bluuebunny/crossref_metadata_2025_split huggingface dataset:
Levels, trends and reasons for unmet need for family planning among married women in Botswana: a cross-sectional study
Authors: Letamo Gobopamang , Navaneetham Kannan 
Published: April 2015

ObjectivesThe objectives of this study are: (1) to estimate the prevalence of unmet need for family planning among married women using Botswana Family Health Survey 2007 data and (2) to identify risk factors for unmet need for family planning among married women.DesignThis study used secondary data from a cross-sectional survey that was conducted to provide a snapshot of health issues in Botswana.SettingNationally representative population survey data.Participants2601 married or in union women aged 15–49 years who participated in the 2007 Botswana Family Health Survey were included in the analysis.Primary outcomeUnmet need for family planning, which was defined as the percentage of all fecund married women who are not using a method of contraception even though they do not want to get pregnant.ResultsMarried women who had unmet need for family planning were 9.6% in 2007. Most of the unmet need was for limiting (6.7%) compared to spacing (2.9%). Unmet need for family planning was more likely to be among women whose partners disapproved of family planning, non-Christians, had one partner and had never discussed family planning with their partner. Women of low parity, aged 25–34 years, and greater exposure to mass media, were less likely to have experienced unmet need. The patterns and magnitude of covariates differed between unmet need for limiting and for spacing.ConclusionsThe prevalence of unmet need for family planning was low in Botswana compared to other sub-Saharan African countries. The findings from this study reemphasise the importance of women's empowerment and men's involvement in women's sexual and reproductive healthcare needs and services. Different approaches are needed to satisfy the demand for family planning for spacing and limiting.
Impaired mental well-being and psychosocial risk: a cross-sectional study in female nursing home direct staff
Authors: Pélissier C , Fontana L , Fort E , Vohito M , Sellier B , Perrier C , Glerant V , Couprie F , Agard J P , Charbotel B 
Published: April 2015

ObjectivesThe present study sought to quantify the impaired mental well-being and psychosocial stress experienced by nursing home staff and to determine the relationship between impaired mental well-being assessed on the 12-item General Health Questionnaire (GHQ-12) and exposure to psychosocial stress assessed on Siegrist's effort/reward and overcommitment model.MethodsA transverse study was conducted in France on 2471 female employees in 105 nursing homes for the elderly. Personal and occupational data were collected by questionnaire for 668 housekeepers, 1454 nursing assistants and 349 nurses.Results36.8% of participants (n=896) showed impaired mental well-being, 42.7% (n=1039) overcommitment and 9% (n=224) effort/reward imbalance. Overcommitment (prevalence ratio (PR)=1.27; 95% CI (1.21 to 1.34)) and effort–reward imbalance (PR=1.19; 95% CI (1.12 to 1.27)) were significantly associated with presence of impaired mental well-being after adjustment for personal factors (age and private life events). Taking effort and reward levels into account, the frequency of impaired mental well-being was highest in case of exposure to great extrinsic effort and low rewards of any type: esteem, PR=3.53, 95% CI (3.06 to 4.08); earnings, PR=3.48, 95% CI (2.99 to 4.06); or job security, PR=3.30, 95% CI (2.88 to 3.78). Participants in situations of overcommitment and of effort/reward imbalance were at the highest risk of impaired mental well-being: PR=3.86, 95% CI (3.42 to 4.35).ConclusionsSeveral changes in nursing home organisation can be suggested to reduce staff exposure to factors of psychosocial stress. Qualitative studies of the relation between impaired mental well-being and psychosocial stress in nursing home staff could guide prevention of impaired mental well-being at work.
National Audit of Seizure management in Hospitals (NASH): results of the national audit of adult epilepsy in the UK
Authors: Dixon Peter A , Kirkham Jamie J , Marson Anthony G , Pearson Mike G 
Published: April 2015

ObjectivesAbout 100 000 people present to hospitals each year in England with an epileptic seizure. How they are managed is unknown; thus, the National Audit of Seizure management in Hospitals (NASH) set out to assess prior care, management of the acute event and follow-up of these patients. This paper describes the data from the second audit conducted in 2013.Setting154 emergency departments (EDs) across the UK.ParticipantsData from 4544 attendances (median age of 45 years, 57% men) showed that 61% had a prior diagnosis of epilepsy, 12% other neurological problems and 22% were first seizure cases. Each ED identified 30 consecutive adult cases presenting due to a seizure.Primary and secondary outcome measuresDetails were recorded of the patient's prior care, management at hospital and onward referral to neurological specialists onto an online database. Descriptive results are reported at national level.ResultsOf those with epilepsy, 498 (18%) were on no antiepileptic drug therapy and 1330 (48%) were on monotherapy. Assessments were often incomplete and witness histories were sought in only 759 (75%) of first seizure patients, 58% were seen by a senior doctor and 57% were admitted. For first seizure patients, advice on further seizure management was given to 264 (27%) and only 55% were referred to a neurologist or epilepsy specialist. For each variable, there was wide variability among sites that was not explicable. For the sites who partook in both audits, there was a trend towards better care in 2013, but this was small and dwarfed by the intersite variability.ConclusionsThese results have parallels with the Sentinel Audit of Stroke performed a decade earlier. There is wide intersite variability in care covering the entire care pathway, and a need for better organised and accessible care for these patients.
Fosfomycin versus meropenem in bacteraemic urinary tract infections caused by extended-spectrum β-lactamase-producingEscherichia coli(FOREST): study protocol for an investigator-driven randomised controlled trial
Authors: Rosso-Fernández Clara , Sojo-Dorado Jesús , Barriga Angel , Lavín-Alconero Lucía , Palacios Zaira , López-Hernández Inmaculada , Merino Vicente , Camean Manuel , Pascual Alvaro , Rodríguez-Baño Jesús ,   and the FOREST Study Group
Published: April 2015

IntroductionFinding therapeutic alternatives to carbapenems in infections caused by extended-spectrum β-lactamase-producingEscherichia coli(ESBL-EC) is imperative. Although fosfomycin was discovered more than 40 years ago, it was not investigated in accordance with current standards and so is not used in clinical practice except in desperate situations. It is one of the so-called neglected antibiotics of high potential interest for the future.Methods and analysisThe main objective of this project is to demonstrate the clinical non-inferiority of intravenous fosfomycin with regard to meropenem for treating bacteraemic urinary tract infections (UTI) caused by ESBL-EC. This is a ‘real practice’ multicentre, open-label, phase III randomised controlled trial, designed to compare the clinical and microbiological efficacy, and safety of intravenous fosfomycin (4 g/6 h) and meropenem (1 g/8 h) as targeted therapy for this infection; a change to oral therapy is permitted after 5 days in both arms, in accordance with predetermined options. The study design follows the latest recommendations for designing trials investigating new options for multidrug-resistant bacteria. Secondary objectives include the study of fosfomycin concentrations in plasma and the impact of both drugs on intestinal colonisation by multidrug-resistant Gram-negative bacilli.Ethics and disseminationEthical approval was obtained from the Andalusian Coordinating Institutional Review Board (IRB) for Biomedical Research (Referral Ethics Committee), which obtained approval from the local ethics committees at all participating sites in Spain (22 sites). Data will be presented at international conferences and published in peer-reviewed journals.DiscussionThis project is proposed as an initial step in the investigation of an orphan antimicrobial of low cost with high potential as a therapeutic alternative in common infections such as UTI in selected patients. These results may have a major impact on the use of antibiotics and the development of new projects with this drug, whether as monotherapy or combination therapy.Trial registration numberNCT02142751. EudraCT no: 2013-002922-21. Protocol V.1.1 dated 14 March 2014.
Protocol for a pre-implementation and post-implementation study on shared decision-making in the surgical treatment of women with early-stage breast cancer
Authors: Savelberg Wilma , Moser Albine , Smidt Marjolein , Boersma Liesbeth , Haekens Christel , Weijden Trudy van der 
Published: April 2015

BackgroundThe majority of patients diagnosed with early-stage breast cancer are in a position to choose between having a mastectomy or lumpectomy with radiation therapy (breast-conserving therapy). Since the long-term survival rates for mastectomy and for lumpectomy with radiation therapy are comparable, patients’ informed preferences are important for decision-making. Although most clinicians believe that they do include patients in the decision-making process, the information that women with breast cancer receive regarding the surgical options is often rather subjective, and does not invite patients to express their preferences. Shared decision-making (SDM) is meant to help patients clarify their preferences, resulting in greater satisfaction with their final choice. Patient decision aids can be very supportive in SDM. We present the protocol of a study to β test a patient decision aid and optimise strategies for the implementation of SDM regarding the treatment of early-stage breast cancer in the actual clinical setting.Methods/designThis paper concerns a pre-implementation and post-implementation study, lasting from October 2014 to June 2015. The intervention consists of implementing SDM using a patient decision aid. The intervention will be evaluated using qualitative and quantitative measures, acquired prior to, during and after the implementation of SDM. Outcome measures are knowledge about treatment, perceived SDM and decisional conflict. We will also conduct face-to-face interviews with a sample of these patients and their care providers, to assess their experiences with the implementation of SDM and the patient decision aid.Ethics and disseminationThis protocol was approved by the Maastricht University Medical Centre (MUMC) ethics committee. The findings will be disseminated through peer-reviewed journal articles and presentations at national conferences. Findings will be used to finalise a multi-faceted implementation strategy to test the implementation of SDM and a patient decision aid in terms of cost-effectiveness, in a multicentre cluster randomised controlled trial (RCT).Study registration numberNTR4879.
Using a virtual environment to study child pedestrian behaviours: a comparison of parents’ expectations and children's street crossing behaviour
Authors: Morrongiello Barbara A , Corbett Michael 
Published: April 2015

ObjectiveThe aim of this study was to compare parents’ expectations for their children crossing streets with children's actual crossing behaviours and determine how accurately parents judge their own children's pedestrian behaviours to be.MethodUsing a fully immersive virtual reality system interfaced with a 3D movement measurement system, younger (7–9 years) and older (10–12 years) children's crossing behaviours were assessed. The parent viewed the same traffic conditions and indicated if their child would cross and how successful she/he expected the child would be when doing so.ResultsComparing children's performance with what their parents expected they would do revealed that parents significantly overestimated the inter-vehicle gap threshold of their children, erroneously assuming that children would show safer pedestrian behaviours and select larger inter-vehicle gaps to cross into than they actually did; there were no effects of child age or sex. Child and parent scores were not correlated and a logistic regression indicated these were independent of one another.ConclusionsParents were not accurate in estimating the traffic conditions under which their children would try and cross the street. If parents are not adequately supervising when children cross streets, they may be placing their children at risk of pedestrian injury because they are assuming their children will select larger (safer) inter-vehicle gaps when crossing than children actually do.
Continuous daily use of cilostazol prevents in-stent restenosis following carotid artery stenting: serial angiographic investigation of 229 lesions
Authors: Miyazaki Yuichi , Mori Takahisa , Iwata Tomonori , Aoyagi Yoshinori , Tanno Yuhei , Kasakura Shigen , Yoshioka Kazuhiro 
Published: April 2015

BackgroundSeveral studies have reported that cilostazol (CLS) may reduce in-stent restenosis (ISR) after carotid artery stenting (CAS). However, it is not known for how long CLS must be continued to prevent ISR.MethodsWe retrospectively reviewed a prospectively collected database of patients who underwent elective CAS and follow-up angiography at 3 months and 1 year after the procedure. ISR was defined as stenosis of 50% or greater on digital subtraction angiography. The cumulative incidence rates of angiographic ISR were compared between the three groups, divided according to duration of CLS use : (1) patients who were maintained on CLS for 12 months or more after CAS (12M CLS group, n=70), (2) patients who were treated with CLS for the first 3 months after CAS (3M CLS group, n=23), and (3) patients who did not receive CLS (no CLS group, n=136).ResultsA total of 229 lesions in 199 patients were included in our analysis. During a median follow-up of 365 days, ISR was detected in 15 lesions. The cumulative ISR rates overall and in the 12M CLS, 3M CLS, and no CLS groups were 5.6%, 0%, 5.0%, and 8.4%, respectively, at 1 year, and the log rank test showed that there was a significant difference between the three groups (p<0.05). Cox regression analysis demonstrated that the 12M CLS group had a significantly lower risk of ISR than the 3M CLS group (adjusted relative risk (aRR) 3.06e-10, 95% CI 0 to 0.51, p<0.05) and the no CLS group (aRR 1.41e-10, 95% CI 0 to 0.15, p<0.001), whereas no difference was found between the 3M CLS group and the no CLS group.ConclusionsAn overall cumulative ISR rate of 5.6% was documented angiographically at 1 year after CAS. Continuous daily use of CLS (for at least 1 year) may have a beneficial effect on long term prevention of ISR.
Diabetes distress: understanding the hidden struggles of living with diabetes and exploring intervention strategies
Authors: Berry Emma , Lockhart Sam , Davies Mark , Lindsay John R , Dempster Martin 
Published: April 2015

ABSTRACT
Diabetes distress is a rational emotional response to the threat of a life-changing illness. Distinct from depression, it is conceptually rooted in the demands of diabetes management and is a product of emotional adjustment. Diabetes distress has been found to be significantly associated with glycated haemoglobin (HbA1c) level and the likelihood of an individual adopting self-care behaviours. The lack of perceived support from family, friends and healthcare professionals significantly contributes to elevated diabetes distress, and this issue tends to be overlooked when designing interventions. Pioneering large-scale research, DAWN2, gives voices to the families of those with diabetes and reaffirms the need to consider psychosocial factors in routine diabetes care. Structured diabetes education programmes are the most widely used in helping individuals cope with diabetes, but they tend not to include the psychological or interpersonal aspects of diabetes management in their curricula. The need for health practitioners, irrespective of background, to demonstrate an understanding of diabetes distress and to actively engage in discussion with individuals struggling to cope with diabetes is emphasised.
Dynamic Pricing with Limited Supply
Authors: Babaioff Moshe , Dughmi Shaddin , Kleinberg Robert , Slivkins Aleksandrs 
Published: April 2015

We consider the problem of designing revenue-maximizing online posted-price mechanisms when the seller has limited supply. A seller haskidentical items for sale and is facingnpotential buyers (“agents”) that are arriving sequentially. Each agent is interested in buying one item. Each agent’s value for an item is an independent sample from some fixed (but unknown) distribution with support [0,1]. The seller offers a take-it-or-leave-it price to each arriving agent (possibly different for different agents), and aims to maximize his expected revenue.We focus on mechanisms that do not use any information about the distribution; such mechanisms are calleddetail-free(orprior-independent). They are desirable because knowing the distribution is unrealistic in many practical scenarios. We study how the revenue of such mechanisms compares to the revenue of the optimal offline mechanism that knows the distribution (“offline benchmark”).We present a detail-free online posted-price mechanism whose revenue is at most O((klogn)2/3) less than the offline benchmark, for every distribution that is regular. In fact, this guarantee holds withoutanyassumptions if the benchmark is relaxed to fixed-price mechanisms. Further, we prove a matching lower bound. The performance guarantee for the same mechanism can be improved toO(√klogn), with a distribution-dependent constant, if the ratiok/nis sufficiently small. We show that, in the worst case over all demand distributions, this is essentially the best rate that can be obtained with a distribution-specific constant.On a technical level, we exploit the connection to multiarmed bandits (MAB). While dynamic pricing with unlimited supply can easily be seen as an MAB problem, the intuition behind MAB approaches breaks when applied to the setting with limited supply. Our high-level conceptual contribution is that even the limited supply setting can be fruitfully treated as a bandit problem.
The Price of Anarchy in Games of Incomplete Information
Authors: Roughgarden Tim 
Published: April 2015

We define smooth games of incomplete information. We prove an ’’extension theorem” for such games:price of anarchy bounds for pure Nash equilibria for all induced full-information games extendautomatically, without quantitative degradation, to all mixed-strategy Bayes-Nash equilibria withrespect to a product prior distribution over players’ preferences. We also note that, for Bayes-Nashequilibria in games with correlated player preferences, there is no general extension theorem forsmooth games.
We give several applications of our definition and extension theorem. First, we show that many gamesof incomplete information for which the price of anarchy has been studied are smooth in our sense.Our extension theorem unifies much of the known work on the price of anarchy in games of incompleteinformation. Second, we use our extension theorem to prove new bounds on the price of anarchy ofBayes-Nash equilibria in routing games with incomplete information.
PARD3 Inactivation in Lung Squamous Cell Carcinomas Impairs STAT3 and Promotes Malignant Invasion
Authors: Bonastre Ester , Verdura Sara , Zondervan Ilse , Facchinetti Federica , Lantuejoul Sylvie , Chiara Maria Dolores , Rodrigo Juan Pablo , Carretero Julian , Condom Enric , Vidal Agustin , Sidransky David , Villanueva Alberto , Roz Luca , Brambilla Elisabeth , Savola Suvi , Sanchez-Cespedes Montse 
Published: April 2015

Abstract
Correct apicobasal polarization and intercellular adhesions are essential for the appropriate development of normal epithelia. Here, we investigated the contribution of the cell polarity regulator PARD3 to the development of lung squamous cell carcinomas (LSCC). Tumor-specific PARD3 alterations were found in 8% of LSCCs examined, placing PARD3 among the most common tumor suppressor genes in this malignancy. Most PAR3-mutant proteins exhibited a relative reduction in the ability to mediate formation of tight junctions and actin-based protrusions, bind atypical protein kinase C, activate RAC1, and activate STAT3 at cell confluence. Thus, PARD3 alterations prevented the formation of contacts between neighboring cells and the subsequent downstream signaling. Notably, reconstituting PAR3 activity in vivo reduced tumor-invasive and metastatic properties. Our findings define PARD3 as a recurrently inactivated cell polarity regulator in LSCC that affects tumor aggressiveness and metastasis. Cancer Res; 75(7); 1287–97. ©2015 AACR.
Satisfaction with a Quitline-based Smoking Cessation Intervention among Cancer Survivors
Authors: Weaver KE , Kaplan S , Griffin L , Urbanic J , Zbikowski S , Danhauer SC 
Published: April 2015

Abstract
Continued smoking after diagnosis jeopardizes cancer survivors' health and well-being. Quitline-based smoking cessation treatment is convenient, widely available and free, yet the appropriateness of this treatment approach for survivors is not known. We assessed satisfaction among participants in an enhanced quitline intervention as part of a randomized clinical trial assessing feasibility. Methods: We recruited cancer survivors through the NCI Community Clinical Oncology Program (CCOP) network within 6 months of treatment who smoked within the last 7 days and randomized them 2:1 to an enhanced quitline- based intervention (brief in-person motivational interviewing counseling session, quitline telephone counseling, 6 weeks of nicotine replacement patches) or usual care. We collected treatment satisfaction data and self-reported smoking status at 12 weeks and confirmed smoking status for reported non-smokers using a semi-quantitative urinary cotinine assessment. Results: We enrolled 146 survivors (75% female, 79% non-Hispanic white, mean age = 58 years). At entry, survivors reported smoking an average of 15 cigarettes per day; 77% reported smoking within 30 minutes of awakening. Assessments were completed by 63% of the quitline group and 75% of the usual care group at 12 weeks (P &gt; 0.05). 83% of participants in the intervention arm (n = 98) completed at least one quitline call, and 18% completed ≥3 calls. Use of nicotine patches was 61% in the quitline group and 42% in usual care. Quitline participants were generally satisfied with both the in-person counseling (mean satisfaction score = 4.2 (SD = 1.0), on 1–5 scale) and the quitline telephone counseling (mean satisfaction score = 3.4 (SD = 1.3)). 87% would recommend the quitline program to others. Self-reported 7-day point prevalence cessation was 26% in the quitline group and 17% in the usual care arm (P = 0.33). Conclusions: An enhanced quitline smoking cessation intervention appears to be acceptable to cancer survivors and to result in a trend towards slightly higher cessation at 12 weeks. Increased efforts to retain survivors in treatment and encourage the use of nicotine replacement may be necessary to increase the impact of this intervention approach.