bluuebunny/crossref_metadata_2025_split huggingface dataset:
A survey of social support for exercise and its relationship to health behaviours and health status among endurance Nordic skiers
Authors: Anderson Paul J , Bovard Ralph S , Wang Zhen , Beebe Timothy J , Murad Mohammad Hassan 
Published: June 2016

ObjectivesRegular exercise is a key component of obesity prevention and 48% of Americans do not meet minimum guidelines for weekly exercise. Social support has been shown to help individuals start and maintain exercise programmes. We evaluated social support among endurance athletes and explored the relationship between social support for exercise, health behaviours and health status.DesignSurvey.SettingThe largest Nordic ski race in North America.Participants5433 past participants responded to an online questionnaire.Outcome measuresSocial support, health behaviours and health status.ResultsThe mean overall support score was 32.1 (SD=16.5; possible range=−16.0 to 88.0). The most common forms of social support were verbal such as discussing exercise, invitations to exercise and celebrating the enjoyment of exercise. We found that an increase of 10 points in the social support score was associated with a 5 min increase in weekly self-reported exercise (5.02, 95% CI 3.63 to 6.41).ConclusionsPhysical activity recommendations should incorporate the importance of participation in group activities, especially those connected to strong fitness cultures created by community and competitive events.
Father’s role in supporting breastfeeding of preterm infants in the neonatal intensive care unit: a qualitative study
Authors: Denoual H , Dargentas M , Roudaut S , Balez R , Sizun J 
Published: June 2016

ObjectiveTo analyse the social beliefs, representations and experiences of fathers of preterm newborns (NBs) regarding breastfeeding.DesignA qualitative interview study with analysis of transcripts using the Alceste software.SettingA tertiary university hospital neonatal intensive care unit (NICU) in France.Participants20 fathers of preterm NBs hospitalised in an NICU.ResultsThe software classified 72% of the corpus into six lexical classes. Two main networks of classes emerged from the analysis: one for lactation, consisted of ‘breastfeeding’ and ‘expression of milk’ classes, and one for ‘care’. The analysis demonstrated that fathers were sensitive to arguments related to the health benefits of human milk. Fathers mentioned that breastfeeding preterm NBs was constraining and tiring for their partners (multiple daily sessions of milk expression with breast pumps, time constraints and need for supplements to tube-feeding…). They also mentioned how they could genuinely help their partners during breastfeeding.ConclusionsThe results of this qualitative study provide insight into how fathers can be supportive of breastfeeding when experiencing a preterm birth. Targeted information and practical advice provided by caregivers on the first days of life can help fathers to get involved in the breastfeeding process.
Extended opening hours and patient experience of general practice in England: multilevel regression analysis of a national patient survey
Authors: Cowling Thomas E , Harris Matthew , Majeed Azeem 
Published: June 2016

BackgroundThe UK government plans to extend the opening hours of general practices in England. The ‘extended hours access scheme’ pays practices for providing appointments outside core times (08:00 to 18.30, Monday to Friday) for at least 30 min per 1000 registered patients each week.ObjectiveTo determine the association between extended hours access scheme participation and patient experience.MethodsRetrospective analysis of a national cross-sectional survey completed by questionnaire (General Practice Patient Survey 2013–2014); 903 357 survey respondents aged ≥18 years old and registered to 8005 general practices formed the study population. Outcome measures were satisfaction with opening hours, experience of making an appointment and overall experience (on five-level interval scales from 0 to 100). Mean differences between scheme participation groups were estimated using multilevel random-effects regression, propensity score matching and instrumental variable analysis.ResultsMost patients were very (37.2%) or fairly satisfied (42.7%) with the opening hours of their general practices; results were similar for experience of making an appointment and overall experience. Most general practices participated in the extended hours access scheme (73.9%). Mean differences in outcome measures between scheme participants and non-participants were positive but small across estimation methods (mean differences ≤1.79). For example, scheme participation was associated with a 1.25 (95% CI 0.96 to 1.55) increase in satisfaction with opening hours using multilevel regression; this association was slightly greater when patients could not take time off work to see a general practitioner (2.08, 95% CI 1.53 to 2.63).ConclusionsParticipation in the extended hours access scheme has a limited association with three patient experience measures. This questions expected impacts of current plans to extend opening hours on patient experience.
Family-witnessed resuscitation: focus group inquiry into UK student nurse experiences of simulated resuscitation scenarios
Authors: Pontin David , Kenny Gerard , Bray Issy , Albarran John 
Published: June 2016

AimsTo describe the impact of family members’ presence on student nurse performance in a witnessed resuscitation scenario. To explore student nurses’ attitudes to simulated family-witnessed resuscitation and their views about its place in clinical practice.BackgroundFamily-witnessed resuscitation remains controversial worldwide. Hospital implementation remains inconsistent despite professional organisation support. Systematic reviews of international literature indicate family members wish to be involved and consulted; healthcare professionals express concerns about being observed while resuscitating. Student nurse perspectives have not been addressed.DesignQualitative, focus groups.MethodsParticipants: UK university second-year student nurses (n=48) who participated in simulated resuscitation scenarios (family member absent, family member present but quiet or family member present but distressed). Data generation 2014: focus group interview schedule—five open-ended questions and probing techniques. Audio recordings transcribed, analysed thematically. Research ethics approval via University Research Ethics committee.FindingsOverarching theme=students’ sense making—making sense of situation (practically/professionally), of themselves (their skills/values) and of others (patients/family members). Students identify as important team leader allocating tasks, continuity of carer and number of nurses needed. Three orientations to practice are identified and explored—includes rule following, guidance from personal/proto-professional values and paternalistic protectionism.DiscussionWe explore issues of students’ fluency of response and skills repertoire to support family-witnessed resuscitation; explanatory potential to account for the inconsistent uptake of family-witnessed resuscitation. Possible future lines of inquiry include family members’ gaze as a motivational trigger, and management of guilt.
Stroke care: initial data from a county-based bypass protocol for patients with acute stroke
Authors: Zaidi Syed F , Shawver Julie , Espinosa Morales Aixa , Salahuddin Hisham , Tietjen Gretchen , Lindstrom David , Parquette Brent , Adams Andrea , Korsnack Andrea , Jumaa Mouhammad A 
Published: June 2016

BackgroundEarly identification and transfer of patients with acute stroke to a primary or comprehensive stroke center results in favorable outcomes.ObjectiveTo describe implementation and results of an emergency medical service (EMS)-driven stroke protocol in Lucas County, Ohio.MethodAll county EMS personnel (N=464) underwent training in theRapidArterial oCclusionEvaluation (RACE) score. The RACE Alert (RA) protocol, whereby patients with stroke and a RACE score ≥5 were taken to a facility that offered advanced therapy, was implemented in July 2015. During the 6-month study period, 109 RAs were activated. Time efficiencies, diagnostic accuracy, and mechanical thrombectomy (MT) outcomes were compared with standard ‘stroke-alert’ (N=142) patients from the preceding 6 months.ResultsAn increased treatment rate (25.6% vs 12.6%, p<0.05) and improved time efficiency (median door-to-CT 10 vs 28 min, p<0.05; door-to-needle 46 vs 75 min, p<0.05) of IV tissue plasminogen activator within the RA cohort was achieved. The rate of MT (20.1% vs 7.7%, p=0.06) increased and treatment times improved, including median arrival-to-puncture (68 vs 128 min, p=0.04) and arrival-to-recanalization times (101 vs 205 min, p=0.001) in favor of the RA cohort. A non-significant trend towards improved outcome (50% vs 36.4%, p=0.3) in the RA cohort was noted. The RA protocol also showed improved diagnostic specificity for ischemic stroke (52.3% vs 30.1%, p<0.05).ConclusionsOur results indicate that EMS adaptation of the RA protocol within Lucas County is feasible and effective for early triage and treatment of patients with stroke. Using this protocol, we can significantly improve treatment times for both systemic thrombolysis and MT.
Association of adiposity, measured by skinfold thickness, with parental history of diabetes in a South Indian population: data from CURES-114
Authors: Surendar J , Indulekha K , Deepa M , Mohan V , Pradeepa R 
Published: June 2016

AbstractPurpose of the studyTo look at the association of central and peripheral skinfold thickness with parental history of diabetes in subjects without diabetes.MethodsSubjects with no parental history of diabetes (n=1132), subjects with one parent with diabetes (n=271) and subjects with both parents with diabetes (n=51) were recruited from the Chennai Urban Rural Epidemiological Study (CURES) conducted between 2001 and 2003. Biceps, triceps, medial calf, mid-thigh, chest, abdomen, mid-axillary, suprailiac and subscapsular sites were measured with Lange skinfold callipers.ResultsTrunk fat measurements, such as chest (p=0.020), mid-axillary (p=0.005), suprailiac (p=0.014), subscapsular (p&lt;0.001) and abdomen (p=0.010) skinfolds, were highest in subjects with both parents with diabetes followed by those with one parent with diabetes, and lowest in those with no parental history of diabetes. However, the peripheral fat measurements, ie, biceps, triceps, medial calf and mid-thigh, were not significantly different between the study groups. Total truncal and peripheral fat skinfold thicknesses showed a significant positive association with other indices of obesity such as body mass index (BMI) and waist circumference in relation to trunk fat (BMI: r=0.748, p&lt;0.001; waist: r=0.776, p&lt;0.001) and peripheral fat (BMI: r=0.681, p&lt;0.001; waist: r=0.569, p&lt;0.001).ConclusionsA significant association was observed between truncal and peripheral fat, assessed by skinfold thickness, and parental history of diabetes among subjects without diabetes in this urban South Indian population.
Does the ‘slipping slipper sign’ in patients with diabetes predict the presence of retinopathy and nephropathy?
Authors: Teelucksingh Joel David , Ramdass Neela , Ramnath Alicia , Teelucksingh Siara S , Seemungal Terence A , Teelucksingh Surujpal 
Published: June 2016

AbstractBackgroundPrevious research had noted that an affirmative response in patients with diabetes to the question ‘Have you ever lost your slipper/flip-flop from your feet while walking and not realised that you have done so’? That is, the presence of the ‘slipping slipper sign’ (SSS) reflected the presence of severe diabetic peripheral neuropathy with a high degree of precision. The objective of the current study was to determine whether the SSS may also predict the presence of diabetic retinopathy and/or nephropathy since microvascular complications are known to cosegregate.Subjects and methodsAmong 100 patients with diabetes, including 33 cases with the SSS and 67 controls without the SSS, data on demography, dipstick proteinuria as well as the presence and staging of diabetic retinopathy were obtained.ResultsThe mean (SD) age of all patients was 54.6 (13.0) years, mean duration of diabetes was 12.7 (10.2) years and mean haemoglobin A1c (HbA1c) 8.42 (1.95) %; 43% were males. All 33 (100%) of the patients with SSS but only 12 (18%) of the patients without SSS were found to exhibit diabetic retinopathy, p&lt;0.001. Among those patients with retinopathy, proliferative retinopathy was far more likely (39%) in the SSS group compared with non-SSS subjects (8%). Similarly, 15 (46%) with SSS and only 4 (6%) without SSS were found to have dipstick proteinuria. The sensitivity of the SSS for retinopathy was 73% and the specificity was 100% with a positive predictive value (PPV) of 100% and negative predictive value (NPV) of 82%. For proteinuria, both the sensitivity and specificity was 78%.ConclusionsBoth diabetic retinopathy and dipstick proteinuria are strongly associated with the presence of the SSS that therefore holds potential as a tool for easier identification of this high-risk group.
Mentoring among Pakistani postgraduate resident doctors
Authors: Sheikh Ali Sibtain Farooq , Sheikh Saman Ali , Huynh Minh-Huy , Mohamed Mona Adel 
Published: June 2016

ABSTRACTBackgroundMentorship is the key to career success, improving job quality and productivity; however, several barriers are prevalent in many academic institutions. Low/middle-income countries are particularly facing difficulty dealing with poor and often non-existing mentoring.PurposeTo gauge the quality of mentorship at King Edward Medical University and discover factors responsible for satisfaction or dissatisfaction of mentors and mentees.MethodsThis was an institution-based cross-sectional study using web-based questionnaires: one for mentors and another one for mentees. The authors analysed the collected data using the R statistical package (V.2.15.1). The authors used Fisher’s exact test to assess associations between the satisfactions of mentees and mentors and various factors such as having defined goals or the hours spent towards mentoring. p Values &lt;0.05 were regarded as significant.Results52 mentees and nine mentors completed questionnaires. Greater face time, clear agreement in regard to goals and expectations and proper advice from mentor regarding best practices to advance in career were associated with greater mentee satisfaction (p&lt;0.001, p=0.006 and p&lt;0.001 respectively). Problems faced by mentees included deficiency of protected time for mentorship, poor communication and little understanding of their needs by the mentors. The majority of the mentors (seven out of nine), believed that a certification course in mentorship should be mandatory.ConclusionThere is a lack of opportunities for effective mentorship at King Edward Medical University. Adequate training of mentors and mentees to adopt strategies for a better career outcome of young doctors should be in place.
Scintigraphic detection of TNF-driven inflammation by radiolabelled certolizumab pegol in patients with rheumatoid arthritis and spondyloarthritis
Authors: Carron Philippe , Lambert Bieke , Van Praet Liesbet , De Vos Filip , Varkas Gaëlle , Jans Lennart , Elewaut Dirk , Van den Bosch Filip 
Published: June 2016

BackgroundBiologicals are the cornerstone for many treatment algorithms in inflammatory arthritis. While tumour necrosis factor (TNF) inhibitors may achieve important responses in ∼50% of patients with rheumatoid arthritis (RA) and spondyloarthritis (SpA), a significant fraction of patients are partial or non-responders. We hypothesised that in vivo assessment of TNF by scintigraphy with 99mTc-radiolabelled certolizumab pegol (CZP) might lead to a more ‘evidence-based biological therapy’.ObjectivesOur goal was to perform a proof-of-concept study of in vivo detection of TNF by immunoscintigraphy of a radiolabelled TNF inhibitor in RA and SpA, and correlate this with clinical, imaging findings and therapeutic outcome.MethodsCZP was conjugated with succinimidyl-6-hydrazino-nicotinamide and subsequently radiolabelled with Tc99m. Whole body and static images of hands, feet and sacroiliac joints of 20 patients (5 RA; 15 SpA) were acquired at 3 time points. Immunoscintigraphic findings were scored semiquantitatively. Subsequently, all patients were treated with CZP.ResultsIn peripheral joints, clinically affected joints or abnormal ultrasound findings were observed more frequently (p<0.001) in the scintigraphic-positive group. In patients with axial SpA, bone marrow edema on MRI was detected more frequently (p<0.001) in quadrants with tracer uptake. At the patient level, the odds of a joint remaining tender despite 24 weeks of CZP treatment was significantly smaller in joints with clear tracer uptake as compared with those with no uptake (OR=0.42, p=0.04).ConclusionsImmunoscintigraphy with radiolabelled CZP demonstrated both axial and peripheral inflammation, and displayed good correlation with clinical features, conventional imaging and therapy response.Trial registration numberNCT01590966; Results.
Alteration of MX-80 bentonite backfill material by high-pH cementitious fluids under lithostatic conditions – an experimental approach using core infiltration techniques
Authors: Dolder F. , Mäder U. , Jenni A. , Münch B. 
Published: June 2016

Abstract
We characterize and quantify processes at a cement–bentonite interface spatially and temporally during a long-term core infiltration experiment.

A young ordinary Portland cement pore fluid (K
+
–Na
+
–OH
−
: pH 13.4) was infiltrated into a MX-80 bentonite core with an initial saturated density of 1920 kg m
−3
that shifted to 1890–1930 kg m
−3
after 761 days. A hydrostatic external pressure of 4.1 MPa and an infiltration pressure of 2.1 MPa were applied in a triaxial-type apparatus. A decrease in hydraulic conductivity from approximately 2.2×10
−13
to approximately 4.2×10
−15
m s
−1
was observed passing from advection-dominated flow to a diffusion-dominated regime. Sulphate replaced chloride in the outflow during the high-pH infiltration period controlled by the dissolution of gypsum, the uptake of K
+
by ion exchange, and complex mineral reactions occurred near the inlet. X-ray computed tomography (CT) scans performed repeatedly during the experiment tracked a progressing hemispherical reaction plume in the first millimetres of the bentonite, revealing a zone of bulk density increase. This zone consisted of two distinct, but overlapping, zones of Mg- and Ca-enrichment related to precipitation of saponite and calcite. The experiment attested an effective chemical buffering capacity for bentonite, a progressing coupled hydraulic–chemical sealing process and also the preservation of the physical integrity of the interface region in this set-up with a total pressure boundary condition on the core sample.
Approaches to evaluate and underpin the technical feasibility of the Belgian disposal concept
Authors: Doudou S. , Harvey E. J. , Richardson P. J. , Wickham S. M. , Van Marcke P. , Raymaekers D. , Wacquier W. 
Published: June 2016

Abstract
In 2009, ONDRAF/NIRAS, the Belgian Agency for Radioactive Waste and Enriched Fissile Materials, established a six-year research, development and demonstration (RD&D) programme to explore the feasibility of its concept for the geological disposal of Category B and C radioactive waste in Belgium. This programme, generally referred to as the ‘B&C Techno project’, aims to acquire evidence and build arguments in order to demonstrate that the proposed disposal system can be constructed, operated and progressively closed, taking into account long-term safety requirements and operational safety requirements.

Galson Sciences Ltd (GSL) has been supporting the co-ordination of the activities involved in this project. This support has included synthesis of research outputs, and the development of various tools and methods to demonstrate that the Belgian geological disposal concept is feasible to implement. Two examples of studies conducted by GSL for ONDRAF/NIRAS as part of the B&C Techno project to substantiate feasibility are described in this paper:

A review of other national geological disposal concepts to identify transferable experience relating to the feasibility of constructing, and assembling comparable disposal system components.

Development of a storyboard illustrating the different steps involved in disposing of Category B and C waste.
Modelling of water and gas flow through an excavation damaged zone in the Callovo-Oxfordian argillites in the framework of a single porosity model
Authors: Bénet Luc-Vincent , Blaud Étienne , Wendling Jacques 
Published: June 2016

Abstract
The excavation damaged zone (EDZ) of the Callovo-Oxfordian argillites can be regarded as a double-porosity media consisting of blocks of undisturbed argillites separated by cracks generated by shear or traction stresses. However, owing to hardware limitations, most of the hydraulic-gas simulations undertaken on large scales are based on an equivalent-porous-media model of the EDZ, where the fractures are not explicitly represented. The aim of this study is to improve the equivalent-porous-media model's consistency with the double-porosity flow behaviours shown by experimental data while keeping the same level of simplification. The new model has been developed through a performance assessment (PA)-like approach in two steps: a phenomenological model including explicit fractures has been designed in accordance with the actual geometrical and hydraulic understanding of the EDZ; then, the properties of the simplified model have been calibrated to comply with the hydraulic behaviour of the explicit-fracture model. This methodological approach has been used on an access gallery parallel to the main horizontal stress axis. The new equivalent-porous-media model differs from the previous one on the following three main points: the gallery EDZ has an anisotropic intrinsic permeability that is lower than previously; the same retention law is used as the undisturbed host rock; and there is a higher relative permeability for gas and water than previously.