bluuebunny/crossref_metadata_2025_split huggingface dataset:
Smoking cessation in adults with diabetes: a systematic review and meta-analysis of data from randomised controlled trials
Authors: Nagrebetsky Alexander , Brettell Rachel , Roberts Nia , Farmer Andrew 
Published: March 2014

ObjectivesTo evaluate the effects of more intensive smoking cessation interventions compared to less intensive interventions on smoking cessation in people with type 1 or type 2 diabetes.DesignA systematic review and meta-analysis of randomised trials of smoking cessation interventions was conducted. Electronic searches were carried out on the following databases: MEDLINE, EMBASE, CINAHL and PsycINFO to September 2013. Searches were supplemented by review of trial registries and references from identified trials. Citations and full-text articles were screened by two reviewers. A random-effect Mantel-Haenszel model was used to pool data.SettingPrimary, secondary and tertiary care.ParticipantsAdults with type 1 or type 2 diabetes.InterventionsSmoking cessation interventions or medication (more intensive interventions) compared to usual care, counselling or optional medication (less intensive interventions).Outcome measuresBiochemically verified smoking cessation was the primary outcome. Secondary outcomes were adverse events and effects on glycaemic control. We also carried out a pooled analysis of self-reported smoking cessation outcomes.ResultsWe screened 1783 citations and reviewed seven articles reporting eight trials in 872 participants. All trials were of 6 months duration. Three trials included pharmacotherapy for smoking cessation. The risk ratio of biochemically verified smoking cessation was 1.32 (95% CI 0.23 to 7.43) for the more intensive interventions compared to less intensive interventions with significant heterogeneity (I2=76%). Only one trial reported measures of glycaemic control.ConclusionsThere is an absence of evidence of efficacy for more intensive smoking cessation interventions in people with diabetes. The more intensive strategies tested in trials to date include interventions used in the general population, adding in diabetes-specific education about increased risk. Future research should focus on multicomponent smoking cessation interventions carried out over a period of at least 1 year, and also assess impact on glycaemic control.
Assessing communication quality of consultations in primary care: initial reliability of the Global Consultation Rating Scale, based on the Calgary-Cambridge Guide to the Medical Interview
Authors: Burt Jenni , Abel Gary , Elmore Natasha , Campbell John , Roland Martin , Benson John , Silverman Jonathan 
Published: March 2014

ObjectivesTo investigate initial reliability of the Global Consultation Rating Scale (GCRS: an instrument to assess the effectiveness of communication across an entire doctor–patient consultation, based on the Calgary-Cambridge guide to the medical interview), in simulated patient consultations.DesignMultiple ratings of simulated general practitioner (GP)–patient consultations by trained GP evaluators.SettingUK primary care.Participants21 GPs and six trained GP evaluators.Outcome measuresGCRS score.Methods6 GP raters used GCRS to rate randomly assigned video recordings of GP consultations with simulated patients. Each of the 42 consultations was rated separately by four raters. We considered whether a fixed difference between scores had the same meaning at all levels of performance. We then examined the reliability of GCRS using mixed linear regression models. We augmented our regression model to also examine whether there were systematic biases between the scores given by different raters and to look for possible order effects.ResultsAssessing the communication quality of individual consultations, GCRS achieved a reliability of 0.73 (95% CI 0.44 to 0.79) for two raters, 0.80 (0.54 to 0.85) for three and 0.85 (0.61 to 0.88) for four. We found an average difference of 1.65 (on a 0–10 scale) in the scores given by the least and most generous raters: adjusting for this evaluator bias increased reliability to 0.78 (0.53 to 0.83) for two raters; 0.85 (0.63 to 0.88) for three and 0.88 (0.69 to 0.91) for four. There were considerable order effects, with later consultations (after 15–20 ratings) receiving, on average, scores more than one point higher on a 0–10 scale.ConclusionsGCRS shows good reliability with three raters assessing each consultation. We are currently developing the scale further by assessing a large sample of real-world consultations.
The impact of re-education of airway clearance techniques (REACT) on adherence and pulmonary function in patients with cystic fibrosis
Authors: Zanni Robert L , Sembrano Eduardo U , Du Doantrang T , Marra Bridget , Bantang Ronald 
Published: March 2014

BackgroundOur centre's median forced expiratory volume in one second (FEV1) reported in the 2005 Cystic Fibrosis (CF) Foundation Patient Registry was below the national median. The focus of our quality improvement initiative was to improve lung function through re-education of airway clearance techniques (REACT).AimThe global aim was to improve the median FEV1in our patients. The specific aim was to encourage adherence to airway clearance techniques (ACT). To achieve these goals we implemented the REACT programme for patients.MethodsEducational sessions introduced the concept of improving clinical outcomes and the importance of airway clearance in achieving optimal lung function. The REACT programme utilised an anonymous survey, in-clinic questionnaire and ACT demonstration to assess knowledge, practices and barriers to ACT. Patients were then categorised as non-adherent or adherent with correct or incorrect technique. Improper techniques were corrected. All patients were re-educated on the rationale for ACT.ResultsOur surveys revealed that 43% of patients had barriers to ACT and 53% were non-adherent. Following implementation of REACT, median FEV1increased from 84% to 92% (national median 91–94%) from 2005 to 2010 for patients aged 6–17. For patients 18 and older, median FEV1increased from 56% to 64% (national median 62–65%) from 2005 to 2010.ConclusionsBy introducing a programme focused on technique and adherence, we were able to improve median FEV1in patients with CF. Sustained improvement of FEV1was accomplished by continued use of the REACT programme.
Accelerating implementation of biomedical research advances: critical elements of a successful 10 year Cystic Fibrosis Foundation healthcare delivery improvement initiative
Authors: Marshall Bruce C , Nelson Eugene C 
Published: March 2014

Context: Scientific and therapeutic advancesRemarkable biomedical research advances have led to innovative and increasingly effective therapies. We highlight several scientific milestones in elucidating the pathophysiology of cystic fibrosis (CF) and review the therapies that have become available over the past 20 years.Impact of the quality improvement initiativeIn 2002, the CF Foundation launched a multifaceted quality improvement initiative to accelerate improvement in CF care. We present evidence of substantial improvement in process measures, such as more consistent outpatient follow-up, and key medical outcomes, including survival, pulmonary function and nutritional status.Critical success factorsWe offer our perspective on factors critical to the success of the quality improvement initiative, including a compelling strategic plan and the commitment of the CF Foundation to its implementation; the investment in building improvement capacity at CF care centres; the engagement of people with CF and their families as partners; and the integration of quality improvement into the existing CF care framework.Directions for the next decadeIn addition to a continued investment in building and sustaining improvement capacity at CF care centres, and deeper patient engagement, we will address the oppressive treatment burden. We will also complement the measurement of clinical outcomes with patient reported outcomes and healthcare costs for a balanced assessment of the quality and value of care.ConclusionsMajor advances in basic science and therapeutic development coupled with improvements in healthcare delivery have resulted in striking gains in medical outcomes for people with CF.
Female users of internet-based screening for rectal STIs: descriptive statistics and correlates of positivity
Authors: Ladd Jessica , Hsieh Yu-Hsiang , Barnes Mathilda , Quinn Nicole , Jett-Goheen Mary , Gaydos Charlotte A 
Published: March 2014

BackgroundInternet-based screening for vaginal sexually transmitted infections (STI) has been shown to reach high-risk populations. Published studies of internet-based screening for rectal STIs in women are needed. Our objectives were to describe the female users of a rectal internet-based screening intervention and assess what factors correlated with rectal positivity for STIs.MethodsThe websitehttp://www.iwantthekit.orgoffers free STI testing via home self-sampling kits. Women could order vaginal and rectal kits, both containing questionnaires. Rectal and vaginal swabs were tested forChlamydia trachomatis,Neisseria gonorrhoeaeandTrichomonas vaginalisusing nucleic acid amplification tests. Data were analysed from 205 rectal kits from January 2009 through February 2011. Self-reported characteristics of participants were examined, and correlates of rectal STI positivity were analysed.ResultsOf the 205 rectal samples returned and eligible for testing, 38 (18.5%) were positive for at least one STI. The women were young (mean age 25.8 years), mostly African–American (50.0%), and only 14.0% always used condoms. After adjusting for age and race, Black race (AOR=3.06) and vaginal STI positivity (AOR=40.6) were significantly correlated with rectal STI positivity. Of women testing positive for rectal STIs who also submitted vaginal swabs, 29.4% were negative in the vaginal sample.ConclusionsInternet-based rectal screening can reach populations that appear to be at high risk for rectal STIs (18.5% prevalence) and led to the diagnosis of STIs in women who would not have been diagnosed vaginally. Black race and vaginal STI positivity were highly correlated with rectal STI positivity.
Impact of a Biospecimen Collection Seminar on Willingness to Donate Biospecimens among Chinese Americans: Results from a Randomized, Controlled Community-Based Trial
Authors: Tong Elisa K. , Fung Lei-Chun , Stewart Susan L. , Paterniti Debora A. , Dang Julie H.T. , Chen Moon S. 
Published: March 2014

Abstract
Background: Biospecimen collection from diverse populations can advance cancer disparities research, but is currently underrepresented.
Methods: We partnered with a community-based clinic serving Cantonese-speaking Chinese Americans to develop and revise an educational seminar on biospecimen collection. Through a randomized controlled trial (n = 395), the intervention seminar was compared with a control seminar (cancer prevention) on change in willingness to donate biospecimens.
Results: At baseline, many were willing to donate a biospecimen (saliva, urine, hair, toenails, blood, unused cancerous tissue) whether healthy or hypothetically had cancer. Also, many would donate because future generations would benefit, and few had concerns about donation. In logistic regression analyses, there was an intervention effect for willingness to donate: urine if had cancer [OR, 2.2; 95% confidence interval (CI), 1.3–3.7], toenails if healthy (OR, 2.1; 95% CI, 1.4–3.2) or had cancer (OR, 2.3; 95% CI, 2.0–2.7), hair if healthy (OR, 1.8; 95% CI, 1.3–2.5) or had cancer (OR, 2.8; 95% CI, 1.9–4.0), and unused cancerous tissue (OR, 1.8; 95% CI, 1.2–2.9). There was also an intervention effect for donating because future generations would benefit (OR, 2.0; 95% CI, 1.4–3.0), and this attitude was a strong independent predictor for willingness to donate all biospecimens, whether healthy or had cancer (OR, 2.9–4.2).
Conclusion: Cantonese-speaking Chinese American participants of an educational seminar on biospecimen collection showed greater increases in willingness to donate biospecimens and donating for the benefit of future generations, than participants who attended a control seminar.
Impact: Donating for the benefit of future generations is a theme that should be incorporated in messages that encourage biospecimen donation for Chinese Americans.
See all articles in this CEBP Focus section, “Community Network Program Centers.”
Cancer Epidemiol Biomarkers Prev; 23(3); 392–401. ©2014 AACR.
Development and Validation of the Biobanking Attitudes and Knowledge Survey (BANKS)
Authors: Wells Kristen J. , Arevalo Mariana , Meade Cathy D. , Gwede Clement K. , Quinn Gwendolyn P. , Luque John S. , San Miguel Gloria , Watson Dale , Phillips Rebecca , Reyes Carmen , Romo Margarita , West Jim , Jacobsen Paul B. 
Published: March 2014

Abstract
Background: No validated multiscale instruments exist that measure community members' views on biobanking and biospecimen donation. This study describes the development and psychometric properties of the English-language BANKS (Biobanking Attitudes and Knowledge Survey).
Methods: The BANKS was created by item generation through review of scientific literature, focus groups with community members, and input from a community advisory board. Items were refined through cognitive interviews. Content validity was assessed through an expert panel review. Psychometric properties of the BANKS were assessed in a sample of 85 community members.
Results: The final BANKS includes three scales: attitudes, knowledge, and self-efficacy; as well as three single items, which evaluated receptivity and intention to donate a biospecimen for research. Cronbach α coefficients for two scales that use Likert response format indicated high internal consistency (attitudes: α, 0.88; self-efficacy: α, 0.95). Content validity indices were moderate, ranging from 0.69 to 0.89. Intention to donate blood and intention to donate urine were positively correlated with attitudes, knowledge, self-efficacy, and receptivity to learning more about biobanking (P values range from 0.029 to &lt;0.001).
Conclusions: The final BANKS shows evidence of satisfactory reliability and validity, is easy to administer, and is a promising tool to inform biospecimen research. Additional studies should be conducted with larger samples considering biospecimen donation to further assess the reliability and validity of the instrument.
Impact: A valid and reliable instrument measuring community members' views about biobanking may help researchers evaluate relevant communication interventions to enhance understanding, intention, and actual biospecimen donation. A Spanish-language BANKS is under development.
See all articles in this CEBP Focus section, “Community Network Program Centers.”
Cancer Epidemiol Biomarkers Prev; 23(3); 374–82. ©2014 AACR.
Effective Recruitment Strategies and Community-Based Participatory Research: Community Networks Program Centers' Recruitment in Cancer Prevention Studies
Authors: Greiner K. Allen , Friedman Daniela B. , Adams Swann Arp , Gwede Clement K. , Cupertino Paula , Engelman Kimberly K. , Meade Cathy D. , Hébert James R. 
Published: March 2014

Abstract
Background: Community-based participatory research (CBPR) approaches that involve community and academic partners in activities ranging from protocol design through dissemination of study findings can increase recruitment of medically underserved and underrepresented racial/ethnic minority populations into biomedical research.
Methods: Five cancer screening and prevention trials in three National Cancer Institute (Bethesda, MD)–funded Community Networks Program Centers (CNPC), in Florida, Kansas, and South Carolina, were conducted across diverse populations. Data were collected on total time period of recruitment, ratios of participants enrolled over potential participants approached, selected CBPR strategies, capacity-building development, and systematic procedures for community stakeholder involvement.
Results: Community-engaged approaches used included establishing colearning opportunities, participatory procedures for community–academic involvement, and community and clinical capacity building. A relatively large proportion of individuals identified for recruitment was actually approached (between 50% and 100%). The proportion of subjects who were eligible among all those approached ranged from 25% to more than 70% (in the community setting). Recruitment rates were very high (78%–100% of eligible individuals approached) and the proportion who refused or who were not interested among those approached was very low (5%–11%).
Conclusions: Recruitment strategies used by the CNPCs were associated with low refusal and high enrollment ratios of potential subjects. Adherence to CBPR principles in the spectrum of research activities, from strategic planning to project implementation, has significant potential to increase involvement in biomedical research and improve our ability to make appropriate recommendations for cancer prevention and control programming in underrepresented diverse populations.
Impact: CBPR strategies should be more widely implemented to enhance study recruitment.
See all articles in this CEBP Focus section, “Community Network Program Centers.”
Cancer Epidemiol Biomarkers Prev; 23(3); 416–23. ©2014 AACR.
Clinic Type and Patient Characteristics Affecting Time to Resolution After an Abnormal Cancer-Screening Exam
Authors: Krok JL , Kurta ML , Weier RC , Young GS , Carey AB , Tatum CM , Paskett ED 
Published: March 2014

Abstract
Research shows that multilevel factors influence health care delivery and patient outcomes. The goal of this study was to examine how clinic type (primary care clinic within an academic medical center (AMC) or federally-qualified health center (FQHC)) and patient characteristics influence time to resolution (TTR) among individuals enrolled in a patient navigation (PN) intervention. Data were obtained from the Ohio Patient Navigation Research Project, a group randomized trial in which 862 patients from 18 clinics in Columbus, OH participated. Patient's TTR after an abnormal breast, cervical, or colorectal test and the clinics' patient and provider characteristics were obtained. Descriptive statistics and Cox shared frailty proportional hazards regression models of TTR were used to analyze the data. The mean patient age was 44.8 years and 71% of patients were White. In models adjusted for study arm, the interaction between time and study arm and a clinic random effect, FQHC patients had a 39% lower rate of resolution than AMC patients (HR = 0.61, p = 0.004); college educated patients had an 87% higher rate of resolution than patients with less than a high school education (HR = 1.87, p = 0.0007); privately insured patients had a 79% higher rate of resolution than uninsured patients (HR = 1.79, p &lt; 0.0001); patients with annual incomes ≥ $50,000 had a 51% higher rate of resolution than patients with annual incomes &lt; $10,000 (HR = 1.51, p = 0.02); and there was a 4% increase in the rate of resolution for each five year increase in patient age (HR = 1.04, p = 0.004). After using multiple imputation to impute income and insurance status where missing, factors that potentially confounded the effect of clinic type on TTR were assessed using forward selection. After adjustment for patient insurance status, education level and age, clinic type was not significantly associated with TTR. Controlling for clinic type, patient insurance status and age were significantly associated with TTR (p = 0.005 and p = 0.01, respectively) and patient education level was marginally significant (p = 0.06). These results suggest that TTR among individuals participating in PN programs is influenced by multiple socioeconomic (SES) patient-level factors rather than clinic type. Consequently, PN interventions should be tailored to address SES factors that influence TTR within patient populations.
Collagen Fiber Alignment in Relation to Prognostic Markers for Ductal Carcinoma In Situ of the Breast
Authors: Trentham-Dietz A , Sprague BL , Conklin MW , Hampton JM , Gangnon RE , Eliceiri KW , Newcomb PA , Friedl A , Kelly PJ 
Published: March 2014

Abstract
Almost 20% of new diagnoses of breast cancer are ductal carcinoma in situ (DCIS). DCIS increases risk for invasive breast cancer, and new prognostic markers of disease-free survival are needed to complement the few that are known. Limited studies have investigated the prognostic value of the tumor microenvironment, which is increasingly recognized as potentially playing a key role in tumor invasion and progression. Collagen is the most abundant component of the stroma surrounding the breast ducts, and laboratory studies suggest that collagen alignment facilitates cancer cell invasion and migration. Here we examined whether collagen alignment patterns in human DCIS specimens correlate with known prognostic markers. We evaluated collagen fiber alignment in 235 Wisconsin women diagnosed with DCIS in 1997–2000 who participated in a clinicopathologic cohort study. Fiber alignment was evaluated from routine H&E tissue slides prepared at the time of diagnosis using second harmonic generation (SHG) microscopy, a label-free multiphoton laser scanning technique that selectively images collagen. Images were evaluated for the presence of collagen fibers arranged in a radial pattern (approximately 75- to 90-degree angles) with respect to the DCIS lesion/stroma boundary, a phenotype termed TACS (Tumor Associated Collagen Signature). Chi-square tests were used to compare presence or absence of TACS with prognostic factors from a central review of pathology reports and slides, and analysis of tissue for ER, PR, Ki-67, and HER2. Overall, slides for about half (49.8%) of DCIS cases showed the TACS phenotype. TACS was not associated with age of the cases (P = 0.29), size of the lesion (P = 0.76), grade (P = 0.61), or margin size (P = 0.77). However, results suggested that TACS was more common (63.1%) among DCIS cases detected symptomatically than by mammography (47.3%, P = 0.09). TACS was more common among cases that were ER-negative (P = 0.002), PR-negative (P = 0.02), Ki-67 positive (P = 0.06), and HER2-positive (P = 0.002). This study underscores the relevance of the tumor microenvironment, in particular the arrangement of the collagen fiber matrix. On-going analysis will examine disease-free survival among DCIS cases according to patterns of collagen fiber alignment.