bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bed sharing when parents do not smoke: is there a risk of SIDS? An individual level analysis of five major case–control studies
Authors: Carpenter Robert , McGarvey Cliona , Mitchell Edwin A , Tappin David M , Vennemann Mechtild M , Smuk Melanie , Carpenter James R 
Published: June 2013

ObjectiveTo resolve uncertainty as to the risk of Sudden Infant Death Syndrome (SIDS) associated with sleeping in bed with your baby if neither parent smokes and the baby is breastfed.DesignBed sharing was defined as sleeping with a baby in the parents’ bed; room sharing as baby sleeping in the parents’ room. Frequency of bed sharing during last sleep was compared between babies who died of SIDS and living control infants. Five large SIDS case–control datasets were combined. Missing data were imputed. Random effects logistic regression controlled for confounding factors.SettingHome sleeping arrangements of infants in 19 studies across the UK, Europe and Australasia.Participants1472 SIDS cases, and 4679 controls. Each study effectively included all cases, by standard criteria. Controls were randomly selected normal infants of similar age, time and place.ResultsIn the combined dataset, 22.2% of cases and 9.6% of controls were bed sharing, adjusted OR (AOR) for all ages 2.7; 95% CI (1.4 to 5.3). Bed sharing risk decreased with increasing infant age. When neither parent smoked, and the baby was less than 3 months, breastfed and had no other risk factors, the AOR for bed sharing versus room sharing was 5.1 (2.3 to 11.4) and estimated absolute risk for these room sharing infants was very low (0.08 (0.05 to 0.14)/1000 live-births). This increased to 0.23 (0.11 to 0.43)/1000 when bed sharing. Smoking and alcohol use greatly increased bed sharing risk.ConclusionsBed sharing for sleep when the parents do not smoke or take alcohol or drugs increases the risk of SIDS. Risks associated with bed sharing are greatly increased when combined with parental smoking, maternal alcohol consumption and/or drug use. A substantial reduction of SIDS rates could be achieved if parents avoided bed sharing.
INterpreting the Processes of the UMPIRE Trial (INPUT): protocol for a qualitative process evaluation study of a fixed-dose combination (FDC) strategy to improve adherence to cardiovascular medications
Authors: Salam Abdul , Stewart Frances , Singh Kavita , Thom Simon , Williams Hilarie Jane , Patel Anushka , Jan Stephen , Laba Tracey , Prabhakaran Dorairaj , Maulik Pallab , Day Sophie , Ward Helen 
Published: June 2013

IntroductionThis paper describes a planned process evaluation of the Use of a Multidrug Pill In Reducing Cardiovascular Events (UMPIRE) trial, one of several randomised clinical trials taking place globally to assess the potential of cardiovascular drugs as a fixed-dose combination (polypill) in cardiovascular disease prevention. A fixed-dose combination may be a promising strategy for promoting adherence to medication; alleviating pill burden through simplifying regimens and reducing cost. This process evaluation will complement the UMPIRE trial by using qualitative research methods to inform understanding of the complex interplay of factors that underpin trial outcomes.MethodsA series of semistructured, in-depth interviews with local health professionals and UMPIRE trial participants in India and the UK will be undertaken. The aim is to understand their views and experiences of the trial context and of day-to-day use of medications more generally. The grounded theory approach will be used to analyse data and help inform the processes of the UMPIRE trial.Ethics and disseminationThe study has received ethical approval for all sites in the UK and India where trial participant interviews will be undertaken. The process evaluation will help inform and enhance the understanding of the UMPIRE trial results and its applicability to clinical practice as well as shaping policy regarding strategies for improving cardiovascular medication adherence.
GenotypingChlamydia trachomatisstrains among men who have sex with men from a Northern Spain region: a cohort study
Authors: Mejuto P , Boga J A , Junquera M , Torreblanca A , Leiva P S 
Published: June 2013

ObjectivesTo determine the prevalence of anorectalChlamydia trachomatisserovars in a group of men who have sex with men (MSM) with high risk sexual behaviour, attendees at a sexually transmitted infection (STI) unit from a region in Northwest Spain.DesignRetrospective and descriptive study of all swabs obtained from all MSM attendees at an STI unit, from 2007 to 2011.Retrospective ethical approval was granted by the Ethical Regional Committee of Clinical Investigation of the Principality of Asturias.SettingThe STI clinic in Oviedo, Spain, offers screening and free-of-charge treatment to about 3646 patients per year.Participants303 symptomatic and asymptomatic consecutive and unselected MSM patients (mean age 36.7 and range 21–55 years) were evaluated for anorectal chlamydial infection.Main outcome measuresC trachomatisDNA extraction and detection in all rectal and in 36 urethral swabs. Characterisation ofC trachomatisgenotypes through sequencing ofompAgene amplicons and further phylogenetic tree analysis.ResultsWe found 40 (13. 2%) positive rectal samples. The distribution of genotypes was E (37. 5%) followed by G (25%), D (12. 5%), J (10%) and L2b (5%).25 (62.5%, 95% CI 46.2 to 78.7) of the chlamydia-infected MSM showed clinical manifestations while 15 (37.5%, 95% CI 21.25 to 53.75) reported no symptoms. Concurrent infection with other STIs was documented in 27 (67.5%, 95% CI 51.7 to 83.2) patients. The most frequently reported clinical symptom was anal ulcer (7 cases, 17.5%; 95% CI 4.47 to 30.52). E genotype was mostly detected in asymptomatic patients. There were non-E genotypes detected in 21 (84%, 95% CI 63.9 to 95.5) of 25 symptomatic patients (p<0.001).ConclusionsThe first two confirmed cases of lymphogranuloma venereum (LGV) in MSM in Asturias are reported, probably indicating the increase of this infection. The SpanishC trachomatislaboratory-based surveillance system may underlie an underestimated number of chlamydial infections. Whenever mild and atypical symptoms exist, laboratory evaluation would contribute to the early implementation of appropriate therapy and prevent LGV dissemination.
Confidence in the future, health-related behaviour and psychological distress: results from a web-based cross-sectional study of 101 257 Finns
Authors: Joutsenniemi Kaisla , Härkänen Tommi , Pankakoski Maiju , Langinvainio Heimo , Mattila Antti S , Saarelma Osmo , Lönnqvist Jouko , Mustonen Pekka 
Published: June 2013

ObjectivesTo investigate the role of socioeconomic status and psychological stress to potential associations between confidence in the future and a wide range of health-related behaviours.DesignWeb-based cross-sectional study including an ‘Electronic Health Check’ at the Finnish Happiness-Flourishing Study website linked to a TV programme on happiness and depression.SettingThe Finnish population with access to the internet.Participants101 257 Finns aged 18 and above (21 365 men; 79 892 women). Participants who were under the age of 18 and who did not provide information about their gender were excluded.Primary outcome measuresAs planned, we assessed smoking, weekly alcohol consumption and binge drinking, daily intake of fruits and vegetables and regular exercise.ResultsCompared with participants with low confidence in the future, those with high confidence were less likely to be daily smokers (men OR 0.58, 95% CI 0.52 to 0.65; women 0.57, 95% CI 0.53 to 0.61) and binge drinkers (men 0.57; 0.52 to 0.63; women 0.54; 0.50 to 0.57). Participants with high confidence in the future were more likely to exercise regularly (men OR 2.82, 95% CI 2.55 to 3.13; women 2.57, 95% CI 2.44 to 2.71) and consume vegetables (men OR 2.48, 95% CI 2.25 to 2.74; women 2.13, 95% CI 2.03 to 2.24) and fruits (men OR 2.09, 95% CI 1.86 to 2.35; women 1.83, 95% CI 1.74 to 1.93) daily. Adjustment for current psychological distress and satisfaction for income attenuated the results.ConclusionsHaving confidence in the future is strongly associated with a healthy lifestyle, as assessed by a healthy diet, physical exercise and substance abuse. Health-related interventions may benefit from tailoring interventions according to the target population's level of confidence in the future as well as their level of psychological distress.
Error rates in a clinical data repository: lessons from the transition to electronic data transfer—a descriptive study
Authors: Hong Matthew K H , Yao Henry H I , Pedersen John S , Peters Justin S , Costello Anthony J , Murphy Declan G , Hovens Christopher M , Corcoran Niall M 
Published: June 2013

ObjectiveData errors are a well-documented part of clinical datasets as is their potential to confound downstream analysis. In this study, we explore the reliability of manually transcribed data across different pathology fields in a prostate cancer database and also measure error rates attributable to the source data.DesignDescriptive study.SettingSpecialist urology service at a single centre in metropolitan Victoria in Australia.ParticipantsBetween 2004 and 2011, 1471 patients underwent radical prostatectomy at our institution. In a large proportion of these cases, clinicopathological variables were recorded by manual data-entry. In 2011, we obtained electronic versions of the same printed pathology reports for our cohort. The data were electronically imported in parallel to any existing manual entry record enabling direct comparison between them.Outcome measuresError rates of manually entered data compared with electronically imported data across clinicopathological fields.Results421 patients had at least 10 comparable pathology fields between the electronic import and manual records and were selected for study. 320 patients had concordant data between manually entered and electronically populated fields in a median of 12 pathology fields (range 10–13), indicating an outright accuracy in manually entered pathology data in 76% of patients. Across all fields, the error rate was 2.8%, while individual field error ranges from 0.5% to 6.4%. Fields in text formats were significantly more error-prone than those with direct measurements or involving numerical figures (p<0.001). 971 cases were available for review of error within the source data, with figures of 0.1–0.9%.ConclusionsWhile the overall rate of error was low in manually entered data, individual pathology fields were variably prone to error. High-quality pathology data can be obtained for both prospective and retrospective parts of our data repository and the electronic checking of source pathology data for error is feasible.
Validation of a questionnaire measuring preschool children's reactions to and coping with noise in a repeated measurement design
Authors: Persson Waye Kerstin , van Kamp Irene , Dellve Lotta 
Published: June 2013

ObjectivesThe aim of the study was to explore and describe the reliability and validity of an instrument to measure preschool children's reactions to and coping with indoor noise at preschools or day care centres.DesignData were derived from an acoustical before and after intervention study providing repeated measurements.SettingThe study was performed at seven preschools in Mölndal, Sweden.ParticipantsChildren were recruited from these preschools and the final sample comprised 61 and 59 preschool children aged 4–5 years, with a response rate of 98% and 48% girls and 52% boys. Two children were excluded from analysis because they fell outside the age range.Primary and secondary outcome measuresThe instrument was developed based on a qualitative study performed in Swedish preschools. Questions pertained to preschool children's perception of noise when at school, their bodily and emotional reactions to it, non-specific symptoms and the coping strategies used by them to diminish the detrimental effects of the noise.ResultsConfirmative factor analysis yielded a three-factor model fitted to 10 items pertaining to angry reactions, symptoms and coping. The model fit was moderate to good (standardised root mean square residual=0.08, 0.12; adjusted goodness of fit=0.97/0.91) in the before and after conditions, respectively. The scales showed moderate to good reliability in terms of internal consistency, with an α ranging between 0.52 and 0.67, and was stronger in the before condition. Concurrent validity was strongest for symptoms by comparing groups based on bodily reaction (general and sound specific).ConclusionsYoung children's emotional and bodily reactions to coping with noise can be reliably measured with this instrument. Like adults and older children, young children are able to distinguish between emotional reactions, bodily reactions, coping and unwell-being. Future research on larger groups of preschool children is needed to further refine the questions, in particular the questions pertaining to well-being.
Serum perfluoroalkyl acids concentrations and memory impairment in a large cross-sectional study
Authors: Gallo Valentina , Leonardi Giovanni , Brayne Carol , Armstrong Ben , Fletcher Tony 
Published: June 2013

ObjectivesTo examine the cross-sectional association between serum perfluorooctanate (PFOA), perfuorooctane sulfonate (PFOS), perfluorononanoic acid (PFNA) and perfluorohexane sulfonate (PFHxS) concentrations with self-reported memory impairment in adults and the interaction of these associations with diabetes status.DesignCross-sectional study.SettingPopulation-based in Mid-Ohio Valley, West Virginia following contamination by a chemical plant.ParticipantsThe C8 Health Project collected data and measured the serum level of perfluoroalkyl acids (PFAAs) of 21 024 adults aged 50+ years.Primary outcome measureSelf-reported memory impairment as defined by the question ‘have experienced short-term memory loss?’ResultsA total of 4057 participants self-reported short-term memory impairment. Inverse associations between PFOS and PFOA and memory impairment were highly statistically significant with fully adjusted OR=0.93 (95% CI 0.90 to 0.96) for doubling PFOS and OR=0.96 (95% CI 0.94 to 0.98) for doubling PFOA concentrations. Comparable inverse associations with PFNA and PFHxS were of borderline statistical significance. Inverse associations of PFAAs with memory impairment were weaker or non-existent in patients with diabetes than overall in patients without diabetes.ConclusionsAn inverse association between PFAA serum levels and self-reported memory impairment has been observed in this large population-based, cross-sectional study that is stronger and more statistically significant for PFOA and PFOS. The associations can be potentially explained by a preventive anti-inflammatory effect exerted by a peroxisome proliferator-activated receptor agonist effect of these PFAAs, but confounding or even reverse causation cannot be excluded as an alternative explanation.
Vitamin C may alleviate exercise-induced bronchoconstriction: a meta-analysis
Authors: Hemilä Harri 
Published: June 2013

ObjectiveTo determine whether vitamin C administration influences exercise-induced bronchoconstriction (EIB).DesignSystematic review and meta-analysis.MethodsMEDLINE and Scopus were searched for placebo-controlled trials on vitamin C and EIB. The primary measures of vitamin C effect used in this study were: (1) the arithmetic difference and (2) the relative effect in the postexercise forced expiratory volume in 1 s (FEV1) decline between the vitamin C and placebo periods. The relative effect of vitamin C administration on FEV1was analysed by using linear modelling for two studies that reported full or partial individual-level data. The arithmetic differences and the relative effects were pooled by the inverse variance method. A secondary measure of the vitamin C effect was the difference in the proportion of participants suffering from EIB on the vitamin C and placebo days.Results3 placebo-controlled trials that studied the effect of vitamin C on EIB were identified. In all, they had 40 participants. The pooled effect estimate indicated a reduction of 8.4 percentage points (95% CI 4.6 to 12) in the postexercise FEV1decline when vitamin C was administered before exercise. The pooled relative effect estimate indicated a 48% reduction (95% CI 33% to 64%) in the postexercise FEV1decline when vitamin C was administered before exercise. One study needed imputations to include it in the meta-analyses, but it also reported that vitamin C decreased the proportion of participants who suffered from EIB by 50 percentage points (95% CI 23 to 68); this comparison did not need data imputations.ConclusionsGiven the safety and low cost of vitamin C, and the positive findings for vitamin C administration in the three EIB studies, it seems reasonable for physically active people to test vitamin C when they have respiratory symptoms such as cough associated with exercise. Further research on the effects of vitamin C on EIB is warranted.
Primary healthcare costs associated with sleep problems up to age 7 years: Australian population-based study
Authors: Quach J , Gold L , Hiscock H , Mensah F K , Lucas N , Nicholson J M , Wake M 
Published: June 2013

ObjectivesIn Australian 0–7-year olds with and without sleep problems, to compare (1) type and costs to government of non-hospital healthcare services and prescription medication in each year of age and (2) the cumulative costs according to persistence of the sleep problem.DesignCross-sectional and longitudinal data from a longitudinal population study.SettingData from two cohorts participating in the first two waves of the nationally representative Longitudinal Study of Australian Children.ParticipantsBaby cohort at ages 0–1 and 2–3 (n=5107, 4606) and Kindergarten cohort at ages 4–5 and 6–7 (n=4983, 4460).MeasurementsFederal Government expenditure on healthcare attendances and prescription medication from birth to 8 years, calculated via linkage to Australian Medicare data, were compared according to parent report of child sleep problems at each of the surveys.ResultsAt both waves and in both cohorts, over 92% of children had both sleep and Medicare data. The average additional healthcare costs for children with sleep problems ranged from $141 (age 5) to $43 (age 7), falling to $98 (age 5) to $18 (age 7) per child per annum once family socioeconomic position, child gender, global health and special healthcare needs were taken into account. This equates to an estimated additional $27.5 million (95% CI $9.2 to $46.8 million) cost to the Australian federal government every year for all children aged between 0 and 7 years. In both cohorts, costs were higher for persistent than transient sleep problems.ConclusionsHigher healthcare costs were sustained by infants and children with sleep problems. This supports ongoing economic evaluations of early prevention and intervention services for sleep problems considering impacts not only on the child and family but also on the healthcare system.
Identifying HIV most-at-risk groups in Malawi for targeted interventions. A classification tree model
Authors: Emina Jacques B O , Madise Nyovani , Kuepie Mathias , Zulu Eliya M , Ye Yazoume 
Published: June 2013

ObjectivesTo identify HIV-socioeconomic predictors as well as the most-at-risk groups of women in Malawi.DesignA cross-sectional survey.SettingMalawiParticipantsThe study used a sample of 6395 women aged 15–49 years from the 2010 Malawi Health and Demographic Surveys.InterventionsN/APrimary and secondary outcome measuresIndividual HIV status: positive or not.ResultsFindings from the Pearson χ2and χ2Automatic Interaction Detector analyses revealed that marital status is the most significant predictor of HIV. Women who are no longer in union and living in the highest wealth quintiles households constitute the most-at-risk group, whereas the less-at-risk group includes young women (15–24) never married or in union and living in rural areas.ConclusionsIn the light of these findings, this study recommends: (1) that the design and implementation of targeted interventions should consider the magnitude of HIV prevalence and demographic size of most-at-risk groups. Preventive interventions should prioritise couples and never married people aged 25–49 years and living in rural areas because this group accounts for 49% of the study population and 40% of women living with HIV in Malawi; (2) with reference to treatment and care, higher priority must be given to promoting HIV test, monitoring and evaluation of equity in access to treatment among women in union disruption and never married or women in union aged 30–49 years and living in urban areas; (3) community health workers, households-based campaign, reproductive-health services and reproductive-health courses at school could be used as canons to achieve universal prevention strategy, testing, counselling and treatment.
Suicide risk in relation to air pollen counts: a study based on data from Danish registers
Authors: Qin Ping , Waltoft Berit L , Mortensen Preben B , Postolache Teodor T 
Published: June 2013

ObjectivesSince the well-observed spring peak of suicide incidents coincides with the peak of seasonal aeroallergens as tree-pollen, we want to document an association between suicide and pollen exposure with empirical data from Denmark.DesignEcological time series study.SettingData on suicide incidents, air pollen counts and meteorological status were retrieved from Danish registries.Participants13 700 suicide incidents over 1304 consecutive weeks were obtained from two large areas covering 2.86 million residents.Primary and secondary outcome measuresRisk of suicide associated with pollen concentration was assessed using a time series Poisson-generalised additive model.ResultsWe noted a significant association between suicide risk and air pollen counts. A change of pollen counts levels from 0 to ‘10–<30’ grains/m3air was associated with a relative risk of 1.064, that is, a 6.4% increase in weekly number of suicides in the population, and from 0 to ‘30–100’ grains, a relative risk of 1.132. The observed association remained significant after controlling for effects of region, calendar time, temperature, cloud cover and humidity. Meanwhile, we observed a significant sex difference that suicide risk in men started to rise when there was a small increase of air pollen, while the risk in women started to rise until pollen grains reached a certain level. High levels of pollen had slightly stronger effect on risk of suicide in individuals with mood disorder than those without the disorder.ConclusionsThe observed association between suicide risk and air pollen counts supports the hypothesis that aeroallergens, acting as immune triggers, may precipitate suicide.