bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relation between illness representation and self-reported degree-of-worry in patients calling out-of-hours services: a mixed-methods study in Copenhagen, Denmark
Authors: Thilsted Sita LeBlanc , Egerod Ingrid , Lippert Freddy Knudsen , Gamst-Jensen Hejdi 
Published: September 2018

ObjectivesTo examine the relation between patients’ illness representations, presented in telephone consultation to out-of-hours (OOH) services, and self-reported degree-of-worry (DOW), as a measure of self-evaluated urgency. If a clear relation is found, incorporating DOW during telephone triage could aid the triage process, potentially increasing patient safety.DesignA convergent parallel mixed methods design with quantitative data; DOW and qualitative data from recorded telephone consultations. Thematic analysis of the qualitative data was used to explore the content of the quantitatively scaled DOW, using the Common-Sense Model of Self-Regulation (CSM).SettingA convenience sampling of calls to the OOH services in Copenhagen, Denmark, during 3 days was included in the study.ParticipantsCalls from adults (≥15 years of age) concerning somatic illness during the data collection period were eligible for inclusion. Calls made on behalf of another person, calls concerning perceived life-threatening illness or calls regarding logistical/practical problems were excluded, resulting in analysis of 180 calls.ResultsAll five components of the CSM framework, regardless of DOW, were present in the data. All callers referred to identity and timeline and were least likely to refer to consequence (37%). Through qualitative analysis, themes were defined. Callers with a strong identity, illness duration of less than 24 hours, clear cause and solution for cure/control seemed to present a lower DOW. Callers with a medium identity, illness duration of more than 24 hours and a high consequence seemed to present a higher DOW.ConclusionThis study suggests a relation between a patient’s illness representation and self-evaluation of urgency. Incorporating a patient’s DOW during telephone triage could aid the triage process in determining urgency and type of healthcare needed, potentially increasing patient safety. Research on patient outcome after DOW-assisted triage is needed before implementation of the DOW scale is recommended.
Incidence of unintended pregnancy among female sex workers in low-income and middle-income countries: a systematic review and meta-analysis
Authors: Ampt Frances H , Willenberg Lisa , Agius Paul A , Chersich Matthew , Luchters Stanley , Lim Megan S C 
Published: September 2018

ObjectivesTo determine the incidence of unintended pregnancy among female sex workers (FSWs) in low-income and middle-income countries (LMICs).DesignWe searched MEDLINE, PsychInfo, Embase and Popline for papers published in English between January 2000 and January 2016, and Web of Science and Proquest for conference abstracts. Meta-analysis was performed on the primary outcomes using random effects models, with subgroup analysis used to explore heterogeneity.ParticipantsEligible studies targeted FSWs aged 15–49 years living or working in an LMIC.Outcome measuresStudies were eligible if they provided data on one of two primary outcomes: incidence of unintended pregnancy and incidence of pregnancy where intention is undefined. Secondary outcomes were also extracted when they were reported in included studies: incidence of induced abortion; incidence of birth; and correlates/predictors of pregnancy or unintended pregnancy.ResultsTwenty-five eligible studies were identified from 3866 articles. Methodological quality was low overall. Unintended pregnancy incidence showed high heterogeneity (I²>95%), ranging from 7.2 to 59.6 per 100 person-years across 10 studies. Study design and duration were found to account for heterogeneity. On subgroup analysis, the three cohort studies in which no intervention was introduced had a pooled incidence of 27.1 per 100 person-years (95% CI 24.4 to 29.8; I2=0%). Incidence of pregnancy (intention undefined) was also highly heterogeneous, ranging from 2.0 to 23.4 per 100 person-years (15 studies).ConclusionsOf the many studies examining FSWs’ sexual and reproductive health in LMICs, very few measured pregnancy and fewer assessed pregnancy intention. Incidence varied widely, likely due to differences in study design, duration and baseline population risk, but was high in most studies, representing a considerable concern for this key population. Evidence-based approaches that place greater importance on unintended pregnancy prevention need to be incorporated into existing sexual and reproductive health programmes for FSWs.PROSPERO registration numberCRD42016029185
Group cognitive remediation therapy for adults with obesity prior to behavioural weight loss treatment: study protocol for a randomised controlled superiority study (CRT study)
Authors: Hilbert Anja , Blume Marie , Petroff David , Neuhaus Petra , Smith Evelyn , Hay Phillipa J , Hübner Claudia 
Published: September 2018

IntroductionIndividuals with obesity show deficits in executive functioning which have been implicated in decreased weight loss outcome. Preliminary evidence suggests that cognitive remediation therapy (CRT) improves executive functioning and weight loss in obesity. However, confirmatory support, especially for pre-weight loss use, is lacking. The CRT study aims at determining the efficacy of CRT versus no treatment control in patients with obesity before entering behavioural weight loss (BWL) treatment. It is hypothesised that individuals who receive CRT will show better weight loss outcome, improved executive functioning, greater weight loss-related behavioural changes and higher attendance of BWL treatment, 6 and 12 months after cessation of CRT.Methods and analysisIn a single-centre, assessor-blinded, randomised, two-armed parallel-group superiority trial, 260 adults with body mass index ≥35.0 kg/m2are centrally randomised to 8-week group-based CRT versus no treatment, before entering BWL treatment. Primary outcome is the amount of weight loss (%) at 6-month follow-up, compared with pre-treatment, derived from measured body weight. Secondary outcomes include improvement in executive functioning post-treatment and in weight loss-related behaviour, mental and physical health, and attendance to BWL treatment at 6-month and 12-month follow-up. Maintenance of weight loss at 12-month follow-up will be determined. Mixed model analyses based on intent-to-treat will be used to compare the CRT and control groups with respect to differences in weight change between pre-treatment and 6-month follow-up. Similar models will be used for analysing 12-month follow-up data and secondary outcomes. Further analyses will include additional covariates to identify predictors of treatment outcome.Ethics and disseminationThe study was approved by the Ethical Committee of the University of Leipzig (256-15-13072015, version ‘Final 1.0 from 28 May 2015). The study results will be disseminated through peer-reviewed publications.Trial registration numberDRKS00009333; Pre-results.
Management of sepsis in out-of-hours primary care: a retrospective study of patients admitted to the intensive care unit
Authors: Loots Feike J , Smits Marleen , van Steensel Carlijn , Giesen Paul , Hopstaken Rogier M , van Zanten Arthur R H 
Published: September 2018

ObjectivesTimely recognition and treatment of sepsis is essential to reduce mortality and morbidity. Acutely ill patients often consult a general practitioner (GP) as the first healthcare provider. During out-of-hours, GP cooperatives deliver this care in the Netherlands. The aim of this study is to explore the role of these GP cooperatives in the care for patients with sepsis.DesignRetrospective study of patient records from both the hospital and the GP cooperative.SettingAn intensive care unit (ICU) of a general hospital in the Netherlands, and the colocated GP cooperative serving 260 000 inhabitants.ParticipantsWe used data from 263 patients who were admitted to the ICU due to community-acquired sepsis between January 2011 and December 2015.Main outcome measuresContact with the GP cooperative within 72 hours prior to hospital admission, type of contact, delay from the contact until hospital arrival, GP diagnosis, initial vital signs and laboratory values, and hospital mortality.ResultsOf 263 patients admitted to the ICU, 127 (48.3%) had prior GP cooperative contacts. These contacts concerned home visits (59.1%), clinic consultations (18.1%), direct ambulance deployment (12.6%) or telephone advice (10.2%). Patients assessed by a GP were referred in 64% after the first contact. The median delay to hospital arrival was 1.7 hours. The GP had not suspected an infection in 43% of the patients. In this group, the in-hospital mortality rate was significantly higher compared with patients with suspected infections (41.9% vs 17.6%). Mortality difference remained significant after correction for confounders.ConclusionGP cooperatives play an important role in prehospital management of sepsis and recognition of sepsis in this setting proved difficult. Efforts to improve management of sepsis in out-of-hours primary care should not be limited to patients with a suspected infection, but also include severely ill patients without clear signs of infection.
Witnessing violence in early secondary school predicts subsequent student impairment
Authors: Janosz Michel , Brière Frédéric N , Galand Benoît , Pascal Sophie , Archambault Isabelle , Brault Marie-Christine , Moltrecht Brigitte , Pagani Linda S 
Published: September 2018

BackgroundPast research suggests that adolescents who witness violence are at risk of adjustment problems. However, few studies have implemented a longitudinal design and have accounted for direct experiences of victimisation and other major confounders. This prospective study examines the relationship between witnessing school violence and subsequent impairment and whether such associations depend on the kind of violence witnessed.Methods3936 adolescents from Quebec (Canada) were followed from ages 12 through 15 years. Linear regression tested associations between witnessing school violence at age 13 and subsequent antisocial behaviour (drug use, delinquency), emotional distress (social anxiety, depressive symptoms) and academic adjustment (school achievement, engagement) at age 15. We compared the relative contribution of differing forms of witnessing school violence versus being victimised directly.ResultsGeneral school violence predicted later impairment. The adjusted associations between indirectly experiencing violence as a bystander and subsequent impairment were comparable to those of direct victimisation. Witnessing covert and major violence was associated with drug use and delinquency. Witnessing minor violence was associated with increases in drug use, social anxiety, depressive symptoms and decreases in school engagement.ConclusionsAlmost all students witnessed school violence, which predicted impairment. Witnessing violence was associated with risk of subsequent adjustment problems 2 years later. Directly experienced victimisation showed a comparable magnitude of risk. This suggests that when it comes to symptoms of conduct disorder, witnessing violence might have the same impact as experiencing it directly. Witnessing earlier covert and major violence predicted social impairment whereas minor violence predicted psychological and academic impairment.
A comparison of direct aspiration versus stent retriever as a first approach (‘COMPASS’): protocol
Authors: Turk Aquilla S , Siddiqui Adnan H , Mocco J 
Published: September 2018

Background and objectiveAcute ischemic stroke is a potentially devastating condition and leading cause of morbidity and mortality, affecting an estimated 800 000 people per year in the USA. The natural history of untreated or unrevascularized large vessel occlusions in acute stroke patients results in mortality rates approaching 30%, with only 25% achieving good neurologic outcomes at 90 days. Recently, data have demonstrated that early endovascular recanalization of large vessel occlusions results in better outcomes than medical therapy alone. However, the majority of patients in these studies were treated with a stent retriever based approach. The purpose of COMPASS is to evaluate whether patients treated with a direct aspiration first pass (ADAPT) approach have non-inferior functional outcomes to those treated with a stent retriever as the firstline (SRFL) approach.Materials and methodsAll patients who meet the inclusion and exclusion criteria and consent to participate will be enrolled at participating centers. Treatment will be randomly assigned by a central web based system in a 1:1 manner to treatment with either ADAPT or SRFL thrombectomy. Statistical methodology is prespecified with details available in the statistical analysis plan.ResultsThe trial recently completed enrollment, and data collection/verification is ongoing. The final results will be made available on completion of enrollment and follow-up.ConclusionsThis paper details the design of the COMPASS trial, a randomized, blinded adjudicator, concurrent, controlled trial of patients treated with either ADAPT or SRFL approaches in order to evaluate whether ADAPT results in non-inferior functional outcome.Trial registration numberNCT02466893, Results.
Sexual relationships, intimate partner violence and STI partner notification in Cape Town, South Africa: an observational study
Authors: Mathews Catherine , Kalichman Moira O , Laubscher Ria , Hutchison Cameron , Nkoko Koena , Lurie Mark , Kalichman Seth C 
Published: September 2018

ObjectivesWe aimed to identify individual and sexual partnership characteristics associated with partner notification (PN) among people with STI. We hypothesised that PN would be less likely in more casual sexual partnerships and in partnerships with intimate partner violence (IPV).MethodsWe conducted an observational study among the first 330 patients with STI enrolled in a trial of a behavioural intervention to reduce STI incidence, at a clinic in a poor, Cape Town community. We included 195 index patients (those reporting STI symptoms), and conducted longitudinal analyses using participant-completed questionnaires on the day of diagnosis and 2 weeks later. Using partnership data for five recent sexual partners, we assessed factors associated with reported PN with logistic regressions, adjusting for repeated measurements on the same participant for each partner.ResultsThe sample included 99 males with 303 partners and 96 females with 158 partners. Males reported perpetrating IPV in 46.2% of partnerships. Females reported being IPV victims in 53.2% of partnerships. Males notified 58.1%, females 75.4% of partners during the 2 weeks following diagnosis. Type of partner was an independent correlate of PN for males and females, with the odds of PN lower in more casual partnerships. For males, reporting physical IPV perpetration in the partnership was an independent correlate of PN. For females, there was no association between IPV victimisation in a partnership and PN.ConclusionsEfforts to decrease the pool of infectious partners need to have a strong focus on the promotion of PN in casual relationships and one-night stands. IPV was not identified as a barrier to PN. In future, we need to investigate the association between IPV with an objective measure of PN success such as partner testing or treatment, or index patient reinfection.Clinical trial registrationPACTR201606001682364; Pre-results.
Intake of Vitamin K Antagonists and Worsening of Cardiac and Vascular Disease: Results From the Population‐Based Gutenberg Health Study
Authors: Eggebrecht Lisa , Prochaska Jürgen H. , Schulz Andreas , Arnold Natalie , Jünger Claus , Göbel Sebastian , Laubert‐Reh Dagmar , Binder Harald , Beutel Manfred E. , Pfeiffer Nobert , Blankenberg Stefan , Lackner Karl J. , Spronk Henri M. , ten Cate Hugo , Münzel Thomas , Wild Philipp S. 
Published: September 2018

Background

Preclinical data have indicated a link between use of vitamin K antagonists (
VKA
) and detrimental effects on vascular structure and function. The objective of the present study was to determine the relationship between
VKA
intake and different phenotypes of subclinical cardiovascular disease in the population.

Methods and Results

Clinical and laboratory data, as well as medical–technical examinations were assessed from 15 010 individuals aged 35 to 74 years during a highly standardized 5‐hour visit at the study center of the population‐based Gutenberg Health Study. In total, the study sample comprised 287
VKA
users and 14 564
VKA
nonusers. Multivariable analysis revealed an independent association between
VKA
intake and stiffness index (β=+2.54 m/s; [0.41/4.66];
P
=0.019), ankle‐brachial index (β=−0.03; [−0.04/−0.01];
P
<0.0001), intima‐media thickness (β=+0.03 mm [0.01/0.05];
P
=0.0098), left ventricular ejection fraction (β=−4.02% [−4.70/−3.33];
P
<0.0001), E/E′ (β=+0.04 [0.01/0.08];
P
=0.014) left ventricular mass (β=+5.34 g/m
2.7
[4.26/6.44];
P
<0.0001), and humoral markers of cardiac function and inflammation (midregional pro‐atrial natriuretic peptide: β=+0.58 pmol/L [0.50/0.65];
P
<0.0001; midregional pro‐adrenomedullin: β=+0.18 nmol/L [0.14/0.22];
P
<0.0001; N‐terminal pro B‐type natriuretic peptide: β=+1.90 pg/mL [1.63/2.17];
P
<0.0001; fibrinogen: β=+143 mg/dL [132/153];
P
<0.0001; C‐reactive protein: β=+0.31 mg/L [0.20/0.43];
P
<0.0001). Sensitivity analysis in the subsample of participants with atrial fibrillation stratified by intake of
VKA
demonstrated consistent and robust results. Genetic variants in

CYP
2C9

,

CYP
4F2

, and

VKORC
1

were modulating effects of
VKA
on subclinical markers of cardiovascular disease.

Conclusions

These data demonstrate negative effects of
VKA
on vascular and cardiac phenotypes of subclinical cardiovascular disease, indicating a possible influence on long‐term disease development. These findings may be clinically relevant for the provision of individually tailored antithrombotic therapy.
Association of Bystander and First‐Responder Efforts and Outcomes According to Sex: Results From the North Carolina HeartRescue Statewide Quality Improvement Initiative
Authors: Malta Hansen Carolina , Kragholm Kristian , Dupre Matthew E. , Pearson David A. , Tyson Clark , Monk Lisa , Rea Thomas D. , Starks Monique A. , Nelson Darrell , Jollis James G. , McNally Bryan , Corbett Claire M. , Granger Christopher B. 
Published: September 2018

Background
The Institute of Medicine has called for actions to understand and target sex‐related differences in care and outcomes for out‐of‐hospital cardiac arrest patients. We assessed changes in bystander and first‐responder interventions and outcomes for males versus females after statewide efforts to improve cardiac arrest care.

Methods and Results

We identified out‐of‐hospital cardiac arrests from North Carolina (2010–2014) through the CARES (Cardiac Arrest Registry to Enhance Survival) registry. Outcomes for men versus women were examined through multivariable logistic regression analyses adjusted for (1) nonmodifiable factors (age, witnessed status, and initial heart rhythm) and (2) nonmodifiable plus modifiable factors (bystander cardiopulmonary resuscitation and defibrillation before emergency medical services), including interactions between sex and time (ie, year and year
2
). Of 8100 patients, 38.1% were women. From 2010 to 2014, there was an increase in bystander cardiopulmonary resuscitation (men, 40.5%–50.6%; women, 35.3%–51.8%;
P
for each <0.0001) and in the combination of bystander cardiopulmonary resuscitation and first‐responder defibrillation (men, 15.8%–23.0%,
P
=0.007; women, 8.5%–23.7%,
P
=0.004). From 2010 to 2014, the unadjusted predicted probability of favorable neurologic outcome was higher and increased more for men (men, from 6.5% [95% confidence interval (CI), 5.1–8.0] to 9.7% [95%
CI,
8.1–11.3]; women, from 6.3% [95%
CI,
4.4–8.3] to 7.4% [95%
CI,
5.5–9.3%]); while adjusted for nonmodifiable factors, it was slightly higher but with a nonsignificant increase for women (from 9.2% [95%
CI,
6.8–11.8] to 10.2% [95%
CI,
8.0–12.5]; men, from 5.8% [95%
CI,
4.6–7.0] to 8.4% [95%
CI,
7.1–9.7]). Adding bystander cardiopulmonary resuscitation and defibrillation before
EMS
(modifiable factors) did not substantially change the results.

Conclusions
Bystander and first‐responder interventions increased for men and women, but outcomes improved significantly only for men. Additional strategies may be necessary to improve survival among female cardiac arrest patients.
SUPPORT‐AF: Piloting a Multi‐Faceted, Electronic Medical Record‐Based Intervention to Improve Prescription of Anticoagulation
Authors: Kapoor Alok , Amroze Azraa , Golden Jessica , Crawford Sybil , O'Day Kevin , Elhag Rasha , Nagy Ahmed , Lubitz Steve A. , Saczynski Jane S. , Mathew Jomol , McManus David D. 
Published: September 2018

Background

Only 50% of eligible atrial fibrillation (
AF
) patients receive anticoagulation (
AC
). Feasibility and effectiveness of electronic medical record (EMR)–based interventions to profile and raise provider
AC
percentage is poorly understood. The SUPPORT‐AF (Supporting Use of AC Through Provider Profiling of Oral AC Therapy for AF) study aims to improve rates of adherence to AC guidelines by developing and delivering supportive tools based on the EMR to providers treating patients with AF.

Methods and Results

We emailed cardiologists and community‐based primary care providers affiliated with our institution reports of their
AC
percentage relative to peers. We also sent an electronic medical record–based message to these providers the day before an appointment with an atrial fibrillation patient who was eligible but not receiving
AC
. The electronic medical record message asked the provider to discuss
AC
with the patient if he or she deemed it appropriate. To assess feasibility, we tracked provider review of our correspondence. We also tracked the change in
AC
for intervention providers relative to alternate primary care providers not receiving our intervention. We identified 3786, 1054, and 566 patients cared for by 49 cardiology providers, 90 community‐based primary care providers, and 88 control providers, respectively. At baseline, the percentage of
AC
was 71.3%, 63.5%, and 58.3% for these 3 respective groups. Intervention providers reviewed our e‐mails and electronic medical record messages 45% and 96% of the time, respectively. For providers responding, patient refusal was the most common reason for patients not being on
AC
(21%) followed by high bleeding risk (19%). At follow‐up 10 weeks later, change in
AC
was no different for either cardiology or community‐based primary care providers relative to controls (0.2% lower and 0.01% higher, respectively).

Conclusions

Our intervention profiling
AC
was feasible, but not sufficient to increase
AC
in our population.
“No Poor Among Them”: Sabbath and Jubilee Years in Lukan Social Ethics
Authors: Smith David Andrew 
Published: September 2018

AbstractThis article examines the reconfiguration of socially poignant Pentateuchal texts in Luke-Acts. Beginning with a critical examination of the Jubilee background of Jesus’ Nazareth sermon, the article moves to elucidate Luke’s interweaving of scriptural traditions of the Jubilee and Sabbath years and related economically rich scriptural texts into the story of Jesus and the early church. This study explores how the author of Luke and Acts has integrated the life and teachings of Jesus with thekerygmaand social existence of the early church by way of sustained, subtle reference to idealized visions of communal life in Israel’s foundational scriptures.