bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of a Romanian scale to detect antenatal depression
Authors: Wallis Anne , Fernandez Roberto , Oprescu Florin , Cherecheş Răzvan , Zlati Alina , Dungy Claibourne 
Published: December 2011

AbstractThe aim of this study was to develop and validate a linguistically and culturally appropriate version of the Edinburgh Postnatal Depression Scale (EPDS) for use with women attending antenatal care in Romania. We translated and tested a Romanian version of the EPDS (EPDS-R) in four hospitals in three Romanian cities: Cluj-Napoca, Satu Mare, and Sighetu-Marmatiei. The study population included third-trimester women attending antenatal clinics (n=418); 364 subjects were included in the analytic sample. We used the Center for Epidemiologic Studies Depression Scale (CES-D) as a “gold standard”. We assessed reliability, validity, and conducted sensitivity analysis to establish an EPDS-R cutpoint. We found that reliability was robust (α=0.89) and there was a significant linear relationship between EPDS-R and CES-D scores (r=0.77; p<0.001). We established an EPDS-R cutpoint of >12 to balance sensitivity and specificity. Principal component analysis revealed a two-factor solution. We detected antenatal depressive symptoms prevalence rates of 32% (CES-D) and 38% (EPDS-R). This is the first study to report exclusively on antenatal depression and the use of the EPDS in Central and Eastern Europe. The EPDS-R is easy to administer, reliable, and valid for screening depression among antenatal women in Romania.
Assessment of immunization Status of Children between 12-23 months in Bareilly District
Authors: Joshi Hari S , Gupta Rakesh , Singh Arun , Mahajan Vipul 
Published: December 2011

Objectives: To assess the immunization status of children in the age group 12-23 months and to know the reasons for non-immunization of children. Method: - A cross-sectional survey was conducted using WHO’s thirty cluster sampling technique in rural and urban areas of Bareilly district from August 2008 to January 2009. Rural areas were divided into blocks and blocks were divided into villages. Urban areas were divided into wards. Villages and wards were taken as clusters. During the house-to-house survey, a total of 240 children of age 12-23 months were included in the present study. Result: only around 50% of children were fully immunized while 27.5% were partially and 22.5 % were not immunized at all. Immunization coverage was highest for BCG (62.5%) and lowest for measles (39.2%). Dropout rates were 37.3%, 19.7% and 18.2% for BCG to measles, DPT1 to DPT3 and OPV1 to OPV3 respectively. Vitamin A prophylaxis showed a decline from 38.3 % to 16.7%. Amongst the various reasons for not immunizing the child, the most common in both rural (78.7%) and urban areas (28.6%) was lack of awareness for the need of vaccination. However in rural areas lack of availability of services (87.2%) was the major cause for not immunizing the child. Conclusion: The present study shows a low coverage of immunization and Vitamin A prophylaxis in both rural and urban areas. Important reasons for non-immunization were lack of awareness about vaccination and availability of immunization services in rural areas and urban areas.Key Words: Immunization coverage; Children between 12-23 months; Vitamin A Prophylaxis.DOI: http://dx.doi.org/10.3126/nje.v1i2.5091 Nepal Journal of Epidemiology 2011;1 (2):47-50
Diagnostic Accuracy of Serological Markers in Viral Hepatitis and Non Alcoholic Fatty Liver Disease. A Comparative Study in Tertiary Care Hospital of Western Nepal
Authors: Mittal Ankush , Sathian Brijesh , Chandrasekharan Nishida , Lekhi Akshay , Farooqui Shamim Mohammad , Pandey Naresh 
Published: December 2011

Background: Liver diseases is apparently increasing and emerging as a major public health problem. Worldwide, chronic hepatitis B has become the tenth leading cause of death and persons infected with chronic hepatitis B virus (HBV) and hepatitis C virus (HCV), are about 350 million and 125 million respectively. The aim of current retrospective comparative study was concerned primarily to evaluate the significance of non invasive serological markers for diagnosing liver diseases and their predictive implications in Pokhara valley. Materials and Methods: It was a hospital based retrospective study carried out using the data maintained in the Department of Biochemistry of the Manipal Teaching Hospital, Pokhara, Nepal between 1st June 2009 and 31st October 2010. The variables collected were total protein, albumin, AST, ALT, total bilirubin, direct bilirubin. Descriptive statistics and testing of hypothesis were used for the analysis. Data was analyzed using EPI INFO and SPSS 16 software. Results: Of 515 subjects, 120 were suffering from viral hepatitis and 88 had non alcoholic fatty liver disease. In cases of viral hepatitis, mean values of AST (CI 730.65 to 902.68) and ALT (CI 648.14 to 847.59) were markedly increased as compared to controls. Mild to moderate elevations in serum levels of aspartate aminotransferase (CI 43.42 to 49.49), alanine aminotransferase (CI 43.90 to 53.92) were the most common laboratory abnormalities found in patients with nonalcoholic fatty liver disease. Conclusion: Non invasive tests have demonstrated a reasonable ability to identify significant fibrosis, cirrhosis in particular, nor is it surprising that liver disease specialists and patients favour a non invasive approach.Key words: Viral hepatitis; Nonalcoholic fatty liver disease; Nepal.DOI: http://dx.doi.org/10.3126/nje.v1i2.5137 Nepal Journal of Epidemiology 2011;1 (2):60-63
An Assessment of Asymptomatic Bacteriuria among Women with Vesico-Vaginal Fistula in South-Eastern Nigeria
Authors: Adeoye Ileogben Sunday , Oladeinde Oladapo , Uneke Jesse , Adeoye Julie 
Published: December 2011

Objective: Vesico-vaginal fistula (VVF) involves the pathological communication between the urinary bladder and vagina, possible complications arising from urinary tract infection merits consideration. This study seeks to evaluate significant bacteriuria among VVF clients. Setting: The setting was the South east Fistula Centre, Abakaliki, Ebonyi State, Nigeria. Population: This was a total population study of all consenting HIV negative VVF clients. Method: This cross-sectional study assessing asymptomatic bacteriuria was conducted among 109 HIV negative VVF clients using standard microbiological technique. Haematological and anthropometric parameters were also assessed. Results: The prevalence of asymptomatic bacteriuria was 76.1% and the highest prevalence was among clients aged 21-30years (90.3%), those who have had more than seven deliveries (85.0%) and those whose labour duration lasted above 48hours (76.7%). The prevalence of bacteriuria was least among women with VVF for less than a year. The prevalence was highest among patients with intra cervical fistula (83.3%). Bacteriuria prevalence was highest among women of blood group AB (100%). The rate was higher among women whose heights were > 1.53metres and whose weights were < 51kilogram. Six different bacterial species isolated include E. coli (41.0%), Proteus species (21.7%), and Klebsiella species (18.1%). Though the bacterial isolates were resistance to many of the antibiotics assessed, the highest level of resistance was observed with perfloxacin, cotrimoxazole, while the highest level of susceptibility was with Ciprofloxacin. Conclusion: The prevalence of bacteriuria in this study is rather high and should not be neglected in the management of VVF clients.Key Words: Assessment; Asymptomatic Bacteriuria; VVF; Southeast Nigeria.DOI: http://dx.doi.org/10.3126/nje.v1i2.5141 Nepal Journal of Epidemiology 2011;1 (2):64-69
Extracorporeal Shockwave Lithotripsy in the Management of a Large Proximal Ureteric Stone: A Case Report
Authors: Freeg Mohammad A H Aly , Ranade Anu V , Muttappallymyalil Jayakumary , Ghaffar Tarek F A 
Published: December 2011

Urinary stone disease still persists as a major health care problem due to its high prevalence. The management of patients with ureteral stones still remains under debate in several areas. There are different therapeutic approaches for ureteral stones depending on stone size, location, anatomical variations of the urogenital tract and patient performance. Extracorporeal shockwave lithotripsy (ESWL) being the main stay of treatment of choice for the stones, the management of large stone remains a point of discussion. With the latest advance in technology coupled with knowledge, there have been recent changes in therapeutic options for ureteric stones. Therefore, the treatment approaches may be individualized in order to achieve optimum outcomes. This article reports on a case of a large proximal ureteric stone with acute flank pain and hematuria managed by ESWL. Key words: Urinary stone; Ureteric stone; ESWL.DOI: http://dx.doi.org/10.3126/nje.v1i2.5144 Nepal Journal of Epidemiology 2011;1 (2):70-73
Pharyngeal motor evoked potentials elicited by transcranial electrical stimulation for intraoperative monitoring during skull base surgery
Authors: Fukuda Masafumi , Oishi Makoto , Hiraishi Tetsuya , Saito Akihiko , Fujii Yukihiko 
Published: December 2011

Object
The purpose of this study was to determine whether monitoring of pharyngeal motor evoked potentials (PhMEPs) elicited by transcranial electrical stimulation during skull base tumor surgery might be useful for predicting postoperative swallowing deterioration.

Methods
The authors analyzed PhMEPs in 21 patients during 22 surgical procedures for the treatment of skull base tumors. Corkscrew electrodes positioned at C3 or C4 and Cz were used to deliver supramaximal stimuli (220–550 V). Pharyngeal MEPs were recorded from the posterior wall of the pharynx through a modified endotracheal tube. The correlation between the final/baseline PhMEP ratio and postoperative swallowing function was examined.

Results
Postoperative swallowing function was significantly (p < 0.05), although not strongly (r = −0.47), correlated with the final/baseline PhMEP ratio. A PhMEP ratio < 50% was recorded during 4 of 22 procedures; in all 4 of these cases, the patients experienced postoperative deterioration of swallowing function. After 18 procedures, the PhMEP ratios remained > 50%; nevertheless, after 4 (22.2%) of these 18 procedures, patients showed deterioration of swallowing function.

Conclusions
Intraoperative PhMEP monitoring can be useful for predicting swallowing deterioration following skull base surgery, especially in patients with swallowing disturbances that are mainly due to reduction in the motor functions of the pharyngeal muscles.
Flexible Modeling of Malignant Melanoma Survival
Authors: Eckel K. T. , Pfahlberg A. , Gefeller O. , Hothorn T. 
Published: December 2011

Summary

Objectives:
This paper compares the diagnostic capabilities of flexible ensemble methods modeling the survival time of melanoma patients in comparison to the well established proportional hazards model. Both a random forest type algorithm for censored data as well as a model combination of the proportional hazards model with recursive partitioning are investigated.

Methods:
Benchmark experiments utilizing the integrated Brier score as a measure for goodness of prediction are the basis of the performance assessment for all competing algorithms. For the purpose of comparing regression relationships represented by the models under test, we describe fitted conditional survival functions by a univariate measure derived from the area under the curve. Based on this measure, we adapt a visualization technique useful for the inspection and comparison of model fits.

Results:
For the data of malignant melanoma patients the predictive performance of the competing models is on par, allowing for a fair comparison of the fitted relationships. Newly introduced MODplots visualize differences in the fitting structure of the underlying models.

Conclusion:
The paper provides a framework for comparing the predictive and diagnostic performance of a parametric, a non-parametric and a combined approach.
An Analysis of Breast Cancer Coverage in Selected Women's Magazines, 1987–1995
Authors: Marino Christina , Gerlach Karen K. 
Published: December 2011

Purpose. Women's magazines are a significant source of health information for many women, but there is some concern that the media may misrepresent a woman's risk of breast cancer. This review analyzes breast cancer articles in selected women's magazines to determine if the information presented is accurate and balanced. Search Methods. For the years 1987 to 1995, the quantity and content of breast cancer articles were examined in four popular women's magazines and three magazines with a large African-American audience. Fifty-nine lead factual breast cancer articles were analyzed for the information presented on prevention measures, risk factors, incidence/mortality statistics, and lifetime risk. The age at diagnosis for women featured in these articles was also determined. Summary of Important Findings. Breast cancer was the topic of 34.9% of the 585 cancer articles published in these seven magazines. Mammography screening guidelines were recommended in 68% of articles that discussed prevention; 66% presented the American Cancer Society guidelines. Risk factors for breast cancer were reported as age greater than 50 in 41 % and family history in 78 % of the articles that discussed risk factors. Twenty articles used the lifetime risk statistic of developing breast cancer; six explained what this statistic means. The average age of diagnosis for women featured in the articles was 40.5. Major Conclusions. The proportion of breast cancer articles to all cancer articles in these magazines (34.9%) was similar to breast cancer incidence (32.2%) but was higher than its contribution to either female cancer mortality (17.2%) or overall female mortality (4.0%). Magazines that targeted the African-American audience had fewer breast cancer articles than the other four magazines. Risk factors for breast cancer were not discussed in proportion to their impact on risk. The popular lifetime risk statistic was not explained in the majority of cases where it was presented. The average age of diagnosis for the women featured in these articles was far below the median age of diagnosis of 65. Thus, magazine reports may be contributing to women's misunderstanding of their true breast cancer risk.
Evaluation of a Skin Cancer Prevention Module for Nurses: Change in Knowledge, Self-Efficacy, and Attitudes
Authors: McCormick Laura K. , Mâsse Louise C. , Cummings Sharon S. , Burke Catherine 
Published: December 2011

Purpose. The purpose of this study was to evaluate the effectiveness of a 1-week didactic and clinical skin cancer prevention training module. The evaluation assessed both the immediate and the 3-month effects of the module on nurse participants. In addition, this study assessed whether the module had any secondary effects on skin cancer practices, including perceived support from colleagues, resources, time, and perceived responsibility to conduct skin cancer screening activities and education. Methods. A quasi-experimental design with 32 intervention and 87 comparison subjects was employed. Instruments developed and validated specifically for this study were used to assess knowledge, self-efficacy, priority of skin cancer, and organizational level constructs. Results. The findings indicate that the module significantly increased general and prevention knowledge as well as screening ability; the increase was stable over time. The module was also found to improve self-efficacy to screen and to educate. There was no effect on the organizational-level constructs. Conclusions. Baseline knowledge assessments validated other studies indicating that nurses need more education about skin cancer. Despite promising results from program participants, system-level barriers could impose substantial barriers to implementation in health care practice. Knowledgeable nurses must educate their colleagues, their supervisors, and the public about the priority of skin cancer screening and develop strategies for creating organizational change to increase the likelihood that screening and patient education will occur for people at risk for skin cancer.
Social Support in Worksite Smoking Cessation: Qualitative Analysis of the EASE Project
Authors: Fisher Edwin B. , Bishop Donald B. , Levitt-Gilmour Tami , Cappello Marian T. , Ashenberg Zev S. , Newman Elana 
Published: December 2011

Purpose. Mobilize and study social support in EASE, a worksite smoking cessation program. Design. Qualitative study of social support in two pilot and two test worksites. Setting. Collaboration with American Lung Association of eastern Missouri to implement program in 12 companies between 1982 and 1985. Subjects. Ninety-eight participants in cessation clinics at pilot and test sites and 350 randomly sampled respondents from among all 877 employees at test sites. Intervention. Steering committees included representatives of management and line employees and tailored the program from plans and materials for program promotion, self-help manuals, and a standard curriculum for a Group Comprehensive Clinic. Measures. Implementation and participation from project records. Outcomes and perceptions of social support from surveys of employees. Results. Twelve to 24 months after program initiation, smoking cessation among active participants ranged from 21% to 41%. Consistent with emphasis on promoting support for quitting throughout the worksite, 10% to 25% of nonparticipants were abstinent at follow-ups, exceeding national base rates. Surveys indicated greater importance of social support than of program's procedures or materials and greater benefits of social ties to nonsmokers than to others attempting to quit. Differences among companies in both reported social support for nonsmoking and cessation rates paralleled differences in Steering Committees' activities and organizational support for the program. Conclusion. Though limited by lack of experimental controls, this qualitative study of active program participants as well as random samples of all employees indicates social support can be a strength of worksite smoking cessation programs.
Cigarette Smoking Control Strategies of Firms with Small Work Forces in Two Northeastern States
Authors: Flynn Brian S. , Gurdon Michael A. , Secker-Walker Roger H. 
Published: December 2011

Purpose. Cigarette smoking control strategies of firms with small work forces were assessed and compared with those of larger firms. Design. A cross-sectional telephone survey was conducted in 1990 among private employers systematically selected from a proprietary database. Setting. These firms were located in four counties of two northeastern stales. Subjects. Interviews were conducted with managers of 470 small (25 employees; n=262), medium (26–50; n=87), and larger (<50; n=121) firms. Measures. Interviews assessed characteristics of the firms and their cigarette smoking policies and cessation programs. Results. Small firms differed from larger firms in several areas. They were less likely to have written policies, used fewer methods to communicate their policies, and their policies were consistently less restrictive. Small firms also offered less assistance to employees who wished to quit. Conclusions. The less restrictive smoking policies reported here may be relatively ineffective in protecting nonsmokers in small firms. Small firms may encounter difficulties introducing more restrictive smoking policies because of the relative closeness of employee relations, smaller work spaces, and inability to deliver smoking cessation services to employees. Methods should be developed to assist managers of smaller firms to implement stronger smoking policies and to devise ways of making cessation assistance more easily available to their employees.
A Debunking of the Myth of Healthy Asian Americans and Pacific Islanders
Authors: Chen Moon S. , Hawks Betty Lee 
Published: December 2011

Purpose. To present evidence that the model of healthy Asian Americans and Pacific Islanders (AAPIs) stereotype is a myth. Search Method. The authors retrieved literature from the National Library of Medicine's compact disk databases (Cancerlit, CINAHL, Health, and MEDLINE), and examined pertinent federal government publications supplemented by the authors' knowledge of other published materials. Important Findings. This review paper presents three reasons why AAPIs are underserved: (1) the population growth rate has been unusually rapid and recent; (2) data regarding the health status of AAPIs are inadequate; and (3) the myth that AAPIs are model minority populations in terms of their health status was promulgated. Major Conclusions. The conclusions are as follows: (1) AAPIs are heterogenous with respect to demographic factors and health risk factors; (2) because the current databases on the health status of AAPIs include small sample sizes, both the quantity and quality of these data need to be improved with respect to appropriate gender and ethnic group representation; (3) Risk factor and mortality data for AAPIs suggest that the burden of certain preventable diseases, namely, tuberculosis, hepatitis-B, liver cancer, and lung cancer may be higher than those of any other racial and ethnic population. The model healthy AAPI stereotype is a myth.
Health Promotion and African-Americans: From Personal Empowerment to Community Action
Authors: Neighbors Harold W. , Braithwaite Ronald L. , Thompson Estina 
Published: December 2011

Purpose. Self-help among African-Americans is that tradition of individual and group efforts aimed toward racial progress and defending against a hostile society. The purpose of this paper is to encourage African-Americans, regardless of income, to take personal responsibility for their health. This review discusses each side of the individual versus societal responsibility issue and provides a rationale for integrating these two perspectives. It argues that the tradition of community-based self-help among African-Americans is a mechanism for personal empowerment that can lead to collective action; it therefore has important implications for the improvement of African-American health. Search Methods. The search made use of a computer-based inquiry with self-help, community health empowerment, and African-American or blacks used as descriptors. We also used a computerized search by the last names of key authors writing in the area of minority health. The review was limited to references between 1964 and 1994. The review also relied on our own professional libraries. Finally, 15 knowledgeable individuals employed at universities around the country were queried about their work, focusing on this subject. They were asked about their perceptions of the issues pertinent to the role of personal and societal responsibility in modifying health behaviors of African-Americans. Summary of Important Points. Effective health behavior change strategies with black populations will require an integration of personal responsibility and advocacy for social systems change. The formation of effective self-help community-based coalition partnerships is a viable strategy for forging systemic changes to address the health disparity problem. Major Conclusions. The discussion concludes that blacks should hold themselves more personally responsible for solving their own problems while rejecting debilitating forms of extreme self-blame. Affiliation with self-help organizations and community coalitions for health empowerment is offered as a strategy for community infrastructure development with potential for improving quality of life.