bluuebunny/crossref_metadata_2025_split huggingface dataset:
Are sociodemographic characteristics associated with spatial variation in the incidence of OHCA and bystander CPR rates? A population-based observational study in Victoria, Australia
Authors: Straney Lahn D , Bray Janet E , Beck Ben , Bernard Stephen , Lijovic Marijana , Smith Karen 
Published: November 2016

BackgroundRates of out-of-hospital cardiac arrest (OHCA) and bystander cardiopulmonary resuscitation (CPR) have been shown to vary considerably in Victoria. We examined the extent to which this variation could be explained by the sociodemographic and population health characteristics of the region.MethodsUsing the Victorian Ambulance Cardiac Arrest Registry, we extracted OHCA cases occurring between 2011 and 2013. We restricted the calculation of bystander CPR rates to those arrests that were witnessed by a bystander. To estimate the level of variation between Victorian local government areas (LGAs), we used a two-stage modelling approach using random-effects modelling.ResultsBetween 2011 and 2013, there were 15 830 adult OHCA in Victoria. Incidence rates varied across the state between 41.9 to 104.0 cases/100 000 population. The proportion of the population over 65, socioeconomic status, smoking prevalence and education level were significant predictors of incidence in the multivariable model, explaining 93.9% of the variation in incidence among LGAs. Estimates of bystander CPR rates for bystander witnessed arrests varied from 62.7% to 73.2%. Only population density was a significant predictor of rates in a multivariable model, explaining 73% of the variation in the odds of receiving bystander CPR among LGAs.ConclusionsOur results show that the regional characteristics which underlie the variation seen in rates of bystander CPR may be region specific and may require study in smaller areas. However, characteristics associated with high incidence and low bystander CPR rates can be identified and will help to target regions and inform local interventions to increase bystander CPR rates.
Home and Online Management and Evaluation of Blood Pressure (HOME BP) digital intervention for self-management of uncontrolled, essential hypertension: a protocol for the randomised controlled HOME BP trial
Authors: Band Rebecca , Morton Katherine , Stuart Beth , Raftery James , Bradbury Katherine , Yao Guiqing Lily , Zhu Shihua , Little Paul , Yardley Lucy , McManus Richard J 
Published: November 2016

IntroductionSelf-management of hypertension, including self-monitoring and antihypertensive medication titration, lowers blood pressure (BP) at 1 year compared to usual care. The aim of the current trial is to assess the effectiveness of the Home and Online Management and Evaluation of Blood Pressure (HOME BP) intervention for the self-management of hypertension in primary care.Methods and analysisThe HOME BP trial will be a randomised controlled trial comparing BP self-management—consisting of the HOME BP online digital intervention with self-monitoring, lifestyle advice and antihypertensive drug titration—with usual care for people with uncontrolled essential hypertension. Eligible patients will be recruited from primary care and randomised to usual care or to self-management using HOME BP. The primary outcome will be the difference in mean systolic BP (mm Hg) at 12-month follow-up between the intervention and control groups adjusting for baseline BP and covariates. Secondary outcomes (also adjusted for baseline and covariates where appropriate) will be differences in mean BP at 6 months and diastolic BP at 12 months; patient enablement; quality of life, and economic analyses including all key resources associated with the intervention and related services, adopting a broad societal perspective to include NHS, social care and patient costs, considered within trial and modelled with a lifetime horizon. Medication beliefs, adherence and changes; self-efficacy; perceived side effects and lifestyle changes will be measured for process analyses. Qualitative analyses will explore patient and healthcare professional experiences of HOME BP to gain insights into the factors affecting acceptability, feasibility and adherence.Ethics and disseminationThis study has received NHS ethical approval (REC reference 15/SC/0082). The findings from HOME BP will be disseminated widely through peer-reviewed publications, scientific conferences and workshops. If successful, HOME BP will be directly applicable to UK primary care management of hypertension.Trial registration numberISRCTN13790648; pre-results.
Parental responses to child experiences of trauma following presentation at emergency departments: a qualitative study
Authors: Williamson Victoria , Creswell Cathy , Butler Ian , Christie Hope , Halligan Sarah L 
Published: November 2016

ObjectiveParents are often children's main source of support following fear-inducing traumatic events, yet little is known about how parents provide that support. The aim of this study was to examine parents' experiences of supporting their child following child trauma exposure and presentation at an emergency department (ED).DesignSemistructured qualitative interviews analysed using thematic analysis.SettingThe setting for this study was two National Health Service EDs in England.Participants20 parents whose child experienced a traumatic event and attended an ED between August 2014 and October 2015.ResultsParents were sensitive to their child's distress and offered reassurance and support for their child to resume normal activities. However, parental beliefs often inhibited children's reinstatement of pretrauma routines. Support often focused on preventing future illness or injury, reflective of parents' concerns for their child's physical well-being. In a minority of parents, appraisals of problematic care from EDs contributed to parents' anxiety and perceptions of their child as vulnerable post-trauma. Forgetting the trauma and avoidance of discussion were encouraged as coping strategies to prevent further distress. Parents highlighted their need for further guidance and support regarding their child's physical and emotional recovery.ConclusionsThis study provides insight into the experiences of and challenges faced by parents in supporting their child following trauma exposure. Perceptions of their child's physical vulnerability and treatment influenced parents' responses and the supportive strategies employed. These findings may enable clinicians to generate meaningful advice for parents following child attendance at EDs post-trauma.
Study protocol for a framework analysis using video review to identify latent safety threats: trauma resuscitation using in situ simulation team training (TRUST)
Authors: Fan Mark , Petrosoniak Andrew , Pinkney Sonia , Hicks Christopher , White Kari , Almeida Ana Paula Siquiera Silva , Campbell Douglas , McGowan Melissa , Gray Alice , Trbovich Patricia 
Published: November 2016

IntroductionErrors in trauma resuscitation are common and have been attributed to breakdowns in the coordination of system elements (eg, tools/technology, physical environment and layout, individual skills/knowledge, team interaction). These breakdowns are triggered by unique circumstances and may go unrecognised by trauma team members or hospital administrators; they can be described as latent safety threats (LSTs). Retrospective approaches to identifying LSTs (ie, after they occur) are likely to be incomplete and prone to bias. To date, prospective studies have not used video review as the primary mechanism to identify any and all LSTs in trauma resuscitation.Methods and analysisA series of 12 unannounced in situ simulations (ISS) will be conducted to prospectively identify LSTs at a level 1 Canadian trauma centre (over 800 dedicated trauma team activations annually). 4 scenarios have already been designed as part of this protocol based on 5 recurring themes found in the hospital's mortality and morbidity process. The actual trauma team will be activated to participate in the study. Each simulation will be audio/video recorded from 4 different camera angles and transcribed to conduct a framework analysis. Video reviewers will code the videos deductively based on a priori themes of LSTs identified from the literature, and/or inductively based on the events occurring in the simulation. LSTs will be prioritised to target interventions in future work.Ethics and disseminationInstitutional research ethics approval has been acquired (SMH REB #15-046). Results will be published in peer-reviewed journals and presented at relevant conferences. Findings will also be presented to key institutional stakeholders to inform mitigation strategies for improved patient safety.
Photoaging smartphone app promoting poster campaign to reduce smoking prevalence in secondary schools: the Smokerface Randomized Trial: design and baseline characteristics
Authors: Brinker Titus J , Holzapfel Julia , Baudson Tanja G , Sies Katharina , Jakob Lena , Baumert Hannah Maria , Heckl Marlene , Cirac Ana , Suhre Janina L , Mathes Verena , Fries Fabian N , Spielmann Hannah , Rigotti Nancy , Seeger Werner , Herth Felix , Groneberg David A , Raupach Tobias , Gall Henning , Bauer Claudia , Marek Pat , Batra Anil , Harrison Chase H , Taha Lava , Owczarek Andreas , Hofmann Felix J , Thomas Roger , Mons Ute , Kreuter Michael 
Published: November 2016

IntroductionSmoking is the largest cause of preventable death globally. Most smokers smoke their first cigarette in early adolescence. We took advantage of the widespread availability of mobile phones and adolescents’ interest in appearance to develop a free photoaging app which is promoted via a poster campaign in secondary schools. This study aims to evaluate its effectiveness regarding smoking prevalence and students’ attitudes towards smoking.Methods and analysisA randomised controlled trial is conducted with 9851 students of both genders with an average age of 12 years in grades 6 and 7 of 126 secondary schools in Germany. At present, cigarette smoking prevalence in our sample is 4.7%, with 4.6% of the students currently using e-cigarettes (1.6% use both). The prospective experimental study design includes measurements at baseline and at 6, 12 and 24 months postintervention via a questionnaire plus a random cotinine saliva sample at 24 months postintervention. The study groups consist of randomised schools receiving the Smokerface poster campaign and control schools with comparable baseline data (no intervention). The primary end point is the difference of change in smoking prevalence in the intervention group versus the difference in the control group at 24 months follow-up. Longitudinal changes in smoking-related attitudes, the number of new smokers and quitters and the change in the number of never-smokers will be compared between the two groups as secondary outcomes.Ethics and disseminationEthical approval was obtained from the ethics committee of the University of Gießen and the ministries of cultural affairs, both in Germany. Results will be disseminated at conferences, in peer-reviewed journals, on our websites and throughout the multinational Education Against Tobacco network.Trial registration numberNCT02544360, Pre-results.
Improving asthma care in a pediatric resident clinic
Authors: Lee Julia , Gogo Albina , Tancredi Daniel , Fernandez y Garcia Erik , Shaikh Ulfat 
Published: November 2016

There is variation in pediatric asthma management in the outpatient setting. Adherence to national asthma guidelines provides a systematic standardized approach to asthma management. There is a gap between usual and guideline-consistent asthma care in resident clinics. Practice improvement modules aimed at improving resident physician adherence to asthma care guidelines have not been consistently utilized and have not yet been studied.Our aim was to increase guideline consistent care in our pediatric resident clinic in a twelve-month period via increasing performance on the following measures to 75%: spirometry testing; influenza immunization recommendation; level of control assessed through the use of a standardized questionnaire; appropriate medications per national guideline; and use of written asthma action plans.A summarized pediatric-specific version of the National Heart Lung and Blood Institute National Asthma Education and Prevention Program Expert Panel Report 3 (NHLBI EPR-3) guidelines was made readily available to increase provider education. Electronic health record (EHR) enhancements included adding templates to create standardized asthma action plan, asthma control test and a pediatric asthma controller medication order-set. We also addressed the education of patients by simplifying patient instructions. We monitored our progress through the use of an online practice improvement module.We found statistically significant increases in use of a standardized instrument to determine level of control (20% to 81%); recommendation of influenza immunization (56% to 97%); use of national medication treatment guidelines (28% to 98%); distribution of asthma action plans (29% to 65%); and provision of asthma self-management education (35% to 74%).Standardizing the implementation of national guidelines for pediatric asthma through the use of a practice improvement module and electronic health records improved adherence to guidelines. The module allowed us to identify goals for improvement, collect and analyze our group performance data over time, assess the impact of each change, and redesign our process. Improving adherence to national pediatric asthma care guidelines is especially important in settings such as resident teaching clinics which provide care to underserved populations at higher risk for complications related to asthma.
The utility of a blood culture database to identify patients suitable for outpatient parenteral antibiotic treatment
Authors: Melzer Mark , Macpherson Liana , Welch Catherine 
Published: November 2016

ABSTRACTBackgroundThe clinical and cost-effectiveness of outpatient parenteral antimicrobial therapy (OPAT) services are well described. We used a blood culture database as a novel approach to case finding and determined its utility in identifying inpatients suitable for OPAT.MethodsFrom December 2012 to November 2013, consecutive adult inpatients with bacteraemia, and those recruited to OPAT, were prospectively studied. Univariate and multivariate logistic regression analysis were used to investigate the association between bacteraemic patient characteristics and OPAT recruitment.ResultsThere were 470 bacteraemic and 134 OPAT patients. The blood culture database identified 22 (16.4%; CI 10.5 to 23.6) additional patients suitable for OPAT, 4.7% (95% CI 3.0% to 7.0%) of the total bacteraemic cohort. 20 (90.9%) of these patients had community-acquired bacteraemia. Bacteraemic patients with urinary tract infections (UTIs), 11/157 (7.0%; 95% CI 3.5% to 12.2%) were most commonly recruited to OPAT and Escherichia coli was the most common blood culture isolate. In the E. coli bacteraemic subgroup, extended-spectrum β-lactamase (ESBL) producers were significantly higher in the OPAT group, compared with the non-OPAT group, 9/11 (81.8%) vs 17/192 (8.9%), p&lt;0.001. Among OPAT patients, there were no deaths within 30 days and no significant difference in relapse rates between bacteraemic and non-bacteraemic patients, 1/22 (4.6%) vs 5/112 (4.5%). In logistic regression analysis, there were no patient characteristics in the bacteraemic cohort that predicted recruitment to OPAT. In a subgroup analysis of patients with Gram-negative bacteraemia, ESBL production was strongly associated with OPAT recruitment, OR 5.85 (95% CI 1.94 to 17.58), p=0.002.ConclusionsA blood culture database proved a useful adjuvant to a clinical referral system, particularly for patients with community onset, multidrug resistant UTIs caused by ESBL producing E. coli. All bacteraemic patients recruited to OPAT received treatment safely and had good clinical outcomes.
Established T Cell–Inflamed Tumors Rejected after Adaptive Resistance Was Reversed by Combination STING Activation and PD-1 Pathway Blockade
Authors: Moore Ellen , Clavijo Paul E. , Davis Ruth , Cash Harrison , Van Waes Carter , Kim Young , Allen Clint 
Published: November 2016

Abstract
Patients with head and neck squamous cell carcinoma harbor T cell–inflamed and non–T cell–inflamed tumors. Despite this, only 20% of patients respond to checkpoint inhibitor immunotherapy. Lack of induction of innate immunity through pattern-recognition receptors, such as the stimulator of interferon (IFN) genes (STING) receptor, may represent a significant barrier to the development of effective antitumor immunity. Here, we demonstrate robust control of a T cell–inflamed (MOC1), but not non–T cell–inflamed (MOC2), model of head and neck cancer by activation of the STING pathway with the synthetic cyclic dinucleotide RP,RP dithio-c-di-GMP. Rejection or durable tumor control of MOC1 tumors was dependent upon a functional STING receptor and CD8 T lymphocytes. STING activation resulted in increased tumor microenvironment type 1 and type 2 IFN and greater expression of PD-1 pathway components in vivo. Established MOC1 tumors were rejected and distant tumors abscopally controlled, after adaptive immune resistance had been reversed by the addition of PD-L1 mAb. These findings suggest that PD-1 pathway blockade may reverse adaptive immune resistance following cyclic dinucleotide treatment, enhancing both local and systemic antitumor immunity. Cancer Immunol Res; 4(12); 1061–71. ©2016 AACR.
Аналіз ефективності лікування пацієнтів із суглобовими скронево-нижньощелепними розладами
Authors: Rybert Yu. O. 
Published: November 2016

Articular forms of temporomandibular disorder (compression of bilaminar region, displacement of meniscus, hypermobility, arthritis, arthrosis) combine with advanced forms of dental pathology leading to disturbances of functional occlusion. The comorbidities of occlusal pathology are characteristic of older patients (over 40), while the orthodontic pathology is characteristic of patients aged 20–40. The complexity of comorbidity of TMJ and occlusal pathology requires a thorough diagnostic study, detailed treatment plan that ranges from dental health to the application of occlusal splints of different types of action with mandatory completion of treatment with prosthetic rehabilitation using prosthetic restorations to restore functional occlusion. The analysis of results of treatment of patients with comorbidities of temporomandibular disorders and occlusal pathology using occlusal therapy, splintline therapy, and various types of prosthetic restorations at the final stage to stabilize functional occlusion is presented. The analysis is based on the comparison of axiograms before and after the treatment.
СЕРЕДОВИЩНІ ФАКТОРИ РИЗИКУ СТЕНОЗУЮЧОГО ЛАРИНГОТРАХЕЇТУ В ДІТЕЙ.
Authors: Stanislavchuk L. M. 
Published: November 2016

Вивчено зв’язок між стенозуючим ларинготрахеїтом (СЛТ) у дітей і такими екзогенними факторами, як тютюновий дим, скупченість у житлових приміщеннях, вогкість у квартирі, наявність домашніх тварин, несприятливий психологічний клімат у сім’ї. Встановлено, що в дітей зі СЛТ значно частіше, ніж у контрольній групі, спостерігались випадки проживання в умовах скупченості в житлових приміщеннях і несприятливого психологічного клімату в сім’ї. Відсоток тих, хто проживав у сім’ях, де курять і, зокрема, де курить мати, серед дітей з 1–3 епізодами СЛТ був суттєво більшим, ніж серед дітей контрольної групи. Не виявлено значущої різниці між дітьми з рецидивним СЛТ (4 і більше епізодів захворювання) і дітьми контрольної групи щодо пасивного куріння. Дещо частіше, ніж у контрольній групі, серед дітей зі СЛТ траплялись випадки проживання у квартирах, де є вогкість (р<0,1). Не виявлено суттєвої різниці між дітьми зі СЛТ і дітьми контрольної групи стосовно наявності домашніх тварин.
СТАН КЛІТИННОГО ТА ГУМОРАЛЬНОГО ІМУНІТЕТУ, ЦИТОКІНОВИЙ СТАТУС І МЕДІАТОРИ ЗАПАЛЕННЯ ПРИ АТОПІЧНОМУ ДЕРМАТИТІ В ДІТЕЙ.
Authors: Fedortsiv O. Ye. , Mochulska O. M. , Oliinyk Ya. V. 
Published: November 2016

У даній статті наведено результати імунологічного обстеження дітей з атопічним дерматитом та практично здорових дітей віком від 1 до 18 років. Виявлено зміни та проведено оцінку показників клітинної і гуморальної ланок імунітету, цитокінового статусу та рівня сироваткових імуноглобулінів, що залежали від ступеня тяжкості клінічного перебігу атопічного дерматиту. Оцінку тяжкості перебігу захворювання проводили напівкількісним методом за індексом SСORAD (Scoring of Atopik Dermatitis). Обґрунтовано доцільність і перспективу застосування імунологічного обстеження у дітей з атопічним дерматитом для оцінки динаміки перебігу захворювання.
ГІСТОХІМІЧНІ ОСОБЛИВОСТІ ПЛАЦЕНТИ В ПРОГНОЗУВАННІ ПРЕЕКЛАМПСІЇ ТА ЇЇ ВІДДАЛЕНИХ НАСЛІДКІВ.
Authors: Aksionova A. V. 
Published: November 2016

У статті представлено результати вивчення гістохімічних особливостей плацент при вагітності, ускладненій прееклампсією (ПЕ) різного ступеня тяжкості, з акцентом на виявлення атерозу і прогнозування можливих серцево судинних ризиків у майбутньому. Проведено гістохімічне дослідження плацент жінок, вагітність яких ускладнилась ПЕ. Відповідно, I групу склали плаценти від 12 жінок з легкою ПЕ; II групу – 9 плацент від жінок із середнім та важким ступенями ПЕ; III групу (контроль) склали 15 плацент від жінок без акушерської і соматичної патології без клініки ПЕ, розроджених у термін через природні пологові шляхи. У плаценті жінок переважно з середнім та важким перебігом ПЕ виявлені явища атерозу різного ступеня вираженості, що корелюють із показниками ліпідного профілю в сироватці крові, визначених у II триместрі вагітності, та вказують на глибокі порушення ліпідного метаболізму у даної категорії пацієнток. Атероз спіральних артерій та децидуальної оболонки плаценти є одним із предикторів можливого розвитку метаболічних порушень та серцево судинної патології у майбутньому серед жінок, вагітність яких ускладнюється розвитком ПЕ.
ПРИЧИНИ ПОРУШЕНЬ МОТОРИКИ ТОНКОЇ КИШКИ В ЖІНОК ПІСЛЯ АКУШЕРСЬКО-ГІНЕКОЛОГІЧНИХ ОПЕРАЦІЙ. ПРОФІЛАКТИКА І ЛІКУВАННЯ.
Authors: Benedykt V. V. 
Published: November 2016

У роботі звертається увага на гостру функціональну непрохідність тонкої кишки, яка виникає в ранньому післяопераційному періоді після лапаротомій. Метою повідомлення є розробка патогенетичних методів для її профілактики і лікування на основі дослідження причин ії виникнення в ранньому післяопераційному періоді у жінок після акушерсько-гінекологічних операцій. Визначені основні зміни в стінці тонкої кишки після лапаротомії і етапність у відновленні її рухової функції. Пропонується лікувальний комплекс, спрямований на відновлення моторики травного каналу після операції.
ВІДДАЛЕНІ РЕЗУЛЬТАТИ ЛІКУВАННЯ ПОЗАМАТКОВОЇ ВАГІТНОСТІ ОПЕРАТИВНИМ І КОНСЕРВАТИВНИМ МЕТОДАМИ.
Authors: Boychuk A. V. , Yakymchuk Yu. B. 
Published: November 2016

У статті представлено аналіз віддалених результатів лікування пацієнтів з позаматковою вагітністю, що перебували на лікуванні у Тернопільській комунальній міській лікарні № 2 протягом 2005–2015 років. Джерелом інформації для клініко-анамнестичного аналізу слугували медичні карти стаціонарного хворого (ф. 003/о). Метросальпінгографію проводили за 2–4 місяці після виписки зі стаціонару. Прохідність маткових труб у жінок з позаматковою вагітністю в анамнезі оцінювали за результатами цифрової і аналогової метросальпінгографії.