bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cancer patients' perceptions of quality‐of‐care attributes—Associations with age, perceived health status, gender and education
Authors: Suhonen Riitta , Stolt Minna , Berg Agneta , Katajisto Jouko , Lemonidou Chryssoula , Patiraki Elisabeth , Sjövall Katarina , Charalambous Andreas 
Published: May 2017

Aims and objectivesThe aim of this study was to explore the associations between patients' gender, education, health status in relation to assessments of patient‐centred quality and individuality in care and trust in nurses for those <65 (working age) and ≥65 years (older people).BackgroundPatients' assessments of the quality of care they receive are essential for the development of the provision of patient care and services. Previous studies have revealed age of the patient is associated with their assessment of care quality attributes.DesignThe study employed a cross‐sectional, multicultural comparative survey design.MethodsThe data were collected using questionnaires among hospitalised cancer patients (N = 876, n = 599, 68%) in four European countries: Greece, Cyprus, Sweden and Finland. The data were divided into two subgroups based on age (cut point 65 years) and were analysed statistically.ResultsCancer patients' age, gender and level of education were not related to their assessments of care quality attributes: person‐centred care quality, individuality in care and trust in nurses. Subgroup analysis of the older adults and those of working age showed clear associations with patients' assessments of quality‐of‐care attributes and perceived health status. The lower the perceived health status, the lower the assessment of care quality attributes.DiscussionThe results suggest that the cancer itself is the strongest determinant of the care delivered, rather than any patient characteristics, such as age, education or gender. Perceived health status, in association with cancer patient assessments of care quality attributes, may be useful in the development of patient‐centred, individualised care strategies alongside a stronger focus on people instead of cancer‐care‐related processes and duties.ConclusionsHealth status was the only factor associated with cancer patients' assessments of care quality attributes. Cancer itself may be the strongest determinant of the care quality perceptions, rather than any patient characteristics.Relevance to clinical practiceThe findings of this study have implications for cancer care professionals in terms of patient assessment and care planning. The measures may be useful in assessing quality of cancer nursing care.
The Quebec experience in promoting healthy lifestyles and preventing obesity: how can we do better?
Authors: Le Bodo Y. , Blouin C. , Dumas N. , De Wals P. , Laguë J. 
Published: May 2017

SummaryOver the last years, many actions have been implemented in the Canadian province of Quebec to prevent health issues related to diet, physical activity and obesity. As a new public health programme is being launched, the ‘How can we do better?’ project aimed to identify priority areas for further action. An exhaustive search led to identify 166 interventions rolled out in Quebec between 2006 and 2014. We compared it with evidence‐based recommendations. Findings were challenged during a 2‐d deliberative forum gathering 25 key stakeholders. At the crossroads of these analyses, 50 proposals emerged to sustain/bolster current efforts or to implement new initiatives. Specific improvements were recommended, e.g. about food supply quality monitoring, healthy food accessibility and affordability, physical activity promotion through land use policies, schools and childcare facilities retrofit and urban planning. Crosscutting proposals stress the importance to implement a new governmental prevention strategy and to reinforce evaluation at all levels. This call for action takes place at a critical period for political commitment and should be maintained until and after curbing the prevalence of obesity and related diseases. Although Quebec‐focused, ‘How can we do better?’ project outcomes may be informative for other jurisdictions, and the methods may be inspiring for those interested in combining knowledge syntheses and deliberative processes to inform decision makers in a limited time frame.
Observations of the structural changes that occur during charcoalification: implications for identifying charcoal in the fossil record
Authors: Hudspith Victoria A. , Belcher Claire M. 
Published: May 2017

AbstractAll of our current understanding of fossil charcoal structure comes from observations of modern wood charcoal produced in furnaces. These charcoals consistently show cell wall homogenization after prolonged heating (>325°C) and this is therefore considered to be a key identifying feature of fossil charcoal. Yet furnaces are unable to replicate the full combustion processes that occur during a wildfire. Here, for the first time, we have studied the microscopic structural evolution of charcoal produced using calorimetry, wherein the wood is ignited under controlled conditions and the heat release rate and other parameters measured, and the resulting charcoal studied using reflected light microscopy. We show that homogenization of cell walls is actually only a short‐lived phase of charcoal formation that occurs during the early heating stages as the pyrolysis front traverses through the wood. Cell wall homogenization is then rapidly overprinted by the thinning, distortion and breakdown of cell walls, and a notable visual increase in reflectance. Our preliminary study therefore suggests that we need to first improve our understanding of charcoal formation in order to better understand the fossil record of wildfires.
Optimal Proliferation and Differentiation of Chlamydia Trachomatis
Authors: Wan Frederic Y. M. , Enciso Germán A. 
Published: May 2017

Chlamydia trachomatis is a bacterium that causes eye infection and blindness in humans. In the simplest form, it has an unusual life cycle involving two developmental forms. Within a cytoplasmic inclusion, the reticulate body (RB) repeatedly divides by binary fission and asynchronously differentiates into the infectious elementary body (EB). Upon the death of the mammalian cell that host many such inclusions, only the EB form of the bacteria survive and proceed to infect other cells. Given the bacteria's fast spreading infection, conventional wisdom would have the few initial EB turn into RB, divide and proliferate first, and then eventually start converting to maximize the terminal EB population upon host cell lysis. Several biological processes are seen as possible mechanisms for implementing such a conversion strategy. However, the optimality of an instinctual strategy with a period of proliferate without conversion prior to the onset of differentiation has never been substantiated theoretically or justified mathematically.This paper formulates three relatively simple models that capture the essential features of the Chlamydia life cycle. When the initial infection is caused by the endocytosis of a small EB population well below the carrying capacity of the host cell, the Maximum Principle in control theory requires for these models an optimal conversion strategy that confirms and rigorously justifies the prevailing view of no conversion at the early stage of the host cell infection. However, the conventional supposition is found to be inappropriate for an initial EB (‐to‐RB) population near or above the carrying capacity. Previously suggested and new biological mechanisms are examined for their role in implementing the different optimal conversion strategies associated with models investigated herein.
Obstacles to reducing plasma levels of uremic solutes by hemodialysis
Authors: Sirich Tammy L. 
Published: May 2017

AbstractMore intensive hemodialysis has provided limited clinical benefit. The lack of benefit may be due in part to the failure of intensive dialysis to reduce uremic solute levels in plasma. Two well‐described factors limiting the reduction in these levels are the intermittency of dialysis treatment and the distribution of solutes in multiple body compartments. Efforts to increase the clearance of large solutes and protein‐bound solutes have revealed two other considerations—the presence of nonrenal clearance and increases in solute generation. For β2 microglobulin, a commonly measured large solute, nonrenal clearance limits reduction in its levels. For the bound solute p‐cresol sulfate, an increase in generation appears to limit its reduction. A variety of factors likely determine the behavior of different solutes. More data on solute toxicity are needed as is better knowledge of solute kinetics. We will then be better able to design optimal therapeutic interventions. A combination of dialytic and nondialytic strategies may well be needed to reduce the plasma levels of toxic solutes and improve patients’ health.
Predictores de una interacción eficaz entre madre e hijo/a en contextos de riesgo psicosocial.
Authors: Álvarez Lorenzo Miriam , Rodrigo López María José , Rodríguez Suárez Guacimara 
Published: May 2017

Resumen
Este estudio analiza la influencia de las prácticas, las metas, la representación materna de las propias acciones y la predictibilidad de prácticas y metas según los hijos/as sobre la interaccion entre madre-hijo/a observada en una tarea colaborativa. Los participantes fueron 82 diadas en riesgo psicosocial. Las madres reportaron las prácticas y las metas en situaciones hipotéticas y la representación de la propia acción en la interacción. Los hijos/as reportaron la predictibilidad de las prácticas y las metas de las propias madres. Los modelos de regresión muestran la influencia negativa de las prácticas coercitivas y restrictivas, la influencia positiva de la representación de la acción y de la predictibilidad de prácticas y metas en la dinámica de la interacción madre-hijo/a.
Predictors of Postpartum Exercise According to Prepregnancy Body Mass Index and Gestational Weight Gain
Authors: Downs Danielle Symons , Leonard Krista S. , Beiler Jessica S. , Paul Ian M. 
Published: May 2017

Background:The study purposes were to examine (1) differences in postpartum exercise (EX) and related personal/psychological correlates in women according to prepregnancy weight and pregnancy gestational weight gain (GWG) status and (2) predictors of EX at 2 weeks, 2 months, and 6 months postpartum.Methods:Participants (N = 891) were recruited at maternity hospitalization and completed interviews to assess EX (Leisure-Time Exercise Questionnaire) and personal correlates (demographics, anxiety/depressive symptoms) before/during pregnancy. Telephone interviews were conducted to assess postpartum EX/psychological correlates. Women were categorized according to prepregnancy weight (normal and overweight) and pregnancy GWG status (above or within weight gain guidelines): normal-above, normal-within, overweight-above, and overweight-within.Results:Low levels of EX minutes were observed in all women with significant differences for strenuous EX minutes (overweight-within women had the lowest strenuous EX; normal-weight women had more strenuous EX than overweight women regardless of GWG). Correlates explained 14%–37% of the variance in postpartum EX; prepregnancy EX and pregnancy EX were strong determinants of early postpartum EX, and early postpartum EX predicted 6-month postpartum EX. Unique predictors of EX also emerged (eg, depressive symptoms for women with GWG above guidelines).Conclusions:These study findings highlight the benefits of EX before/during pregnancy for promoting postpartum EX and suggest tailoring postpartum EX interventions based on personal/psychological correlates to maximize effectiveness.
A cross-sectional survey using electronic distribution of a questionnaire to subscribers of educational material written by clinicians, for clinicians, to evaluate whether practice change resulted from reading the Clinical Communiqué
Authors: Cunningham Nicola , Pham Tony , Kennedy Briohny , Gillard Alexander , Ibrahim Joseph 
Published: May 2017

ObjectiveTo explore whether subscribers reported clinical practice changes as a result of reading the Clinical Communiqué (CC). Secondarily, to compare the characteristics of subscribers who self-reported changes to clinical practice with those who did not, and to explore subscribers’ perceptions of the educational value of the CC.Design, setting and participantsOnline cross-sectional survey between 21 July 2015 and 18 August 2015 by subscribers of the CC (response rate=29.9%, 1008/3373), conducted by a team from Monash University, Australia.Main outcome measuresChange in clinical practice as a result of reading the CC.Results53.0% of respondents reported that their practice had changed after reading the CC. Respondents also found that the CC raised awareness (96.5%) and provided ideas about improving patient safety and care (94.1%) leading them to discuss cases with their colleagues (79.6%) and review their practice (75.7%). Multivariate analysis indicated that working in a residential aged care facility (p<0.05) and having taken part in an inquest (p<0.05) were significantly associated with practice change.ConclusionThe design and content of the CC has generated a positive impact on the healthcare community. It is presented in a format that appears to be accessible and acceptable to readers and achieves its goals of promoting safer clinical care through greater awareness of the medico-legal context of practice.
Validation of asthma recording in electronic health records: protocol for a systematic review
Authors: Nissen Francis , Quint Jennifer K , Wilkinson Samantha , Mullerova Hana , Smeeth Liam , Douglas Ian J 
Published: May 2017

BackgroundAsthma is a common, heterogeneous disease with significant morbidity and mortality worldwide. It can be difficult to define in epidemiological studies using electronic health records as the diagnosis is based on non-specific respiratory symptoms and spirometry, neither of which are routinely registered. Electronic health records can nonetheless be valuable to study the epidemiology, management, healthcare use and control of asthma. For health databases to be useful sources of information, asthma diagnoses should ideally be validated. The primary objectives are to provide an overview of the methods used to validate asthma diagnoses in electronic health records and summarise the results of the validation studies.MethodsEMBASE and MEDLINE will be systematically searched for appropriate search terms. The searches will cover all studies in these databases up to October 2016 with no start date and will yield studies that have validated algorithms or codes for the diagnosis of asthma in electronic health records. At least one test validation measure (sensitivity, specificity, positive predictive value, negative predictive value or other) is necessary for inclusion. In addition, we require the validated algorithms to be compared with an external golden standard, such as a manual review, a questionnaire or an independent second database. We will summarise key data including author, year of publication, country, time period, date, data source, population, case characteristics, clinical events, algorithms, gold standard and validation statistics in a uniform table.Ethics and disseminationThis study is a synthesis of previously published studies and, therefore, no ethical approval is required. The results will be submitted to a peer-reviewed journal for publication. Results from this systematic review can be used to study outcome research on asthma and can be used to identify case definitions for asthma.PROSPERO registration numberCRD42016041798.
Relationship between dietary factors and the number of altered metabolic syndrome components in Chinese adults: a cross-sectional study using data from the China Health and Nutrition Survey
Authors: Cheng Maowei , Wang Huijun , Wang Zhihong , Du Wenwen , Ouyang Yifei , Zhang Bing 
Published: May 2017

ObjectivesTo study the correlation between dietary factors and the number of altered metabolic syndrome components (MetS) in Chinese adults systematically.SettingA cross-sectional study using demographic and dietary data of adults aged 18–75 years from the China Health and Nutrition Survey (2009) was conducted in nine provinces in China.ParticipantsThere were 6034 eligible subjects (2800 men and 3234 women) in this study.OutcomesThe primary outcome of this study were diet assessments and the number of altered MetS components. Dietary intake was measured using a combination of a 3-day period with 24-hour and household food inventory; average daily intakes of nutrients were estimated according to the Chinese Food Composition Table. Blood samples were analysed in a national central laboratory and the number of clustering MetS components was calculated by adding the presence of each MetS component.ResultsAfter adjusting for covariates, and taking zero MetS as comparison, the high risk factors correlating with increased numbers of altered MetS components in men were higher intake of protein (70.4–73.4 g;Ptrend=0.0004), cholesterol (238.7–266.6 mg;Ptrend=0.004), meat (90.6–105.7 g;Ptrend=0.016), fish/seafood (30.4–42.3 g;Ptrend=0.001), and lower intake of coarse cereals (16.5–12.7 g;Ptrend=0.051), tubers (37.3–32.7 g;Ptrend=0.030), and dietary fibre (11.7–11.5 g; ANCOVA p=0.058). Meanwhile, the high risk factors correlating with the increased number of altered MetS components in women were higher intake of wheat (101.9–112.6 g;Ptrend=0.066) and sodium (3862.3–4005.7 mg,Ptrend=0.032), and lower intake of β-carotene (1578.6–1382.7 µg;Ptrend=0.007), milk, and dairy products (17.8–11.5 g;Ptrend=0.002).ConclusionsSome foods and nutritional factors correlate with an increased number of altered MetS components in Chinese adults. More prospective, multicentre and clinical research work to further examine these associations is underway.
Trends in alcohol-related injury admissions in adolescents in Western Australia and England: population-based cohort study
Authors: O’Donnell Melissa , Sims Scott , Maclean Miriam J , Gonzalez-Izquierdo Arturo , Gilbert Ruth , Stanley Fiona J 
Published: May 2017

BackgroundAlcohol-related harm in young people is now a global health priority. We examined trends in hospital admissions for alcohol-related injuries for adolescents in Western Australia (WA) and in England, identified groups most at risk and determined causes of injuries.MethodsAnnual incidence rates for alcohol-related injury rates were calculated using population-level hospital admissions data for WA and England. We compared trends in different types of alcohol-related injury by age and gender.ResultsDespite a decrease in the overall rate of injury admissions for people aged 13–17 years in WA, alcohol-related injuries have increased significantly from 1990 to 2009 (from 8 to 12 per 10 000). Conversely, alcohol-related injury rates have declined in England since 2007. In England, self-harm is the most frequently recorded cause of alcohol-related injury. In WA, unintentional injury is most common; however, violence-related harm is increasing for boys and girls.ConclusionAlcohol-related harm of sufficient severity to require hospital admission is increasing among adolescents in WA. Declining trends in England suggest that this trend is not inevitable or irreversible. More needs to be done to address alcohol-related harm, and on-going monitoring is required to assess the effectiveness of strategies.
Epidural analgesia in critically ill patients with acute pancreatitis: the multicentre randomised controlled EPIPAN study protocol
Authors: Bulyez Stéphanie , Pereira Bruno , Caumon Elodie , Imhoff Etienne , Roszyk Laurence , Bernard Lise , Bühler Leo , Heidegger Claudia , Jaber Samir , Lefrant Jean-Yves , Chabanne Russell , Bertrand Pierre-Marie , Laterre Pierre-François , Guerci Philippe , Danin Pierre-Eric , Escudier Etienne , Sossou Achille , Morand Dominique , Sapin Vincent , Constantin Jean-Michel , Jabaudon Matthieu 
Published: May 2017

BackgroundAcute pancreatitis (AP) is associated with high morbidity and mortality in its most severe forms. Most patients with severe AP require intubation and invasive mechanical ventilation, frequently for more than 7 days, which is associated with the worst outcome. Recent increasing evidence from preclinical and clinical studies support the beneficial effects of epidural analgesia (EA) in AP, such as increased gut barrier function and splanchnic, pancreatic and renal perfusion, decreased liver damage and inflammatory response, and reduced mortality. Because recent studies suggest that EA might be a safe procedure in the critically ill, we sought to determine whether EA reduced AP-associated respiratory failure and other major clinical outcomes in patients with AP.Methods and analysisThe Epidural Analgesia for Pancreatitis (EPIPAN) trial is an investigator-initiated, prospective, multicentre, randomised controlled two-arm trial with assessor-blinded outcome assessment. The EPIPAN trial will randomise 148 patients with AP requiring admission to an intensive care unit (ICU) to receive EA (with patient-controlled epidural administration of ropivacaine and sufentanil) combined with standard care based on current recommendations on the treatment of AP (interventional group), or standard care alone (reference group). The primary outcome is the number of ventilator-free days at day 30. Secondary outcomes include main complications of AP (eg, organ failure and mortality, among others), levels of biological markers of systemic inflammation, epithelial lung injury, renal failure, and healthcare-associated costs.Ethics and disseminationThe study was approved by the appropriate ethics committee (CPP Sud-Est VI). Informed consent is required. If the combined application of EA and standard care proves superior to standard care alone in patients with AP in the ICU, the use of EA may become standard practice in experienced centres, thereby decreasing potential complications related to AP and its burden in critically ill patients. The results will be disseminated in a peer-reviewed journal.Trial registration numberNCT02126332.
Exploring the acceptability of a ‘limited patient consent procedure’ for a proposed blood-borne virus screening programme: a Delphi consensus building technique
Authors: Crane Denise , Henderson Emily J , Chadwick David R 
Published: May 2017

ObjectiveTo identify components of a proposed blood-borne virus (BBV) population screening programme and its associated consent procedure that both the public and health practitioners (HPs) would find acceptable. The proposed BBV screening system would aim to reduce late diagnosis of BBVs and be used in patients undergoing routine blood tests, aided by risk stratification software to target individuals at higher risk of infection.DesignA Delphi technique was used to build consensus among two separate groups, public participants and HPs in England.MethodsA survey incorporating vignettes was developed, with input from an external panel of experts. Over three rounds, 46 public participants and 37 HPs completed the survey, rating statements on a four-point Likert scale. The survey covered issues around stigma and sensitivity, the use of risk stratification algorithms and ‘limited’ patient consent (ie, preinformed of the option to ‘opt-out’). Consensus was defined as >70% of participants agreeing or disagreeing with each statement.ResultsConsensus was achieved among both groups in terms of acceptability of the screening programme. There was also consensus on using patient data to risk-stratify screening algorithms and the need to obtain some form of consent around the time of drawing blood.ConclusionsThis study found that the special protected status of HIV in England is no longer deemed necessary today and hinders appropriate care. We propose that a novel ‘limited consent procedure’ could be implemented in future screening programmes.