bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enhancing memory self-efficacy during menopause through a group memory strategies program
Authors: Unkenstein Anne E. , Bei Bei , Bryant Christina A. 
Published: December 2016

Abstract

Objective:
Anxiety about memory during menopause can affect quality of life. We aimed to improve memory self-efficacy during menopause using a group memory strategies program.

Methods:
The program was run five times for a total of 32 peri- and postmenopausal women, age between 47 and 60 years, recruited from hospital menopause and gynecology clinics. The 4-week intervention consisted of weekly 2-hour sessions, and covered how memory works, memory changes related to ageing, health and lifestyle factors, and specific memory strategies. Memory contentment (CT), reported frequency of forgetting (FF), use of memory strategies, psychological distress, and attitude toward menopause were measured. A double-baseline design was applied, with outcomes measured on two baseline occasions (1-month prior [T1] and in the first session [T2]), immediately postintervention (T3), and 3-month postintervention (T4). To describe changes in each variable between time points paired sample t tests were conducted. Mixed-effects models comparing the means of random slopes from T2 to T3 with those from T1 to T2 were conducted for each variable to test for treatment effects.

Results:
Examination of the naturalistic changes in outcome measures from T1 to T2 revealed no significant changes (all Ps > 0.05). CT, reported FF, and use of memory strategies improved significantly more from T2 to T3, than from T1 to T2 (all Ps < 0.05). Neither attitude toward menopause nor psychological distress improved significantly more postintervention than during the double-baseline (all Ps > 0.05). Improvements in reported CT and FF were maintained after 3 months.

Conclusions:
The use of group interventions to improve memory self-efficacy during menopause warrants continued evaluation.
Caregiver Sleep and Patient Neutrophil Engraftment in Allogeneic Hematopoietic Stem Cell Transplant
Authors: Sannes Timothy S. , Mikulich-Gilbertson Susan K. , Natvig Crystal L. , Brewer Benjamin W. , Simoneau Teresa L. , Laudenslager Mark L. 
Published: December 2016

Background:
Caregiving for allogeneic hematopoietic stem cell transplant (Allo-HSCT) patients can be significantly burdensome. Caregiver well-being often mirrors patients' suffering. However, to our knowledge, this dyadic relationship has not been linked to patient outcome.

Objective:
Caregiver's objective and subjective sleep and overall distress before transplantation were hypothesized to be related to patient's time to engraftment in secondary analyses.

Methods:
Dyads (N = 124) were Allo-HSCT patients (mean [SD] age, 49.2 [12.7] years) and their caregivers (mean [SD] age, 52.7 [12.3] years). Caregiver's subjective sleep quality was measured via the Pittsburgh Sleep Quality Index, objective sleep was measured by actigraphy, and distress was measured by combining validated psychological measures.

Results:
Both caregiver reports of worse sleep (β = .22; P < .05) and objective measurement of caregiver sleep patterns (higher sleep efficiency; less time awake after sleep onset) collected before engraftment significantly predicted shorter time to patient engraftment (β values = −.34 and .29, respectively; P values < .05). Caregiver distress was unrelated to engraftment (β = .14; P = .22).

Conclusions:
Despite limitations in available patient data, these findings appear to link caregiver well-being to patient outcome. This underscores the interrelatedness of the patient-caregiver dyad in Allo-HSCT. Future research should examine psychological and biomedical mediators.

Implications for Practice:
Given that caregiver well-being during the peritransplantation period was associated with patient outcome in this study, such findings highlight the need to address caregiver and patient well-being during Allo-HSCT. There may be potential to improve patient outcome by focusing on the caregiver, which nursing staff is well positioned to monitor.
Association Between Sarcopenia and Metabolic Syndrome in Cancer Survivors
Authors: Lee Su Jung , Kim Nam Cho 
Published: December 2016

Background:
Advanced cancer treatments have improved survival from cancer, but the incidence of cardiovascular disease in survivors has recently increased. Sarcopenia and metabolic syndrome (MetS) are related to cancer survival, and sarcopenia is an emerging risk factor for cardiovascular disease. However, evidence of a relationship between sarcopenia and MetS in cancer survivors is lacking.

Objectives:
The aims of this study were to determine the prevalence of sarcopenia and MetS in cancer survivors and to investigate independent predictors of MetS in cancer survivors.

Methods:
From the fourth and fifth Korea National Health and Nutritional Exam Survey (2008–2011), 798 consecutive cancer survivors were analyzed. Sarcopenia was defined as the appendicular skeletal muscle mass divided by weight less than 1 SD below the sex-specific healthy population aged 20 to 39 years. Metabolic syndrome was defined using the National Cholesterol Education Program definition.

Results:
Among 798 cancer survivors, the prevalence rates of sarcopenia and MetS were 23.1% and 30.0%, respectively. Survivors with sarcopenia were more likely to have a higher waist circumference, body mass index, triglyceride level, and blood pressure and to have a lower high-density lipoprotein cholesterol level compared with those without sarcopenia. In multivariable analysis, sarcopenia was an independent predictor of MetS (odds ratio, 2.76; 95% confidence interval, 1.92–3.97). In addition, age and type of cancer were independent predictors of MetS.

Conclusion:
Sarcopenia was associated with an increased prevalence of MetS in cancer survivors.

Implications for Practice:
Interventions to prevent sarcopenia may be necessary to improve cardiovascular outcome in cancer survivors.
The Effects of Muscle Relaxation and Therapeutic Walking on Depression, Suicidal Ideation, and Quality of Life in Breast Cancer Patients Receiving Chemotherapy
Authors: Sun Fan-Ko , Hung Chao-Ming , Yao YuChun , Lu Chu-Yun , Chiang Chun-Ying 
Published: December 2016

Background:
The suicide rate of cancer patients is high in Taiwan. Breast cancer has a high incidence rate and is the leading cause of cancer in women. There is a lack of research examining breast cancer–related depression, suicidal ideation, and quality of life.

Objectives:
This study evaluated the effects of muscle relaxation and therapeutic walking on depression, suicidal ideation, and quality of life in breast cancer patients receiving chemotherapy.

Methods:
An experimental approach was adopted. A group of 87 breast cancer patients receiving chemotherapy were randomly assigned into an experimental group (n = 44) or a control group (n = 43). The subjects in the experimental group received 2 interventions for 3 months. This study used 3 instruments, including (1) the Center for Epidemiological Studies Depression Scale, (2) the Beck Scale for Suicidal Ideation, and (3) the World Health Organization Questionnaire on Quality of Life.

Results:
The results showed no significant difference in any outcome variable in the pretest. The results of the posttest indicated that the 2 groups scored significantly differently only on the Center for Epidemiological Studies Depression Scale (U = 638.00, P < .05). The breast cancer patients who participated in the 3 month muscle relaxation and therapeutic walking interventions had a lower level of depression (RE
¯ = 37.00) than those who did not (RC
¯ = 51.16).

Conclusion:
The muscle relaxation and therapeutic walking program was effective in the reduction of breast cancer patients’ depression.

Implications for Practice:
Nursing staff could teach muscle relaxation and therapeutic walking to breast cancer patients to reduce their depression.
Research on Experiences Related to the Possibility of Consciousness Beyond the Brain
Authors: Daher Jorge Cecílio , Damiano Rodolfo Furlan , Lucchetti Alessandra Lamas Granero , Moreira-Almeida Alexander , Lucchetti Giancarlo 
Published: December 2016

Abstract
This study aims to conduct a search of publications investigating experiences commonly associated with the possibility of the existence of a consciousness independent of the brain held on the main scientific databases (Pubmed, Web of Knowledge, PsycINFO, Science Direct, and Scopus). Of the 9065 articles retrieved, 1954 were included (598 near-death experiences, 223 out-of-body experiences, 56 end-of-life experiences, 224 possession, 244 memories suggestive of past lives, 565 mediumship, 44 others). Over the decades, there was an evident increase in the number of articles on all the areas of the field, with the exception of studies on mediumship that showed a decline during the late 20th century and subsequent rise in the early 21st century. Regarding the types of articles found, with the exception of past-life memories and end-of-life experiences (mostly original studies), publications were predominantly review articles. The articles were published in journals with an impact factor similar to other areas of science.
Patient Outcomes After Early Versus Late Tracheostomy in the Puerto Rico Trauma Hospital
Authors: Romero Vázquez Ana M. , García Rodríguez Omar , Ramos Meléndez Ediel , Rodríguez Ortiz Pablo 
Published: December 2016

Objective
This study aimed to evaluate the impact of early tracheostomy (ET, ≤7 days) versus that of late tracheostomy (LT, >7 days) on outcomes such as hospital length of stay (LOS), intensive care unit (ICU) days, mechanical ventilation (MV) days, and mortality ratio.

Methods
A historical cohort study was undertaken using charts of patients admitted to the Puerto Rico Trauma Hospital who required MV and underwent tracheostomies, from 2000 to 2013. A logistic regression was performed to evaluate the association between timing of tracheostomy and complications and mortality. To estimate the relationship between ET and outcomes related to hospital stay, a binomial-negative regression was performed. A P < 0.05 was considered statistically significant.

Results
A total of 1134 patients were evaluated, 313 of whom underwent ET and 821 underwent LT. Early tracheostomy patients had a lower Injury Severity Score compared with their counterparts (P = 0.004) and showed lower complications (respiratory failure: odds ratio [OR], 0.61; 95% confidence interval [CI], 0.45–0.84; acute respiratory distress syndrome: OR, 0.44; 95% CI, 0.30–0.64; pneumonia: OR, 0.53; 95% CI, 0.40–0.71; septicemia: OR, 0.48; 95% CI, 0.33–0.70; bacteremia: OR, 0.59; 95% CI, 0.40–0.86) than LT patients. Those with ET had lower MV days (RRadj, 0.74; 95% CI, 0.68–0.82), ICU days (RRadj, 0.66; 95% CI, 0.59–0.73), and LOS (RRadj, 0.74; 95% CI, 0.69–0.80) compared with those with LT, after adjusting for age, Injury Severity Score, and complications. However, there were no differences in mortality ratio (ORadj, 0.66; 95% CI, 0.44–1.01) among ET and LT patients, after adjusting for confounders.

Conclusions
Our results suggested that ET reduced complications, MV days, ICU days, and LOS, having an indirect effect on mortality ratio. Standardized protocols for ET are recommended to enhance health outcomes in trauma patients.
Using mHealth for HIV/TB Treatment Support in Lesotho: Enhancing Patient–Provider Communication in the START Study
Authors: Hirsch-Moverman Yael , Daftary Amrita , Yuengling Katharine A. , Saito Suzue , Ntoane Moeketsi , Frederix Koen , Maama Llang B. , Howard Andrea A. 
Published: December 2016

Background:
mHealth is a promising means of supporting adherence to treatment. The Start TB patients on ART and Retain on Treatment (START) study included real-time adherence support using short-text messaging service (SMS) text messaging and trained village health workers (VHWs). We describe the use and acceptability of mHealth by patients with HIV/tuberculosis and health care providers.

Methods:
Patients and treatment supporters received automated, coded medication and appointment reminders at their preferred time and frequency, using their own phones, and $3.70 in monthly airtime. Facility-based VHWs were trained to log patient information and text message preferences into a mobile application and were given a password-protected mobile phone and airtime to communicate with community-based VHWs. The use of mHealth tools was analyzed from process data over the study course. Acceptability was evaluated during monthly follow-up interviews with all participants and during qualitative interviews with a subset of 30 patients and 30 health care providers at intervention sites. Use and acceptability were contextualized by monthly adherence data.

Findings:
From April 2013 to August 2015, the automated SMS system successfully delivered 39,528 messages to 835 individuals, including 633 patients and 202 treatment supporters. Uptake of the SMS intervention was high, with 92.1% of 713 eligible patients choosing to receive SMS messages. Patient and provider interviews yielded insight into barriers and facilitators to mHealth utilization. The intervention improved the quality of health communication between patients, treatment supporters, and providers. HIV-related stigma and technical challenges were identified as potential barriers.

Conclusions:
The mHealth intervention for HIV/tuberculosis treatment support in Lesotho was found to be a low-tech, user-friendly intervention, which was acceptable to patients and health care providers.
Development of a National Campaign Addressing South African Men's Fears About HIV Counseling and Testing and Antiretroviral Treatment
Authors: Orr Neil , Hajiyiannis Helen , Myers Laura , Makhubele Mzamani Benjamin , Matekane Tselisehang , Delate Richard , Mahlasela Lusanda , Goldblatt Brenda 
Published: December 2016

Introduction:
South African men are less likely to get tested for HIV than women and are more likely to commence antiretroviral treatment (ART) at later stages of disease, default on treatment, and to die from AIDS compared with women. The purpose of this study was to conduct formative research into the ideational and behavioral factors that enable or create obstacles to mens' uptake of HIV counseling and testing (HCT) and ART. The study consulted men with a goal of developing a communication campaign aimed at improving the uptake of HIV testing and ART initiation among men.

Methods:
Eleven focus groups and 9 in-depth interviews were conducted with 97 male participants in 6 priority districts in 4 South African provinces in rural, peri-urban, and urban localities.

Results:
Fears of compromised masculine pride and reputation, potential community rejection, and fear of loss of emotional control (“the stress of knowing”) dominated men's rationales for avoiding HIV testing and treatment initiation.

Conclusions:
A communication campaign was developed based on the findings. Creative treatments aimed at redefining a ‘strong’ man as someone who faces his fears and knows his HIV status. The resultant campaign concept was: “positive or negative—you are still the same person.”
Effective Interpersonal Health Communication for Linkage to Care After HIV Diagnosis in South Africa
Authors: Mabuto Tonderai , Charalambous Salome , Hoffmann Christopher J. 
Published: December 2016

Background:
Early in the global response to HIV, health communication was focused toward HIV prevention. More recently, the role of health communication along the entire HIV care continuum has been highlighted. We sought to describe how a strategy of interpersonal communication allows for precision health communication to influence behavior regarding care engagement.

Methods:
We analyzed 1 to 5 transcripts from clients participating in longitudinal counseling sessions from a communication strategy arm of a randomized trial to accelerate entry into care in South Africa. The counseling arm was selected because it increased verified entry into care by 40% compared with the standard of care. We used thematic analysis to identify key aspects of communication directed specifically toward a client's goals or concerns.

Results:
Of the participants, 18 of 28 were female and 21 entered HIV care within 90 days of diagnosis. Initiating a communication around client-perceived consequences of HIV was at times effective. However, counselors also probed around general topics of life disruption—such as potential for child bearing—as a technique to direct the conversation toward the participant's needs. Once individual concerns and needs were identified, counselors tried to introduce clinical care seeking and collaboratively discuss potential barriers and approaches to overcome to accessing that care.

Conclusions:
Through the use of interpersonal communication messages were focused on immediate needs and concerns of the client. When effectively delivered, it may be an important communication approach to improve care engagement.
Community Mobilization for HIV Testing Uptake: Results From a Community Randomized Trial of a Theory-Based Intervention in Rural South Africa
Authors: Lippman Sheri A. , Neilands Torsten B. , MacPhail Catherine , Peacock Dean , Maman Suzanne , Rebombo Dumisani , Twine Rhian , Selin Amanda , Leslie Hannah H. , Kahn Kathleen , Pettifor Audrey 
Published: December 2016

Background:
HIV testing uptake in South Africa is below optimal levels. Community mobilization (CM) may increase and sustain demand for HIV testing, however, little rigorous evidence exists regarding the effect of CM interventions on HIV testing and the mechanisms of action.

Methods:
We implemented a theory-driven CM intervention in 11 of 22 randomly-selected villages in rural Mpumalanga Province. Cross-sectional surveys including a community mobilization measure were conducted before (n = 1181) and after (n = 1175) a 2-year intervention (2012–2014). We assessed community-level intervention effects on reported HIV testing using multilevel logistic models. We used structural equation models to explore individual-level effects, specifically whether intervention assignment and individual intervention exposure were associated with HIV testing through community mobilization.

Results:
Reported testing increased equally in both control and intervention sites: the intervention effect was null in primary analyses. However, the hypothesized pathway, CM, was associated with higher HIV testing in the intervention communities. Every standard deviation increase in village CM score was associated with increased odds of reported HIV testing in intervention village participants (odds ratio: 2.6, P = <0.001) but not control village participants (odds ratio: 1.2, P = 0.53). Structural equation models demonstrate that the intervention affected HIV testing uptake through the individual intervention exposure received and higher personal mobilization scores.

Conclusions:
There was no evidence of community-wide gains in HIV testing due to the intervention. However, a significant intervention effect on HIV testing was noted in residents who were personally exposed to the intervention and who evidenced higher community mobilization. Research is needed to understand whether CM interventions can be diffused within communities over time.
Counseling Framework for HIV-Serodiscordant Couples on the Integrated Use of Antiretroviral Therapy and Pre-exposure Prophylaxis for HIV Prevention
Authors: Morton Jennifer F. , Celum Connie , Njoroge John , Nakyanzi Agnes , Wakhungu Imeldah , Tindimwebwa Edna , Ongachi Snaidah , Sedah Eric , Okwero Emmanuel , Ngure Kenneth , Odoyo Josephine , Bulya Nulu , Haberer Jessica E. , Baeten Jared M. , Heffron Renee ,   for the Partners Demonstration Project Team
Published: December 2016

Background:
For HIV-serodiscordant couples, integrated delivery of antiretroviral therapy (ART) for HIV-positive partners and time-limited pre-exposure prophylaxis (PrEP) for negative partners virtually eliminates HIV transmission. Standardized messaging, sensitive to the barriers and motivators to HIV treatment and prevention, is needed for widespread scale-up of this approach.

Methods:
Within the Partners Demonstration Project, a prospective interventional project among 1013 serodiscordant couples in Kenya and Uganda, we offered ART to eligible HIV-positive partners and PrEP to HIV-negative partners before ART initiation and through the HIV-positive partner's first 6 months of ART use. We conducted individual and group discussions with counseling staff to elicit the health communication framework and key messages about ART and PrEP that were delivered to couples.

Results:
Counseling sessions for serodiscordant couples about PrEP and ART included discussions of HIV serodiscordance, PrEP and ART initiation and integrated use, and PrEP discontinuation. ART messages emphasized daily, lifelong use for treatment and prevention, adherence, viral suppression, resistance, side effects, and safety of ART during pregnancy. PrEP messages emphasized daily dosing, time-limited PrEP use until the HIV-positive partner sustained 6 months of high adherence to ART, adherence, safety during conception, side effects, and other risks for HIV.

Conclusions:
Counseling messages for HIV-serodiscordant couples are integral to the delivery of time-limited PrEP as a “bridge” to ART-driven viral suppression. Their incorporation into programmatic scale-up will maximize intervention impact on the global epidemic.
Training and Validating a Deep Convolutional Neural Network for Computer-Aided Detection and Classification of Abnormalities on Frontal Chest Radiographs
Authors: Cicero Mark , Bilbily Alexander , Colak Errol , Dowdell Tim , Gray Bruce , Perampaladas Kuhan , Barfett Joseph 
Published: December 2016

Objectives
Convolutional neural networks (CNNs) are a subtype of artificial neural network that have shown strong performance in computer vision tasks including image classification. To date, there has been limited application of CNNs to chest radiographs, the most frequently performed medical imaging study. We hypothesize CNNs can learn to classify frontal chest radiographs according to common findings from a sufficiently large data set.

Materials and Methods
Our institution's research ethics board approved a single-center retrospective review of 35,038 adult posterior-anterior chest radiographs and final reports performed between 2005 and 2015 (56% men, average age of 56, patient type: 24% inpatient, 39% outpatient, 37% emergency department) with a waiver for informed consent. The GoogLeNet CNN was trained using 3 graphics processing units to automatically classify radiographs as normal (n = 11,702) or into 1 or more of cardiomegaly (n = 9240), consolidation (n = 6788), pleural effusion (n = 7786), pulmonary edema (n = 1286), or pneumothorax (n = 1299). The network's performance was evaluated using receiver operating curve analysis on a test set of 2443 radiographs with the criterion standard being board-certified radiologist interpretation.

Results
Using 256 × 256-pixel images as input, the network achieved an overall sensitivity and specificity of 91% with an area under the curve of 0.964 for classifying a study as normal (n = 1203). For the abnormal categories, the sensitivity, specificity, and area under the curve, respectively, were 91%, 91%, and 0.962 for pleural effusion (n = 782), 82%, 82%, and 0.868 for pulmonary edema (n = 356), 74%, 75%, and 0.850 for consolidation (n = 214), 81%, 80%, and 0.875 for cardiomegaly (n = 482), and 78%, 78%, and 0.861 for pneumothorax (n = 167).

Conclusions
Current deep CNN architectures can be trained with modest-sized medical data sets to achieve clinically useful performance at detecting and excluding common pathology on chest radiographs.