bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hybrid Cognitive‐Behavioral Therapy Intervention for Adolescents With Co‐Occurring Migraine and Insomnia: A Single‐Arm Pilot Trial
Authors: Law Emily F. , Wan Tham See , Aaron Rachel V. , Dudeney Joanne , Palermo Tonya M. 
Published: August 2018

ObjectiveThis study aimed to evaluate feasibility and acceptability of a hybrid cognitive‐behavioral therapy intervention for adolescents with co‐occurring migraine and insomnia.BackgroundMany youth with chronic migraine have co‐occurring insomnia. Little research has been conducted to evaluate behavioral treatments for insomnia in youth with migraine.Design and MethodsWe conducted a single‐arm pilot trial to evaluate the feasibility and acceptability of delivering cognitive‐behavioral therapy for insomnia to 21 youth (mean age 15.5, standard deviation 1.6) with co‐occurring chronic migraine and insomnia. Adolescents completed up to 6 individual treatment sessions over 6 to 12 weeks, and 1 booster session 1 month later. Assessments included a prospective 7‐day headache and sleep diary, and self‐report measures of insomnia, sleep quality, sleep habits, and activity limitations at pre‐treatment, immediate post‐treatment, and 3‐month follow‐up.ResultsAdolescents demonstrated good treatment adherence and families rated the intervention as highly acceptable. Preliminary analyses indicated improvements from pre‐treatment to post‐treatment in primary outcomes of headache days (M = 4.7, SD = 2.1 vs M = 2.8, SD = 2.7) and insomnia symptoms (M = 16.9, SD = 5.2 vs M = 9.5, SD = 6.2), which were maintained at 3‐month follow‐up (M = 2.7, SD = 2.8; M = 9.3, SD = 5.0, respectively). We also found improvements in secondary outcomes of pain‐related activity limitations as well as sleep quality, sleep hygiene, and sleep patterns.ConclusionsThese preliminary data indicate that hybrid cognitive‐behavioral therapy is feasible and acceptable for youth with co‐occurring chronic migraine and insomnia. Future randomized controlled trials are needed to test treatment efficacy on migraine, sleep, and functional outcomes. ClinicalTrials.gov Identifier: NCT03137147.
The association between malnutrition and childhood disability in low‐ and middle‐ income countries: systematic review and meta‐analysis of observational studies
Authors: Hume‐Nixon Maeve , Kuper Hannah 
Published: August 2018

AbstractObjectiveThe aim of this study was to evaluate the association between childhood disability and malnutrition in low‐ and middle‐ income countries (LMICs).MethodsArticles were identified from 1990 to August 2017 by searching nine electronic databases. Epidemiological studies, undertaken in LMICs that compared the prevalence of malnutrition in children with disabilities to children without disabilities were eligible for inclusion. Titles, abstracts, and full texts were screened by two reviewers, and data were extracted using a structured table for eligible papers. Meta‐analyses for the association between childhood disability and undernutrition were performed.ResultsThe search generated 4678 results, from which 17 articles were eligible. Fifty‐three per cent of these studies showed a positive association between childhood disability and undernutrition. Results varied when disaggregated by type of disability, with positive associations identified for 44% of studies focussed on neurodevelopmental disability, 60% of general disability studies and 67% of studies on hearing impairment. Only four studies were identified that considered overnutrition outcomes, and these showed variable results. Eighteen per cent of eligible studies were considered at low risk of bias, 53% had a medium risk, and 29% had a high risk of bias. Pooled ORs showed that children with disabilities were almost three times more likely to be underweight (OR 2.97, 95% CI 2.33, 3.79), and nearly twice as likely to experience stunting and wasting (Stunting: 1.82, 1.40, 2.36; Wasting: 1.90, 1.32–2.75), compared to controls.ConclusionsChildren with disabilities may be a vulnerable group for undernutrition in LMICs, which should be reflected in disability and nutritional programming and policy‐making.
Modifying maternal sleep position in the third trimester of pregnancy with positional therapy: a randomised pilot trial
Authors: Kember Allan J , Scott Heather M , O’Brien Louise M , Borazjani Ali , Butler Michael B , Wells Jesse H , Isaac Andre , Chu Kaishin , Coleman Jerry , Morrison Debra L 
Published: August 2018

ObjectiveTo evaluate whether the percentage of time spent supine during sleep in the third trimester of pregnancy could be reduced using a positional therapy device (PrenaBelt) compared with a sham device.DesignA double-blind, randomised, sham-controlled, cross-over pilot trial.SettingConducted between March 2016 and January 2017, at a single, tertiary-level centre in Canada.Participants23 participants entered the study. 20 participants completed the study. Participants were low-risk, singleton, third-trimester pregnant women aged 18 years and older with body mass index <35 kg/m2at the first antenatal appointment for the index pregnancy and without known fetal abnormalities, pregnancy complications or medical conditions complicating sleep.InterventionsA two-night, polysomnography study in a sleep laboratory. Participants were randomised by computer-generated, one-to-one, simple randomisation to receive either a PrenaBelt or a sham-PrenaBelt on the first night and were crossed over to the alternate device on the second night. Allocation concealment was by unmarked, security-tinted, sealed envelopes. Participants, the recruiter and personnel involved in setting up, conducting, scoring and interpreting the polysomnogram were blinded to allocation.Primary and secondary outcome measuresThe primary outcome was the percentage of time spent supine during sleep. Secondary outcomes included maternal sleep architecture, respiration, self-reported sleep position and feedback.ResultsThe median percentage of sleep time supine was reduced from 16.4% on the sham night to 3.5% on the PrenaBelt night (pseudomedian=5.8, p=0.03). We were unable to demonstrate differences in sleep architecture or respiration. Participants underestimated the time they spent sleeping supine by 7.0%, and six (30%) participants indicated they would make changes to the PrenaBelt. There were no harms in this study.ConclusionsThis study demonstrates that the percentage of sleep time supine during late pregnancy can be significantly reduced via positional therapy.Trial registration numberNCT02377817; Results.
Excess costs of alcohol-dependent patients in German psychiatric care compared with matched non-alcohol-dependent individuals from the general population: a secondary analysis of two datasets
Authors: Dams Judith , Buchholz Angela , Kraus Ludwig , Reimer Jens , Scherbaum Norbert , Konnopka Alexander , König Hans-Helmut 
Published: August 2018

ObjectivesHeavy alcohol use can cause somatic and mental diseases, affects patients’ social life and is associated with social isolation, unemployment and reduced quality of life. Therefore, societal costs of alcohol dependence are expected to be high. The aim of this study was to estimate excess costs of patients with alcohol dependence diagnosed using theDiagnostic and Statistical Manual of Mental Disorders, 4th Edition criteria compared with individuals without alcohol dependence in Germany.DesignIn a secondary analysis, baseline data of patients with alcohol dependence enrolled in a randomised controlled trial (German Clinical Trials Register DRS00005035) were compared with data collected via a telephone survey from individuals without alcohol dependence and that had been matched by entropy balancing. Health service use was evaluated retrospectively for a 6-month period.SettingsFour German psychiatric university clinics (patients with alcohol dependence) and the German general adult population (individuals without alcohol dependence).Participantsn=236 adult patients with alcohol dependence and n=4687 adult individuals without alcohol dependence.Primary and secondary outcome measuresThe excess costs of health service use, absenteeism and unemployment of patients with alcohol dependence were calculated and compared with individuals without alcohol dependence. In subgroup analyses, the associations between excess cost and gender, comorbidities and the duration of disease were investigated.ResultsTotal 6-month excess costs of €11 839 (95% CI €11 529 to €12 147) were caused by direct excess costs of €4349 (95% CI €4129 to €4566) and indirect costs of €7490 (95% CI €5124 to €9856). In particular, costs of inpatient treatment, formal long-term care, absenteeism and unemployment were high.ConclusionsAlcohol dependence causes substantial direct and indirect excess costs. Cost-effective interventions to prevent and treat alcohol dependence are urgently needed.Trial registration numberDRKS00005035.
Differential intervention effectiveness of a universal school-based resilience intervention in reducing adolescent substance use within student subgroups: exploratory assessment within a cluster-randomised controlled trial
Authors: Hodder Rebecca Kate , Freund Megan , Bowman Jenny , Wolfenden Luke , Campbell Elizabeth , Dray Julia , Lecathelinais Christophe , Oldmeadow Christopher , Attia John , Wiggers John 
Published: August 2018

ObjectivesInterventions addressing the individual and environmental protective factors of adolescents are suggested to have potential for reducing adolescent substance use. While universally delivered school-based substance use prevention interventions are common, previous studies have suggested variable effectiveness by subgroups of students. An exploratory study was undertaken to examine the differential effectiveness of a universal school-based resilience intervention on adolescent substance use and protective factors according to their sociodemographic and previous substance use.DesignSecondary analysis of data from a cluster-randomised controlled trial.Setting32 Australian secondary schools.ParticipantsCohort of grade 7 students (n=3155) followed up in grade 10 (aged 15–16 years; 2014; n=2105).InterventionThree-year universal school-based intervention implemented by school staff that targeted a range of student resilience protective factors (2012–2014).MeasurementsPrimary outcomes included: tobacco (recent, number of cigarettes) and alcohol (recent, ‘risk’ and number of drinks) use, and secondary outcomes included: marijuana (recent) and other illicit substance (recent) use, and aggregate individual and environmental protective factor scores. Generalised and linear mixed models examined interactions between treatment and student subgroups (gender; socioeconomic disadvantage (low/high); geographic location (major city/inner regional/outer regional-remote); and previous substance use (non-user/user)) at follow-up (36 models).ResultsAnalysis of student follow-up data showed no differential intervention effect for any substance use or protective factor outcome for any subgroup, with the exception of one differential effect found by socioeconomic status for the outcome of mean number of cigarettes smoked by recent smokers (p=0.003). There was no evidence of an intervention effect within the low (mean difference (MD) −12.89, 95% CI −26.00 to 0.23) or high (MD 16.36, 95% CI −1.03 to 33.76) socioeconomic subgroups.ConclusionsNo evidence of an intervention effect on substance use and protective factors was found according to student subgroups defined by sociodemographic characteristics or previous substance use.Trial registration numberACTRN12611000606987.
Knowledge mobilisation: an ethnographic study of the influence of lay mindlines on eczema self-management in primary care in the UK
Authors: Cowdell Fiona 
Published: August 2018

ObjectiveTo investigate the way in which mindlines, ‘collectively reinforced, internalised tacit guidelines’, are constructed among lay people with eczema in primary care.DesignEthnographic study.SettingObservation in one general practice in the UK and interviews across central England.ParticipantsIn observation, patients in the participating general practice regardless of presenting complaint and in interviews, people with eczema or parents of children with eczema (n=16).ResultsObservation of over 250 hours and interview data were combined and analysed using an ethnographic approach through the lenses of mindlines and self-management. Four themes were identified: doctor knows best; not worth bothering the doctor; I need to manage this myself; and how I know what to do. Themes were set within the context of four broad typologies of lay people’s approach to self-management: content to self-manage; content to accept practitioner management; self-managing by default; and those referred to secondary care.ConclusionsThis study is the first to examine how lay eczema mindlines are developed and to recognise typologies of people with different need for, and receptiveness to, information. Lay eczema mindlines are constructed in many ways. The outstanding challenge is to find strategies to revise or modify these mindlines by adding reliable and useful knowledge and by erasing outdated or inaccurate information.
Acute poisoning in Shenyang, China: a retrospective and descriptive study from 2012 to 2016
Authors: Zhang Yajie , Yu Boxin , Wang Nana , Li Tiegang 
Published: August 2018

ObjectivesUp-to-date information on the patterns of acute poisoning is crucial for the proper management of poisoning events. The objectives of this study were to analyse the characteristics of patients suffering from acute poisoning admitted to the emergency department (ED) in a tertiary medical centre in Northeast China and to compare these characteristics with those of a previous comparable study.DesignRetrospective and descriptive study.SettingData were collected from the hospital information system in Shengjing Hospital, China, from January 2012 to December 2016.ParticipantsAll cases aged ≥11 years old with a diagnosis of acute poisoning.ResultsIn total, 5009 patients aged ≥11 years presented to the ED with acute poisoning during the study period. The average age of the patients was 36.0±15.1 years and over half (52.7%) were in the 20–39age group. The female to male ratio was 1.2:1. Patients with acute poisoning mainly lived in rural areas rather than in urban areas. The majority of patients consumed poison as suicide attempts (56.7%). Men were more commonly poisoned by drug abuse than women, but women outnumbered men in suicidal poisoning. The most common form of poison intake was ingestion (oral intake; 86.2%). The five most common toxic agent groups, in descending order, were therapeutic drugs (32.6%), pesticides (26.9%), alcohol (20.7%), fumes/gases/vapours (11.4%) and chemicals (3.6%). Sedatives/hypnotics in the therapeutic drugs group and paraquat in the pesticides group were the most common toxic agents, respectively. The mortality rate of study participants was 1.3%, with 64 deaths.ConclusionsThe results of this study indicate the need to strengthen education on the rational and safe use of drugs in Shenyang.
Sunbed use 2007–2015 and skin cancer projections of campaign results 2007–2040 in the Danish population: repeated cross-sectional surveys
Authors: Køster Brian , Meyer Maria KH , Andersson Therese M-L , Engholm Gerda , Dalum Peter 
Published: August 2018

ObjectiveTo evaluate the effect of the Danish Sun Safety Campaign 2007–2015 on the prevalence of sunbed use and to model future effects on the skin cancer incidences 2007–2040.DesignThe study has a repeated, cross-sectional design.SettingExposure to ultraviolet radiation is the main risk factor for skin cancer. Denmark has the highest prevalence of sunbed use reported and one of the highest incidences of skin cancer worldwide.ParticipantsDuring 2007–2015, survey data were collected for 37 766 Danes, representative of the Danish population with regards to age, gender and region.InterventionsIn 2007, an ongoing long-term antisunbed campaign was launched in Denmark.Primary and secondary outcome measuresSunbed use was evaluated by annual cross-sectional surveys. Skin cancer incidence was modelled in the Prevent programme, using population projections, historic cancer incidence, sunbed use exposure and relative risk of sunbed use on melanoma.ResultsThe prevalence of recent sunbed use in Denmark was reduced from 32% and 18% to 13% and 8% for women and men, respectively. The campaigns results during 2007–2015 are estimated to reduce the number of skin cancer cases from more than 5000 (746malignant melanoma, 1562 SCC, 2673 BCC) totally during 2007–2040. Keeping the 2015 level of sunbed use constant by continued campaign pressure or introduction of structural interventions would potentially prevent more than 750 skin cancer cases annually in 2040 and 16 000 skin cancer cases in total during 2007–2040.ConclusionWe have shown the value of prevention and of long-term planning in prevention campaigning. Sunbed use was reduced significantly during 2007–2015 and further reductions are possible by structural interventions. Consequently, significantly fewer skin cancer cases are anticipated during 2007–2040. The Danish Parliament has population support to enforce structural interventions to avoid a large burden of this disease.
Attitude towards active surveillance: a cross-sectional survey among patients with uroandrological disorders
Authors: Capogrosso Paolo , Boeri Luca , Ventimiglia Eugenio , Camozzi Ilenya , Cazzaniga Walter , Chierigo Francesco , Scano Roberta , Briganti Alberto , Montorsi Francesco , Salonia Andrea 
Published: August 2018

ObjectivesWe looked at subjective attitude towards active surveillance (AS) as the first option for cancer management in a cohort of patients seeking first medical help for uroandrological disorders prior to a formal discussion with a caregiver.DesignCross-sectional observational study.SettingUroandrological outpatient clinic of a European academic centre.ParticipantsData of 1059 patients at their first access for uroandrological purposes from January 2014 to December 2016 were analysed.InterventionPatients were invited to complete a survey with closed questions investigating their attitude towards AS, prior to any clinical evaluation. Likewise, patients were invited to score the importance given to different aspects of personal life in the case of a cancer diagnosis, using a 10-point Likert scale.Primary and secondary outcomes measuresThe reported opinion towards AS management for cancer was assessed. Logistic regression analyses tested participants’ sociodemographic characteristics associated with a positive opinion on AS.ResultsPositive, negative and doubtful attitudes towards AS were observed in 347 (33%), 331 (31%) and 381 (36%) patients, respectively. Female patients were more likely to report a negative attitude towards AS (38.7% vs 29.6%, p=0.04) while patients with previous parenthood more frequently reported a positive opinion on AS (37.2% vs 29.9%, p=0.005). Patient age emerged as the only predictor of a positive attitude towards AS (OR 1.03; 95% CI 1.01 to 1.04, p<0.001), with a 46% and 33% probability of being pro-AS for a patient aged 65 and 45 years, respectively.ConclusionsOne out of three patients would express positive feedbacks on AS in the unfortunate case of tumour diagnosis, only according to his/her baseline personal opinion and prior to any discussion with a cancer caregiver. The older the patient, the higher the probability of being compliant with a conservative management for cancer.
Minor flow disruptions, traffic-related factors and their effect on major flow disruptions in the operating room
Authors: Joseph Anjali , Khoshkenar Amin , Taaffe Kevin M , Catchpole Ken , Machry Herminia , Bayramzadeh Sara 
Published: August 2018

BackgroundStudies in operating rooms (OR) show that minor disruptions tend to group together to result in serious adverse events such as surgical errors. Understanding the characteristics of these minor flow disruptions (FD) that impact major events is important in order to proactively design safer systemsObjectiveThe purpose of this study is to use a systems approach to investigate the aetiology of minor and major FDs in ORs in terms of the people involved, tasks performed and OR traffic, as well as the location of FDs and other environmental characteristics of the OR that may contribute to these disruptions.MethodsUsing direct observation and classification of FDs via video recordings of 28 surgical procedures, this study modelled the impact of a range of system factors—location of minor FDs, roles of staff members involved in FDs, type of staff activities as well as OR traffic-related factors—on major FDs in the OR.ResultsThe rate of major FDs increases as the rate of minor FDs increases, especially in the context of equipment-related FDs, and specific physical locations in the OR. Circulating nurse-related minor FDs and minor FDs that took place in the transitional zone 2, near the foot of the surgical table, were also related to an increase in the rate of major FDs. This study also found that more major and minor FDs took place in the anaesthesia zone compared with all other OR zones. Layout-related disruptions comprised more than half of all observed FDs.ConclusionRoom design and layout issues may create barriers to task performance, potentially contributing to the escalation of FDs in the OR.
Comparative effectiveness of individualised homeopathy and antibiotics in the treatment of bovine clinical mastitis: randomised controlled trial
Authors: Keller Diana , Sundrum Albert 
Published: August 2018

Based on the widespread use of homeopathy in dairy farm practice when treating mastitis, a blind randomised controlled trial (RCT) was conducted to assess the effectiveness of homeopathic treatment of clinical mastitis on four dairy farms. The study considered specific guidelines for RCTs as well as the basic principles of individualised homeopathy and involved 180 lactating dairy cows. Evaluation of cure rates was based on clinical investigation of the udder and on laboratory analysis of milk samples. In culture‐positive cases, the antibiotic treatment provided suboptimal bacteriological cures (60–81 per cent) but was more effective than individualised homeopathy (33–43 per cent) whose effects appeared little different to those of placebos (45–47 per cent) (P≤0.05). On the cytological cure level, all three treatment methods were similarly ineffective: antibiotic being 2–21 per cent, individualised homeopathy 0–8 per cent and placebo 3–13 per cent (P≤0.05; P=0.13). Antibiotics, individualised homeopathy and placebo had similar effects on bacteriological and cytological cure in cases of culture‐negative milk samples (P>0.4) and Escherichia coli infections (P=1.0). The study results implied that the effectiveness of individualised homeopathy does not go beyond a placebo effect and successful treatment is highly dependent on the specific mastitis pathogen. Thus, antimicrobial or alternative remedies used should be based on the bacterial culture of the milk sample.Trial registration numberNTP‐ID: 00008011‐1‐9, Pre‐results.
Interpreting deviations between AR-VTG and GR
Authors: Dale Roberto , Sáez Diego 
Published: August 2018

The cosmic microwave background (CMB) anisotropies predicted by two cosmological models are compared, one of them is the standard model of general relativity with cold dark matter and cosmological constant, whereas the second model is based on a consistent vector-tensor theory of gravitation explaining solar system and cosmological observations. It is proved that the resulting differences — between the anisotropies of both models — are due to the so-called late integrated Sachs–Wolfe effect and, consequently, cross-correlations between maps of CMB temperatures and tracers of the dark matter distribution could be used in future to select one of the above models. The role of reionization is analyzed in detail.