bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical need-directed blood tests: a step in saving the NHS?
Authors: Mughal Zahir , Narayanan Aravindan , Gupta Vivek , Reay-Jones Nick 
Published: January 2016

Background Unnecessary blood tests are estimated to contribute to 25% of wastage in the National Health Service. The aim of this study was to assess the financial implication of clinical need-focused blood tests guided by a senior clinician in a district general hospital. Methods We conducted an observational longitudinal study over six months with pre- and postanalysis of a vetting intervention. A colorectal firm (Team A) implemented a vetting system that required a registrar or consultant to discuss which blood tests needed to be requested for each in-patient with junior doctors. Another colorectal firm (Team B) with a similar caseload was blinded to the study and was used as a control. Results The vetting initiative demonstrated a reduction of 33% of blood test requests, translating to a cost-saving of £2406 over three months. Following the intervention, the median number of tests requested per patient per day by Team A for C-reactive protein reduced from 0.8 to 0.63 ( P = 0.0074), full blood counts reduced from 0.8 to 0.67 ( P = 0.0138), liver function tests decreased from 0.8 to 0.6 ( P = 0.0021) and urea and electrolytes fell from 0.8 to 0.63 ( P = 0.0083). The number of tests per patient per day after the intervention was significantly less than the control group ( P < 0.001). The length of hospital stay and admission to critical care were not adversely affected in the group that had less blood tests, P = 0.808 and P = 0.58, respectively. Conclusion The direction, by a senior clinician, of the requesting of blood tests by junior doctors to ensure that requests were based on clinical need, reduced the number of inappropriate blood tests and resulted in some reduction in laboratory costs.
Assessing and Strengthening Evidence-Based Program Registries’ Usefulness for Social Service Program Replication and Adaptation
Authors: Horne Christopher S. 
Published: January 2016

Background: Government and private funders increasingly require social service providers to adopt program models deemed “evidence based,” particularly as defined by evidence-based program registries, such as What Works Clearinghouse and National Registry of Evidence-Based Programs and Practices. These registries summarize the evidence about programs’ effectiveness, giving near-exclusive priority to evidence from experimental-design evaluations. The registries’ goal is to aid decision making about program replication, but critics suspect the emphasis on evidence from experimental-design evaluations, while ensuring strong internal validity, may inadvertently undermine that goal, which requires strong external validity as well. Objective: The objective of this study is to determine the extent to which the registries’ reports provide information about context-specific program implementation factors that affect program outcomes and would thus support decision making about program replication and adaptation. Method: A research-derived rubric was used to rate the extent of context-specific reporting in the population of seven major registries’ evidence summaries ( N = 55) for youth development programs. Findings: Nearly all (91%) of the reports provide context-specific information about program participants, but far fewer provide context-specific information about implementation fidelity and other variations in program implementation (55%), the program’s environment (37%), costs (27%), quality assurance measures (22%), implementing agencies (19%), or staff (15%). Conclusion: Evidence-based program registries provide insufficient information to guide context-sensitive decision making about program replication and adaptation. Registries should supplement their evidence base with nonexperimental evaluations and revise their methodological screens and synthesis-writing protocols to prioritize reporting—by both evaluators and the registries themselves—of context-specific implementation factors that affect program outcomes.
Prepregnancy Obesity Class Is a Risk Factor for Failure to Exclusively Breastfeed at Hospital Discharge among Latinas
Authors: Martinez Josefa L. , Chapman Donna J. , Pérez-Escamilla Rafael 
Published: January 2016

Background: Suboptimal infant feeding practices, including the failure to exclusively breastfeed, are modifiable risk factors that affect multiple maternal and child health outcomes. Women who are overweight or obese prenatally are more likely to fail to exclusively breastfeed. In the United States, Latinas represent a high-risk population with respect to overweight, obesity, and suboptimal infant feeding practices. Objectives: Examine whether exclusive breastfeeding status at hospital discharge among overweight and obese Latinas was associated with (1) prepregnancy body mass index (BMI) and gestational weight gain and (2) sociodemographic, psychosocial, and maternal/infant biomedical factors. Methods: An electronic medical records review was conducted to determine exclusive breastfeeding status at hospital discharge among Latinas who gave birth at Hartford Hospital, Hartford, Connecticut, USA (N = 480). Eligible participants were ≥ 16 years, Latina, overweight or obese (BMI ≥ 25.0 kg/m2) and delivered a healthy full-term (≥ 37 weeks) singleton. Results: In the multivariable model, obese class II (BMI, 35.0-39.9 kg/m2) women had increased odds of failing to exclusively breastfeed at hospital discharge compared with overweight women. Planned formula use/partial breastfeeding was the single strongest predictor of nonexclusive breastfeeding status. Other risk factors included Puerto Rican ethnicity and parity. Conclusion: Maternal prepregnancy obesity class is an important predictor of exclusive breastfeeding status at hospital discharge among overweight and obese Latinas. Future research should examine why in-hospital exclusive breastfeeding behaviors differ by obesity class to subsequently inform the design of breastfeeding promotion and support interventions tailored to the needs of Latinas by obesity class. Culturally appropriate prenatal breastfeeding promotion interventions emphasizing action and coping planning should be considered.
Within-Group Effect-Size Benchmarks for Trauma-Focused Cognitive Behavioral Therapy With Children and Adolescents
Authors: Rubin Allen , Washburn Micki , Schieszler Christine 
Published: January 2016

Purpose: This article provides benchmark data on within-group effect sizes from published randomized clinical trials (RCTs) supporting the efficacy of trauma-focused cognitive behavioral therapy (TF-CBT) for traumatized children. Methods: Within-group effect-size benchmarks for symptoms of trauma, anxiety, and depression were calculated via the Glass approach and adjusted for sample size using Hedges’ g. Results: Overall TF-CBT and control group benchmarks are presented, as well as specific benchmarks for sexual abuse and mixed trauma, and whether included studies utilized intent-to-treat analysis. Discussion: Community practitioners can use these benchmarks as a comparison tool to evaluate whether the way they are adopting or adapting the TF-CBT intervention is satisfactory, needs to be modified, or should be replaced by a different intervention approach. These benchmarks also have potential utility for future implementation research on TF-CBT assessing which service provision conditions are associated with effect sizes approximating benchmarks provided in this article.
Adult Relationships in Multiple Contexts and Associations With Adolescent Mental Health
Authors: Capp Gordon , Berkowitz Ruth , Sullivan Kathrine , Astor Ron Avi , De Pedro Kris , Gilreath Tamika D. , Benbenishty Rami , Rice Eric 
Published: January 2016

Purpose: Adult relationships provide critical support for adolescents because of their potential to foster positive development and provide protective influences. Few studies examine multiple ecological layers of adult relationships in connection with well-being and depression. This study examines the influence of relationships from multiple contexts for adolescents and their mental health. Method: Data from the 2011 California Healthy Kids Survey was used for this analysis; a sample of 7th-, 9th-, and 11th-grade students ( N = 14,931) was drawn from 6 school districts in Southern California. Results: Regression analyses revealed that parent, teacher, and community adult support were all significantly positively associated with well-being and significantly negatively associated with depression. Discussion: Social support explained more variance in well-being than in depression, indicating that adult support may be more important for supporting well-being. This study supports the belief that individual categories and combinations of adult support are important.
ICU Deaths in Patients With Advanced Cancer
Authors: Nasir Syed Sameer , Muthiah Muthiah , Ryder Kathryn , Clark Karen , Niell Harvey , Weir Alva 
Published: January 2016

Background: A significant number of advanced cancer admissions to the intensive care unit (ICU) are inappropriate in that they do not result in prolonged survival. No clear consensus criteria for reasonable admissions of advanced cancer patients have been developed. Method: We established four criteria for reasonable admissions to ICU in patients who suffered from advanced, incurable cancer: post procedure complication, recent notification of cancer, ECOG performance status of 0-1, and life expectancy of more than 6 months. Based on these criteria, we reviewed the charts of all patients who died in the ICU at the University of Tennessee Health Science Center (UTHSC) affiliated Veteran’s Affairs Medical Center between 10/2005 and 10/2010. We identified patients with advanced, incurable cancer and performed an in depth review of their charts. Results: In the 421 charts of patients who died in our ICU between October 2005 and October 2010 we identified 52 patients admitted to the ICU with advanced, incurable cancer. 14 patients were diagnosed with cancer one month or less prior to admission. 21 patients had ECOG performance status of 0-1. 14 patients had life expectancy of more than 6 months and 8 patients were admitted for post procedure complication. 47% of patients who did not satisfy any of our reasonable admission criteria had APDs. Conclusions: Incorporating proposed admission criteria in ICU admission guidelines may prevent 37% of inappropriate, advanced cancer admissions to the ICU. A simple increase in numbers of APDs would not likely change significantly the numbers of inappropriate ICU admissions.
Topical Docosahexaenoic Acid (DHA) Accelerates Skin Wound Healing in Rats and Activates GPR120
Authors: Arantes Eva L. , Dragano Nathalia , Ramalho Albina , Vitorino Daniele , de-Souza Gabriela F. , Lima Maria H. M. , Velloso Licio A. , Araújo Eliana P. 
Published: January 2016

Background: The development of methods for improving skin wound healing may have an impact on the outcomes of a number of medical conditions. The topical use of polyunsaturated fatty acids (PUFAs) can accelerate skin wound healing through mechanisms that involve, at least in part, the modulation of inflammatory activity. Purpose: We evaluated whether G-protein-coupled receptor 120 (GPR120), a recently identified receptor for docosahexaenoic acid (DHA) with anti-inflammatory activity, is expressed in the skin and responds to topical DHA. Method: Male Wistar rats were submitted to an 8.0-mm wound on the back and were immediately administered a topical treatment of a solution containing 30 μM of DHA once a day. The healing process was photodocumented, and tissues were collected on Days 5, 9, and 15 for protein and RNA analyses and histological evaluation. Results: GPR120 was expressed in the intact skin and in the wound. Keratinocytes expressed the most skin GPR120, while virtually no expression was detected in fibroblasts. Upon DHA topical treatment, wound healing was significantly accelerated and was accompanied by the molecular activation of GPR120, as determined by its association with β-arrestin-2. In addition, DHA promoted a reduction in the expression of interleukin (IL) 1β and an increase in the expression of IL-6. Furthermore, there was a significant increase in expression of transforming growth factor β (TGF-β) and the keratinocyte marker involucrin. Discussion: Topical DHA improved skin wound healing. The activation of GPR120 is potentially involved in this process.
A longitudinal analysis of students’ autobiographical memories of participation in multiple Sport Education seasons
Authors: Wahl-Alexander Zachary , Sinelnikov Oleg , Curtner-Smith Matthew 
Published: January 2016

The purpose of this study was to examine middle school students’ recollections of their participation in a significant number of Sport Education seasons over a period of five years. Thirty-one (18 boys and 13 girls) eighth-grade students (average age at data collection = 13 years) who had all participated in at least 17 Sport Education seasons served as the participants in this study. Autobiographical memory theory guided qualitative data collection, which included surveys, formal interviews, focus group interviews, and autobiographical critical reflections. Student responses were categorized into general events, which had a focus on evaluating, preparation, first season, integrity, competition, and gamesmanship. Descriptive event-specific memories included authenticity and gameplay as most memorable aspects of students’ experiences within multiple Sport Education seasons. The findings suggested that participating in multiple Sport Education seasons leads to better developed student roles and a stronger sense of fair play. More importantly, adherence to the central features of Sport Education and meaningful participation in several iterations of quality Sport Education seasons may be required for students to move closer to achieving the lofty goals of the model for students to become competent, literate, and enthusiastic sportspeople.
Cross-linguistic differences affect late Chinese-English learners on-line processing of English tense and aspect
Authors: Yao Panpan , Chen Baoguo 
Published: January 2016

Aims: The present study aimed to explore how varied cross-linguistic differences affect late Chinese-English learners’ on-line processing of tense and aspect in English. Methodology: We used the self-paced reading task (Experiment 1) and the eye-tracking technique (Experiment 2) to test the above question. Data and analysis: Reading times in Experiment 1 and first-fixation duration, and gaze time in Experiment 2 in four interested positions were analysed in R by ANOVAs and t-tests. Findings: Both high- and low-proficiency participants showed their sensitivity to the violation of progressive, which is nearly congruent between English and Chinese. Only high-proficiency participants were sensitive to the violation of past tense, which is similar but not congruent between Chinese and English. With regard to present third person singular, which is incongruent between Chinese and English, high-proficiency participants also showed their sensitivity to its violation; however, this sensitivity is only detected by the eye-tracking method (Experiment 2). These results suggested that cross-linguistic differences affect late second language learners’ on-line processing of English tense and aspect. Originality: To the best of our knowledge, this study is the first one exploring varied cross-linguistic differences’ influence on late Chinese-English learners’ on-line processing of tense and aspect in English. Significance: Our results provide new evidence to support the Performance Deficit Account.
Comparative efficacy of fixed-dose combinations of long-acting muscarinic antagonists and long-acting β2-agonists: a systematic review and network meta-analysis
Authors: Schlueter Max , Gonzalez-Rojas N , Baldwin Michael , Groenke Lars , Voss Florian , Reason Tim 
Published: January 2016

Background: A number of long-acting muscarinic antagonist (LAMA)/long-acting β2-agonist (LABA) fixed-dose combinations (FDCs) for treatment of moderate-to-very severe chronic obstructive pulmonary disease (COPD) have recently become available, but none have been directly compared in head-to-head randomized controlled trials (RCTs). The purpose of this study was to assess the relative clinical benefit of all currently available LAMA/LABA FDCs using a Bayesian network meta-analysis (NMA). Methods: A systematic literature review identified RCTs investigating the efficacy, safety and quality of life associated with licensed LAMA/LABA FDCs for the treatment of moderate-to-very severe COPD. RCTs were screened for inclusion in the NMA using prespecified eligibility criteria. Data were extracted for outcomes of interest, including change in trough forced expiratory volume in 1 second (tFEV1) from baseline, St. George Respiratory Questionnaire (SGRQ) percentage of responders, Transition Dyspnea Index (TDI) percentage of responders, change in SGRQ score from baseline, change in TDI focal score from baseline, moderate-to-severe exacerbations, all-cause discontinuation, and discontinuation due to adverse events. Results: Following screening, a total of 27 trials from 26 publications with 30,361 subjects were eligible for inclusion in the NMA. Nonsignificant results were seen in most analyses comparing efficacy, exacerbations and discontinuation rates of included LAMA/LABA FDCs (i.e. aclidinium/formoterol 400/12 µg, glycopyrronium/indacaterol 110/50 µg, tiotropium + olodaterol 5/5 µg, umeclidinium/vilanterol 62.5/25 µg). Meta-regression controlling for post-bronchodilator percentage of tFEV1 predicted at baseline as well as meta-regression adjusting for concomitant use of inhaled corticosteroids at baseline was performed to assess the magnitude of effect modification and produced similar results as observed in the base case analysis. Conclusion: All LAMA/LABA FDCs were found to have similar efficacy and safety. Definitive assessment of the relative efficacy of different treatments can only be performed through direct comparison in head-to-head RCTs. In the absence of such data, this indirect comparison may be of value in clinical and health economic decision-making.
White Coat Adherence in Pediatric Patients With Type 1 Diabetes Who Use Insulin Pumps
Authors: Driscoll Kimberly A. , Wang Yuxia , Bennett Johnson Suzanne , Lynch Rebecca , Stephens Haley , Willbur Katelyn , Gill Elizabeth , Wright Nancy , Deeb Larry C. 
Published: January 2016

Background: The purpose was to assess the occurrence of white coat adherence, defined as an increase in adherence to treatment regimens prior to a clinic appointment, in children and adolescents with type 1 diabetes (T1D) who use insulin pumps. Methods: Blood glucose monitoring (BGM) data, carbohydrate inputs, and insulin boluses delivered were downloaded from the insulin pumps of children and adolescents, aged 7-19 years with T1D, at 2 consecutive routine diabetes clinic visits. Linear mixed models were used to analyze patterns of BGM, carbohydrate inputs, and insulin boluses delivered in patients who had ≥28 days of data stored in their insulin pumps. Results: In general, younger children engaged in more frequent BGM, carbohydrate inputs, and insulin boluses delivered than older children and adolescents. White coat adherence occurred with frequency of BGM, carbohydrate inputs, and insulin boluses delivered, but only in younger children. Conclusions: Diabetes care providers need to be aware that white coat adherence may occur, particularly in young children. Providers routinely download meter and insulin pump data for the 1- to 2-week period before the clinic visit. For patients exhibiting white coat adherence, their data will overestimate the patient’s actual adherence.
Design to Improve Visibility
Authors: Hadi Khatereh , Zimring Craig 
Published: January 2016

Objective: This study analyzes 10 intensive care units (ICUs) to understand the associations between design features of space layout and nurse-to-patient visibility parameters. Background: Previous studies have explored how different hospital units vary in their visibility relations and how such varied visibility relations result in different nurse behaviors toward patients. However, more limited research has examined the specific design attributes of the layouts that determine the varied visibility relations in the unit. Changes in size, geometry, or other attributes of design elements in nursing units, which might affect patient observation opportunities, require more research. Methods: This article reviews the literature to indicate evidence for the impact of hospital unit design on nurse/patient visibility relations and to identify design parameters shown to affect visibility. It further focuses on 10 ICUs to investigate how different layouts diverge regarding their visibility relations using a set of metrics developed by other researchers. Shape geometry and corridor width, as two selected design features, are compared. Results: Corridor width and shape characteristics of ICUs are positively correlated with visibility. Results suggest that floor plans, which are repeatedly broken down into smaller convex (higher convex fragmentation values), or units, which have longer distances between their rooms or between their two opposite ends (longer relative grid distances), might have lower visibility levels across the unit. The findings of this study also suggest that wider corridors positively affect visibility of patient rooms. Conclusion: Changes in overall shape configuration and corridor width of nursing units may have important effects on patient observation and monitoring opportunities.
Can Hospital Form Trigger Fear Response?
Authors: Pati Debajyoti , O’Boyle Michael , Hou Jiancheng , Nanda Upali , Ghamari Hessam 
Published: January 2016

Objective: To examine whether exposure to curve versus sharp contours in the built healthcare setting produces systematic and identifiable patterns of amygdala activation and behavioral response in healthy adults. Background: Recent studies in cognitive neuroscience suggest that humans prefer objects with a curved contour compared with objects that have pointed features and a sharp-angled contour. An implicit perception of threat represented by sharp objects, in humans, was hypothesized to explain this bias. Method: The study adopted a within-subject experimental design, where 36 subjects (representing three age-groups and both sexes) were exposed to a randomized order of 312 real-life images (objects, interiors, exteriors, landscape, and a set of control images). Amygdala activation was simultaneously captured using functional magnetic resonance imaging technology. Subjects’ preference (like/dislike) data were also collected while in the scanner. Data were collected in 2013. Results: In case of images depicting landscape and healthcare objects, brain scans show significant higher amygdala activation associated with sharp contours. However, in relation to images depicting hospital interiors and exterior envelops, brain scans show significant higher amygdala activation associated with curve contours. These activations pertain to exposure during the precognitive stages of the subjects’ perception. Conclusion: Hospital forms do have systematic impact on fear response during precognitive stages of human perception. Whether this first impression colors the subsequent experience of an actual patient with real illness or injury is unknown.