bluuebunny/crossref_metadata_2025_split huggingface dataset:
Requesting Cesareans without Medical Indications: An Option Being Considered by Young Canadian Women
Authors: Gallagher Frances , Bell Linda , Waddell Guy , Benoît Annie , Côté Nathalie 
Published: January 2012

Abstract:  Background:  Cesarean delivery on maternal request is a worldwide growing phenomenon. The goal of this study was to describe young nulliparous women’s attitudes about cesarean delivery on maternal request.Methods:  A total of 140 nulliparous women in Canada aged between 18 and 24 years and attending school from the vocational (n = 53), college (n = 61), and university (n = 18) levels (n = 8 other) participated in the survey. The self‐administered questionnaire consisted of 23 open‐ended questions. The outcome measure was the participant’s attitude toward cesarean delivery on maternal request. Descriptive, bivariate, and multiple regression analyses were performed.Results:  Many of the respondents (63%) had previously heard about cesarean delivery on maternal request, and of these women 28.6 percent had a favorable attitude toward the procedure. Sociodemographic variables were not associated with participants’ attitudes toward cesarean delivery on maternal request except for place of residence and type of professional preferred for pregnancy care. Thinking that vaginal birth was more painful than cesarean delivery (p = 0.012) and had more consequences for the mother (p < 0.001) were related to a positive attitude toward cesarean delivery on maternal request. A positive attitude by peers was also associated with participants’ favorable attitude toward cesarean delivery on maternal request (p < 0.001). The overall predictive success of the model was 66.5 percent.Conclusions:  Young women are spreading the word about cesarean delivery on maternal request and may influence one another about their preferred delivery method. During prenatal visits practitioners need to address women’s fear of vaginal birth and its consequences for the mother, counseling, and women’s understanding of the consequences of cesarean delivery. This study supports the urgent need to systematically document cesarean delivery on maternal request as a medical procedure and to study its prevalence and related factors. (BIRTH 39:1 March 2012)
Web‐based News Reports on Midwives Compared with Obstetricians: A Prospective Analysis
Authors: Dahlen Hannah G. , Homer Caroline S. E. 
Published: January 2012

Abstract:  Background:  The media both creates and reflects public opinion. The way in which health professionals are depicted in the media is likely to influence views held by and about different health professions. The aim of this study was to examine how midwives and obstetricians are reported in English language web‐based news reports from around the world.Methods:  News alerts from the Internet search engine Google were created to search for the terms “midwife,”“midwives,”“midwifery,”“obstetrics,” and “obstetricians.” These alerts were received over a 12‐month period (May 1, 2006–April 31, 2007), downloaded, and analyzed using quantitative content analysis.Results:  A total of 522 web‐based news reports for midwifery and 564 for obstetrics (n = 1,086) were found. Dominant categories for midwives were: “mainstreaming midwives” (models of care/rise of midwifery) (28%); “the Cinderella of the maternity care” (workforce/industrial) (27%); “delivering the baby with your hands tied” (funding, insurance, and legislation) (21%); “ask the expert” (education, research, and health advice) (8%), “recognizing midwives” (awards and announcements) (7%), “unsafe midwives” (litigation) (6%); and “the art of birth” (books, film, and photographs) (2%). Dominant categories for obstetricians were: “ask the expert” (research and advice) (26%); “doctors are heroes amongst us” (awards and announcements) (19%); “obstetric workforce woes” (workforce/industrial) (19%); “new frontiers” (trends in care and new technology) (17%); “the disappearing obstetrician” (insurance and litigation) (10%); and “human‐interest news reports” (9%). Obstetricians were more likely to be recognized as experts on pregnancy and birth and receive public recognition compared with midwives. Midwives were more likely to be depicted as struggling to be a mainstream option while being hampered by lack of funding, insurance, and legislative barriers.Conclusions:  Although midwives have rising acceptance, they still struggle with recognition. Obstetricians have both acceptance and recognition. Countries where midwifery is a mainstream option have more news reports related to midwifery than obstetrics. Different issues appear more dominant in some countries, such as work force in the United Kingdom and funding, insurance, and legislation in the United States. (BIRTH 39:1 March 2012)
High‐resolution geochemical record of fluid–rock interaction in a mid‐crustal shear zone: a comparative study of major element and oxygen isotope transport in garnet
Authors: RAIMONDO T. , CLARK C. , HAND M. , CLIFF J. , HARRIS C. 
Published: January 2012

AbstractGarnet grains from an intensely metasomatized mid‐crustal shear zone in the Reynolds Range, central Australia, exhibit a diverse assortment of textural and compositional characteristics that provide important insights into the geochemical effects of fluid–rock interaction. Electron microprobe X‐ray maps and major element profiles, in situ secondary ion mass spectrometry oxygen isotope analyses, and U–Pb and Sm–Nd geochronology are used to reconstruct their thermal, temporal and fluid evolution. These techniques reveal a detailed sequence of garnet growth, re‐equilibration and dissolution during intracontinental reworking associated with the Ordovician–Carboniferous (450–300 Ma) Alice Springs Orogeny. A euhedral garnet porphyroblast displays bell‐shaped major element profiles diagnostic of prograde growth zoning during shear zone burial. Coexisting granulitic garnet porphyroclasts inherited from precursor wall rocks show extensive cation re‐equilibration assisted by fracturing and fragmentation. Oxygen isotope variations in the former are inversely correlated with the molar proportion of grossular, suggesting that isotopic fractionation is linked to Ca substitution. The latter generally show close correspondence to the isotopic composition of their precursor, indicating slow intergranular diffusion of O relative to Fe2+, Mg and Mn. Peak metamorphism associated with shearing (∼550 °C; 5.0–6.5 kbar) occurred at c. 360 Ma, followed by rapid exhumation and cooling. Progressive Mn enrichment in rim domains indicates that the retrograde evolution caused partial garnet dissolution. Accompanying intra‐mineral porosity production then stimulated limited oxygen isotope exchange between relict granulitic garnet grains and adjacent metasomatic biotite, resulting in increased garnet δ18O values over length scales <200 μm. Spatially restricted oxygen interdiffusion was thus facilitated by increased fluid access to reaction interfaces. The concentration of Ca in channelled fracture networks suggests that its mobility was enhanced by a similar mechanism. In contrast, the intergranular diffusion of Fe2+, Mg and Mn was rock‐wide under the same P–T regime, as demonstrated by a lack of local spatial variations in the re‐equilibration of these components. The extraction of detailed reaction histories from garnet must therefore take into account the variable length‐ and time‐scales of elemental and isotopic exchange, particularly where the involvement of a fluid phase enhances the possibility of measureable resetting profiles being generated for slowly diffusing components such as Ca and O, even at low ambient temperatures and relatively fast cooling rates.
Transdermal Sumatriptan for Acute Treatment of Migraineurs With Baseline Nausea
Authors: Schulman Elliot A. 
Published: January 2012

Objective.— To evaluate the efficacy and safety of transdermal sumatriptan in migraine patients who have baseline nausea.Background.— Migraine‐associated nausea and vomiting can limit the effectiveness of acute treatment with oral agents by causing delays, avoidance, or incomplete absorption of medication due to post‐dose vomiting.Methods.— In a multicenter, randomized, double‐blind, placebo‐controlled study in adult (aged 18‐66 years) migraineurs, 530 patients were randomized to receive transdermal sumatriptan or a placebo patch and remained in the study until they had treated a single moderate to severe migraine attack or had gone 2 months without treatment. At baseline (before applying the study patch), patients recorded headache pain intensity and the presence or absence of migraine‐associated symptoms, including nausea. The use of analgesic or anti‐emetic rescue medications within 2 hours of patch activation was prohibited. Post‐hoc analyses were conducted to assess the proportion of patients with nausea at baseline who experienced headache relief and who were free from nausea, photophobia, and phonophobia at 1 and 2 hours post‐activation.Results.— A total of 454 patients were included in the intent‐to‐treat population for efficacy analyses. Baseline demographic and migraine headache characteristics were generally similar between the treatment groups. In the overall study population, transdermal sumatriptan was significantly superior to placebo at 1 hour post‐activation for pain relief (29% vs 19%, respectively; P < .0135) and freedom from nausea (71% vs 58%, respectively; P < .05) and at 2 hours post‐activation for freedom from pain (18% vs 9%, respectively; P < .009), pain relief (53% vs 29%, respectively; P < .0001), freedom from nausea (84% vs 63% respectively; P < .001), freedom from photophobia (51% vs 36%, respectively; P < .0028), freedom from phonophobia (55% vs 39%, respectively; P < .0002); and freedom from migraine (16% vs 8%, respectively; P < .0135). In the post‐hoc analysis, transdermal sumatriptan was markedly superior to placebo for pain relief and freedom from pain, nausea, photo‐, and phonophobia at 1 and 2 hours post‐activation.Conclusions.— Transdermal sumatriptan is superior to oral triptans for migraine patients whose baseline nausea causes them to delay or avoid acute treatment.
Successful Dose Finding with Sublingual Fentanyl Tablet: Combined Results from 2 Open‐Label Titration Studies
Authors: Nalamachu Srinivas R. , Rauck Richard L. , Wallace Mark S. , Hassman David , Howell Julian 
Published: January 2012

AbstractObjective:  This analysis was conducted to determine the likelihood of identifying an effective dose of fentanyl sublingual tablet during the initial titration phase of 2 clinical trials, to characterize the actual effective dose in patients achieving successful titration, and to examine the relationship between baseline characteristics and likelihood of achieving an effective dose.Methods:  Data were derived from 2 clinical trials (Study 1, n = 131; Study 2, n = 139) of fentanyl sublingual tablet in patients with cancer‐associated breakthrough pain (BTP). Both trials comprised a 2‐week titration phase and 12‐month maintenance phase. The initial dose was 100 μg, titrated to an effective dose (producing effective relief of all BTP episodes on 2 consecutive days) of 100 to 800 μg.Results:  A total of 270 patients entered the titration phase. Mean (SD) baseline BTP opioid dose was 25.7 (88.9) mg morphine equivalent, and mean baseline around‐the‐clock opioid dose was 196.5 (151.6) mg morphine equivalent. Using conservative criteria for determining effective dose, 174 patients (64.4%) were successfully titrated to an effective dose (mean [SD], 498.2 [234.8] μg). The most frequent (27.6%) effective dose was 800 μg, and more than 85% of patients required an effective dose ≥ 300 μg. There were no significant relationships between any baseline characteristics and titration success.Conclusion:  Despite stringent criteria, 64.4% of patients achieved an effective dose of fentanyl sublingual tablet within the dose range of 100 to 800 μg. Baseline characteristics were not identified to be associated with the likelihood of successful titration or with the actual effective dose of fentanyl sublingual tablet.
Real‐World Role of Tricyclic Antidepressants in the Treatment of Fibromyalgia
Authors: Reed Catherine , Birnbaum Howard G. , Ivanova Jasmina I. , Schiller Matt , Waldman Tracy , Mullen Rose E. , Swindle Ralph 
Published: January 2012

AbstractObjective:  To examine the real‐world role of tricyclic antidepressants (TCAs) in fibromyalgia (FM) treatment.Methods:  Using privately insured U.S. administrative claims data, this study examined TCA use for newly diagnosed FM patients. Patients ages 18 to 64 years with ≥ 2 FM diagnoses (ICD‐9‐CM: 729.1) during Q1:2007 to Q1:2009, no previous FM diagnosis, and continuous eligibility for insurance during the year before and after the first FM diagnosis (“study period”) were identified as newly diagnosed (N = 10,129). Treatment with TCAs was examined over the first treatment episode (allowing up to a 45‐day gap between refills). A sensitivity analysis was performed excluding patients with depression/anxiety diagnoses during the study period.Results:  During the study period, 8.9% of patients with FM used TCAs at anytime, 5.0% used TCAs during the year before FM diagnosis, and 7.2% used TCAs during the year after. The mean (median) duration of the first treatment episode was 150 (58) days. During this episode, 84.0% used other medications concomitantly, with 60.3% using analgesics and 39.6% using other antidepressants. Additionally, 60.8% augmented TCA use with other drugs, 61.8% switched to another drug at the end of their TCA episode, and 22.8% discontinued TCAs without switching. Similar patterns were observed for the subset of patients with no depression or anxiety (N = 7,655).Discussion:  Research covering 1999 to 2005 using the same methods found that 15.9% of patients with FM used TCAs during the year before FM diagnosis and 20.7% used TCAs during the year after. These findings suggest that TCA use among the patients with FM is uncommon and may be declining in real‐world practice.
Prevalence of anti‐dengue immunoglobulin G antibodies among American Red Cross blood donors in Puerto Rico, 2006
Authors: Mohammed Hamish , Tomashek Kay M. , Stramer Susan L. , Hunsperger Elizabeth 
Published: January 2012

BACKGROUND: Dengue is endemic in Puerto Rico and causes periodic outbreaks involving thousands of persons. Seroprevalence studies among blood donors can provide useful data on the immune status of the adult population. The objective of this study was to determine the prevalence of anti‐dengue immunoglobulin (Ig)G antibodies in a random sample of blood donors to the American Red Cross (ARC) in Puerto Rico.STUDY DESIGN AND METHODS: Three‐hundred randomly selected blood donations collected by the ARC from February 1 to March 31, 2006, were tested using an anti‐dengue IgG enzyme‐linked immunosorbent assay. One‐third of the positive specimens were randomly selected and tested by a microneutralization test (MNT) to determine the serotypes of previous dengue infections.RESULTS: Most (84%) blood donors were male, and the mean age was 44.6 years (range, 18‐80 years). The prevalence (95% confidence interval) of anti‐dengue IgG antibodies was 92% (89%‐95%). Of the 92 specimens tested by the MNT, reactivity to all four dengue serotypes was observed and 96% were secondary infections. The predominant serotype with the highest neutralization titers, as identified by at least a fourfold higher titer compared to any other serotype tested, was identified in 32 specimens; the most common predominant serotypes identified by the MNT were DENV‐3 and DENV‐2 (63%). Recent infection with DENV‐1 was detected but, in 2005, routine surveillance did not detect any cases of this serotype.CONCLUSION: Supplementary serologic testing of donated blood can potentially provide information on the silent circulation or introduction of dengue serotypes.
Factor VIII/von Willebrand factor concentrate therapy for ventricular assist device–associated acquired von Willebrand disease
Authors: Cushing Melissa , Kawaguchi Kathy , Friedman Kenneth D. , Mark Tomer 
Published: January 2012

BACKGROUND: Acquired von Willebrand disease (aVWD) can lead to a propensity to bleed, and many different modalities have been used to treat this condition. The efficacy of these agents in patients with aVWD secondary to cardiac assist devices is not fully understood.STUDY DESIGN AND METHODS: A case is reported of a patient with two risk factors for aVWD, multiple myeloma and ventricular assist device (VAD), who was successfully treated with von Willebrand factor (VWF)/Factor VIII concentrate (Humate‐P, CSL Behring) during the bridge to VAD replacement.RESULTS: Although continued absence of high‐molecular‐weight VWF persisted after VWF replacement with Humate‐P, the patient's VWF antigen and activity increased and clinical hemostasis was achieved. The VAD clotted on a few occasions, despite a continuous heparin infusion; however, these events were resolved with temporarily holding the Humate‐P. A VAD exchange was performed and the patient was successfully bridged to heart transplant.CONCLUSION: The treatment of VAD‐associated aVWD may be augmented with Humate‐P, and successful treatment can allow a bridge to heart transplantation. However, careful monitoring for thrombosis in the VAD circuit must be undertaken.
Challenges and opportunities to prevent transfusion errors: a Qualitative Evaluation for Safer Transfusion (QUEST)
Authors: Heddle Nancy M. , Fung Mark , Hervig Tor , Szczepiorkowski Zbigniew M. , Torretta Lorella , Arnold Emmie , Lane Shannon , Murphy Michael F. ,   for the BEST Collaborative
Published: January 2012

BACKGROUND: One of the most frequent causes of transfusion‐associated morbidity or mortality is the transfusion of the wrong blood to the wrong patient. This problem persists in spite of the incorporation of numerous procedures into the pretransfusion checking process in an effort to improve patient safety. A qualitative study was undertaken to understand this process from the perspective of those who administer blood products and to identify concerns and suggestions to improve safety.STUDY DESIGN AND METHODS: Twelve focus group discussions and seven individual interviews were conducted at six hospitals in five countries (n = 72 individuals). Health care professionals from a variety of clinical areas participated. Data analysis identified common themes using the constant comparison method.RESULTS: Five major themes emerged from the analysis: the pretransfusion checking process, training, policy, error, and monitoring. Findings include the following: staff were aware and appreciative of the seriousness of errors and were receptive to continuous monitoring, the focus was on checking the bag label with the paperwork rather than the bag label with the patient at the bedside, training methods varied with most perceived to have minimal effectiveness, and access to policies was challenging and keeping up to date was difficult. Other factors that could contribute to errors included high volume of workload distractions and interruptions and familiarity or lack of familiarity with patients.CONCLUSIONS: Multiple factors can contribute to errors during the pretransfusion checking limiting the effectiveness of any individual intervention designed to improve safety. Areas of further research to improve safety of blood administration were identified.
Monitoring Device Acceptance in Implantable Cardioverter Defibrillator Patients Using the Florida Patient Acceptance Survey
Authors: VERSTEEG HENNEKE , STARRENBURG ANNEMIEKE , DENOLLET JOHAN , PALEN JOB VAN DER , SEARS SAMUEL F. , PEDERSEN SUSANNE S. 
Published: January 2012

Background:

Patient device acceptance might be essential in identifying patients at risk for adverse patient‐reported outcomes following implantation of an implantable cardioverter defibrillator (ICD). We examined the validity and reliability of the Florida Patient Acceptance Scale (FPAS) and identified correlates of device acceptance in a Dutch cohort of ICD patients.
Methods:

Patients with a first‐time ICD (N = 272, mean age = 59.2 ± 11.9, 82% men) recruited from the Erasmus Medical Center, Rotterdam, or the Medisch Spectrum Twente, Enschede, The Netherlands completed the FPAS, the Type D Scale, and the Hospital Anxiety and Depression Scale.
Results:

Exploratory and confirmatory factor analyses indicated that eliminating three items from the FPAS, leaving 12 items contributing to three factors, is equivalent to the original four‐factor version of the FPAS. The abbreviated FPAS had a high internal consistency both for the total scale and all subscales, with Cronbach's alphas ranging from 0.76 to 0.82. Anxiety (odds ratio [OR]: 9.75; 95% confidence interval [CI]: 2.38–39.87; P = 0.002), depression (OR: 2.96; 95% CI: 0.98–8.93; P = 0.05), and the distressed (Type D) personality (OR: 5.04; 95% CI: 1.50–16.92; P = 0.01), but not demographic and clinical factors including shocks, were significant independent correlates of poor device acceptance.
Conclusion:

A shortened 12‐item, three‐factor version of the FPAS was shown to be a valid and internally consistent instrument to assess device acceptance in Dutch ICD patients. Psychological but not clinical factors were the primary correlates of device acceptance, which underlines the importance of taking into account the patient's psychological profile when seeking to identify patients at risk for adjustment difficulties after ICD implantation. (PACE 2011;XX:1–10)
Visually Guided Sequential Pulmonary Vein Isolation: Insights into Techniques and Predictors of Acute Success
Authors: SCHMIDT BORIS , GUNAWARDENE MELANIE , URBAN VERENA , KULIKOGLU MEHMET , SCHULTE‐HAHN BRITTA , NOWAK BERND , BORDIGNON STEFANO , CHUN KR J. 
Published: January 2012

Sequential PVI with Laser Balloon. Introduction: Pulmonary vein isolation (PVI) is a challenging procedure most often requiring sophisticated technical aids such as electroanatomical mapping, double transseptal access, and the use of a circular mapping catheter. We sought to develop a PVI strategy solely based on visual guidance with a single ablation device as well as a single transseptal puncture using the endoscopic ablation system (EAS).Methods and Results: In 35 patients with drug‐refractory atrial fibrillation (18 male, mean age: 62 ± 9 years) ablation was performed. PVI was achieved in 96 of 137 PVs (70%) purely by visually guided circular ablation. Predictors of acute isolation were the degree of PV occlusion by EAS as well as the number of catheter repositionings but not total ablation energy or the number of laser applications. Conduction gaps were detected at sites with suboptimal occlusion as well as esophageal temperature elevations. Further EAS ablation resulted in a 98% acute isolation rate. Mean procedure and fluoroscopy times were 154 ± 38 minutes and 16 ± 6 minutes, respectively. Between the first and last 12 cases, a reduction in procedure times (175 ± 48 minutes vs 138 ± 26 minutes; P = 0.05) was observed. One pericardial tamponade and 1 right‐sided phrenic nerve palsy occurred. During a median follow‐up of 266 days (q‐q3: 218–389), 27 of 35 patients (77%) remained free of any tachyarrhythmia recurrence off antiarrhythmic drugs.Conclusions: Sequential PVI based solely on endoscopic visual information with a single device and a single transseptal puncture is feasible. Optimal PV occlusion and few controlled repositionings facilitate PVI. (J Cardiovasc Electrophysiol, Vol. 23, pp. 576–582, June 2012)