bluuebunny/crossref_metadata_2025_split huggingface dataset:
Value conflicts in mothers' snack choice for their 2‐ to 7‐year‐old children
Authors: Damen Femke W.M. , Luning Pieternel A. , Hofstede Gert Jan , Fogliano Vincenzo , Steenbekkers Bea L.P.A. 
Published: June 2019

AbstractValue conflicts appear when people experience struggles, doubts, and feelings of guilt when making food choices. This study aims to provide insight into value conflicts, which mothers may experience while providing snacks to their young children. Mothers are mainly responsible for providing the snacks their young children eat, making it a big responsibility for them as children's dietary behaviour tracks into adulthood. Possible value conflicts Dutch mothers (n = 136) experience while providing snacks to their 2‐ to 7‐year‐old children were investigated using food and motivation diaries and semi‐structured interviews. Differences between mothers' educational level, first versus not‐first child, and the differences in age of the children were taken into account. Results showed that the younger the children, the more value conflicts the mothers experienced. Mothers experienced most value conflicts when they provided snacks perceived as unhealthy. Six main value conflicts are elicited by this study, namely, conflicts between healthy and unhealthy snacks; conflicts between healthy and convenient snacks; conflicts related to providing snacks just before dinner; conflicts related to influence of others; conflicts when the child asks but the mother says “no”; and conflicts related to many unhealthy snacks at parties or visits. The insights gained in this study can be used for interventions to promote a healthier lifestyle, support the design of new snack products, and can give guidance for marketing challenges in global snack markets.
Greater household food insecurity is associated with lower breast milk intake among infants in western Kenya
Authors: Miller Joshua D. , Young Sera L. , Boateng Godfred O. , Oiye Shadrack , Owino Victor 
Published: June 2019

AbstractHousehold food insecurity has been hypothesized to negatively impact breastfeeding practices and breast milk intake, but this relationship has not been rigorously assessed. To generate an evidence base for breastfeeding recommendations among food‐insecure mothers in settings where HIV is highly prevalent, we explored infant feeding practices among 119 mother–infant dyads in western Kenya at 6 and 24 weeks postpartum. We used the deuterium oxide dose‐to‐the‐mother technique to determine if breastfeeding was exclusive in the prior 2 weeks, and to quantify breast milk intake. Sociodemographic data were collected at baseline and household food insecurity was measured at each time point using the Household Food Insecurity Access Scale. Average breast milk intake significantly increased from 721.3 g/day at 6 weeks postpartum to 961.1 g/day at 24 weeks postpartum. Household food insecurity at 6 or 24 weeks postpartum was not associated with maternal recall of exclusive breastfeeding (EBF) in the prior 24 hr or deuterium oxide‐measured EBF in the prior 2 weeks at a significance level of 0.2 in bivariate models. In a fixed‐effects model of quantity of breast milk intake across time, deuterium oxide‐measured EBF in the prior 2 weeks was associated with greater breast milk intake (126.1 ± 40.5 g/day) and every one‐point increase in food insecurity score was associated with a 5.6 (±2.2)‐g/day decrease in breast milk intake. Given the nutritional and physical health risks of suboptimal feeding, public health practitioners should screen for and integrate programs that reduce food insecurity in order to increase breast milk intake.
Assessing appropriateness of paediatric asthma management: A population‐based sample survey
Authors: Homaira Nusrat , Wiles Louise K. , Gardner Claire , Molloy Charlotte J. , Arnolda Gaston , Ting Hsuen P. , Hibbert Peter , Boyling Claire , Braithwaite Jeffrey , Jaffe Adam ,   on behalf of the CareTrack Kids Investigative Team
Published: June 2019

ABSTRACTBackground and objectiveWe conducted a comprehensive assessment of guideline adherence in paediatric asthma care, including inpatient and ambulatory services, in Australia.MethodsNational and international clinical practice guidelines (CPG) relating to asthma in children were searched and 39 medical record audit indicator questions were developed. Retrospective medical record review was conducted across hospital inpatient admissions, emergency department (ED) presentations, general practice (GP) and paediatrician consultations in three Australian states for children aged ≤15 years receiving care in 2012 and 2013. Eligibility of, and adherence to, indicators was assessed from medical records by nine experienced and purpose‐trained paediatric nurses (surveyors).ResultsSurveyors conducted 18 453 asthma indicator assessments across 1600 visits for 881 children in 129 locations. Overall, the adherence for asthma care across the 39 indicators was 58.1%, with 54.4% adherence at GP (95% CI: 46.0–62.5), 77.7% by paediatricians (95% CI: 40.5–97.0), 79.9% in ED (95% CI: 70.6–87.3) and 85.1% for inpatient care (95% CI: 76.7–91.5). For 14 acute asthma indicators, overall adherence was 56.3% (95% CI: 47.6–64.7). Lowest adherences were for recording all four types of vital signs in children aged >2 years presenting with asthma attack (15.1%, 95% CI: 8.7–23.7), and reviewing patients’ compliance, inhaler technique and triggers prior to commencing a new drug therapy (20.5%, 95% CI: 10.1–34.8).ConclusionThe study demonstrated differences between existing care and CPG recommendations for paediatric asthma care in Australia. Evidence‐based interventions to improve adherence to CPG may help to standardize quality of paediatric asthma care and reduce variation of care.
Pregnancy complications, sick leave and service needs of women who experience perinatal distress, weak social support and dissatisfaction in their partner relationships
Authors: Jonsdottir Sigridur Sia , Swahnberg Katarina , Thome Marga , Oskarsson Guðmundur Kristjan , Bara Lydsdottir Linda , Olafsdottir Halldora , Sigurdsson Jon Fridrik , Steingrimsdottir Thora 
Published: June 2019

IntroductionAlthough perinatal distress is acknowledged as a burdening condition for pregnant women, its effects on pregnancy are not well known. This study was conducted to increase knowledge regarding the effects of distress on pregnancy‐related problems. The study also assessed women's need for sick leave and increased prenatal care due to distress, and the effects of weak social support and dissatisfaction with their partner relationships.MethodsIn total, 2523 women were screened for perinatal distress three times during pregnancy in this quantitative cohort study. Structured psychiatric interviews were conducted following the screening, with 562 of the participants. Data from participants’ pregnancy records were also analysed. The study was conducted in primary healthcare centres in Iceland after receiving approval from the Icelandic National Bioethical Committee. The main outcome measures were pregnancy problems, sick leave issued and prenatal service needs.ResultsData from 503 women were analysed. The perinatal distress group (PDG) was significantly more likely than was the nondistressed group (NDG) to experience fatigue, vomiting and pelvic pain after controlling for background variables. Distressed women who reported weak family support experienced symptoms of nausea and heartburn. The PDG needed more frequent prenatal care than did the NDG and was issued sick leave for up to 42 days longer. Dissatisfaction in the partner relationship and with the division of household tasks and childcare was strongly associated with distress, the development of complications and the need for sick leave.DiscussionIdentification of perinatal distress by midwives and other healthcare professionals is important, since distress may be linked to women's complaints of fatigue, vomiting, pelvic pain and need for prolonged sick leave, and additional prenatal care services will be needed. Perceived dissatisfaction in the partner relationship and with the division of household tasks should also form part of clinical practice and assistance provided.
Distance from core competences and new export survival: Evidence from multi‐product exporters
Authors: Goya Daniel , Zahler Andrés 
Published: June 2019

AbstractWe study the determinants of the survival of new export products of multi‐product firms. We use micro‐level data from Chile to estimate linear fixed‐effects and non‐linear survival models to show that a measure of “distance” between a firm's new export and its previous export basket is a negative and significant determinant of the survival of the new export, especially during its first year. Our interpretation of this finding is that exports further away from firms’ core competences have lower chances of survival in exports since it is more difficult for firms to achieve competitiveness in them. Our results suggest that country‐level diversification, at least through existing firms, should be gradual.
Retrospective evaluation of the clinical presentation, magnetic resonance imaging findings, and outcome of dogs diagnosed with intracranial empyema (2008–2015): 9 cases
Authors: Forward Alexander K. , Plessas Ioannis N. , Guilherme Sérgio , De Decker Steven 
Published: June 2019

AbstractObjectiveTo describe the clinical presentation, advanced imaging findings, and short‐ and long‐term outcomes in dogs with intracranial empyema.DesignRetrospective case series.AnimalsClient‐owned dogs diagnosed with intracranial empyema.MethodsMedical records from 2 referral hospitals were searched for dogs diagnosed with intracranial empyema. To be included in this study, dogs had to fulfill 1 or more of the following 3 inclusion criteria: a magnetic resonance imaging (MRI) scan with space occupying accumulation of extra‐axial material suggestive of empyema, a cerebrospinal fluid analysis suggestive of empyema, or direct visualization of purulent material during intracranial surgery.ResultsNine dogs with intracranial empyema were included, with a median age of 3.5 years (range: 4 mo–12.5 y). All presented as emergencies with 7 of the 9 dogs showing neurological abnormalities and 2 of the 9 with retrobulbar swelling and exophthalmos. Six had surgical intervention, 1 was medically managed, and the remaining 2 dogs were euthanized. Typical MRI findings included extra‐axial, T1‐weighted hypo‐ to isointense, T2‐weighted hyperintense material compared to gray matter with varying degrees of contrast enhancement, with 6 of 8 showing evidence of contiguous infection from adjacent structures on MRI. For 7 dogs, ≥1 samples were sent for culture and sensitivity, withEnterococcus(surgical swab),Streptococcus pneumonia(from cerebral spinal fluid), and coagulase positiveStaphylococcus(ear swab) being cultured. The median antimicrobial course length was 6 weeks (range: 2–28 wk). All dogs for which treatment was attempted survived to discharge, with a median hospitalization time of 7 days (range: 4–10 d). Four of the 7 are still alive at the time of writing (1 lost to follow‐up; 2 euthanized for other reasons) with all 4 considered neurologically normal with a successful long‐term outcome.ConclusionAlthough intracranial empyema in dogs is a rare condition, excellent outcomes are possible in those cases treated appropriately.
Effectiveness of interventions for dementia in low- and middle-income countries: protocol for a systematic review, pairwise and network meta-analysis
Authors: Salcher-Konrad Maximilian , Naci Huseyin , McDaid David , Alladi Suvarna , Oliveira Deborah , Fry Andra , Hussein Shereen , Knapp Martin , Musyimi Christine Wayua , Ndetei David Musyimi , Lopez-Ortega Mariana , Comas-Herrera Adelina 
Published: June 2019

IntroductionThere are more people living with dementia in low- and middle-income countries (LMICs) than in high-income countries. Evidence-based interventions to improve the lives of people living with dementia and their carers are needed, but a systematic mapping of methodologically robust studies in LMICs and synthesis of the effectiveness of dementia interventions in these settings is missing.Methods and analysisA systematic review and meta-analysis will be conducted to answer the question: Which dementia interventions were shown to be effective in LMICs and how do they compare to each other? Electronic database searches (MEDLINE, EMBASE, PsycINFO, CINAHL Plus, Global Health, WHO Global Index Medicus, Virtual Health Library, Cochrane CENTRAL, Social Care Online, BASE, MODEM Toolkit, Cochrane Database of Systematic Reviews) will be complemented by hand searching of reference lists and local knowledge of existing studies from an international network of researchers in dementia from LMICs. Studies will be eligible for inclusion if they were published between 2008 and 2018, conducted in LMICs and evaluated the effectiveness of a dementia intervention using a study design that supports causal inference of the treatment effect. We will include both randomised and non-randomised studies due to an anticipated low number of well-conducted randomised trials in LMICs and potentially greater external validity of non-randomised studies conducted in routine care settings. In addition to narrative synthesis of the interventions, feasibility of pairwise and network meta-analyses will be explored to obtain pooled effects of relative treatment effects.Ethics and disseminationSecondary analysis of published studies, therefore no ethics approval required. Planned dissemination channels include a peer-reviewed publication as well as a website, DVD and evidence summaries.Prospero registration numberCRD42018106206.
Latent profile analysis of anxiety disorder among left-behind children in rural Southern China: a cross-sectional study
Authors: Liao Haining , Pan Minyi , Li Weinan , Lin Changqi , Zhu Xuhao , Li Xingru , Li Jinghua , Zhou Shudong 
Published: June 2019

ObjectivesPrevious studies have used latent profile analysis (LPA) to examine rural left-behind children’s anxiety. Further study is needed to identify the heterogeneous characteristics of rural left-behind children’s anxiety and explore the related factors.SettingA cross-sectional survey using a school-based sample was conducted in January 2018 in Qingxin district, Qingyuan city, Guangdong province.Participants1026 left-behind children (effective response rate of the questionnaire: 95.39%).Main outcome measuresProfile latent classes (LC) and anxiety disorder.ResultsThe LPA identified three anxiety LC: ‘low anxiety’ (56.6%), ‘medium anxiety’ (34.8%) and ‘severe anxiety’ (8.6%). The multinomial logistic regression model was used to predict the relationship between personal, family, school factors and anxiety. We found that the variables directly related to lower anxiety classes included age (12–14 years), harmonious or fair relationship with classmates, no neglect, harmonious parental relationship and the duration of mother migration <6 months.ConclusionsThese findings suggested the need for careful consideration of differences in anxieties among rural left-behind children. Identifying latent subgroups may provide an empirical basis for teachers and public health practitioners to implement anxiety intervention efforts.
Prospective repeated assessment of self-reported sleep quality and sleep disruptive factors in the intensive care unit: acceptability of daily assessment of sleep quality
Authors: Alsulami Ghaida , Rice Ann Marie , Kidd Lisa 
Published: June 2019

IntroductionDespite the importance of sleep, the assessment of sleep quality does not form part of standard clinical care in intensive care unit (ICU). Continuous assessment of self-reported quality of ICU patients’ sleep has been strongly recommended. Prior to implementing such an assessment in the ICU, it is important to assess the acceptability of this method of assessment to the ICU’s patients. The aims of this study were to assess the acceptability to ICU patients of completing daily self-reports on sleep quality during their ICU stay and to assess ICU patients’ self-reported sleep quality and sleep disruptive factors during their time in ICU.MethodsAn observational prospective-repeated assessment was conducted on n=120 patients in an ICU in Saudi Arabia. The participants were both intubated and non-intubated.Outcomes measuresOver a 3-month period, sleep quality was assessed using the Arabic version of the Richards-Campbell Sleep Questionnaire (RCSQ-A), and self-reported sleep disruptive factors were identified. Clinical factors, such as ICU interventions, and previously administered sedatives were also examined. The patients’ acceptance of completing daily RCSQ-A reports was assessed using various indicators of acceptability.ResultsA total of 381 self-reports (RCSQ-A) were collected for this analysis. The patients reported 34.4±5.60, indicating that sleep quality was poor on average. The group of intubated patients reported much poorer sleep quality during intubation than after extubation. In the multivariate analysis, factors which most significantly affected sleep (exp(b), p value) were midazolam (−6.424, p<0.0005), propofol (−3.600, p<0.05), noise (−1.033, p<0.05), gender (1.836, p<0.05), daytime sleepiness (0.856, p<0.05) and the presence of mechanical ventilation (−1.218, p<0.05).ConclusionThe acceptability and feasibility of using daily RCSQ-A for sleep quality assessment was demonstrated. Sleep quality was reported as poor by all participants and the factors affecting sleep were varied. This study provided various recommendations for healthcare providers and researchers in terms of evaluating and improving sleep quality in ICU patients.
Implementation evaluation of multiple complex early years interventions: an evaluation framework and study protocol
Authors: Dharni Nimarta , Dickerson Josie , Willan Kathryn , Ahern Sara , Dunn Abigail , Nielsen Dea , Uphoff Eleonora , McEachan Rosemary R C , Bryant Maria 
Published: June 2019

IntroductionImplementation evaluations are integral to understanding whether, how and why interventions work. However, unpicking the mechanisms of complex interventions is often challenging in usual service settings where multiple services are delivered concurrently. Furthermore, many locally developed and/or adapted interventions have not undergone any evaluation, thus limiting the evidence base available. Born in Bradford’s Better Start cohort is evaluating the impact of multiple early life interventions being delivered as part of the Big Lottery Fund’s ‘A Better Start’ programme to improve the health and well-being of children living in one of the most socially and ethnically diverse areas of the UK. In this paper, we outline our evaluation framework and protocol for embedding pragmatic implementation evaluation across multiple early years interventions and services.Methods and analysisThe evaluation framework is based on a modified version of The Conceptual Framework for Implementation Fidelity. Using qualitative and quantitative methods, our evaluation framework incorporates semistructured interviews, focus groups, routinely collected data and questionnaires. We will explore factors related to content, delivery and reach of interventions at both individual and wider community levels. Potential moderating factors impacting intervention success such as participants’ satisfaction, strategies to facilitate implementation, quality of delivery and context will also be examined. Interview and focus guides will be based on the Theoretical Domains Framework to further explore the barriers and facilitators of implementation. Descriptive statistics will be employed to analyse the routinely collected quantitative data and thematic analysis will be used to analyse qualitative data.Ethics and disseminationThe Health Research Authority (HRA) has confirmed our implementation evaluations do not require review by an NHS Research Ethics Committee (HRA decision 60/88/81). Findings will be shared widely to aid commissioning decisions and will also be disseminated through peer-reviewed journals, summary reports, conferences and community newsletters.
Junior doctor engagement: what is it, why does it matter and what the workplace can do to improve it
Authors: Ward Emily 
Published: June 2019

BackgroundAcross the world, there is a struggle to balance the provision of adequate healthcare with trained healthcare professionals. In the UK, the National Health Service (NHS) is struggling with increasing demand coupled with a reduction in funding, an older multimorbid population and rising patient expectations.ObjectivesThe landscape within which doctors practise is constantly changing with increasing devolution, changing political priorities and new technologies, and as a result, we cannot afford to have disengaged staff.MethodsEmployee engagement is a process, a description of how a business or workplace interacts with its staff. Research has demonstrated that while engagement can improve certain patient outcomes, the manner in which Junior Doctors are employed in the NHS can create many barriers to organisational workplace engagement.ResultsThis discussion focuses on how workplace engagement is being developed across healthcare; and some of the challenges to workplace engagement with Junior Doctors with a focus on issues such as placement durations, demanding workloads and lack of basic provisions for junior staff. It gives simple suggestions for how these barriers can be overcome and how Junior Doctors can be incorporated into teams, resulting in increased workplace engagement and improved patient outcomes.
Exposure and reach of the US court-mandated corrective statements advertising campaign on broadcast and social media
Authors: Kostygina Ganna , Szczypka Glen , Tran Hy , Binns Steven , Emery Sherry L , Vallone Donna , Hair Elizabeth C 
Published: June 2019

ObjectiveAs a remedy to committing fraud and violating civil racketeering laws, in November 2017, four major tobacco companies were court-ordered to develop and disseminate corrective statements regarding smoking health risks using mass media channels. We aimed to describe the nature, timing, reach of and exposure to the court-mandated tobacco industry corrective advertising campaign on social, broadcast and print media.MethodsData from social, print and broadcast media were used to measure potential exposure to corrective messages. Keyword rules were used to collect campaign-related posts from the Twitter Firehose between November 2017 and January 2018. Data were analysed using a combination of machine learning, keyword algorithms and human coding. Posts were categorised by source (commercial/institutional, organic) and content type (eg, sentiment). Analysis of social media data was triangulated with ratings data for television advertising and print advertising expenditure data.ResultsKeyword filters retrieved 13 846 tweets posted by 9232 unique users. The majority of tweets were posted by institutional/commercial sources including news organisations, bots and tobacco control-related accounts and contained links to news and public health-related websites. Approximately 60% of campaign-related tweets were posted during the first week of campaign launch. Household exposure to the televised corrective advertisements averaged 0.56 ads per month.DiscussionThe corrective campaign failed to generate social media engagement. The size and timing of the advertising buys were not consistent with strategies effective in generating high sustained impact and audience reach, particularly among youth.