bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of a community based health‐promotion programme in 2‐ to 9‐year‐old children in Europe on markers of the metabolic syndrome, the IDEFICS study
Authors: Mårild S. , Russo P. , Veidebaum T. , Tornaritis M. , De Henauw S. , De Bourdeaudhuij I. , Molnár D. , Moreno L. A. , Bramsved R. , Peplies J. , Ahrens W. ,   on behalf of the IDEFICS consortium
Published: December 2015

SummaryIntroductionOne objective of ‘Identification and prevention of Dietary‐and lifestyle‐induced health EFfects In Children and infantS’, the IDEFICS study, was to implement a community‐oriented childhood obesity prevention intervention in eight European countries.ObjectiveTo assess the effect of an obesity primary prevention programme on metabolic markers.MethodsThe study had a non‐randomized cluster‐experimental design. In each country, children were recruited from distinct communities serving as intervention and control regions. Health examinations were done during 2007–2008 before the intervention (T0) and during 2009–2010 (T1). Children with results available from T0 and T1 on blood pressure, waist circumference and at least one blood‐marker (fasting glucose, insulin, HOMA‐IR, HbA1c, HDL‐ and LDL‐cholesterol, triglycerides, C‐reactive protein) were included. A metabolic syndrome (MetS) score was calculated.ResultsA total of 7,406 children (age 2–9.9 years) of the 16,228 participating at T0 provided the necessary data. No effect of the intervention was seen on insulin, HOMA‐IR, CRP or the MetS score. Overall fasting glucose increased less in the intervention than in the control region, a pattern driven by three of the eight countries and more pronounced in children of parents with low education. Overall, HbA1c and waist circumference increased more and blood pressure less in the intervention regions.ConclusionWe observed no convincing effect of the intervention on markers of the metabolic syndrome. We identified diverse patterns of change for several markers of uncertain relation to the intervention. © 2015 World Obesity
Advances in the microbial etiology and pathogenesis of early childhood caries
Authors: Hajishengallis E. , Parsaei Y. , Klein M.I. , Koo H. 
Published: December 2015

SummaryEarly childhood caries (ECC) is one of the most prevalent infectious diseases affecting children worldwide. ECC is an aggressive form of dental caries, which, left untreated, can result in rapid and extensive cavitation in teeth (rampant caries) that is painful and costly to treat. Furthermore, it affects mostly children from impoverished backgrounds, and so constitutes a major challenge in public health. The disease is a prime example of the consequences arising from complex, dynamic interactions between microorganisms, host, and diet, leading to the establishment of highly pathogenic (cariogenic) biofilms. To date, there are no effective methods to identify those at risk of developing ECC or to control the disease in affected children. Recent advances in deep‐sequencing technologies, novel imaging methods, and (meta)proteomics–metabolomics approaches provide an unparalleled potential to reveal new insights to illuminate our current understanding about the etiology and pathogenesis of the disease. In this concise review, we provide a broader perspective about the etiology and pathogenesis of ECC based on previous and current knowledge on biofilm matrix, microbial diversity, and host–microbe interactions, which could have direct implications for developing new approaches for improved risk assessment and prevention of this devastating and costly childhood health condition.
NewB for newbies: a randomized control trial training housestaff to perform neonatal intubation with direct and videolaryngoscopy
Authors: Koele‐Schmidt Lindsey , Vasquez Margarita M. 
Published: December 2015

SummaryBackgroundCompetency rates in neonatal intubation among pediatric residents are low and currently not meeting ACGME/AAP standards.AimsThe aim of this study was to compare standard bedside teaching of neonatal endotracheal intubation to a computer module, as well as introduce residents to the emerging technology of videolaryngoscopy.MethodsThe study population consisted of The University of Texas Health Science Center at San Antonio Pediatric interns/residents and PGY‐1 Anesthesia interns rotating through the NICU. Prior to participating in the study, the residents completed a survey addressing past experiences with intubation, comfort level, and prior use of direct and videolaryngoscopy. Participants then performed timed trials of both direct and videolaryngoscopy on the SimNewB®. They had up to three attempts to successfully intubate, with up to 30 s on each attempt. After randomization, participants received one of the following teaching interventions: standard, computer module, or both. This was followed by a second intubation trial and survey completion.ResultsThirty residents were enrolled in the study. There was significant improvement in time to successful intubation in both methods after any teaching intervention (direct 22.0 ± 13.4 s vs 14.7 ± 5.9 s, P = 0.002 and videolaryngoscopy 42.2 ± 29.3 s vs 26.8 ± 18.6 s, P = 0.003). No differences were found between the types of teaching. Residents were faster at intubating with direct laryngoscopy compared to videolaryngoscopy before and after teaching. By the end of the study, only 33% of residents preferred using videolaryngoscopy over direct laryngoscopy, but 76% felt videolaryngoscopy was better to teach intubation.ConclusionsBoth standard teaching and computer module teaching of neonatal intubation on a mannequin model results in improved time to successful intubation and overall improved resident confidence with intubation equipment and technique. Although intubation times were lower with direct laryngoscopy compared to videolaryngoscopy, the participating residents felt that videolaryngoscopy is an important educational tool.
Morbidity in preterm infants with fetal inflammatory response syndrome
Authors: Ozalkaya Elif , Karatekin Güner , Topcuoğlu Sevilay , Gürsoy Tuğba , Ovalı Fahri 
Published: December 2015

AbstractBackgroundThe aim of this study was to evaluate the relationship between umbilical cord blood interleukin (IL)‐6 concentration and preterm morbidity and mortality in premature infants born with fetal inflammatory response syndrome (FIRS).MethodsThis prospective, observational study included 84 preterm infants with a gestational age of 24–36 weeks who had been admitted to the neonatal intensive care unit (NICU). FIRS was defined as umbilical cord blood IL‐6 > 11 pg/mL. In premature infants with FIRS, morbidities (multiple organ failure [MOF], respiratory distress syndrome [RDS], patent ductus arteriosus, intraventricular hemorrhage, bronchopulmonary dysplasia, retinopathy of prematurity) and death were evaluated. Critical umbilical cord blood IL‐6 concentrations for the development of RDS, death, and for MOF were determined in premature infants with FIRS.ResultsFifty‐two infants with IL‐6 concentration > 11 pg/mL constituted the FIRS group. Thirty‐two infants without FIRS served as a control group. RDS, MOF, and mortality were significantly higher in the FIRS group (P = 0.001, P = 0.001, and P = 0.005, respectively). Umbilical cord blood IL‐6 concentration > 26.7 pg/mL in the FIRS group was found to be predictive of RDS, with 70% sensitivity and 85% specificity. Umbilical cord blood IL‐6 concentration > 37.7 pg/mL was found to be predictive of death, with 78.6% sensitivity and 60% specificity. The predictive value of IL‐6 for the development of MOF was 17.5 pg/mL, with 91% sensitivity and 66% specificity.ConclusionsUmbilical cord blood IL‐6 concentration > 26.7, 37.7, and 17.5 pg/mL in premature infants with FIRS was found to be predictive for RDS, death, and MOF, respectively.
Intellectual maturity and physical fitness in preschool children
Authors: Latorre‐Román Pedro Á , Mora‐López David , García‐Pinillos Felipe 
Published: December 2015

AbstractBackgroundThere is an important connection between body growth, physical fitness and cognition. The association between physical fitness and cognitive function has been investigated in some studies, but little is known about the relationship between physical and motor performance and intellectual maturity in preschool children. The aim of this study was therefore to analyze the association between intellectual maturity and physical and motor fitness in preschool children.MethodsA total of 1012 children aged 3–6 years participated voluntarily. A fitness test battery and the Goodenough–Harris drawing test (GHDT) were used.ResultsBoys did better in the standing broad jump and 20 m sprint (P < 0.001), and girls had a better crude GHDT score (P = 0.001). With regard to age group, there were significant differences (P < 0.01) between all groups in all fitness test variables and GHDT. Moreover, a significant correlation was found between crude GHDT score and the fitness test variables.ConclusionsFrom an early age, physical–motor performance and intellectual maturity are linked. Fitness condition is able to predict intellectual maturity. Increasing the amount of time devoted to physical education can promote cognitive benefits in preschool children.
Racecadotril for acute diarrhoea in children: systematic review and meta-analyses
Authors: Gordon Morris , Akobeng Anthony 
Published: December 2015

ObjectiveRacecadotril is an antisecretory agent that can prevent fluid/electrolyte depletion from the bowel as a result of acute diarrhoea without affecting intestinal motility. An up-to-date systematic review is indicated to summarise the evidence on racecadotril for the treatment of acute diarrhoea in children.DesignA Cochrane format systematic review of randomised controlled trials (RCTs). Data extraction and assessment of methodological quality were performed independently by two reviewers. Methodological quality was assessed using the Cochrane risk of bias tool.PatientsChildren with acute diarrhoea, as defined by the primary studies.InterventionsRCTs comparing racecadotril with placebo or other interventions.Main outcome measursDuration of illness, stool output/volume and adverse events.ResultsSeven RCTs were included, five comparing racecadotril with placebo or no intervention, one with pectin/kaolin and one with loperamide. Moderate to high risk of bias was present in all studies. There was no significant difference in efficacy or adverse events between racecadotril and loperamide. A meta-analysis of three studies with 642 participants showed significantly shorter duration of symptoms with racecadotril compared with placebo (mean difference −53.48 h, 95% CI −65.64 to −41.33). A meta-analysis of five studies with 949 participants showed no significant difference in adverse events between racecadotril and placebo (risk ratio 0.99, 95% CI 0.73 to 1.34).ConclusionsThere is some evidence that racecadotril is more effective than placebo or no intervention in reducing the duration of illness and stool output in children with acute diarrhoea. However, the overall quality of the evidence is limited due to sparse data, heterogeneity and risk of bias. Racecadotril appears to be safe and well tolerated.
Are primary care factors associated with hospital episodes for adverse drug reactions? A national observational study
Authors: McKay Ailsa J , Newson Roger B , Soljak Michael , Riboli Elio , Car Josip , Majeed Azeem 
Published: December 2015

ObjectiveIdentification of primary care factors associated with hospital admissions for adverse drug reactions (ADRs).Design and settingCross-sectional analysis of 2010–2012 data from all National Health Service hospitals and 7664 of 8358 general practices in England.MethodWe identified all hospital episodes with an International Classification of Diseases (ICD) 10 code indicative of an ADR, in the 2010–2012 English Hospital Episode Statistics (HES) admissions database. These episodes were linked to contemporary data describing the associated general practice, including general practitioner (GP) and patient demographics, an estimate of overall patient population morbidity, measures of primary care supply, and Quality and Outcomes Framework (QOF) quality scores. Poisson regression models were used to examine associations between primary care factors and ADR-related episode rates.Results212 813 ADR-related HES episodes were identified. Rates of episodes were relatively high among the very young, older and female subgroups. In fully adjusted models, the following primary care factors were associated with increased likelihood of episode: higher deprivation scores (population attributable fraction (PAF)=0.084, 95% CI 0.067 to 0.100) and relatively poor glycated haemoglobin (HbA1c) control among patients with diabetes (PAF=0.372; 0.218 to 0.496). The following were associated with reduced episode likelihood: lower GP supply (PAF=−0.016; −0.026 to −0.005), a lower proportion of GPs with UK qualifications (PAF=−0.035; −0.058 to −0.012), lower total QOF achievement rates (PAF=−0.021; −0.042 to 0.000) and relatively poor blood pressure control among patients with diabetes (PAF=−0.144; −0.280 to −0.022).ConclusionsVarious aspects of primary care are associated with ADR-related hospital episodes, including achievement of particular QOF indicators. Further investigation with individual level data would help develop understanding of the associations identified. Interventions in primary care could help reduce the ADR burden. ADRs are candidates for primary care sensitive conditions.
Systems science and systems thinking for public health: a systematic review of the field
Authors: Carey Gemma , Malbon Eleanor , Carey Nicole , Joyce Andrew , Crammond Brad , Carey Alan 
Published: December 2015

ObjectivesThis paper reports on findings from a systematic review designed to investigate the state of systems science research in public health. The objectives were to: (1) explore how systems methodologies are being applied within public health and (2) identify fruitful areas of activity.DesignA systematic review was conducted from existing literature that draws on or uses systems science (in its various forms) and relates to key public health areas of action and concern, including tobacco, alcohol, obesity and the social determinants of health.Data analysis117 articles were included in the review. An inductive qualitative content analysis was used for data extraction. The following were systematically extracted from the articles: approach, methodology, transparency, strengths and weaknesses. These were then organised according to theme (ie, commonalities between studies within each category), in order to provide an overview of the state of the field as a whole. The assessment of data quality was intrinsic to the goals of the review itself, and therefore, was carried out as part of the analysis.Results4 categories of research were identified from the review, ranging from editorial and commentary pieces to complex system dynamic modelling. Our analysis of each of these categories of research highlighted areas of potential for systems science to strengthen public health efforts, while also revealing a number of limitations in the dynamic systems modelling being carried out in public health.ConclusionsThere is a great deal of interest in how the application of systems concepts and approach might aid public health. Our analysis suggests that soft systems modelling techniques are likely to be the most useful addition to public health, and align well with current debate around knowledge transfer and policy. However, the full range of systems methodologies is yet to be engaged with by public health researchers.
Burden of poor oral health in older age: findings from a population-based study of older British men
Authors: Ramsay S E , Whincup P H , Watt R G , Tsakos G , Papacosta A O , Lennon L T , Wannamethee S G 
Published: December 2015

ObjectivesEvidence of the extent of poor oral health in the older UK adult population is limited. We describe the prevalence of oral health conditions, using objective clinical and subjective measures, in a population-based study of older men.DesignCross-sectional study.Setting and participantsA representative sample of men aged 71–92 years in 2010–2012 from the British Regional Heart Study, initially recruited in 1978–1980 from general practices across Britain. Physical examination among 1660 men included the number of teeth, and periodontal disease in index teeth in each sextant (loss of attachment, periodontal pocket, gingival bleeding). Postal questionnaires (completed by 2147 men including all participants who were clinically examined) included self-rated oral health, oral impacts on daily life and current perception of dry mouth experience.ResultsAmong 1660 men clinically examined, 338 (20%) were edentulous and a further 728 (43%) had <21 teeth. For periodontal disease, 233 (19%) had loss of attachment (>5.5 mm) affecting 1–20% of sites while 303 (24%) had >20% sites affected. The prevalence of gingival bleeding was 16%. Among 2147 men who returned postal questionnaires, 35% reported fair/poor oral health; 11% reported difficulty eating due to oral health problems. 31% reported 1–2 symptoms of dry mouth and 20% reported 3–5 symptoms of dry mouth. The prevalence of edentulism, loss of attachment, or fair/poor self-rated oral health was greater in those from manual social class.ConclusionsThese findings highlight the high burden of poor oral health in older British men. This was reflected in both the objective clinical and subjective measures of oral health conditions. The determinants of these oral health problems in older populations merit further research to reduce the burden and consequences of poor oral health in older people.
Cigarette smoking susceptibility among youth alternate tobacco product users: implications of flavoured tobacco from a national cross-sectional Canadian sample (YSS 2012/2013)
Authors: Minaker Leia M , Shuh Alanna , Nguyen Nghia , Azagba Sunday , Manske Steve R 
Published: December 2015

ObjectivesDeclines in cigarette smoking have been accompanied by increases in alternative tobacco product (ATP) use, particularly among youth. This study examines smoking susceptibility and ATP use in a national sample of Canadian youth.MethodsData from grades 9–12 students who participated in the 2012/2013 Youth Smoking Survey, a nationally generalisable sample of Canadian students (n=27 404) were used to examine cigarette smoking susceptibility among never smokers (n=17 396). Logistic regression models were used to examine differences in smoking susceptibility by use of flavoured and all ATPs and by sociodemographic and lifestyle characteristics.ResultsOverall, 30% of Canadian grades 9–12 never smokers were susceptible to cigarette smoking. Compared to never users, those who had ever tried ATPs (OR=1.96, 95% CI 1.59 to 2.42) and those who had ever tried flavoured ATPs (OR=2.20, 95% CI 1.63 to 2.96) had significantly higher odds of being susceptible to cigarette smoking.ConclusionsATP use is associated with smoking susceptibility among youth never smokers. Findings from this study, along with existing evidence, can be used by policymakers to improve regulation around youth access to ATPs (particularly flavoured varieties).
A supported psychoeducational intervention to improve family mental health following discharge from paediatric intensive care: feasibility and pilot randomised controlled trial
Authors: Als Lorraine C , Nadel Simon , Cooper Mehrengise , Vickers Bea , Garralda M Elena 
Published: December 2015

ObjectiveTo assess feasibility and pilot a supported psychoeducational tool to improve parent and child mental health following discharge from a paediatric intensive care unit (PICU), in preparation for a large randomised controlled trial (RCT).DesignFeasibility assessment and single-centre, parallel group, pilot RCT. A concealed computer generated list was used to randomise participants, with an allocation of 2:1 in favour of the intervention.SettingA PICU in an acute care hospital in London, UK.Participants31 parents of children aged 4–16 years-old admitted to PICU.InterventionParents received a psychoeducational tool supported by a telephone call. The psychoeducational tool outlined the possible psychological reactions in children and parents alongside management advice. The telephone call addressed each family's postdischarge experience, reinforced the psychoeducational material and encouraged parents to put into practice the advice given.Main outcome measuresThe primary outcome was the number of feasibility criteria successfully met (linked to the intervention and the study design). Secondary outcomes were questionnaire data collected at 3–6-month follow-up assessing mental health in parents and children.Results31 parents were randomised (intervention n=22; treatment as usual, TAU n=9). 23 parents were included in the analysis of secondary outcomes (intervention n=17; TAU n=6). 3 (of 6) intervention and 1 (of 6) study design feasibility criteria were fully met. All unmet criteria could be addressed with minor or significant modifications to the protocol. At follow-up there was a tendency for parents who received the intervention to report lower post-traumatic stress symptoms in themselves and fewer emotional and behavioural difficulties in their children than TAU parents. This needs to be explored in a fully powered trial.ConclusionsThis feasibility and pilot RCT provided valuable information on the intervention and trial design for a full RCT.Trials registration numberNCT01737021; Results.
Has the difference in mortality between percutaneous coronary intervention and coronary artery bypass grafting in people with heart disease and diabetes changed over the years? A systematic review and meta-regression
Authors: Herbison Peter , Wong Cheuk-Kit 
Published: December 2015

ObjectivesTo examine the difference in outcome between percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG), to see if it has changed over the years in diabetics deemed eligible for both treatments; and to contrast the long-term mortality findings with those in non-diabetics.DesignMeta-analyses using data from randomised controlled trials found by searches on MEDLINE, EMBASE and the Cochrane Controlled Trials Register, from their inception until March 2015.SettingStudies had to be randomised controlled trials comparing PCI with CABG.ParticipantsThose taking part in the studies had to have multivessel cardiac or left main artery cardiac disease and be deemed eligible for both treatments.InterventionsPCI or CABG.Primary and secondary outcomesThe primary outcome was all cause mortality. Secondary outcomes were a composite of mortality, stroke and myocardial infarction; cardiovascular death; and MACCE (Major Adverse Cardiac or Cerebrovascular Event). The longest follow-up was used in the analysis.ResultsAmong 14 studies (4868 diabetics) reported over three decades, meta-regression shows no relationship between the year of publication and the difference in long term all cause mortality between PCI and CABG. CABG has maintained an approximately 30% mortality advantage compared to PCI. The other outcomes used showed the same lack of change over the years. These findings held true among insulin-requiring and non-insulin-requiring diabetics. However, among non-diabetics included in the 14 studies, there was no difference in mortality outcome between PCI and CABG.ConclusionsThe difference in outcome between PCI and CABG in diabetics has not narrowed from the beginning—with balloon angioplasty to current PCI—with the second generation of drug eluting stents. In contrast to the non-diabetics, there is a persistent 30% benefit in all cause mortality favouring CABG in diabetics, and this should be a major factor in treatment recommendation.