bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of conflict on medical education: a cross-sectional survey of students and institutions in Iraq
Authors: Barnett-Vanes Ashton , Hassounah Sondus , Shawki Marwan , Ismail Omar Abdulkadir , Fung Chi , Kedia Tara , Rawaf Salman , Majeed Azeem 
Published: February 2016

ObjectiveThis study surveyed all Iraqi medical schools and a cross-section of Iraqi medical students regarding their institutional and student experiences of medical education amidst ongoing conflict. The objective was to better understand the current resources and challenges facing medical schools, and the impacts of conflict on the training landscape and student experience, to provide evidence for further research and policy development.SettingDeans of all Iraqi medical schools registered in the World Directory of Medical Schools were invited to participate in a survey electronically. Medical students from three Iraqi medical schools were invited to participate in a survey electronically.OutcomesPrimary: Student enrolment and graduation statistics; human resources of medical schools; dean perspectives on impact of conflict. Secondary: Medical student perspectives on quality of teaching, welfare and future career intentions.FindingsOf 24 medical schools listed in the World Directory of Medical Schools, 15 replied to an initial email sent to confirm their contact details, and 8 medical schools responded to our survey, giving a response rate from contactable medical schools of 53% and overall of 33%. Five (63%) medical schools reported medical student educational attainment being impaired or significantly impaired; 4 (50%) felt the quality of training medical schools could offer had been impaired or significantly impaired due to conflict. A total of 197 medical students responded, 62% of whom felt their safety had been threatened due to violent insecurity. The majority (56%) of medical students intended to leave Iraq after graduating.ConclusionsMedical schools are facing challenges in staff recruitment and adequate resource provision; the majority believe quality of training has suffered as a result. Medical students are experiencing added psychological stress and lower quality of teaching; the majority intend to leave Iraq after graduation.
Inpatient detection of cardiac-inherited disease: the impact of improving family history taking
Authors: Waddell-Smith Kathryn E , Donoghue Tom , Oates Stephanie , Graham Amanda , Crawford Jackie , Stiles Martin K , Aitken Andrew , Skinner Jonathan R 
Published: February 2016

Objectives‘Idiopathic’ cardiac conditions such as dilated cardiomyopathy (DCM) and resuscitated sudden cardiac death (RSCD) may be familial. We suspected that inpatient cardiology services fail to recognise this. Our objective was to compare diagnostic value of family histories recorded by inpatient cardiology teams with a multigenerational family tree obtained by specially trained allied professionals.Methods2 experienced cardiology nurses working in 2 tertiary adult cardiac units were trained in cardiac-inherited diseases and family history (FHx) taking, and established as regional coordinators for a National Cardiac Inherited Disease Registry. Over 6 months they sought ‘idiopathic’ cardiology inpatients with conditions with a possible familial basis, reviewed the FHx in the clinical records and pursued a minimum 3-generation family tree for syncope, young sudden death and cardiac disease (full FHx).Results37 patients (22 males) were selected: mean age 51 years (range 15–79). Admission presentations included (idiopathic) RSCD (14), dyspnoea or heart failure (11), ventricular tachycardia (2), other (10). 3 patients had already volunteered their familial diagnosis to the admitting team. FHx was incompletely elicited in 17 (46%) and absent in 20 (54%). 29 patients (78%) provided a full FHx to the coordinator; 12 of which (41%) were strongly consistent with a diagnosis of a cardiac-inherited disease (DCM 7, hypertrophic cardiomyopathy 3, long QT 1, left ventricular non-compaction 1). Overall, a familial diagnostic rate rose from 3/37(8%) to 12/37 (32%).ConclusionsAdult cardiology inpatient teams are poor at recording FHx and need to be reminded of its powerful diagnostic value.
The New Smartphone Application for Wrist Rehabilitation
Authors: Matera Giuseppe , Boonyasirikool Chinnakart , Saggini Raul , Pozzi Alessandro , Pegoli Loris 
Published: February 2016

Background: The rehabilitation after wrist surgery is extremely important. An instructed therapy in hospital is widely practiced. However, a dependent aging society and rush life style in younger generation have precluded patients to access to the frequent formal therapy. With the advancement in telecommunication technology, we have invented an application for smartphone for home-based wrist motion rehabilitation. Methods: Twenty participants were included in four-week wrist motion rehabilitation programme after wrist surgery. Participants were instructed to use the application by physical therapist and informed details of home-based wrist rehabilitation. The feasibility of application was evaluated by satisfaction level in various aspects and the adherence to the therapy was monitored by function provided in the application. The degrees of motion were compared at the end of prescribed programme. Results: Patient satisfaction was consistently high in every aspects. Also, the adherence to the therapy was high (90.42%). Ranges of motion significantly gained in every plane of wrist motion ([Formula: see text]). Conclusions: This novel smartphone application seems to be a promising and convenient alternative for patients who need to gain wrist motion without formal rehabilitation in the hospital. Adherence to the therapy is also easily traced with this application.
Interobserver Agreement and Intraobserver Reproducibility of Barzullah Working Classification of Distal End Radius Fractures among Orthopaedic Residents
Authors: Kamal Younis , Khan Hayat Ahmad , Gani Naseem UI , Farooq Munir , Shah Adil Bashir , Khan Mohammad Ashraf 
Published: February 2016

Background: The purpose of this study is to test the hypothesis of the new classification system of distal end radius fractures (Barzullah working classification) proposed by one of the author in a prospective cohort study, among the orthopaedic residents. Methods: The initial post-injury radiographs of 300 patients with distal radius fractures in a tertiary centre were classified by two junior residents (JR1 and JR2) and two senior residents (SR1 and SR2) in the emergency department over a period of two years. The collected data was analysed statistically by using Cohan's kappa for measuring Intraobserver reproducibility and Fleiss kappa for measuring Interobserver agreement. Results: The mean kappa value for Interobserver agreement was 0.53 (moderate agreement) at the end of one year and the mean kappa value at the end of study period was 0.64 (substantial agreement). The mean kappa value for Intraobserver reproducibility of JR1 was 0.45 (moderate agreement), JR2 was 0.39 (fair agreement), SR1 was 0.62 (substantial agreement) and SR2 was 0.67 (substantial agreement). Conclusions: Barzullah working classification of distal radius fractures presented in this study has good characteristics compared to those of already studied classification systems among orthopaedic residents.
Transcutaneous Peripheral Nerve Stimulation for the Treatment of Neuropathic Pain in the Upper Limb
Authors: Sierakowski A. , Jing S.S. , Poel J. , Elliot D. 
Published: February 2016

Background: A small number of patients develop intractable peripheral nerve pain following injury or surgery to the upper limb that is refractory to pharmacological treatment. This study reports our results of using transcutaneous peripheral nerve stimulation (TPNS), a non-invasive form of neuromodulation, to treat this difficult problem. Methods: Seventy-two patients were treated for intractable pain in the upper limb using this technique. Electrical current was delivered transcutaneously through a handheld probe, placed on the skin overlying the affected peripheral nerve proximal to the site of pain. Pain severity was determined before and immediately after treatment by subjective patient self-assessment using a visual analogue pain scale. Pre-post treatment changes in pain severity were analysed by Student's test for paired data. Outcome in respect of overall effectiveness of this treatment, was graded according to the maximum duration of pain relief achieved. Results: Overall, TPNS reduced pain intensity from 8.4 (SD 1.6) before treatment to 4.2 (SD 3.5) immediately after treatment, a highly significant effect ([Formula: see text]). The treatment achieved cure in 8/72 (11%) of our patients and a useful therapeutic outcome (pain relief ≥ 1 day) in 27/72 (38%). The treatment failed in 37/72 (51%). Conclusions: TPNS warrants consideration as a therapy for neuropathic pain in the upper limb after drug treatment has failed and before offering surgery or spinal root stimulation.
Effect of Anticoagulation on Hospitalization Costs After Intracranial Hemorrhage in Atrial Fibrillation
Authors: Vestergaard Anne Sig , Skjøth Flemming , Lip Gregory Y.H. , Larsen Torben Bjerregaard 
Published: February 2016

Background and Purpose—
Intracranial hemorrhage (ICH) is the most feared adverse event with oral anticoagulant therapy in patients with atrial fibrillation. The health economic aspects of resuming oral anticoagulant therapy after ICH are unknown. The aim was to estimate hospitalization costs of thromboembolism and hemorrhage subsequent to ICH in 2 patient groups with atrial fibrillation surviving the first 90 days post ICH: (1) patients resuming warfarin therapy within 90 days post ICH and (2) patients discontinuing therapy.

Methods—

Retrospective data from Danish national registries were linked to identify patients with atrial fibrillation who suffered an ICH between January 1, 1997, and April 1, 2011. Study start was 90 days after incident ICH. Mortality was evaluated using the Kaplan–Meier estimate. Occurrence of hospitalization-requiring thromboembolism and hemorrhage was used to estimate hospitalization costs by linkage of
International Classification of Diseases
, Tenth Revision, codes to Danish Diagnosis–Related Group tariffs. The effect of resuming warfarin therapy on average 3-year hospitalization costs was estimated by regression analysis adjusted for between-group differences in baseline characteristics.

Results—
In the inclusion period, 2162 patients had an ICH; 1098 survived the first 90 days and were included for analysis, and of those, 267 resumed warfarin therapy. Therapy resumption reduced the mean 3-year hospitalization cost of hospitalized patients significantly by US$ 1588 (95% confidence interval, −2925 to −251) and was significantly correlated with fewer hospitalization days per hospitalized patient (−4.6 [95% confidence interval, −7.6 to −1.6]). The marginal effect of therapy resumption on hospitalization costs per patient was US$ −407 (95% confidence interval, −815 to 2).

Conclusions—
Resuming warfarin therapy within 90 days after ICH in patients with atrial fibrillation is associated with a decrease in average hospitalization costs.
Planning, practising and prioritising wellness through an integrative behaviour change plan
Authors: Crossman Joanne M 
Published: February 2016

Study objective: To describe a successful approach to teaching principles and practices of behaviour change through a behaviour change plan (BCP) initiative to improve personal health while advancing health knowledge and general education intellectual skills. Students’ perspectives of obstacles, behaviours important towards goal attainment and the benefits of the BCP were also explored. The paper illustrates the feasibility, utility and various challenges of theory-based BCPs within a limited context. Design: A one-group posttest-only design was utilised to conduct quantitative analysis of reported BCP success and qualitative evaluation of students’ perspectives. Participants were 145 students enrolled in eight sections of a required freshman-level health education/general education course. Methodology: Students set and tracked a nutrition, fitness, sleep, smoking cessation or spirituality goal. They strategised to mitigate anticipated challenges, established support systems, rewards, self-assessed progress, described corresponding implications, reviewed evidence-based research and wrote reflections. Goal achievement data were tabulated for each focus area, and report narratives distilled into common themes. Results: Among 145 students, 71 set fitness goals (55% achieved, 39% partially achieved, 11.3% did not achieve) and 63 set nutrition goals (63.5% achieved, 27% partially achieved, 8% did not achieve). Commonly reported barriers were lack of time, laziness/apathy/boredom, discouragement, temptations and sickness/injury/pain. Behaviours important to goal attainment were utilising time management, enlisting support or competition, using visual cues, trying something new, re-adjusting expectations, removing temptations and using rewards. Benefits included physical, psychological and financial types. Final reflections showed students would use the BCP process again. Conclusion: This approach to teaching health behaviour change provides real-life opportunity for planning, practising and prioritising wellness. Grounded in behaviour therapy, and framed by the Transtheoretical Model for Behaviour Change and essential health education and general education intellectual outcomes, this BCP highlights the inherent link between personal health principles and liberal learning outcomes. It may be adopted or refined by health educators willing to engage in this type of student-centred learning.
Effectiveness of Program Modification Strategies of the Diabetes Prevention Program
Authors: Neamah Hind H. , Kuhlmann Anne K. Sebert , Tabak Rachel G. 
Published: February 2016

Purpose The purpose of this study is to review the effectiveness of commonly used program modifications classified under cultural adaptation and program translational strategies for the Diabetes Prevention Program (DPP) in terms of risk reduction for type 2 diabetes. Methods Authors extracted data about weight, body mass index (BMI), and 5 areas of program modification strategies from 28 interventions and analyzed them in SPSS software. Bivariate analyses examined the odds of achieving a significant reduction in outcomes by each modification of the DPP and by presence of a maintenance component, as well as the mean reduction of weight and BMI by more versus fewer modifications and by the presence of a maintenance component. Results There were no statistically significant differences in achieving a significant reduction in weight or BMI by any type of modification or by the presence of a maintenance component. Programs with fewer modifications reported significantly greater reduction in mean weight at 12 months postintervention and the furthest time point extracted. Programs with a maintenance component achieved significantly greater reduction in mean weight measured at the furthest time point extracted. Conclusions The DPP appears to be programmatically robust to a variety of cultural adaptation and translational strategies. Potentially cost-saving modifications do not seem to reduce effectiveness, which should encourage implementation on a broader scale. Program planners should, however, make efforts to include maintenance components because they appear to significantly reduce risk for acquiring type 2 diabetes.
Early stage primary ovarian mucinous carcinoma: Outcome-based clinicopathological study in comparison with serous carcinoma
Authors: Tian Qifang , Lu Bingjian , Ye Jing , Lu Weiguo , Xie Xing , Wang Xinyu 
Published: February 2016

Objective To compare clinicopathological characteristics and survival rates between patients with primary ovarian mucinous carcinoma and those with primary ovarian serous carcinoma. Methods This retrospective study reviewed archival tumour specimens, originally diagnosed as primary ovarian mucinous carcinoma, using refined histological criteria. All patients were contacted to establish survival status. Clinicopathological characteristics and patient survival data were compared with a group of control patients with primary ovarian serous carcinoma. Results Of the 33 patients originally diagnosed with primary ovarian mucinous carcinoma, this diagnosis was only confirmed in 18. Primary ovarian mucinous carcinoma was more commonly associated with early International Federation of Gynecology and Obstetrics tumour stages and low-grade histology than primary ovarian serous carcinoma. Patients with primary ovarian mucinous carcinoma had a significantly higher overall 5-year survival rate than those with primary ovarian serous carcinoma (12/12 [100%] versus 14/24 [58%]). Kaplan–Meier survival plots demonstrated that patients with primary ovarian mucinous carcinoma had a survival advantage over patients with primary ovarian serous carcinoma. Conclusions Primary ovarian mucinous carcinomas are frequently low-grade, stage I tumours and have an excellent prognosis.
Risk factors for preoperative respiratory complications in children with tracheobronchial foreign bodies
Authors: Yang Yi-Hui , Zhang Xin-Gang , Zhang Jian-Li , Zhang Yong-Bo , Kou Cui-Ping 
Published: February 2016

Objective To identify risk factors for preoperative respiratory complications associated with tracheobronchial foreign body aspiration (TFBA) by retrospectively analysing paediatric cases presenting with or without complications. Methods Paediatric patients who presented with TFBA and were admitted to hospital were enrolled in the study. Patients were divided into two groups based on occurrence of preoperative respiratory complications as confirmed by computed tomography. Age, sex, TFBA symptoms, type of foreign body, retention timeand location of the foreign body were documented and compared between the groups. Results In total, 223 children were included: group A ( n = 161) included those with respiratory complications; group B ( n = 62) included those without respiratory complications. Univariate and multivariate analyses found that type of foreign body, and symptoms differed significantly between the two groups. Conclusion Respiratory complications of TFBA in children were correlated with the type of foreign body and symptoms.
Epidermal growth factor and prostaglandin E2 levels in Helicobacter pylori-positive gastric intraepithelial neoplasia
Authors: Chen Zhitao , Wu Jie , Xu Dan , Huang Manling , Sun Shengbin , Zhang Heng , Huang Xiaodong , Wang Ping 
Published: February 2016

Objective To investigate levels of epidermal growth factor (EGF) and prostaglandin E2 (PGE2) in Han Chinese patients with Helicobacter pylori-positive gastric low-grade intraepithelial neoplasia (LGIN). Methods In this prospective, observational study, gastric specimens from patients with LGIN were collected by gastroscopy with consecutive biopsy. EGF and PGE2 concentrations in serum and gastric juice from patients with LGIN were measured by enzyme-linked immunosorbent assay. Presence of H. pylori infection was assessed in patients with LGIN and healthy controls. Results Out of 5 638 patients and 548 controls, H. pylori infection in patients with chronic gastritis was associated with disease type (endoscopic classification) and disease severity. Patients with H. pylori-positive LGIN had significantly higher concentrations of serum EGF and lower concentrations of serum PGE2 versus patients with H. pylori-negative LGIN. Serum EGF and PGE2 levels in patients with LGIN were not significantly associated with disease type, but were significantly associated with disease severity. Conclusions H. pylori infection was associated with chronic gastritis type (endoscopic classification) and disease severity. Abnormal EGF and PGE2 levels may be associated with H. pylori-positive LGIN in Han Chinese patients in central China.
Obesity, Dietary Habits, and Sedentary Behaviors Among Adolescents in Sudan
Authors: Musaiger Abdulrahman O. , Nabag Fatima O. , Al-Mannai Mariam 
Published: February 2016

Objective: The aim of this study was to investigate the prevalence of obesity, dietary habits, and sedentary patterns among Sudanese adolescents. Methods: A multistage stratified sampling method was used to select 945 adolescents (507 males and 438 females) aged 14 to 18 years, from Khartoum State, Sudan. A self-reported pretested questionnaire was used to collect the data. Overweight and obesity were determined using the International Obesity Task Force standard, which is based on body mass index for sex and age. Results: Overweight and obesity were growing problems among urban Sudanese adolescents (10.7%). Breakfast was commonly consumed on a daily basis by the majority of adolescents (74.2%), followed by lunch (63.9%) and supper (33.5%). Snacking was not a common practice among these individuals. Vegetables (63.9%) were more frequently consumed (more than 3 days per week) than fruit (30.1%). There were significant differences between genders regarding intake of vegetables ( P < .048), chicken ( P < .013), dairy products, sweets, nuts, chocolate, and legumes ( P < .001 for all). Sedentary behaviors (long duration of television viewing and Internet use) were highly prevalent, and physical activity was rarely practiced (6.8%). Conclusion: The findings indicated that risk factors for diet-related chronic diseases such as unhealthy dietary habits and sedentary behaviors are starting to rise among urban adolescents in Sudan. This creates the need for immediate action to prevent and control these risk factors before these diseases become major public health problems.
Austerity as an opportunity for union revival: Québec public school teachers
Authors: Grenier Jean-Noël , Jalette Patrice 
Published: February 2016

AbstractThis article proposes an account of how two teachers’ labour federations have been reacting to austerity measures in public education. Current austerity measures have coincided with the renewal of collective agreements, thus allowing the study of how unions link bargaining stances to wider issues of service quality and accessibility. Union responses are the result of at least three influences: the institutional framework for public sector collective bargaining and worker representation, the previous orientation of members and their organisations towards social and work relations, and ongoing innovations for renewal and member engagement. We posit that union responses can contribute to renewal if they are guided by concerns to redefine union purpose, union organisation and building capacities. Under these conditions, unions are able to engage members and push forward an alternative agenda to that of the government. In doing so, they may be able to forge temporary alliances with outside stakeholders, namely parents. Analysis of union responses should consider the dialectic between union renewal effort and the opportunities and constraints of the institutional framework for public sector collective bargaining. The challenge for these two labour federations is in sustaining member engagement and activism beyond the current context of collective bargaining.