bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ultra-processed foods and recommended intake levels of nutrients linked to non-communicable diseases in Australia: evidence from a nationally representative cross-sectional study
Authors: Machado Priscila P , Steele Euridice M , Levy Renata B , Sui Zhixian , Rangan Anna , Woods Julie , Gill Tim , Scrinis Gyorgy , Monteiro Carlos A 
Published: August 2019

ObjectiveThis study aimed to describe the consumption of ultra-processed foods in Australia and its association with the intake of nutrients linked to non-communicable diseases (NCDs).DesignCross-sectional study.SettingNational Nutrition and Physical Activity Survey (2011-2012).Participants12,153 participants aged 2+ years.Main outcome measuresAverage dietary content of nutrients linked to NCDs and the prevalence of intake outside levels recommended for the prevention of NCDs.Data analysisFood items were classified according to the NOVA system, a classification based on the nature, extent and purpose of industrial food processing. The contribution of each NOVA food group and their subgroups to total energy intake was calculated. Mean nutrient content of ultra-processed food and non-ultra-processed food fractions of the diet were compared. Across quintiles of the energy contribution of ultra-processed foods, differences in the intake of nutrients linked to NCDs as well as in the prevalence of intakes outside levels recommended for the prevention of NCDs were examined.ResultsUltra-processed foods had the highest dietary contribution (42.0% of energy intake), followed by unprocessed or minimally processed foods (35.4%), processed foods (15.8%) and processed culinary ingredients (6.8%). A positive and statistically significant linear trend was found between quintiles of ultra-processed food consumption and intake levels of free sugars (standardised β 0.43, p<0.001); total (β 0.08, p<0.001), saturated (β 0.18, p<0.001) and trans fats (β 0.10, p<0.001); sodium (β 0.21, p<0.001) and diet energy density (β 0.41, p<0.001), while an inverse relationship was observed for dietary fibre (β -0.21, p<0.001) and potassium (β -0.27, p<0.001). The prevalence of non-recommended intake levels of all studied nutrients increased linearly across quintiles of ultra-processed food intake, notably from 22% to 82% for free sugars, from 6% to 11% for trans fat and from 2% to 25% for dietary energy density, from the lowest to the highest ultra-processed food quintile.ConclusionThe high energy contribution of ultra-processed foods impacted negatively on the intake of non-ultra-processed foods and on all nutrients linked to NCDs in Australia. Decreasing the dietary share of ultra-processed foods would substantially improve the diet quality in the country and help the population achieve recommendations on critical nutrients linked to NCDs.
Multicentre, randomised waitlist control trial investigating a parent-assisted social skills group programme for adolescents with brain injuries: protocol for the friends project
Authors: Gilmore Rose , Sakzewski Leanne , Ziviani Jenny , Mcintyre Sarah , Smithers Sheedy Hayley , Hilton Nicola , Williams Tracey , Quinn Kirsten , Sarandrea Anne Marie , Laugeson Elizabeth , Chatfield Mark 
Published: August 2019

IntroductionAdolescents with brain injury frequently have difficulties with social competence, which persist into adulthood affecting their participation in daily life. To date, there has been limited research into the efficacy of social competence interventions in this population. Research from the Program for the Education and Enrichment of Relational Skills (PEERS) has demonstrated significant improvements in social competence skills, maintained at 1-year to 5-year follow-up, for adolescents with autism spectrum disorder. PEERS has not yet been tested among adolescents with brain injury. This protocol describes a pragmatic, parallel two-group pre-test post-test randomised waitlist control trial across two sites in Australia, which aims to evaluate the feasibility, acceptability and efficacy of PEERS in adolescents with brain injury compared with usual care.Methods and analysisForty adolescents with an acquired brain injury or cerebral palsy will be randomly assigned to either the 14-week PEERS group or waitlist care as usual group. The waitlist group will then receive PEERS following the 26-week retention time point. Outcomes will be assessed at baseline, 14 weeks (immediately postintervention) and 26 weeks follow-up (retention). The primary outcomes are self-report and parent report on the Social Skills Improvement System Rating Scales immediately post PEERS at 14 weeks. Secondary outcomes include increased frequency of get-togethers with peers with reduced conflict and increased adolescent self-reported knowledge of social skills. Acceptability and feasibility will be examined through qualitative analysis of focus group data collected after the completion of each group.Ethics and disseminationEthics approval has been granted by the Medical Research Ethics Committee Children’s Health Queensland Hospital and Health Service Human Research Ethics Committee (HREC/17/QRCH/87), The University of Queensland (2017000864) and the Cerebral Palsy Alliance Ethics Committee (20170802/HREC:EC00402). The findings will be disseminated in peer-reviewed journals, by conference presentation and newsletters to consumers.Trial registration numberACTRN12617000723381.
Association between psychosocial factors at work and health outcomes after retirement: a protocol for a systematic review and meta-analysis
Authors: Imamura Kotaro , Tsutsumi Akizumi , Asai Yumi , Arima Hideaki , Ando Emiko , Inoue Akiomi , Inoue Reiko , Iwanaga Mai , Eguchi Hisashi , Otsuka Yasumasa , Kobayashi Yuka , Sakuraya Asuka , Sasaki Natsu , Tsuno Kanami , Hino Ayako , Watanabe Kazuhiro , Shimazu Akihito , Kawakami Norito 
Published: August 2019

IntroductionThe world’s population is rapidly ageing, and health among older people is thus an important issue. Several previous studies have reported an association between adverse psychosocial factors at work before retirement and postretirement health. The objective of this systematic review and meta-analysis is to examine the association between psychosocial factors at work and health outcomes after retirement, based on a synthesis of well-designed prospective studies.Methods and analysisThe participants, exposures, comparisons and outcomes of the studies in this systematic review and meta-analysis are defined as follows: (P) people who have retired from their job, (E) presence of adverse psychosocial factors at work before retirement, (C) absence of adverse psychosocial factors at work before retirement and (O) any physical and mental health outcomes after retirement. Published studies were searched using the following electronic databases: MEDLINE, EMBASE, PsycINFO, PsycARTICLES and Japan Medical Abstracts Society. The included studies will be statistically synthesised in a meta-analysis to estimate pooled coefficients and 95% CIs. The quality of each included study will be assessed using the Risk Of Bias In Non-randomised Studies-of Interventions. For the assessment of meta-bias, publication bias will be assessed by using Egger’s test, as well as visually on a funnel plot. Heterogeneity will be assessed using the χ² test with Cochran’s Q statistic and I2.Ethics and disseminationResults and findings will be submitted and published in a scientific peer-reviewed journal and will be disseminated broadly to researchers and policy-makers interested in the translatability of scientific evidence into good practices.PROSPERO registration numberCRD42018099043.
Automated virtual reality (VR) cognitive therapy for patients with psychosis: study protocol for a single-blind parallel group randomised controlled trial (gameChange)
Authors: Freeman Daniel , Yu Ly-Mee , Kabir Thomas , Martin Jen , Craven Michael , Leal José , Lambe Sinéad , Brown Susan , Morrison Anthony , Chapman Kate , Dudley Robert , O'Regan Eileen , Rovira Aitor , Goodsell Andrew , Rosebrock Laina , Bergin Aislinn , Cryer Tillie L , Robotham Dan , Andleeb Humma , Geddes John R , Hollis Chris , Clark David M , Waite Felicity 
Published: August 2019

IntroductionMany patients with psychosis experience everyday social situations as anxiety-provoking. The fears can arise, for example, from paranoia, hallucinations, social anxiety or negative-self beliefs. The fears lead patients to withdraw from activities, and this isolation leads to a cycle of worsening physical and mental health. Breaking this cycle requires highly active treatment directly in the troubling situations so that patients learn that they can safely and confidently enter them. However patients with psychosis seldom receive such life-changing interventions. To solve this problem we have developed an automated psychological treatment delivered in virtual reality (VR). It allows patients to experience computer simulations of the situations that they find anxiety-provoking. A virtual coach guides patients, using cognitive techniques, in how to overcome their fears. Patients are willing to enter VR simulations of anxiety-provoking situations because they know the simulations are not real, but the learning made transfers to the real world.Methods and analysis432 patients with psychosis and anxious avoidance of social situations will be recruited from National Health Service (NHS) secondary care services. In the gameChange trial, they will be randomised (1:1) to the six-session VR cognitive treatment added to treatment as usual or treatment as usual alone. Assessments will be conducted at 0, 6 (post-treatment) and 26 weeks by a researcher blind to allocation. The primary outcome is avoidance and distress in real-life situations, using a behavioural assessment task, at 6 weeks. The secondary outcomes are psychiatric symptoms, activity levels and quality of life. All main analyses will be intention-to-treat. Moderation and mediation will be tested. An economic evaluation will be conducted.Ethics and disseminationThe trial has received ethical approval from the NHS South Central - Oxford B Research Ethics Committee (19/SC/0075). A key output will be a high-quality automated VR treatment for patients to overcome anxious avoidance of social situations.Trial registration numberISRCTN17308399.
Identification of processes that mediate the impact of workplace violence on emergency department healthcare workers in the USA: results from a qualitative study
Authors: Vrablik Marie C , Chipman Anne K , Rosenman Elizabeth D , Simcox Nancy J , Huynh Ly , Moore Megan , Fernandez Rosemarie 
Published: August 2019

ObjectivesViolence towards emergency department healthcare workers is pervasive and directly linked to provider wellness, productivity and job satisfaction. This qualitative study aimed to identify the cognitive and behavioural processes impacted by workplace violence to further understand why workplace violence has a variable impact on individual healthcare workers.DesignQualitative interview study using a phenomenological approach to initial content analysis and secondary thematic analysis.SettingThree different emergency departments.ParticipantsWe recruited 23 emergency department healthcare workers who experienced a workplace violence event to participate in an interview conducted within 24 hours of the event. Participants included nurses (n=9; 39%), medical assistants (n=5; 22%), security guards (n=5; 22%), attending physicians (n=2; 9%), advanced practitioners (n=1; 4%) and social workers (n=1; 4%).ResultsFive themes emerged from the data. The first two supported existing reports that workplace violence in healthcare is pervasive and contributes to burn-out in healthcare. Three novel themes emerged from the data related to the objectives of this study: (1) variability in primary cognitive appraisals of workplace violence, (2) variability in secondary cognitive appraisals of workplace violence and (3) reported use of both avoidant and approach coping mechanisms.ConclusionHealthcare workers identified workplace violence as pervasive. Variability in reported cognitive appraisal and coping strategies may partially explain why workplace violence negatively impacts some healthcare workers more than others. These cognitive and behavioural processes could serve as targets for decreasing the negative effect of workplace violence, thereby improving healthcare worker well-being. Further research is needed to develop interventions that mitigate the negative impact of workplace violence.
Simulation to improve medical student confidence and preparedness to care for the dying: a feasibility study
Authors: Wells Geoffrey , Montgomery Julia , Hiersche Andreas 
Published: August 2019

BackgroundUndergraduate teaching currently fails to adequately prepare doctors to deliver ‘end-of-life’ care. Despite much evidence supporting simulation-based teaching, its use in medical undergraduate palliative and ‘end-of-life’ care curricula remain low.AimThis study assesses whether simulation can improve the confidence and preparedness of medical students to provide holistic care to dying patients and their families, from clinical assessment to symptom management, communication and care after death.MethodsSix fourth-year medical students undertook individual simulations involving a dying patient (high-fidelity simulator) and family member (actor). Intentional patient death occurred in four of the six scenarios (although unexpected by students). Pre-simulation/post-simulation thanatophobia questionnaires measured student attitudes towards providing care to dying patients. Thematic analysis of post-simulation focus group transcripts generated qualitative data regarding student preparedness, confidence and value of the simulations.ResultsThematic analysis revealed that students felt the simulations were realistic, and left them better prepared to care for dying patients. Students coveted the ‘safe’ exposure to dying patient scenarios afforded by the simulations. Observed post-simulation reduction in mean thanatophobia scores was not found to be statistically significant (p=0.07).ConclusionsResults suggest a feasible potential for simulations to influence undergraduate medical student teaching on the care of a dying patient and their family. We believe that this study adds to the limited body of literature exploring the value of simulation in improving the confidence and preparedness of medical students to provide ‘end-of-life’ care. Further research into the cost-effectiveness of simulation is required to further support its application in this setting.
Comparison of risk engagement and protection survey (REPS) among mothers and fathers of children aged 6-12 years
Authors: Olsen Lise L , Lin Yingyi , Ishikawa Takuro , Mâsse Louise C , Brussoni Mariana 
Published: August 2019

BackgroundParental attitudes regarding child safety and risk engagement play important roles in child injury prevention and health promotion efforts. Few studies have compared mothers’ and fathers’ attitudes on these topics. This study used the risk engagement and protection survey (REPS) previously validated with fathers to compare with data collected from mothers.MethodsMulti-group confirmatory factor analysis was used with a sample of 234 mothers and 282 fathers. Eligible parents had a child 6–12 years attending a paediatric hospital for an injury-related or other reason. We tested the factor structure of the survey by examining configural, metric and scalar invariance. Following this, mothers’ and fathers’ mean scores on the two identified factors of child injury protection and risk engagement were compared.ResultsComparing mothers’ and fathers’ data showed the two-factor structure of the REPS held for the mothers’ data. Comparing mean scores for the two factors suggested that fathers and mothers held equivalent attitudes. For the combined sample, parent injury protection attitude scores were significantly higher for daughters versus sons. In addition, attitude scores were significantly lower for injury protection and higher for risk engagement among parents born in Canada compared with those who were not.ConclusionsThe REPS allows for valid assessment of injury protection and risk engagement factors for fathers and mothers. Mothers conceptualised the two factors as distinct concepts, similar to fathers. The REPS can be used to inform parenting programme development, implementation and evaluation.
Cell block processing is optimal for assessing endoscopic ultrasound fine needle aspiration specimens of pancreatic mucinous cysts
Authors: Wong Newton A C S , Gwiti Paida , Murigu Timothy , Melegh Zsombor , Beavers Sophie , Gordon Fiona , Alexandridis Efstratios , Norton Sally 
Published: August 2019

AimsThe cell block technique for assessing endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) specimens from pancreatic mucinous cystic lesions (MCLs) was systematically evaluated for the first time, including comparisons with three traditional methods of assessing such specimens.MethodsThe prospective arm comprised EUS-FNA specimens from EUS-suspected pancreatic MCLs. The retrospective arm comprised EUS-FNA specimens from pancreatic MCLs surgically resected before the study start. For each specimen, these data points were collected: macroscopic likelihood of mucin, cyst fluid carcinoembryonic antigen (CEA) level and presence of mucin in air-dried, direct smears and in cell block preparations.ResultsThe prospective and retrospective arms of the study comprised 80 and 30 EUS-FNA specimens, respectively. Seven prospective cases led to surgical resections during the study, and therefore, 37 EUS-FNA specimens were confirmed to have originated from MCLs. In the prospective arm, macroscopic mucin was suspected, cyst fluid CEA level exceeded 192 ng/mL, mucin was detected in direct smears and cell block preparations in 78%, 30%, 39% and 73% of cases, respectively. Of the 37 specimens confirmed to originate from MCLs, macroscopic mucin assessment, cyst fluid CEA level, direct smear mucin assessment and cell block mucin assessment had sensitivities for diagnosing MCL of 87%, 45%, 45% and 81%, respectively.ConclusionsCell block preparations are as likely to identify mucin from pancreatic MCLs as macroscopic assessment but are twice as likely to diagnose MCL than direct smears and fluid CEA biochemistry. The cell block technique is easy for sample collection and processing especially because these are identical for solid and cystic pancreatic lesions.
High Levels of C-Reactive Protein Are Associated with an Increased Risk of Ovarian Cancer: Results from the Ovarian Cancer Cohort Consortium
Authors: Peres Lauren C. , Mallen Adrianne R. , Townsend Mary K. , Poole Elizabeth M. , Trabert Britton , Allen Naomi E. , Arslan Alan A. , Dossus Laure , Fortner Renée T. , Gram Inger T. , Hartge Patricia , Idahl Annika , Kaaks Rudolf , Kvaskoff Marina , Magliocco Anthony M. , Merritt Melissa A. , Quirós J. Ramón , Tjonneland Anne , Trichopoulou Antonia , Tumino Rosario , van Gils Carla H. , Visvanathan Kala , Wentzensen Nicolas , Zeleniuch-Jacquotte Anne , Tworoger Shelley S. 
Published: August 2019

Abstract

Growing epidemiologic evidence supports chronic inflammation as a mechanism of ovarian carcinogenesis. An association between a circulating marker of inflammation, C-reactive protein (CRP), and ovarian cancer risk has been consistently observed, yet, potential heterogeneity of this association by tumor and patient characteristics has not been adequately explored. In this study, we pooled data from case–control studies nested within six cohorts in the Ovarian Cancer Cohort Consortium (OC3) to examine the association between CRP and epithelial ovarian cancer risk overall, by histologic subtype and by participant characteristics. CRP concentrations were measured from prediagnosis serum or plasma in 1,091 cases and 1,951 controls. Multivariable conditional logistic regression was used to estimate ORs and 95% confidence intervals (CI). When CRP was evaluated using tertiles, no associations with ovarian cancer risk were observed. A 67% increased ovarian cancer risk was found for women with CRP concentrations &gt;10 mg/L compared with &lt;1 mg/L (OR = 1.67; 95% CI = 1.12–2.48). A CRP concentration &gt;10 mg/L was positively associated with risk of mucinous (OR = 9.67; 95% CI = 1.10–84.80) and endometrioid carcinoma (OR = 3.41; 95% CI = 1.07–10.92), and suggestively positive, although not statistically significant, for serous (OR = 1.43; 95% CI = 0.82–2.49) and clear cell carcinoma (OR = 2.05; 95% CI = 0.36–11.57; Pheterogeneity = 0.20). Heterogeneity was observed with oral contraceptive use (Pinteraction = 0.03), where the increased risk was present only among ever users (OR = 3.24; 95% CI = 1.62–6.47). This study adds to the existing evidence that CRP plays a role in ovarian carcinogenesis and suggests that inflammation may be particularly implicated in the etiology of endometrioid and mucinous carcinoma.

Significance:
C-reactive protein is involved in ovarian carcinogenesis, and chronic inflammation may be particularly implicated in the etiology of mucinous and endometrioid carcinomas.
Contact, Conflict, and Crisis in Eastern Christianity
Authors: Clay J. Eugene 
Published: August 2019

Abstract
In this issue of Canadian-American Slavic Studies, eight authors explore Eastern Christian communities from the sixteenth to the twenty-first centuries. Originating as papers presented at the sixth biennial conference of the Association for the Study of Eastern Christian History and Culture (http://easternchristianity.org) at Rhodes College in 2015, these articles have been carefully selected for their original contributions and revised for publication. From disputes over monastic landholding in the sixteenth century to the vicious persecutions of the Soviet period, Eastern Christians have responded creatively to historical crises, even as they have faced both internal and external conflicts. These thought-provoking essays provide significant analyses of these responses and offer penetrating insights into Eastern Christianity.
Roman Catholic Polemicists, Russian Orthodox Publicists, and the Tsar-Pope Myth in France, 1842–1862
Authors: Bailey Heather 
Published: August 2019

Abstract
In the mid-nineteenth century it was typical for French Roman Catholic publicists to allege that the tsar was the supreme head or “pope” of the Russian Church and that consequently, the Russian Church was completely enslaved to the state. While this idea was largely created by Catholic publicists, some Russian Orthodox individuals contributed intentionally or unintentionally to exaggerated notions of the Russian emperor’s spiritual authority, demonstrating that the Orthodox publicists who wanted to defend Russian interests did not always agree about what those interests really were or about how best to defend them. Following Italy’s national unification (1859–1860), French public figures used these narratives about the Russian tsar-pope to promote specific policies towards Rome and the papacy. For French Roman Catholic publicists, the tsar-pope myth proved that it was vital to preserve unity between the French Church and Rome and to defend the papacy’s temporal power as a guarantor of the Roman Catholic Church’s independence.