bluuebunny/crossref_metadata_2025_split huggingface dataset:
Youth sports clubs’ potential as health-promoting setting: Profiles, motives and barriers
Authors: Meganck Jeroen , Scheerder Jeroen , Thibaut Erik , Seghers Jan 
Published: September 2014

Setting and Objective: For decades, the World Health Organisation has promoted settings-based health promotion, but its application to leisure settings is minimal. Focusing on organised sports as an important leisure activity, the present study had three goals: exploring the health promotion profile of youth sports clubs, identifying objective club characteristics (e.g. size, type of sport), predicting the presence/absence of health promotion in youth sports clubs and identifying perceived motives and barriers to health promotion in youth sports clubs, thereby improving the basis for policy guidelines. Method: Respondents were representatives from the board of 154 youth sports clubs. Data were collected through an online survey, including the health-promoting sports club index (HPSC-I). Linear regression and analysis of variance were used to identify predictors and differences. Results: Even though the motives were strongly supported, a majority of youth sports clubs were rated as low health promoting on the HPSC-I (59%). Overall, linear regression indicated that clubs founded more recently, offering multiple types of sports and offering both recreation and competition scored higher on the health promotion indices. Health promotion not being a priority of the board and lack of expertise were identified as the most important barriers. Conclusion: Progress is needed before youth sports clubs can truly be considered health-promoting settings. Policy suggestions are made to address the barriers, for example, financial incentives to maximise efforts and establishing collaborations between sports clubs and health promotion experts.
Perceived Racial Discrimination in Health Care, Completion of Standard Diabetes Services, and Diabetes Control Among a Sample of American Indian Women
Authors: Gonzales Kelly L. , Lambert William E. , Fu Rongwei , Jacob Michelle , Harding Anna K. 
Published: September 2014

Purpose The purpose of this study is to examine perceived experiences of racial discrimination (perceived discrimination) in health care and its associations with completing standards of care for diabetes management and diabetes control. Methods This cross-sectional study included 200 adult American Indian (AI) women with type 2 diabetes from 4 health care facilities located on tribal reservations in the Pacific Northwest. Participants completed a survey, and medical records were abstracted. Logistic regression was completed to assess associations. Results Sixty-seven percent of AI women reported discrimination during their lifetime of health care. After adjusting for patient characteristics, perceived discrimination was significantly associated with lower rates of dental exam; checks for blood pressure, creatinine, and total cholesterol; and pneumococcal vaccination. The association between perceived discrimination and total number of diabetes services completed was not statistically significant. Perceived discrimination was associated with having A1C values above target levels for diabetes control in unadjusted and adjusted models, but no association was observed for blood pressure or total cholesterol. Conclusions In our sample of AI women with diabetes, two-thirds reported experiencing racial discrimination in their health care experience. Those reporting perceived discrimination completed fewer diabetes services and therefore may be at increased risk for comorbidities of diabetes. This finding supports the continued need for culturally responsive health care and programs of diabetes education to recognize perceived discrimination and its potential to impact success in self-management and services utilization.
Increased Intracranial Pressure in Spontaneous CSF Leak Patients Is Not Associated with Papilledema
Authors: Aaron Geoffrey , Doyle Jennifer , Vaphiades Michael S. , Riley Kristen O. , Woodworth Bradford A. 
Published: September 2014

ObjectiveSpontaneous cerebrospinal fluid (CSF) leaks typically present in patients with undiagnosed idiopathic intracranial hypertension (IIH) secondary to pressure erosion of the skull base. Despite elevated intracranial pressure (ICP) on lumbar puncture or ventriculostomy, patients with spontaneous CSF leaks rarely complain of visual disturbances. The objective of this study is to correlate the presence of preoperative papilledema with opening ICP in patients undergoing endoscopic repair of spontaneous CSF leaks.Study DesignProspective study.SettingTertiary hospital.MethodsProspective evaluation of patients with spontaneous CSF leaks was performed over a 1‐year period (December 2012 to December 2013). Fundoscopic examination for papilledema was completed preoperatively and CSF pressure measured by lumbar puncture or ventriculostomy intraoperatively. Data regarding demographics, nature of presentation, and body mass index (BMI) were also recorded and compared to a control cohort of IIH patients with papilledema.ResultsSixteen patients (average age 52) were evaluated. Obesity was present in 94% of individuals (average BMI = 43, range, 27‐65). Papilledema was absent preoperatively in all subjects. Opening pressures via lumbar puncture/ventriculostomy were 27.4 ± 7.7 cmH20. Following 6 hours of clamping, measurements significantly increased to 36 ± 9.6 cmH20 (P <. 001). IIH controls (average age 33, average BMI = 36, range, 21‐52) exhibited average ICP (36.2 ± 11.7) identical to postclamp measurements in the spontaneous CSF leak cohort.ConclusionsSubjects with spontaneous CSF leaks had postclamping average ICP identical to controls with IIH and papilledema. Such evidence suggests that a CSF leak in this patient population provides sufficient pressure diversion to avoid the development of papilledema.
Red cell distribution width, gamma glutamyl transpeptidase and anticoagulant use affect mortality in acute arterial mesenteric ischemia
Authors: Dinc T , Yildiz BD , Kayilioglu I , Sozen I , Cete M , Coskun F 
Published: September 2014

Background: Despite advances in surgery and intensive care, mortality in acute mesenteric ischemia remains between 50% and 90%. In this study, we evaluated factors affecting mortality in acute arterial mesenteric ischemia. Methods: This is a retrospective cohort study involving 73 patients with an initial diagnosis of arterial acute mesenteric ischemia admitted to Ankara Numune Teaching Hospital between January 2008 and December 2013. We retrospectively collected data about demographic variables, co-morbidities, medications, extent of surgical resection, laboratory values, pathology results and outcome. Results: The mean age of the patients was 69.3±12.6. Thirty one patients were female (42.46%) and 42 (57.53%) were male. We divided the patients into two groups: Group 1 (n=40); those who died and Group 2 (n=33); those who were discharged. In multivariate analysis of high gamma glutamyl transpeptidase and red cell distribution width levels, the presence of anticoagulant use was statistically significant (p<0.05) in favor of Group 1. Conclusion: High red cell distribution width and gamma glutamyl transpeptidase levels and anti-coagulant use are factors affecting mortality in arterial acute mesenteric ischemia. The assessment of these variables could help predict the extent of arterial acute mesenteric ischemia and the mortality associated with it.
Tissue perfusion in neonates undergoing open-heart surgery using autologous umbilical cord blood or donor blood components
Authors: Chasovskyi K , Fedevych O , McMullan DM , Mykychak Y , Vorobiova G , Zhovnir V , Yemets I 
Published: September 2014

Background: This study evaluates the hemoglobin-oxygen relationship and tissue perfusion during cardiopulmonary bypass (CPB) in neonates undergoing open-heart surgery using autologous umbilical cord blood or donor blood components. Methods: We compared perioperative hematocrit (Hct), fetal hemoglobin (HbF), p50O2, pH, pCO2, serum lactate, duration of mechanical ventilation and intensive care unit (ICU) length of stay in neonates undergoing open-heart surgery using autologous umbilical cord blood (Group I, N=45) or donor blood components (Group II, N=65). The groups were similar with respect to diagnosis, weight, type of procedure, duration of CPB and duration of myocardial ischemia. Results: Mean p50O2 was significantly lower in Group I during CPB (19.7 vs. 22.3 mmHg, p=0.004) and at the end of CPB (20.1 vs. 22.8 mmHg, p=0.003). Median peak lactate during CPB was higher in Group I (4.8 vs. 2.2 mmol/l, p<0.001). Carbon dioxide tension was identified as an independent predictor of higher p50O2 during CPB in Group I (β=0.88, p=0.002), but not Group II. Bodyweight, Hct, duration of CPB, pre-CPB lactate level and pCO2 affected peak lactate level during CPB. Although mean duration of ventilation was longer in Group II (mean 51 vs. 43, p=0.004), the groups experienced similar duration of ICU stay (5.8 vs. 5.9 days, p=0.280). Conclusions: Despite the fact that the oxyhemoglobin dissociation curve is shifted leftward in patients who receive autologous umbilical cord blood, tissue oxygen delivery appears to be preserved in neonates who undergo open-heart surgery using autologous umbilical cord blood.
How hospice staff members prepare family caregivers for the patient’s final days of life: An exploratory study
Authors: Kehl Karen A 
Published: September 2014

Background: There is widespread agreement that the families of hospice patients need to be prepared for the final days of life, yet current practices preparing families are not well described. Examining the gap between family needs and current practice will inform the development of effective preparatory interventions. Aim: The purpose of the study was to describe how hospice clinicians prepare family for the final days of life, including (1) the content of the preparatory information, (2) strategies and timing of preparation, and whether the preparation is tailored, and (3) who prepares families. Design: Conventional content analysis guided this study. Individual interviews using semi-structured questions were conducted. Setting/participants: In all, 19 hospice clinicians who provided care in the home setting from two hospice agencies in the United States participated. Results: Preparatory messages included information on signs of impending death, symptoms, implications of the symptoms, what to expect next, and instructions on what to do. Commonly used strategies included listening, engendering trust, repetition, collaboration with other disciplines, and demonstrations. Staff tailored content and delivery of messages on patient, family, and hospice factors. Preparation usually occurred over time. All hospice staff provided preparatory information, but there are some differences by discipline. Conclusions: Most content previous identified as necessary for preparedness is part of the current preparation. The knowledge of the current practice in preparing families can be used to develop systematic means of assessing the factors related to timing and tailoring, which may assist in developing preparatory messages that are effective and timely.
Impact of a clinical pathway on end-of-life care following stroke: A mixed methods study
Authors: Cowey Eileen , Smith Lorraine N , Stott David J , McAlpine Christine H , Mead Gillian E , Barber Mark , Walters Matthew 
Published: September 2014

Background: Death after stroke is common, but little is known about end-of-life care processes in acute stroke units. Aim: (1) To identify family and health-care worker perceptions of an end-of-life care pathway for patients who die after acute stroke. (2) To determine whether patients with fatal stroke judged to require an end-of-life care pathway differ from patients with fatal stroke who die without introduction of such a pathway. Design: Mixed methods study integrating qualitative semistructured interviews with quantitative casenote review. Setting/participants: In four Scottish acute stroke units, 17 relatives of deceased stroke patients and 23 health-care professionals were interviewed. Thematic analysis used a modified grounded theory approach. Multivariate analysis was performed on casenote data, identified prospectively from 100 consecutive stroke deaths. Results: Deciding pathway use was a consultative process, occurring within normal working hours. Families were commonly involved and could veto or trigger aspects of end-of-life care. Families sometimes felt responsible for decisions such as pathway use, resuscitation or hydration. Families were often led to expect their relative’s death early in the post-stroke period. Prolonged dying processes, particularly where patients had severe dysphagia, added to distress for families. Preferences for place of care were discussed infrequently. No link was found between demographic or clinical characteristics and care pathway use. Conclusion: Distressing stroke-related clinical problems dominated relatives’ concerns rather than use of the end-of-life care pathway. At times, relatives felt primarily responsible for key aspects of decision-making. Relatives often felt unprepared for a prolonged dying process after stroke, particularly where patients had persistent major swallowing difficulties.
Risk Factors for Anterior Glenohumeral Instability
Authors: Owens Brett D. , Campbell Scot E. , Cameron Kenneth L. 
Published: September 2014

Background: While anterior glenohumeral instability has been shown to be common in young athletes, the risk factors for injury are poorly understood. Purpose/Hypothesis: To determine the modifiable and nonmodifiable risk factors for anterior shoulder instability in a high-risk cohort. The hypothesis was that specific baseline factors would be associated with the subsequent risk of injury. Study Design: Cohort study (prognosis); Level of evidence, 2. Methods: We conducted a prospective cohort study in which 714 young athletes were followed from June 2006 through May 2010. Baseline assessments included a subjective history of instability, physical examination by a sports medicine fellowship–trained orthopaedic surgeon, range of motion, strength with a handheld dynamometer, and bilateral noncontrast shoulder magnetic resonance imaging (MRI). A musculoskeletal radiologist measured glenoid version, glenoid height, glenoid width, glenoid index (height-to-width ratio), glenoid depth, rotator interval (RI) height, RI width, RI area, RI index, and the coracohumeral interval. Subjects were followed to document all acute anterior shoulder instability events during the 4-year follow-up period. The time to anterior shoulder instability event during the follow-up period was the primary outcome of interest. Univariate and multivariable Cox proportional hazards regression models were used to analyze the data. Results: Complete data were available for 714 subjects. During the 4-year surveillance period, there were 39 anterior instability events documented at a mean of 285 days. While we controlled for covariates, significant risk factors of physical examination were as follows: apprehension sign (hazard ratio [HR], 2.96; 95% CI, 1.48-5.90; P = .002) and relocation sign (HR, 4.83; 95% CI, 1.75-13.33; P = .002). Baseline range of motion and strength measures were not associated with subsequent injury. Significant anatomic risk factors on MRI measurement were glenoid index (HR, 8.12; 95% CI, 1.07-61.72; P = .043) and the coracohumeral interval (HR, 1.20; 95% CI, 1.08-1.34; P = .001). Conclusion: This prospective cohort study revealed significant risk factors for shoulder instability in this high-risk population. Physical examination findings of apprehension and relocation were significant while controlling for history of injury. The anatomic variables of significance were not surprising—tall and thin glenoids were at higher risk compared with short and wide glenoids, and the risk of instability increased by 20% for every 1-mm increase in coracohumeral distance.
Cardiopulmonary correlates of cognition in systemic lupus erythematosus
Authors: Kozora E , Zell J , Swigris J , Strand M , Duggan E C , Burleson A , Make B 
Published: September 2014

Objective We aimed to evaluate the relationship between cognitive dysfunction and lung function, exercise endurance, and self-reported activity levels in patients with systemic lupus erythematosus (SLE). Background Cognitive dysfunction is present in 20%–60% of SLE patients. No studies to date have investigated the inter-relationships between cardiopulmonary factors and cognition in this population. Methods Thirty-seven SLE patients without overt neuropsychiatric histories and 16 healthy controls completed neuropsychological testing, measures of lung function, exercise capacity (distance walked during a timed walk test,1 maximal oxygen uptake2), and exercise questionnaires. Results Thirty-two percent of SLE patients demonstrated cognitive impairment. Cognitive impairment was correlated with Six-Minute Walk Distance (6MWD) ( r = 0.37, p = 0.02) and certain measures of lung function. Also, in SLE patients, self-reported physical activity was correlated with 6MWD ( p = 0.012), but none of the more complex measures of physical activity (VO2max). Conclusions Patients with mild SLE disease activity have cognitive dysfunction associated with certain objective markers of exercise capacity and activity levels. The lack of associations between self-report activity and VO2max suggests the possibility that multiple factors mediate the relationships between perceived and actual physical ability. Additional studies are needed to better understand the relationship between cognition and physical activity in patients with SLE.
Comparison of Cannulated Screws Versus Compression Staples for Subtalar Arthrodesis Fixation
Authors: Herrera-Pérez Mario , Andarcia-Bañuelos Cesar , Barg Alexej , Wiewiorski Martin , Valderrabano Victor , Kapron Ashley L. , De Bergua-Domingo Josep Maria , Pais-Brito Jose Luis 
Published: September 2014

Background: Different fixation techniques have been described in the literature for isolated subtalar arthrodesis (ISA). The purpose of this study was to compare the fusion rate and clinical outcome of ISA using cannulated compression screws or compression staples. Methods: Thirty-three patients (33 feet) underwent ISA using screw (17 feet) or staples (16 feet) fixation. Patients were followed for 42.7 ± 16.4 months (range, 24.5-84.3 months). The subtalar fusion was assessed radiographically and clinically. Clinical outcome measures included the visual analog scale (VAS) for pain and American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score. Results: The average pain score decreased significantly from 6.4 ± 1.1 (range, 5-9) to 0.8 ± 1.3 (range, 0-4) ( P < .001). In the screws group, the average AOFAS hindfoot score increased significantly from 54.6 ± 8.8 (range, 37-67) preoperatively to 86.1 ± 7.1 (range, 71-91) postoperatively ( P < .001). In the staples group, the average AOFAS hindfoot score increased significantly from 53.4 ± 11.1 (range, 33-69) preoperatively to 83.4 ± 6.9 (range, 71-91) postoperatively ( P < .001). The AOFAS hindfoot score was comparable in both groups ( P = .149). Only the AOFAS hindfoot score function subgroup in the screw fixation was significantly higher than in the staples fixation group ( P = .005). There were 4 cases of nonunion at the site of subtalar arthrodesis (2 from screws group, 2 from staples group). The complication rate was comparable in both groups. Conclusion: The fusion rate was comparable in both groups, while the postoperative functional outcome was significantly better in the screw fixation group. Level of Evidence: Level III, retrospective comparative cohort study.
The Effect of Ankle Joint Immobilization on Lower Limb Venous Flow
Authors: Craik Johnathan D. , Clark Amanda , Hendry James , Sott Andrea H. , Hamilton Paul D. 
Published: September 2014

Background: Below-knee cast immobilization is associated with an increased risk of developing deep vein thrombosis secondary to venous stasis. We investigated the effect of weight-bearing in a below-knee cast or pneumatic walking boot on lower limb venous blood flow. Methods: Duplex ultrasonography was used to measure venous blood flow in the popliteal vein of 10 healthy volunteers. Venous blood flow was measured while at rest, ambulating non-weight-bearing, partial weight-bearing, and full weight-bearing. Measurements were performed without ankle joint immobilization, with the ankle immobilized in a neutral cast, and with the ankle immobilized in a pneumatic walking boot in both neutral and equinus. Results: There was no significant reduction in venous blood flow measurements between full weight-bearing without ankle joint immobilization and full weight-bearing in a neutral cast or neutral pneumatic walking boot. However, venous blood flow was reduced when partial weight-bearing (50%) and when full weight-bearing in a pneumatic walking boot in equinus. Conclusion: These results demonstrate that venous blood flow returned to normal levels when the subjects were permitted to fully bear weight in below-knee casts or walking boots, provided that the ankle joint was not in equinus. Clinical Relevance: Weight-bearing status and ankle joint position should be appreciated during decisions for the provision of chemical thromboprophylaxis.
Cryopreserved Human Amniotic Membrane Injection for Plantar Fasciitis
Authors: Hanselman Andrew E. , Tidwell John E. , Santrock Robert D. 
Published: September 2014

Background: Treatment options for plantar fasciitis have resulted in varied patient outcomes. The aim of this study was to compare a novel treatment, cryopreserved human amniotic membrane (c-hAM), to a traditional treatment, corticosteroid. Our hypothesis was that c-hAM would be safe and comparable to corticosteroids for plantar fasciitis in regard to patient outcomes. Methods: A randomized, controlled, double-blind, single-center pilot study was completed. Patients were randomized into one of 2 treatment groups: c-hAM or corticosteroid. Patients received an injection at their initial baseline visit with an option for a second injection at their first 6-week follow-up. Total follow-up was obtained for 12 weeks after the most recent injection. The primary outcome measurement was the Foot Health Status Questionnaire (FHSQ). The secondary outcome measurements were the Visual Analog Scale (VAS) and verbally reported percentage improvement. Data were analyzed between groups for the 2 different cohorts (1 injection versus 2 injections). Twenty-three patients had complete follow-up. Fourteen were randomized to receive corticosteroid and 9 were randomized to receive c-hAM. Results: Three patients in each group received second injections. With the numbers available, the majority of outcome measurements showed no statistical difference between groups. The corticosteroid did, however, have greater FHSQ shoe fit improvement ( P = .0244) at 6 weeks, FHSQ general health improvement ( P = .0132) at 6 weeks, and verbally reported improvement ( P = .041) at 12 weeks in the one-injection cohort. Cryopreserved hAM had greater FHSQ foot pain improvement ( P = .0113) at 18 weeks in the 2-injection cohort. Conclusion: Cryopreserved hAM injection may be safe and comparable to corticosteroid injection for treatment of plantar fasciitis. This is a pilot study and requires further investigation. Level of Evidence: Level I, prospective randomized trial.