bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long‐Term Hormone Replacement Therapy Is Associated with Low Coronary Artery Calcium Levels in a Cohort of Older Women: The Age, Gene/Environment Susceptibility—Reykjavik Study
Authors: Gudmundsson Adalsteinn , Aspelund Thor , Sigurdsson Gunnar , Harris Tamara , Launer Lenore J. , Gudnason Vilmundur , Jonsson Helgi 
Published: November 2016

ObjectivesTo assess the relationship between hormone replacement therapy (HRT) and coronary artery calcium (CAC).DesignCross‐sectional.SettingEstablished population‐based cohort in Reykjavik, Iceland.ParticipantsWomen (mean age 76 ± 5) who had completed questionnaires on HRT use (N = 2,867).MeasurementsCoronary artery calcium assessed using computed tomography was the outcome variable and was compared between women with history of HRT and those who had never used HRT and analyzed according to age, length of use, and time after menopause that HRT was initiated.ResultsEight hundred seventy‐two (30.4%) participants had used HRT, and 312 (10.9%) were current users. After adjustment for age, other late‐life variables, and a propensity score based on midlife data for HRT use as observed in late life, there were significant negative associations between CAC and history and length of HRT use. This association was evident in all age categories. When HRT had been used for longer than 15 years, median CAC level was less than 50% of that observed in never users. The lowest CAC was observed in those who started HRT within 5 years after menopause. The prevalence of coronary events was comparable in both groups.ConclusionA strong association was found between long‐term HRT use and low CAC. The negative association between duration of HRT and CAC was evident in all age groups of older women.
How Often Do Clinically Diagnosed Catheter‐Associated Urinary Tract Infections in Nursing Homes Meet Standardized Criteria?
Authors: Armbruster Chelsie E. , Prenovost Katherine , Mobley Harry L.T. , Mody Lona 
Published: November 2016

ObjectivesTo determine the relationship between clinically diagnosed catheter‐associated urinary tract infection (CAUTI) and standardized criteria and to assess microorganism‐level differences in symptom burden in a cohort of catheterized nursing home (NH) residents.DesignPost hoc analysis of a prospective longitudinal study.SettingTwelve NHs in southeast Michigan.ParticipantsNH residents with indwelling urinary catheters (n = 233; 90% white, 52% male, mean age 73.7).MeasurementsClinical and demographic data, including CAUTI epidemiology and symptoms, were obtained at study enrollment, 14 days, and monthly thereafter for up to 1 year.ResultsOne hundred twenty participants with an indwelling catheter (51%) were prescribed systemic antibiotics for 182 clinically diagnosed CAUTIs. Common signs and symptoms were acute change in mental status (28%), fever (21%), and leukocytosis (13%). Forty percent of clinically diagnosed CAUTIs met Loeb's minimum criteria, 32% met National Health Safety Network (NHSN) criteria, and 50% met Loeb's minimum or NHSN criteria. CAUTIs involving Staphylococcus aureus and Enterococcus spp. were least likely to meet criteria. CAUTIs involving Klebsiella pneumoniae were most likely to meet Loeb's minimum criteria (odds ratio (OR) = 9.7, 95% confidence interval (CI) = 2.3–40.3), possibly because of an association with acute change in mental status (OR = 5.9, 95% CI = 1.8–19.4).ConclusionFifty percent of clinically diagnosed CAUTIs met standardized criteria, which represents an improvement in antibiotic prescribing practices. At the microorganism level, exploratory data indicate that symptom burden may differ between microorganisms. Exploration of CAUTI signs and symptoms associated with specific microorganisms may yield beneficial information to refine existing tools to guide appropriate antibiotic treatment.
Age and gender‐related differences in emotional and behavioural problems and autistic features in children and adolescents with Down syndrome: a survey‐based study of 674 individuals
Authors: Nærland T. , Bakke K. A. , Storvik S. , Warner G. , Howlin P. 
Published: November 2016

AbstractBackgroundRecent studies have indicated an increased risk of autism, behavioural and emotional problems and attention‐deficit/hyperactivity disorder in individuals with Down syndrome.MethodIn a large‐scale survey‐based study, we examined the rates of these problems and their relationship to age and gender, in a sample of 674 individuals (4–18 years) with Down syndrome. The relationship with IQ level was also explored in a subsample (n = 175). The Strengths and Difficulties Questionnaire and the Social Communication Questionnaire were used to assess behavioural and emotional problems and autism traits.ResultsOn the Strengths and Difficulties Questionnaire, peer problems were the most frequently reported difficulty (48% > cut‐off), followed by hyperactivity/inattention (34% > cut‐off). On the Social Communication Questionnaire, 37% scored at or above cut‐off (≥15) for autism spectrum disorder; 17% were at or above the suggested cut‐off (≥22) for autism. Little association between age and behavioural or emotional problems or with severity of autistic symptomatology was found. However, peer problems were more common in adolescents than in junior school children (P < 0.001); Hyperactivity/inattention was less prevalent among adolescents (P < 0.001).ConclusionsHigh rates of autistic features, emotional and behavioural problems are documented. These problems are related to age, gender and degree of intellectual disability.
Accuracy of the prediction equation for the determination of maximum heart rate in adults with Down syndrome
Authors: Boer P.‐H. 
Published: November 2016

AbstractBackgroundThe purpose of the study was to determine if the regression formula developed for the prediction of maximum heart rate (HR) is valid for adults with Down syndrome (DS).MethodsThirty‐six adults with DS (31.7 ± 6.8 years; 20 men, 16 women) completed a maximal aerobic test. Maximum HR and VO2 peak were measured directly on a motorised treadmill with a metabolic analyser. Predicted HR was estimated with the regression equation developed for individuals with DS (Fernhall et al. 2001). Differences between measured versus predicted maximum HR were assessed with a dependent T‐test and the relationship with Pearson correlational analyses. Agreement was assessed with Bland–Altman analysis.ResultsThere was a significant difference between directly measured maximum HR and predicted maximum HR (P < 0.01). There was no significant relationship between these variables. Bland–Altman analysis indicated that there was measurement bias (+4.7) and large limits of agreement (+26.7 and −17.4) between measured and predicted maximum HR. The Bland–Altman plot also demonstrated the presence of heteroscedasticity.ConclusionsThe results indicate that the regression formula developed for individuals with DS was not accurate in this sample of DS adults aged 19 to 46 years. Future studies should develop different prediction equations for more specific age and body mass index categories for individuals with DS.
Relationship between healthy lifestyle behaviors and health locus of control and health‐specific self‐efficacy in university students
Authors: Açıkgöz Çepni Serap , Kitiş Yeter 
Published: November 2016

AimTo investigate the relationship between the healthy lifestyle behaviors and the health locus of control and health‐specific self‐efficacy in university students.MethodsThe study included 572 undergraduate students of a university in the central Anatolia region of Turkey. The data were collected with the General Characteristics Form, the Health‐Promoting Lifestyle Profile II, the Multidimensional Health Locus of Control Scale, and the Perceived Health Competence Scale and investigated with the structural equation model.ResultsHealth‐specific self‐efficacy was an important predictor of healthy lifestyle behaviors. The Internal health locus of control influenced the healthy lifestyle behaviors through health‐specific self‐efficacy. The other dimension was the Powerful Others health locus of control that affected healthy lifestyle behaviors, both directly and indirectly, through health‐specific self‐efficacy. There was a chance that the health locus of control had a negative effect on healthy lifestyle behaviors through self‐efficacy.ConclusionHealth‐specific self‐efficacy is an important prerequisite for changes in healthy lifestyle behaviors, which supports Pender's model. The subscales of the health locus of control vary in their effects on healthy lifestyle behaviors, which partly supports Pender's model. Nurses, by using this model, can examine ways of improving these cognitive–perceptual factors and implement health education programs that are directed towards improving them in young persons.
Self‐efficacy in the context of heart transplantation – a new perspective
Authors: Almgren Matilda , Lennerling Annette , Lundmark Martina , Forsberg Anna 
Published: November 2016

Aims and objectivesAn in‐depth exploration of self‐efficacy among heart transplant recipients by means of Bandura's self‐efficacy theory.BackgroundAn essential component of chronic illness management is self‐management, which refers to activities carried out by people to create order, structure and control in their lives. Self‐efficacy is an important aspect of self‐management, which seems to have become the main paradigm for long‐term management after solid organ transplantation.DesignA directed content analysis using Bandura's self‐efficacy theory.MethodsOpen‐ended, in‐depth interviews were conducted with 14 heart transplant recipients at their 12‐month follow‐up after heart transplantation.ResultsThis study generated the hypothesis that from the patients’ perspective, self‐efficacy after heart transplantation concerns balancing expectations to find the optimum level of self‐efficacy. Performance accomplishment was found to have the greatest impact on self‐efficacy, while its absence was the main source of disappointments. It was also revealed that the gap between performance accomplishment and efficacy expectations can be understood as uncertainty.ConclusionsIt is essential to assess both expectations and disappointments from the patient perspective in order to promote an optimum level of self‐efficacy among heart transplant recipients. This includes supporting the heart recipient to adopt mental and physical adjustment strategies to balance her/his expectations as a means of minimising disappointments. The understanding that uncertainty can undermine self‐efficacy is crucial.Relevance to clinical practiceThe merging of the uncertainty in illness and self‐efficacy theories provides an excellent framework for the provision of self‐management support. In addition, focusing on a partnership between the transplant professionals and the recipient is essential because it minimises the use of a behavioural approach.
Isolated thoughts and feelings and unsolved concerns: adolescents’ and parents’ perspectives on living with type 1 diabetes – a qualitative study using visual storytelling
Authors: Castensøe‐Seidenfaden Pernille , Teilmann Grete , Kensing Finn , Hommel Eva , Olsen Birthe Susanne , Husted Gitte Reventlov 
Published: November 2016

Aims and objectivesTo explore and describe the experiences of adolescents and their parents living with type 1 diabetes, to identify their needs for support to improve adolescents’ self‐management skills in the transition from child‐ to adulthood.BackgroundAdolescents with type 1 diabetes often experience deteriorating glycaemic control and distress. Parents are important in adolescents’ ability to self‐manage type 1 diabetes, but they report anxiety and frustrations. A better understanding of the challenges adolescents and parents face, in relation to the daily self‐management of type 1 diabetes, is important to improve clinical practice.DesignA qualitative explorative study using visual storytelling as part of individual interviews.MethodsA purposive sample of nine adolescents and their parents (seven mothers, six fathers) took photographs illustrating their experiences living with type 1 diabetes. Subsequently, participants were interviewed individually guided by participants’ photographs and a semistructured interview guide. Interviews were analysed using thematic analysis.ResultsFour major themes were consistent across adolescents and their parents: (1) striving for safety, (2) striving for normality, (3) striving for independence and (4) worrying about future. Although adolescents and parents had same concerns and challenges living with type 1 diabetes, they were experienced differently. Their thoughts and feelings mostly remained isolated and their concerns and challenges unsolved.ConclusionsThe concerns and challenges adolescents and their parents face in the transition from child‐ to adulthood are still present despite new treatment modalities. Parents are fundamental in supporting the adolescents’ self‐management‐work; however, the parties have unspoken concerns and challenges.Relevance to clinical practiceHealthcare providers should address the parties’ challenges and concerns living with type 1 diabetes to diminish worries about future including fear of hypoglycaemia, the burden of type 1 diabetes and the feeling of being incompetent in diabetes self‐management. It is important to focus on supporting both adolescents and their parents, and to provide a shared platform for communication.
Even Optimists Get the Blues: Interindividual Consistency in the Tendency to Brace for the Worst
Authors: Sweeny Kate , Falkenstein Angelica 
Published: November 2016

AbstractObjectiveThe present research examined whether the tendency to brace for the worst by becoming pessimistic as news approaches varies across people, namely, people who differ in their trait‐like outlooks on the future (dispositional optimism, defensive pessimism).MethodAcross nine studies in laboratory and field settings, we examined the roles of dispositional optimism and defensive pessimism in the propensity to brace for the worst when awaiting uncertain news. The studies used a variety of paradigms, including predictions about performance on the bar exam, peer ratings of attractiveness, and feedback on an intelligence test. Results: Results from these studies consistently failed to support individual differences in the tendency to brace for the worst.ConclusionsTrait‐like differences in future outlooks seem to influence only the level and not trajectories of outcome predictions, pointing to relative commonalities in the development of the tendency to brace for the worst.
Paediatrician beliefs and practices around influenza vaccination
Authors: P Newcombe James , Kaur Rajneesh , Wood Nicholas , Seale Holly , Palasanthiran Pamela , Snelling Thomas L 
Published: November 2016

AimThe uptake of influenza vaccination in children with high‐risk medical conditions continues to be low in Australia and internationally. We aimed to determine Australian paediatricians’ beliefs and practices around the influenza vaccination of children.MethodsThis was conducted as a cross sectional survey of paediatricians from two tertiary paediatric hospitals in Sydney.ResultsThere were 101 participants. Influenza vaccination was not prioritised compared with other vaccines and clinical issues, with fewer than half of respondents strongly agreeing that influenza vaccination was useful. Paediatricians’ knowledge of guidelines and recommendations in this area was suboptimal. Interventions thought most likely to improve vaccine coverage included better education of doctors, greater vaccine availability in outpatient clinics and automated reminder systems.ConclusionThe inclusion of influenza vaccine on the standard Australian immunisation schedule may be required to improve vaccine coverage in high‐risk children.
Implementation of dextrose gel in the management of neonatal hypoglycaemia
Authors: Ter Marene , Halibullah Ikhwan , Leung Laura , Jacobs Susan 
Published: November 2016

AimThe aim of this study was to evaluate dextrose gel in the management of neonatal hypoglycaemia in the postnatal wards at an Australian tertiary level perinatal centre.MethodsAn audit was performed before and after implementation of dextrose gel. Pre‐implementation, neonatal hypoglycaemia was managed with feed supplementation alone, and dextrose gel was used in addition to feed supplementation in the post‐implementation phase. Outcomes included admission to neonatal intensive care unit (NICU) for management of hypoglycaemia, proportion of neonates who achieved normoglycaemia (defined as blood glucose ≥2.6 mmol/L, with no clinical signs after one or two treatment attempts) and proportion of neonates with hypoglycaemia recurrence after normoglycaemia and one or two treatment attempts.Results
NICU admission for treatment of hypoglycaemia reduced significantly post‐implementation of dextrose gel (29/100 (29%) vs. 14/100 (14%), P = 0.01). No significant difference was seen in the proportion of neonates achieving normoglycaemia (71/100 (71%) vs. 75/100 (75%), P = 0.52), but hypoglycaemia recurrence was higher in the post‐implementation group (22/71 (31%) vs. 37/75 (49%), P = 0.02).ConclusionsDextrose gel is effective in the management of neonatal hypoglycaemia in the postnatal ward setting, reducing admission to NICU and mother–infant separation.
Drinking frequency effects on the performance of cattle: a systematic review
Authors: Williams L. R. , Jackson E. L. , Bishop‐Hurley G. J. , Swain D. L. 
Published: November 2016

SummaryThis study used a systematic literature review methodology to determine whether there is evidence that drinking frequency has effects on cattle performance, what performance responses to drinking frequency are documented and how performance responses vary according to environmental and animal factors. Electronic databases were searched for English language articles with original data on at least one performance attribute (e.g. water intake, feed intake, live weight) of cattle in response to voluntary drinking frequency or controlled access periods to water. Sixteen experiments on dairy cows and 12 experiments on beef cattle were retrieved from the literature. For beef cattle, all experiments reported reduced water and feed intake with access to water once every second and/or third day compared with once‐daily access. Median reductions of 15% and 25% in water intake and 16% and 9% in feed intake were found across experiments respectively. Live weight responses of beef cattle to access to water were limited and yielded positive, negative and no effects. For dairy cows, most experiments reported reduced water intake, milk yield and milk fat content with access to water twice or once daily compared with controls (ad libitum or ad libitum except at the dairy). Median reductions of 13% and 12% in water intake, 2% and 1% in milk yield and 1% and 2% in milk fat content were found across experiments respectively. Water availability effects on feed intake and live weight were very limited for dairy cows and yielded positive, neutral and negative effects. Season, climate, experiment conditions, animal class and animal genotype were identified to potentially influence intake responses of cattle. The review highlights a number of important gaps in the literature where future work is required to better understand the optimum drinking frequency of cattle and implications of water availability on health, welfare and performance.
Comparison of computed tomographic angiography and intraoperative mesenteric portovenography for extrahepatic portosystemic shunts
Authors: Parry A. T. , White R. N. 
Published: November 2016

ObjectivesComparison of intra‐operative mesenteric portovenography and computed tomographic angiography for the documentation of the portal vasculature in patients with single extrahepatic portosystemic shunts.MethodsRetrospective study of patients with extrahepatic portosystemic shunts that underwent preoperative computed tomographic angiography and intra‐operative mesenteric portography. Studies were compared for identification of the intra‐ and extrahepatic portal vasculature.ResultsComputed tomographic angiography demonstrated all four portal vein tributaries and sub‐tributaries. Intra‐operative mesenteric portography inconsistently demonstrated the cranial mesenteric vein, the gastroduodenal vein (12 of 49 dogs and 0 of 10 cats), splenic vein (46 of 49 dogs and 8 of 10 cats) and caudal mesenteric vein (3 of 49 dogs and 2 of 10 cats). Computed tomographic angiography showed the intrahepatic portal vein with shunts emanating from the left gastric vein, splenocaval shunts or shunts involving the left colic vein. It showed intrahepatic portal branching in 5 of 12 patients with shunts involving the right gastric vein. Intra‐operative mesenteric portography showed the intrahepatic portal vein in 29 of 59 patients but was outperformed by computed tomographic angiography in all cases except those patients with a shunt involving the right gastric vein.Clinical SignificanceIn cases that have undergone diagnostic preoperative computed tomographic angiography there is no indication for diagnostic intra‐operative mesenteric portovenography before ligation. In contrast, portovenography performed “after” temporary full ligation of the shunt provides clinical useful information and might be considered an integral investigation during shunt attenuation surgery.