bluuebunny/crossref_metadata_2025_split huggingface dataset:
The mental health of fire-fighters: An examination of the impact of repeated trauma exposure
Authors: Harvey Samuel B , Milligan-Saville Josie S , Paterson Helen M , Harkness Emily L , Marsh Annabel M , Dobson Mark , Kemp Richard , Bryant Richard A 
Published: November 2015

Objective: Emergency workers, such as fire-fighters, are routinely exposed to potentially traumatic events. While a number of studies have examined the occurrence of post-traumatic stress disorder, the role of multiple traumas on other mental health sequelae, such as depression and alcohol misuse, among emergency workers remains unclear. This study aimed to assess the prevalence of post-traumatic stress disorder, depression and alcohol misuse in a sample of current and retired fire-fighters and examine their relationship with cumulative trauma exposure. Method: A cross-sectional survey was completed by current ( n = 488) and retired ( n = 265) fire-fighters from Fire and Rescue New South Wales, Australia. Demographic and occupational information was collected, including the number of fatal incidents fire-fighters reported attending across years of service. Validated, self-report measures were used to determine probable caseness for post-traumatic stress disorder, depression and heavy drinking. Results: Among current fire-fighters, rates of post-traumatic stress disorder and depression were 8% and 5%, respectively, while 4% reported consumption of more than 42 alcoholic drinks per week. Retired fire-fighters reported significantly greater levels of symptomatology, with the prevalence estimates of post-traumatic stress disorder at 18% ( p = 0.001), depression at 18% ( p < 0.001) and heavy drinking at 7%. There was a significant positive linear relationship between the number of fatal incidents attended and rates of post-traumatic stress disorder, depression and heavy drinking. Conclusion: Fire-fighters suffer from high rates of mental disorders, with rates of post-traumatic stress disorder, depression and heavy drinking continuing to rise in a linear manner with each additional trauma exposure. The level of psychiatric morbidity among retired fire-fighters appears to be particularly high. Our findings have important implications for the ongoing debates surrounding the detection of mental disorders in high-risk occupations and for policy considerations around the welfare of current and retired emergency workers.
When and Why Threats Go Undetected
Authors: Meuter Renata F. I. , Lacherez Philippe F. 
Published: November 2015

Objective: We aimed to assess the impact of task demands and individual characteristics on threat detection in baggage screeners. Background: Airport security staff work under time constraints to ensure optimal threat detection. Understanding the impact of individual characteristics and task demands on performance is vital to ensure accurate threat detection. Method: We examined threat detection in baggage screeners as a function of event rate (i.e., number of bags per minute) and time on task across 4 months. We measured performance in terms of the accuracy of detection of Fictitious Threat Items (FTIs) randomly superimposed on X-ray images of real passenger bags. Results: Analyses of the percentage of correct FTI identifications (hits) show that longer shifts with high baggage throughput result in worse threat detection. Importantly, these significant performance decrements emerge within the first 10 min of these busy screening shifts only. Conclusion: Longer shift lengths, especially when combined with high baggage throughput, increase the likelihood that threats go undetected. Application: Shorter shift rotations, although perhaps difficult to implement during busy screening periods, would ensure more consistently high vigilance in baggage screeners and, therefore, optimal threat detection and passenger safety.
In-patient hospital mortality patterns by day of the week: an analysis of admissions to a regional renal unit
Authors: Haddock Rosemary , Deighan Christopher , Thomson Peter C 
Published: November 2015

Background and aims Higher mortality rates have been reported for patients admitted at a weekend compared to a weekday. Our aim was to assess in-patient mortality patterns by day of the week, in a tertiary renal unit. Method and results Mortality related to day of admission and day of death was analysed over a two-year period at Glasgow Western Infirmary renal unit. Typical caseload was also assessed over two random four-week periods. As a proportion of admissions, 30-day mortality was 46/540 (8.5%) on a weekend day compared with a weekday 107/2013 (5.3%) (RR1.60, p = 0.005). Thirty-day mortality rate was 46/208 = 0.22 deaths/weekend day of admission compared with 107/523 = 0.20 deaths/weekday of admission (incident rate ratio = 1.08, p = 0.67). There was no significant increased risk of death on a weekend day compared to a weekday (RR1.23, p = 0.23). A higher proportion of weekend admissions were from other hospitals. Acute kidney injury and haemodialysis patients formed a higher percentage of admissions. Conclusion Admission day mortality expressed as a death rate/day does not differ between weekend/weekday admissions. Admission day mortality expressed as a proportion of total admissions was significantly higher at weekends. This suggests admission case-mix/workload differs at weekends with fewer ‘well’ patients admitted. In-patient mortality patterns are complex and any conclusions made should take into account case mix and workload.
Subglottic Squamous Cell Carcinoma
Authors: Marchiano Emily , Patel Dhruv M. , Patel Tapan D. , Patel Amit A. , Xue Yuhan E. , Eloy Jean Anderson , Baredes Soly , Park Richard Chan W. 
Published: November 2015

ObjectiveSubglottic squamous cell carcinoma (SCCa) is a rare malignancy representing <5% of all laryngeal cancers. Patients often present with late‐stage disease, and survival outcomes are reportedly worse than those for SCCa in other regions of the larynx.Study DesignAnalysis of a population‐based tumor registry.SettingAcademic medical center.Subjects and MethodsThe US National Cancer Institute’s Surveillance, Epidemiology, and End Results database was queried for cases of subglottic SCCa from 1973 to 2011 (889 cases). Resulting data were analyzed, including patient demographics, therapeutic measures, and survival outcomes.ResultsSubglottic SCCa most frequently occurred in the fifth to seventh decade of life, with a mean age at diagnosis of 65.7 ± 11.3 years. There was a strong male predilection, with a male:female ratio of 3.83:1. Most patients were stage III and IV (64.4%) per the American Joint Committee on Cancer. The most common treatment modality was a combination of radiotherapy and surgery (38.8%), followed by radiotherapy alone (33.9%), and surgery alone (17.0%). Overall 5‐year disease‐specific survival rate was 53.7%. When stratified by treatment modality, 5‐year disease‐specific survival was 62.4% for surgery alone, 56.7% for radiotherapy alone, and 55.1% for surgery with adjuvant radiotherapy (P =. 3892).ConclusionThis study represents the largest cohort of subglottic SCCa. It shows a strong predilection for men in the US population. Surgery with adjuvant radiotherapy was the most commonly employed treatment modality. No statistically significant differences were observed in 5‐year DSS by treatment modality.
The scientific evidence of arterial line filtration in cardiopulmonary bypass
Authors: Johagen Daniel , Svenmarker Staffan 
Published: November 2015

Background: The indication for arterial line filtration (ALF) is to inhibit embolisation during cardiopulmonary bypass. Filtration methods have developed from depth filters to screen filters and from a stand-alone component to an integral part of the oxygenator. For many years, ALF has been a standard adopted by a majority of cardiac centres worldwide. The following review aims to summarize the available evidence in support for ALF and report on its current practice in Europe. Method: The principles and application of ALF in Europe was investigated using a survey conducted in 2014. The scientific evidence for ALF was examined by performing a systematic literature search in six different databases, using the following search terms: “Cardiopulmonary bypass AND filters AND arterial”. The primary endpoint was protection against cerebral injury verified by the degree of cerebral embolisation or cognitive tests. The secondary endpoint was improvement of the clinical outcome verified elsewise. Only randomised clinical trials were considered. Results: The response rate was 31% (n=112). The great majority (88.5%) of respondents were using ALF, following more than 10 years of experience. Integrated arterial filtration was used by 55%. Of respondents not using ALF, fifty-four percent considered starting using integrated arterial filtration. The systematic literature database search returned 180 unique publications where 82 were specifically addressing ALF in cardiopulmonary bypass. Only four out of the 82 identified publications fulfilled our inclusion criteria. Of these, three were more than 20 years old and based on the use of bubble oxygenation. Conclusion: ALF is a standard implemented in a majority of cardiopulmonary bypass procedures in Europe. The level of scientific evidence available in support of current arterial line filtration methods in cardiopulmonary bypass is, however, poor. Large, well-designed, randomised trials are warranted.
Perceptions of health professionals on subcutaneous hydration in palliative care: A qualitative study
Authors: Cabañero-Martínez María José , Velasco-Álvarez María Luisa , Ramos-Pichardo Juan Diego , Ruiz Miralles María Luisa , Priego Valladares Manuel , Cabrero-García Julio 
Published: November 2015

Background: Evidence indicates that hypodermoclysis is as safe and effective as intravenous rehydration in the treatment of the symptomatology produced by mild to moderate dehydration in patients for whom oral route administration is not possible. However, the knowledge about the use of the subcutaneous hydration and its correlates is still limited. Aim: To explore the perceptions, attitudes and opinions of health professionals in palliative care on the administration of subcutaneous hydration. Design: This is a qualitative focus group study with health professionals of palliative care. Four focus groups were carried out until data saturation. A qualitative content analysis was performed. Setting/participants: A total of 37 participants, physicians and nurses, were recruited from different services of palliative care in Spain. Results: In all, 856 meaning units were identified, from which 56 categories were extracted and grouped into 22 sub-themes, which were distributed among four themes: ‘factors which influence the hydration decision’, ‘factors related to the choice of the subcutaneous route for hydration’, ‘the subcutaneous hydration procedure’ and ‘performance guidelines and/or protocols’. Conclusions: Variables which most often influence the use of subcutaneous route to hydration are those that are linked to the characteristics of the patient, the team and the family, and other like the context and professionals’ subjective perceptions about this medical practice.
A Blinded, Cluster-Randomized, Placebo-Controlled School FeedingTrial in Burundi Using Rice Fortified With Iron, Zinc, Thiamine, and Folic Acid
Authors: Parker Megan E. , Mosites Emily , Reider Kathryn , Ndayishimiye Nicolas , Waring Melody , Nyandimbane Gloriose , Masumbuko Dominique , Ndikuriyo Leonidas , Matthias Dipika 
Published: November 2015

Background: Iron-deficiency anemia is a major public health problem among school-aged children in sub-Saharan Africa. Objective: To evaluate the effectiveness of micronutrient-fortified rice to increase hemoglobin (Hb) concentration and reduce the prevalence of anemia among schoolchildren. Methods: Nine hundred four schoolchildren participated in this cluster-randomized trial during a 7-month intervention period. The study was conducted in 12 primary schools in rural Burundi. Hemoglobin, socioeconomic status, febrile illness, and dietary diversity were measured at baseline and follow-up. The changes in Hb concentration and anemia status were analyzed using linear and logistic mixed models, respectively. The micronutrient formulation contained an iron-to-zinc molar ratio of approximately 2.2. Results: There was no significant difference in Hb concentration between the intervention and control groups (β = .09 g/dL; 95% confidence interval: −0.21 to 0.38) following the 7-month intervention. Nearly half the children reported having a fever within 2 weeks prior to baseline or follow-up. Children with febrile illness preceding follow-up were less than half as likely to show improvement in anemia status (odds ratio = 0.47, P < .001), with an average 0.56 g/dL smaller improvement in Hb at follow-up ( P < .001). Conclusion: The high prevalence of fever and low iron-to-zinc molar ratio of the Ultra Rice formulation may have contributed to the lack of improvement in Hb. Alternatively, the detected anemia may not have been due to nutrient deficiencies. Anemia interventions in Burundi should implement multiple strategies to eliminate both iron deficiency and infectious causes of anemia.
Group Analysis and the Different Approaches: The Portuguese Contribution. A Tribute to E.L. Cortesão
Authors: Ferreira Guilherme 
Published: November 2015

The development of psychoanalysis itself and, in particular, the publication of the so called Freud’s anthropological works led to the appearance and growth of group psychotherapy, namely, of their psychoanalytic approaches. Their general characteristics are described and some of their particular aspects (Slavson, Wolf and Schwartz, Ezriel, Bion) referred. The importance of the contributions of Ego psychology, ORT and self-psychology in this evolution are particularly stressed. The use of philosophical (existential) models, though complemented by psychoanalytical and behavioural contributions (Yalom) are also referred. The point of view and basic conceptions of group analysis, the most diffused of analytical group psychotherapies in Europe, are particularly described and, in their context, the points of view of Trigant Burrow, Foulkes and Cortesão compared. Cortesão’s points of view are particularly developed and, among them, the conceptions of group-analytic process (developed in analogy with Bibring similar point of view established in the psychoanalytic setting), group-analytic pattern and matrix, changing levels of experience and interpretation, specific aspects of group-analytical transference, commutative interpretation, aesthetic balance and its importance in the group analytic process. The working through of the group transference neurosis becomes a nuclear step in this approach. Finally, Foulkes’ and Cortesão’s approaches in group-analysis are compared and the similarities between them underlined, in spite of some apparent contradictions.
Background review for the ‘2015 European guideline on the management of Chlamydia trachomatis infections’
Authors: Lanjouw E , Ouburg S , de Vries HJ , Stary A , Radcliffe K , Unemo M 
Published: November 2015

Summary Chlamydia trachomatis infections are major public health concerns globally. Of particular grave concern is that the majority of persons with anogenital Chlamydia trachomatis infections are asymptomatic and accordingly not aware of their infection, and this silent infection can subsequently result in severe reproductive tract complications and sequelae. The current review paper provides all background, evidence base and discussions for the 2015 European guideline on the management of Chlamydia trachomatis infections (Lanjouw E, et al. Int J STD AIDS 2015). Comprehensive information and recommendations are included regarding the diagnosis, treatment and prevention of anogenital, pharyngeal and conjunctival Chlamydia trachomatis infections in European countries. However, Chlamydia trachomatis also causes the eye infection trachoma, which is not a sexually transmitted infection. The 2015 European Chlamydia trachomatis guideline provides up-to-date guidance regarding broader indications for testing and treatment of Chlamydia trachomatis infections; clearer recommendation of using validated nucleic acid amplification tests only for diagnosis; advice on (repeated) Chlamydia trachomatis testing; recommendation of increased testing to reduce the incidence of pelvic inflammatory disease and prevent exposure to infection and recommendations to identify, verify and report Chlamydia trachomatis variants. Improvement of access to testing, test performance, diagnostics, antimicrobial treatment and follow-up of Chlamydia trachomatis patients are crucial to control its spread.
Insuring the unknown
Authors: Parsons C 
Published: November 2015

Uncertainty is the central element in insurance. This article examines how insurers evaluate and price risks that can present very high levels of uncertainty, and which many underwriters regard as especially hazardous in insurance terms. These are the risks associated with new medical devices, new pharmaceutical products and others substances for human consumption, such as food additives. Insurance is likely to be needed for these products both during their research and development phases, including insurance for clinical trials, and also once the device, drug or other substance gains approval and is in regular use. The article examines the types of insurance that are available to cover these risks, the organizations that provide insurance and how the insurance is organised. It discusses the basic principles that insurers use to price insurance before considering the difficulties presented by novel and complex risks generally. The article concludes with a description of the techniques that insurers employ to analyse and price the particular risks that are our subject and a discussion of how underwriters seek to overcome the special problems associated with them.
Trends in job satisfaction among German nurses from 1990 to 2012
Authors: Alameddine Mohamad , Bauer Jan Michael , Richter Martin , Sousa-Poza Alfonso 
Published: November 2015

Objective Improving the job satisfaction of nurses is essential to enhance their productivity and retention and to improve patient care. Our aim was to analyse trends in German nurses' job satisfaction to enhance understanding of the nursing labour market and inform future policies. Methods We used 1990–2012 German Socioeconomic Panel data for trends in nurses' job satisfaction. Comparisons were drawn with doctors, other health care workers, and employees in other sectors of employment. Analysis explored associations between job satisfaction trends and other aspects of employment, such as whether full time or part time and pay. To account for fluctuations across the period of analysis, linear trends were generated using ordinary least squares. Results Over 23 years, job satisfaction of German nurses underwent a steady and gradual decline, dropping by an average 7.5%, whereas that of doctors and other health care workers increased by 14.4% and 1%, respectively. The decline for part-time nurses (13%) was more pronounced than that for full-time nurses (3%). At the same time, nurses' pay rose by only 3.8% compared to a 23.8% increase for doctors. Conclusions The steady decline in nurses' job satisfaction over the last two decades may be attributable to the multiple reforms and associated policy changes that generally disadvantaged nurses. Contributing factors to job satisfaction decline include lower pay and the demanding and strenuous work environment. Irrespective of the reason, health services researchers, leaders, and policy makers should investigate the reasons for this decline given the forecast growth in work load and complexity of care. Supportive policies for nurses would help enhance the quality and sustainability of German health care.
Facilitating Task Acquisition through the Use of a Self-Operated Auditory Prompting System
Authors: Alberto Paul A. , Sharpton William R. , Briggs Anita , Stright Mary Helen 
Published: November 2015

This study investigated effects of a self-operated auditory prompting system, utilizing a Walkman-type cassette player, on the acquisition and maintenance of functional tasks by adolescents with severe handicaps. A multiple baseline design across tasks was employed to evaluate the effectiveness of the procedure for meal preparation, washing machine operation, and a vocational assembly task. Results indicated that each of the four participants successfully learned and maintained performance of each task.
Prerequisite Skills for Semi-Independent Living Services (SILS) Placement
Authors: Rudrud Eric H. , Vaudt Tom M. 
Published: November 2015

The goal of residential services should be placement in the least restrictive setting. Individuals and programs who make placement decisions should therefore understand what skills are needed to move from a more restrictive residential setting (ICF-MR) to a less restrictive semi-independent living services (SILS) program. A survey instrument, Independent Living Evaluation and Training Program, was sent to 128 directors of SILS, directors of Class A ICF-MR group homes, and directors of combined programs (SILS/ICF-MR). Directors were asked to identify what they believed to be prerequisite skills for placement into SILS programs. Seventy surveys were returned, representing a 56% response rate. Large differences were found among and between directors of the ICF-MR group homes, SILS providers, and those directors offering both programs. ICF-MR program directors identified more skills and rated skills as being more important than did SILS directors.
Promoting Community-Based Services: Implications for Program Design, Implementation, and Public Policy
Authors: Powers Michael D. 
Published: November 2015

As persons with severe developmental disabilities are transferred from institutional environments to community-based programs for habilitation and residential care, a wide variety of service delivery needs and public policy issues must be confronted. In those jurisdictions where the courts have intervened and mandated alternatives to institutional living, the process of change and ensuing alternatives can be profoundly affected by appropriate legal intervention. The task of balancing professional, community, legal, ethical, and political needs in bringing alternatives into existence represents a formidable challenge to all involved. This article describes five community-based projects developed and maintained by the Georgetown University Child Development Center University Affiliated Facility providing services to children and adults with severe developmental disabilities and those at risk for handicapping conditions. Special emphasis is placed on training and public policy issues, the consultative process, and interdisciplinary service delivery models as they relate to the development of community-based programs.