bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mothers’ online message board questions about parenting infants and toddlers
Authors: Porter Noriko , Ispa Jean M. 
Published: May 2012

porter n. & ispa j.m. (2013) Mothers’ online message board questions about parenting infants and toddlers. Journal of Advanced Nursing69(3), 559–568. doi: 10.1111/j.1365‐2648.2012.06030.xAbstractAim.  To report a study conducted to explore childrearing concerns through an analysis of online parenting message boards managed by popular parenting magazines.Background.  Increasingly, mothers appear to be turning to the Web for childrearing advice and support. However, no previous studies have examined the childrearing concerns of mothers of infants and toddlers through the analysis of online message board postings.Design.  Ethnographic content analysis methods were used to analyse the online postings.Methods.  A total of 120 messages posted in 2007 by mothers of 0–2 year olds on the websites of two best‐selling parenting magazines in the United States were submitted to ethnographic content analysis. Each message pertained to one or more of six childrearing domains: Feeding/Eating, Sleep, Development, Discipline, Toilet‐Training and Mother–Child Relationships.Results.  Questions and pleas for support were most prominently centred on feeding/eating and sleep issues. Mothers expressed concerns about when and how their children should begin to sleep and eat independently. In addition to the themes specific to particular domains, across‐domain themes were identified involving mothers’ parenting stress, questioning of advice from families/paediatricians and worries that children were not developing normally.Conclusion.  Online forums have become a space where mothers can openly describe their own negative emotions towards parenting and ask questions or gain reassurance to resolve mixed messages about how one should rear infants and toddlers. Paediatric nurses should be aware that mothers are confused about conflicting messages, especially in the domains of sleeping and eating. Reviewing parenting message boards occasionally would give nurses continuing insight into common parenting concerns.
Analysis of scientific truth status in controlled rehabilitation trials
Authors: Kerry Roger , Madouasse Aurélien , Arthur Antony , Mumford Stephen D. 
Published: May 2012

AbstractRationale, aims and objectives  Systematic reviews, meta‐analyses and clinical guidelines (reviews) are intended to inform clinical practice, and in this sense can be thought of as scientific truthmakers. High‐quality controlled trials should align to this truth, and method quality markers should predict truth status. We sought to determine in what way controlled trial quality relates to scientific truth, and to determine predictive utility of trial quality and bibliographic markers.Method  A sample of reviews in rehabilitation medicine was examined. Two scientific truth dimensions were established based on review outcomes. Quality and bibliographic markers were extracted from associated trials for use in a regression analysis of their predictive utility for trial truth status. Probability analysis was undertaken to examine judgments of future trial truth status.Results  Of the 93 trials included in contemporaneous reviews, overall, n = 45 (48%) were true. Randomization was found more in true trials than false trials in one truth dimension (P = 0.03). Intention‐to‐treat analysis was close to significant in one truth dimension (P = 0.058), being more commonly used in false trials. There were no other significant differences in quality or bibliographic variables between true and false trials. Regression analysis revealed no significant predictors of trial truth status. Probability analysis reported that the reasonable chance of future trials being true was between 2 and 5%, based on a uniform prior.Conclusions  The findings are at odds with what is considered gold‐standard research methods, but in line with previous reports. Further work should focus on scientific dynamics within healthcare research and evidence‐based practice constructs.
Diagnosis and management of acute coronary syndrome in an outpatient setting: good guideline adherence in Swiss primary care
Authors: Tandjung Ryan , Senn Oliver , Rosemann Thomas , Loy Monika 
Published: May 2012

AbstractBackground  Switzerland lacks of national guidelines for the initial treatment of an acute coronary syndrome (ACS). ACS is not as frequent in an outpatient setting as in an emergency department; nevertheless, missing an ACS is associated with high morbidity and mortality. We wanted to observe actual infrastructure and performance based on case vignettes in outpatient general practitioners (GPs) and cardiologists (CAs); as a second outcome, we wanted to compare GPs to CAs.Methods  We conducted a postal vignette‐based survey to investigate the management of outpatients presenting with acute chest pain by doctors in private practice. The use of troponin and cardiac stress testing for the evaluation of acute chest pain as well as referral practice and use of antiplatelet agents were assessed and compared between GPs and CAs.Results  There were 507 of the 571 respondents (response rate 39.7%) who were CAs (36) or GPs (471) and were included in the analysis. Whereas all CAs were equipped with electrocardiogram (ECG), cardiac stress testing and troponin assays, the majority of GPs had an ECG (97.8%) and applied troponin testing (76.3%), and 38.7% performed cardiac stress testing. The vast majority responded to directly refer a STEMI to the next catheter lab (87.7%), or in the case of a troponin‐positive NSTEMI, to an inpatient ward (94.1%) with no difference between GPs and CAs. A majority of the GPs responded to use antiplatelet agents in the case of a STEMI (89.6%) and reported further workup with cardiac stress testing in the case of a troponin‐negative acute chest pain (78.7%), which was lower compared to CAs who applied antiplatelet agents and cardiac stress testing in 100% and 97.0%.Conclusions  We could show that international guideline adherence in ACS of GPs is high and GPs perform as well as CAs. Nevertheless there is room for optimization in the antiplatelet therapy and the use of cardiac stress testing in a low‐risk population. National guidelines for treatment of an ACS in an outpatient setting are indicated.
The influence of clinical evidence on surgical practice
Authors: Honeybul S. , Ho K. M. 
Published: May 2012

AbstractGiven the considerable interest in the use of evidence‐based medicine to guide clinical practice, it is surprising that the results of a recent randomized controlled trial have been met with such a limited response. The DECompressive CRAniectomy study investigators have recently published the results of a landmark trial in neurosurgery, comparing early decompressive craniectomy with standard medical therapy in patients who developed intracranial hypertension after diffuse closed traumatic brain injury (TBI). This is the first ever randomized controlled trial investigating the surgical management of adult patients with severe TBI. The trial clearly demonstrated that early decompression did not provide clinical benefit; however, rather than having a significant impact on clinical practice, it has been almost uniformly criticized. While there were some problems with randomization and crossover, we feel that the trial has been somewhat misinterpreted and in this article we address some of the key issues.
The development and evaluation of the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP©) for use by healthcare staff
Authors: McCarthy H. , Dixon M. , Crabtree I. , Eaton‐Evans M. J. , McNulty H. 
Published: May 2012

McCarthy H., Dixon M., Crabtree I., Eaton‐Evans M. J. & McNulty H. (2012) The development and evaluation of the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP©) for use by healthcare staff.J Hum Nutr Diet.25, 311–318AbstractBackground: The early identification of malnutrition and nutrition risk through nutrition screening is common practice in adult clinical care but, in children, this has been hampered by the lack of an appropriate nutrition screening tool. The present study aimed to develop and evaluate a simple, child‐specific nutrition screening tool for administration by non‐nutrition healthcare professionals.Methods: In a two‐phase observational study, significant predictors of nutrition risk were identified using a structured questionnaire. These were then combined to produce a nutrition screening tool. For evaluation purposes, the reliability, sensitivity and specificity of the newly‐developed Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP©) were estimated by comparing the classification of nutrition risk using the tool with that determined by a full nutritional assessment by a registered dietitian.Results: A total of 122 children were recruited for development phase and a separate cohort of 238 children was recruited for the evaluation phase. Low percentile weight for age, reported weight loss, discrepancy between weight and height percentile and recently changed appetite were all identified as predictors of nutrition risk. These predictors, together with the expected nutrition risk of clinical diagnoses, were combined to produce STAMP©. Evaluation of STAMP©demonstrated fair to moderate reliability in identifying nutrition risk compared to the nutrition risk classification determined by a registered dietitian (κ = 0.541; 95% confidence interval = 0.461–0.621). Sensitivity and specificity were estimated at 70% (51–84%) and 91% (86–94%), respectively.Conclusions: The present study describes the development and evaluation of a new nutrition screening tool specifically for use in a UK general paediatric inpatient population.
Genetic structure in a fragmented Northern Hemisphere rainforest: large effective sizes and high connectivity among populations of the epiphytic lichenLobaria pulmonaria
Authors: HILMO OLGA , LUNDEMO SVERRE , HOLIEN HÅKON , STENGRUNDET KIRSTI , STENØIEN HANS K. 
Published: May 2012

AbstractAn extraordinary diversity of epiphytic lichens is found in the boreal rainforest of central Norway, the highest‐latitude rainforest in the world. These rainforest relicts are located in ravine systems, and clear cutting has increased the distance between remaining patches. We hypothesized that the relatively small lichen populations in the remaining forest stands have suffered a depletion of genetic diversity through bottlenecks and founder events. To test this hypothesis, we assessed genetic diversity and structure in the populations of the tripartite lichenLobaria pulmonariausing eight SSR loci. We sampled thalli growing onPicea abiesbranches and propagules deposited in snow at three localities. Contrary to expectations, we found high genetic diversity in lichen and snow samples, and high effective sizes of the studied populations. Also, limited genetic differentiation between populations, high historical migration rates, and a high proportion of first generation immigrants were estimated, implying high connectivity across distances <30 km. Almost all genetic variation was attributed to variation within sites; spatial genetic structures within populations were absent or appeared on small scales (5–10 m). The high genetic diversity in the remaining old boreal rainforests shows that even relict forest patches might be suitable for conservation of genetic diversity.
Coalescence patterns of endemic Tibetan species of stream salamanders (Hynobiidae: Batrachuperus)
Authors: LU BIN , ZHENG YUCHI , MURPHY ROBERT W. , ZENG XIAOMAO 
Published: May 2012

AbstractOrogenesis of topographically diverse montane regions often drives complex evolutionary histories of species. The extensive biodiversity of the eastern edge of the Tibetan Plateau, which gradually decreases eastwardly, facilitates a comparison of historical patterns. We use coalescence methods to compare species of stream salamanders (Batrachuperus) that occur at high and low elevations. Coalescent simulations reveal that closely related species are likely to have been influenced by different drivers of diversification. Species living in the western high‐elevation region with its northsouth extending mountains appear to have experienced colonization via dispersal followed by isolation and divergence. In contrast, species on the eastern low‐elevation region, which has many discontinuous mountain ranges, appear to have experienced fragmentation, sometimes staged, of wide‐ranging ancestral populations. The two groups of species appear to have been affected differently by glaciation. High‐elevation species, which are more resistant to cooler temperatures, appear to have experienced population declines as recently as the last glaciation (0.016–0.032 Ma). In contrast, salamanders dwelling in the warmer and wetter habitats at low‐elevation environs appear to have been affected less by the relatively recent, milder glaciation, and more so by harsher, extensive glaciations (0.5–0.175 Ma). Thus, elevation, topography and cold tolerance appear to drive evolutionary patterns of diversification and demography even among closely related taxa. The comparison of multiple species in genealogical analyses can lead to an understanding of the evolutionary drivers.
Development of a Prenatal Psychosocial Screening Tool for Post‐Partum Depression and Anxiety
Authors: McDonald Sheila , Wall Jennifer , Forbes Kaitlin , Kingston Dawn , Kehler Heather , Vekved Monica , Tough Suzanne 
Published: May 2012

AbstractMcDonald S, Wall J, Forbes K, Kingston D, Kehler H, Vekved M, Tough S. Development of a prenatal psychosocial screening tool for post‐partum depression and anxiety. Paediatric and Perinatal Epidemiology 2012; ••: ••–••.Background:  Post‐partum depression (PPD) is the most common complication of pregnancy in developed countries, affecting 10–15% of new mothers. There has been a shift in thinking less in terms of PPD per se to a broader consideration of poor mental health, including anxiety after giving birth. Some risk factors for poor mental health in the post‐partum period can be identified prenatally; however prenatal screening tools developed to date have had poor sensitivity and specificity. The objective of this study was to develop a screening tool that identifies women at risk of distress, operationalized by elevated symptoms of depression and anxiety in the post‐partum period using information collected in the prenatal period.Methods:  Using data from the All Our Babies Study, a prospective cohort study of pregnant women living in Calgary, Alberta (N = 1578), we developed an integer score‐based prediction rule for the prevalence of PPD, as defined as scoring 10 or higher on the Edinburgh Postnatal Depression Scale (EPDS) at 4‐months postpartum.Results:  The best fit model included known risk factors for PPD: depression and stress in late pregnancy, history of abuse, and poor relationship quality with partner. Comparison of the screening tool with the EPDS in late pregnancy showed that our tool had significantly better performance for sensitivity. Further validation of our tool was seen in its utility for identifying elevated symptoms of postpartum anxiety.Conclusion:  This research heeds the call for further development and validation work using psychosocial factors identified prenatally for identifying poor mental health in the post‐partum period.
High‐resolution MRI demonstrates detailed anatomy of the axillary brachial plexus. A pilot study
Authors: KJELSTRUP T. , COURIVAUD F. , KLAASTAD Ø. , BREIVIK H. , HOL P. K. 
Published: May 2012

BackgroundAxillary block is the most commonly performed brachial plexus block and may be guided by nerve stimulation or ultrasound. Magnetic resonance imaging (MRI) has proven to be beneficial in presenting anatomy of interest for regional anaesthesia and in demonstrating spread of local anaesthetic. The aim of this pilot study was to demonstrate the anatomy as shown by MRI of the brachial plexus in the axillary region.MethodsNine volunteers and nine patients were examined in a 3.0 Tesla MR. The patients had two different brachial plexus blocks. Subsequently, they were scanned by MRI and finally tested clinically for block efficacy before operation. Axial images, with and without local anaesthetics injected, were viewed in a sequence loop to identify the anatomy.ResultsWith the high‐resolution MRI, we obtained images of good quality, and cords and all terminal nerves could be identified. When local anaesthetics are injected, neurovascular structures are displaced, and the vein is compressed. Viewing the images in a sequence loop facilitates identification of the different nerves and has high instructive value (links S1–3 to these loops are enclosed).ConclusionClinical high‐field 3.0 Tesla MRI scanner gives good visualization of brachial plexus in the axilla. The superior ability to detect local anaesthetics after it has been injected and the multiplanar imaging capability make MRI a useful tool in studies of the brachial plexus.
Impact of shed blood products on stimulated cytokine release in an in vitro model of transfusion
Authors: SCHNEIDER S. O. , BIEDLER A. E. , BEHMENBURG F. , VOLK T. , RENSING H. 
Published: May 2012

BackgroundBlood transfusion is reported to suppress the recipient's immune system. To avoid allogenic transfusion, post‐operative shed blood retransfusion is a commonly used method. The aim of this study was to investigate the dose‐related impact of post‐operatively collected shed blood products on the stimulated cytokine release in an in vitro model of transfusion.MethodsVenous blood samples obtained from 20 patients undergoing hip arthroplasty were mixed with post‐operatively collected unprocessed, processed, and irradiated shed blood as well as normal saline as a control. Shed blood was processed by centrifugation and separating the cellular fraction from the soluble fraction and washing the cellular fraction with phosphate buffered saline to eliminate any cell fragments and other substances. Mixing ratios were 1 : 3, 1 : 1, and 3 : 1. Endotoxin‐stimulated release of Tumor Necrosis Factor‐alpha (TNF‐α) was measured after 24 h of culture by enzyme‐linked immunosorbent assay.ResultsUnprocessed, irradiated shed blood and the soluble fraction caused a significant suppression of stimulated TNF‐α release compared to control. The addition of the cellular shed blood fraction had no significant influence on the TNF‐α release compared to control.ConclusionShed blood and its components caused a dose‐independent immunomodulation as indicated by a suppressed stimulated TNF‐α release. Leukocytes seem to play a minor role, as we observed a sustained suppression after transfusion of γ‐irradiated shed blood. Only the elimination of soluble factors by centrifugation and followed by an additional washing step prevented the observed suppression of TNF‐α. Thus, we assume that washing of shed blood can prevent potential detrimental effects.
Wellness program for anesthesiology residents: a randomized, controlled trial
Authors: SAADAT H. , SNOW D. L. , OTTENHEIMER S. , DAI F. , KAIN Z. N. 
Published: May 2012

BackgroundMultiple reports illustrate the deleterious effects of stress on physicians’ mental and physical health, as well as on patient care. This study evaluates the effects of a wellness program on anesthesiology residents’ well‐being.MethodsSixty residents were randomly assigned to one of three groups: (1) wellness intervention group, (2) no‐treatment control with release time, and (3) no‐treatment control with routine duties. Coping, stressors, social support, psychological symptoms, and alcohol and tobacco use were measured using a pre‐test–post‐test design.ResultsResidents in the wellness program reported significantly fewer stressors in their role as parent, increased social support at work, greater problem‐solving coping, and less anxiety as compared with one or both of the control groups. Findings related to reducing avoidance coping and alcohol consumption also were suggestive of positive intervention effects.ConclusionsAn intervention to increase the use of active coping and social support, to reduce reliance on avoidance coping, and to decrease work and family stressors had an overall pattern of beneficial effects on residents’ well‐being. The importance of offering such programs during residency training, ways to strengthen intervention effectiveness, and areas for future research are discussed.
High‐frequency TENS in post‐episiotomy pain relief in primiparous puerpere: A randomized, controlled trial
Authors: Pitangui Ana Carolina Rodarti , de Sousa Ligia , Gomes Flávia Azevedo , Ferreira Cristine Homsi Jorge , Nakano Ana Márcia Spanó 
Published: May 2012

AbstractAim:  We evaluated the effectiveness of high‐frequency transcutaneous electrical nerve stimulation (TENS) as a pain relief resource for primiparous puerpere who had experienced natural childbirth with an episiotomy.Methods:  A controlled, randomized clinical study was conducted in a Brazilian maternity ward. Forty puerpere were randomly divided into two groups: TENS high frequency and a no treatment control group. Post‐episiotomy pain was assessed in the resting and sitting positions and during ambulation. An 11‐point numeric rating scale was performed in three separate evaluations (at the beginning of the study, after 60 min and after 120 min). The McGill pain questionnaire was employed at the beginning and 60 min later. TENS with 100 Hz frequency and 75 µs pulse for 60 min was employed without causing any pain. Four electrodes ware placed in parallel near the episiotomy site, in the area of the pudendal and genitofemoral nerves.Results:  An 11‐point numeric rating scale and McGill pain questionnaire showed a significant statistical difference in pain reduction in the TENS group, while the control group showed no alteration in the level of discomfort. Hence, high‐frequency TENS treatment significantly reduced pain intensity immediately after its use and 60 min later.Conclusion:  TENS is a safe and viable non‐pharmacological analgesic resource to be employed for pain relief post‐episiotomy. The routine use of TENS post‐episiotomy is recommended.
Is there any association between retroperitoneal lymphadenectomy and survival benefit in advanced stage epithelial ovarian carcinoma patients?
Authors: Sakai Kotaro , Kajiyama Hiroaki , Umezu Tomokazu , Shibata Kiyosumi , Mizuno Mika , Suzuki Shiro , Kawai Michiyasu , Nagasaka Tetsuro , Kikkawa Fumitaka 
Published: May 2012

AbstractAim:  The effect of systematic retroperitoneal lymphadenectomy (SRL) remains controversial in patients with advanced epithelial ovarian cancer (aEOC) who are optimally debulked.Material and Methods:  Demographic and clinicopathologic data were obtained from the Tokai Ovarian Tumor Study Group between 1986 and 2009. All patients were divided into two groups. Group A (n = 93): (i) patients did not undergo SRL; and (ii) lymph node exploration or sampling was optional. Group B (n = 87): patients underwent SRL. Survival curves were calculated using the Kaplan–Meier method. Differences in survival rates were analyzed using the log–rank test.Results:  All pT3–4 aEOC patients were optimally debulked (residual tumor <1 cm). The median age was 55 years (range: 18–84). The 5‐year progression‐free survival (PFS) rates of groups A and B were 46.7 and 41.9%, respectively (P = 0.658). In addition, the 5‐year overall survival (OS) rates were 62.9 and 59.0%, respectively (P = 0.853). Subsequently, there was no significant difference in OS and PFS in the two groups stratified to histological type (serous or non‐serous type). Furthermore, there was no significant difference in recurrence rates in retroperitoneal lymph nodes regardless of completion of lymphadenectomy.Conclusion:  Our data suggest that aEOC patients with optimal cytoreduction who underwent SRL did not show a significant improvement in survival irrespective of each histological type.