bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reducing food’s environmental impacts through producers and consumers
Authors: Poore J. , Nemecek T. 
Published: June 2018

The global impacts of food production
Food is produced and processed by millions of farmers and intermediaries globally, with substantial associated environmental costs. Given the heterogeneity of producers, what is the best way to reduce food's environmental impacts? Poore and Nemecek consolidated data on the multiple environmental impacts of ∼38,000 farms producing 40 different agricultural goods around the world in a meta-analysis comparing various types of food production systems. The environmental cost of producing the same goods can be highly variable. However, this heterogeneity creates opportunities to target the small numbers of producers that have the most impact.

Science
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987
The effect of partisanship and political advertising on close family ties
Authors: Chen M. Keith , Rohla Ryne 
Published: June 2018

Curtailed conversations
Most articles written about U.S. politics in the past few years have mentioned the increasing polarization of the electorate. But is this real, or does it merely reflect the increasing polarization of the media? Chen and Rohla estimate that in 2016, Thanksgiving dinners in which the hosts and guests lived in oppositely voting precincts were up to 50 minutes shorter than same-party-precinct dinners. That is, family members, adjured to avoid talking about contentious subjects, may have simply talked less.

Science
, this issue p.
1020
Effects of polymorphisms in APOA5 on the plasma levels of triglycerides and risk of coronary heart disease in Jilin, northeast China: a case–control study
Authors: You Yueyue , Wu Yan-Hua , Zhang Yangyu , Zhang Lili , Song Yan , Bai Wei , Li Yuanyuan , Yu Yaqin , Kou Changgui 
Published: June 2018

ObjectiveThe goal of this study is to investigate the associations of apolipoprotein A5 (APOA5) polymorphisms with coronary artery disease (CAD) in a Chinese population.MethodThis case–control study included 710 subjects (355 patients with CAD and 355 controls) who were recruited from a cross-sectional study. Three single nucleotide polymorphisms (SNPs) rs662799 (−1131T>C), rs651821 (−3A>G) and rs2075291 (G185C) inAPOA5were selected and genotyped using the matrix-assisted laser desorption ioniasation time of flight mass spectrometry technology. The χ2test and haplotype analysis were performed to analyse the associations betweenAPOA5SNPs and CAD using the SPSS V.22.0 software package and the online SNPStats program.ResultsAPOA5SNPs rs662799 and rs651821 exhibited significant differences in genotype and allele distributions between patients with CAD and control subjects. The SNP rs662799 was significantly correlated with an increased risk of CAD when a dominant model was considered. The SNP rs651821 was significantly correlated with an increased risk of CAD when a codominant model was considered. Moreover, the variant C alleles of rs662799 and the variant G alleles of the rs651821 polymorphism were significantly correlated with increased plasma triglyceride (TG) levels in the CAD group (all p<0.05). Additionally, a mediating effect of TG on the associations between theAPOA5rs662799 and rs651821 polymorphisms and CAD was observed.ConclusionBased on these data, variants of theAPOA5gene are associated with CAD susceptibility and may modulate plasma TG levels among a Chinese population.
Factors associated with pregnancy-related anxiety in Tanzanian women: a cross sectional study
Authors: Wall Vanessa , Premji Shahirose Sadrudin , Letourneau Nicole , McCaffrey Graham , Nyanza Elias Charles 
Published: June 2018

ObjectiveTo identify factors predictive of pregnancy-related anxiety (PRA) among women in Mwanza, Tanzania.DesignA cross-sectional study was used to explore the relationship between psychosocial health and preterm birth.SettingAntenatal clinics in the Ilemela and Nyamagana districts of Mwanza, Tanzania.ParticipantsPregnant women less than or equal to 32 weeks’ gestational age (n=212) attending the two antenatal clinics.MeasuresPRA was measured using a revised version of the 10-item PRA Questionnaire (PRA-Q). Predictive factors included social support (Multidimensional Scale of Perceived Social Support), stress (Perceived Stress Scale), depression (Edinburg Postpartum Depression Scale) and sociodemographic data. Bivariate analysis permitted variable selection while multiple linear regression analysis enabled identification of predictive factors of PRA.ResultsTwenty-five per cent of women in our sample scored 13 or higher (out of a possible 30) on the PRA-Q. Perceived stress, active depression and number of people living in the home were the only statistically significant predictors of PRA in our sample.ConclusionsOur findings were contrary to most current literature which notes socioeconomic status and social support as significant factors in PRA. A greater understanding of the experience of PRA and its predictive factors is needed within the social cultural context of low/middle-income countries to support the development of PRA prevention strategies specific to low/middle income countries.
How do adolescent girls and boys perceive symptoms suggestive of endometriosis among their peers? Findings from focus group discussions in New York City
Authors: Gupta Jhumka , Cardoso Lauren F , Harris Courtney S , Dance Arielle D , Seckin Tamer , Baker Nina , Ferguson Yvonne O 
Published: June 2018

ObjectiveSymptoms of endometriosis, including pelvic pain, back and nerve pain, and gastrointestinal pain, often begin in adolescence. Yet, research on the experience of these debilitating symptoms among young people is scarce. Of particular concern is the influence of adolescent girls’ social context. This study qualitatively examined how, among adolescents, endometriosis and symptoms suggestive of endometriosis is perceived at the family, peer/school and community/society levels.DesignEight focus groups were conducted; vignettes were used to elicit participants’ perceptions of factors that may shape girls’ experiences of endometriosis. Data were analysed using constant comparison analysis.ParticipantsAn ethnically diverse sample of girls and boys ages 14–18 (n=54) residing in New York City.ResultsFifteen themes emerged and were distilled to eight cross-cutting factors that influence perceptions of endometriosis at different levels of the ecological model: distrust of community healthcare providers, societal stigma of menstruation, peer stigma of endometriosis symptoms, distrust of school healthcare providers, lack of endometriosis knowledge among peers and school personnel, inequitable gender norms, invisibility of symptoms and the stigma of teen sex among parents. Further, these factors may compound symptoms’ impact on individual girl’s social, educational and emotional well-being.ConclusionsFindings underscore the importance of understanding the social environment of girls experiencing symptoms suggestive of endometriosis and educating and engaging their peers, family and school personnel to create a supportive, informed social climate. Efforts should specifically include stigma reduction campaigns targeted towards female and male adolescents.
Experiences of older people dying in nursing homes: a narrative systematic review of qualitative studies
Authors: Greenwood Nan , Menzies-Gow Emma , Nilsson David , Aubrey Dawn , Emery Claire L , Richardson Angela 
Published: June 2018

ObjectivesTo identify and synthesise qualitative research from 2001 investigating older people’s (65+ years) experiences of dying in nursing and care homes.Methods and outcomesEight electronic databases (AMED, ASSIA, CINAHL Plus, Embase, HMIC, Medline, PsychINFO and Scopus) from 2001 to July 2017 were searched. Studies were included if they were qualitative, primary research and described the experiences of dying in nursing or care homes from the perspectives of the older people themselves, their families or staff. Study quality assessment was undertaken to systematically assess methodological quality, but no studies were excluded as a result.Results1305 articles were identified. Nine met the inclusion criteria. North American studies dominated. Most used a mixture of observations and interviews. All the included studies highlighted the physical discomfort of dying, with many older people experiencing potentially avoidable symptoms if care were to be improved. Negative psychosocial experiences such as loneliness and depression were also often described in addition to limited support with spiritual needs.ConclusionsMore qualitative research giving a holistic understanding of older people’s experiences of dying in residential care homes is needed. Undertaking research on this topic is challenging and requires great sensitivity, but the dearth of qualitative research from the perspectives of those most closely involved in older people’s deaths hampers service improvement.
Implementing the I-DECIDED clinical decision-making tool for peripheral intravenous catheter assessment and safe removal: protocol for an interrupted time-series study
Authors: Ray-Barruel Gillian , Cooke Marie , Mitchell Marion , Chopra Vineet , Rickard Claire M 
Published: June 2018

IntroductionMillions of acute care hospital patients need a peripheral intravenous catheter (PIVC) each year. However, up to half of PIVCs remain in situ when not being used, and 30%–50% of intravenous (IV) catheters develop complications or stop working before treatment is finished, requiring the insertion of a new device. Improved assessment could prompt timely removal of redundant catheters and prevent IV complications. This study aims to validate an evidence-based PIVC assessment and decision-making tool called I-DECIDED and evaluate the effect of implementing this tool into acute hospital clinical practice.Methods and analysisThe protocol outlines a prospective, multicentre, mixed-methods study using an interrupted time-series (multiple measures preintervention and postintervention) implementation at three Australian hospitals between August 2017 and July 2018. The study will examine the effectiveness of the I-DECIDED assessment and decision-making tool in clinical practice on prompting timely PIVC removal and early detection of complications. Primary outcomes are prevalence of redundant PIVCs (defined as device in situ without a clear purpose), IV complications (occlusion, dislodgement, infiltration, extravasation and phlebitis) and substandard dressings (loose, lifting, moist or soiled); device utilisation ratios; and primary bloodstream infection rates. Secondary outcomes including staff barriers and enablers to PIVC assessment and removal, patient participation, documentation of PIVC assessment and decisions taken to continue or remove the PIVC will be recorded. Using the Promoting Action on Research Implementation in Health Services framework, we will undertake staff focus groups, bedside patient interviews and PIVC assessments and chart audits. Patients aged 18 years or more with a PIVC will be eligible for inclusion.Ethics and disseminationEthical approval from Queensland Health (HREC/17/QPCH/47), Griffith University (Ref No. 2017/152) and St Vincent’s Health and Aged Care Human Research and Ethics Committee (Ref No. 17/28). Results will be published.Trial registration numberANZCTR: 12617000067370; Pre-results.
Study protocol of the randomised placebo-controlled GLOBE trial:GLP-1 forbridging of hyperglycaemia during cardiac surgery
Authors: Hulst Abraham H , Visscher Maarten J , Godfried Marc B , Thiel Bram , Gerritse Bas M , Scohy Thierry V , Bouwman R Arthur , Willemsen Mark G A , Hollmann Markus W , DeVries J Hans , Preckel Benedikt , Hermanides Jeroen 
Published: June 2018

IntroductionPerioperative hyperglycaemia is common during cardiac surgery and associated with postoperative complications. Although intensive insulin therapy for glycaemic control can reduce complications, it carries the risk of hypoglycaemia. GLP-1 therapy has the potential to lower glucose without causing hypoglycaemia. We hypothesise that preoperative liraglutide (a synthetic GLP-1 analogue) will reduce the number of patients requiring insulin to achieve glucose values<8 mmol l-1in the intraoperative period.Methods and analysisWe designed a multi-centre randomised parallel placebo-controlled trial and aim to include 274 patients undergoing cardiac surgery, aged 18–80 years, with or without diabetes mellitus. Patients will receive 0.6 mg liraglutide or placebo on the evening before, and 1.2 mg liraglutide or placebo just prior to surgery. Blood glucose is measured hourly and controlled with an insulin bolus algorithm, with a glycaemic target between 4–8 mmol l−1. The primary outcome is the percentage of patients requiring insulin intraoperatively.Ethics and disseminationThis study protocol has been approved by the medical ethics committee of the Academic Medical Centre (AMC) in Amsterdam and by the Dutch competent authority. The study is investigator-initiated and the AMC, as sponsor, will remain owner of all data and have all publication rights. Results will be submitted for publication in a peer-reviewed international medical journal.Trial registration numberNTR6323; Pre-results.
Health trainer-led motivational intervention plus usual care for people under community supervision compared with usual care alone: a study protocol for a parallel-group pilot randomised controlled trial (STRENGTHEN)
Authors: Thompson Tom P , Callaghan Lynne , Hazeldine Emma , Quinn Cath , Walker Samantha , Byng Richard , Wallace Gary , Creanor Siobhan , Green Colin , Hawton Annie , Annison Jill , Sinclair Julia , Senior Jane , Taylor Adrian H 
Published: June 2018

IntroductionPeople with experience of the criminal justice system typically have worse physical and mental health, lower levels of mental well-being and have less healthy lifestyles than the general population. Health trainers have worked with offenders in the community to provide support for lifestyle change, enhance mental well-being and signpost to appropriate services. There has been no rigorous evaluation of the effectiveness and cost-effectiveness of providing such community support. This study aims to determine the feasibility and acceptability of conducting a randomised trial and delivering a health trainer intervention to people receiving community supervision in the UK.Methods and analysisA multicentre, parallel, two-group randomised controlled trial recruiting 120 participants with 1:1 individual allocation to receive support from a health trainer and usual care or usual care alone, with mixed methods process evaluation. Participants receive community supervision from an offender manager in either a Community Rehabilitation Company or the National Probation Service. If they have served a custodial sentence, then they have to have been released for at least 2 months. The supervision period must have at least 7 months left at recruitment. Participants are interested in receiving support to change diet, physical activity, alcohol use and smoking and/or improve mental well-being. The primary outcome is mental well-being with secondary outcomes related to smoking, physical activity, alcohol consumption and diet. The primary outcome will inform sample size calculations for a definitive trial.Ethics and disseminationThe study has been approved by the Health and Care Research Wales Ethics Committee (REC reference 16/WA/0171). Dissemination will include publication of the intervention development process and findings for the stated outcomes, parallel process evaluation and economic evaluation in peer-reviewed journals. Results will also be disseminated to stakeholders and trial participants.Trial registration numbersISRCTN80475744; Pre-results.
Preventing chronic disease in patients with low health literacy using eHealth and teamwork in primary healthcare: protocol for a cluster randomised controlled trial
Authors: Parker Sharon M , Stocks Nigel , Nutbeam Don , Thomas Louise , Denney-Wilson Elizabeth , Zwar Nicholas , Karnon Jon , Lloyd Jane , Noakes Manny , Liaw Siaw-Teng , Lau Annie , Osborne Richard , Harris Mark F 
Published: June 2018

IntroductionAdults with lower levels of health literacy are less likely to engage in health-promoting behaviours. Our trial evaluates the impacts and outcomes of a mobile health-enhanced preventive intervention in primary care for people who are overweight or obese.Methods and analysisA two-arm pragmatic practice-level cluster randomised trial will be conducted in 40 practices in low socioeconomic areas in Sydney and Adelaide, Australia. Forty patients aged 40–70 years with a body mass index ≥28 kg/m2will be enrolled per practice. The HeLP-general practitioner (GP) intervention includes a practice-level quality improvement intervention (medical record audit and feedback, staff training and practice facilitation visits) to support practices to implement the clinical intervention for patients. The clinical intervention involves a health check visit with a practice nurse based on the 5As framework (assess, advise, agree, assist and arrange), the use of a purpose-built patient-facing app,my snapp, and referral for telephone coaching. The primary outcomes are change in health literacy, lifestyle behaviours, weight, waist circumference and blood pressure. The study will also evaluate changes in quality of life and health service use to determine the cost-effectiveness of the intervention and examine the experiences of practices in implementing the programme.Ethics and disseminationThe study has been approved by the University of New South Wales (UNSW) Human Research Ethics Committee (HC17474) and ratified by the University of Adelaide Human Research Ethics committee. There are no restrictions on publication, and findings of the study will be made available to the public via the Centre for Primary Health Care and Equity website and through conference presentations and research publications. Deidentified data and meta-data will be stored in a repository at UNSW and made available subject to ethics committee approval.Trial Registrationregistration numberACTRN12617001508369; Pre-results.
Safety and efficacy of 4-terpineol against microorganisms associated with blepharitis and common ocular diseases
Authors: Su Chen-Wei , Tighe Sean , Sheha Hosam , Cheng Anny M S , Tseng Scheffer C G 
Published: June 2018

ObjectiveMicrobial infection has been reported to cause blepharitis, conjunctivitis and keratitis. We evaluated the safety and efficacy of a foam formulation of 2% 4-terpineol (T4O) against common ocular microorganisms.Material and methodsThe antimicrobial effect of a 2% T4O formulation was evaluated by the United States Pharmacopeia 51 (USP <51>) antimicrobial effectiveness test for 14 and 28 days, as well as by a Time Kill Study (ASTM E2315) with a 60 s exposure time. Its potential of causing skin and ocular irritation was evaluated by the Repeated Insult Patch Test and the Hen’s Egg Chorioallantoic Membrane Test, respectively.Results and discussionIt was seen that 2% T4O formulation did not cause ocular irritation, skin irritation, sensitisation or allergic contact dermatitis in human subjects. Most importantly, it killed microorganisms listed in USP <51> at both 14 and 28 days and exerted a rapid killing effect within 60 s against 13 bacteria, 1 fungus andAcanthamoeba castellanii.ConclusionThe above finding suggests that 2% T4O formulation is safe and effective in killing microorganisms related to common ocular and skin infective diseases.Translational relevanceAlthough the clinical efficacy in treating ocular disease was not directly studied; this foam formulation containing 2% T4O, based on the in vitro results of this work, demonstrated that it can potentially be used as a preservative-free cleansing agent for ocular hygiene maintenance due to its ability to exert a broad-spectrum antimicrobial effect without causing ocular or skin irritation.
Addressing the challenges of knowledge co-production in quality improvement: learning from the implementation of the researcher-in-residence model
Authors: Vindrola-Padros Cecilia , Eyre Laura , Baxter Helen , Cramer Helen , George Bethan , Wye Lesley , Fulop Naomi J , Utley Martin , Phillips Natasha , Brindle Peter , Marshall Martin 
Published: June 2018

The concept of knowledge co-production is used in health services research to describe partnerships (which can involve researchers, practitioners, managers, commissioners or service users) with the purpose of creating, sharing and negotiating different knowledge types used to make improvements in health services. Several knowledge co-production models have been proposed to date, some involving intermediary roles. This paper explores one such model, researchers-in-residence (also known as ‘embedded researchers’).In this model, researchers work inside healthcare organisations, operating as staff members while also maintaining an affiliation with academic institutions. As part of the local team, researchers negotiate the meaning and use of research-based knowledge to co-produce knowledge, which is sensitive to the local context. Even though this model is spreading and appears to have potential for using co-produced knowledge to make changes in practice, a number of challenges with its use are emerging. These include challenges experienced by the researchers in embedding themselves within the practice environment, preserving a clear focus within their host organisations and maintaining academic professional identity.In this paper, we provide an exploration of these challenges by examining three independent case studies implemented in the UK, each of which attempted to co-produce relevant research projects to improve the quality of care. We explore how these played out in practice and the strategies used by the researchers-in-residence to address them. In describing and analysing these strategies, we hope that participatory approaches to knowledge co-production can be used more effectively in the future.
Evaluating mild traumatic brain injury management at a regional emergency department
Authors: Brown Ashlee Maree , Twomey Dara M , Wong Shee Anna 
Published: June 2018

BackgroundEmergency departments (EDs) are usually the first point of contact, and often the only medical service available, for patients with mild traumatic brain injury (mTBI) in rural and regional areas. Clinical practice guidelines (CPGs) have been created to ensure best practice management of mTBI in EDs. Adherence to mTBI CPGs has rarely been evaluated in rural and regional areas.AimThe aim of this paper was to assess a regional health service’s adherence to their mTBI CPG.MethodsThis was a 12-month retrospective audit of 1280 ED records of patients ≥16 years presenting with mTBI to a regional Australian ED. Case selection used the Victorian Admitted Episodes Dataset codes for suspected head injury: principal diagnosis codes (S00-T98), concussive injury recorded in diagnosis codes (S06.00-S06.05) and unintentional external cause code (V00-X59). The data were collected to determine 4-hour observation rates, CT scan rates, safe discharge and appropriate referral documentation.ResultsFewer people received a CT scan than qualified (n=245, 65.3%), only 45% had 4-hour observations recorded, safe discharge was documented in 74.1% of cases and 33% received educational resources.Discussion/conclusionSeveral key elements for the management of mTBI were under-recorded, particularly 4-hour observations, safe discharge and education. Acquired brain injury clinic referrals were received in overwhelmingly fewer cases than had a CT scan (n=19, 6.3%). Overall, this study suggests that the regional health service does not currently fully adhere to the CPG and that the referral services are potentially underutilised.