic with frequent minorities of Protestants and Jews, and—after 1995—a few Buddhists, Muslims, and Humanists. Most worked in higher education, healthcare, and prisons. While much of the chaplains’ work seems improvisational and varied, we identify services related to ceremonies, bearing witness, and working around death as common occurrences across the venues where chaplains worked. To the extent that these patterns are evident in other cities, they suggest that chaplains have regularly been a quiet part of the religious landscape, that they are a consistent part of the institutional field, and that their work has more commonalities across sectors than previous studies suggest.
Spatial variability of microzooplankton in the central Arabian Sea during spring intermonsoon
Authors: Sai Elangovan S. , Gauns Manguesh , Begum Mulla Amara , Ahmed Ayaz 
Published: January 2019

AbstractSpatial variability of microzooplankton (MZP; organisms in size 20–200 μm) along with total heterotrophic bacteria (THB) and picophytoplankton in the upper 120‐m water column of the central Arabian Sea (AS) was studied during the spring intermonsoon period (March 2015). Six stations divided into three regions (northern, southern, and central) were sampled along 68°E transect, between 9°N and 21°N. A total of 25 species of MZP were recorded corresponding to loricate ciliates (11 species), aloricate ciliates (two species), and heterotrophic dinoflagellates (12 species). Along the transect, MZP total abundance that varied between 5 and 9 × 103 org./m3 was largely contributed by ciliates, especially loricate ciliates (30%–62%) followed by heterotrophic dinoflagellates (23%–26%). MZP counts were lower in the central region (SD ± 0.4, 7–8 × 103 org./m3) than in the northern and the southern regions (SD ± 0.7, 8–9 × 103 org./m3) of the Arabian Sea. Heterotrophic bacterial counts were higher in the northern (28–202 × 103 cells/ml) and southern (16–92 × 103 cells/ml) and lowest in the central (13–89 × 103 cells/ml) region. In contrast, picophytoplankton showed higher counts in central (3–54 × 103 cells/ml) and southern (4–113 × 103 cells/ml) regions and lowest in the north (1–45 × 103 cells/ml). Strong positive coupling of MZP–THB (0.05 > p > 0.01) than that of MZP–picophytoplankton density and MZP–chlorophyll a concentration suggests the spatial scale variability and functioning of microbial loop in the central Arabian Sea during the spring intermonsoon period.
Workers' sons rescue genetic diversity at the sex locus in an invasive honey bee population
Authors: Gloag Rosalyn S. , Christie Joshua R. , Ding Guiling , Stephens Ruby E. , Buchmann Gabriele , Oldroyd Benjamin P. 
Published: January 2019

AbstractThe hallmark of eusociality is the division of labour between reproductive (queen) and nonreproductive (worker) females. Yet in many eusocial insects, workers retain the ability to produce haploid male offspring from unfertilized eggs. The reproductive potential of workers has well‐documented consequences for the structure and function of insect colonies, but its implications at the population level are less often considered. We show that worker reproduction in honey bees can have an important role in maintaining genetic diversity at the sex locus in invasive populations. The honey bee sex locus is homozygous‐lethal, and, all else being equal, a higher allele number in the population lead to higher mean brood survival. In an invasive population of the honey beeApis ceranain Australia, workers contribute significantly to male production: 38% of male‐producing colonies are queenless, and these contribute one‐third of all males at mating congregations. Using a model, we show that such male production by queenless workers will increase the number of sex alleles retained in nascent invasive populations following founder events, relative to a scenario in which only queens reproduce. We conclude that by rescuing sex locus diversity that would otherwise be lost, workers' sons help honey bee populations to minimize the negative effects of inbreeding after founder events and so contribute to their success as invaders.
Trainees’ perspectives of assessment messages: a narrative systematic review
Authors: Scarff Catherine E , Bearman Margaret , Chiavaroli Neville , Trumble Steve 
Published: January 2019

ObjectivesThis study was designed as a narrative systematic literature review of medical specialist trainees’ perspectives of the assessment messages they receive in the context of clinical performance assessments. The aim of the study was to determine if trainees value the information they receive through the formats designed to promote their development and, if not, the reasons for this.MethodsThe authors searched the ERIC, EMBASE, Ovid MEDLINE and PsycINFO databases for articles published up to 16 June 2018 that present original data on trainees’ perspectives of the assessment messages they receive in the context of work‐based assessments (WBAs) and in‐training assessments (ITAs) used within their training programmes. All authors screened 938 abstracts and 139 full‐text articles were assessed after this. Descriptions of quantitative data and thematic analysis of qualitative data were used to present the opinions of trainees.ResultsThirty‐three articles met the inclusion criteria. Twenty‐six articles (79%) described trainees’ perspectives in the context of WBA and the remaining articles referred to ITA formats. Wide‐ranging opinions were reported. The analysis categorised these into three themes: trainees value developmental assessment messages; trainees become disengaged when assessment messages are not developmental, and trainees’ views depend on the environment, the assessor and themselves. Some trainees reported that the assessment messages were valuable and provided input on their performance to guide their development, but many disagreed. In particular, the trainee's own level of engagement with the assessments influenced his or her perspectives on the messages received.ConclusionsTrainees do not universally perceive that clinical performance assessments provide them with the valuable developmental input on their performance they were designed to do. Factors related to the environment, the assessor and themselves influence their perspectives.
Where philosophy meets culture: exploring how coaches conceptualise their roles
Authors: Watling Christopher J , LaDonna Kori A 
Published: January 2019

ContextAlthough conceptually attractive, coaching in medicine remains ill‐defined, with little examination of the transferability of coaching principles from other fields. Here we explore how coaching is enacted both within and outside of medicine; we aim to understand both the elements required for coaching to be useful and the factors that may influence its translation to the medical education context.MethodsIn this constructivist grounded theory study, we interviewed 24 individuals across three groups: physicians who consider themselves coaches in clinical learning settings (n = 8), physicians with experience as sports, arts or business coaches (n = 10), and sports coaches without medical backgrounds (n = 6). Data collection and analysis were conducted iteratively using constant comparison to identify themes and explore their relationships.ResultsWe identified a shared philosophy of coaching, comprising three core elements that our participants endorsed regardless of the coaching context: (i) mutual engagement, with a shared orientation towards growth and development; (ii) ongoing reflection involving both learners and coaches, and (iii) an embrace of failure as a catalyst for learning. Enacting these features appeared to be influenced by culture, which affected how coaching was defined and developed, how the coaching role was positioned within the learning context, and how comfortably vulnerability could be expressed. Participants struggled to clearly define the coaching role in medicine, instead acknowledging that the lines between educational roles were often blurred. Further, the embrace of failure appeared challenging in medicine, where showing vulnerability was perceived as difficult for both learners and teachers.ConclusionsMedical education's embrace of coaching should be informed by an understanding of both coach and learner behaviours that need to be encouraged and trained, and the cultural and organisational supports that are required to foster success.
A systematic review and meta‐analysis of the effectiveness of meal replacements for weight loss
Authors: Astbury Nerys M. , Piernas Carmen , Hartmann‐Boyce Jamie , Lapworth Sophia , Aveyard Paul , Jebb Susan A. 
Published: January 2019

SummaryMeal replacements (MR) are generally not recommended in clinical guidelines for the management of obesity. The aim of this review is to provide an up‐to‐date systematic evaluation of the effect of weight loss interventions incorporating MR compared with alternative interventions on weight change at 1 year in adults with overweight or obesity. Six electronic databases were searched from inception to the end of August 2018 for randomized controlled trials comparing the effect of MR with interventions that did not include MR on weight at 1 year. We excluded studies using diets providing <3347 kJ/(800 kcal)/day and those which used total diet replacement (TDR) from this review. Risk of bias was assessed using the Cochrane risk of bias tool. Twenty‐three studies with 7884 adult participants were included. Six out of 23 studies were judged at low risk of bias across all domains, and 5/23 studies were judged at high risk of bias in at least one domain. Studies with similar intervention and comparators were grouped into five comparisons for analysis. Mean weight change at 1 year favoured the MR group relative to the control group in each comparison. In those comparisons where we conducted meta‐analysis, in people assigned to a diet incorporating MR, mean difference was −1.44 kg (−2.48 to −0.39 kg; I2 = 38%) compared with alternative kinds of diets. In those assigned to a MR diet along with support, mean difference was −2.22 kg (−3.99 to −0.45, I2 = 81%) compared with other diets with support and −3.87 kg (−7.34 to −0.40; I2 = 60%) compared with other kinds of diet without support. In those assigned a MR diet with an enhanced level of support, mean difference was −6.13 kg (−7.35 to −4.91, I2 = 19%) compared with alternative diets and regular support. Programmes incorporating meal replacements led to greater weight loss at 1 year than comparator weight loss programmes and should be considered as a valid option for management of overweight and obesity in community and health care settings.
Streptococcus mutans serotypes and collagen‐binding proteins Cnm/Cbm in children with caries analysed by PCR
Authors: Momeni Stephanie S. , Ghazal Tariq , Grenett Hernan , Whiddon Jennifer , Moser Stephen A. , Childers Noel K. 
Published: January 2019

Streptococcus mutans, a primary bacterium associated with dental caries, has four known clinical serotypes (c, e, fand k). Certain serotypes, the presence of multiple serotypes and strains with collagen‐binding proteins (CBP, Cnm and Cbm) have been linked with systemic disease. Evaluation of S mutans serotype distribution and caries association is needed in the United States. The purpose of this study was to evaluate the prevalence of S mutans serotypes from two cohorts of African‐American children in rural Alabama using three sample types (saliva, plaque and individual S mutans isolates) by PCR detection for association with caries. Detection of CBP was also performed by PCR. In total, 129 children were evaluated and overall prevalence of serotypes were: serotype c(98%), e(26%), f(7%) and k(52%). Serotype c was statistically associated with higher caries scores in older children (P < 0.001) and serotype k was statistically more likely in females (P = 0.004). Fourteen per cent of children had CBP. Thirteen S mutans isolates from five children tested positive for both CBP. This study is the first to report on the prevalence of S mutans serotypes in a US population using the PCR‐based approach. The frequency of serotype k in this study is the highest reported in any population, illustrating the need for further study to determine the prevalence of this clinically relevant serotype in the US. This is the first study to report S mutans isolates with both Cnm and Cbm in the same strain, and further analysis is needed to determine the clinical significance of these strains.