bluuebunny/crossref_metadata_2025_split huggingface dataset:
Material, psychosocial and behavioural factors associated with self-reported health in the Republic of Ireland: cross-sectional results from the SLÁN survey
Authors: Niedhammer Isabelle , Kerrad Sarra , Schütte Stefanie , Chastang Jean-François , Kelleher Cecily C 
Published: June 2013

ObjectivesTo explore the associations between various material, psychosocial and behavioural factors and self-reported health (SRH), and to determine whether these associations varied according to educational level.DesignRepresentative national cross-sectional survey.SettingRepublic of Ireland.Participants4369 men and 5995 women aged 18 or more (Survey of Lifestyle, Attitudes and Nutrition (SLÁN) 2007).MethodsSRH was measured using one single item. Three groups of factors were studied: material, psychosocial and behavioural factors. Statistical analyses were performed using logistic regression analysis and interaction testing, the sample design being taken into account. All results were adjusted for age and educational level and stratified on gender.ResultsWhen each group of factors was studied separately, non-working status, no private health insurance, inability to afford enough food, no car, being non-married, low social participation, serious neighbourhood problems, low social support, smoking, no alcohol consumption, illicit drug use, low physical activity and obesity were associated with poor SRH. When studied together, some material and psychosocial factors were no longer significant. Four significant interaction terms were found, suggesting that some factors might have a stronger association with SRH among low-educated people.ConclusionsVarious types of factors were found to be associated with SRH, and most of these associations were similar according to educational level. Behavioural factors might be intermediate factors in the causal pathways from material and psychosocial factors to SRH. Prevention policies should integrate a large number of factors comprehensively to improve SRH.
Mapping the 12-item multiple sclerosis walking scale to the EuroQol 5-dimension index measure in North American multiple sclerosis patients
Authors: Sidovar Matthew F , Limone Brendan L , Lee Soyon , Coleman Craig I 
Published: June 2013

ObjectiveTo map the 12-item Multiple Sclerosis Walking Scale (MSWS-12) onto the EuroQol 5-dimension (EQ-5D) health-utility index in multiple sclerosis (MS) patients participating in the North American Research Committee on Multiple Sclerosis (NARCOMS) registry.DesignCross-sectional MSWS-12 to EQ-5D cross-walking analysis.SettingNARCOMS registry spring 2010 biannual update and supplemental survey.ParticipantsNorth American patients completing both the MSWS-12 and the EQ-5D randomly split into derivation and validation cohorts.Outcome measuresOrdinary least squares regression was performed within the derivation cohort, with participants’ EQ-5D as the dependent variable. Results of the MSWS-12 were input as independent variable(s) into six regression models. Model goodness-of-fit was subsequently assessed in the validation cohort using the mean absolute error (MAE), root mean square error (RMSE) and the adjusted R2. The best performing model was refined in the entire cohort and utilised for additional analyses.ResultsA total of 3505 NARCOMS participants were included. Their mean±SD EQ-5D and MSWS-12 scores were 0.74±0.18 and 50.8±33.5, respectively, and these assessments were found to be moderately correlated (r=–0.553, p<0.001). The model using all individual MSWS-12 item scores as independent variables was found to have the best fit (MAE=0.109±0.096, RMSE=0.145, adjusted R2=0.329). The percentage of EQ-5D estimates within 0.05 and 0.10 of the actual value were 30% and 61%, respectively. This mapping equation was more precise in patients with moderate mobility impairment (MAE=0.087±0.061 at patient-determined disease step (PDDS) of 3–6) and less precise in patients with no (MAE=0.141±0.128 at PDDS of 0–2) or severe mobility impairment (MAE=0.121±0.049 at PDDS ≥7).ConclusionsThe EQ-5D scores can be predicted using the MSWS-12 item scores with reasonable precision in North American patients with MS. Prediction estimates were more precise in patients with moderate mobility impairment.
On the time spent preparing grant proposals: an observational study of Australian researchers
Authors: Herbert Danielle L , Barnett Adrian G , Clarke Philip , Graves Nicholas 
Published: June 2013

ObjectiveTo estimate the time spent by the researchers for preparing grant proposals, and to examine whether spending more time increase the chances of success.DesignObservational study.SettingThe National Health and Medical Research Council (NHMRC) of Australia.ParticipantsResearchers who submitted one or more NHMRC Project Grant proposals in March 2012.Main outcome measuresTotal researcher time spent preparing proposals; funding success as predicted by the time spent.ResultsThe NHMRC received 3727 proposals of which 3570 were reviewed and 731 (21%) were funded. Among our 285 participants who submitted 632 proposals, 21% were successful. Preparing a new proposal took an average of 38 working days of researcher time and a resubmitted proposal took 28 working days, an overall average of 34 days per proposal. An estimated 550 working years of researchers' time (95% CI 513 to 589) was spent preparing the 3727 proposals, which translates into annual salary costs of AU$66 million. More time spent preparing a proposal did not increase the chances of success for the lead researcher (prevalence ratio (PR) of success for 10 day increase=0.91, 95% credible interval 0.78 to 1.04) or other researchers (PR=0.89, 95% CI 0.67 to 1.17).ConclusionsConsiderable time is spent preparing NHMRC Project Grant proposals. As success rates are historically 20–25%, much of this time has no immediate benefit to either the researcher or society, and there are large opportunity costs in lost research output. The application process could be shortened so that only information relevant for peer review, not administration, is collected. This would have little impact on the quality of peer review and the time saved could be reinvested into research.
‘The body we leave behind’: a qualitative study of obstacles and opportunities for increasing uptake of male circumcision among Tanzanian Christians
Authors: Downs Jennifer A , Fuunay Lucas D , Fuunay Mary , Mbago Mary , Mwakisole Agrey , Peck Robert N , Downs David J 
Published: June 2013

ObjectivesMale circumcision (MC) reduces HIV infection by approximately 60% among heterosexual men and is recommended by the WHO for HIV prevention in sub-Saharan Africa. In northwest Tanzania, over 60% of Muslims but less than 25% of Christian men are circumcised. We hypothesised that the decision to circumcise may be heavily influenced by religious identity and that specific religious beliefs may offer both obstacles and opportunities to increasing MC uptake, and conducted focus group discussions to explore reasons for low rates of MC among Christian church attenders in the region.DesignQualitative study using focus group discussions and interpretative phenomenological analysis.SettingDiscussions took place at churches in both rural and urban areas of the Mwanza region of northwest Tanzania.ParticipantsWe included 67 adult Christian churchgoers of both genders in a total of 10 single-gender focus groups.ResultsChristians frequently reported perceiving MC as a Muslim practice, as a practice for the sexually promiscuous, or as unnecessary since they are taught to focus on ‘circumcision of the heart’. Only one person had ever heard MC discussed at church, but nearly all Christian parishioners were eager for their churches to address MC and felt that MC could be consistent with their faith.ConclusionsChristian religious beliefs among Tanzanian churchgoers provide both obstacles and opportunities for increasing uptake of MC. Since half of adults in sub-Saharan Africa identify themselves as Christians, addressing these issues is critical for MC efforts in this region.
The influence of pregnancy termination on the outcome of subsequent pregnancies: a retrospective cohort study
Authors: Scholten Brenda L , Page-Christiaens Godelieve C M L , Franx Arie , Hukkelhoven Chantal W P M , Koster Maria P H 
Published: June 2013

ObjectiveTo compare the incidences of preterm delivery, cervical incompetence treated by cerclage, placental implantation or retention problems (ie, placenta praevia, placental abruption and retained placenta) and postpartum haemorrhage between women with and without a history of pregnancy termination.Design A retrospective cohort study using aggregated data from a national perinatal registry.SettingAll midwifery practices and hospitals in the Netherlands.ParticipantsAll pregnant women with a singleton pregnancy without congenital malformations and a gestational age of ≥20 weeks who delivered between January 2000 and December 2007.Main outcome measuresPreterm delivery, cervical incompetence treated by cerclage, placenta praevia, placental abruption, retained placenta and postpartum haemorrhage.ResultsA previous pregnancy termination was reported in 16 000 (1.2%) deliveries. The vast majority of these (90–95%) were performed by surgical methods. The incidence of all outcome measures was significantly higher in women with a history of pregnancy termination. Adjusted ORs (95% CI) for cervical incompetence treated by cerclage, preterm delivery, placental implantation or retention problems and postpartum haemorrhage were 4.6 (2.9 to 7.2), 1.11 (1.02 to 1.20), 1.42 (1.29 to 1.55) and 1.16 (1.08 to 1.25), respectively. Associated numbers needed to harm were 1000, 167, 111 and 111, respectively. For any listed adverse outcome, the number needed to harm was 63.ConclusionsIn this large nationwide cohort study, we found a positive association between surgical termination of pregnancy and subsequent preterm delivery, cervical incompetence treated by cerclage, placental implantation or retention problems and postpartum haemorrhage in a subsequent pregnancy. Absolute risks for these outcomes, however, remain small. Medicinal termination might be considered first whenever there is a choice between both methods.
Trends and risk factors for severe perineal trauma during childbirth in New South Wales between 2000 and 2008: a population-based data study
Authors: Dahlen Hannah , Priddis Holly , Schmied Virginia , Sneddon Anne , Kettle Christine , Brown Chris , Thornton Charlene 
Published: June 2013

ObjectivesTo determine trends and risk factors for severe perineal trauma between 2000 and 2008.DesignThis was a population-based data study.SettingNew South Wales, Australia.Participants510 006 women giving birth to a singleton baby during the period 2000–2008.Main outcome measuresRates of severe perineal trauma between 2000 and 2008 and associated demographic, fetal, antenatal, labour and delivery events and factors.ResultsThere was an increase in the overall rate of severe perineal trauma from 2000 to 2008 from 1.4% to 1.9% (36% increase). Compared with women who were intact or had minor perineal trauma (first-degree tear, vaginal graze/tear), women who were primiparous (adjusted OR (AOR) 1.8 CI (1.65 to 1.95), were born in China or Vietnam (AOR 1.1 CI (1.09 to 1.23), gave birth in a private hospital (AOR 1.1 CI (1.03 to 1.20), had an instrumental birth (AOR 1.8 CI (1.65 to 1.95) and male baby (AOR 1.3 CI (1.27 to 1.34) all had a significantly higher risk of severe perineal trauma. Only giving birth to a male baby, adjusted for birth weight (AOR 1.5 CI (1.44 to 1.58), remained significant, when women with severe perineal trauma were compared with all other women not experiencing severe perineal trauma. This association increased over the study period.ConclusionsTo our knowledge, this is the first time that having a male baby has been found to exert such a strong independent risk for severe perineal trauma and the increasing significance of this in recent years needs further exploration.
The neurophysiological effects of dry needling in patients with upper trapezius myofascial trigger points: study protocol of a controlled clinical trial
Authors: Abbaszadeh-Amirdehi Maryam , Ansari Noureddin Nakhostin , Naghdi Soofia , Olyaei Gholamreza , Nourbakhsh Mohammad Reza 
Published: June 2013

IntroductionDry needling (DN) is an effective method for the treatment of myofascial trigger points (MTrPs). There is no report on the neurophysiological effects of DN in patients with MTrPs. The aim of the present study will be to assess the immediate neurophysiological efficacy of deep DN in patients with upper trapezius MTrPs.Methods and analysisA prospective, controlled clinical trial was designed to include patients with upper trapezius MTrPs and volunteered healthy participants to receive one session of DN. The primary outcome measures are neuromuscular junction response and sympathetic skin response. The secondary outcomes are pain intensity and pressure pain threshold. Data will be collected at baseline and immediately after intervention.Ethics and disseminationThis study protocol has been approved by the Research Council, School of Rehabilitation and the Ethics Committee of Tehran University of Medical Sciences. The results of the study will be disseminated in a peer-reviewed journal and presented at international congresses.
A 12-month incidence of exercise-related injuries in previously sedentary community-dwelling older adults following an exercise intervention
Authors: Little Robert M D , Paterson Donald H , Humphreys David A , Stathokostas Liza 
Published: June 2013

ObjectivesFear of injury is reported as a barrier to exercise by older adults. However, the literature is limited in describing exercise injuries in older adults.DesignThis study prospectively evaluated the 12-month incidence of exercise-related injuries to community-dwelling older adults (n=167 respondents; 63 men, 104 women; mean age 69±5 year).MethodsA questionnaire developed for use in older adults was administered to document self-reported injuries. Linear regression analysis was conducted to identify covariates related to injury outcomes.Results23 people (14%) reported injuries. 41% of injuries were to the lower extremities, where the most common type was overuse muscle strains (32%, n=7). Overexertion was the most common cause of injury (n=9) and walking accounted for half of the activities during which injury occurred. 70% of injuries required medical treatment. 44% were not able to continue exercising after injury and return-to-activity time varied from 1 to 182 days. Sex, age and exercise volume were not significantly associated with injury occurrence.ConclusionsThese results showed similar, or lower, exercise-related injury rates as compared with previous reports on younger and middle-aged adults; however, the definition of, and criteria for, ‘injury’ reporting varies in the literature. This study indicates that older adults taking up exercise are not at increased risk of injury versus younger age groups.
Social determinants of syphilis in South China: the effect of sibling position on syphilis and sexual risk behaviours
Authors: Tucker Joseph D , Young Darwin , Yang Ligang , Yang Bin , Adimora Adaora A 
Published: June 2013

ObjectiveThis study evaluated the relationship between sibling position and sexual risk based on behavioural and syphilis infection data from sexually transmitted infection (STI) patients in South China.DesignA cross-sectional study examining sexual behaviours and syphilis infection.Setting4 STI clinics in the Pearl River Delta of South China.Participants1792 Chinese men and women attending STI clinics.Primary outcome measuresSTI history, syphilis infection defined as positive non-treponemal and treponemal tests.ResultsAmong all clinic patients, 824 (46.3%) were first-born, 354 (19.9%) were middle-born and 602 (33.8%) were final-born. Middle-born individuals had a higher percentage of reported STI history (44.7% compared to 34.7%, p<0.001) and syphilis infection (9.7% compared to 4.9%, p=0.01) among men (n=1163) compared to other sibling positions in bivariate analyses, but not in the final multivariate model. The relationship between sibling position and syphilis was independent of income and education level. There was no trend observed between middle-born position and female sexual risk behaviours (n=626). Higher education was significantly associated with syphilis among women and men in respective multivariate models.ConclusionsThis study suggests that middle-born men in China may have an increased sexual risk compared to other sibling positions. As Chinese family and social structures change, a more thorough understanding of how demographic factors influence sexual risk behaviours is needed.
Costs of surgical procedures in Indian hospitals
Authors: Chatterjee Susmita , Laxminarayan Ramanan 
Published: June 2013

ObjectiveDespite a growing volume of surgical procedures in low-income and middle-income countries, the costs of these procedures are not well understood. We estimated the costs of 12 surgical procedures commonly conducted in five different types of hospitals in India from the provider perspective, using a microcosting method.DesignCost and utilisation data were collected retrospectively from April 2010 to March 2011 to avoid seasonal variability.SettingFor this study, we chose five hospitals of different types: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed district hospital, a 655-bed private teaching hospital and a 778-bed tertiary care teaching hospital based on their willingness to cooperate and data accessibility. The hospitals were from four states in India. The private, charitable and tertiary care hospitals serve urban populations, the district hospital serves a semiurban area and the private teaching hospital serves a rural population.ResultsCosts of conducting lower section caesarean section ranged from rupees 2469 to 41 087; hysterectomy rupees 4124 to 57 622 and appendectomy rupees 2421 to 3616 (US$1=rupees 52). We computed the costs of conducting lap and open cholecystectomy (rupees 27 732 and 44 142, respectively); hernia repair (rupees 13 204); external fixation (rupees 8406); intestinal obstruction (rupees 6406); amputation (rupees 5158); coronary artery bypass graft (rupees 177 141); craniotomy (rupees 75 982) and functional endoscopic sinus surgery (rupees 53 398).ConclusionsEstimated costs are roughly comparable with rates of reimbursement provided by the Rashtriya Swasthya Bima Yojana (RSBY)—India's government-financed health insurance scheme that covers 32.4 million poor families. Results from this type of study can be used to set and revise the reimbursement rates.
Salpingectomy as standard at hysterectomy? A Danish cohort study, 1977–2010
Authors: Guldberg Rikke , Wehberg Sonja , Skovlund Charlotte Wessel , Mogensen Ole , Lidegaard Øjvind 
Published: June 2013

ObjectiveTo assess if the risk of first-time salpingectomy was affected by prior hysterectomy with retained fallopian tubes and by prior sterilisation.DesignA historical cohort study.SettingDenmark.Participants170 000 randomly selected women born 1947–1963 (10 000/year) were followed from 1977 until the end of 2010.Main outcome measuresEffect of hysterectomy with retained fallopian tubes or sterilisation on the risk of salpingectomy. Both were modelled in a Cox proportional hazards model as time-dependent covariates, analysing time to first salpingectomy. End of follow-up period was 31 December 2010.ResultsOf 9591 hysterectomies, 6456 (67.3%) had both fallopian tubes retained. HRs for salpingectomy after hysterectomy with retained fallopian tubes and sterilisation were 2.13 (95% 1.88 to 2.42) and 2.42 (2.21 to 2.64), as compared with those for non-hysterectomised and non-sterilised women.ConclusionsWomen undergoing hysterectomy with retained fallopian tubes or sterilisation have at least a doubled risk of subsequent salpingectomy. Removal of the fallopian tubes at hysterectomy should therefore be recommended.
Hypogonadism and low bone mineral density in patients on long-term intrathecal opioid delivery therapy
Authors: Duarte Rui V , Raphael Jon H , Southall Jane L , Labib Mourad H , Whallett Andrew J , Ashford Robert L 
Published: June 2013

ObjectivesThis study aimed to investigate the hypothalamic-pituitary-gonadal axis in a sample of male patients undertaking intrathecal opioid delivery for the management of chronic non-malignant pain and the presence of osteopaenia and/or osteoporosis in those diagnosed with hypogonadism.DesignObservational study using health data routinely collected for non-research purposes.SettingDepartment of Pain Management, Russells Hall Hospital, Dudley, UK.PatientsTwenty consecutive male patients attending follow-up clinics for intrathecal opioid therapy had the gonadal axis evaluated by measuring their serum luteinising hormone, follicle stimulating hormone, total testosterone, sex hormone binding globulin and calculating the free testosterone level. Bone mineral density was measured by DEXA scanning in those patients diagnosed with hypogonadism.ResultsBased on the calculated free testosterone concentrations, 17 (85%) patients had biochemical hypogonadism with 15 patients (75%) having free testosterone <180 pmol/L and 2 patients (10%) between 180 and 250 pmol/L. Bone mineral density was assessed in 14 of the 17 patients after the exclusion of 3 patients. Osteoporosis (defined as a T score ≤−2.5 SD) was detected in three patients (21.4%) and osteopaenia (defined as a T score between −1.0 and −2.5 SD) was observed in seven patients (50%). Five of the 14 patients (35.7%) were at or above the intervention threshold for hip fracture.ConclusionsThis study suggests an association between hypogonadism and low bone mass density in patients undertaking intrathecal opioid delivery for the management of chronic non-malignant pain. Surveillance of hypogonadism and the bone mineral density levels followed by appropriate treatment may be of paramount importance to reduce the risk of osteoporosis development and prevention of fractures in this group of patients.