bluuebunny/crossref_metadata_2025_split huggingface dataset:
A qualitative study looking at informed choice in the context of non‐invasive prenatal testing for aneuploidy
Authors: Lewis Celine , Hill Melissa , Chitty Lyn S. 
Published: August 2016

AbstractObjectiveTo explore women's attitudes towards non‐invasive prenatal testing (NIPT) and determine factors influencing their decisions around uptake of NIPT.MethodWe conducted qualitative interviews to assess knowledge, attitude and deliberation amongst women offered NIPT in a public health service. In total, 45 women took part in telephone interviews (79% participation rate).ResultsMost women could recount the key aspects of NIPT discussed during pre‐test counselling but had variable knowledge about Down syndrome. Analysis of women's attitudes towards undergoing NIPT revealed three dominant factors they considered when reflecting on the test: (1) how NIPT compared with alternative testing options, (2) reflections on coping and (3) moral or religious values. Exploring the deliberative process revealed the different paths women take when making decisions. For some, it was an extension of the decision to have Down syndrome screening; some considered it early on following the booking‐in appointment; others made step‐wise decisions about NIPT when it became relevant to them.ConclusionOur findings support the importance of personalised counselling, whereby women and their partners have the opportunity to reflect on the implications of the test results in the context of their own lives and values. Our data highlight the influence of personal circumstances on decision‐making. © 2016 The Authors. Prenatal Diagnosis published by John Wiley & Sons, Ltd.
Advancement in Catalytic Asymmetric Hydrogenation of Ketones and Imines, and Development of Asymmetric Isomerization of Allylic Alcohols
Authors: Ohkuma Takeshi , Arai Noriyoshi 
Published: August 2016

AbstractCatalytic asymmetric hydrogenation of ketones through the “metal–ligand cooperative mechanism” has been improved in terms of the efficiency, stereoselectivity, and scope of substrates by varying the arrangement of the catalyst structure and reaction conditions. Imino compounds are also smoothly converted to the optically active amines with appropriate catalysts. This type of catalyst exhibits excellent performance on the asymmetric isomerization of primary allylic alcohols into the optically active aldehydes. This personal account describes recent progress on these topics.
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Qualitative study of the role of men in maternal health in resource‐limited communities in western Kenya
Authors: Brubaker Kathryn , Nelson Brett D. , McPherson Heather , Ahn Roy , Oguttu Monica , Burke Thomas F. 
Published: August 2016

AbstractObjectiveTo better understand the beliefs of men and women in western Kenya regarding the appropriate role of men in maternal health and to identify barriers to greater involvement.MethodsBetween June 1 and July 31, 2014, a cross‐sectional qualitative study enrolled lay men, lay women, and community health workers from Kisumu and Nyamira counties in western Kenya. Semi‐structured focus group discussions were conducted and qualitative approaches were utilized to analyze the transcripts and identify common themes.ResultsIn total, 134 individuals participated in 18 focus group discussions. Participants discussed the role of men and a general consensus was recorded that it was a man's duty to protect women during pregnancy. When discussing obstacles to male involvement, female participants highlighted gender dynamics and male participants raised financial limitations.ConclusionThere was considerable discrepancy between how men described their roles and how they actually behaved, although educated men appeared to describe themselves as performing more supportive behaviors compared with male participants with less education. It is suggested that interventions aimed at increasing male involvement should incorporate the existing culturally sanctioned roles men perform as a foundation upon which to build, rather than attempting to construct roles that oppose prevailing norms.
The relative importance of anxiety and depression in pain impact in individuals with migraine headaches
Authors: Tomé-Pires Catarina , Solé Ester , Racine Mélanie , Galán Santiago , Castarlenas Elena , Jensen Mark P. , Miró Jordi 
Published: August 2016

Abstract

Background
Psychological factors are thought to impact headache as triggering, maintaining, and exacerbating factors. A better understanding of the role that modifiable factors, such as anxiety or depression, play in the impact of migraine could help identify potential treatment targets in this population.

Objectives
The objective of this study was to evaluate the relative importance of anxiety and depression as predictors of the impact of migraine on function. Thus, we aim to understand the relative importance that anxiety and depression have on the impact of migraines by assessing both and some life domains.

Methods
Cross-sectional study involving forty-three individuals, mostly females (93%), with migraine headaches aged between 20 and 60 years old. Participants answered questions about headache pain intensity at the time of data collection and the usual in the past 30 days (0–10 Numerical Rating Scales) as well as other pain characteristics (i.e., duration, frequency, and duration), headache impact (vitality and social, role, and cognitive functioning), anxiety and depression by using the Hospital Anxiety and Depression Scale.

Results
Anxiety (r = 0.56, p < .001), but not depression (r = 0.09, p = .59), was significantly associated with headache impact. Thus showing the relative importance that anxiety has on headache impact.

Conclusions
The findings support a larger role for anxiety than depression in the impact of migraine headaches on patient function. There are a number of mechanisms by which anxiety could potentially influence the impact of headache on patient function, and this study highlights that anxiety could potentially be a trigger of headache activity.

Implications
The findings thus suggest the possibility that treatments that focus on anxiety might be potentially more important for individuals with migraine than treatments that focus on depression, at least with respect to having a beneficial impact on the interference of headache with activity. Research is needed to evaluate the beneficial impact of anxiety treatment in individuals with migraine headaches. Clinicians should evaluate and consider treating, as appropriate and necessary, anxiety in patients with migraine.
Evaluation of a Semi-Quantitative CO2 Monitor with Pulse Oximetry for Prehospital Endotracheal Tube Placement and Management
Authors: George Shawn , Macnab Andrew J. 
Published: August 2016

AbstractObjective:To evaluate three prototype versions of semi-quantitative end-tidal CO2 monitors with different alarm features during prehospital or inter-facility use.Methods:Subjects were 43 adult, non-pregnant patients requiring intubation, or who already were intubated and required transport. Teams at one AirEvac and seven Advanced Life Support (ALS) paramedic stations were trained in the use of the monitors. Team members at each station evaluated each model for eight days. Participants completed questionnaires following each use.Results:The monitors performed properly in all cases, but in one case, vomit in the airway adapter tube prevented obtaining a readout. The monitors aided management in 40 of 43 cases (93%); in one, the monitor reading was reported as variable (between 20 and 30 mmHg) although the teams knew the monitors were semi-quantitative; in another, the monitor was not required, but performed properly; and the third was the one in which vomit in the tube prevented a reading. In 26 of 43 cases (60.4%), the monitor was used to confirm endotracheal tube placement (there were no instances of incorrect placement). In all cases, the devices were used to monitor respiration and oxygen saturation. Alarms were audible in the environment, but only preferred in the AirEvac situation. The “breath beep” feature was useful, particularly in patients in whom chest movements during respiration were difficult to observe.Conclusions:“Breath beeps” were clearly audible and were a useful feature in all prehospital and transport environments, while audible alarms were desired only in the AirEvac situation. Semi-quantitative CO2 detection is valuable in the ALS/AirEvac environment, even for teams with high intubation success rates.
The Value of EMS Experience when Applying to Medical School?
Authors: Pipas Lauren , Audet Robert F. , Brown Lawrence H. 
Published: August 2016

AbstractIntroduction:This study explores the value of Emergency Medical Services (EMS) experience for students applying to medical school. Methods: Surveys were sent to 67 medical schools in the eastern United States and Canada. Using a five-point Likert scale, the survey asked the respondent to rate the amount of consideration given to Emergency Medical Technician (EMT) or paramedic experience when making admissions decisions (1 = very little to 5 = strong), and to describe the influence of that experience (1 = very negative to 5 = very positive).Results:Usable responses were received from 21 schools. The median rating for the consideration given to EMS experience was “some consideration” for both EMT and paramedic experience, with 85.7% of respondents assigning that rating or higher. The median rating for the influence of that experience was “somewhat positive” for both EMT and paramedic experience. Only 14.3% of the returned surveys rated EMS experience as “neutral”, and no respondent reported EMS experience as a “negative”.Conclusion:EMS experience receives at least some consideration during the admissions process at most of the responding institutions in the United States and Canada. Experiences at either the EMT or Paramedic level are viewed similarly. None of the responding institutions viewed EMS experience negatively.
Health of Displaced Albanian Kosovars in the Former Yugoslav Republic of Macedonia: Fitness to Travel and Health Outcomes Assessment
Authors: MacPherson Douglas W. , Weekers Jacqueline E. M. , O'Rourke Thomas F. , Stiles Cecilia , Gushulak Brian D. 
Published: August 2016

AbstractIntroduction:During the 1999 conflict in Kosovo, an estimated 850,000 people were displaced from Kosovo. Many thousands of these people arrived in the Former Yugoslav Republic of Macedonia (FYROM), for whom a humanitarian evacuation programme (HEP) was conducted by the United Nations High Commissioner for Refugees (UNHCR) and the International Organization for Migration (IOM). More than 91,000 people were moved to third countries under this programme.Methods:A health assessment tool was designed, validated, and implemented to document the health status of the refugees prior to departure. The IOM evaluated 41,652 pre-travel “fitness to travel” medical assessments for refugees transported by the Organization. A colour coding system for fitness-to-travel was used to clearly identify refugees to the receiving health authorities according to their health condition at the time of departure.Results:A total of 41,652 fitness-to-travel assessments were performed between 05 April and 25 June 1999, and were entered into a database. There were 21,923 females and 19,566 males. The average age was 25.3 years (women, 26 years; men, 24.3 years). Of these assessments, 4,647 (11.2%) individuals who were deemed fit-to-travel required medical assessment at the host destination, and of those 1,204 required urgent care. The majority of health complaints were acute respiratory tract infections and hypertension.Conclusions:A rapid and efficient system for fitness-to-travel was created to assist in the management of health issues related to the urgent and mass movement of refugees. The collected health information was of use to health-care planners during the crisis and for those responsible for the health-care of newly arrived refugees. The lessons learned have implications for future similar operations and for the development of research and education programs for both the refugees and the host recipient nations.
Emergency Health and Risk Management in Sub-Saharan Africa: A Lesson from the Embassy Bombings in Tanzania and Kenya
Authors: Clack Zoanne A. , Keim Mark E. , Macintyre Anthony G. , Yeskey Kevin 
Published: August 2016

AbstractIn 1998, terrorists simultaneously bombed United States Embassies in Dar es Salaam, Tanzania and Nairobi, Kenya. The local response to these bombings was unorganized and ad hoc, indicating the need for basic disaster preparedness and improvement of emergency management capabilities in both countries.In this context, risk and risk management are defined and are related to the health hazards affecting Tanzanians and Kenyans. In addition, the growing number of injuries in Tanzania is addressed and the relationship between risk management and injury is explored. Also, an emergency medicine-based strategy for injury control and prevention is proposed. Implications of implementing such a protocol in developing nations also are discussed.
Rapid Epidemiological Assessment of Health Status in Displaced
Populations—An Evolution toward Standardized Minimum Essential Data
Sets
Authors: Bradt David A. , Drummond Christina M. 
Published: August 2016

Abstract
Rapid epidemiological assessment (REA) has evolved over the past 30
years into an essential tool of disaster management. Small area survey and
sampling methods are the major application. While REA is protocol driven,
needs assessment of displaced populations remains highly non-standardized.
The United Nations and other international organizations continue to call
for the development of standardized instruments for post-disaster needs
assessment.
This study examines REA protocols from leading agencies in humanitarian
health assistance across an evaluation criteria of best-practice attributes.
Analysis of inconsistencies and deficits leads to the derivation of a
Minimum Essential Data Set (MEDS) proposed for use by relief agencies in
post-disaster REA of health status in displaced populations. This data set
lends itself to initial assessment, ongoing monitoring, and evaluation of
relief efforts. It is expected that the task of rapid epidemiological
assessment, and more generally, the professional practice of post-disaster
health coordination, will be enhanced by development, acceptance, and use of
standardized Minimum Essential Data Sets (MEDS).
Terrorism in South Korea
Authors: Wang Soon Joo , Choi Jin Tae , Arnold Jeffrey 
Published: August 2016

Abstract
South Korea has experienced >30 suspected terrorism-related events
since 1958, including attacks against South Korean citizens in foreign
countries. The most common types of terrorism used have included bombings,
shootings, hijackings, and kidnappings. Prior to 1990, North Korea was
responsible for almost all terrorism-related events inside of South Korea,
including multiple assassination attempts on its presidents, regular
kidnappings of South Korean fisherman, and several high-profile bombings.
Since 1990, most of the terrorist attacks against South Korean citizens have
occurred abroad and have been related to the emerging worldwide pattern of
terrorism by international terrorist organizations or deranged
individuals.
The 1988 Seoul Olympic Games provided a major stimulus for South Korea
to develop a national emergency response system for terrorism-related events
based on the participation of multiple ministries. The 11 September 2001
World Trade Center and Pentagon attacks and the 2001 United States of
America (US) anthrax letter attacks prompted South Korea to organize a new
national system of emergency response for terrorism-related events. The
system is based on five divisions for the response to specific types of
terrorist events, involving conventional terrorism, bioterrorism, chemical
terrorism, radiological terrorism, and cyber-terrorism. No terrorism-related
events occurred during the 2002 World Cup and Asian Games held in South
Korea. The emergency management of terrorism-related events in South Korea
is adapting to the changing risk of terrorism in the new century.
Terrorism in Spain: Emergency Medical Aspects
Authors: Riesgo Luis García-Castrillo , Merino Antonio García 
Published: August 2016

Abstract
A terrorism movement has been active in Spain during the last 20 years,
with a painful number of victims. Civil Defense is in charge of the
coordination of all the structures that are implicated in a terrorist
incident. There are three typical patterns of attacks: (1) individual
attacks; (2) group attacks; and (3) mass attacks. The individual attacks are
done with guns, usually 9 mm, fired from a short distance; victims die from
serious intracranial damage. Collective attacks are done using explosives
under vehicles, tramp bombs, or “bomb vehicles;” victims are of different
severity with wounds, burns, and blast injuries. With mass attacks with
“bomb vehicles” in buildings or crowded public places, the numbers of
victims are elevated and produce brutal social consequences.
Emergency Medical Services integrated in to “Civil Defense” try to
minimize the damage by initializing treatment on-scene and with the rapid
provision of definitive care. During the last year, post-traumatic stress
disorder treatment groups have been providing care to the victims and
personnel. Chemical or biological weapons have not been used, although this
is a great concern to the authorities.
Variables Influencing Medical Usage Rates, Injury Patterns, and Levels of
Care for Mass Gatherings
Authors: Milsten Andrew M. , Seaman Kevin G. , Liu Peter , Bissell Rick A. , Maguire Brian J. 
Published: August 2016

Abstract

Objectives:

Mass gatherings create difficult environments for which to plan
emergency medical responses. The purpose of this study was to identify
those variables that are associated with increased medical usage rates
(MURs) and certain injury patterns that can be used to facilitate the
planning process.

Methods:

Patient information collected at three types of mass gatherings
(professional American football and baseball games and rock concerts)
over a three-year period was reviewed retrospectively. Specific
variables were abstracted: (1) event type; (2) gender; (3) age; (4)
weather; and (5) attendance. All 216 events (total attendance9,708,567)
studied were held in the same metropolitan region. All MURs are reported
as patients per 10,000 (PPTT).

Results:

The 5,899 patient encounters yielded a MUR of 6.1 PPTT. Patient
encounters totaled 3,659 for baseball games (4.85 PPTT), 1,204 for
football games (6.75 PPTT), and 1,036 for rock concerts (30 PPTT). The
MUR for Location A concerts (no mosh pits) was 7.49 PPTT, whereas the
MUR for the one Location B concert (with mosh pits) was110 PPTT. The MUR
for Location A concerts was higher than for baseball, but not football
games (p = 0.005). Gender distribution was
equal among patrons seeking medical care. The mean values for patient
ages were 29 years at baseball games, 33 years at football games, and 20
years at concerts. The MUR at events held when the apparent temperature
was £80°F significantly lower statistically than that at events
conducted at temperatures <80°F were (18°C) (4.90 vs. 8.10 PPTT
(p = 0.005)). The occurrence of
precipitation and increased attendance did not predict an increased MUR.
Medical care was sought mostly for minor/basic-level care (84%) and less
so for advanced-level care (16%). Medical cases occurred more often
atsporting events (69%), and were more common than were cases with
traumatic injuries (31%). Concerts with precipitation and rock concerts
had a positive association withthe incidence of trauma and the incidence
of injuries; whereas age and gender were not associated with medical or
traumatic diagnoses.

Conclusions:

Event type and apparent temperature were the variables that best
predicted MUR as well as specific injury patterns and levels of
care.
Randomized, Controlled Trial of Three Levels of Critical Incident Stress
Intervention
Authors: Macnab Andrew , Sun Charles , Lowe John 
Published: August 2016

Abstract

Background:

Stress debriefing following exposure to a critical incident
isbecoming more prevalent. Its aim is to prevent or minimize the
development of excessive stress response symptoms that lead to loss of
productivity or effectiveness in the workplace or at home. There is
little evidence that any form of psychological debriefing is effective.
This study evaluated the effectiveness of three intervention strategies,
and attempted to correlate the symptoms with the severity of the
incidentand level of intervention.

Methods:

A randomized, controlled trial of three levels of critical stress
intervention was conducted in the British Columbia Ambulance Service
(BCAS), in British Columbia, Canada, among paramedics and emergency
medical technicians (EMTs), reporting critical incident stress. Outcomes
were measured at one week (Stanford Acute Stress Reaction Questionnaire
(SASRQ), the Life Impact Score (LIS), and Schedule of Recent Events
(SRE)), and at three months and six months following the intervention
(Impact of Events (IE), Coping Mechanisms, LIS, and SRE).

Results:

Fifty calls were received during the 26-month study period (<1
per 10,000 BCAS response calls): 23 were by third parties, but the
involved EMT did not call;nine were placed by crew unwilling to
participate in the study; 18 subjects enrolled, but six completed no
forms. No correlation was found between severity of the incident and
scores on the SASRQ, IE, or LIS, or between any of these scores. There
was no consistent pattern in the stress scores over time.

Conclusion:

Requests for critical incident stress intervention were uncommon.
The need for intervention may not be as great as generally is assumed.
Further randomized trials, ideally multicenter studies, are
indicated.
The Traumatic Process: Conceptualization and Treatment
Authors: Noy Shabtai 
Published: August 2016

AbstractTraumatic stress stems from a threat to an individual's or a group's very existence. The impact of the existential threat may be compounded by an inability to cope, which affects the perception of helplessness and loss of lawfulness. A model is proposed in which the traumatic process is conceptualized to develop through three stages: (1) alert; (2) impact; and (3) post-trauma. In this model, treatment of traumatic stress emphasizes the need to control and expand life, and to achieve lawfulness and meaningfulness. In the proposed model of treatment, there are essential differences at each of the stages of the traumatic process: (1) primary prevention at the stage of alert focuses on planning strategies for coping; (2) secondary prevention at the stage of impact is based on forward treatment and debriefing; and (3) tertiary treatment at the post-trauma stage attends to coping with internal chaos and arbitrariness.
Acute Psychological Impact of Disaster and Large-Scale Trauma: Limitations of Traditional Interventions and Future Practice Recommendations
Authors: Gray Matt J. , Maguen Shira , Litz Brett T. 
Published: August 2016

AbstractNearly everyone will experience emotional and psychological distress in the immediate aftermath of a disaster or other large-scale traumatic event. Although extremely upsetting and disruptive, the reaction is understood best as a human response to inordinate adversity, which in the majority of cases remits over time without formal intervention. Nevertheless, some people experience sustained difficulties. To prevent chronic post-traumatic difficulties, mental health professionals provide early interventions soon after traumatic exposure. These interventions typically take the form of single-session debriefings, which have been applied routinely following disasters. The research bearing on these traditional forms of early crisis interventions has shown that, although well-received by victims, there is no empirical support for their continued use. However, promising evidence-based, early interventions have been developed, which are highlighted. Finally, traumatic bereavement and complicated grief in survivors of disasters, an area largely neglected in the field, is discussed.