bluuebunny/crossref_metadata_2025_split huggingface dataset:
Measurement of Pain in the Prehospital Setting Using a Visual Analogue
Scale
Authors: Lord Bill A. , Parsell Brian 
Published: May 2013

Abstract

Introduction:

The aim of this study was to use a visual analogue scale (VAS) to
measure the adequacy of prehospital pain management. Patients reported
pain severity at two points in time during treatment and transport by
ambulance paramedics. The change in pain score was compared with a
benchmark reduction of 20 mm that has been shown to correspond with the
minimum clinically significant change in pain perception reported by
patients.

Methods:

This prospective, observational study used a VA S to record pain
severity among patients reporting pain who were transported to a
hospital by paramedics. Patients used a VAS to score pain severity
during the initial patient assessment process (T0), and again at the
hospital of destination (Tend). This study reports the mean changes in
the scores, and the percentage of cases for whom the difference between
T0and Tend in the study population achieved or exceeded the 20 mm
benchmark. A survey also was administered to paramedics who participated
in this study in order to identify attitudes, values, and beliefs
relating to the measurement of pain.

Results:

A total of 262 patients were enrolled in this study. The mean value
for thereduction in VAS (T0-Tend) was 18.2±23.9 mm [±SD] (Median =
14.0mm, 95% confidence interval (CI) = 15.3–21.1 mm). One hundred and
thirty-four patients (51.1%) did not receive analgesia (either morphine
sulfate or methoxyflurane). The mean initial (T0) pain score for the
no-analgesia group was 54.5 ±24.7 mm [±SD], with the mean value for the
change in VAS (T0-Tend) = 10.6 mm (median = 5 mm, 95% CI = 6.4–14.8 mm).
Fo rty-six patients (17.6%) recorded some deterioration in their pain
score at Tend (T0-Tend<0 mm). Survey results identified attitudes
that may affect paramedics' pain management practice.

Conclusion:

The results suggest that inadequate analgesia is an issue in this
study setting. Effective analgesia requires formal protocols or
guidelines supported by effective analgesic therapies along with
education that addresses attitudes that may inhibit pain assessment or
management by paramedics. Regular audits form part of clinical quality
assurance programs that assess analgesic practice. However, such
auditsmust have access to data obtained from patient self-reporting of
pain using a valid and reliable pain measurement tool.
Paramedic Identification of Electrocardiograph J-Point and ST-Segments
Authors: Williams Brett , Boyle Mal , Lord Bill 
Published: May 2013

AbstractIntroduction:Correct identification of the J-Point and ST-segment on an electrocardiograph (ECG) is an important clinical skill for paramedics working in acute healthcare settings. The skill of ECG analysis and interpretation is known to be challenging to learn and often is a difficult concept to teach.Objectives:The objective of the study was to determine if undergraduate paramedic students could accurately identify ECG ST-segment elevation and J-Point location.Methods:A convenience sample of undergraduate paramedic students (n = 148) was provided with four enlarged ECGs (ECG1–4) that illustrated different levels, patterns, and characteristics of ST-segment elevation. Participants were asked to identify whether ST-elevation was present, and if so, height in millimeters (mm) and the correct location of the J-Point.Results:There were significant variations in students'accuracy with both J-Point and ST-segment determination. Eleven (10%) students correctly identified the ST-segment being present in all ECGs. Also, ECG 2 reflected 6 mm of ST-elevation; however, only one student correctly identified this. Overall the students were 0.55 mm (95% CI = 0.29–0.81 mm, range = -6.5–5.8 mm) from the J-point on the horizontal and -0.18 mm (95% CI = -0.31–0.04 mm, range = -2.8–2.3 mm) on the vertical axis.Conclusions:Undergraduate paramedic students recognize ST-segment elevation. However, inaccuracies occurred with measurements of ST-segment and precise location of J-Points. Errors in ECG analysis may reflect weaknesses in teaching this skill. Consideration should be given to the design of an educational program that can reliably improve performance of this skill.
Dietary patterns and breast cancer risk among women
Authors: Karimi Zeinab , Jessri Mahsa , Houshiar-Rad Anahita , Mirzaei Hamid-Reza , Rashidkhani Bahram 
Published: May 2013

AbstractObjectiveBreast cancer is the most common type of cancer in women worldwide. Several studies have examined the role of single nutrients and food groups in breast cancer pathogenesis but fewer investigations have addressed the role of dietary patterns. Our main objective was to identify the relationship between major dietary patterns and breast cancer risk among Iranian women.DesignHospital-based case–control study.SettingShohada Teaching Hospital, Tehran, Iran.SubjectsOverall, 100 female patients aged 30–65 years with breast cancer and 174 female hospital controls were included in the present study. Dietary intake was assessed using a valid and reliable semi-quantitative FFQ consisting of 168 food items.ResultsTwo dietary patterns were identified explaining 24·31 % of dietary variation in the study population. The ‘healthy’ food pattern was characterized by the consumption of vegetables, fruits, low-fat dairy products, legumes, olive and vegetable oils, fish, condiments, organ meat, poultry, pickles, soya and whole grains; while the ‘unhealthy’ food pattern was characterized by the consumption of soft drinks, sugars, tea and coffee, French fries and potato chips, salt, sweets and desserts, hydrogenated fats, nuts, industrial juice, refined grains, and red and processed meat. Compared with the lowest tertile, women in the highest tertile of the ‘healthy’ dietary pattern score had 75 % decreased risk of breast cancer (OR = 0·25, 95 % CI 0·08, 0·78), whereas women in the highest tertile of the ‘unhealthy’ dietary pattern had a significantly increased breast cancer risk (OR = 7·78, 95 % CI 2·31, 26·22).ConclusionsA healthy dietary pattern may be negatively associated with breast cancer risk, while an unhealthy dietary pattern is likely to increase the risk among Iranian women.
Sodium and nutrition labelling: a qualitative study exploring New Zealand consumers’ food purchasing behaviours
Authors: McLean Rachael , Hoek Janet 
Published: May 2013

AbstractObjectiveDietary sodium reduction is an important public health intervention that would reduce blood pressure and chronic disease. An understanding of how New Zealand consumers’ food purchasing behaviour is influenced by perceptions of dietary sodium will inform future sodium-reduction strategies.DesignThe present qualitative study used in-depth interviews of adult consumers to explore consumer knowledge, understanding of food labels and food purchasing behaviour with respect to dietary sodium.SettingNew Zealand.SubjectsA convenience sample of sixteen adult grocery shoppers.ResultsA thematic analysis of the transcripts showed New Zealand consumers lacked the background knowledge necessary to understand and regulate their own salt intake and were unable to interpret existing food labels with respect to dietary salt.ConclusionsThe findings add further weight to calls for food labels that do not require background knowledge or numerical skills and highlight the need for population-based public health interventions. Education of New Zealand consumers on the health benefits of sodium reduction and how this may be achieved would complement this approach.
Is frequency of family meals associated with parental encouragement of healthy eating among ethnically diverse eighth graders?
Authors: Poulos Natalie S , Pasch Keryn E , Springer Andrew E , Hoelscher Deanna M , Kelder Steven H 
Published: May 2013

AbstractObjectiveThe purpose of the present study was to explore the relationship between family meals and parental encouragement of healthy eating overall and by ethnicity.DesignFamily meal frequency was measured with one item asking how many times in the past 7 d all or most of the family ate a meal together, which was then categorized to represent three levels of family meals (≤2 times, 3–6 times and ≥7 times). Parental encouragement of healthy eating assessed how often parents encouraged the student to eat fruits and vegetables, drink water, eat wholegrain bread, eat breakfast and drink low-fat milk (never to always). An overall scale of parental encouragement of healthy eating was created. Mixed-effect regression analyses were run controlling for gender, ethnicity, age and socio-economic status. Moderation by ethnicity was explored.SettingMiddle schools.SubjectsParticipants included 2895 US eighth grade students participating in the Central Texas CATCH (Coordinated Approach To Child Health) Middle School Project (mean age 13·9 years; 24·5 % White, 52·7 % Hispanic, 13·0 % African-American, 9·8 % Other; 51·6 % female).ResultsEating more family meals was significantly associated with having parents who encouraged healthy eating behaviours (P for trend <0·001). The number of family meals was positively associated with encouragement of each of the healthy eating behaviours (P for trend <0·0001). There were no differences in the relationships by ethnicity of the students.ConclusionsFamilies who eat together are more likely to encourage healthy eating in general. Interventions which promote family meals may include tips for parents to increase discussions about healthy eating.
Women respondents report higher household food insecurity than do men in similar Canadian households
Authors: Matheson Jesse , McIntyre Lynn 
Published: May 2013

AbstractObjectiveWe investigated factors accounting for the consistently higher levels of household food insecurity reported by women in Canada.DesignTwo cycles of the Canadian Community Health Survey for the years 2005/2006 and 2007/2008 were pooled to examine the association between household food insecurity, measured using the Household Food Security Survey Module and other metrics, and respondent sex. We stratified households as married/cohabiting (in which case, the household respondent was chosen randomly) or non-married (single/widowed/separated/divorced) and adjusted for differences in household characteristics, including the presence of children.SettingCanada.SubjectsAnalysis was restricted to households dependent on employment/self-employment and whose reported annual household income was below $CAN 100 000. Exclusions included respondents less than 18 years of age, any welfare receipt, and missing food insecurity, marital status, income source and amount, or household composition data.ResultsFor non-married households, increased food insecurity in female-v. male-led households was accounted for by significant differences in household socio-economic characteristics. In contrast, in married/cohabiting households with or without children, higher food insecurity rates were reported when the respondent was female and neither respondent characteristics nor socio-economic factors accounted for the differences.ConclusionsHigher rates of food insecurity in non-married households in Canada are largely attributable to women's socio-economic disadvantage. In married households, women appear to report higher levels of food insecurity than men. These findings suggest a possible bias in the measurement of population-level household food insecurity in surveys that do not account for the sex of the respondent in married/cohabiting households.
Racial/ethnic and immigrant differences in early childhood diet quality
Authors: de Hoog Marieke LA , Kleinman Ken P , Gillman Matthew W , Vrijkotte Tanja GM , van Eijsden Manon , Taveras Elsie M 
Published: May 2013

AbstractObjectiveTo assess racial/ethnic differences in the diet in young children and the explanatory role of maternal BMI, immigrant status and perception of child's weight.DesignAmong white, black and Hispanic 3-year-olds, we used negative binomial and linear regression to examine associations of race/ethnicity with foods and nutrients assessed by a validated FFQ.SettingProject Viva, Boston (MA), USA.SubjectsChildren aged 3 years (n 898).ResultsMean age was 38·3 (sd 2·8) months; 464 (52 %) were boys and 127 mothers (14 %) were immigrants. After adjustment for sociodemographic factors, black and Hispanic children (v. white) had a higher intake of sugar-sweetened beverages (rate ratio (RR) = 2·59 (95 % CI 1·95, 3·48) and RR = 1·59 (95 % CI 1·07, 2·47), respectively) and lower intakes of skimmed/1 % milk (RR = 0·42 (95 % CI 0·33, 0·53) and RR = 0·43 (95 % CI 0·31, 0·61), respectively) and trans-fat (−0·10 (95 % CI −0·18, −0·03) % of energy and −0·15 (95 % CI −0·26, −0·04) % of energy, respectively). Among Hispanics only, a lower intake of snack food (RR = 0·83 (95 % CI 0·72, 0·98)) was found and among blacks only, a higher intake of fast food (RR = 1·28 (95 % CI 1·05, 1·55)) and lower intakes of saturated fat (−0·86 (95 % CI −1·48, −0·23) % of energy), dietary fibre (0·85 (95 % CI 0·08, 1·62) g/d) and Ca (−120 (95 % CI −175, −65) mg/d) were found. Being born outside the USA was associated with more healthful nutrient intakes and less fast food.ConclusionsThree-year-old black and Hispanic (v. white) children ate more sugar-sweetened beverages and less low-fat dairy. Total energy intake was substantially higher in Hispanic children. Snack food (Hispanic children) and fat intakes (black children) tended to be lower. Children of immigrants ate less fast food and bad fats and more fibre.
The current development of CNS drug research
Authors: Wegener Gregers , Rujescu Dan 
Published: May 2013

Abstract
In the past few years, several high profiled pharmaceutical companies have decided to shut down major research activities within the central nervous system (CNS) area. For example, in December 2011 Novartis announced that the company is closing its neuroscience facility in Basel, Switzerland, where Novartis is headquartered (Abbott, 2011). It follows similar moves by GlaxoSmithKline and AstraZeneca, both based in the UK, which in 2010 announced the closure of major parts of their neuroscience research divisions globally (Jack, Financial Times, 4 February 2010). Also companies primarily based in the USA, Pfizer and Merck, as well as the French company Sanofi, have pulled back on research into brain disorders. This development is still proceeding, as e.g. AstraZeneca closed their CNS/pain centres (Fiercebiotech, press release, 2 February 2012). Several of the companies have launched smaller new initiatives based on studies of genetics and biomarkers, but as mental disorders such as unipolar depression impose the largest disease burden worldwide, e.g. 6.2% disability-adjusted life year of total (WHO, 2008), and current treatments do not work particularly well for many patients, this has obviously raised a number of concerns related to how the future developments should be carried out, and whether the genetic approach may be sufficient. In June 2012, the International College of Neuropsychopharmacology (http://www.cinp.org) hosted an international workshop in order to discuss and consider the consequences and implications of the withdrawal of these research activities. This paper presents the problem background together with a summary of the viewpoints of the invited speakers and recommendations for future intervention.
Resolving views on Antarctic Neogene glacial history – the Sirius debate
Authors: Barrett P. J. 
Published: May 2013

ABSTRACTThe discovery of marine Pliocene diatoms in warm-based glacial deposits (now termed the Sirius Group) high in the Transantarctic Mountains in the 1980s began a three-decade-long controversy over the stability of the East Antarctic Ice Sheet. Their presence implied that this ice sheet had collapsed as recently as three million years ago to allow their deposition in shallow interior seas, followed by transport and deposition from an expanded over-riding ice sheet. Though the glacial deposits included clasts with older diatoms, no evidence of clasts with Pliocene diatoms was published, but the hypothesis gained wide acceptance. Increasing knowledge of ice sheet behaviour and the antiquity and stability of the Transantarctic Mountains, along with new techniques for dating age and denudation rates for landscapes, has led to a more likely alternative hypothesis – that the high-level Sirius Group deposits pre-date Transantarctic Mountains uplift and their Pliocene diatoms are atmospheric contaminants. Surveys have shown that marine diatoms from the Antarctic margin and the Southern Ocean are indeed reaching the surface of the ice sheet and blowing through the mountains, with permafrost processes providing opportunities for contamination. Modelling and geological evidence is now consistent with a stable East Antarctic Ice Sheet in the interior for the last 14 Ma, with some retreat around the margins and periodic collapse of the West Antarctic ice sheet in Pliocene times.
Seabirds maintain offspring provisioning rate despite fluctuations in prey abundance: a multi‐species functional response for guillemots in the North Sea
Authors: Smout Sophie , Rindorf Anna , Wanless Sarah , Daunt Francis , Harris Michael P. , Matthiopoulos Jason 
Published: May 2013

Summary
Seabirds that consume more than one prey type may adjust their foraging to maintain provisioning rates for their chicks. How energetically effective are these strategies, and what are the implications for the management of seabirds and their marine habitat?
A multi‐species functional response links consumption rates to the availability of multiple prey types, but fitting multi‐species functional responses to field data can be difficult, requiring consumption measurements over a range of different prey abundances. Such detailed data may be especially difficult to obtain in marine ecosystems.
We used annual time‐series data on chick provisioning for the common guillemot Uria aalge together with abundance indices for its two main prey (lesser sandeel Ammodytes marinus and sprat Sprattus sprattus) to parameterize a multi‐species functional response for parents provisioning chicks at a major North Sea colony from 1992 to 2005.
The fitted model reproduced changes in diet and consumption rate which were consistent with changes in local prey abundance including a long‐term decline in sandeels.
The model predicted that energy intake by chicks would be more sensitive to changes in sprat abundance than sandeel abundance. Guillemots appeared able to adjust their foraging tactics over a wide range of prey abundances to maintain a consistent energetic intake rate for chicks.
Synthesis and applications. Our results suggest guillemot chicks obtain adequate calorific intake from their parents despite fluctuating prey abundances, conferring some resilience in the face of environmental variation. The parameterized multi‐species functional response model can be used to estimate levels of severe prey shortage that compromise provisioning. It also enables us to interpret predator consumption rates so that these can be used as a metric of prey availability. Further, quantifying trophic links between marine prey and apex predators is needed to support the development of multi‐species models in which the predators can be included. Such models are needed as tools to effectively manage the marine ecosystem, taking into account the objectives of fishing, conservation and the need to maintain Good Environmental Status.
Association between gestational diabetes mellitus and subsequent overactive bladder among premenopausal female twins
Authors: Tettamanti G , Iliadou AN , Pedersen NL , Bellocco R , Altman D 
Published: May 2013

ObjectiveTo investigate the association between a history of gestational diabetes mellitus (GDM) and overactive bladder (OAB) in women of premenopausal age.DesignPopulation‐based study.SettingThe Swedish Twin Register.PopulationIn 2005, a total of 14 094 female twins born between 1959 and 1985 in the Swedish Twin Registry participated in a comprehensive survey on common exposures and complex diseases. Structured questions provided information on GDM and OAB. The present study was designed as a cross‐sectional analysis including all women in the cohort having given birth before 2005 (n = 7855).MethodsA logistic regression model based on generalised estimating equations was used to derive odds ratios (ORs).Main outcome measureThe association between a history of GDM and OAB was estimated using ORs with 95% confidence intervals (CIs).ResultsThe prevalence of OAB in women with a history of GDM was 19.1% compared with 10.7% in women without GDM. This corresponded to a two‐fold increased odds of OAB in women with a history of gestational diabetes (OR 2.13, 95% CI 1.48–3.05). After adjusting the analysis for age, body mass index, parity, smoking, and diabetes mellitus, having had GDM was associated with doubled odds of OAB (OR 1.88, 95% CI 1.26–2.80).ConclusionsA history of GDM was positively associated with OAB among women of premenopausal age. The association does not seem to be mediated by body mass index or type‐I or type‐II diabetes mellitus.
Impact of loop electrosurgical excision procedure for cervical intraepithelial neoplasia on HIV‐1 genital shedding: a prospective cohort study
Authors: Huchko MJ , Woo VG , Liegler T , Leslie H , Smith‐McCune K , Sawaya GF , Bukusi EA , Cohen CR 
Published: May 2013

ObjectiveWe sought to examine the impact of the loop electrosurgical excision procedure (LEEP) on the rate and magnitude of HIV‐1 genital shedding among women undergoing treatment for cervical intraepithelial neoplasia 2/3 (CIN2/3).DesignProspective cohort study.PopulationWomen infected with HIV‐1 undergoing LEEP for CIN2/3 in Kisumu, Kenya.MethodsParticipants underwent specimen collection for HIV‐1 RNA prior to LEEP and at 1, 2, 4, 6, 10, and 14 weeks post‐LEEP. HIV‐1 viral load was measured in cervical and plasma specimens using commercial real‐time polymerase chain reaction (PCR) assays, to a lower limit of detection of 40 copies per specimen.Main outcome measuresPresence and magnitude of HIV‐1 RNA (copies per specimen or cps) in post‐LEEP specimens, compared with baseline.ResultsAmong women on highly active antiretroviral therapy (HAART), we found a statistically significant increase in cervical HIV‐1 RNA concentration at week 2, with a mean increase of 0.43 log10 cps (95% CI 0.03–0.82) from baseline. Similarly, among women not receiving HAART, we found a statistically significant increase in HIV‐1 shedding at week 2 (1.26 log10 cps, 95% CI 0.79–1.74). No other statistically significant increase in concentration or detection of cervical HIV‐1 RNA at any of the remaining study visits were noted.ConclusionsIn women infected with HIV undergoing LEEP, an increase in genital HIV shedding was observed at 2 but not at 4 weeks post‐procedure. The current recommendation for women to abstain from vaginal intercourse for 4 weeks seems adequate to reduce the theoretical increased risk of HIV transmission following LEEP.