bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contact with the baby following stillbirth and parental mental health and well-being: a systematic review
Authors: Hennegan Julie M , Henderson Jane , Redshaw Maggie 
Published: November 2015

ObjectiveTo collate and critically appraise extant evidence for the impact of contact with the stillborn infant on parental mental health, well-being and satisfaction.DesignSystematic review.Data sourcesA structured systematic search was conducted in 13 databases, complemented by hand-searching.Study eligibility criteriaEnglish language studies providing quantitative comparison of outcomes for parents who held their baby or engaged in other memory-making activities, such as having photos and handprints, compared to those who did not, were eligible for inclusion.Outcome measuresPrimary outcomes included clinically diagnosed mental health issues, standardised assessment of mental health issues or self-reported psychological distress. Secondary outcomes included poor health, relationship difficulties and satisfaction with the decision to have contact with the baby.ResultsTwo authors independently screened abstracts, selected potentially eligible studies, extracted data and evaluated the quality of included papers. 11 eligible studies, reported in 18 papers, were included. Studies were heterogeneous, precluding quantitative synthesis, thus a narrative synthesis is presented. Studies presented high risks of bias, particularly in regard to sample representativeness, and confounder identification and adjustment. Results were mixed concerning the impact of holding the stillborn baby on mental health and well-being. One study found no significant effects, and two studies reported no impact on depression. Conflicting effects were found for anxiety and post-traumatic stress. Other memory-making activities were not found to have a significant association with mental health or well-being outcomes. Across studies, mothers were satisfied with their decision to hold their baby or engage in other memory making.ConclusionsEvidence for the impact of holding the stillborn baby on mental health and well-being is sparse, and of poor quality. High-quality research guided by a priori hypotheses, with attention to potential confounders and moderating effects, is needed to provide more rigorous evidence to guide practitioners’ and parents’ decision-making for care following stillbirth.Review protocol numberPROSPERO CRD42014013890.
Preschool children's vision screening in New Zealand: a retrospective evaluation of referral accuracy
Authors: Langeslag-Smith Miriam A , Vandal Alain C , Briane Vincent , Thompson Benjamin , Anstice Nicola S 
Published: November 2015

ObjectivesTo assess the accuracy of preschool vision screening in a large, ethnically diverse, urban population in South Auckland, New Zealand.DesignRetrospective longitudinal study.MethodsB4 School Checkvision screening records (n=5572) were compared with hospital eye department data for children referred from screening due to impaired acuity in one or both eyes who attended a referral appointment (n=556). False positive screens were identified by comparing screening data from the eyes that failed screening with hospital data. Estimation of false negative screening rates relied on data from eyes that passed screening. Data were analysed using logistic regression modelling accounting for the high correlation between results for the two eyes of each child.Primary outcome measurePositive predictive value of the preschool vision screening programme.ResultsScreening produced high numbers of false positive referrals, resulting in poor positive predictive value (PPV=31%, 95% CI 26% to 38%). High estimated negative predictive value (NPV=92%, 95% CI 88% to 95%) suggested most children with a vision disorder were identified at screening. Relaxing the referral criteria for acuity from worse than 6/9 to worse than 6/12 improved PPV without adversely affecting NPV.ConclusionsTheB4 School Checkgenerated numerous false positive referrals and consequently had a low PPV. There is scope for reducing costs by altering the visual acuity criterion for referral.
Patient and healthcare perspectives on the importance and efficacy of addressing spiritual issues within an interdisciplinary bone marrow transplant clinic: a qualitative study
Authors: Sinclair Shane , McConnell Shelagh , Raffin Bouchal Shelley , Ager Naree , Booker Reanne , Enns Bert , Fung Tak 
Published: November 2015

ObjectivesThe purpose of this study was to use a qualitative approach to better understand the importance and efficacy of addressing spiritual issues within an interdisciplinary bone marrow transplant clinic from the perspectives of patients and healthcare providers.SettingParticipants were recruited from the bone marrow transplant clinic of a large urban outpatient cancer care centre in western Canada.Participants: Focus groups were conducted with patients (n=7) and healthcare providers (n=9) to explore the importance of addressing spiritual issues across the treatment trajectory and to identify factors associated with effectively addressing these needs.ResultsData were analysed using the qualitative approach of latent content analysis. Addressing spiritual issues was understood by patients and healthcare providers, as a core, yet under addressed, component of comprehensive care. Both sets of participants felt that addressing basic spiritual issues was the responsibility of all members of the interdisciplinary team, while recognising the need for specialised and embedded support from a spiritual care professional. While healthcare providers felt that the impact of the illness and treatment had a negative effect on patients’ spiritual well-being, patients felt the opposite. Skills, challenges, key time points and clinical indicators associated with addressing spiritual issues were identified.ConclusionsDespite a number of conceptual and clinical challenges associated with addressing spiritual issues patients and their healthcare providers emphasised the importance of an integrated approach whereby basic spiritual issues are addressed by members of the interdisciplinary team and by an embedded spiritual care professional, who in addition also provides specialised support. The identification of clinical issues associated with addressing spiritual needs provides healthcare providers with clinical guidance on how to better integrate this aspect of care into their clinical practice, while also identifying acute incidences when a more targeted and specialised approach may be of benefit.
Potential for advice from doctors to reduce the number of patients referred to emergency departments by NHS 111 call handlers: observational study
Authors: Anderson Andrew , Roland Martin 
Published: November 2015

ObjectiveTo determine the effect of using experienced general practitioners (GPs) to review the advice given by call handlers in NHS 111, a national service giving telephone advice to people seeking medical care.DesignObservational study following the introduction of GPs to review call handlers’ decisions which had been made using decision support software.SettingNHS 111 call centre covering Cambridgeshire and Peterborough.InterventionWhen a call handler using standard NHS 111 decision support software would have advised the caller to attend the hospital accident and emergency (A&E) department, the decision was reviewed by an experienced GP.Main outcome measuresPercentage of calls where an outcome other than A&E attendance was recommended by the GP.ResultsOf 1474 cases reviewed, the GP recommended A&E attendance in 400 cases (27.1%). In the remainder of cases, the GP recommended attendance at a primary care out-of-hours centre or minor injury unit in 665 cases (45.2%) and self-management or some alternative strategy in 409 (27.8%).ConclusionsFewer callers to NHS 111 would be sent to emergency departments if the decision was reviewed by an experienced GP. Telephone triage services need to consider whether using relatively unskilled call handlers supported by computer software is the most cost-effective way to handle requests for medical care.
Delayed/back up antibiotic prescriptions: what do the public think?
Authors: McNulty Cliodna A M , Lecky Donna M , Hawking Meredith K D , Quigley Anna , Butler Chris C 
Published: November 2015

ObjectiveTo describe the general public's understanding, acceptance and use of delayed antibiotics.DesignFace to face computer-assisted survey using an Ipsos MORI Capibus survey.SettingRandomly selected households in England using multistage sampling.RespondentsA representative sample of 1625 adults aged over 15 years and recruited from household visits in England, using age and gender quotas for each area.Data collection and analysisThe survey was undertaken in January 2014. Weights based on gender, age, ethnicity, working status, social grade, housing tenure and Government Office Region corrected for selection biases, so that results are broadly representative of the population.Main outcomes measuresProportion of respondents; understanding the meaning of the term delayed antibiotic prescription and how the strategy is used in general practice; in favour of, or opposed to clinicians offering them a delayed antibiotic; reporting receipt, use and acceptability of delayed antibiotic prescriptions in the past year.Results17% reported fully understanding the meaning of delayed antibiotic prescription and strategy use in general practice;72% were unaware of the term or strategy; 36–39% were in favour of, and 28–30% opposed to clinicians offering them a delayed antibiotic for throat, urine, ear or chest infections. Half of those who were fully aware of the term and practice were in favour of delayed antibiotics. Women, and older respondents, were more strongly opposed to delayed prescribing. Only 4% of all respondents, and 15% of those prescribed an antibiotic, reported being offered a delayed antibiotic in the last year.ConclusionsWider understanding and acceptance of delayed prescribing may facilitate increased uptake. Further research is needed to determine why groups are so strongly in favour or opposed to delayed prescribing.
Randomised, single-masked non-inferiority trial of femtosecond laser-assisted versus manual phacoemulsification cataract surgery for adults with visually significant cataract: the FACT trial protocol
Authors: Day Alexander C , Burr Jennifer M , Bunce Catey , Doré Caroline J , Sylvestre Yvonne , Wormald Richard P L , Round Jeff , McCudden Victoria , Rubin Gary , Wilkins Mark R 
Published: November 2015

IntroductionCataract is one of the leading causes of low vision in the westernised world, and cataract surgery is one of the most commonly performed operations. Laser platforms for cataract surgery are now available, the anticipated advantages of which are broad and may include better visual outcomes through greater precision and reproducibility, and improved safety. FACT is a randomised single masked non-inferiority trial to establish whether laser-assisted cataract surgery is as good as or better than standard manual phacoemulsification.Methods and analysis808 patients aged 18 years and over with visually significant cataract will be randomised to manual phacoemulsification cataract surgery (standard care) or laser-assisted cataract surgery (intervention arm). Outcomes will be measured at 3 and 12 months after surgery. The primary clinical outcome is uncorrected distance visual acuity (UDVA, logMAR) at 3 months in the study eye recorded by an observer masked to the trial group. Secondary outcomes include UDVA at 12 months, corrected distance visual acuity at 3 and 12 months, complications, endothelial cell loss, patient-reported outcome measures and a health economic analysis conforming to National Institute for Health and Care Excellence standards.Ethics and disseminationResearch Ethics Committee Approval was obtained on 6 February 2015, ref: 14/LO/1937. Current protocol: v2.0 (08/04/2015). Study findings will be published in peer-reviewed journals.Trial registration numberISRCTN: 77602616.
Teammate familiarity and risk of injury in emergency medical services
Authors: Patterson P Daniel , Weaver Matthew D , Landsittel Douglas P , Krackhardt David , Hostler David , Vena John E , Hughes Ashley M , Salas Eduardo , Yealy Donald M 
Published: November 2015

ObjectiveWe investigated the association between teammate familiarity and workplace injury in the emergency medical services (EMS) setting.MethodsFrom January 2011 to November 2013, we abstracted a mean of 29 months of shift records and Occupational Safety Health Administration injury logs from 14 EMS organisations with 37 total bases located in four US Census regions. Total teammate familiarity was calculated for each dyad as the total number of times a clinician dyad worked together over the study period. We used negative binomial regression to examine differences in injury incidence rate ratios (IRRs) by familiarity.ResultsWe analysed 715 826 shift records, representing 4197 EMS clinicians and 60 701 unique dyads. We determined the mean shifts per dyad was (5.9, SD 19.7), and quartiles of familiarity were 1 shift worked together over the study period, 2–3 shifts, 4–9 shifts and ≥10 shifts worked together. More than half of all dyads worked one shift together (53.9%, n=32 739), 24.8% of dyads 2–3 shifts, 11.8% worked 4–9 shifts and 9.6% worked ≥10 shifts. The overall incidence rate of injury across all organisations was 17.5 per 100 full-time equivalent (FTE), range 4.7–85.6 per 100 FTE. The raw injury rate was 33.5 per 100 FTEs for dyads with one shift of total familiarity, 14.2 for 2–3 shifts, 8.3 for 4–9 shifts and 0.3 for ≥10 shifts. Negative binomial regression confirmed that dyads with ≥10 shifts had the lowest incidence of injury (IRR 0.03; 95% CI 0.02 to 0.04).ConclusionsFamiliarity between teammates varies in the EMS setting, and less familiarity is associated with greater incidence of workplace injury.
Double staining of bacilli and antigen Ag85B improves the accuracy of the pathological diagnosis of pulmonary tuberculosis
Authors: Che Nanying , Qu Yang , Zhang Chen , Zhang Li , Zhang Haiqing 
Published: November 2015

BackgroundA pathological examination plays an important role in the confirmation of a diagnosis of tuberculosis, especially for smear- and culture-negative cases. However, conventional Ziehl–Neelsen staining and histological tests lack sensitivity and specificity.ObjectiveTo evaluate the diagnostic value of immunohistochemical staining to detectMycobacterium tuberculosisprotein Ag85B and a newly developed double staining (ZC staining) method that can simultaneously detect acid-fast bacilli andM. tuberculosisantigen in the same histological section.MethodsA total of 282 formalin-fixed paraffin-embedded lung tissues were identified following histological examination, including 212 cases of pulmonary tuberculosis and 70 other pulmonary diseases. Ziehl–Neelsen staining, Ag85B-immunohistochemistry and the newly developed ZC staining were performed on serial sections of all the specimens.ResultsExpression patterns of Ag85B were consistent with the distribution patterns of acid-fast bacilli. The signal produced by Ag85B-immunohistochemistry was much stronger than that produced by Ziehl–Neelsen staining. The sensitivity of Ag85B-immunohistochemistry was significantly higher than that of Ziehl–Neelsen staining, 53.8% (95% CI 47.0% to 60.5%) vs 34.4% (95% CI 28.0% to 40.9%). The newly developed ZC staining, integrating advantages of both Ziehl–Neelsen staining and immunohistochemistry, further improved the rate of sensitivity up to 65.6% (95% CI 59.1% to 72.0%).ConclusionsThis new method, detecting both acid-fast bacilli andM. tuberculosisantigen, is a simple and sensitive method for the pathological diagnosis of tuberculosis and can be easily incorporated into routine tests of pathological laboratories.
Anesthetic variation and potential impact of anesthetics used during endovascular management of acute ischemic stroke
Authors: Sivasankar Chitra , Stiefel Michael , Miano Todd A , Kositratna Guy , Yandrawatthana Sukanya , Hurst Robert , Kofke W Andrew 
Published: November 2015

BackgroundMany authors have reported that general anesthesia (GA), as a generic and uncharacterized therapy, is contraindicated for patients undergoing endovascular management of acute ischemic stroke (EMAIS). The recent American Heart Association update cautiously suggests that it might be reasonable to favor conscious sedation over GA during EMAIS. We are concerned that such recommendations will result in patients undergoing endovascular treatment without consideration of the effects of specific anesthetic agents and anesthetic dose, and without appropriate critical consideration of the individual patient's issues. We hypothesized that significant variation in anesthetic practice comprises GA, and that outcome differences among types of GA would arise.MethodsWith IRB approval, we examined the records of patients who underwent anterior circulation EMAIS at the University of Pennsylvania from 2010 to 2015. Patients were managed by different anesthesiologists with no specific protocol. We analyzed American Society of Anesthesiologists status, NIH Stroke Scale, type of stroke, procedure, different types of anesthetic, blood pressure control, and outcome metrics. Modified Rankin Scale (mRS) scores were determined from medical records.ResultsGA was used in 91% of patients. Several types of GA were employed: intravenous, volatile, and intravenous/volatile combined. mRS scores ≤2 at discharge were observed in 42.8% of patients receiving volatile anesthesia and were better in patients receiving only volatile agents after induction of anesthesia (p<0.05).ConclusionsOur data support the notion that anesthetic techniques and associated physiology used in EMAIS are not homogeneous, making any statements about the effects of generic GA in stroke ambiguous. Moreover, our data suggest that the type of GA may affect the outcome after EMAIS.
Safety and efficacy of a new prophylactic tirofiban protocol without oral intraoperative antiplatelet therapy for endovascular treatment of ruptured intracranial aneurysms
Authors: Liang Xiao-dong , Wang Zi-liang , Li Tian-xiao , He Ying-kun , Bai Wei-xing , Wang Yang-yang , Zhou Guo-yu 
Published: November 2015

BackgroundCoil embolization of intracranial aneurysms is being increasingly used; however, thromboembolic events have become a major periprocedural complication.ObjectiveTo determine the safety and efficacy of prophylactic tirofiban in patients with ruptured intracranial aneurysms.MethodsTirofiban was administered as an intravenous bolus (8.0 μg/kg over 3 min) followed by a maintenance infusion (0.10 μg/kg/min) before stent deployment or after completion of single coiling. Dual oral antiplatelet therapy (loading doses) was overlapped with half the tirofiban dose 2 h before cessation of the tirofiban infusion. Cases of intracranial hemorrhage or thromboembolism were recorded.ResultsTirofiban was prophylactically used in 221 patients, including 175 (79.19%) who underwent stent-assisted coiling and 46 (20.81%) who underwent single coiling, all in the setting of aneurysmal subarachnoid hemorrhage. Six (2.71%) cases of intracranial hemorrhage occurred, including four (1.81%) tirofiban-related cases and two (0.90%) antiplatelet therapy-related cases. There were two (0.90%) cases of fatal hemorrhage, one related to tirofiban and the other related to dual antiplatelet therapy. Thromboembolic events occurred in seven (3.17%) patients (6 stent-assisted embolization, 1 single coiling), of which one (0.45%) event occurred during stenting and six (2.72%) occurred during intravenous tirofiban maintenance. No thromboembolic events related to dual antiplatelet therapy were found.ConclusionsTirofiban bolus over 3 min followed by maintenance infusion appears to be a safe and efficient prophylactic protocol for the endovascular treatment of ruptured intracranial aneurysms and may be an alternative to intraoperative oral antiplatelet therapy, especially in the case of stent-assisted embolization.
Opera through Varying Theological Lenses
Authors: Hale Frederick 
Published: November 2015

Although a great deal of scholarly attention has been devoted to Richard Wagner and his renowned works since the nineteenth century, and considerable attention has been given to Christian interpretations of them from continental European perspectives, many theological perspectives on the man and his operas in the English-speaking world have remained unilluminated. The present article seeks to redress aspects of that neglect by examining how two theologically educated British Nonconformists, namely P.T. Forsyth and Ramsden Balmforth (the latter of whose ministerial career was in Cape Town from 1897 until 1937) understood Wagner’s opera about the Holy Grail, Parsifal. It is argued that Forsyth’s interpretation was informed in large measure by his evolving understanding of the meaning of the Atonement and redemption, while Balmforth’s was shaped to a considerable degree by his Fabian socialism.
Extending the scope of speaking assessment criteria in a specific-purpose language test: Operationalizing a health professional perspective
Authors: O’Hagan Sally , Pill John , Zhang Ying 
Published: November 2015

Criticism of specific-purpose language (LSP) tests is often directed at their limited ability to represent fully the demands of the target language use situation. Such criticisms extend to the criteria used to assess test performance, which may fail to capture what matters to participants in the domain of interest. This paper reports on the outcomes of an attempt to expand the construct of a specific-purpose test through the inclusion of two new professionally relevant criteria designed to reflect the values of domain experts. The test in question was the speaking component of the Occupational English Test (OET), designed to assess the language proficiency of overseas-trained health professionals applying to practise their profession in Australia. The criteria were developed from analysis of health professionals’ feedback to trainees, a source that reflected what the professionals value, that is, their indigenous assessment criteria. The criteria considered amenable to inclusion in the OET were as follows: (1) Clinician Engagement with the patient and (2) Management of Interaction in the consultation. Seven OET assessors were trained to apply these professionally relevant criteria at a workshop that introduced a checklist derived from the original data analysis as a tool to aid understanding of the new criteria. Following the workshop, assessors rated a total of 300 pre-recorded OET speaking test performances using both new and existing criteria. Statistical analyses of the ratings indicate the extent to which a) the judgements of the language-trained assessors using the new criteria were consistent and b) the new and existing criteria aligned in terms of the construct(s) they represent. Furthermore, feedback from the assessors in the process shows how comfortable and confident they are to represent a health professional perspective.
The Contrasting Philosophies of Martin Buber and Frantz Fanon: The political in Education as dialogue or as defiance
Authors: Morgan W. John , Guilherme Alex 
Published: November 2015

AbstractEducation has two distinct but interconnected layers. There is an outer layer concerned with knowledge transfer and skills and an inner layer concerned with the development of character and relationships with others, both individually and socially. This inner layer provides the individual with the capacity to influence and to change society. In that sense, such an inner layer is ‘political’. In this article we argue that the ‘political’ in education can take two distinct forms: either that of dialogue or of defiance. We claim that the former is epitomised by the philosophy of Martin Buber and the latter by the philosophy of Frantz Fanon. Our analysis contrasting these two philosophies clarifies the implications for education, and thereby for the individual and for society.