bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health and social care professionals’ experiences of supporting parents and their dependent children during, and following, the death of a parent: A qualitative review and thematic synthesis
Authors: Franklin Penny , Arber Anne , Reed Liz , Ream Emma 
Published: October 2018

Background: Children need to be prepared for the death of a parent and supported afterwards. Parents seek support from health and social care professionals to prepare their children. Support is not always forthcoming. Aim: To systematically identify, analyse and synthesise literature reporting of the experiences of health and social care professionals when supporting parents and children during, and following, the death of a parent. Design: A systematically constructed qualitative review and thematic synthesis. Registered on Prospero (CRD42017076345). Data sources: MEDLINE, CINAHL, Embase, PsycINFO, PsycARTICLES and PROSPERO, searched from January 1996 to July 2018 for qualitative studies in English, containing verbatim reporting of health and social care professionals’ experiences of supporting parents and children during, and following, the death of a parent. Qualitative data were appraised using a modified Critical Appraisal Skills Programme qualitative appraisal checklist. Results: The search yielded 15,758 articles. Of which, 15 met the inclusion criteria. A total of 13 included professionals’ experiences of supporting parents and children before parental death. Two included experiences of supporting surviving parents and children afterwards. Three analytical themes identified as follows: (1) aspiring to deliver family-focussed care, (2) health and social care professionals’ behaviours and emotions and (3) improving connections with parents and children. Connecting empathically with parents and children to prepare and support children entails significant emotional labour. Professionals seek to enhance their confidence to connect. Conclusion: Professionals struggle to connect empathically with parents and their children to prepare and to support children when a parent is dying and afterwards. Awareness of professionals’ needs would enable provision of appropriate support for parents and children.
Pre-emptive prescription of medications for the management of potential, catastrophic events in patients with a terminal illness: A survey of palliative medicine doctors
Authors: Katz Naomi T , Sacks Bronwyn H , Le Brian H , Hynson Jenny L 
Published: October 2018

Background: Distressing and potentially life-threatening events, such as significant external bleeding, may occur in patients with a known terminal condition. These events are often referred to as catastrophic or crisis events. Pharmacological management varies and there is little evidence to guide practice. Aim: The aim of this study was to explore Australasian palliative medicine doctors’ approaches to pre-emptive prescription of medications to manage catastrophic events. Design: Anonymous survey data were collected electronically. Setting/Participants: Australian and New Zealand palliative medicine fellows and trainees were surveyed. Results: Surveys were completed by 121 doctors; 108 (89.2%) who care for adult patients only and 13 (10.8%) who care for paediatric patients or paediatric and adult patients. In all, 74 (61.2%) respondents pre-emptively prescribed medications at least five times per year, and most orders were never administered. Significant visible bleeding and severe, acute airway obstruction were almost universally considered catastrophic events. Many respondents expressed concern about the lack of evidence to guide pre-emptive medication prescription in this setting. Clinicians reported adverse events related to pre-emptive medication orders being available ( n = 30, 24.8%), as well as orders not being available ( n = 61, 50.4%). Conclusion: Our study supports the need for guidelines, as well as formal education programmes for medical trainees and nursing staff about this important area of practice.
3,4-Methylenedioxymethamphetamine-assisted psychotherapy for treatment of chronic posttraumatic stress disorder: A randomized phase 2 controlled trial
Authors: Ot’alora G Marcela , Grigsby Jim , Poulter Bruce , Van Derveer Joseph W , Giron Sara Gael , Jerome Lisa , Feduccia Allison A , Hamilton Scott , Yazar-Klosinski Berra , Emerson Amy , Mithoefer Michael C , Doblin Rick 
Published: October 2018

Background: Posttraumatic stress disorder often does not resolve after conventional psychotherapies or pharmacotherapies. Pilot studies have reported that 3,4-methylenedioxymethamphetamine (MDMA) combined with psychotherapy reduces posttraumatic stress disorder symptoms. Aims: This pilot dose response trial assessed efficacy and safety of MDMA-assisted psychotherapy across multiple therapy teams. Methods: Twenty-eight people with chronic posttraumatic stress disorder were randomized in a double-blind dose response comparison of two active doses (100 and 125 mg) with a low dose (40 mg) of MDMA administered during eight-hour psychotherapy sessions. Change in the Clinician-Administered PTSD Scale total scores one month after two sessions of MDMA served as the primary outcome. Active dose groups had one additional open-label session; the low dose group crossed over for three open-label active dose sessions. A 12-month follow-up assessment occurred after the final MDMA session. Results: In the intent-to-treat set, the active groups had the largest reduction in Clinician-Administered PTSD Scale total scores at the primary endpoint, with mean (standard deviation) changes of −26.3 (29.5) for 125 mg, −24.4 (24.2) for 100 mg, and −11.5 (21.2) for 40 mg, though statistical significance was reached only in the per protocol set ( p=0.03). Posttraumatic stress disorder symptoms remained lower than baseline at 12-month follow-up ( p<0.001) with 76% ( n=25) not meeting posttraumatic stress disorder criteria. There were no drug-related serious adverse events, and the treatment was well-tolerated. Conclusions: Our findings support previous investigations of MDMA-assisted psychotherapy as an innovative, efficacious treatment for posttraumatic stress disorder.
Higher serum zinc levels may reduce the risk of cervical cancer in Asian women: A meta-analysis
Authors: Xie Yueying , Wang Junjie , Zhao Xiaoya , Zhou Xuli , Nie Xiaohui , Li Chuncheng , Huang Fulian , Yuan Haibin 
Published: October 2018

Objective This meta-analysis was conducted to examine the possible association between serum zinc concentration and cervical cancer risk. Methods PubMed, WanFang, China National Knowledge Infrastructure, and SinoMed databases were searched for relevant articles published between January 1980 and September 2017. Results were combined using a random-effects model, and pooled standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated to compare serum zinc levels in patients with cervical cancer versus controls. Publication bias was evaluated using Begg’s funnel plot and Egger’s regression asymmetry test. Results Twelve articles regarding serum zinc levels and cervical cancer were included in this meta-analysis. Combined results showed that serum zinc levels in cervical cancer cases were significantly lower than in controls without cervical cancer (summary SMD –1.379, 95% CI –1.527, –1.231), with high heterogeneity ( I2 = 98.8%). Analysis of data stratified by geographic location showed a significant association between serum zinc levels and cervical cancer risk in Asian populations (summary SMD –1.391, 95% CI –1.543, –1.239). Conclusions Higher serum zinc levels may be a protective factor for cervical cancer in Asian women.
Modernization, Poverty Eradication, and the Process of Social Transformation in Uganda
Authors: Byekwaso Ndinawe 
Published: October 2018

To eradicate poverty, pro-market policies were implemented in Uganda. This article reveals that the policies did not improve the welfare of peasants. Instead, the peasants were made to depend on the market as a result of the harsh environment created that compelled them to increasingly abandon self-provisioning farming. Consequently, the people are increasingly faced with food shortages and the number of children dying of malnutrition is on the rise while land seizures are taking place. JEL Classification: Q02, Q11, Q15
Traffic Violations among Young People with Attention-Deficit Hyperactivity Disorder
Authors: Ferro Mark A. , Leatherdale Scott T. 
Published: October 2018

Background: Evidence whether individuals with attention-deficit hyperactivity disorder (ADHD) are at increased risk for traffic violations/collisions is mixed. This study investigated the association between ADHD and traffic violations among youth and young adults; examined whether this association differed by age, sex, or comorbid mental or physical problems; and modelled factors associated with traffic violations among individuals with ADHD. Methods: Data come from the 2012 Canadian Community Health Survey–Mental Health (CCHS-MH), a cross-sectional epidemiological study. The sample was restricted to youth and young adults aged 15 to 39 years and categorized into 3 groups: 15 to 19 years ( n = 1886), 20 to 29 years ( n = 3679), and 30 to 39 years ( n = 3659). Lifetime ADHD and past-year contact with police for traffic violations were self-reported. Logistic regression models quantified the association between ADHD and traffic violations, stratified by age. Interactions were included to examine moderating effects. Results: No evidence suggested an association between ADHD and past-year traffic violations (odds ratio [OR], 1.07; 95% confidence interval (CI), 0.64 to 1.79), age-specific estimates did not differ across age groups ( P = 0.696), and no factors moderated the association. Three factors were found to increase odds for past-year traffic violations among individuals with ADHD: aged 20 to 29 years (OR, 3.84; 95% CI, 1.47 to 10.06), male sex (OR, 3.48; 95% CI, 1.39 to 8.59), and white ethnicity (OR, 5.62; 95% CI, 1.24 to 25.51). Conclusions: Individuals with ADHD are not an at-risk group for traffic violations but instead share similar risk factors with individuals in the general population without ADHD—information useful for health professionals. Replication studies are needed to examine the robustness of these findings.
Primary gastric diffuse large B-cell lymphoma: The role of dose-dense chemotherapy
Authors: Avilés Agustin , Nambo Maria-Jesus , Neri Natividad 
Published: October 2018

Objective To assess if the use of a dose-dense regimen of chemotherapy can improve the prognosis in patients with primary gastric diffuse large B-cell lymphoma in early stages (I–II) but associated with worse prognostic factors. Methods One hundred and eight consecutive patients with primary gastric diffuse large B-cell lymphoma in early stages (I–II) with high serum levels of lactic dehydrogenase and beta 2 microglobulin (more than >2 of normal levels), which were associated with a worse prognostic outcome, were treated with a dose-dense chemotherapy: CHOP with increased doses of cyclophosphamide and doxorubicin, was administered every 14 days (instead of 21 days). The end points of this study were to improve outcome measured from progression-free survival and overall survival and to evaluate acute toxicities. Results Complete response was achieved in 85 patients (78%). Actuarial curves at five years show that progression-free survival was 82% and overall survival was 85%. Hematological toxicities were severe, but no death-related treatment was observed. Conclusions We considered that in this setting of patients, the use of a dose-dense regimen could be of benefit because it improves outcome and toxicities were well controlled.
Integration of Biomarkers Into a Signature Profile of Persistent Traumatic Brain Injury Involving Autoimmune Processes Following Water Hammer Injury From Repetitive Head Impacts
Authors: Kornguth Steven , Rutledge Neal 
Published: October 2018

Objectives: To assemble an algorithm that will describe a “Signature” predictive of an individual’s vulnerability to persistent traumatic brain injury (TBI) Subjects and Methods: Studies of athletes and warriors who are subjected to repeated head impacts with rapid acceleration/deceleration forces are used to assist in the diagnosis and management of TBI-affected individuals. Data from multiple areas, including clinical, anatomical, magnetic resonance imaging, cognitive function, and biochemical analyses, are integrated to provide a Signature of persistent TBI. Results: Studies to date indicate that susceptibility to TBI results from an interaction between host genetic and structural vulnerability factors and force and torque of impact on the head and torso. The host factors include molecular markers affecting immune and inflammatory responses to stress/insult as well as anatomical features such as the degree of transcortical fiber projections and vascular malformations. The host response to forceful impact includes the release of intracellular neural proteins and nucleic acids into the cerebrospinal fluid and vascular compartment as well as mobilization of cytokines and macrophages into the central nervous system with subsequent activation of microglia and inflammatory responses including autoimmune processes. Maximum impact to the base of the sulci via a “water hammer effect” is consistent with the localization of microvascular and inflammatory responses in the affected brain region. Conclusions: An assessment of an individuals’ predisposition to persistent TBI with delayed cognitive deficits and behavioral changes requires an understanding of host vulnerability (genetic factors and brain structure) and external stressors (force and torque of impact as well as repetitive head injury and time interval between impacts). An algorithm that has utility in predicting vulnerability to TBI will include qualitative and quantitative measures of the host factors weighted against post impact markers of neural injury. Implementation of the resulting “Signature” of vulnerability at early stages of injury will help inform athletes and warriors, along with commanders and management, of the risk/benefit approaches that will markedly diminish health care costs to the nation and suffering to this population. This report attempts to define a strategy to create such an algorithm.
Time-course of attentional bias for culture-related cues in Mongolian-Chinese bilingual children
Authors: Yu Hongyu , Yao Nisha , Zhang Jijia , Gao Bing 
Published: October 2018

Aims and objectives/purpose/research questions: Using a modified dot-probe task, the present research examined the time-course of attentional bias for culture-related cues in Mongolian-Chinese bilinguals. Design/methodology/approach: Using a mixed experimental design, children with different language fluency (fluent bilingual, limited bilingual and mandarin monolingual) were recruited ( N = 168; 51% boys; Mage = 9.88 years, SD = 0.38 years; 59% Mongolian) to complete a dot-probe task in which they were shown pairs of pictures representing Mongolian and Han culture for short (60 ms) and long (500 ms) exposure durations. The difference between fluent and limited bilinguals lies in their proficiency in Mongolian. Data and analysis: The attentional bias scores ( d) were entered into a 2 × 3 mixed design repeated-measures analysis of variance with language fluency (fluent bilingual versus limited bilingual versus monolingual) as a between-subjects variable and the time-course (60 versus 500 ms) as a within-subject variable. Findings/conclusions: In the task, compared with pictures representing Han culture, all students showed preferential attention to pictures conveying Mongolian culture across presentation durations. However, for 60 ms, fluent bilinguals showed a smaller attentional bias than did monolinguals, with no difference between limited bilinguals and monolinguals; there was no significant difference among the three groups at 500 ms. Originality: Relatively less research has been performed on comparative analysis between fluent and non-fluent bilinguals, and most of the culture-related content is measured by subjective methods. This study attempts to directly compare these two bilinguals’ attentional bias for culture-related cues using a dot-probe task. Significance/implications: The results of comparative analysis showed that fluent bilinguals were more familiar with Mongolian language and preserved their ethnic culture better, which may indicate a close relationship between language and culture.
Communication Empowerment Framework: An integrative framework to support effective communication and interaction between carers and people living with dementia
Authors: Morris Lydia , Mansell Warren , Williamson Tracey , Wray Alison , McEvoy Phil 
Published: October 2018

Objectives To demonstrate the power of integrating three theoretical perspectives (Mentalization Theory, Perceptual Control Theory and the Communicative Impact model), which jointly illuminate the communication challenges and opportunities faced by family carers of people with dementia. To point the way to how this framework informs the design and delivery of carer communication and interaction training. Method Conceptual synthesis based on a narrative review of relevant literature, supported by examples of family carers. Results We use the conceptual models to show how the capacity to mentalize (“holding mind in mind”) offers a greater sense of control over internal and external conflicts, with the result that they can be deescalated in pursuit of mutual goals. Conclusions The integrative conceptual framework presented here highlights specific psychological and relational mechanisms that can be targeted through carer training to enhance communication with a person living with dementia.
Therapeutic responses to a frontal/executive programme in autism spectrum disorder: Comparison with schizophrenia
Authors: Miyajima Maki , Omiya Hidetoshi , Yamashita Kiyoko , Yambe Kenji , Matsui Mie , Denda Kenzo 
Published: October 2018

Introduction Studies on autism spectrum disorder in recent years have controversially indicated similarities with schizophrenia. Cognitive dysfunction is present in both disorders, and while there is a rich array of interventions for cognitive dysfunction in schizophrenia, there are few such treatments for autism spectrum disorder. In this study, we have investigated a potentially useful approach in autism spectrum disorder by comparing autism spectrum disorder with schizophrenia in regard to the characteristics of cognitive dysfunction and therapeutic response to cognitive remediation therapy. Method We studied seven patients with autism spectrum disorder and eight patients with schizophrenia, using a frontal/executive programme as the intervention. The characteristics of cognitive dysfunction in autism spectrum disorder before frontal/executive programme and the therapeutic response to frontal/executive programme in autism spectrum disorder patients were compared with those in schizophrenia patients, based on evaluation of cognitive function and social function. The changes in cognitive and social function after treatment in each patient group were compared using the Mann–Whitney’s U test. Results The severity of cognitive dysfunction did not differ significantly between autism spectrum disorder and schizophrenia. Frontal/executive programme was effective in autism spectrum disorder, with subjects showing about the same therapeutic response as in schizophrenia. Conclusion Frontal/executive programme appears to be useful for patients with autism spectrum disorder. Furthermore, the similarities in cognitive dysfunction and therapeutic response between autism spectrum disorder and schizophrenia are highly relevant to the recent debate concerning the similarity between these two disease concepts.
Flow-diverter stents in the endovascular treatment of remnants in previously clipped ruptured aneurysms: a feasibility study
Authors: Romagna Alexander , Ladisich Barbara , Schwartz Christoph , Winkler Peter A , Rahman Al-Schameri Abdul 
Published: October 2018

Background The rate of intracranial aneurysm remnants/recurrences after microsurgical clipping varies widely. The optimal management for these patients remains a matter of debate. Repeat surgery in particular bears a high risk of periprocedural complications due to anatomical distortion from prior procedures. This study aims to evaluate the risk–benefit profile of flow-diverter stents in these patients. Methods The patient database of our neurovascular centre was queried to identify patients with clipped aneurysms who subsequently underwent endovascular treatment with intraluminal flow-diverter stents. The outcome analysis consisted of an assessment of clinical parameters (modified Rankin scale) and the post-interventional angiographic occlusion status (according to the Raymond–Roy occlusion classification). Results Six patients underwent endovascular treatment with flow-diverter stents of recurrent aneurysms after clipping. Treatment was necessary in two patients due to progressive neurological deficits, and due to angiographic proof of an increasing aneurysm size in the other four patients. Median aneurysm size was 0.45 cm. All patients had a prior history of subarachnoid haemorrhage. The time from primary clipping to recurrence was 10.6 years. Complete radiological aneurysm occlusion was feasible in five out of six cases. Two patients who had experienced pre-interventional neurological deficits showed a complete remission of symptoms on last follow-up. No periprocedural morbidity or mortality was recorded and no patient required retreatment within the median follow-up. Conclusion This case series suggests that endovascular treatment with flow-diverter stents of aneurysm remnants after previous microsurgical clipping is a feasible treatment concept with a low-risk profile, which might prevent the treatment burden and risks of repeat surgery.
Rethinking neck circumference in STOP-BANG for Asian OSA
Authors: Loh John Ming-Ren , Toh Song-Tar 
Published: October 2018

Introduction: The STOP-BANG questionnaire is a simple screening tool for obstructive sleep apnoea (OSA) which has been validated for use in Asian populations. The original cut-off values for neck circumference were defined based on Caucasian populations. This study aims to validate the neck circumference component of the STOP-BANG score in Asians. Methods: A retrospective analysis of all patients suspected of having OSA who underwent a diagnostic polysomnography at a tertiary sleep centre in Singapore over the course of 1 year was conducted. Neck circumference was measured and correlated to the presence of OSA. A receiver operating curve was performed to obtain the optimal cut-off value for screening OSA in Asian patients. Results: 591 Asian subjects with OSA were analysed. The optimal neck circumference predictive for OSA was found to be 39 cm in males and 35 cm in females, with a sensitivity of 83.4% and 84.6% respectively. The existing STOP-BANG cut-off of 40 cm had 71% and 32% sensitivity in Asian males and females, respectively. Conclusion: The STOP-BANG cut-off value for neck circumference for screening for sleep apnoea in Asian males can be maintained at 40 cm, but the neck circumference value used for screening Asian females should be lowered to 35 cm.